scholarly journals COMPARATION OF EFFICACY OF DIFFERENT PERIOPERATIVE MEDICAL PREPARATION SCHEMES FOR TRANSPAPILLAR ENDOSCOPIC INTERVENTIONS

2021 ◽  
Vol 21 (3) ◽  
pp. 64-68
Author(s):  
S.V. Dolzhkovyi
Keyword(s):  
Intramuscular Injection ◽  
Perioperative Period ◽  
Early Postoperative Period ◽  
Butyl Bromide ◽  
Surgical Department ◽  
Medical Preparation ◽  
Peristaltic Activity ◽  
Selective Cannulation ◽  
Total Procedure

The intensity of peristaltic activity has significant impact on the duration of transpapillar endoscopic interventions and in some cases (juxtapapillary diverticulum, stenotising papillitis or severe oedema of papilla) can impede operations. Therefore, proper inhibition of duodenal peristalsis is one of the important preconditions for successful fulfilment of such procedures. The aim of the study was to carry out comparative analysis of impact of antispasmodic medications used through the perioperative period on the quality of transpapillar endoscopic interventions. Case histories of patients, who were treated at the Surgical Department of Municipal Enterprise “Sklifosovskiy Poltava Regional Clinical Hospital” for 2017-2019, were investigated, and 75 cases were chosen for further analysis. We divided our cohort in two groups depending on medications used for duodenal peristalsis inhibition: I group – hyoscine butyl bromide (1 ml 2% solution intramuscular injection); II – hyoscine butyl bromide (1 ml 2% solution intramuscular injection), and atropine (1ml 0,1% solution intramuscular injection). Time needed for selective cannulation, total procedure length, number and type of adverse events during manipulation and in early postoperative period were compared between the groups. After statistical data processing the following conclusions were made: 1) proper medical preparation significantly facilitates the implementation of transpapillar endoscopic interventions; 2) combined scheme to reduce duodenal peristalsis, which includes hyoscine butyl bromide and atropine, is not superior to hyoscine butyl bromide alone.

scholarly journals Clinical effect of application of nursing concept of rehabilitation surgery for improvement of quality of postoperative recovery in orthopedics

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hong Lv ◽  
Ning Yang
Keyword(s):  
Tract Infection ◽  
Perioperative Period ◽  
Postoperative Recovery ◽  
Control Group ◽  
Observation Group ◽  
Activity Time ◽  
Joint Function ◽  
Vein Thrombosis ◽  
Accelerated Rehabilitation

Abstract Objective To analyze the application of concept nursing of accelerated rehabilitation surgery in orthopedic postoperative recovery. Methods A total of 120 patients who received orthopedic surgery were divided into the control group undergoing routine orthopedic nursing and the observation group undergoing the concept of accelerated rehabilitation surgery nursing. Results Patients in the observation group had shorter in-bed activity time and out-of-bed activity time, average time of hospital stay, and lower total treatment costs. The incidence of incision infection, respiratory system infection, digestive tract infection, urinary tract infection, deep vein thrombosis, and other complications in the observation group was much lower. The recovery scores of joint function in the observation group at 1, 3, 6, and 12 months after the operation were all better, and the recovery rate of joint function within 1 year after the operation was higher. Conclusion Following the concept of accelerated rehabilitation surgery nursing during the perioperative period can improve the quality of postoperative orthopedic recovery.

scholarly journals The effect of opioid-free anesthesia on the quality of recovery after gynecological laparoscopy: study protocol for a prospective randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jae Yen Song ◽  
Hoon Choi ◽  
Minsuk Chae ◽  
Jemin Ko ◽  
Young Eun Moon
Keyword(s):  
General Anesthesia ◽  
Assessment Tool ◽  
Controlled Trial ◽  
Perioperative Period ◽  
Postoperative Outcomes ◽  
Control Group ◽  
Quality Of Recovery ◽  
Gynecological Laparoscopy ◽  
Prospective Randomized Controlled Trial

Abstract Background Because of the indiscriminate use of opioids during the perioperative period, opioid-free anesthesia (OFA) has been increasingly required. Nevertheless, the studies on the detailed techniques and effects of OFA are not sufficient. The Quality of Recovery-40 (QoR-40) questionnaire is a validated assessment tool for measuring recovery from general anesthesia. However, no study has used the QoR-40 to determine if OFA leads to better recovery than standard general anesthesia. Therefore, we aim to perform this study to determine the effects of OFA using dexmedetomidine and lidocaine on the quality of recovery as well as the various postoperative outcomes. Methods The participants (n = 78) will be allocated to one of the two groups; the study group will receive bolus and infusion of dexmedetomidine and lidocaine, and the control group will receive remifentanil infusion during general anesthesia for gynecological laparoscopy. The other processes including anesthetic and postoperative care will be performed similarly in the two groups. Intraoperative hemodynamic, anesthetic, and nociceptive variables will be recorded. Postoperative outcomes such as QoR-40, pain severity, and opioid-related side effects will be assessed. Additionally, an ancillary cytokine study (inflammatory cytokine, stress hormone, and reactive oxygen species) will be performed during the study period. Discussion This will be the first study to determine the effect of OFA, using the combination of dexmedetomidine and lidocaine, on the quality of recovery after gynecological laparoscopy compared with standard general anesthesia using remifentanil. The findings from this study will provide scientific and clinical evidence on the efficacy of OFA. Trial registration ClinicalTrials.gov NCT04409964. Registered on 28 May 2020

