scholarly journals Suprapubic Catheterization in Neurogenic Bladder by Distending Bladder with Air-A Novel Technique

2021 ◽  
Vol 6 (09) ◽  
pp. 627-629
Author(s):  
Xinghui Sun
Keyword(s):  
High Risk ◽  
Blood Loss ◽  
Neurogenic Bladder ◽  
Local Anaesthesia ◽  
Foley Catheter ◽  
Safe Method ◽  
Novel Technique ◽  
Suprapubic Catheterization ◽  
The Mean ◽  
General Method

Suprapubic catheterization (SPC) in patients with neurogenic bladder (NGB) is difficult and high risk. Our aim is to provide a novel SPC method in patients with NGB by distending the bladder with air. A total of 26 patients with NGB underwent SPC using this new method. The bladder was first filled with air based on its volume of urine or liquids. Then, a reusable trocar was advanced into the bladder as per the general method. Preoperative demographics of patients and operative details were recorded. SPC was performed under local anaesthesia in 26 patients with NGB, including 18 men and 8 women. The mean age of the patients was 36 years (range, 28-77). An 18F Foley catheter was used for all patients. Blood loss was minimal, and the procedure was performed successfully in all patients without any complication. By distending the bladder with air, the SPC method is presented as an effective and safe method suited for patients with NGB. To our knowledge, this is the first report of this novel procedure.

Local anaesthetic with vasoconstrictor combinations in septal surgery

1988 ◽  
Vol 102 (9) ◽  
pp. 793-795 ◽  
Author(s):  
L. G. Mcclymont ◽  
J. A. Crowther
Keyword(s):  
Blood Loss ◽  
Local Anaesthetic ◽  
Local Anaesthesia ◽  
Operating Field ◽  
Cardiac Dysrhythmias ◽  
Septal Surgery ◽  
The Mean

AbstractLocal anaesthetic with vasoconstrictor combinations are often used to reduce bleeding and hence improve the operating field in septal surgery. Two commonly used combinations are lignocaine with adrenaline and prilocaine with felypressin (citanest with octapressin). Most surgeons prefer to use lignocaine with adrenaline but because of the risks of cardiac dysrhythmias when used with halothane anaesthetists prefer prilocaine with felypressin. In a trial with lignocaine 2 per cent and adrenaline 1 in 200,000 against prilocaine 3 per cent and felypressin 0.03 international units/ml in 18 patients undergoing septal surgery with local anaesthesia alone there was significantly less blood loss in the lignocaine with adrenaline group, p>0.01. The mean blood loss in the adrenaline group was 7.5 ml. and 32.7 ml. with felypressin. Both combinations were equally effective in producing adequate local anaesthesia. It is concluded that lignocaine with adrenaline is superior to prilocaine with felypressin in achieving a dry operating field in septal surgery under local anaesthesia.

Novel use of the ClariVein® Catheter for Pharmacomechanical Thrombolysis of Thrombosed Hemodialysis Grafts: A Case Series

2017 ◽  
Vol 18 (6) ◽  
pp. 508-514 ◽  
Author(s):  
Darryl Lim ◽  
Derek C. Ho ◽  
Lionel Chen ◽  
Michiel A. Schreve ◽  
Yih Kai Tan ◽  
...  
Keyword(s):  
Clinical Success ◽  
Demographic Data ◽  
Case Series ◽  
Secondary Patency ◽  
Success Rates ◽  
Safe Method ◽  
Novel Technique ◽  
Early Results ◽  
Procedural Time ◽  
The Mean

Introduction The aim of this prospectively collected case series is to demonstrate a novel technique of using the ClariVein® catheter for pharmacomechanical thrombolysis of thrombosed hemodialysis grafts. Methods The analysis comprised 11 procedures in 9 patients from 1 July to 31 December 2016 in which the ClariVein catheter was used in combination with urokinase. Demographic data, procedural data, technical and clinical success rates, and complications were evaluated. The primary and secondary patency rates at 1 and 3 months were also analyzed. Results In the 11 procedures performed, the technical and clinical success was 100%. The mean procedural time was 66.8 minutes (range 50-90 minutes), and the mean amount of urokinase administered was 87,000 units. The primary unassisted patency rates at 1 and 3 months were 81.8% and 63.6%, respectively. The secondary patency rates at 1 and 3 months were 90.9% and 81.8%, respectively. Perforation occurred after balloon angioplasty in 1 (9.1%) of the 11 procedures, for which covered stenting was performed. No major complications occurred. Conclusions The combination use of the ClariVein catheter with urokinase for pharmacomechanical thrombolysis in thrombosed hemodialysis grafts is a feasible and safe method that can be performed in a relatively short duration. Our early results have shown 100% technical and clinical success. This case series serves as a platform for an upcoming prospective study to further evaluate this method.

