39-year-old male with obesity and obstructive sleep apnea scheduled for knee joint surgery : Preparation for the medical specialist examination: part 37.

[39-year-old male with obesity and obstructive sleep apnea scheduled for knee joint surgery : Preparation for the medical specialist examination: part 37]. Anaesthesist. 2019 Oct 17;: Authors: Lewandowski K PMID: 31624879 [PubMed - as supplied by publisher]
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research

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Abstract Obstructive sleep apnea (OSA) has a prevalence of up to 5% in children and 50% in obese children. OSA is associated with various comorbidities in the general population and in the perioperative period. In this review, we will provide background of OSA and insights into the available treatment options both surgically and medically. Unlike adults, most pediatric OSA are treated with adenotonsillectomy. Continuous positive airway pressure therapy is the commonly used medical treatment. Management of pediatric OSA is multidisciplinary. We will discuss the surgical options and medical options of managing pedia...
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
Publication date: Available online 23 November 2019Source: American Journal of OtolaryngologyAuthor(s): Michael Eggerstedt, Matthew J. Urban, Emily Chi, Ethan M. Ritz, Phillip LosavioAbstractPurposeDrug-induced sleep endoscopy (DISE) is a cost-effective, safe, and reliable tool to evaluate obstructive sleep apnea (OSA) patients by revealing upper airway sites, patterns, and severity of obstruction. DISE provides valuable data because reliable evaluation of the OSA airway while awake has remained elusive. Few studies (with mixed results) have analyzed the correlation between pre-operation, awake airway assessments routinely...
Source: American Journal of Otolaryngology - Category: Endocrinology 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
Purpose of review Although both cost and patient preference tend to favor the office-based setting, one must consider the hidden costs in managing complications and readmissions. The purpose of this review is to provide an update on safety outcomes of office-based procedures, as well as to identify common patient-specific factors that influence the decision for office-based surgery or impact patient outcomes. Recent findings Office-based anesthesia (OBA) success rates from the latest publications of orthopedic, plastic, endovascular, and otolaryngologic continue to improve. A common thread among these studies is the a...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: AMBULATORY ANESTHESIA: Edited by Claude Meistelman Source Type: research
This article presents a super obese patient (BMI 57 kg/m2) with drug-refractory epilepsy and obstructive sleep apnea who underwent left anterior temporal lobectomy through awake craniotomy to preserve language and memory, using warmed humidified high flow nasal cannula (HFNC) oxygen therapy. Awake craniotomy was facilitated by the use of HFNC, which proved essential to prevent airway collapse by creating continuous positive airway pressure through high flow and facilitated intraoperative neurologic language and memory testing while maintaining adequate oxygenation. PMID: 31686115 [PubMed - as supplied by publisher]
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
Authors: De Jong A, Verzilli D, Chanques G, Futier E, Jaber S Abstract The obese patient is at an increased risk of perioperative complications. Most importantly, these include difficult access to the airways (intubation, difficult or impossible ventilation), and post-extubation respiratory distress secondary to the development of atelectasis or obstruction of the airways, sometimes associated with the use of morphine derivatives. The association of obstructive sleep apnea syndrome (OSA) with obesity is very common, and induces a high risk of peri- and postoperative complications. Preoperative OSA screening is cruc...
Source: Revue des Maladies Respiratoires - Category: Respiratory Medicine Tags: Rev Mal Respir Source Type: research
This study evaluated the validity of existing OSA screening tools in a cohort of extremely obese pregnant women [body mass index (BMI) ≥40 kg/m2] and determined what screening factors were most strongly associated with OSA in this cohort.
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Mechanisms, Equipment, Hazards Source Type: research
This study demonstrated ultrasonography in predicting difficult laryngoscopy lacked utility. Ultrasound utilization as an efficacious means of difficult airway assessment requires further research with a larger sample size. Further studies using sonography on those patients with known difficult airways may provide data to determine if ultrasound has utility in predicting difficult laryngoscopy.
Source: Trends in Anaesthesia and Critical Care - Category: Anesthesiology Source Type: research
Obstructive sleep apnea (OSA) is a disorder characterized by breathing cessation caused by obstruction of the upper airway during sleep. It is associated with multiorgan comorbidities such as obesity, hypertension, heart failure, arrhythmias, diabetes mellitus, and stroke. Patients with OSA have an increased prevalence of ophthalmic disorders such as cataract, glaucoma, central serous retinopathy (detachment of retina, macular hole), eyelid laxity, keratoconus, and nonarteritic anterior ischemic optic neuropathy; and some might require surgery.
Source: Journal of Cataract and Refractive Surgery - Category: Opthalmology Authors: Tags: Review/update Source Type: research
Purpose of review With new medical technologies and changing life styles, maternal demographics has changes and consequently older and sicker women are becoming pregnant. In this review, we present these different high-risk parturient populations, which were once considered rare for the practicing obstetric anesthesiologist. Recent findings With lifestyle and medical advances, older and sicker women are getting pregnant. Older women are more prone to pregnancy complications. Cancer survivors are becoming pregnant and more pregnant women are being diagnosed with cancer. Previous neurological and cardiac conditions con...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Emilia Guasch and Manuel Wenk Source Type: research
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