scholarly journals Combined Thoracic and Abdominal Organ Transplantation: Special Considerations

2019 ◽  
Vol 24 (1) ◽  
pp. 84-95 ◽  
Author(s):  
Ashley Yager ◽  
Sarah Khorsand ◽  
Ripple Chokshi ◽  
Sreekanth Cheruku
Keyword(s):  
Organ Transplantation ◽  
Postoperative Care ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Technical Expertise ◽  
Abdominal Organ ◽  
Specialized Knowledge ◽  
Unique Challenge ◽  
Thoracic And Abdominal ◽  
Recipient Selection

Combined thoracic-abdominal organ transplants are infrequently performed procedures indicated for patients with failure of two or more transplantable organs. In this review, we discuss recipient selection, surgical considerations, anesthetic management, and outcomes associated with common combinations of thoracic-abdominal transplant operations. General principles regarding the postoperative care of these patients are also discussed. These procedures present a unique challenge requiring specialized knowledge, technical expertise, and leadership from the anesthesiology team throughout the perioperative period.

scholarly journals Multimodal anesthesia and analgesia at the stages of the perioperative period in children with abdominal surgical pathology

2021 ◽  
Vol 24 (1) ◽  
pp. 27-31
Author(s):  
Elmira A. Satvaldieva ◽  
Otabek Ya. Fayziev ◽  
Anvar S. Yusupov
Keyword(s):  
General Anesthesia ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Postoperative Recovery ◽  
Surgical Pathology ◽  
Abdominal Organ ◽  
Epidural Blockade ◽  
Abdominal Operations

Aim of the study was assess both the effectiveness and safety of anesthetic management and optimizing postoperative anesthesia under conditions of multimodal anesthesia and analgesia during abdominal operations in children. Patients and methods. The authors examined 58 children aged 1 to 17 years with abdominal operations (malformations, diseases, and abdominal organ injuries). To ensure anesthetic protection, patients underwent combined general anesthesia with propofol and fentanil (induction) with inhalation of sevoflurane + propofol intra venous (maintenance) in combination with epidural blockade with bupivacaine. Results. According to surgical intervention, the arrangement of perioperative analgesic protection provided a favorable correction of the hemodynamic status of patients, a decrease in inhalation anesthetic, promoted a smooth course of the postoperative period, a long painless period, an excellent psychoemotional background, and rapid postoperative recovery.

Preoperative preparation of alcohol and psychoactive substances-addicted patients

2011 ◽  
Vol 58 (2) ◽  
pp. 151-155
Author(s):  
Ivan Dimitrijevic ◽  
Zoran Zoricic ◽  
Miodrag Milenovic ◽  
Ivan Palibrk ◽  
Draga Dimitrijevic ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Postoperative Care ◽  
Surgical Intervention ◽  
Elective Surgery ◽  
Perioperative Period ◽  
Psychoactive Substance ◽  
Preoperative Preparation ◽  
Psychoactive Substances ◽  
Key Issues ◽  
Proper Diagnosis

Proper diagnosis of psychoactive substance abuse and addiction, as well as acute intoxication, withdrawal syndrome and overdosing are of great importance in patients who are preparing for surgical intervention. There are some specific details in their preoperative preparation whether they underwent emergency or elective surgery. Good knowledge of the characteristics of psychoactive substance abuse and addiction, interaction of psychoactive substances and anesthetics and any other drugs that could be used in the perioperative period is important especially for anastesiologist. In this work we present key issues for recognizing theese patients as well as some guidelines for adequate preoperative preparation and postoperative care.

scholarly journals General anesthesia with remimazolam in a patient with mitochondrial encephalomyopathy: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuji Suzuki ◽  
Matsuyuki Doi ◽  
Yoshiki Nakajima
Keyword(s):  
Lactic Acidosis ◽  
General Anesthesia ◽  
Mitochondrial Disease ◽  
Muscle Relaxation ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Mitochondrial Encephalomyopathy ◽  
Anesthesia Induction ◽  
General Anesthetic ◽  
Anesthetic Agents

