Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Intraoperative Period”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 451 records · Page 25Linked to original sources
PubMed1984

Calorimetrical comparison of insulative properties of metalized plastic, clear polyethylene, and polyester blanket.

The thermal insulation properties of metalized plastic sheeting (MPS), clear polyethylene sheeting (CPS) and 100 per cent polyester thermal bed blanket (TBB) were tested and compared quantitatively using direct calorimetry. The experiments were carried out on individual subjects sitting in a whole body calorimeter and covered first with a TBB bag up to the neck. Then the three materials were tested, one at a time, over the original TBB up to the neck. The temperature of the calorimeter was set at normal operating room temperature of 18 degrees C. MPS provided the greatest reduction in sensible heat loss (SHL) of all three materials tested. The total SHL saving provided by an MPS over TBB was 29.7 per cent and was statistically highly significantly different from that provided by a CPS or TBB over TBB (the difference is 9.6 and 9.9 per cent, respectively, p less than 0.001 for both). While the SHL saving provided by a CPS over TBB was 20.1 per cent, and a TBB over TBB was 19.8 percent, the difference of 0.3 per cent is statistically not significant (p greater than 0.5). An additional finding was that MPS is electrically conductive on one side. Precautions must be taken when it is used on patients connected to electrical devices. Also, insensible perspiration trapped inside the bag can be as much as 10 g X hour-1 and may become a problem when the patient is wrapped in MPS for an extended period of time.

Body Temperature Regulation↗
PubMed2002

[Perioperative management of blood loss during surgical treatment for craniosynostosis].

Blood saving is the major challenge during the surgical repair of craniofacial deformities. Treated patients have a low reserve volume and the techniques available to lower homologous blood transfusions are limited or insufficiently evaluated in this particular case. The most important factor determining blood loss is the quality of the surgical haemostasis. Blood saving begins with early preoperative evaluation of the patient's bleeding risk, which is a function of the type of surgery, of the surgical technique, of the number of sutures involved, of the length of surgery, and of the patients age, weight and physical status. Elaborated blood saving techniques such as preoperative autologous blood donation, erythropoietin administration, normovolaemic haemodilution, and peroperative autologous blood saving and reinfusion have revealed disappointing where used alone. These techniques require a heavy setup and still need to be evaluated extensively. They should be used in selected cases such as in patients with a very high risk of bleeding or face to Jehovah Witnesses. Monitoring during surgery should include precise evaluation of blood losses and haematocrit measurements at regular intervals. The haematocrit threshold allowing homologous blood transfusion should be set at 21%, provided that any other source of autologous blood is exhausted. Postoperative monitoring should also include precise evaluation of blood losses and haematocrit measurements. The 21% threshold should remain the reference during that period.

Blood Loss, Surgical↗
PubMed1999

Target-controlled propofol vs. sevoflurane: a double-blind, randomised comparison in day-case anaesthesia.

We compared target-controlled propofol with sevoflurane in a randomised, double-blind study in 61 day-case patients. Anaesthesia was induced with a propofol target of 8 microgram.ml-1 or 8% sevoflurane, reduced to 4 microgram.ml-1 and 3%, respectively, after laryngeal mask insertion and subsequently titrated to clinical signs. Mean (SD) times to unconsciousness and laryngeal mask insertion were significantly shorter with propofol [50 (9) s and 116 (33) s, respectively] than with sevoflurane [73 (14) s and 146 (29) s; p < 0.0001 and p = 0.0003, respectively]; however, these differences were not apparent to the blinded observer. Propofol was associated with a higher incidence of intra-operative movement (55 vs. 10%; p = 0.0003), necessitating more adjustments to the delivered anaesthetic. Emergence was faster after sevoflurane [5.3 (2.2) min vs. 7.1 (3.7) min; p = 0.027], but the inhaled anaesthetic was associated with more nausea and vomiting (30 vs. 3%; p = 0.006), which delayed discharge [258 (102) min vs. 193 (68) min; p = 0.005]. Direct costs were lower with sevoflurane but nausea would have increased indirect costs. Patient satisfaction was high (>/= 90%) with both techniques. In conclusion, both techniques had advantages and disadvantages for day-case anaesthesia.

Adolescent↗
PubMed1998

Preoperative preparation programs in children: a comparative examination.

