medRxiv - Anesthesia最新文献_第3页

An Open-label Clinical Study of Brief Submaximal Cardiopulmonary Testing in Pre-surgical Evaluation: Feasibility of implementation 在手术前评估中进行简短的最大限度以下心肺测试的开放标签临床研究：实施的可行性

medRxiv - Anesthesia Pub Date : 2024-01-26 DOI: 10.1101/2024.01.24.24301611

Zyad James Carr, Daniel Agarkov, Judy Li, Jean Charchaflieh, Andres Brenes-Bastos, Jonah Freund, Jill Zafar, Robert B Schonberger, Paul Heerdt

{"title":"An Open-label Clinical Study of Brief Submaximal Cardiopulmonary Testing in Pre-surgical Evaluation: Feasibility of implementation","authors":"Zyad James Carr, Daniel Agarkov, Judy Li, Jean Charchaflieh, Andres Brenes-Bastos, Jonah Freund, Jill Zafar, Robert B Schonberger, Paul Heerdt","doi":"10.1101/2024.01.24.24301611","DOIUrl":"https://doi.org/10.1101/2024.01.24.24301611","url":null,"abstract":"Objectives: We tested the logistic feasibility of integrating brief submaximal cardiopulmonary exercise testing (smCPET) in a pre-surgical evaluation (PSE) clinic. Design: Prospective open-label clinical device trial. Setting: Pre-surgical evaluation clinic.\u0000Participants: 43 participants who met criteria of i) age > 60 years old, ii) revised cardiac risk index of <2, iii) self-reported metabolic equivalents (METs) of >4.6 (i.e. ability to climb 2 flights of stairs), and iv) presenting for noncardiac surgery. Interventions: Pre-intervention self-reported METs, Duke Activity Status Index (DASI) surveys, smCPET trial, Borg survey of perceived exertion, and post-intervention survey. Measurements: Feasibility endpoints were 1) operational efficiency as measured by length of time of experimental session < 20 minutes, 2) no more than moderate perceived physical exertion as quantified by a modified Borg survey of perceived exertion of <7 in the absence of observed complications, 3) high participant satisfaction with smCPET task execution, represented as a score of >8, and 4) high patient satisfaction with scheduling of smCPET testing, represented as a score of >8. Results: Session time was 16.9 minutes (+/-6.8). Post-test modified Borg survey was 5.35 (+/-1.8), corresponding to moderate perceived exertion. Satisfaction [on a scale of 1 (worst) to 10 (best)] regarding ease of smCPET tasks was 9.6 (+/-0.7) and mean patient satisfaction with smCPET scheduling was 9.5 (+/-1.5). Operational efficiency was achieved after 10-15 experimental sessions. Conclusions: Our findings suggest that smCPET integration in a PSE clinic; 1) is time efficient 2) shows high participant satisfaction with task, and 3) rapidly achieved operational efficiency.","PeriodicalId":501303,"journal":{"name":"medRxiv - Anesthesia","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139585555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ratios Of Submitted Charge Amounts To Medicare Allowed Amounts Have Variably Worsened For Anesthesiologists And Certified Registered Nurse Anesthetists Serving Medicare Beneficiaries Across The United States During 2013-2021 Period 2013-2021 年期间，全美为医疗保险受益人服务的麻醉师和注册麻醉师提交的收费金额与医疗保险允许金额之比出现不同程度的恶化

medRxiv - Anesthesia Pub Date : 2024-01-17 DOI: 10.1101/2024.01.17.24301422

Deepak Gupta, Yara Ismaeil

引用次数: 0

Assessing the Incidence of Postoperative Diabetes in Gastric Cancer Patients: A Comparative Study of Roux-en-Y Gastrectomy and Other Surgical Reconstruction Techniques 评估胃癌患者术后糖尿病的发生率：Roux-en-Y胃切除术与其他外科重建技术的比较研究

medRxiv - Anesthesia Pub Date : 2024-01-15 DOI: 10.1101/2024.01.13.24301276

Tatsuki Onishi

引用次数: 0

Bronchoscopy in children with diffuse alveolar hemorrhage under general anesthesia with spontaneous respiration by face mask ventilation 在面罩通气自主呼吸的全身麻醉下为弥漫性肺泡出血的儿童进行支气管镜检查

