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At least 415 records · Page 23Linked to original sources
PubMed1993

The lumbar multifidus muscle five years after surgery for a lumbar intervertebral disc herniation.

Biopsy specimens of the lumbar multifidus were obtained from 18 patients with lumbar disc herniation at operation and after a postoperative follow-up period of 5 years. The structure and morphometry of the muscle fibers were analyzed and these data were compared with intraoperative biopsy results and the clinical outcome of the operation. The main findings were: 1) on the basis of occupational handicap score 10 patients belonged in the "positive" and 8 in the "negative" outcome group; 2) the intraoperatively recorded selective type 2 muscle fiber atrophy and the extent of pathologic inner structure changes both decreased in the "positive" outcome group, whereas they persisted in the "negative" group; 3) grouping as a definite sign of reinnervation was seen in only two versus four patients of the "positive" versus "negative" outcome group; 4) the relative amount of adipose tissue within the muscle decreased more markedly in the "positive" outcome group. The authors propose that both inactivity and axonal injury (mainly of neurapraxia type) contribute to the selective type 2 atrophy and inner structure changes in disc patients' multifidus muscle. These pathologic structural changes correlated well with the clinical outcome, and most importantly they are reversible and can be diminished by adequate therapy.

Adult↗
PubMed1988

An open comparison of propofol and enflurane for prolonged abdominal operations.

Anaesthesia in 15 patients scheduled for prolonged abdominal surgery was induced with hexobarbitone and maintained with nitrous oxide and enflurane, while in a further 15 patients propofol was used for induction and maintenance. Three patients in the latter group required additional fentanyl but cardiovascular responses were otherwise similar in the two groups. Return of consciousness, response to verbal command, ability to answer questions and adequate spontaneous ventilation was more rapid in the propofol patients. EEG power spectra also returned to baseline more rapidly in the propofol group.

Abdomen↗
PubMed2004

Reduction in the incidence of awareness using BIS monitoring.

BACKGROUND: Explicit recall (ER) is evident in approximately 0.2% of patients given general anaesthesia including muscle relaxants. This prospective study was performed to evaluate if cerebral monitoring using BIS to guide the conduction of anaesthesia could reduce this incidence significantly. PATIENTS AND METHODS: A prospective cohort of 4945 consecutive surgical patients requiring muscle relaxants and/or intubation were monitored with BIS and subsequently interviewed for ER on three occasions. BIS values between 40 and 60 were recommended. The results from the BIS-monitored group of patients was compared with a historical group of 7826 similar cases in a previous study when no cerebral monitoring was used. RESULTS: Two patients in the BIS-monitored group, 0.04%, had ER as compared with 0.18% in the control group (P < 0.038). Both BIS-monitored patients with ER were aware during intubation when they had high BIS values (> 60) for 4 min and more than 10 min, respectively. However, periods with high BIS = 4 min were also evident in other patients with no ER. Episodes with high BIS, 4 min or more, were found in 19% of the monitored patients during induction, and in 8% of cases during maintenance. CONCLUSIONS: The use of BIS monitoring during general anaesthesia requiring endotracheal intubation and/or muscle relaxants was associated with a significantly reduced incidence of awareness as compared with a historical control population.

Adolescent↗
PubMed2002

Radioguided surgery in primary hyperparathyroidism.

UNLABELLED: Surgical neck exploration is usually made in primary hyperparathyroidism (PHPT). Localization of the adenoma or detection of hyperplasia may reduce the operation period and limit the extent of the surgery. In this study the effficacy of preoperative Tc-99m MIBI scintigraphy and intraoperative gamma probe was evaluated. MATERIALS AND METHODS: Six patients with PHPT had preoperative Tc-99m MIBI parathyroid scintigraphy and intraoperative gamma probe (IGP) was used in surgical neck exploration. RESULTS: Parathyroid adenoma was observed in 2/6 patients on scintigraphy in the right retroclavicular region and the left lobe of the thyroid. Both of them were clearly detected by IGP during the surgery and easily removed by the surgeon in a short time (35 min) with a small incision. Pathologic examination confirmed the parathyroid adenoma. No abnormal MIBI uptake was not observed in scintigraphy in 4/6 patients. Subtotal parathyroidectomy was performed in these patients. CONCLUSION: Preoperative Tc-99m MIBI scintigraphy and the use of IGP may limit the exploration and also the operation time and reduce surgical complications.

Adenoma↗
PubMed1989

[Studies of parenteral fat emulsion clearance in peri-operative patients].

In a group of 24 peri-operative patients, all received total parenteral nutrition support (artificial gut support) for 11 days using a mixed energy source (50% from glucose and 50% from liposyn-2/intralipid). Intralipid was used in the fat clearance. A test dose of 10% or 20% Intralipid (Kabivitrum) was administered over a 5 hours period at a dosage of 0.17 +/- 0.017g fat/kg/h. The results show that after 11 days of fat infusion, the fat clearance was accelerated (P less than 0.05). One day after operation(POD + 1), the elimination of fat emulsion was also obviously accelerated (P less than 0.01). Blood chemistry values reflecting organ function did not change following fat emulsion infusion. In this prospective study, Chinese patients well tolerated 50% fat calorie TPN support in the peri-operative period. Patients received satisfactory parenteral nutrition support without high blood glucose side effects in the post-operative period.

Adult↗
PubMed1992

[The dynamics of the cerebral circulation during the surgical treatment of paragangliomas of the neck].

