scholarly journals EFFICIENCY OF ANESTHESIA DURING RECONSTRUCTIVE AND AESTHETIC SURGERY ON THE BREAST

2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Y.L. Kuchin ◽  
D.S. Sazhin ◽  
G.I. Patlazhan ◽  
D.V Shorikova
Keyword(s):  
Comparative Analysis ◽  
General Anesthesia ◽  
Reconstructive Surgery ◽  
Aesthetic Surgery ◽  
Mammary Glands ◽  
Single Stage ◽  
Intravenous Anesthesia ◽  
Number Of Patients ◽  
Combined Anesthesia ◽  
Aesthetic Intervention

The purpose of the study – to perform a comparative analysis of anesthesia effectivenessduring reconstructive surgery on the mammary glands.Material and methods. 120 women undergoing aesthetic intervention were divided intoanesthesia groups: intravenous anesthesia with propofol; inhalation with sevoflurane,combined with opioids; combined anesthesia with PECS-block.Results. It has been found that the group of combined anesthesia with PECS- block required the least time for analgesia (p<0,05). The greatest depth of medication sleepwas in the group of propofol, the smallest - in the combination of general anesthesia withPECS-block (p <0,05).It was verified that the largest number of patients with unstable hemodynamics wasin the group of propofol (33,3%), and the smallest number - in the group of combinedanesthesia with opioids (6,7%). Predisposition to tachycardia has been reported withthe use of propofol and the combination of sevoflurane with opioids. Bradycardic type ofsinus rhythm was observed in the group of combined anesthesia with PECS-block.Conclusions. In reconstructive interventions on the mammary glands, combinedinhalation anesthesia with sevoflurane in combination with opioids or single-stage PECSI block is promising.

Comparative analysis of the magnetoelectric drive with linear drives of low-speed single-stage piston units

2020 ◽  
Author(s):  
A. A. Tatevosyan ◽  
S. S. Busarov ◽  
R. E. Kobyl'skiy ◽  
T. A. Zamiralova
Keyword(s):  
Comparative Analysis ◽  
Single Stage ◽  
Low Speed

scholarly journals Effect of intravenous oxycodone on the physiologic responses to extubation following general anesthesia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Menglu Jiang ◽  
Jiawei Ji ◽  
Xin Li ◽  
Zhenqing Liu
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
General Anesthesia ◽  
Control Group ◽  
Study Group ◽  
Clinical Trial Registry ◽  
Blood Oxygen Saturation ◽  
Blood Concentrations ◽  
Number Of Patients ◽  
Blood Hormones

Abstract Background Endotracheal intubation and extubation may cause undesirable hemodynamic changes. Intravenous oxycodone has recently been introduced and used for relieving hemodynamic alterations in response to intubation, but there is insufficient information regarding its application in stabilizing hemodynamics during extubation in the patients emerging from general anesthesia. Methods One hundred patients, who had undergone assorted laparoscopic surgeries under general anesthesia, were randomly assigned to Control group (saline injection, 50 cases) and Study group (intravenous injection of 0.08 mg/kg oxycodone immediately after completion of the surgical procedure, 50 cases). Blood pressure, heart rate, blood oxygen saturation (SpO2) as well as blood concentrations of epinephrine, norepinephrine, and cortisol were recorded or measured immediately before extubation (T0), during extubation (T1), as well as one minute (T2), 5 min (T3), and 10 min after extubation (T4). In addition, coughing and restlessness, time of eye-opening, and duration from completing surgery to extubation as well as Ramsay Sedation Scale were analyzed. Results Blood pressure and heart rate as well as blood concentrations of epinephrine, norepinephrine, and cortisol were significantly higher in the Control group compared with the Study group at the time of extubation as well as 1, 5, and 10 min after extubation (P < 0.05). When the patients emerged from general anesthesia, 70 % of the Control group had cough, which was significantly higher than that of Study group (40 %, P < 0.05). Significantly higher number of patients manifested restlessness in the Control group before (40 %) and after extubation (20 %) compared with that in the Study group (20 and 2 %, respectively, P < 0.05). In addition, patients of Control group had lower Ramsay score at extubation (1.7 ± 0.7) as well as 30 min after extubation (2.4 ± 0.9) compared to that of the patients of Study group (2.2 ± 0.9, and 3.0 ± 0.8, respectively, P = 0.003 and 0.001). Conclusions Intravenous oxycodone attenuated alterations of hemodynamics and blood hormones associated with extubation during emergence from general anesthesia. Trial registration Chinese Clinical Trial Registry: ChiCTR2000040370 (registration date: 11-28-2020) “‘retrospectively registered”.