UNLABELLED: We sought to determine whether an extensive behavioral preparation program for children undergoing surgery is more effective than a limited behavioral program. The primary end point was child and parent anxiety during the preoperative period. Secondary end points included behavior of the child during the induction of anesthesia and the postoperative recovery period. Several days before surgery, children (n = 75) aged 2-12 yr randomly received either an information-based program (OR tour), an information + modeling-based program (OR tour + videotape), or an information + modeling + coping-based program (OR tour + videotape + child-life preparation). Using behavioral and physiological measures of anxiety, we found that children who received the extensive program exhibited less anxiety immediately after the intervention, in the holding area on the day of surgery, and on separation to the operating room. These findings, however, achieved statistical significance only in the holding area on the day of surgery (44[10-72] vs 32[8-50] vs 9[6-33]; P = 0.02). Similarly, parents in the extensive program were significantly less anxious on the day of surgery in the preoperative holding area, as assessed by behavioral (P = 0.015) and physiological measures (P = 0.01). In contrast, no differences were found among the groups during the induction of anesthesia, recovery room period, or 2 wk postoperatively. We conclude that children and parents who received the extensive preoperative preparation program exhibited lower levels of anxiety during the preoperative period, but not during the intraoperative or postoperative periods. IMPLICATIONS: The extensive behavioral preoperative program that we undertook had limited anxiolytic effects. These effects were localized to the preoperative period and did not extended to the induction of anesthesia or the postoperative recovery period.

Anxiety↗
PubMed1985

Role of sodium hyaluronate (Healonid) in triangular flap trabeculectomy.

The role of sodium hyaluronate (Healonid) in trabeculectomy to prevent a shallow or flat anterior chamber and hypotonia in the immediate postoperative period is reported. Twenty-nine eyes of 27 patients were included in a randomised controlled study. Thirteen eyes had trabeculectomy alone, and 16 eyes had trabeculectomy performed with Healonid injected into the anterior chamber. The results showed that shallowing of the anterior chamber and hypotonia occurred in both groups until day 21 postoperatively. There was no statistically significant difference between the two groups (p greater than 0.05). Healonid has no significant value in maintaining anterior chamber depth and preventing hypotonia in the early postoperative period following trabeculectomy.

Aged↗
PubMed1998

Lipoprotein(a) changes during and after coronary artery bypass grafting: an epiphenomenon?

The lipoprotein(a) (Lp(a)) time course during and after coronary artery bypass grafting was examined in 20 caucasoid patients, in relation to the time courses of serum cholesterol and serum triglycerides. Samples were taken at eight different time points. Baseline geometric means (SD) for Lp(a), cholesterol and triglycerides were 115 (336) mg/L, 5.73 (1.10) mmol/L and 1.73 (1.21) mmol/L, respectively. Up to 10 min after cardiopulmonary bypass (CPB) and after correction for haemodilution, no observable effect of CPB on serum concentrations of Lp(a) could be demonstrated, whereas serum concentrations of total cholesterol and triglycerides showed a progressive and significant decline. Ten minutes after stopping CPB geometric means for cholesterol and triglyceride were 3.90 (0.82) and 0.90 (0.58) mmol/L, respectively. At the third post-operative day geometric Lp(a) and cholesterol means decreased to 62(90) mg/L and 2.97 (0.84) mmol/L, respectively, while triglycerides went up. It is concluded that Lp(a) levels remain constant during CPB, but mimic total cholesterol changes in the post-CABG period.

Adult↗
PubMed1983

Alteration in thyroid hormone concentration during and after coronary bypass operation.

The effect of a surgical stress on serum TSH, T4, free T4, T3, rT3 and TBG was measured before, during and after a coronary bypass operation. Precautions were taken to age, sex, pre-operative nutritional state, anamnestic illness, pre- and post-operative medication. Compared to the pre-operative period TSH increased during operation and normalized at the first post-operative day, while only minor alterations for total and free serum T4 were observed. T3 and rT3 declined at the start of extracorporal circulation, T3 remained reduced during the post-operative period, while rT3 reached its pre-operative value at the first post-operative day. It is concluded that the coronary bypass operation evokes a rapid decline in T3, which is not normalized by the TSH induced response of the thyroid gland, while the post-operative period is characterized by a "low T3 state". The clinical relevance of this finding is discussed with respect to the cardiovascular and the nutritional state of the patients in the post-operative period.

Adult↗
PubMed1992

[Perioperative blood glucose levels in children].

