scholarly journals Intraoperative Blood Loss during Induced Abortion: A Comparison of Anesthetics

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Camille A. Clare ◽  
Gabrielle E. Hatton ◽  
Neela Shrestha ◽  
Michael Girshin ◽  
Andre Broumas ◽  
...  
Keyword(s):  
Blood Loss ◽  
Retrospective Chart Review ◽  
First Trimester ◽  
Induced Abortion ◽  
Anesthetic Technique ◽  
Anesthetic Techniques ◽  
Intraoperative Blood Loss ◽  
Anesthetic Agents ◽  
Dilatation And Curettage ◽  
Increased Risk

Objective. To determine whether there is a difference in intraoperative bleeding with inhalational versus noninhalational anesthetic agents for patients undergoing suction dilatation and curettage for first-trimester induced abortion.Methods. This is an IRB-approved retrospective chart review of the electronic medical records of patients undergoing induced abortion at gestational ages between 5 0/7 and 14 0/7 weeks of pregnancy at the New York City Health + Hospitals/Metropolitan. The records of 138 patients who underwent suction dilatation and curettage for induced abortion between June 2012 and June 2014 were reviewed for an association between anesthetic technique and intraoperative hemorrhage. Twenty patients received inhalational anesthetic agents, while 118 received intravenous anesthetics. Blood loss was estimated by the operating gynecologists.Results. The mean intraoperative blood loss for inhalational anesthetics (113.6 ml) was significantly higher than with noninhalational agents (40.2 ml) (p=0.007). Age, body mass index, and gestational age were not statistically different between the groups; the number of methylergonovine doses at induced abortion trended higher with inhalation anesthetics.Conclusions. The difference in blood loss between the two types of anesthetic techniques was statistically significant. These findings may be important for patients with significant anemia or at an increased risk of bleeding, such as those with unrecognized coagulopathies.

Risk Factors for and Outcomes of Intraoperative Blood Loss in Liver Resection for Hepatocellular Tumors

2020 ◽  
pp. 000313482094999
Author(s):  
Daisuke Imai ◽  
Takashi Maeda ◽  
Huanlin Wang ◽  
Tomonari Shimagaki ◽  
Kensaku Sanefuji ◽  
...  
Keyword(s):  
Liver Resection ◽  
Blood Loss ◽  
Serum Creatinine ◽  
Tumor Size ◽  
Major Hepatectomy ◽  
Anesthetic Technique ◽  
Intraoperative Blood Loss ◽  
Liver Malignancies ◽  
Data Set ◽  
Surgical Devices

Intraoperative blood loss (IBL) during liver resection is a predictor of morbidity, mortality, and tumor recurrence after hepatectomy; however, there have been few reports on patient factors associated with increased IBL. We enrolled consecutive patients who underwent liver resection for primary liver malignancies, and evaluated the predictors of IBL using a data set in which factors that might influence IBL, such as surgical devices, methods and anesthetic technique, were all standardized. We studied 244 patients. A multivariate analysis revealed that higher IBL was an independent risk factor for post-hepatectomy liver failure grade ≥B and overall survival. Multiple linear regression analyses showed serum creatinine, clinically significant portal hypertension (CSPH), tumor size, and major hepatectomy were all significant predictors of IBL. In conclusion, higher IBL was significantly associated with increased morbidity and mortality in patients with primary HCC who underwent liver resection. The risk of IBL was related to several factors including tumor size, serum creatinine, CSPH, and major hepatectomy.

Impact of anesthetic technique on intraoperative blood loss in prostate surgery

2006 ◽  
Vol 23 (Supplement 37) ◽  
pp. 122
Author(s):  
B. Krivic ◽  
J. Filimonovic ◽  
B. Gvozdic ◽  
N. Popovic ◽  
C. Tulic
Keyword(s):  
Blood Loss ◽  
Anesthetic Technique ◽  
Intraoperative Blood Loss

scholarly journals Patient Blood Management in obstetrics

2020 ◽  
pp. 75-77
Author(s):  
Yu.V. Davydova
Keyword(s):  
Iron Deficiency ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Pregnant Women ◽  
Postpartum Hemorrhage ◽  
Hemoglobin Concentration ◽  
First Trimester ◽  
Third Trimester ◽  
Intravenous Drugs ◽  
Increased Risk

