Timing the First Postoperative Dose of Anticoagulants

CHEST Journal ◽  
2015 ◽  
Vol 148 (3) ◽  
pp. 587-595 ◽  
Author(s):  
Jeremy S. Paikin ◽  
Jack Hirsh ◽  
Noel C. Chan ◽  
Jeffrey S. Ginsberg ◽  
Jeffrey I. Weitz ◽  
...  
Keyword(s):  
Postoperative Dose

scholarly journals Flurbiprofen Axetil Enhances Analgesic Effects of Sufentanil and Attenuates Postoperative Emergence Agitation and Systemic Proinflammation in Patients Undergoing Tangential Excision Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Wujun Geng ◽  
Wandong Hong ◽  
Junlu Wang ◽  
Qinxue Dai ◽  
Yunchang Mo ◽  
...  
Keyword(s):  
Postoperative Analgesia ◽  
Emergence Agitation ◽  
Patient Controlled Analgesia ◽  
Analog Scale ◽  
Flurbiprofen Axetil ◽  
Analgesic Effects ◽  
Preoperative Administration ◽  
Postoperative Administration ◽  
Postoperative Dose ◽  
Ramsay Score

Objective. Our present study tested whether flurbiprofen axetil could reduce perioperative sufentanil consumption and provide postoperative analgesia with decrease in emergency agitation and systemic proinflammatory cytokines release.Methods. Ninety patients undergoing tangential excision surgery were randomly assigned to three groups: (1) preoperative dose of 100 mg flurbiprofen axetil and a postoperative dose of 2 μg/kg sufentanil and 10 mL placebo by patient-controlled analgesia (PCA) pump, (2) preoperative dose of 100 mg flurbiprofen axetil and a postoperative dose of 2 μg/kg sufentanil and 100 mg flurbiprofen axetil by PCA pump, and (3) 10 mL placebo and a postoperative dose of 2 μg/kg sufentanil and 10 mL placebo by PCA pump.Results. Preoperative administration of flurbiprofen axetil decreased postoperative tramadol consumption and the visual analog scale at 4, 6, 12, and 24 h after surgery, which were further decreased by postoperative administration of flurbiprofen axetil. Furthermore, flurbiprofen axetil attenuated emergency agitation score and Ramsay score at 0, 5, and 10 min after extubation and reduced the TNF-αand interleukin- (IL-) 6 levels at 24 and 48 h after the operation.Conclusion. Flurbiprofen axetil enhances analgesic effects of sufentanil and attenuates emergence agitation and systemic proinflammation in patients undergoing tangential excision surgery.

Grafting of perfused adrenal medullary tissue into the caudate nucleus of patients with Parkinson's disease

1991 ◽  
Vol 75 (2) ◽  
pp. 234-243 ◽  
Author(s):  
Juan J. López-Lozano ◽  
Gonzalo Bravo ◽  
Javier Abascal ◽  
_ _
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Daily Intake ◽  
Access Point ◽  
Surgical Trauma ◽  
Content Type ◽  
Medullary Tissue ◽  
Postoperative Dose ◽  
Disease Grade ◽  
Fine Print

✓ The authors report results obtained in 20 severely affected patients with Parkinson's disease (Grade IV or V) who received an autotransplant of perfused adrenal medullary tissue. This study seems to indicate that these autoimplants can improve the parkinsonian symptomatology and induce amelioration in the patients' performance of routine activities. All the symptoms analyzed showed improvement, although it differed in intensity and time of onset. Moreover, this improvement was accompanied by a reduction in the daily intake of L-dopa, with discontinuance of dopamine agonists and amantadine. A number of medical complications were encountered, including three deaths, probably related to performing abdominal surgery in seriously affected parkinsonian patients who were unable to tolerate the discontinuance of their medication. The transient psychiatric disorders observed appeared to be related to the postoperative dose of L-dopa and/or anticholinergic agents administered, and diminished or disappeared when the doses were reduced. The reasons for improvement, which was bilateral, remain unknown, although one cause may be the surgical trauma (minicaudotomy) together with the implantation of adrenal medullary tissue, which may promote the sprouting of surviving dopaminergic fibers. Moreover, in this series, perfusion of adrenal medulla increased the capacity for revascularization of the tissue and may have reduced the damaging effects of warm ischemia on the cells. This, together with the existence of fenestrated vessels, could hypothetically have served as an access point for drugs, and if the implanted cells were viable, they might have served to store and manufacture different factors and/or transmitters. These results as well as those of other groups justify the development of a controlled international clinical trial.