The perioperative blood glucose (BG) level may represent autonomic responses to various stresses by anesthesia and surgery. We studied the effects of regional blocks combined with general anesthesia on the BG response in pediatric patients. We could not find any significant differences in BG levels between blocked and non-blocked patients. However, BG levels of the children who had been hysterical or crying during the induction of anesthesia were significantly higher than those of the children who had been calm or sleeping. Forty healthy children, aged 1-3 yrs who were scheduled for elective urological surgery were studied. Anesthesia was induced with halothane in oxygen. The anesthesiologist recorded the children's attitude before and during the induction of anesthesia, and described as "calm or asleep (Calm-group), and hysterical or crying (Crying-group)". Patients were assigned randomly to two groups as follow; Group A (n = 20): receiving nerve blocks, Group B (n = 20): without the blocks. The anesthesia was maintained with 1-2.5% halothane in oxygen required to maintain the hemodynamic parameters within 10% of baseline value before surgery. Both groups received lactated-Ringer's solution during the study period. The venous BG levels were determined 5 times, i.e. immediately after asleep, 5, 15, 30 minutes after skin incision and at the conclusion of surgery. BG levels were compared between groups using Mann-Whitney Test. There was no significant difference in BG levels between Group A and B throughout the study period. But BG values of Crying-group (n = 9) were significantly higher than those of Calm-group (n = 31) during perioperative period.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Inhalation↗
PubMed1989

[Interaction of nimodipine and isoflurane in surgery of intracranial aneurysm].

A moderate controlled hypotension has been performed with isoflurane in the presence of nimodipine (4 mg.h-1) on ten patients anesthetized for cerebral aneurysm clipping. The administration of both drugs induced a dose-dependent hypotension secondary to the reduction of the systemic vascular resistance without impairment of cardiac index. Nimodipine did not modify the cardiovascular effects of isoflurane. It is concluded that intravenous administration of nimodipine should be continued during the operative period.

Drug Interactions↗
PubMedDate not supplied

Arterial reconstruction for distal disease of the lower extremities by the in situ vein graft technique.

From January 1st, 1975 to December 31st, 1979, 285 femoropopliteal and femorocrural bypasses have been performed in 260 patients. In 57% of all cases the operation was carried out for limb salvage. The first 100 in situ transplants were angiographically examined 2 years after the operation. 5 years after the operation all patients were examined clinically, angiologically and by ultra sound Doppler technique. The patency rate amounts to 84% after 2 years and 76% after 5 years. With a patency rate of 57% after 2 years and 38% after 5 years the results achieved in the revascularization of a single crural artery are much more unfavourable. The results may be compared with those demonstrated by other authors who use the in situ technique. Compared to the classical venous bypass, the in situ bypass comes off a little better after a five years period.

Aged↗
PubMed1996

[Assessment of cardiac functions in patients for coronary artery bypass graft using transesophageal echocardiography before and after cardiopulmonary bypass].

We evaluated cardiac functions in 7 patients for elective coronary artery bypass graft surgery before and after cardiopulmonary bypass (CPB) using transesophageal echocardiography (TEE). There was no significant difference in the ratio of end-systolic meridional wall stress (ESS) and end-systolic area (ESA), which is a good indicator of cardiac contractility, before and after CPB period. However, left ventricular stroke work index (LVSWI) decreased after CPB compared to that before CPB. There was a positive correlation between the ESS/ESA ratio after induction of anesthesia and left ventricular ejection fraction at the pre-operative study. As the ESS/ESA ratio represents cardiac contractility and the ESS is a reliable indicator of afterload, we thought it possible to assess cardiac contractility and precise afterload by using TEE during perioperative period.

Aged↗
PubMed2006

Tissue oxygenation response to mild hypercapnia during cardiopulmonary bypass with constant pump output.

BACKGROUND: Tissue oxygenation is the primary determinant of wound infection risk. Mild hypercapnia markedly improves cutaneous, subcutaneous (s.c.), and muscular tissue oxygenation in volunteers and patients. However, relative contributions of increased cardiac output and peripheral vasodilation to this response remains unknown. We thus tested the hypothesis that increased cardiac output is the dominant mechanism. METHODS: We recruited 10 ASA III patients, aged 40-65 yr, undergoing cardiopulmonary bypass for this crossover trial. After induction of anaesthesia, a Silastic tonometer was inserted s.c. in the upper arm. S.C. tissue oxygen tension was measured with both polarographic electrode and fluorescence-based systems. Oximeter probes were placed bilaterally on the forehead to monitor cerebral oxygenation. After initiation of cardiopulmonary bypass, in random order patients were exposed to two arterial CO(2) partial pressures for 30 min each: 35 (normocapnia) or 50 mm Hg (hypercapnia). Bypass pump flow was kept constant throughout the measurement periods. RESULTS: Hypercapnia during bypass had essentially no effect on Pa(CO(2)) , mean arterial pressure, or tissue temperature. Pa(CO(2)) and pH differed significantly. S.C. tissue oxygenation was virtually identical during the two Pa(CO(2)) periods [139 (50-163) vs 145 (38-158), P=0.335] [median (range)]. In contrast, cerebral oxygen saturation (our positive control measurement) was significantly less during normocapnia [57 (28-67)%] than hypercapnia [64 (37-89)%, P=0.025]. CONCLUSIONS: Mild hypercapnia, which normally markedly increases tissue oxygenation, did not do so during cardiopulmonary bypass with fixed pump output. This suggests that hypercapnia normally increases tissue oxygenation by increasing cardiac output rather than direct dilation of peripheral vessels.