Background. Patient blood management (PBM) in obstetrics is the timely application of evidence-based therapeutic and surgical concepts, aimed at maintaining hemoglobin concentration, optimizing hemostasis, and minimizing blood loss to improve clinical outcomes for the patient. Objective. To describe PBM in obstetrics. Materials and methods. Analysis of literature data on this issue. Results and discussion. Risk factors for increased blood loss include the history peculiarities (cesarean section, postpartum hemorrhage, rapid delivery), placenta previa, placenta accreta, multiple pregnancy, polyhydramnios, large fetus, comorbid conditions of the mother. The prevalence of postpartum anemia in 48 hours after delivery is about 50 % in Europe and up to 80 % in developing countries. The reasons for insufficient detection and correction of anemia and iron deficiency in the antenatal period include the lack of standardized examinations for iron deficiency and algorithms for its treatment, incomplete history, and misinterpretation of examination results. Most obstetric guidelines recommend screening for anemia in pregnant women only with a comprehensive blood test without ferritin. Early identification of anemia allows to eliminate it before entering the labor process. Ways to solve the problem of anemia in pregnant women and women in labor include the detection of iron deficiency before pregnancy or in its early stages, correction of iron deficiency with oral (first trimester) or intravenous (third trimester) drugs. In case of the increased blood loss during childbirth or abdominal delivery, rapid correction of iron deficiency with iron saccharate may be required. The consensus of the Network for the Advancement of PBM, Hemostasis and Thrombosis Prevention (NATA) recommends that maximum efforts must be made to treat iron deficiency anemia before delivery. Severe cases may require hospital settings. To eliminate individually calculated postpartum iron deficiency, it is recommended to use intravenous drugs (Sufer, “Yuria-Pharm”). After cesarean section, the aministration of uterotonics (oxytocin) is recommended. In women at increased risk of postpartum hemorrhage, the administration of tranexamic acid (Sangera, “Yuria-Pharm”) should also be considered. The WOMAN project (The World Maternal Antifibrynolytic) aimed to determine the effect of early administration of tranexamic acid on mortality, hysterectomy and other adverse effects of bleeding. About 20,000 women who received tranexamic acid or placebo were examined. Significantly lower bleeding mortality was observed with tranexamic acid (1.5 % vs. 1.9 % in the placebo group; p<0.045). It is recommended to enter the first dose of this drug as soon as possible (within the first 3 hours) from the beginning of bleeding, the second – in case of the effect absence of effect in 30 minutes. Conclusions. 1. PBM in obstetrics is the timely application of evidence-based therapeutic and surgical concepts aimed at maintaining hemoglobin concentration, optimizing hemostasis and minimizing blood loss. 2. Early identification of anemia allows to eliminate it before entering the labor process. 3. Ways to solve the problem of anemia in pregnant women and women in labor are the detection of iron deficiency before pregnancy or in its early stages, correction of iron deficiency with oral (first trimester) or intravenous (third trimester) drugs. 4. To eliminate postpartum iron deficiency, it is recommended to use intravenous drugs (Sufer). 5. In women at increased risk of postpartum hemorrhage, the administration of tranexamic acid (Sangerа) should also be considered.

scholarly journals To compare the Effectiveness and Tolerability of Misoprostol as a Cervical Ripening Agent in the First Trimester Abortion through Sublingual and Vaginal Routes of Administration

2016 ◽  
Vol 27 (2) ◽  
pp. 63-66 ◽  
Author(s):  
Jayati Nath ◽  
Maneesha Jain ◽  
Rehana Najam ◽  
Rina Sharma
Keyword(s):  
Blood Loss ◽  
First Trimester ◽  
Cervical Ripening ◽  
Research Centre ◽  
Intraoperative Blood Loss ◽  
Vaginal Route ◽  
Trimester Abortion ◽  
Routes Of Administration ◽  
The Mean ◽  
Group B