863 Peri-Implant Fluid Collection in Breast Reconstruction and Aesthetic Surgery

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
G Karagiannidis ◽  
E Mallidis
Keyword(s):  
Reconstructive Surgery ◽  
Cell Lymphoma ◽  
Breast Implant ◽  
Fluid Collection ◽  
Aesthetic Surgery ◽  
Large Cell ◽  
Inclusion Criteria ◽  
Electronic Data Collection ◽  
Fluid Collections ◽  
Mean Time

Abstract Introduction Peri-implant fluid more than 6 months from surgery is a known complication of breast surgery.Differential diagnosis includes infection, inflammation,implant rupture and haematoma.Other than infection raised no concern until the identification of Breast Implant Associated Anaplastic Large Cell Lymphoma(BIA-ALCL). Method Retrospective electronic data collection for women 18 years or older who met the following inclusion criteria:(a)oncoplastic and/or cosmetic reconstructive surgery with placement of implant(b)peri-implant fluid collection after 6-36 months. Results In total,17 women with implants with a mean age of 56 years were included in the study.The mean time between reconstructive surgery and the peri-implant fluid collection was 23 months.The median peri-implant fluid collection size was 143 ml.14 of the 17 peri-implant fluid collections were benign.12 of 14 had polyurethane-coated textured implants.4 of the 17 were BIA-ALCL. Conclusions The current literature suggests that late peri-implant seromas arise from friction as the implant moves within the cavity and that this friction is increased with textured rather than smooth implants.In our unit 12/14 of the benign collections appeared in reconstructions with polyurethane implants.Furthermore,BIA-ALCL should always be considered in this situation and aspirate should be sent for cytology.Is this change in polyurethane implants a new entity?

scholarly journals Сlinical, immunological and morphological features in different types of autoimmune hepatitis

2020 ◽  
Vol 92 (2) ◽  
pp. 43-47
Author(s):  
Yu. G. Sandler ◽  
K. G. Saliev ◽  
S. N. Backih ◽  
S. G. Khomeriki ◽  
T. Yu. Khaymenova ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Statistical Analysis ◽  
Autoimmune Hepatitis ◽  
Clinical Laboratory ◽  
Clinical Manifestations ◽  
Morphological Characteristics ◽  
Morphological Features ◽  
Assessment System ◽  
Associated Diseases ◽  
Number Of Patients

Due to the absence of the pathognomonic diagnostic criteria and to the diversity of clinical, serological and morphological manifestations, the diagnostic of the autoimmune hepatitis (AIH) remains to be a difficult task, which might lead to the delay of the timely beginning of the immunosuppressive therapy (IST), which in turn affects the disease outcomes. Aim.To studying the clinical, biochemical, immunological and morphological markers in patients with seronegative (SN) and seropositive (SP) AIH and the qualities of their response to the IST. Materials and methods.This retrospective cohort study included 82 AIH patients over the course of the years 20142019. All patients were selected in accordance with the criteria of the simplified assessment system of the IAIHG. Clinical, laboratorial and morphological characteristics of the AIH were analyzed. Therapy response was evaluated by the level of the ALT and IgG in 612 months after the start of the IST. The study material underwent statistical analysis using methods of parametrical and nonparametrical analysis. Statistical analysis was performed in the Statistica 13.3 (developed by StatSoft Inc., USA). Results.67/82 (81.70%) of the patients studied were women, median age of 54 years old [38; 70]. Patients with the diagnosis of the possible AIH according to the IAIHG made 85.4% (70 people). Almost everyone 96% (79/82) had morphological features of the interface-hepatitis with the lymphocytic/plasmocytic infiltration; emperipolesis was discovered in 63% of patients (49/82), hepatocellular rosette in 23% (19/82). Patients with SN AIH comprised 36.5% (30/82), with SP 63.4% (52/82). Comparative analysis demonstrated that the clinical profile in patients with SN and SP AIH is the same, while the incidence of immuno-associated diseases is significantly higher in the group of seronegative AIH. The morphological profile in the two AIH groups is identical in both typical and atypical manifestations. The number of responders to IST was 63% (19/30) SN AIH vs 67% SP AIH (35/52), did not differ significantly (p=0.529).However, that the number of patients with liver cirrhosis in the SN AIH group was twice as big as the ones with SP: 37% vs 17% (p=0.089). Conclusions.A comparative analysis of clinical, laboratory, morphological and clinical manifestations in the SN and SP AIH groups did not detected statistically significant significant differences, which may indicate that SN and SP AIH are the faces of one disease. It is possible that AB cannot be identified within the known spectrum of antibodies, or antibodies have slow expression, or are suppressed by the immune system. In any case, suspicions of AIH, in the absence of antibodies, it is recommended that liver biopsy be performed for the timely diagnosis of AIH and IST. Сirrhosis was more often diagnosed in the group SN AIH, which may be due to a later diagnosis, and therefore to untimely IST. The found frequent association of SN AIH with other immune-associated diseases requires a carefully study of this problem. The variety of clinical manifestations of AIH requires further study, the identification of clinical phenotypes with certain feature. This can help in the future to timely identify potentially problematic patients and predict a response to IST.

