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 523 records · Page 29Linked to original sources
PubMed1997

[Recent advances in adjuvant chemotherapy in colonic cancers].

Carcinoma of the large bowel is one of the most common malignant disease. In France, 15,000 died each year from the metastatic or locoregional progression of this cancer. In the past, effective surgical adjuvant therapy has been an elusive goal with no evidence of benefit from chemotherapy or immunotherapy. However, a meta-analysis published in 1988 showed that one-year adjuvant chemotherapy using 5-fluorouracil (5-FU) containing regimens may slightly improve survival. Accelerated progress has been made since 1990: in colon cancer with regional nodal metastasis (stage C tumor), therapy with combined 5-FU and levamisole has resulted in a 33% reduction in the death rate. Controlled clinical trials demonstrated improved tumor response rates when the combination of 5-FU and leucovorin was compared with single-agent 5-FU in patients with metastatic colorectal cancer. Recent results indicate that this combination is effective in preventing tumor relapse and improving survival in patients with high risk colon cancer (especially stage C tumor). The comparison of 5-FU and leucovorin to 5-FU and levamisole is ongoing; the preliminary results of these controlled trials showed that 6 months of adjuvant therapy with 5-FU and leucovorin is as effective as the standard 12 months 5-FU and levamisole regimen and less toxic. No clear adjuvant benefit has been established in patients with Dukes' stage B2 colon cancer. The lack of statistical power of the trials and the 80% overall survival rate of these patients may explain these negative results. Almost all the specialists of these tumors considered that it is possible to select patients who are at sufficiently high risk of recurrence so that treatment can be justified. These patients are those who presented initially with tumor perforation or obstruction, adherence to or invasion of adjacent organs, young patients. Clinical trials suggest a survival benefit from the direct portal administration of the 5-FU in the immediate post-operative period, although the magnitude of the effect is less than that seen in the systemic therapy trials.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Pharmacologic pupillary modulation in the perioperative period.

The perioperative management of the pupil is essential to the success of anterior segment surgery. A new dilating regimen was tested in 65 cases of cataract extraction and intraocular lens implantation. The alpha-adrenergic agonist, phenylephrine 2.5%, was used after pretreatment with the adrenergic beta-blocker, timolol 0.5%. This treatment successfully dilated the pupil in all but three cases, was maintained by intraoperative epinephrine infusion, and was readily reversed with intraocular acetylcholine. We conclude that this pharmacologic regimen provided a successful and easily reversible mydriasis during surgery.

Acetylcholine↗
PubMedDate not supplied

[Platelet changes during heart surgery with extracorporeal circulation].

The changes in the number of platelets during anesthesia and operation were evaluated in 24 patients (8 females and 16 males) scheduled for cardiac surgery with cardiopulmonary bypass. There was a significant (p less than 0.05) thrombopenia at the beginning of perfusion, which persisted 60 minutes after the end of cardiopulmonary bypass. There were no significant differences when these changes were evaluated depending on the type of oxygenator, the need for transfusion or the duration of cardiopulmonary bypass. There was a reduction in the platelet count at the beginning of the bypass (207 to 124 x 10(9).1(-1), when blood contacts with the synthetic surfaces of the circuits and the oxygenator, al though-the most marked reduction was found at the end of bypass (95.9 x 10(9).1-1), coinciding with protamine administration. The function and number of platelets tended to become normal in the first hours of the postoperative period.

Adult↗
PubMed1980

[Blood circulation in the lower extremities after reconstructive operations on the vessels in arteriosclerosis obliterans of the aorta and major arteries].

Circulation in the lower limbs of 22 patients with obliterating arteriosclerosis of the aorta and main arteries was studied during operation by means of occlusion plethysmography and from the results of manometry and flow measurement. All patients underwent reconstructive operations on the vessels. Ejection of blood into the limb with a large volume of the contributing vascular bed was encountered immediately and in the first few days after the operation; the specific blood flow (ml/min/100 cm3 tissue) sharply increased in the limb most affected by ischemia. Circulation in the lower limbs was gradually normalized by the 5 th--7 th day. Some indices obtained during the study are important for understanding the course of the postoperative period in patients with the pathological condition discussed.

Adult↗
PubMed1989

Cardiac output in women undergoing cesarean section with epidural or general anesthesia.