scholarly journals Epidural analgesia in a paediatric teaching hospital: Trends, developments, and a brief review of literature

2017 ◽  
Vol 27 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Jolin Wong ◽  
Serene Siu Tin Lim
Keyword(s):  
Epidural Analgesia ◽  
Teaching Hospital ◽  
Perioperative Period ◽  
Review Of Literature ◽  
Good Tool ◽  
Patient Demographics ◽  
Included Patient ◽  
Continuous Epidural Analgesia ◽  
Continued Use

Introduction: Continuous epidural analgesia has proven to be a good tool in the anaesthetist’s quest to provide excellent pain relief for an extended perioperative period. Pharmaceutical advances provide us with a larger array of both local anaesthetic (LA) drugs and additives that can prolong the duration or enhance the quality of analgesia, or both. The avoidance of LA toxicity is of paramount importance for safe prescription, especially in the high-risk neonatal and infant cohort, and all patients stand to benefit from ‘safer’ LA agents and adjuvants that promote the use of a lowered concentration of epidural LA infusions. We present a descriptive review of trends in epidural prescription and technique in our hospital. Methods: Our observational study was conducted over a period of 19 years in a tertiary paediatric teaching hospital. Prospectively collected data that included patient demographics, level of epidural catheter insertion, LA drugs and adjuvants used, as well as postoperative infusion rates, were then analysed retrospectively. Results: There was a decline in the use of paediatric epidural analgesia. Over the study period, we also observed a shift in preference of LAs and adjuvant drugs toward safer alternatives. Conclusion: Paediatric epidural analgesia is gradually being superseded by other analgesic modalities with superior safety profiles (e.g. peripheral neural blockade). However, indications remain for its continued use, and anaesthetists should be familiar with its technical aspects and pitfalls.

Effect of Rapid Rehabilitation Concepts on Quality of Life and Pain in Patients Undergoing Radical Breast Cancer Surgery in Perioperative Period

2021 ◽  
Vol 7 (5) ◽  
pp. 1538-1544
Author(s):  
Xin Li ◽  
Hai-yan An ◽  
Yi Zhao ◽  
Mingli Ji ◽  
Jing An ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Perioperative Period ◽  
Nursing Intervention ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Control Group ◽  
T Lymphocyte Subsets ◽  
Significant Difference

To study the effect of rapid rehabilitation nursing on patients’ quality of life and pain level during the perioperative period of radical breast cancer surgery. Methods: 126 patients who were hospitalized in our hospital from January 2018 to February 2020 and underwent radical breast cancer surgery were divided into control group and rapid rehabilitation group according to the perioperative period intervention method. Routine nursing intervention and rapid rehabilitation nursing intervention were used respectively. The general conditions of the two groups were recorded, and the differences of T cell subsets before operation and 3 days after operation were detected. Visual analogue pain (VAS) score was used to evaluate the changes of pain degree at 1 day, 3 days and 5 days after operation and on the day of discharge. Postoperative complications and satisfaction were compared between the two groups. Quality of life (QOL) was assessed at 1 month and 3 months after operation using the CARES-SF score. Results: Anesthesia waking time (26.12 ± 5.77) min, off-bed activity time (14.25 ± 2.87) h and hospital stay (7.82 ± 2.15) d in the rapid rehabilitation group were shorter than those in the control group (P < 0.05). The operation time (92.02 ± 14.78) min and intraoperative blood loss (57.96 ± 13.96) mL in the rapid rehabilitation group were not significantly different from those in the control group (P > 0.05). In the control group, 3d after operation, T lymphocyte subsets were decreased gradually than that before operation (P < 0.05), CD3+ was decreased 3d after operation than that before operation in the rapid rehabilitation group (P < 0.05), but CD4+, CD8+, CD4+ / CD8 + 3d after operation had no significant difference than that before operation (P > 0.05). In rapid rehabilitation group, T lymphocyte subsets at 3d after operation were higher than those in the control group (P < 0.05). The postoperative complication rate of the rapid rehabilitation group was lower than that of the control group, and the satisfaction degree was higher than that of the control group, with significant difference (P < 0.05). After follow-up, it was found that the scores of qualities of life, such as physiology, psychosocial, marriage, sexual life and relationship with medical staff in the rapid rehabilitation group were lower than those in the control group at 1 month and 3 months after operation (P < 0.05). Conclusion: The concept of rapid rehabilitation nursing can stabilize the immune function of patients after radical breast cancer surgery, promote the postoperative rehabilitation and improve the quality of life after operation.