Objective: To compare the effectiveness and tolerability of misoprostol as a cervical ripening agent in first trimester abortion through sublingual and vaginal routes of administration.Material and Methods: This study was carried out in the department of Obst. & Gynae Teerthanker Mahaveer Medical College and Research Centre (TMMC&RC). A total of 120 patients were included in the study. They were divided in two groups Group A – 60 patients – sublingual Group B – 60 patients – vaginal The drug was administered 3-4 hours before suction and evacuation by sublingual and vaginal routes. Efficacy was assessed on the basis of time taken for ripening, dilatation achieved, duration of the procedure, intraoperative blood loss and pain. The patient‘s tolerability was noted on the basis of side effects.Results: The mean time taken for cervical ripening was more in the sublingual group as compared to the vaginal ( P<0.001).The duration of suction and evacuation was less as compared to the vaginal route. The mean intraoperative blood loss was more in sublingual as compared to the vaginal group. The intraoperative pain score was comparatively lower (P<0.05) as compared to the vaginal route. Side effects like loose motions, nausea vomiting were more with sublingual group.Conclusion: Sublingual Misoprostol is an effective and favourable cervical ripening agent for 1st trimester abortions.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(2) : 63-66

scholarly journals Blood loss and coagulation profile in pregnant and non-pregnant queens undergoing elective ovariohysterectomy

2020 ◽  
pp. 1098612X2095961
Author(s):  
James Mack Fudge ◽  
Bernie Page ◽  
Amy Mackrell ◽  
Inhyung Lee ◽  
Unity Jeffery
Keyword(s):  
Blood Loss ◽  
Whole Blood ◽  
Point Of Care ◽  
Alpha Angle ◽  
Clot Formation ◽  
Clot Lysis ◽  
Intraoperative Blood Loss ◽  
Increased Risk ◽  
Midline Approach ◽  
Clot Formation Time

Objectives The aims of this study were to determine if there is increased risk of intraoperative bleeding in pregnant cats undergoing elective ovariohysterectomy (OHE), and to compare coagulation in queens in various stages of estrus and pregnancy subjected to elective OHE using a whole-blood viscoelastic assay. Methods Intraoperative blood loss was compared between non-pregnant and pregnant cats undergoing elective OHE. Viscoelastic evaluations of whole blood drawn pre- and postoperatively were performed using a point-of-care device measuring clot time (CT), clot formation time (CFT), alpha angle, maximum clot formation (MCF), amplitude at 10 and 20 mins (A10 and A20, respectively), and lysis index at 30 and 45 mins after MCF (LI30 and LI45, respectively). Results One hundred and ninety-three cats underwent OHE by a ventral midline approach. Median blood loss was greater for pregnant cats (2.0 ml, range <0.5–13 ml) than non-pregnant cats (<0.5 ml, range <0.5–15 ml; P <0.0001). Preoperatively, pregnant cats had a shorter median CFT (165 s vs 190.5 s), increased median A10 (31 from 25.5 VCM units) and A20 (38 from 35 VCM units), and a lower median LI45 (99% from 100%) than non-pregnant cats. Postoperatively, A10 and A20 increased, and LI30 and LI45 decreased in both non-pregnant and pregnant queens. In pregnant queens, mean CT also increased postoperatively. Conclusions and relevance Pregnant cats were relatively hypercoagulable and had an increased rate of clot lysis than non-pregnant cats. Intraoperative blood loss was increased in pregnant vs non-pregnant cats, but no clinically relevant bleeding conditions occurred.

Frequency and risk factors of surgical complications in patients with locally advanced cervical esophageal cancer

2022 ◽  
pp. 37-40
Author(s):  
Z. A-G. Radzhabova ◽  
M. A. Kotov ◽  
E. V. Levchenko
Keyword(s):  
Esophageal Cancer ◽  
Surgical Treatment ◽  
Blood Loss ◽  
Locally Advanced ◽  
Fistula Formation ◽  
Intraoperative Blood Loss ◽  
Cervical Esophageal Cancer ◽  
Simultaneous Reconstruction ◽  
Increased Risk ◽  
Duration Of Surgery