scholarly journals HIV INFECTION AMONG PATIENTS WITH TUBERCULOSIS IN MOSCOW

2018 ◽  
Vol 23 (4) ◽  
pp. 178-185
Author(s):  
Mikhail Valerevich Sinitsyn ◽  
S. E. Borisov ◽  
E. M. Belilovskiy ◽  
E. M. Bogorodskaya
Keyword(s):  
Comparative Analysis ◽  
Hiv Infection ◽  
Monitoring System ◽  
Drug Users ◽  
Significant Contribution ◽  
Age Group ◽  
Tuberculosis Patients ◽  
Number Of Patients ◽  
The Impact ◽  
Epidemiological Situation

The study is devoted to the evaluation of the impact of the spread of HIV infection on the epidemiological indicators of tuberculosis in a megacity. Based on information from the registers of the tuberculosis monitoring system in Moscow for 2014-2015. A comparative analysis of indicators for patients with tuberculosis was conducted with the presence and absence of co-infected HIV infection. The results showed that among patients with tuberculosis combined with HIV infection, patients from the city’s permanent population, from the age group of 31-40 years old, non-working, injecting drug users are much more likely than other TB patients. The number of tuberculosis patients who died of HIV infection, in comparison with the number of patients who died from tuberculosis, accounted for more than a third of the total number of tuberculosis-related deaths. Thus, when assessing the epidemiological situation of tuberculosis, it is necessary to take into account the significant contribution of HIV infection to the values of the main indicators and their dynamics.

scholarly journals Incidence of Postoperative Cognitive Dysfunction Following Inhalational Vs. Total Intravenous General Anesthesia: A Systematic Review and Meta-Analysis.

2022 ◽  
Author(s):  
Daniel Negrini ◽  
Andrew Wu ◽  
Atsushi Oba ◽  
Ben Harnke ◽  
Nicholas Ciancio ◽  
...  
Keyword(s):  
Systematic Review ◽  
General Anesthesia ◽  
Cognitive Dysfunction ◽  
Meta Analysis ◽  
Postoperative Cognitive Dysfunction ◽  
Primary Objective ◽  
Intravenous Anesthesia ◽  
Robust Designs ◽  
Secondary Objective ◽  
Intravenous General Anesthesia

Abstract Postoperative cognitive dysfunction (POCD) has been increasingly recognized as a contributor to postoperative complications. A consensus-working group recommended that POCD should be distinguished between delayed cognitive recovery, i.e., evaluations up to 30 days postoperative, and neurocognitive disorder, i.e., assessments performed between 30 days and 12 months after surgery. Additionally, the choice of the anesthetic, either inhalational or total intravenous anesthesia (TIVA) and its effect on the incidence of POCD, has become a focus of research. Our primary objective was to search the literature and conduct a meta-analysis to verify whether the choice of general anesthesia may impact the incidence of POCD in the first 30 days postoperatively. As a secondary objective, a systematic review of the literature was conducted to estimate the effects of the anesthetic on POCD between 30 days and 12 months postoperative. For the primary objective, an initial review of 1,913 articles yielded 12 studies with a total of 3,639 individuals. For the secondary objective, five studies with a total of 751 patients were selected. In the first 30 days postoperative, the odds-ratio for POCD in TIVA group was 0.60 (95% CI = 0.40 - 0.91; p = 0.02), compared to the inhalational group. TIVA was associated with a lower incidence of POCD in the first 30 days postoperatively. Regarding the secondary objective, due to the small number of selected articles and its high heterogeneity, a metanalysis was not conducted. Giving the heterogeneity of criteria for POCD, future prospective studies with more robust designs should be performed to fully address this question.

