Carotid Surgery Under Local Anesthesia in the Elderly

1988 ◽  
Vol 36 (6) ◽  
pp. 545-547 ◽  
Author(s):  
Aharon Mashiah ◽  
David Soroker ◽  
Solomon Pasik ◽  
Tonni Mashiah
Keyword(s):  
Local Anesthesia ◽  
The Elderly ◽  
Carotid Surgery

scholarly journals External Fixator in Elderly Patients with Hip Fractures

2013 ◽  
Vol 3 (1) ◽  
pp. 11-13
Author(s):  
Shilu Shrestha ◽  
Bibek Banskota ◽  
Tarun Rajbhandary ◽  
Babukaji Shrestha ◽  
Jwala Raj Pandey ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Local Anesthesia ◽  
Hip Fractures ◽  
External Fixator ◽  
Early Mobilization ◽  
Fragility Fractures ◽  
The Elderly ◽  
Harris Hip Score ◽  
Average Delay

Introduction: Fragility fractures around the hip are common in the elderly and are associated with significant morbidity and mortality. Early stabilization and mobilization reduces mortality associated with prolonged recumbence. In patients who are not fi t for general anesthesia, external fixation under local anesthesia will help early mobilization. Methods: A retrospective study of hip fractures treated between 2002 to 2009 was undertaken. Out of 242 hip fractures, 13 patients with inter-trochanteric fractures had undergone external fixator application under local anesthesia. There were 9 females and 4 males; five were on right side and 8 on left side. As per the system of American Society of Anesthesiologists (ASA), 10 were of grade III, 2 of grade IV and 1 of grade E. The age of the patient ranged from 60 to 92 years (average 80 years). The average delay in surgery was 8.2 days for cases presenting soon after the injury. Results: Follow up was done at 6 weeks, 3 months and 6 months with the average follow up of 4.7 months. All the fractures (n=13) united and the average time to radiological union was 3 months. Three patients had grade I pin tract infection which was easily controlled with local care. The average Harris hip score at final follow-up was 92. Conclusion: External fixator can be a valuable tool for the treatment of hip fractures in high risk elderly patients with concomitant medical co-morbidities. DOI: http://dx.doi.org/10.3126/noaj.v3i1.9319   Nepal Orthopedic Association Journal 2013 Vol.3(1): 11-13

Cochlear Implantation Under Local Anesthesia With Conscious Sedation in the Elderly: First 100 Cases

2020 ◽  
Author(s):  
Joseph R. Connors ◽  
Nicholas L. Deep ◽  
T. Kate Huncke ◽  
J. Thomas Roland
Keyword(s):  
Local Anesthesia ◽  
Cochlear Implantation ◽  
Conscious Sedation ◽  
The Elderly

scholarly journals Outcome of Chronic Subdural Hematoma Treated with Single Burr Hole Under Local Anesthesia

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Abebe Mersha ◽  
Sahlu Abat ◽  
Tsegaye Temesgen ◽  
Abebe Nebyou
Keyword(s):  
Hospital Stay ◽  
Local Anesthesia ◽  
Subdural Hematoma ◽  
Addis Ababa ◽  
Chronic Subdural Hematoma ◽  
Postoperative Outcome ◽  
The Elderly ◽  
Burr Hole ◽  
Cross Sectional ◽  
Burr Hole Evacuation

BACKGROUND: Chronic subdural hematoma (CSDH) is a common condition encountered in daily neurosurgical practice usually affecting the elderly population. Various surgical procedures have been used for the evacuation of hematoma in patients with CSDH. The objective of this paper was to study the postoperative outcome of patients who were operated for CSDH and to describe the easy, safest and effective procedure that can be performed at primary level hospitals.METHODS: Institutional based cross-sectional retrospective study was conducted among patients operated for CSDH from January 1, 2012 to December 31, 2015 at Teklehaymanot General Hospital, a private hospital in Addis Ababa, Ethiopia. Descriptive statistics, using SPSS version 20, was used to determine the postoperative outcomes including hospital stay, complications and recurrence rate.RESULTS: Of the 195 charts reviewed, 70.3% were of males, with M: F ratio of 2.4:1. 68.2% of patients being above the age of 55 years with a mean age at presentation of 57.63. The most common presenting symptom was headache followed by extremity weakness. The diagnosis of CSDH was made with either head CT scan or MRI. Forty one percent of patients had a left side hematoma and 48(24.6%) patients had bilateral CSDH. All patients were operated with a single burr hole evacuation under local anesthesia and postoperative subdural closed system drainage by a single neurosurgeon. The mean hospital stay was 3.68±2.6 days. The postoperative outcome was assessed using the Glasgow Outcome Score, and 95.9% of the patients reported good recovery. Thirteen (6.6%) patients were operated twice for recurrence, and there were four deaths.CONCLUSIONS: Single burr hole craniostomy is an easy, safe and effective technique for the treatment of CSDH.

scholarly journals External Approach for the Treatment of the Aging Nasal Tip

2016 ◽  
Vol 7 (3) ◽  
pp. 165-167 ◽  
Author(s):  
Hu Melissa
Keyword(s):  
Local Anesthesia ◽  
Nasal Obstruction ◽  
Functional Impairment ◽  
The Elderly ◽  
External Approach ◽  
Skin Elasticity ◽  
Nasal Tip ◽  
Nasal Cartilages ◽  
Head Neck

