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Results for “Anesthesia--contraindications”

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PubMed1999

Anesthetic considerations in hepatic porphyrias.

Porphyrias are inherited defects of heme synthesis with manifestations that can mimic surgical diseases; they can be provoked by administration of certain drugs. Manifestations such as abdominal pain, vomiting, tachycardia, hypertension, neuropathy, fever, confusion, and seizures have been described. Management of patients with porphyria is designed to avoid triggering drugs, such as barbiturates, and perhaps, benzodiazepines and ketamines. Nontriggering drugs should be used in the management of patients with porphyria. Because starvation can induce an attack, glucose infusions are important in the prevention and treatment of porphyria.

Anesthesia↗
PubMed1999

Anaesthetic assessment and management of cardiac patients for non-cardiac surgery. Part I: Assessment.

Cardiac disease is known to increase the risk of non-cardiac surgery to patients who suffer from it. Clinical and investigation data may be used to identify those at increased risk. Attempts have been made to integrate these risk factors into systems that can quantify risk in terms of increased morbidity and mortality. In this article we discuss the various aspects of cardiac illness that are known to increase risk for patients and then look at the different scoring systems that have been produced. We consider the type and urgency of surgery and finish by providing an approach to risk assessment for non-cardiac surgery.

Anesthesia↗
PubMed1999

[In the year 2000, are there still anesthesiologic contraindications for laparoscopic abdominal surgery?].

Indications for laparoscopic surgery have been extended in the last ten years. Patients with several organ failures may also benefit of such technique. Therefore, it seems interesting to study and analyse the interactions between clinical status and the consequences of intra-abdominal gas insufflation. Because the postoperative benefits of laparoscopic surgery are notable, this technique is more and more proposed to old patients. The only imperative is to anticipate medical problems.

Abdomen↗
PubMedDate not supplied

Emergency non-obstetrics surgery during pregnancy.

Female constitute the majority of the population in Nigeria according to the 1991 census. Since most of these are young women in childbearing age, it is to be expected that the need for emergency, non-obstetric surgery will occasionally arise in them. This review article sets out a consideration of the anatomical and physiological factors that influence presentation, diagnosis therapy and outcome in these patients. The various common clinical scenarios are discussed and their outcome reviewed.

Anesthesia↗
PubMedDate not supplied

[Thalassemic syndromes and anesthesia].

Thalassemic syndromes are produced by a quantitative defect in the synthesis of globin chains of hemoglobin. They are classified according to the severity of the clinical picture and to the type of globin chain that is affected. Physiopathology, clinical picture, and treatment of thalassemias are discussed in this work. Thalassemia minor does not create, in general, anesthetic problems. In cases of thalassemia major one should consider not only problems derived from the severity of the anemia it self, but also those related to transfusional therapy, and to bony malformations that may disturb tracheal intubation. Discussion on the management of homozygotic thalassemia during the pre, per, and postoperative phase completes this revision.

Adult↗
PubMed1990

[Criteria for selection and contra-indications of ambulatory surgery].

Ambulatory surgery means to us the scheduled surgery and investigations carried out under various modes of anaesthesia in patients who are admitted in the morning and discharged in the evening. Now the strictness and guarantees required and the essential conditions of safety and efficiency can only be achieved if a number of selection criteria and contraindications are complied with. The authors first study the lesions for which ambulatory treatment is possible, as well as the criteria regarding both the patient and the attending physician responsible for the follow-up at home. Since a close co-operation between the anaesthesist and the surgeon proves to be essential, the criteria of anaesthesia must also be dealt with. The contraindications are connected to the type of surgery, to the type of anaesthesia, to the patient, to the patient's circle, to the medical team, and finally to the equipment and organization of the unit in which ambulatory surgery is performed. These many aspects of the problem are analyzed and discussed.

Ambulatory Surgical Procedures↗
PubMed1995

[Ambulatory surgery in the hospital--analysis of a 1978-1994 patient sample].

