scholarly journals Postoperative prolonged epidural analgesia using disposable elastomeric pumps in elderly patients after spinal neurosurgery

2021 ◽  
Vol 15 (2) ◽  
pp. 137-146
Author(s):  
Alla V. Solenkova ◽  
Andrey Yu. Lubnin ◽  
Olga N. Ivanova ◽  
Nikolay A. Konovalov ◽  
Vasiliy A. Korolishin ◽  
...  
Keyword(s):  
Immune System ◽  
Pain Relief ◽  
Elderly Patients ◽  
Epidural Analgesia ◽  
Traditional Method ◽  
Surgical Stress ◽  
Serum Levels ◽  
Hemodynamic Parameters ◽  
Efficacy And Safety ◽  
Surgical Stress Response

BACKGROUND: Postoperative pain is a significant problem in patients that causes various complications. AIM: To evaluate the efficacy and safety of prolonged epidural analgesia using disposable elastomeric pumps in elderly patients undergoing spinal neurosurgery and its comparison with the traditional method of postoperative analgesia in 80 patients. MATERIALS AND METHODS: Hemodynamic parameters were recorded and the efficiency of pain relief and nature of postoperative complications were assessed in comparable groups. The concentration of interleukin-6 (IL-6) and IL-2 were determined. RESULTS: In the group with prolonged epidural analgesia with 0.2% ropivacaine solution, an adequate level of analgesia was achieved in 92% of the patients. The revealed changes in the blood serum levels of cytokines IL-6 and IL-2 may indicate a balanced response of the immune system in the group with prolonged epidural analgesia. CONCLUSIONS: Prolonged epidural analgesia using disposable elastomeric pumps provides complete pain relief for patients and correction of individual links of the surgical stress response.

Neopterin: A Potential Biomarker for Delirium in Elderly Patients

2014 ◽  
Vol 39 (1-2) ◽  
pp. 116-124 ◽  
Author(s):  
Angelique Egberts ◽  
Eline H.A. Wijnbeld ◽  
Durk Fekkes ◽  
Milly A. van der Ploeg ◽  
Gijsbertus Ziere ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Oxidative Stress ◽  
Immune System ◽  
Growth Factor ◽  
Elderly Patients ◽  
Analysis Of Variance ◽  
Interleukin 6 ◽  
Postoperative Delirium ◽  
Serum Levels ◽  
Potential Biomarker

Background/Aims: The diagnosis of delirium is not supported by specific biomarkers. In a previous study, high neopterin levels were found in patients with a postoperative delirium. In the present study, we investigated levels of neopterin, interleukin-6 (IL-6) and insulin-like growth factor-1 (IGF-1) in acutely ill admitted elderly patients with and without a delirium. Methods: Plasma/serum levels of neopterin, IL-6 and IGF-1 were determined in patients aged ≥65 years admitted to the wards of Internal Medicine and Geriatrics. Differences in biomarker levels between patients with and without a delirium were investigated by the analysis of variance in models adjusted for age, gender, comorbidities and eGFR (when appropriate). Results: Eighty-six patients were included; 23 of them with a delirium. In adjusted models, higher mean levels of neopterin (70.5 vs. 45.9 nmol/l, p = 0.009) and IL-6 (43.1 vs. 18.5 pg/ml, p = 0.034) and lower mean levels of IGF-1 (6.3 vs. 9.3 nmol/l, p = 0.007) were found in patients with a delirium compared to those without. Conclusions: The findings of this study suggest that neopterin might be a potential biomarker for delirium which, through oxidative stress and activation of the immune system, may play a role in the pathophysiology of delirium. © 2014 S. Karger AG, Basel

The effect of perioperative use of dexmedetomidine on hemodynamic parameters and surgical stress response in chronic hypertensive patients

2013 ◽  
Vol 2 (3) ◽  
pp. 194-203
Author(s):  
Ali Sarpkaya ◽  
Kazim Karaaslan ◽  
Hasan Kocoglu ◽  
Guler Bugdayci ◽  
Hakan Bayir ◽  
...  
Keyword(s):  
Stress Response ◽  
Surgical Stress ◽  
Hemodynamic Parameters ◽  
Hypertensive Patients ◽  
Surgical Stress Response

Recovery of Muscular Performance After Surgical Stress in Elderly Patients

2014 ◽  
Vol 20 (19) ◽  
pp. 3215-3221 ◽  
Author(s):  
I. Bautmans ◽  
N. Winkel ◽  
A. Ackerman ◽  
L. Dobbeleer ◽  
E. Waele ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Surgical Stress ◽  
Muscular Performance

Role of Inflammatory Markers in Elderly Type 2 Diabetic Patients with Mild Cognitive Impairment