Abstract Background Systemic anesthetic management of patients with mitochondrial disease requires careful preoperative preparation to administer adequate anesthesia and address potential disease-related complications. The appropriate general anesthetic agents to use in these patients remain controversial. Case presentation A 54-year-old woman (height, 145 cm; weight, 43 kg) diagnosed with mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes underwent elective cochlear implantation. Infusions of intravenous remimazolam and remifentanil guided by patient state index monitoring were used for anesthesia induction and maintenance. Neither lactic acidosis nor prolonged muscle relaxation occurred in the perioperative period. At the end of surgery, flumazenil was administered to antagonize sedation, which rapidly resulted in consciousness. Conclusions Remimazolam administration and reversal with flumazenil were successfully used for general anesthesia in a patient with mitochondrial disease.

Clinical Outcomes in Patients Receiving Simultaneous Heart and Abdominal Organ Transplantation

2015 ◽  
Vol 34 (4) ◽  
pp. S176-S177
Author(s):  
S. Fedson ◽  
C. Murks ◽  
L. Potter ◽  
s. Qamar ◽  
T. Riley ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Organ Transplantation ◽  
Abdominal Organ

scholarly journals ORi™: a new indicator of oxygenation

2021 ◽  
Author(s):  
Yusuke Ishida ◽  
Toshio Okada ◽  
Takayuki Kobayashi ◽  
Hiroyuki Uchino
Keyword(s):  
Respiratory Function ◽  
Early Stage ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Arterial Oxygen ◽  
Reserve Capacity ◽  
Monitoring Method ◽  
Unit Scale ◽  
Noninvasive Monitor ◽  
Near Future

AbstractIn the perioperative period, hypoxemia and hyperoxia are crucial factors that require attention, because they greatly affect patient prognoses. The pulse oximeter has been the only noninvasive monitor that can be used as a reference of oxygenation in current anesthetic management; however, in recent years, a new monitoring method that uses the oxygen reserve index (ORi™) has been developed by Masimo Corp. ORi is an index that reflects the state of moderate hyperoxia (partial pressure of arterial oxygen [PaO2] between 100 and 200 mmHg) using a non-unit scale between 0.00 and 1.00. ORi monitoring performed together with percutaneous oxygen saturation (SpO2) measurements may become an important technique in the field of anesthetic management, for measuring oxygenation reserve capacity. By measuring ORi, it is possible to predict hypoxemia and to detect hyperoxia at an early stage. In this review, we summarize the method of ORi, cautions for its use, and suitable cases for its use. In the near future, the monitoring of oxygen concentrations using ORi may become increasingly common for the management of respiratory function before, after, and during surgery.

scholarly journals Remimazolam anesthesia for cardiac surgery with cardiopulmonary bypass: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kota Saito ◽  
Sho Ohno ◽  
Makishi Maeda ◽  
Naoyuki Hirata ◽  
Michiaki Yamakage
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Oxygen Saturation ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Maze Procedure ◽  
Intraoperative Awareness ◽  
Case Presentation ◽  
Venous Oxygen Saturation ◽  
Index Value

Abstract Background Remimazolam has less cardiovascular depressant effects than propofol in non-cardiac surgical patients. However, the efficacy and safety of remimazolam in cardiac surgery with cardiopulmonary bypass (CPB) have not been reported. We present a case of successful anesthetic management using remimazolam in cardiac surgery with CPB. Case presentation A 76-year-old female was scheduled for mitral valve repair, tricuspid annuloplasty, maze procedure, and left atrial appendage closure. We used remimazolam in induction (6.0 mg/kg/h) and maintenance (0.6–1.0 mg/kg/h) of general anesthesia, and the bispectral index value was maintained in the range of 36 to 48 including the period of CPB. Hemodynamics, mixed venous oxygen saturation, and bilateral regional cerebral oxygen saturation were maintained within acceptable ranges. There was no intraoperative awareness/recall or serious complications associated with remimazolam throughout the perioperative period. Conclusions Remimazolam can be used the same as other existing anesthetics in cardiac surgery with CPB.

scholarly journals Extreme Tracheal Compression due to Substernal Goiter: Surgical and Anesthetic Management