Adult↗
PubMed1989

The role of nicardipine during anesthesia and surgery.

The stresses of the perioperative period often requires the use of vasoactive drugs for hemodynamic control. Nicardipine hydrochloride is a short-acting dihydropyridine calcium antagonist with a unique configuration and characteristics that make it attractive for intraoperative and postoperative use. Nicardipine has highly specific modes of action, producing coronary and systemic vasodilation, a reduction in coronary spasm, and cardioprotection not consistently seen with other calcium antagonists. It produces a rapid decrease in blood pressure without severe hypotension, sinus arrest, cardiac depression, or clinically significant tachycardia, while it increases myocardial contractility and cardiac output. Nicardipine dilates the cerebral vasculature but does not significantly increase cerebrospinal fluid pressure in surgical patients without intracranial lesions. Unlike nifedipine, which must be administered orally or sublingually, nicardipine is stable in parenteral formulation ("light stable and water soluble") and can be given intravenously. The distinctive characteristics of nicardipine suggest that anesthesiologists might find it preferable to other vasodilators or calcium antagonists for hemodynamic control during and after surgery.

Anesthesia↗
PubMed2005

The effects of acute isovolemic hemodilution on oxygenation during one-lung ventilation.

Data on the effects of isovolemic hemodilution (IH) on oxygenation during one-lung ventilation (OLV) are lacking. We studied 47 patients with hemoglobin >14 g/dL who were scheduled for lung surgery (17 with normal lung function [group NL], 17 with chronic obstructive pulmonary disease [COPD] [group COPD], and 13 with COPD as control for time/anesthesia effects [group CTRL]). Anesthesia was standardized. The tracheas were intubated with a double-lumen tube. Ventilatory settings and fraction of inspired oxygen remained constant. The study was performed with patients in the supine position before surgery. OLV was initiated for 15 min. Two-lung ventilation was reinstituted, and IH was performed (500 mL); an identical volume of hydroxyethyl starch was administered. Subsequently, OLV was again performed for 15 min. In group CTRL, the same sequences of OLV were performed without IH. At the end of each period of OLV, pulmonary mechanics and blood gases were recorded. Data were analyzed by analysis of variance (mean +/- sd). In group NL and group CTRL, the arterial oxygen partial pressure remained constant, whereas it decreased in group COPD from 119 +/- 21 mm Hg before IH to 86 +/- 16 mm Hg after IH (P <0.01). Mild IH impairs gas exchange during OLV in COPD patients, but not in patients with normal lung function.

Aged↗
PubMed2001

Randomized prospective double-blind placebo-controlled trial of effect of intravenous ondansetron on intraocular pressure during ophthalmic surgery.

The effect of i.v. ondansetron, before induction of anaesthesia, on intraocular pressure (IOP) in patients undergoing cataract surgery was investigated. Forty patients (two groups of 20) received either ondansetron 4 mg (treatment group) or 0.9% saline (placebo group) in a double-blind controlled manner. There were no significant differences in IOP between the groups. Ondansetron had no significant effect on IOP during the study period.

Adult↗
PubMed1982

Acebutolol and coronary artery surgery. Plasma levels following oral pre-operative treatment.

Plasma levels of acebutolol and its major human metabolite, diacetolol, were determined before, during and after aortocoronary bypass grafting in 10 patients who had received a chronic oral regimen of acebutolol 200 mg t.d.s. for at least 6 days before surgery, a 200 mg dose with the premedication and 5-10 mg intravenously immediately before intubation. It was found that this regimen produced beta-adrenoceptor antagonist levels which were within the range in which attenuation of hypertension and tachydysrhythmia occurs. These effective plasma levels were sustained throughout surgery and persisted into the early recovery period.

Acebutolol↗