scholarly journals Foley catheter-assisted six-step thrombectomy technique in the surgical management of renal cell carcinoma with Mayo level II to IV tumor thrombus

2019 ◽  
Vol 47 (5) ◽  
pp. 2104-2115 ◽  
Author(s):  
Zhuo Liu ◽  
Shiying Tang ◽  
Xiaojun Tian ◽  
Shudong Zhang ◽  
Guoliang Wang ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Blood Loss ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Foley Catheter ◽  
Red Blood Cell Transfusion ◽  
Level Ii ◽  
The Mean

Objective To simplify Foley catheter-assisted thrombectomy to a six-step approach and determine the feasibility and results of this technique for renal cell carcinoma (RCC) with a Mayo level II to IV tumor thrombus (TT). Methods The surgical records of patients with RCC with a Mayo level II to IV TT treated in our hospital were retrospectively reviewed. Fifteen patients who underwent radical nephrectomy and thrombectomy with a Foley catheter-assisted procedure were included. Epidemiological and clinicopathological features, operation-related variables, and outcomes were evaluated. Results The TTs in all 15 patients were successfully retracted by the Foley catheter. The mean operation time was 420.1 ± 108.9 minutes. The mean intraoperative blood loss and perioperative red blood cell transfusion volumes were 1846.7 ± 1467.8 and 1288.7 ± 1060.6 mL, respectively. Five patients had perioperative complications. The median follow-up time was 9 (range, 0–34) months, and four patients died of the disease. Conclusions Simplification of Foley catheter-assisted thrombectomy to a six-step approach results in the probability of avoiding thoracotomy or cardiopulmonary bypass to a certain degree and is associated with fewer complications, less blood loss, and less perioperative red blood cell transfusion. However, experienced surgeons and multidisciplinary cooperation are still needed.

scholarly journals Safe method for release of severe post burn neck contracture under tumescent local anaesthesia and ketamine

2004 ◽  
Vol 37 (01) ◽  
pp. 51-54 ◽  
Author(s):  
Pawan Agarwal
Keyword(s):  
Blood Loss ◽  
Difficult Intubation ◽  
Local Anaesthesia ◽  
Graft Loss ◽  
Tumescent Anesthesia ◽  
Safe Method ◽  
Life Threatening ◽  
Anesthesia Technique ◽  
Split Skin ◽  
Intravenous Ketamine

ABSTRACTSevere post burn neck contracture results in difficult intubation, which can be life threatening and can result in multiple serious complications and sequels. Thirty patients with age ranging from 12 to 50 years were operated under local tumescent anesthesia supplemented with intravenous ketamine for release of post burn neck contracture and split skin grafted. This technique obviates the need for endotracheal intubation. There were no complications attributed to this anesthesia technique. There was no graft loss and blood loss was minimal.

Outcome of carotid endarterectomy under local anaesthesia with respect to the patients’ risk profile

VASA ◽  
2009 ◽  
Vol 38 (3) ◽  
pp. 225-233 ◽  
Author(s):  
Aleksic ◽  
Luebke ◽  
Brunkwall
Keyword(s):  
Myocardial Infarction ◽  
High Risk ◽  
Carotid Endarterectomy ◽  
Complication Rate ◽  
Local Anaesthesia ◽  
High Risk Group ◽  
High Risk Patients ◽  
Hostile Neck ◽  
Risk Patients ◽  
Angioplasty And Stenting

Background: In the present study the perioperative complication rate is compared between high- and low-risk patients when carotid endarterectomy (CEA) is routinely performed under local anaesthesia (LA). Patients and methods: From January 2000 through June 2008 1220 consecutive patients underwent CEA under LA. High-risk patients fulfilled at least one of the following characteristics: ASA 4 classification, “hostile neck”, recurrent ICA stenosis, contralateral ICA occlusion, age ≥ 80 years. The combined complication rate comprised any new neurological deficit (TIA or stroke), myocardial infarction or death within 30 days after CEA, which was compared between patient groups. Results: Overall 309 patients (25%) were attributed to the high-risk group, which differed significantly regarding sex distribution (more males: 70% vs. 63%, p = 0,011), neurological presentation (more asymptomatic: 72% vs. 62%, p = 0,001) and shunt necessity (33% vs. 14%, p < 0,001). In 32 patients 17 TIAs and 15 strokes were observed. In 3 patients a myocardial infarction occurred. Death occurred in one patient following a stroke and in another patient following myocardial infarction, leading to a combined complication rate of 2,9% (35/1220). In the multivariate analysis only previous neurological symptomatology (OR 2,85, 95% CI 1,38-5,91) and intraoperative shunting (OR 5,57, 95% CI 2,69-11,55) were identified as independent risk factors for an increased combined complication rate. Conclusions: With the routine use of LA, CEA was not associated with worse outcome in high-risk patients. Considering the data reported in the literature, it does not appear justified to refer high-risk patients principally to carotid angioplasty and stenting (CAS) when LA can be chosen to perform CEA.