scholarly journals Association between serum biomarkers and postoperative delirium after cardiac surgery

2019 ◽  
Vol 26 (1) ◽  
pp. 8-10 ◽  
Author(s):  
Mindaugas Gailiušas ◽  
Judita Andrejaitienė ◽  
Edmundas Širvinskas ◽  
Darijus Krasauskas ◽  
Milda Švagždienė ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Delirium ◽  
Neuronal Damage ◽  
Artery Bypass ◽  
Neuron Specific Enolase ◽  
Perioperative Period ◽  
Early Postoperative Period ◽  
Blood Levels ◽  
Increased Risk ◽  
The Individual

Background. In cardiac surgery, patients face an increased risk of developing postoperative delirium (POD) that is associated with poor outcomes. Neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP) have shown some promising results as potential tools for POD risk stratification, diagnosis, monitoring, and prognosis. Methods. Prospective single-centre study enrolled 44 patients undergoing elective coronary artery bypass grafting (CABG) and/ or valve procedures using cardiopulmonary bypass (CPB). The patients were assessed and monitored preoperatively, during surgery, and in the early postoperative period. The blood levels of NSE and GFAP were measured before and after surgery. The early POD was assessed by CAM-ICU criteria and patients were assigned to the POD group (with POD) or to the NPOD group (without POD) retrospectively. Results. The incidence of POD was 18.2%. After surgery, NSE significantly increased in the whole sample (p = 0.002). Comparing between groups, NSE significantly increased in the POD group after surgery (p = 0.042). ΔGFAP (before/after operation) for the whole sample was statistically significant (p = 0.022). There was a significant correlation between ΔGFAP and the lowest MAP during surgery in the POD group (p = 0.033). Conclusions. Our study demonstrated that NSE and GFAP are associated with early POD. An increase in NSE level during the perioperative period may be associated with subclinical neuronal damage. Serum GFAP levels show the damage of glial cells. Further studies are needed to find the factors influencing the individual limits of optimal MAP during surgery.

scholarly journals Perioperative evaluation of kidney function for patients with complicated forms of coronary artery disease

2020 ◽  
pp. 52-58
Author(s):  
O. Gogayeva ◽  
V. Lazoryshynets ◽  
A. Rudenko ◽  
L. Dzakhoieva ◽  
O. Yuvchyk
Keyword(s):  
Coronary Artery Disease ◽  
Acute Kidney Injury ◽  
Coronary Artery ◽  
Kidney Function ◽  
Postoperative Period ◽  
Kidney Injury ◽  
Perioperative Period ◽  
Early Postoperative Period ◽  
Chronic Obstructive ◽  
Artery Disease

The study aimed to analyze kidney function for patients with complicated forms of coronary artery disease (CAD) in the perioperative period. Methods. It was a retrospective analysis of 110 high-risk patients with complicated forms of CAD, who were operated on and discharged from the National M. Amosov Institute for the period from 2009 till 2019 years. Kidney function was evaluated by glomerular filtration rate (GFR), calculated online with СKD-EPI formula. Results. Among the included patients there were 86 (78.1%) patients with metabolic syndrome, 81 (73.59%) patients with disorders of glucose metabolism, 82 (74.5%) subjects with chronic obstructive pulmonary disease and 38 (34.5%) patients had chronic kidney disease (CKD) 3-5 stage. Preoperative risk stratification with EuroScore II scale was 9.4%. All operations performed in cardiopulmonary bypass; Custodial cardioplegia was used in 53 (48.1%) patients. The average perfusion time was 111 minutes, average cross-clamping time was 73.9 minutes. Acute kidney injury in the early postoperative period had 9 (8.1%) patients. Conclusions. At the admittance 38 (34.5%) patients with complicated forms of CAD had CKD 3-5 st. Analysis of the GFR dynamic in the early postoperative period shown a decrease in GFR in 71.05% of patients. Transient acute kidney injury with 50% sCr growth had 9 (8.1%) patients but didn’t require hemodialysis.

scholarly journals Investigation of the hepatoprotective properties of “Phytovenol” capsules on the model of medicamentous hepatitis in rats

2014 ◽  
Vol 27 (4) ◽  
pp. 240-242
Author(s):  
Oleg Gerush ◽  
Olena Lenytska ◽  
Larysa Yakovleva ◽  
Liudmyla Gladkova ◽  
Igor Gerush
Keyword(s):  
Pharmacological Activity ◽  
Medical Practice ◽  
Liver Diseases ◽  
Scientific Paper ◽  
Hepatoprotective Effect ◽  
Experimental Conditions ◽  
Medical Preparation ◽  
Quality Of Treatment ◽  
First Time

