Simultaneous Bilateral Total Knee Arthroplasty Becomes Safer after Institution of Optimal Perioperative Management: A Longitudinal Cohort Study
This study aimed to evaluate whether optimal perioperative management could improve the safety of SBTKA. From 2005 to 2017, 1,166 cases of SBTKA were identified from 14,209 TKA procedures. We retrospectively examined the SBTKA patients' demographics, comorbidity profiles, procedure-related complications, and perioperative management during two time periods. Optimal perioperative workup for managing SBTKA significantly decreased the incidences of major complication from 6.2 to 2.4% (p = 0.001) and minor complications from 28.9 to 21.5% (p = 0.004) during period I and period II, respectively. The efficiency of less tourniquet use along with intraarticular tranexamic acid injection was demonstrated by the decreases of hemoglobin (Hb) change in the first 2 days after surgery (p = 0.005) and blood transfusion requirement (p = 0.035) during the SBTKA. Furthermore, the less tourniquet use group had less thigh pain (visual analog scale decreased from 6.0 to 4.2, p = 0.003), shorter duration of hospital stay (decreased from 7.8 to 7.1, p
ConclusionsPOD is a frequent complication in patients undergoing surgery with colorectal cancer. Several risk factors including history of psychiatric disease, transfusion, comorbidities, male gender, and old age were significant predictors for POD.
Publication date: Available online 18 October 2019Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): Jean-Stéphane David, Kenji Inaba
Publication date: Available online 13 June 2019Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): Pierre-Yves Cordier, Frédérik Bélot De Saint Leger, Stéphane Bégué, Éric Peytel, Christophe Martinaud
Conclusion: A dedicated pathway can be used to select patients with pulmonary hypertension for elective orthopaedic surgery and with careful patient selection and optimal perioperative care good outcomes can be achieved.
Hip and knee arthroplasties are routine orthopaedic procedures commonly associated with acute postoperative anemia, and in many cases requires an allogeneic or autologous blood transfusion. Several techniques have been used to limit postoperative blood loss and risk of transfusion. Tranexamic acid (TXA) is an antifibrinolytic agent that has fundamentally changed blood management in total joint arthroplasty (TJA) by making transfusion an infrequent event.
Hip and knee arthroplasties are routine orthopedic procedures commonly associated with acute postoperative anemia and in many cases require an allogeneic or autologous blood transfusion. Several techniques have been used to limit postoperative blood loss and risk of transfusion. Tranexamic acid (TXA) is an antifibrinolytic agent that has fundamentally changed blood management in total joint arthroplasty (TJA) by making transfusion an infrequent event.
Publication date: July 2018Source: British Journal of Oral and Maxillofacial Surgery, Volume 56, Issue 6Author(s): C. Wang, G. Fu, F. Liu, L. Liu, M. CaoAbstractThe aim of the study was to find out what perioperative risk factors predicted complications in patients having reconstructions with radial forearm free flaps (RFFF). We organised a retrospective study of 169 patients (mean (range) age 54 (22–86) years, 100 of whom were female) who had oral and maxillofacial tumours resected, and reconstructed with RFFF, from January 2011–December 2016. We recorded predictive variables, subdivided into: personal and cli...
CONCLUSION: These patients had a relatively short intraoperative course with stable vital parameters during surgery. We report a low incidence of significant venous air embolism, a blood transfusion rate of 21% and only minor perioperative disturbances in vital parameters. PMID: 29851178 [PubMed - as supplied by publisher]
BY KEVAL PATEL, &AHMED RAZIUDDIN, MDA 41-year-old man with a past medical history of bipolar disorder, PTSD, and alcohol abuse presented to the emergency department for an erection that wouldn't go away. He said his erection had persisted for 28 hours and was starting to be painful. He had taken trazodone the day before but was unable to recall the dosage. He denied any erectile dysfunction in the past when he was on trazodone a year before.Physical examination showed an uncomfortable-appearing man lying supine in bed but in no acute distress. The physical exam was normal except for the genitourinary exam, which rev...
Conclusions: Multilevel PVB was proved to be suitable as the main anesthesia for unilateral mini-invasive PCNL, providing feasible pain relief and quick postoperative recovery.Urol Int 2017;99:326-330