Severe Obesity and Sleep-Disordered Breathing as Risk Factors for Emergence Agitation in Pediatric Ambulatory Surgery.

Severe Obesity and Sleep-Disordered Breathing as Risk Factors for Emergence Agitation in Pediatric Ambulatory Surgery. J Perianesth Nurs. 2018 Jun;33(3):304-311 Authors: Reynolds T, Sankaran S, Chimbira WT, Phan T, Nafiu OO Abstract PURPOSE: Sleep-disordered breathing (SDB) may be a critical risk factor for emergence agitation (EA). We hypothesized that SDB diagnosis is a predictor of EA in children after general anesthesia for ambulatory surgery. DESIGN: Prospective, observational, cohort study. METHODS: Children aged 4 to 17 years were assessed for the occurrence of EA. Differences in probability of EA were assessed using multivariable logistic regression analyses. FINDINGS: Of 1,076 children, 66 (6.1%) had EA. Compared with those without EA, children with EA were younger (P
Source: Journal of Perianesthesia Nursing - Category: Nursing Authors: Tags: J Perianesth Nurs Source Type: research

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Publication date: Available online 14 February 2020Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): Audrey De Jong, Amélie Rollé, François-Régis Souche, Olfa Yengui, Daniel Verzilli, Gérald Chanques, David Nocca, Emmanuel Futier, Samir JaberAbstractThe obese patient is at risk of perioperative complications including difficult airway access (intubation, difficult or impossible ventilation), and postextubation acute respiratory failure due to the formation of atelectases or to airway obstruction. The association of obstructive sleep apnoea syndrome (OSA) with obesity is very ...
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
AbstractMorbidly obese individuals often require surgery, including bariatric (weight management) surgery. Acute pain management in the morbidly obese must consider the risk of chronic post-surgical pain, opioid dependence, and comorbidities (e.g. sleep-disordered breathing). A stepped, multimodal, opioid-sparing approach titrated to the type and severity of pain type should be taken, with co-administration of systemic and local anaesthetic agents when appropriate.
Source: Drugs and Therapy Perspectives - Category: Drugs & Pharmacology Source Type: research
A 40-year-old man was treated with tonsillectomy and underwent early surgical exploration because of bleeding. Postoperative bleeding complications were treated with bronchoscopy. In addition to obesity, normal thyroid function, type 2 diabetes mellitus, and current tobacco abuse with severe obstructive sleep apnea syndrome, biochemistry revealed severe hypercholesterolemia (total cholesterol 572 mg/dL) and hypertriglyceridemia (1,220 mg/dL). During the postoperative period, low doses of propofol (up to 2 mg/kg/h for 10 hours), along with remifentanil (up to 0.0016 mg/kg/h for 20 hours), midazolam, and tramadol, were neede...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
AbstractMorbid obesity (MO) is becoming increasingly prevalent worldwide and is associated with both altered physiology and increased co-morbidities. Together, these can render the perioperative pain management in patients with  MO particularly challenging. With the higher incidence of sleep-disordered breathing in this patient population, traditional opioid-centric pain management can often result in opioid-induced ventilatory impairment and increased morbidity and/or mortality. Multimodal analgesia strategies based o n a step-wise, severity-based, opioid-sparing approach can improve patient safety and...
Source: Drugs - Category: Drugs & Pharmacology Source Type: research
Abstract The prevalence of obesity has substantially increased worldwide during the last ten years. Hence, more anaesthetic procedures will be performed in obese patients in the future and more hospitals have to be prepared for the perioperative treatment of extremely obese patients including medical, technical and organisational issues. These include not only the management of the perioperative problems of adiposity, but also of its numerous concomitant diseases. Besides hyperlipidemia, diabetes mellitus, arterial hypertension and coronary heart disease, the obstructive sleep-apnea syndrome (OSAS) challenges the ...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - Category: Intensive Care Authors: Tags: Anasthesiol Intensivmed Notfallmed Schmerzther Source Type: research
IntroductionPlacement of spinal cord stimulation (SCS) paddles under general anesthesia using intraoperative neuromonitoring (IONM) has been shown to be associated with equivocal or superior clinical outcomes in comparative studies. The value of IONM in percutaneous permanent SCS placement has not been demonstrated.MethodsOutcomes for patients under percutaneous SCS placement performed with IONM were prospectively collected. Descriptive outcomes included numerical rating scale (NRS), the Oswestry disability index (ODI), McGill pain questionnaire, pain catastrophizing scale score (PCS), and Beck Depression Inventory. We als...
Source: Neuromodulation - Category: Neurology Authors: Tags: Clinical Research Source Type: research
Publication date: October 2018Source: Anaesthesia Critical Care &Pain Medicine, Volume 37, Issue 5Author(s): Florence Julien-Marsollier, Pierre Salis, Rachida Abdat, Thierno Diallo, Thierry Van Den Abbelle, Souhayl DahmaniAbstractIntroductionTonsillectomy is considered as a therapeutic option in obstructive sleep apnoea syndrome (OSAS). Postoperative respiratory failure is a complication that can require respiratory support. The main objective of our study is to determine risk factors of postoperative respiratory complications in children undergoing tonsillectomy.Material and methodsThis is a retrospective single centr...
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
Publication date: December 2017Source: Best Practice &Research Clinical Anaesthesiology, Volume 31, Issue 4Author(s): Adrian Sultana, David Torres, Roman SchumannOpioid-free anaesthesia (OFA) is a technique where no intraoperative systemic, neuraxial or intracavitary opioid is administered with the anaesthetic. Opioid-free analgesia similarly avoids opioids in the perioperative period.There are many compelling reasons to avoid opioids in the surgical population.A number of case reports and, increasingly, prospective studies from all over the world support its benefits, especially in the morbidly obese population with o...
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
CONCLUSION No major relationship has been demonstrated between SNP of OPRM1, ABCB1, COMT and morphine requirement, pain level or adverse effects in the postoperative period. TRIAL REGISTRATION NCT00822549 (www.clinicaltrials.gov).
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Genetics Source Type: research
Publication date: December 2017 Source:Best Practice & Research Clinical Anaesthesiology, Volume 31, Issue 4 Author(s): Adrian Sultana, David Torres, Roman Schumann Opioid-free anaesthesia (OFA) is a technique where no intraoperative systemic, neuraxial or intracavitary opioid is administered with the anaesthetic. Opioid-free analgesia similarly avoids opioids in the perioperative period. There are many compelling reasons to avoid opioids in the surgical population. A number of case reports and, increasingly, prospective studies from all over the world support its benefits, especially in the morbidly obese population ...
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research
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