scholarly journals Study of early post-operative complications in relation to nature of anaesthesia and type of surgery

2018 ◽  
Vol 5 (8) ◽  
pp. 2827
Author(s):  
Irfan Parvez Qureshi ◽  
Saima Qureshi ◽  
Vimal Modi

Background: Many people have complications after surgery; some transient, others serious, but all are important to patients. The likelihood of postoperative complications is influenced by the type of surgery, the patients pre-existing comorbid state and perioperative management. Anaesthesia result in a variety of metabolic and endocrine responses, but conventional wisdom maintains that anaesthetic technique has little long-term effect on patient outcomes. There is accumulating evidence that, on contrary, anaesthetic management may in fact exert a number of longer-term effects in postoperative outcome.Methods: A prospective study of early post-operative complication in 100 patients’, who underwent major surgery, was done in the Department of Surgery in a tertiary care teaching hospital, Indore. Therefore, the present study was carried out prospectively to study the incidence of postoperative complications in relation to age, sex and other factors which influence them and correlation of post-operative complications with the nature of anaesthesia, duration of operation, type of surgery and in surgery above diaphragm or below diaphragm.Results: The incidence of post-operative complications was more in patients operated with general anaesthesia (48.38% and 12.9% respectively) the morbidity and mortality in patients who were operated under spinal anaesthesia was lower than general anaesthesia, but morbidity was higher in patients who were operated under epidural anaesthesia, but mortality was lower than epidural.Conclusions: There is accumulating evidence that anaesthetic management may indeed exert a number of influences on longer term postoperative outcomes. Further prospective, randomized, large scale, human trials with long- term follow-up are required to clarify the association between anaesthesia technique and postoperative outcome.

Author(s):  
Fareed Cheema ◽  
Aurora D. Pryor

Weight loss surgery has overall been shown to be very safe and effective. However, long-term outcomes data has allowed codification of post-operative complications specific to the type of weight loss surgery performed. This review focuses specifically on foregut-related postoperative complications after weight loss surgery, most of which are not discussed on a broad scale in the literature yet whose prevalence continues to rise. Clinicians should maintain a broad differential when treating patients with complications after bariatric surgery in order to perform a thorough and precise workup to identify the diagnosis and guide management.


1994 ◽  
Vol 07 (03) ◽  
pp. 110-113 ◽  
Author(s):  
D. L. Holmberg ◽  
M. B. Hurtig ◽  
H. R. Sukhiani

SummaryDuring a triple pelvic osteotomy, rotation of the free acetabular segment causes the pubic remnant on the acetabulum to rotate into the pelvic canal. The resulting narrowing may cause complications by impingement on the organs within the pelvic canal. Triple pelvic osteotomies were performed on ten cadaver pelves with pubic remnants equal to 0, 25, and 50% of the hemi-pubic length and angles of acetabular rotation of 20, 30, and 40 degrees. All combinations of pubic remnant lengths and angles of acetabular rotation caused a significant reduction in pelvic canal-width and cross-sectional area, when compared to the inact pelvis. Zero, 25, and 50% pubic remnants result in 15, 35, and 50% reductions in pelvic canal width respectively. Overrotation of the acetabulum should be avoided and the pubic remnant on the acetabular segment should be minimized to reduce postoperative complications due to pelvic canal narrowing.When performing triple pelvic osteotomies, the length of the pubic remnant on the acetabular segment and the angle of acetabular rotation both significantly narrow the pelvic canal. To reduce post-operative complications, due to narrowing of the pelvic canal, overrotation of the acetabulum should be avoided and the length of the pubic remnant should be minimized.


Animals ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 2049
Author(s):  
Elżbieta Stefanik ◽  
Olga Drewnowska ◽  
Barbara Lisowska ◽  
Bernard Turek

Horses, due to their unique anatomy and physiology, are particularly prone to intraoperative cardiopulmonary disorders. In dorsally recumbent horses, chest wall movement is restricted and the lungs are compressed by the abdominal organs, leading to the collapse of the alveoli. This results in hypoventilation, leading to hypercapnia and respiratory acidosis as well as impaired tissue oxygen supply (hypoxia). The most common mechanisms disturbing gas exchange are hypoventilation, atelectasis, ventilation–perfusion (V/Q) mismatch and shunt. Gas exchange disturbances are considered to be an important factor contributing to the high anaesthetic mortality rate and numerous post-anaesthetic side effects. Current monitoring methods, such as a pulse oximetry, capnography, arterial blood gas measurements and spirometry, may not be sufficient by themselves, and only in combination with each other can they provide extensive information about the condition of the patient. A new, promising, complementary method is near-infrared spectroscopy (NIRS). The purpose of this article is to review the negative effect of general anaesthesia on the gas exchange in horses and describe the post-operative complications resulting from it. Understanding the changes that occur during general anaesthesia and the factors that affect them, as well as improving gas monitoring techniques, can improve the post-aesthetic survival rate and minimize post-operative complications.


Author(s):  
Babita Das ◽  
Apra Shahi ◽  
Vishnu Pratap Chandrapuria ◽  
Shobha Jawre ◽  
Madhu Swamy ◽  
...  

Background: Despite significant advances in canine cataract surgery over the years, many post-operative complications persist and reduces the success rate of phacoemulsification procedure. The aim of current study was to evaluate post-operative complications encountered till 90 days after bimanual phacoemulsification with implantation of different acrylic Intraocular Lenses.Methods: The study was conducted on 24 canine eyes. All the clinical cases were subjected to detailed ocular, ultrasonography and neuro-ophthalmic tests for ascertaining cataract and associated neuro-ophthalmic pathology. Dogs were divided in four groups with 6 eyes in each group and subjected to phacoemulsification procedure for removal of cataractous lens and implanted with square edge or round edge hydrophilic or hydrophobicintra ocular lenses.Result: Statistically non-significant (p£0.05) variations were found for all the post- operative complications among the groups. Within the groups initially higher values were recorded and on subsequent days a declining trend of varying degrees were observed. The corneal opacity was a major postoperative complication leading to failure to achieve vision with other coinciding neuro-ophthalmic conditions.