Objective. Analyze the frequency and prognostic factors of complications in patients with locally advanced cervical esophageal cancer after pharyngolaryngoesophagectomy with simultaneous reconstruction of the defect.Material and methods. The retrospective study included patients with a verified locally advanced cervical esophageal cancer who were treated at the N. N. Petrov National Research Institute of Oncology in the period from 2009 to 2018, who underwent surgical treatment followed by chemoradiotherapy. The end point of the study was the frequency of postoperative complications.Results. Forty-eight patients were included in the study. All patients underwent laryngopharyngoesophagectomy with simultaneous reconstruction of the digestive tract. Forty-one patients (85.4 %) underwent the reconstructive stage using a narrow gastric stalk, and a wide gastric stalk and a small intestine graft were used in 5 (10.4 %) and 2 (4.2 %) patients, respectively. The average duration of the operation was 390 (337.5–525.0) minutes, the volume of blood loss was 300 (200–500) ml, and the average time of hospitalization and the patient’s stay in the intensive care unit was 21.5 (16.00–36.00) and 3 (1.000–6.75) days, respectively. Complications within 30 days after surgical treatment were observed in 54.1 % of patients, while anastomosis failure, fistula formation and pneumonia were observed in 22.9 %, 12.5 % and 18.8 % of cases, respectively. Factors slightly increasing the likelihood of pneumonia in the early postoperative period were: duration of surgery [OR = 1.0 (95 % CI: 1.00–1.01), p = 0.0131] and intraoperative blood loss [OR = 1.0 (95 % CI: 1.00–1.01), p = 0.0017].Conclusion. The overall complication rate after pharyngolaryngoesophagectomy with simultaneous repair of the defect by bioengineered graft was 54.1 %. Intraoperative blood loss and duration of surgery were associated with an increased risk of complications.

Outcomes during and after Pregnancy in Patients with Primary Hypercoagulable States.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 887-887
Author(s):  
Aysha Khalid ◽  
Alice J. Cohen
Keyword(s):  
Gene Mutation ◽  
Fetal Loss ◽  
Factor V Leiden ◽  
Retrospective Chart Review ◽  
First Trimester ◽  
Therapeutic Interventions ◽  
Hypercoagulable State ◽  
Factor V ◽  
Increased Risk ◽  
Adverse Pregnancy

Abstract Pregnant women with primary hypercoagulable states have an increased risk of recurrent fetal loss, fetal growth retardation, preclampsia, and placental abruption, as well as thromboembolism in both the antepartum and postpartum periods. Conditions that have been associated with adverse pregnancy outcomes include inherited gene mutation disorders such as Factor V Leiden G1691A (FVL); prothrombin gene mutation G20210A (PGM); hyperhomocysteinemia with C677T mutation (MTHFR); deficiencies of protein S (PS), protein C (PC), antithrombin III (ATIII); and anticardiolipin antibodies/lupus anticoagulants (LA). Screening by obstetricians for these disorders has led to an increase in diagnosis yet there are no established guidelines and therapeutic interventions are variable. A retrospective chart review was conducted on 59 women and 197 pregnancies (1–12 per pt) in whom primary hypercoagulable state was diagnosed: FVL (n=7), PGM (n=11), MTHFR (n=3), ATIII (n=2), PC (n=1), PS (n=8), LA (n=10), and those with more than one thrombophilic risk (TR) (n=12) or lupus (n=2). Of the 197 pregnancies, only 106 (54%) were carried to term in 50 pts (85%). Of the remaining 91 pregnancies, there were 16 terminations, 5 ectopic pregnancies and 4 preterm live births. 66 fetal losses occurred: 45 in the first trimester (26 with single TR/19 with &gt;1 TR), 19 in the 2nd–3rd trimester (14 with single TR/5 with &gt; 1 TR) and 2 unknown. See Table for risk of fetal loss by class of hypercoagulable state. Venous thromboembolism occurred in 8/106 (8%) of term pregnancies, including 5 postpartum. Of women with previous fetal losses, management with anticoagulation (A/C) subsequently was utilized in 20 pregnancies: 9 low molecular weight heparin (LMWH), 6 LMWH+aspirin (ASA), 3 heparin (H), 1 ASA, and 1 H+ASA. 18/20(90%) of these pregnancies resulted in live term births; 1 loss due to intracranial hemorrhage at 27 weeks in a patient on L+ASA. Compared to 146 pregnancies untreated with A/C, successful completion of pregnancy was significantly greater on A/C, 90% vs. 58% (p=0.006). Conclusions: Fetal losses secondary to TR occurred in both the first and late trimesters in high proportion of pregnancies in women with hypercoagulable states. Outcomes may be improved with the use of A/C therapy. Table - Risk of Fetal Loss by Class of Hypercoagulable State LA PGM MTHFR PS FVL ATIII FVL/other Trimester1 9/38 (24%) 7/44 (16%) 3/9 (33%) 3/27 (11%) 1/27 (4%) 2/5 (40%) 17/42 (40%) Trimester 2–3 5/38 (13%) 1/36 (3%) 0% 5/16 (31%) 2/27 (7%) 1/5 (20%) 4/44 (9%)