medRxiv - Anesthesia Pub Date : 2023-12-06 DOI: 10.1101/2023.12.05.23299486

Ruimin Yang, Qing Wei, Xun Chen, Jing Liu, Yan Li, Jingchen Liu

{"title":"Bronchoscopy in children with diffuse alveolar hemorrhage under general anesthesia with spontaneous respiration by face mask ventilation","authors":"Ruimin Yang, Qing Wei, Xun Chen, Jing Liu, Yan Li, Jingchen Liu","doi":"10.1101/2023.12.05.23299486","DOIUrl":"https://doi.org/10.1101/2023.12.05.23299486","url":null,"abstract":"Purpose: To improve the management level of general anesthesia during bronchoscopy in the children with diffuse alveolar hemorrhage (DAH). Methods: A retrospective study was conducted in the children with DAH who had performed bronchoscopy under general anesthesia with spontaneous respiration by face mask ventilation initially from June 2021 to June 2022 in our hospital. Results: 1. Thirty-four children who had underwent 38 bronchoscopy procedures were included. 2. General anesthesia induction was performed by bolus of propofol intravenous in all the procedures. For maintaining anesthesia, 31 procedures (81.6%) received both propofol and remifentanil intravenously infusion and the rest 7 procedures (18.4%) received propofol intravenously infusion only. An intravenous bolus of ketamine or propofol was given as an anesthetic adjuvant in 21 procedures (55.3%). Thirty-five procedures (92.1%) were successfully completed under non-tracheal intubation ventilation, whereas the rest 3 procedures (7.9%) needed change to tracheal intubation ventilation. 3. Respiratory depression was found in 7 procedures (18.4%), laryngospasm was found in 2 procedure (2.6%) and bronchospasm was found in 17 procedures (44.7%). Sixteen procedures (42.1%) developed intraoperative hypoxemia. The incidence of intraoperative hypoxemia in the procedures at the active phage of disease was significantly higher compared to those at the remission phage of the disease (P<0.05). Sixteen procedures (42.1%) developed intraoperative hypercapnia. Two procedures (5.3%) were complicated by severe pulmonary hemorrhage. Conclusions: General anesthesia with spontaneous respiration by face mask ventilation is feasible and relatively safe for the children with DAH undergoing bronchoscopy, whereas the anesthetic protocol still needs to be improved.","PeriodicalId":501303,"journal":{"name":"medRxiv - Anesthesia","volume":"221 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138546734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Brain mineralization in postoperative delirium and cognitive decline 术后谵妄和认知能力下降的脑矿化

medRxiv - Anesthesia Pub Date : 2023-12-03 DOI: 10.1101/2023.12.02.23299086

Florian Lammers-Lietz, Friedrich Borchers, Insa Feinkohl, Stefan Hetzer, Cicek Kanar, Gunnar Lachmann, Claudia Chien, Claudia Spies, Georg Winterer, Laszlo Zaborszky, Norman Zacharias, Friedemann Paul

{"title":"Brain mineralization in postoperative delirium and cognitive decline","authors":"Florian Lammers-Lietz, Friedrich Borchers, Insa Feinkohl, Stefan Hetzer, Cicek Kanar, Gunnar Lachmann, Claudia Chien, Claudia Spies, Georg Winterer, Laszlo Zaborszky, Norman Zacharias, Friedemann Paul","doi":"10.1101/2023.12.02.23299086","DOIUrl":"https://doi.org/10.1101/2023.12.02.23299086","url":null,"abstract":"Delirium is a severe postoperative complication associated with poor overall and especially neurocognitive prognosis. Altered brain mineralization is found in neurodegenerative disorders but has not been studied in postoperative delirium and postoperative cognitive decline. We hypothesized that mineralization-related hypointensity in susceptibility-weighted magnetic resonance imaging (SWI) is associated with postoperative delirium and cognitive decline.\u0000We analyzed a subsample of cognitively healthy patients ≥65 years presenting for elective major surgery who underwent SWI before (N=65) and three months after surgery (N=33) as part of a subproject in the BioCog study. We measured relative SWI intensities in basal ganglia, hippocampus, and posterior basal forebrain cholinergic system (pBFCS). A post-hoc analysis of two pBFCS subregions (Ch4, Ch4p) was conducted. Patients were screened for delirium until the seventh postoperative day. Cognitive testing was performed before and three months after surgery. Preoperative relative SWI hypointensities in the basal ganglia and pBFCS were associated with increased risk for postoperative delirium after adjustment for surgery duration. After additional adjustment for age, sex, preoperative MMSE and region volume, only the association of pBFCS hypointensity and postoperative delirium remained significant. Adjusted for surgery duration, perioperative change in relative SWI intensities of the pBFCS was associated with cognitive decline three months after surgery. This association remained at a trend level after adjustments for age, sex, and region volume, but a significant independent association especially with pBFCS-subregion Ch4p was found in a post-hoc analysis.\u0000Brain mineralization, particularly in the cerebral cholinergic system, could be a pathomechanism in postoperative delirium and cognitive decline.","PeriodicalId":501303,"journal":{"name":"medRxiv - Anesthesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138524734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bilateral jaw thrust usage is neither universally prevalent during laryngeal mask airway placement nor universally prevalent during anesthesia mask ventilation before laryngoscopy for endotracheal tube placement: A single anesthesia worksite observation 双颌推力的使用既不是在喉罩气道放置时普遍普遍存在，也不是在气管内插管喉镜检查前麻醉面罩通气时普遍普遍存在:一项单一麻醉工地观察