Cardiac output during cesarean section and for 24 hours after delivery was estimated by using a noninvasive ultrasonic Doppler technique and was compared between term pregnant patients who underwent either epidural or general anesthesia. Cardiac output peaked by 36.7% and 26.3% of baseline values at 15 and 30 minutes after delivery, respectively, with epidural anesthesia and by 28% and 17.2%, respectively, with general anesthesia. From 60 minutes to 24 hours after delivery, cardiac output in both groups remained elevated at preoperative levels. This study demonstrates a similar pattern of increase in cardiac output with epidural and general anesthesia and a return by 60 minutes to preoperative levels, which persisted for up to 24 hours after delivery. The applicability of this noninvasive technique can be extended in various circumstances during pregnancy, labor, delivery, and the postpartum period to further define cardiac output in pregnancy.

Anesthesia, Epidural↗
PubMed1993

Comparative evaluation of intramuscular buprenorphine, pentazocine and nefopam in post-operative pain relief.

In immediate postoperative period, many injectable analgesics are being used with diverse side effects. The present study was conducted on 75 patients of both sexes, who underwent various types of surgery, to evaluate pain relief in immediate postoperative period. The drugs used for producing postoperative analgesia are buprenorphine, pentazocine and nefopam, all by intramuscular route.

Adolescent↗
PubMed2001

Anesthetic choice of halothane versus propofol: impact on experimental perioperative stroke.

BACKGROUND AND PURPOSE: It is not known whether preischemic exposure to anesthetic agents affects the amount of damage from transient focal ischemia that occurs after cessation of the anesthetic. We compared the effect of prior exposure to halothane or propofol on infarction size after transient middle cerebral artery occlusion (MCAO) induced in the awakening animal to test the hypothesis that anesthetic type and exposure duration would independently affect the amount of brain injury. METHODS: Male Wistar rats (weight, 200 to 300 g) were anesthetized briefly with halothane for placement of hemodynamic instrumentation. Twenty-four hours later, rats were treated with either a short (approximately 1 hour) or long (8 hours) duration of inhaled halothane (1% to 2%) or intravenous propofol (10 mg/kg bolus, 30 mg/kg per hour infusion). Each cohort (n=8 per group) was then subjected to 2-hour MCAO by the intraluminal suture technique. All anesthesia was discontinued once MCAO was achieved. Infarct volume was measured at 22 hours of reperfusion. In a second cohort, regional cerebral blood flow (CBF) was measured ([(14)C]iodoantipyrine autoradiography) at end-occlusion in short-duration halothane (n=5) or short-duration propofol (n=5) anesthesia groups and in corresponding surgical shams (n=3 each). RESULTS: Pericranial temperature, PaO(2), PaCO(2), and blood pressure were controlled and not different among groups before or during occlusion. MCAO resulted in a similar immediate reduction in laser-Doppler flow signal after discontinuation of anesthesia in the awakening animals. Infarct volume was smaller in rats exposed to short-duration halothane in cortex (87.5+/-16.6 mm(3)) (mean+/-SEM) and caudoputamen (38.3+/-13.7 mm(3)) compared with rats exposed to short-duration propofol (cortex, 177.5+/-16.9 mm(3); caudoputamen, 47.8+/-2.9 mm(3)). Infarct volume was not different in long-duration halothane versus long-duration propofol treatment. Absolute cortical or caudoputamen intraischemic CBF was not different between short-duration halothane or short-duration propofol treatment. CONCLUSIONS: These data demonstrate that short-duration halothane exposure before MCAO in the awakening animal attenuates infarction volume compared with propofol. This protection by halothane is not mediated through preservation of intraischemic CBF. Longer durations of halothane exposure may activate secondary injury pathways, which negate the protective effects of short-term halothane preischemic treatment.

Administration, Inhalation↗
PubMed1993

Is preoperative computerized tomography useful in assessing patients with colorectal carcinoma?

PURPOSE: Controversy exists over the appropriate preoperative evaluation of colorectal cancer patients. Most surgeons agree that basic laboratory studies are indicated. Computerized tomography of the abdomen and pelvis has been used in our practice to augment the preoperative evaluation of these patients. METHODS: One hundred fifty-eight consecutive patients with primary colorectal carcinoma underwent computerized tomography (CT) of the abdomen as part of their preoperative evaluation. Their medical records were retrospectively reviewed. RESULTS: In 88 patients, 120 findings present on CT were otherwise unknown. Of these, 35 percent were clinically significant in that they allowed the surgeon to alter the proposed operative procedure or added additional technical information for consideration preoperatively. Findings include liver metastasis (26), atrophic kidney (3), and abdominal wall or contiguous organ invasion (11). In addition, two other solid organ carcinomas were detected. In the remaining 70 patients, CT contributed no additional pertinent information about the patient prior to this initial operative procedure. CONCLUSIONS: CT aids in the preoperative evaluation of individuals with colorectal carcinoma. It provides important clinical information that is useful to the surgeon planning the procedure. Additionally, CT permits the patient and his family to be aware of their overall status and to subsequent treatment options. Computerized tomography eliminates the need for preoperative intravenous pyelogram, improves the preoperative staging for metastatic disease, and provides a baseline for comparison during the postoperative follow-up period should recurrence be suspected or adjuvant therapy be planned.