In the outpatient department of the University hospital of the Technology University Dresden ambulatory surgery has been performed since 1965. The patients of 16 years were analyzed. From 1978 till VI/1994 we have carried out 13948 elective operations. The personal wish of a cooperative patient without risk factors and an orderly social surrounding are the prerequisites for carrying out outpatient operations. Applied anaesthetic techniques were: general anaesthesia 9.2%, spinal anaesthesia 7.1%, sacral anaesthesia 14.8%, nerveblock of the upper extremity 11.1 and infiltration anaesthesia 57.8%. On the day of operation 61 patients had to be admitted to the hospital because of intraoperative events, expansion of the operation and complications of anaesthesia. Between the first to eight postoperative day 23 patients were hospitalised due to bleeding and 1 patient due to a wound infection. After aseptic elective operations 33 patients (0.35%) and after proctology operations with primary wound closure 10% of the patients developed wound infections. The cooperation of the general practitioner must be ensured in the post-operative days. Outpatient operations lower the financial burden of the health insurance companies, medical care services can be reduced.

Adolescent↗
PubMed1993

[Evaluation of the anesthetic risk in patients with coronary disease prior to non-cardiac surgery].

Evaluation of operative risk in coronary artery disease patients before non-cardiac surgery is a frequent problem concerning 100,000 patients each year in France. Perioperative cardiac morbidity is the first cause of death associated with non-cardiac surgery, with infarction rates of the order of 1 to 2% in coronary disease patients. These infarcts are followed by the death of the patient in 25 to 50% of cases. Evaluation of anesthetic risk is based upon three points: type of surgery, clinical findings and results of investigations. The risk is markedly increased in emergency surgery, and in thoracic, intraperitoneal and above all vascular surgery, in particular when clamping of the aorta is involved. From a clinical standpoint, only a history of infarction and signs of peripheral cardiac failure are independent predictive factors of postoperative complications. Other criteria, e.g. age, uncontrolled hypertension, diabetes and above all the severity of angina are also associated with the onset of perioperative-complications. This evaluation can be refined by electrocardiogram (Q wave, ST segment anomalies, ventricular hypertrophy and left bundle branch block) and chest X-ray. The usefulness and predictive value of exercise tests, when possible in a preoperative context, are particularly precious when the result is positive at low work-load. Many publications have studied the value of myocardial isotope scan, in particular before vascular surgery. They report the excellent negative predictive value (95 to 100%) of this investigation. Furthermore, the predictive value of isotope scan is all the greater when the clinical risk factors seen in the patients and the number of areas with ischemia are taken into account.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗
PubMed1993

An introduction to the automatic implantable cardioverter-defibrillator and its anesthetic implications.

This paper presents a description of the automatic implantable cardioverter-defibrillator (AICD), as well as information pertaining to indications for its use, patient selection criteria, surgical implantation techniques, and anesthetic implications. A brief historical overview of the development of the AICD is included. Complications, indications, and contraindications associated with the device are discussed.

Anesthesia↗
PubMed1997

Direct listing for adult tonsillectomy.

Health care economic efficiency is important. Adult tonsillectomy is a common operation. The decision to operate is made at an out-patient consultation and is based on information in the general practitioner's (GP) referral letter. This study aims to define what proportion of adult tonsillectomies are suitable for listing with an out-patient consultation (direct listing). GPs were informed of the indications (six episodes of tonsillitis in the last year) and contraindications (tonsillectomy for another reason and general ill health) for direct listing. All referrals for 1 year were screened by an otolaryngologist and suitable patients were listed directly. Patients were then reviewed in the anaesthetic pre-admission clinic and inappropriate listings were cancelled and reasons noted. Of all patients, 50% were suitable for direct listing. Of these 3% were later deemed inappropriate. None of the cancellations were due to a flaw in the direct listing process. This would result in savings to the NHS of 2 million pounds per annum.

Adult↗