medRxiv - Anesthesia Pub Date : 2023-11-22 DOI: 10.1101/2023.11.22.23298890

Deepak Gupta, Kaya Chakrabortty, Mohamed Ismaeil

引用次数: 0

Antiemetic effect of pregabalin in breast reconstruction surgery in patients after bariatric surgery: Prospective, randomized, double-blind study 普瑞巴林在减肥手术后乳房重建手术中的止吐效果:前瞻性、随机、双盲研究

medRxiv - Anesthesia Pub Date : 2023-07-24 DOI: 10.1101/2023.07.20.23292941

Rafael Reis Fernandes, Marcello Fonseca Salgado-Filho, Guilherme Bracco Graziosi, André Nery, Flávio Távora, Alice Ramos Oliveira Da Silva, Caio Pontes De Azevedo, Nubia Verçosa, Isma Lima Cavalcanti

{"title":"Antiemetic effect of pregabalin in breast reconstruction surgery in patients after bariatric surgery: Prospective, randomized, double-blind study","authors":"Rafael Reis Fernandes, Marcello Fonseca Salgado-Filho, Guilherme Bracco Graziosi, André Nery, Flávio Távora, Alice Ramos Oliveira Da Silva, Caio Pontes De Azevedo, Nubia Verçosa, Isma Lima Cavalcanti","doi":"10.1101/2023.07.20.23292941","DOIUrl":"https://doi.org/10.1101/2023.07.20.23292941","url":null,"abstract":"Introduction Postoperative nausea and vomiting (PONV) is a common complication after general anesthesia. Pregabalin may reduce its incidence. The objective of this study was to evaluate the adjuvant antiemetic effect of pregabalin in the first 24 hours after surgery in patients undergoing breast reconstruction after bariatric surgery. Materials and Methods This prospective, randomized, double-blind study had 52 female patients aged between 18 and 64 years with physical status 1-2 of the American Society of Anesthesiologists who underwent breast reconstruction after bariatric surgery. The patients were divided into two groups. Patients in the control group received placebo, and those in the pregabalin group received 75 mg of pregabalin 2 hours before surgery and 75 mg 12 hours later. All patients received 4 mg dexamethasone and 4 mg ondansetron. The incidence of PONV was evaluated in the immediate postoperative period and 6 hours, 12 hours, and 24 hours later. The need for rescue doses of antiemetics and adverse events in the first 24 hours were recorded. Results The groups were homogeneous in clinical and treatment variables. There was no significant difference in the incidence of PONV over time in the control group (P = 0.71/no occurrence) or in the pregabalin group (P = 0.11/P = 0.26). There was no significant difference in the need for rescue antiemetic dose (P = 0.40) or in the incidence of adverse events (P = 0.51) between groups. Conclusion The administration of pregabalin in the first 24 hours after surgery did not significantly reduce PONV in patients undergoing breast reconstruction after bariatric surgery.","PeriodicalId":501303,"journal":{"name":"medRxiv - Anesthesia","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138524735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association of effective circulating blood volume with sublingual RBC velocity and microvessel pressure difference in anesthetized individuals: A clinical investigation and computational fluid dynamics modeling 麻醉个体有效循环血容量与舌下红细胞速度和微血管压差的关系:临床研究和计算流体动力学模型

medRxiv - Anesthesia Pub Date : 2022-05-10 DOI: 10.1101/2022.05.09.22274826

Athanasios Chalkias, Michalis Xenos

引用次数: 0

Effects of Intravenous and Inhaled Anesthetics on the Postoperative Complications for the patients undergoing One Lung Ventilation 静脉和吸入麻醉药对单肺通气术后并发症的影响

medRxiv - Anesthesia Pub Date : 2022-04-01 DOI: 10.1101/2022.04.01.22273288

Jing Yang, Qinghua Huang, Rong Cao, Yu Cui

引用次数: 0

The external validity of four risk scores predicting 30-day mortality after surgery 预测术后30天死亡率的四项风险评分的外部效度

medRxiv - Anesthesia Pub Date : 2022-03-16 DOI: 10.1101/2022.03.15.22272450

Frederick Torlot, Chang-Yang Yew, Jennifer R. Reilly, Michael Phillips, Dieter G. Weber, Tomas B. Corcoran, Kwok M. Ho, Andrew J. Toner

引用次数: 0