2015 ◽  
Vol 100 (2) ◽  
pp. 225-232 ◽  
Author(s):  
Sedat Belli ◽  
Huseyin Ozgur Aytac ◽  
Hakan Yabanoglu ◽  
Erdal Karagulle ◽  
Alper Parlakgumus ◽  
...  

The aim of this study is to investigate postoperative complications, mortality rates, and to determine the factors affecting mortality on the patients receiving warfarin therapy preoperatively, as well as comparing the results obtained from emergency and elective surgeries. Surgical outcomes of 61 patients on long-term oral anticoagulation with warfarin who underwent surgery in our center were retrospectively reviewed over an 8-year period. Thirty-three (54.1%) patients were female, with a mean age of 53 years. Mitral valve replacement (62.3%) was the most frequent indication for chronic anticoagulation therapy. Twelve out of 61 (19.2%) patients underwent emergency surgery; 59 (96.7%) operations were classified as major surgery. We did not observe any thromboembolic events on patients receiving our bridging therapy protocol. Cardiopulmonary dysfunction (CPD; 19.7%) and hemorrhage (16.4%) were the most encountered postoperative complications. Presence of CPD, bleeding, endocarditis, and mortality were statistically significant for emergency surgeries when compared with the results obtained from elective surgeries. There were 5 (8.2%) deaths observed during follow-up. It was found that advanced age, prolonged duration of operations, and presence of CPD had a statistically significant effect on mortality (P < 0.05). The patients receiving oral anticoagulant had high postoperative complication and mortality rates. This case was more evident in emergency surgeries. It is recommendable that as mortality is more apparent in the patients who undergo emergency surgeries—being older, having long duration of operations as well as CPD. Therefore during the postoperative follow-up process, the patients should be closely monitored.


Author(s):  
Shukri F. Khuri ◽  
William G. Henderson ◽  
Ralph G. DePalma ◽  
Cecilia Mosca ◽  
Nancy A. Healey ◽  
...  

Author(s):  
Bikram Bhardwaj ◽  
Ava Dipan Desai ◽  
Bijal Manish Patel ◽  
Chetna Deepal Parekh ◽  
Shilpa Mukesh Patel

Background: Hypomagnesemia is an important but unknown risk factor for post-operative complications in patients undergoing surgery for presumed gynecological malignancy. This study aims to evaluate the prevalence of hypomagnesemia in patients undergoing surgery for presumed gynecological cancers referred to our tertiary care Cancer Institute.Methods: This is a prospective observational study of 100 patients admitted with provisional diagnosis of malignancy. They underwent surgery in one of the Gynecologic Oncology units at The Gujarat Cancer Research Institute, Ahmedabad from October 2016 to April 2017. Hypomagnesemia was defined a serum magnesium levels less than 1.8mg/dl.Results: The incidence of pre-operative hypomagnesemia in the entire cohort was 35%. Sixty three percent patients had normal pre-operative magnesium levels and hypermagnesemia was seen in 2% of study population. Patients with benign disease had 29.6% pre-operative hypomagnesemia compared with 39.6% in patients with gynecologic malignancy. Pre-operative hypomagnesemia and even falling levels in post-operative period are an important predictive marker for post-operative complications like increased post-operative pain, post-operative ileus, hypertension and even post-operative hypokalemia. Age, body mass index, hematocrit, surgical indication and length of hospital stay were not associated with hypomagnesemia. Patients undergoing neo-adjuvant chemotherapy before surgery had significant incidence of hypomagnesemia both pre-operatively and post-operatively.Conclusions: Hypomagnesemia is quite prevalent in patients of gynecologic-oncology undergoing surgery. Pre-operative hypomagnesemia and even falling levels in post-operative period have a bearing on the final surgical outcome. Hence pre-operative and post-operative magnesium levels may be included as a valuable marker in all patients undergoing surgery for gynecologic malignancy.


2020 ◽  
pp. 20-23
Author(s):  
anuradha bharati ◽  
pallavi sharma ◽  
sachit mahajan ◽  
Bhavani Raina ◽  
Sanjay Kai

Background and Objectives : Ocular trauma can lead to development of cataract when natural lens is damaged by either blunt or penetrating injury. The management of traumatic cataract follows the same principle as for senile cataract but associated damage to ocular tissues and several post-operative complications may lead to suboptimal visual outcome. This study was conceptualized to evaluate the visual outcomes following management of traumatic cataracts. Material and Methods : This prospective, longitudinal study was conducted on 80 patients with traumatic cataract in tertiary care centre. Patients were managed surgically and were followed up for a period of six months. Visual acuity was measured at every follow-up visit and any post-operative complications were noted and managed, accordingly. Final visual acuity was assessed at the end of six months. Results: Maximum cases of traumatic cataract (53.75%) were observed in age group of <20 years with male to female ratio of 2.63:1. Maximum patients (92.15%) were implanted posterior chamber intraocular lens, either as a primary or secondary procedure. Uveitis and posterior capsular opacification were most common post-operative complications (30%) and 68.75% cases achieved a final visual acuity of 6/6-6/ 18 at the end of six months. Conclusions Traumatic cataract is an important cause of ocular morbidity specially in young patients. Surgery in cases of traumatic cataract can yield good visual outcomes if posterior segment is not involved and if post-operative complications are managed efficiently.


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