Clinical and rheoencephalographic studies ot 17 cases of paraganglioma of the neck revealed insufficient collateral blood circulation after compression of the common carotid artery on the affected side. In such cases, surgery carries a risk of brain ischemia. Improvement of collateral blood circulation was achieved by rheoencephalographically controlled compression of the common carotid artery performed daily with increasing duration. A patient was considered eligible for surgery if no signs of brain hemisphere ischemia were apparent following a 40% or less decrease in rheoencephalographic anacrotism amplitude from baseline. Common or internal carotid arteries were resected in 6 out of 17 cases of neck paraganglioma dissection. Adequate preoperative preparation prevented cerebral ischemia development in the postoperative period.

Adult↗
PubMed2003

Current management of common bile duct stones in a teaching community hospital.

The advent of laparoscopic cholecystectomy (LC) has complicated management of common bile duct (CBD) stones. While LC is routine, laparoscopic CBD exploration (LCBDE) is not, and an algorithm to manage suspected choledocholithiasis has not been uniformly accepted. We evaluated current management of choledocholithiasis. Patients suspected of having CBD stones over a 2-year period were evaluated, and 42 studies in the literature were reviewed. Thirty-two patients were identified. Fourteen patients (44%) had LC with intraoperative cholangiogram (IOC) with no preoperative studies. IOC revealed CBD stones in nine (64%). Seven had CBD exploration (CBDE) at cholecystectomy, and two had postoperative endoscopic retrograde cholangiopancreatography (ERCP). CBDE was successful in five cases, and ERCP was successful in one. Eighteen patients (56%) underwent preoperative ERCP. Five (28%) had no CBD stones. ERCP removed stones in nine patients, and four had open CBDE after failed ERCP. Current literature supports LC with IOC without any preoperative studies. Laparoscopic CBDE is highly successful but depends on surgeon experience. Removing CBD stones with ERCP is also very successful but is associated with increased cost, hospital stay, and complications. We conclude that LC with IOC should be performed without preoperative ERCP when choledocholithiasis is suspected. If found, stones should be removed laparoscopically if possible.

Adult↗
PubMed2005

[Nutrition of patients operated for complicated gastroduodenal ulcers at the early postoperative period].

The investigation is based on an analysis of results of treatment of 102 patients after an emergency resection of the stomach for complicated gastroduodenal ulcers. The probe was inserted into the jejunum intraoperatively. The period of enteral probe nutrition (EPN) was 5-7 days. At the early postoperative period in patients who had undergone the emergency resection of the stomach EPN is an effective method of nutrition maintenance as compared with the infusion-transfusion therapy. The method is simple and open to general use, and is economically advantageous under conditions of any hospital.

Adolescent↗
PubMed1999

Radiometric surface temperature measurements during dye-assisted laser skin closure: in vitro and in vivo results.

BACKGROUND AND OBJECTIVE: A thermal camera was used to measure surface temperatures during laser skin welding to provide feedback for optimization of the laser parameters. STUDY DESIGN/MATERIALS AND METHODS: Two-centimeter-long, full-thickness incisions were made in guinea pig skin in vitro and in vivo. India ink was applied to the incision edges, which were then mechanically apposed. Continuous-wave, 1.06-microm Nd:YAG laser radiation was scanned over the incisions, producing an effective pulse duration of approximately 100 msec. Cooling durations between scans of 1.6, 4.0, and 8.0 sec were studied in vitro. A 5-mm-diameter laser spot was used with the power kept constant at 10 W. Thermal images were obtained at 30 frames per second with a thermal camera detecting 3-5 microm radiation. Surface temperatures were recorded at 0, 1, and 6 mm from the center line of the incision. RESULTS/CONCLUSIONS: Cooling durations of 1.6 and 4.0 seconds in vitro resulted in temperatures at the weld site that remained above approximately 65 degrees C for prolonged periods of time. Cooling durations of 8.0 seconds were sufficient both in vitro and in vivo to prevent a significant rise in baseline temperatures at the weld site over time.

Animals↗
PubMed1983

Circulation, respiration and serotonin levels in carcinoid patients during neurolept anaesthesia.

Release of hormones peri-operatively in patients with metastatic carcinoids may lead to severe circulatory and respiratory disturbances. Fourteen patients with liver metastases were studied during 16 operations with a modified neurolept anaesthesia in order to evaluate the central haemodynamic and respiratory functions as well as plasma serotonin levels. The premedication in five patients was supplemented with levopromazine. During the 11 operations performed on patients not pretreated with levopromazine, no major significant fluctuations in circulatory or respiratory functions were recorded although big variations in serotonin plasma levels were measured. In the patients treated with levopromazine, however, significant changes were observed in heart rate, mean pulmonary artery pressure, cardiac index, and left and right ventricular stroke work especially during flushing episodes. However, these changes did not correlate with the changes in plasma serotonin levels. Modified neurolept anaesthesia without levopromazine pretreatment combined with careful monitoring seems to be a safe procedure for carcinoid patients. Using this type of anaesthetic procedure only one major complication occurred in connexion with 16 major operations and then in the postoperative period.

Adult↗
PubMed1985

Anesthetic implications of prolonged QT interval syndromes.

The prolonged QT interval syndromes consist of two forms, one congenital and one acquired. The congenital form is probably due to an imbalance in the sympathetic nervous system supply to the heart. It is a preventable cause of sudden death both at an early age and during anesthesia. Recognition of congenital forms of prolonged QT interval and treatment with beta-adrenergic blockers have reduced the mortality. Special care in the perioperative period is necessary to prevent anesthetic-related deaths. The acquired form has many causes. These may be present preoperatively or they may occur intraoperatively. It is important that patients with ALQTS are recognized early and the underlying cause treated.

Adrenergic beta-Antagonists↗