Can simple perioperative measures improve quality of recovery following ambulatory laparoscopic surgery in females? An open prospective randomised cohort study, comparing nutritional preoperative drink and chewing gum during recovery to standard care
ConclusionSimply providing 200 ml nutritional preoperative drink and chewing gum during recovery was found effective, improving patients assessed quality of recovery.
Editor ’s PerspectiveWhat We Already Know about This TopicCardiac output is an independent regulator of cerebral blood flow in healthy awake humansThe relationship between cardiac output and cerebral blood flow in anesthetized patients undergoing laparoscopy has not been previously characterizedWhat This Article Tells Us That Is NewAt steady-state depth of anesthesia, in patients undergoing laparoscopic cholecystectomy, creation of pneumoperitoneum decreased cardiac output and internal carotid artery blood flow while mean arterial pressure and end-tidal carbon dioxide levels remained unchangedBackground Little is kno...
Despite many advances in health care, managing pain in the post-anesthetic period continues to be a challenge. With more procedures being performed on an outpatient basis, shorter lengths of stay and drive to improve patient satisfaction, providers are looking for ways to enhance the surgical care experience and reduce opioid use. In addition, the increase burden of obesity in society has contributed to a rise in co-morbidities such as diabetes, cardiovascular, and gallbladder disease making laparoscopic cholecystectomies the second most frequently performed general surgery procedure in the United States.
Conclusion: This exploratory study found an enhanced inflammatory response to cholecystectomy in patients with SCA compared with patients with HbAA. Minimally invasive surgical strategies for this patient group may help to mediate this response. PMID: 31285651 [PubMed - in process]
CONCLUSION: In patients undergoing ambulatory laparoscopic surgery using a perioperative multimodal analgesic regimen, pain was the limiting factor for discharge in 1% of patients operated in an ambulatory set-up. FUNDING: none. TRIAL REGISTRATION: Danish Data Protection Agency: 2012-58-0004, Danish Health Authority: 3-3013-1435/1, Clinicaltrial.gov: NCT02782832. PMID: 31256774 [PubMed - in process]
Conclusion: No significant clinical interaction was revealed between dexamethasone and sugammadex during reversal of deep neuromuscular blockade in patients undergoing laparoscopic cholecystectomy.
We describe the case of a 12-year-old morbidly obese boy, without previous medical issues, scheduled for elective laparoscopic cholecystectomy. Immediately after pneumoperitoneum was established, mechanical ventilation could not be performed. Intraoperative exploration with flexible bronchoscopy showed that the tip of the endotracheal tube was nearly occluded by the posterior tracheal wall bulging anteriorly. Anesthesiologists should be aware of undiagnosed tracheomalacia as a cause of sudden airway collapse, even after the airway is secured with an endotracheal tube.
Conclusion: Single-dose PO APAP is non-inferior to IV APAP for postoperative analgesia in ASC laparoscopic cholecystectomy patients. The value of single-dose IV APAP in this population should be further explored. PMID: 31160871 [PubMed]
Conclusion: The LMA Protector was an effective ventilator device associated with fewer intraoperative hemodynamic stress responses and improved the quality of early recovery after laparoscopic cholecystectomy.
ConclusionsPreincisional subcutaneous OT administration reduced the hemodynamic response produced by the latter. Furthermore, OT also diminished postoperative pain.This article is protected by copyright. All rights reserved.
This study investigated whether intraocular pressure changes differed according to the body mass index of patients undergoing laparoscopic cholecystectomy. Methods: Thirty obese and 30 non-obese patients (body mass index cutoff point, 30 kg/m2) undergoing laparoscopic cholecystectomy were enrolled. Intraocular pressure was measured at baseline (T1), after induction of anesthesia (T2), 5 min after initiation of mechanical ventilation (T3), 5 min after pneumoperitoneum inflation (T4), 5 min after the patient was placed in the head-up position (T5), 5 min after deflation with the patient in the supine position (T6), and 5 min...