scholarly journals Experiência Inicial de um Programa de TAVI: Análise da Decisão Anestésica e sua Evolução

2019 ◽  
Vol 32 (2) ◽  
pp. 126
Author(s):  
Ana Margarida Martins ◽  
Maria Lurdes Castro ◽  
Isabel Fragata
Keyword(s):  
Aortic Valve ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Transcatheter Aortic Valve Implantation ◽  
Anesthetic Technique ◽  
Less Invasive ◽  
Transcatheter Aortic Valve ◽  
Number Of Patients ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Introduction: Transcatheter aortic valve implantation is a less invasive option for aortic valve replacement. The number of transcatheter aortic valve implantations under local anesthesia with sedation has been increasing as the team’s experience increases and less invasive accesses are used. The aim of this study is to describe the evolution of the anesthetic technique in patients undergoing transcatheter aortic valve implantation at our center over the years, as which was compared. Material and Methods: Retrospective study in 149 consecutive patients undergoing transcatheter aortic valve implantation in Hospital Santa Marta (January 2010 to December 2016). Data was collected from the periprocedural records of patients. Patients were stratified according to anesthetic technique. Results: From our patients’ sample, 57.0% were female, with median age 82 [58 - 95] years. Most patients underwent general anesthesia (68.5%). In the local anesthesia with sedation group there was a shorter duration of the procedure (120; [60 - 285] vs 155 [30 - 360]) and a lower number of patients requiring administration of vasopressors (61.8% vs 28.3%) – p < 0.05. There were no differences regarding length of hospital stay (9 [4 - 59] vs 10 [3 - 87]), periprocedural complications (66.0% vs 72.5%), readmission rate (4.3% vs 3.9%) or 30-days (2.1% vs 4.9%) and 1-year mortality (6.4% vs 7.8%) – p > 0.05. There was an increasing number of transcatheter aortic valve implantations performed under local anesthesia with sedation over the years.Discussion: The choice of anesthetic technique depends on the patient’s characteristics, experience and preference of the team.Conclusion: Local anesthesia with sedation seems to be associated with similar results as general anesthesia. The increase in the number of transcatheter aortic valve implantations under local anesthesia with sedation seems to follow the trend of lower invasiveness of the procedure.

scholarly journals Anesthetics and long-term survival after cancer surgery—total intravenous versus volatile anesthesia: a retrospective study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Boohwi Hong ◽  
Sunyeul Lee ◽  
Yeojung Kim ◽  
Minhee Lee ◽  
Ann Misun Youn ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cancer Patients ◽  
Cancer Surgery ◽  
Trial Registration ◽  
Favorable Effect ◽  
Rank Test ◽  
Intravenous Anesthesia ◽  
Term Survival ◽  
Log Rank Test ◽  
Number Of Patients

Abstract Background Intravenous anesthesia has been reported to have a favorable effect on the prognosis of cancer patients. This study was performed to analyze data regarding the relation between anesthetics and the prognosis of cancer patients in our hospital. Methods The medical records of patients who underwent surgical resection for gastric, lung, liver, colon, and breast cancer between January 2006 and December 2009 were reviewed. Depending on the type of anesthetic, it was divided into total intravenous anesthesia (TIVA) or volatile inhaled anesthesia (VIA) group. The 5-year overall survival outcomes were analyzed by log-rank test. Cox proportional hazards modeling was used for sensitivity. Results The number of patients finally included in the comparison after propensity matching came to 729 in each group. The number of surviving patients at 5 years came to 660 (90.5%) in the TIVA and 673 (92.3%) in the VIA. The type of anesthetic did not affect the 5-year survival rate according to the log-rank test (P = 0.21). Variables associated with a significant increase in the hazard of death after multivariable analysis were male sex and metastasis at surgery. Conclusions There were no differences in 5-year overall survival between two groups in the cancer surgery. Trial registration Trial registration: CRIS KCT0004101. Retrospectively registered 28 June 2019.

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