ABSTRACT Changes seen in the nose from increased skin elasticity, weakened nasal cartilages, and detachment of ligaments can lead to cosmetic and functional impairment. Esthetically, the nasal tip droops, the nose lengthens, the columella shortens, and the ala collapse. Functionally, the internal and external nasal valves weaken, the anterior nares narrow, and airway turbulence increases, thus contributing to the effect of nasal obstruction. Skin redundancy of the elderly nose may compromise outcomes when typical rhinoplasty techniques are applied. Herein is described a technique pioneered by Fred Stucker, involving a direct external approach to address the aging nasal tip. The technique can be performed under local anesthesia and in combination with other procedures for the aging nose, such as rhinophyma excision or septoplasty for the aging nose. How to cite this article Hu M. External Approach for the Treatment of the Aging Nasal Tip. Int J Head Neck Surg 2016;7(3):165-167.

Endovascular Therapy for Ruptured Cerebral Aneurysms in the Elderly

Neurosurgery ◽  
2015 ◽  
Vol 77 (4) ◽  
pp. 544-552 ◽  
Author(s):  
Hitoshi Fukuda ◽  
Akira Handa ◽  
Masaomi Koyanagi ◽  
Kazumichi Yoshida ◽  
Benjamin W. Y. Lo ◽  
...  
Keyword(s):  
Local Anesthesia ◽  
Endovascular Therapy ◽  
Intracranial Aneurysms ◽  
Test Procedure ◽  
Multivariable Analysis ◽  
The Elderly ◽  
Endovascular Embolization ◽  
Parent Artery ◽  
Ruptured Intracranial Aneurysms ◽  
Guiding Catheter

Abstract BACKGROUND: Endovascular therapy is favored for ruptured intracranial aneurysms in the elderly. However, poor accessibility to the aneurysm through the parent artery and use of local anesthesia in this age group may predispose to intraprocedural complications. OBJECTIVE: To evaluate whether age-related poor access to the ruptured target aneurysm and use of local anesthesia are associated with increased incidence of procedure-related rupture during endovascular embolization. METHODS: A total of 117 patients with 117 ruptured aneurysms underwent endovascular embolization at a single institution. Correlation of increasing age with poor accessibility of the guiding catheter was analyzed. In addition, the distance from the aneurysm to the guiding catheter was investigated to identify an association with incidence of procedure-related rupture. Correlation of local anesthesia with procedure-related rupture was also evaluated in the multivariable analysis. RESULTS: Increasing age was significantly associated with poor accessibility of the guiding catheter (P = .001, Mann-Whitney U test). Procedure-related rupture occurred in 9 of 117 aneurysms (7.7%). Longer distance between distal aneurysms and low-positioned guiding catheters carried a higher risk of procedure-related rupture than a shorter distance between proximal aneurysms and high-positioned guiding catheters (odds ratio, 19.3; 95% confidence interval, 1.84-201; P = .01, multivariable analysis). Use of local anesthesia was also a significant risk factor of procedure-related rupture by multivariable analysis. CONCLUSION: Increasing age was correlated with poor accessibility of the guiding catheter in endovascular embolization of ruptured intracranial aneurysms. Distally located aneurysms treated through a low-positioned guiding catheter and use of local anesthesia increased the risk of procedure-related rupture.

scholarly journals Fluoroscopically Guided Subacromial Spacer Implantation for Massive Rotator Cuff Tears: Two Years of Prospective Follow-up

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712199346
Author(s):  
Enrico Gervasi ◽  
Eran Maman ◽  
Assaf Dekel ◽  
Elana Markovitz ◽  
Enrico Cautero
Keyword(s):  
Rotator Cuff ◽  
Local Anesthesia ◽  
Case Series ◽  
The Elderly ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Level Of Evidence ◽  
Safety And Efficacy ◽  
Massive Rotator Cuff Tears

Background: Massive rotator cuff tears (MRCTs) are common and have been estimated to account for nearly 40% of all rotator cuff tears. An evolving strategy for management of MRCTs has been the implantation of a degradable subacromial spacer balloon that attempts to restore normal shoulder biomechanics. Purpose: To assess the safety and efficacy of fluoroscopically guided balloon spacer implantation under local anesthesia in a cohort of patients with 2 years of postoperative follow-up. Study Design: Case series; Level of evidence, 4. Methods: The safety and efficacy of using fluoroscopically guided subacromial spacer implantation was assessed in 46 patients. Follow-up visits were scheduled according to routine clinical practice. Shoulder function was evaluated using Constant and American Shoulder and Elbow Society (ASES) scores. Results: Overall, 87.5% (35/40) of patients saw clinically significant improvement in the total Constant and ASES scores from 6 weeks postoperatively, with improvement maintained up to 24 months postoperatively. Conclusion: The data suggest that fluoroscopically guided subacromial spacer implantation under local anesthesia is a low-risk, clinically effective option, especially for the elderly population and those patients who have multiple comorbidities or a contraindication to general anesthesia. Patients undergoing subacromial spacer implantation for the treatment of MRCTs had satisfactory outcomes at 2-year follow-up, with a low rate of complications.

scholarly journals General Anesthesia Versus Local Anesthesia for Carotid Surgery

Neurosurgery ◽  
2009 ◽  
Vol 64 (5) ◽  
pp. N10-N11 ◽  
Author(s):  
RICARDO J. KOMOTAR ◽  
OMAR N. SYED ◽  
E. SANDER CONNOLLY
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Carotid Surgery
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