scholarly journals Adjuvant Iodine131Lipiodol after Resection of Hepatocellular Carcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Ruelan V. Furtado ◽  
Leo Ha ◽  
Stephen Clarke ◽  
Charbel Sandroussi
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Adjuvant Treatment ◽  
Curative Resection ◽  
Disease Free Survival ◽  
High Rate ◽  
Free Survival ◽  
Surgery Group ◽  
Postoperative Dose ◽  
Disease Free

Background. Survival after liver resection for HCC is compromised by a high rate of intrahepatic recurrence. Adjuvant treatment with a single, postoperative dose of intra-arterial I131lipiodol has shown promise, as a means of prolonging disease-free survival (DFS).Methodology. DFS and overall survival (OS) after a single dose of postoperative I131lipiodol were compared to liver resection alone, for treatment of hepatocellular carcinoma (HCC). Data were collected retrospectively for patients who had a curative resection for HCC between December 1993 and September 2011. Seventy-two patients were given I131lipiodol after surgery and 70 patients had surgery alone.Results. The DFS at 1, 3, and 5 years was 72%, 43%, and 26% in the surgery group and 70%, 39%, and 29% in the adjuvant I131lipiodol group(p=0.75). The 1-, 3-, and 5-year OS was 83%, 64%, and 52% in the surgery group and 96%, 72%, and 61% in the adjuvant I131lipiodol group(p=0.16).Conclusion. This retrospective study has found no significant benefit to survival, after adjuvant treatment with I131lipiodol.

scholarly journals COMPARISON OF EFFECTS OF INTRAOPERATIVE AND POSTOPERATIVE METHADONE: ACUTE TOLERANCE TO THE POSTOPERATIVE DOSE?

1983 ◽  
Vol 55 (4) ◽  
pp. 325-332 ◽  
Author(s):  
E.J.B. PORTER ◽  
H.J. MCQUAY ◽  
R.E.S. BULLINGHAM ◽  
L. WEIR ◽  
M.C. ALLEN ◽  
...  
Keyword(s):  
Acute Tolerance ◽  
Postoperative Dose

scholarly journals Pharmacist-assisted electronic prescribing at the time of admission to an inpatient orthopaedic unit and its impact on medication errors: a pre- and postintervention study

2019 ◽  
Vol 10 ◽  
pp. 204209861986398 ◽  
Author(s):  
Tim Tran ◽  
Simone E. Taylor ◽  
Andrew Hardidge ◽  
Elise Mitri ◽  
Parnaz Aminian ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Medication Errors ◽  
Elective Surgery ◽  
Median Number ◽  
Electronic Prescribing ◽  
Vte Prophylaxis ◽  
Dose Time ◽  
Secondary Endpoints ◽  
Time Of Admission ◽  
Postoperative Dose

Background: Prescribing and administration errors related to pre-admission medications are common amongst orthopaedic inpatients. Postprescribing medication reconciliation by clinical pharmacists after hospital admission prevents some but not all errors from reaching the patient. Involving pharmacists at the prescribing stage may more effectively prevent errors. The aim of the study was to evaluate the effect of pharmacist-assisted electronic prescribing at the time of hospital admission on medication errors in orthopaedic inpatients. Methods: A pre- and postintervention study was conducted in the orthopaedic unit of a major metropolitan Australian hospital. During the 10-week intervention phase, a project pharmacist used electronic prescribing to assist with prescribing admission medications and postoperative venous thromboembolism (VTE) prophylaxis, in consultation with orthopaedic medical officers. The primary endpoint was the number of medication errors per patient within 72 h of admission. Secondary endpoints included the number and consequence of adverse events (AEs) associated with admission medication errors and the time delay in administering VTE prophylaxis after elective surgery (number of hours after recommended postoperative dose-time). Results: A total of 198 and 210 patients, pre- and postintervention, were evaluated, respectively. The median number of admission medication errors per patient declined from six pre-intervention to one postintervention ( p < 0.01). A total of 17 AEs were related to admission medication errors during the pre-intervention period compared with 1 postintervention. There were 54 and 63 elective surgery patients pre- and postintervention, respectively. The median delay in administering VTE prophylaxis for these patients declined from 9 h pre-intervention to 2 h postintervention ( p < 0.01). Conclusions: Pharmacist-assisted electronic prescribing reduced the number of admission medication errors and associated AEs.

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