Abstract This scientific paper is an investigation of the pharmacological activity of the new medical preparation “Phytovenol” (capsules in the dose of 150 mg/kg) on the pattern of hepatitis in rats induced by paracetamol administration. The authors of the article, for the first time under experimental conditions, detected a hepatoprotective effect that was brought about by “Phytovenol” capsule administration. This is realized due to the antioxidant, antitoxic and anticytolytic activity of the examined medicine. The study found that its efficacy is not lower than the classical hepatoprotector - “Silibor” tablets. The results obtained suggest that it is possible to extend the range of available hepatoprotectors and improve the quality of treatment for liver diseases, by introducing “Phytovenol” capsules into medical practice.

Regional blockade for prolonged anesthesia in enucleation and evisceration

Reflection ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 47-55
Author(s):  
I.G. Oleshchenko ◽  
◽  
О.P. Mishchenko ◽  
М.А. Gasparyan ◽  
◽  
...  
Keyword(s):  
Postoperative Period ◽  
Choroidal Melanoma ◽  
Opioid Analgesics ◽  
Early Postoperative Period ◽  
Alternative Methods ◽  
Combined Method ◽  
Retrobulbar Anesthesia ◽  
Pterygopalatine Ganglion ◽  
Systemic Side Effects

Regional anesthesia is widely used in ophthalmology both as an independent method and in combination. Retrobulbar anesthesia has risks of complications and is undesirable in the surgical treatment of choroidal melanoma due to the risk of metastasis of tumor cells when it is performed. Therefore, it is necessary to search for alternative methods of regional blockades in order to create prolonged anesthesia. Purpose. To develop and evaluate the clinical efficacy of pterygopalatine blockade as a component of combined method of anesthesia for evisceration or enucleation of the eyeball. Methods. A comparative analysis of the effectiveness of intraoperative anesthesia and the course of postoperative period was carried out in patients of two clinical groups formed depending on the method of anesthesia. Results. Intraoperative monitoring of hemodynamics in the groups did not differ. The nature of pain in the patients of the compared groups in the postoperative period had significant differences in presence and intensity of pain on the scale of verbal sensations. Discussion. Use of pterygopalatine blockade with levobupivacaine in combination with dexamethasone as an adjuvant allows getting a prolonged analgesic, anti-inflammatory and decongestant effect. This makes it possible to avoid the use of opioid analgesics in the early postoperative period, that is, to avoid such systemic side effects as nausea, dizziness, and in rare cases vomiting, which generally improves the quality of the postoperative period. Conclusions. Use of pterygopalatine ganglion blockade with local prolonged-acting anesthetic levobupivacaine and dexamethasone as an adjuvant based on inhaled anesthesia with sevoflurane provides safe and effective anesthesia in patients with evisceration or enucleation of the eyeball, both in the intra- and postoperative period. Key words: enucleation; evisceration; pterygopalatine blockade; dexamethasone.

scholarly journals Outcome of functional endoscopic surgery for chronic rhinosinusitus

2017 ◽  
Vol 5 (1) ◽  
pp. 20-21
Author(s):  
Rabin Chandra Acharya ◽  
B. Pradhan ◽  
N.M. Thapa
Keyword(s):  
Chronic Rhinosinusitis ◽  
Early Postoperative Period ◽  
Functional Endoscopic Sinus Surgery ◽  
University Teaching ◽  
Sinus Surgery ◽  
Radiological Criteria ◽  
Prospective Comparative Study ◽  
Sinonasal Outcome Test ◽  
Psychosocial Domain

Objective: To measure the outcome of Functional Endoscopic Sinus Surgery (FESS) for Chronic Rhinosinusitis in early postoperative period.Materials and Methods: This is a prospective comparative study conducted in Ganesh Man Singh Memorial Academy of ENT-Head and Neck Studies, Tribhuvan University Teaching Hospital, Kathmandu, Nepal from November 2009 to March, 2011. Thirty cases of Chronic Rhinosinusitis diagnosed by clinical and radiological criteria were included in this study. Modified sinonasal outcome test was used to record the pre and postoperative scores and compared by using paired t- test.Results: All the cases showed significant improvement in postoperative scores in both physical and psychosocial domains of modified sinonasal outcome test. Two symptoms, concentration and misery of psychosocial domain didn’t improve significantly.Conclusion: This study attempts to measure the outcome of FESS in patients with CRS. Nepali version of SNOT-10 has been used in the Nepalese population. Significant improvement in quality of life score has been observed in early postoperative period.

Sign in / Sign up

Export Citation Format

Share Document