The Effect of Desmopressin on Reducing Blood Loss in Cardiac Surgery – A Meta-Analysis of Double-Blind, Placebo-Controlled Trials

1995 ◽  
Vol 74 (04) ◽  
pp. 1064-1070 ◽  
Author(s):  
Marco Cattaneo ◽  
Alan S Harris ◽  
Ulf Strömberg ◽  
Pier Mannuccio Mannucci
Keyword(s):  
Cardiac Surgery ◽  
Blood Loss ◽  
Meta Analysis ◽  
Postoperative Blood Loss ◽  
Controlled Trials ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Transfusion Requirements ◽  
The Mean ◽  
Excessive Blood Loss

SummaryThe effect of desmopressin (DDAVP) on reducing postoperative blood loss after cardiac surgery has been studied in several randomized clinical trials, with conflicting outcomes. Since most trials had insufficient statistical power to detect true differences in blood loss, we performed a meta-analysis of data from relevant studies. Seventeen randomized, double-blind, placebo-controlled trials were analyzed, which included 1171 patients undergoing cardiac surgery for various indications; 579 of them were treated with desmopressin and 592 with placebo. Efficacy parameters were blood loss volumes and transfusion requirements. Desmopressin significantly reduced postoperative blood loss by 9%, but had no statistically significant effect on transfusion requirements. A subanalysis revealed that desmopressin had no protective effects in trials in which the mean blood loss in placebo-treated patients fell in the lower and middle thirds of distribution of blood losses (687-1108 ml/24 h). In contrast, in trials in which the mean blood loss in placebo-treated patients fell in the upper third of distribution (>1109 ml/24 h), desmopressin significantly decreased postoperative blood loss by 34%. Insufficient data were available to perform a sub-analysis on transfusion requirements. Therefore, desmopressin significantly reduces blood loss only in cardiac operations which induce excessive blood loss. Further studies are called to validate the results of this meta-analysis and to identify predictors of excessive blood loss after cardiac surgery.

scholarly journals Nonstructural bone graft for single-segment lumbar tuberculosis: surgical indications, clinical efficacy, and preliminary experiences in 34 patients

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098278
Author(s):  
Xing Du ◽  
Yunsheng Ou ◽  
Guanyin Jiang ◽  
Yong Zhu ◽  
Wei Luo ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Bone Graft ◽  
Cobb Angle ◽  
Clinical Efficacy ◽  
Operative Time ◽  
Bone Grafts ◽  
Surgical Indications ◽  
Operative Blood Loss ◽  
The Mean

Objective This study was performed to evaluate the surgical indications, clinical efficacy, and preliminary experiences of nonstructural bone grafts for lumbar tuberculosis (TB). Methods Thirty-four patients with lumbar TB who were treated with nonstructural bone grafts were retrospectively assessed. The operative time, operative blood loss, hospital stay, bone graft fusion time, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) concentration, visual analog scale (VAS) score, Oswestry Disability Index (ODI), American Spinal Injury Association (ASIA) impairment grade, and Cobb angle were recorded and analyzed. Results The mean operative time, operative blood loss, hospital stay, Cobb angle correction, and Cobb angle loss were 192.59 ± 42.16 minutes, 385.29 ± 251.82 mL, 14.91 ± 5.06 days, 9.02° ± 3.16°, and 5.54° ± 1.09°, respectively. During the mean follow-up of 27.53 ± 8.90 months, significant improvements were observed in the ESR, CRP concentration, VAS score, ODI, and ASIA grade. The mean bone graft fusion time was 5.15 ± 1.13 months. Three complications occurred, and all were cured after active treatment. Conclusions Nonstructural bone grafts may achieve satisfactory clinical efficacy for appropriately selected patients with lumbar TB.

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