2012 ◽  
Vol 4 (2) ◽  
pp. 71-73 ◽  
Author(s):  
Benzon Dy ◽  
Kevin Wise ◽  
David Farley ◽  
Brian McGlinch
Keyword(s):  
Operative Treatment ◽  
Multidisciplinary Approach ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Airway Compromise ◽  
Successful Management ◽  
Tracheal Compression ◽  
Substernal Goiter ◽  
Biochemical Abnormalities

ABSTRACT Substernal goiters can have a range of presentations and pathology from a complete lack of symptoms to minimal biochemical abnormalities to potentially lethal physical derangements due to tracheal compression. We review a case of a substernal goiter with severe tracheal compression and airway compromise and describe the presentation, diagnosis, operative treatment, perianesthetic management and outcome of this patient. Substernal goiters can have a myriad of symptoms and etiologies. Once the diagnosis is secured, a multidisciplinary approach is key to successful management in the perioperative period. How to cite this article Dy B, Wise K, Farley D, McGlinch B. Extreme Tracheal Compression due to Substernal Goiter: Surgical and Anesthetic Management. World J Endocr Surg 2012;4(2):71-73.

Abdominal Organ Transplantation: An Overview

2015 ◽  
pp. 489-510
Author(s):  
Jan P. M. Lerut ◽  
Laurent Coubeau ◽  
Robert J. Stratta ◽  
Giuseppe Orlando
Keyword(s):  
Organ Transplantation ◽  
Abdominal Organ

Infection Complications After Abdominal Organ Transplantation

2015 ◽  
pp. 33-56
Author(s):  
Maddalena Giannella ◽  
Michele Bartoletti ◽  
Pierluigi Viale
Keyword(s):  
Organ Transplantation ◽  
Abdominal Organ

scholarly journals Capnography-guided Endotracheal Intubation as an Alternative to Existing Intubation Methods in Rabbits

2019 ◽  
Vol 58 (2) ◽  
pp. 240-245 ◽  
Author(s):  
Lyon Y Lee ◽  
Dongbin Lee ◽  
Hakhyun Ryu ◽  
Janet H Han ◽  
Jungho Ko ◽  
...  
Keyword(s):  
Endotracheal Intubation ◽  
Tube Placement ◽  
Intubation Time ◽  
Technical Expertise ◽  
Unique Challenge ◽  
The Third ◽  
Endotracheal Tube Placement ◽  
New Zealand White Rabbits ◽  
Group A ◽  
One Way Anova

Rabbits provide a unique challenge for routine endotracheal intubation in clinical practice because of various distinctive anatomic and physiologic features. Many previously proposed methods for endotracheal intubation in rabbits are limited by several factors, including the needs for expensive equipment and high levels of technical expertise. We evaluated capnography for its effectiveness in assisting endotracheal intubation in rabbits. New Zealand white rabbits were divided into 3 groups of 5 animals. In the first 2 groups, mainstream (nondiverting) or sidestream (diverting) capnography (MC and SC groups, re- spectively) was used; in the third group (LS group), a laryngoscope with a size 00 Miller blade was used to guide endotracheal tube placement. Anesthesia was induced through intramuscular administration of ketamine (10 mg/kg), medetomidine (0.1 mg/kg), and midazolam (1 mg/kg) mixed in the same syringe prior to administration. Intubation time was defined from the point of opening the jaws to the completion of the first capnogram after intubation. Intubation was accomplished successfully in all animals in both capnography groups, but 2 rabbits in the laryngoscopy group could not be intubated. Intubation time was compared among groups was compared by using one-way ANOVA, and posthoc Bonferroni testing was applied to isolate significant differences between groups. The intubation time (mean ± 1 SD) was 46.4 ± 12.6 s in the MC group, 147.2 ± 44.2 s in the SC group, and 385.0 ± 114.1 in the LS group, with intubation time significantly differing among all groups. In conclusion, both mainstream and sidestream capnography-guided endotracheal intubation techniques were more effective and efficient than conventional laryngoscope-guided endotracheal intubation in rabbits. Furthermore, mainstream capnography was preferred over sidestream capnography because mainstream capnography resulted in significantly shorter intubation times.

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