scholarly journals Anaesthesia for head and neck surgery: United Kingdom National Multidisciplinary Guidelines

2016 ◽  
Vol 130 (S2) ◽  
pp. S23-S27 ◽  
Author(s):  
P Charters ◽  
I Ahmad ◽  
A Patel ◽  
S Russell
Keyword(s):  
Intensive Care Unit ◽  
Head And Neck Cancer ◽  
Intensive Care ◽  
Head And Neck ◽  
Neck Cancer ◽  
Neck Surgery ◽  
World Health ◽  
Operative Care ◽  
Health Organization ◽  
The Uk

AbstractThis is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. The anaesthetic considerations for head and neck cancer surgery are especially challenging given the high burden of concurrent comorbidity in this patient group and the need to share the airway with the surgical team. This paper provides recommendations on the anaesthetic considerations during surgery for head and neck cancer.Recommendations• All theatre staff should participate in the World Health Organization checklist process. (R)• Post-operative airway management should be guided by local protocols. (R)• Patients admitted to post-operative care units with tracheal tubes in place should be monitored with continuous capnography. Removal for tracheal tubes is the responsibility of the anaesthetist. (R)• Anaesthetists should formally hand over care to an appropriately trained practitioner in the post-operative or intensive care unit. (G)• Intensive care unit staff looking after post-operative tracheostomies must be clear about which patients are not suitable for bag-mask ventilation and/or oral intubation in the event of emergencies. (R)

BAHNO surgical specialities: same patients, different practices?

2005 ◽  
Vol 119 (2) ◽  
pp. 97-101 ◽  
Author(s):  
A Murray ◽  
J Dempster
Keyword(s):  
Intensive Care Unit ◽  
Head And Neck Cancer ◽  
Intensive Care ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Healthcare Professionals ◽  
High Dependency Unit ◽  
Operative Care ◽  
High Dependency

The British Association of Head and Neck Oncologists (BAHNO) is ’a multidisciplinary society for healthcare professionals involved in the study and treatment of head and neck cancer’. Surgical members of this organization are from three specialities (otolaryngology, maxillo-facial and plastic surgery). Although the overall impression is that the management of UK head and neck cancer patients is consensus based, there are appreciable differences in each surgical speciality’s practice. Anecdotally, this can lead to variation in the management of very similar patients. To identify some of these variations BAHNO surgeons were surveyed regarding their current head and neck cancer practices from the perspectives of surgical activity and post-operative care. Some unexpected differences were identified, particularly in relation to post-operative care with plastic and maxillo-facial surgeons demonstrating different patterns of high dependency unit (HDU) and intensive care unit (ICU) use for the same patients. The implications for future consensus in the light of these variations are discussed.

Validation of World Health Organization Guidelines for Pain Relief in Head and Neck Cancer

1993 ◽  
Vol 102 (5) ◽  
pp. 342-348 ◽  
Author(s):  
Stefan Grond ◽  
Christoph Diefenbach ◽  
Detlev Zech ◽  
Stephan A. Schug ◽  
John Lynch ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Side Effects ◽  
World Health Organization ◽  
Head And Neck ◽  
Neck Cancer ◽  
World Health ◽  
Who Guidelines ◽  
Antineoplastic Treatment ◽  
Health Organization ◽  
A Prospective Study

In a prospective study of 167 patients with head and neck cancer, we assessed the causes and mechanisms of pain, as well as the efficacy and side effects of analgesic treatment, along World Health Organization (WHO) guidelines. The majority of patients had pain caused by cancer (83%) and/or treatment (28%), 4% had pain due to debility, and 7% had pain unrelated to cancer. Palliative antineoplastic treatment was performed in 32% of patients. Systemic analgesics were administered on 97% of a total of 8,106 treatment days, and coanalgesics or adjuvant drugs on 100%. The treatment proved to be very successful, as severe pain was experienced only during 5% of the observation period. In the absence of serious side effects, the most frequent symptoms observed were insomnia, dysphagia, anorexia, constipation, and nausea. The use of analgesic and adjuvant drugs along WHO guidelines to treat pain in head and neck cancer is highly effective and relatively safe.