2019 ◽  
Vol 15 (3) ◽  
pp. 247-253 ◽  
Author(s):  
Salwa S. Hosny ◽  
Ahmed M. Bahaaeldin ◽  
Mohamed S. Khater ◽  
Meram M. Bekhet ◽  
Hayam A. Hebah ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Elderly Patients ◽  
Vascular Disease ◽  
Plasma Glucose ◽  
Serum Levels ◽  
Diabetic Patients ◽  
Hs Crp ◽  
And Control

<P>Background: Type 2 diabetes (T2DM) is a risk factor for Alzheimer’s disease and mild cognitive impairment. The etiology of cognitive impairment in people with T2DM is uncertain but, chronic hyperglycemia, cerebral micro vascular disease, severe hypoglycemia, and increased prevalence of macro vascular disease are implicated. </P><P> Objectives: To determine the serum levels of soluble vascular adhesion molecule (sVCAM-1) and highly sensitive C-reactive protein (hs-CRP) in elderly type 2 diabetics with mild cognitive impairment (MCI). Methods: Our study was conducted on 90 elderly subjects (aged 60 years old or more). They were divided into Group І, 30 patients with T2DM and mild cognitive impairment, group ІІ, 30 patients with T2DM without cognitive impairment and group III, 30 healthy subjects as a control group. They were subjected to history taking, full clinical examination, anthropometric measurement, the Addenbrooke’s Cognitive Examination III (ACE---III 2012), Fasting plasma glucose, 2 hours plasma glucose, HbA1c, lipid profile, protein/creatinine ratio, serum sVCAM-1 and hs-CRP. Results: Serum levels of sVCAM-1 in diabetic elderly patients with MCI were significantly higher (946.7 ± 162.01 ng/ml) than diabetic elderly patients without cognitive impairment (479.06 ± 65.27 ng/ml) and control (263.7 ± 72.05 ng/ml) with (P=0.002). Serum levels of Hs-CRP in diabetic elderly patients with MCI were significantly higher than as diabetic elderly patients without cognitive impairment and control with (P=0.005). Conclusion: Elderly diabetic patients with mild cognitive impairment have higher levels of soluble adhesion molecules and markers of low-grade systemic inflammation than other groups.</P>

scholarly journals EFFICACY AND SAFETY OF RIVAROXABAN IN ELDERLY PATIENTS WITH SYMPTOMATIC PAD UNDERGOING REVASCULARIZATION: INSIGHTS FROM VOYAGER PAD

2021 ◽  
Vol 77 (18) ◽  
pp. 1783
Author(s):  
Mori Krantz ◽  
William Hiatt ◽  
Sonia Anand ◽  
E. Sebastian Debus ◽  
Manesh Patel ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Efficacy And Safety

Paravertebral Block versus Thoracic Epidural Analgesia for Postthoracotomy Pain Relief: A Meta-Analysis of Randomized Trials

2021 ◽  
Author(s):  
Mu Xu ◽  
Jiajia Hu ◽  
Jianqin Yan ◽  
Hong Yan ◽  
Chengliang Zhang
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Epidural Analgesia ◽  
Meta Analysis ◽  
Thoracic Epidural Analgesia ◽  
Paravertebral Block ◽  
Cochrane Library ◽  
Thoracic Epidural ◽  
Analgesic Consumption ◽  
Postthoracotomy Pain

Abstract Objective Paravertebral block (PVB) and thoracic epidural analgesia (TEA) are commonly used for postthoracotomy pain management. The purpose of this research is to evaluate the effects of TEA versus PVB for postthoracotomy pain relief. Methods A systematic literature search was conducted in PubMed, EMBASE, Web of Science, and the Cochrane Library (last performed on August 2020) to identify randomized controlled trials comparing PVB and TEA for thoracotomy. The rest and dynamic visual analog scale (VAS) scores, rescue analgesic consumption, the incidences of side effects were pooled. Results Sixteen trials involving 1,000 patients were included in this meta-analysis. The pooled results showed that the rest and dynamic VAS at 12, 24, and rest VAS at 48 hours were similar between PVB and TEA groups. The rescue analgesic consumption (weighted mean differences: 3.81; 95% confidence interval [CI]: 0.982–6.638, p < 0.01) and the incidence of rescue analgesia (relative risk [RR]: 1.963; 95% CI: 1.336–2.884, p < 0.01) were less in TEA group. However, the incidence of hypotension (RR: 0.228; 95% CI: 0.137–0.380, p < 0.001), urinary retention (RR: 0.392; 95% CI: 0.198–0.776, p < 0.01), and vomiting (RR: 0.665; 95% CI: 0.451–0.981, p < 0.05) was less in PVB group. Conclusion For thoracotomy, PVB may provide no superior analgesia compared with TEA but PVB can reduce side effects. Thus, individualized treatment is recommended. Further study is still necessary to determine which concentration of local anesthetics can be used for PVB and can provide equal analgesic efficiency to TEA.

Sign in / Sign up

Export Citation Format

Share Document