scholarly journals Anesthesia for radical prostatectomy

2005 ◽  
Vol 52 (4) ◽  
pp. 113-118 ◽  
Author(s):  
J. Filimonovic ◽  
B. Gvozdic ◽  
B. Krivic ◽  
M. Acimovic ◽  
C. Tulic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Radical Prostatectomy ◽  
Treatment Options ◽  
Cell Mass ◽  
Anesthetic Technique ◽  
Anesthetic Techniques ◽  
Anesthetic Agents ◽  
Blood Flow Reduction ◽  
Complications And Mortality

Radical prostatectomy is one of most common treatment options currently recommended for clinically localized prostate cancer. Evaluation of intraoperative and postoperative complications is important in evaluation of relative morbidity of this treatment option. Furthermore, investigation of complications of surgical treatment in correlation with not only surgical technique, but comorbidity, ASA stage and anesthetic technique enables improvements in complete perioperative treatment and decrease of incidence of complications resulting from the procedure. Improvement of anesthetic techniques and use of new anesthetic agents contributes to better outcome of surgical treatment. For radical surgery, combined epidural analgesia and general anesthesia reduces postoperative complications and mortality. Benefits can be conferred most likely by altered coagulation activation in surgery, increased blood flow, reduction of operative stress response. Modalities for reduction of intraoperative blood loss during radical prostatectomy are normovolemic haemodilution, preoperative donation of blood for autologus transfusion and use of erythropoietin for increasing red cell mass.

THE FEASIBILITY OF FAST TRACK PROTOCOL FOR ELDERELY PATIENTS WITH COLORECTAL CANCER

2016 ◽  
pp. 26-29
Author(s):  
D. . Zitta ◽  
V. . Subbotin ◽  
Y. . Busirev
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Surgery ◽  
Blood Loss ◽  
Elderly Patients ◽  
Fast Track ◽  
Randomized Study ◽  
Conventional Group ◽  
Intraoperative Blood Loss ◽  
Elective Colorectal Surgery ◽  
Complications Rate

Fast track protocol is widely used in major colorectal surgery. It decreases operative stress, shortens hospital stay and reduces complications rate. However feasibility and safety of this approach is still controversial in patients older than 70 years. The AIM of the study was to estimate the safety and effectiveness of fast track protocol in elderly patients with colorectal cancer. MATERIALS AND METHODS. Prospective randomized study included 138 elective colorectal resectionfor cancer during period from 1.01.10 till 1.06.15. The main criteria for the patients selection were age over 70 years and diagnosis of colorectal cancer. 82 of these patients received perioperative treatment according to fast track protocol, other 56 had conventional perioperative care. Patients underwent following procedures: right hemicolectomy (n=7), left hemicolectomy (n=12), transverse colectomy (n=1), sigmoidectomy (n=23), abdomeno-perineal excision (n=19) and low anterior resection of rectum (n=76). Following data were analized: duration of operation, intraoperative blood loss, time offirst flatus and defecation, complications rates. RESULTS. Mean age was 77,4 ± 8 years. There were no differences in gender, co morbidities, body mass index, types of operations between groups. Duration of operations didn't differ significantly between 2 groups. Intraoperative blood loss was higher in conventional group. The time of first flatus and defecation were better in FT-group. There was no mortality in FT-group vs 1,8 %o mortality in conventional group. Complications rate was lower in FT-group: wound infections 3,6% vs 9 %, anastomotic leakage 4,8 %o vs 9 %o, ileus 1,2 vs 5,4 %o, peritonitis 2,4 %o vs 3,6%o, bowel obstruction caused by the adhesions 6 % vs 5,3 %. Reoperation rate was similar 4,8 % vs 3,6 %. CONCLUSION. Fast track protocol in major elective colorectal surgery can be safely applied in elderly patients. The application of fast track protocol in elderly patients improves the restoration of bowel function and reduces the risk of postoperative complication.

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