Outcomes for head and neck cancer patients admitted to intensive care in Australia and New Zealand between 2000 and 2016

2021 ◽  
pp. 1-8
Author(s):  
C A Frauenfelder ◽  
E P Raith ◽  
S Krishnan ◽  
A Udy ◽  
D Pilcher
Keyword(s):  
Intensive Care Unit ◽  
Head And Neck Cancer ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Large Scale ◽  
Cohort Analysis ◽  
Public Hospitals

Abstract Objective To report intensive care unit admission outcomes for head and neck cancer patients. Methods A retrospective, observational cohort analysis of all Australian and New Zealander head and neck cancer patient intensive care unit admissions from January 2000 to June 2016, including data from 192 intensive care units. Results There were 10 721 head and neck cancer patients, with a median age of 64 years (71.6 per cent male). Of admissions, 76.4 per cent were in public hospitals, 96.9 per cent were post-operative and 43.6 per cent required mechanical ventilation. Annual head and neck cancer admissions increased from 2000 to 2015 (from 348 to 1132 patients), but the overall proportion of intensive care unit admissions remained constant. In-hospital mortality was 2.7 per cent, and intensive care unit mortality was 0.7 per cent. The in-hospital mortality risk decreased three-fold (p < 0.001). Conclusion Head and neck cancer patients had low mortality in the intensive care unit and in hospital. Risk of dying decreased despite more intensive care unit admissions. This is the first large-scale cohort study quantifying intensive care unit utilisation by head and neck cancer patients. It informs future work investigating alternatives to the intensive care unit for these patients.

No reduction in complication rate by stay in the intensive care unit for patients undergoing surgery for head and neck cancer and microvascular reconstruction

Head & Neck ◽  
2009 ◽  
Vol 31 (11) ◽  
pp. 1461-1469 ◽  
Author(s):  
Emeka Nkenke ◽  
Elefterios Vairaktaris ◽  
Florian Stelzle ◽  
Friedrich W. Neukam ◽  
Michael St. Pierre
Keyword(s):  
Intensive Care Unit ◽  
Head And Neck Cancer ◽  
Intensive Care ◽  
Head And Neck ◽  
Neck Cancer ◽  
Complication Rate ◽  
No Reduction ◽  
Microvascular Reconstruction

scholarly journals Bioelectrical impedance phase angle as a prognostic indicator of survival in head-and-neck cancer

2016 ◽  
Vol 23 (5) ◽  
pp. 481 ◽  
Author(s):  
M.S. Wladysiuk ◽  
R. Mlak ◽  
K. Morshed ◽  
W. Surtel ◽  
A. Brzozowska ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Phase Angle ◽  
Neck Cancer ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Neck Surgery ◽  
Department Head ◽  
Nutrition Status

Background Phase angle could be an alternative to subjective global assessment for the assessment of nutrition status in patients with head-and-neck cancer.Methods We prospectively evaluated a cohort of 75 stage iiib and iv head-and-neck patients treated at the Otolaryngology Department, Head and Neck Surgery, Medical University of Lublin, Poland. Bioelectrical impedance analysis was performed in all patients using an analyzer that operated at 50 kHz. The phase angle was calculated as reactance divided by resistance (Xc/R) and expressed in degrees. The Kaplan–Meier method was used to calculate survival.Results Median overall survival in the cohort was 32.0 months. At the time of analysis, 47 deaths had been recorded in the cohort (62.7%). The risk of shortened overall survival was significantly higher in patients whose phase angle was less than 4.733 degrees than in the remaining patients (19.6 months vs. 45 months, p = 0.0489; chi-square: 3.88; hazard ratio: 1.8856; 95% confidence interval: 1.0031 to 3.5446).Conclusions Phase angle might be prognostic of survival in patients with advanced head-and-neck cancer. Further investigation in a larger population is required to confirm our results.

Postoperative management in the Intensive Care Unit of head and neck surgery patients

2020 ◽  
Vol 44 (1) ◽  
pp. 46-53
Author(s):  
L. Alcázar Sánchez-Elvira ◽  
S. Bacian Martínez ◽  
L. del Toro Gil ◽  
V. Gómez Tello
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Head And Neck ◽  
Neck Surgery ◽  
Postoperative Management ◽  
Head And Neck Surgery
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