Adenocarcinoma↗
PubMed2001

Rapid preparation of a patient with pheochromocytoma with labetolol and magnesium sulfate.

PURPOSE: To describe the rapid perioperative optimization and control of blood pressure in a young patient who presented with pheochromocytoma. He was non-compliant with phenoxybenzamine but insisted on early surgery. He was scheduled for laparoscopic resection of the tumour. CLINICAL FEATURES: This 32-yr-old man presented with uncontrolled hypertension for a few years for which he was treated with nifedipine. He subsequently defaulted follow-up. The patient presented again approximately three months from the day of surgery and was diagnosed to have a pheochromocytoma. The endocrinologist prescribed phenoxybenzamine and propanolol in addition to the nifedipine but the patient stopped taking both drugs six weeks prior to surgery due to their side effects. The patient was admitted the evening before surgery to the intensive care unit for rapid control of his blood pressure. Blood pressure was optimized with an infusion of labetolol and volume expansion titrated under central venous catheter and intraarterial blood pressure guidance throughout the night. On the morning of surgery, a magnesium sulfate infusion was started. The laparoscopic surgery proceeded uneventfully and the patient was hemodynamically stable. There were two transient periods of hypotension after induction and at removal of tumour respectively which were corrected with a brief adrenaline infusion. No adverse outcome was noted. CONCLUSION: This case highlights the possibility of a more rapid perioperative control of pheochromocytoma using high doses of labetolol and a magnesium sulfate infusion to achieve stable intraoperative hemodynamics during laparoscopic resection of pheochromocytoma.

Adult↗
PubMed2006

Is testicular perfusion influenced during laparoscopic inguinal hernia surgery?

BACKGROUND: The influence of laparoscopic inguinal hernia surgery is still unclear. The aim of this study was to compare the possible early effects of laparoscopic and open inguinal hernia repair on testicular perfusion. METHODS: In this prospective trial, 44 patients underwent mesh repair of a primary inguinal hernia assigned to one of two procedures: open anterior mesh repair (n = 29) or a laparoscopic totally extraperitoneal approach (n = 15). Doppler ultrasound was used to determine the hemodynamic characteristics of the testicular blood flow. RESULTS: No statistically significant differences were found between the two groups in terms of Doppler flow parameters for the preoperative, very early (day 1), and early postoperative (day 7) periods. When Doppler flow parameters of the testicular artery were compared in the conventional group, statistically significant differences were found between preoperative and very early postoperative values (p < 0.05). Meanwhile, comparison among flow parameters of the testicular, capsular, and intratesticular arteries of the laparoscopic group showed statistically significant differences between preoperative and very early postoperative and between preoperative and early postoperative values (p < 0.05). There were no statistically differences in postoperative complications between the two groups. CONCLUSION: Testicular blood flow is influenced during laparoscopic inguinal hernia surgery. Whether changes in flow parameters remain in the late postoperative period, and whether they have an impact on complications will be evaluated in further studies.

Adult↗
PubMed1991

Simultaneous right ventricular contraction and left ventricular fibrillation during cardiopulmonary bypass.

Two cases of brief left ventricular fibrillation concurrent with a beating right ventricle during cardiopulmonary bypass are described. Although no left or right ventricular dysfunction was detected postoperatively, this regional electrical heterogenicity suggests inhomogeneous myocardial protection during at least a short period of time. The precise mechanisms concerned are not clear and limited clinical and animal experimental analogies can be found in the literature.

Cardiopulmonary Bypass↗
PubMed1995

A new method to obtain bone biopsies at implant sites peri-operatively: technique and bone structure.

This study aims at evaluating an objective method for the description of bone structure in the human mandible. Human bone biopsies were harvested at mandibular implant sites prior to insertion of self-tapping Mark II fixtures. Altogether 15 biopsies were taken from 12 patients. Three patients donated 2 biopsies each, one proximally and one distally taken. Ground sections of about 100 microns thickness were prepared prior to microradiography. These sections were ground to a final thickness of about 10 microns followed by histological staining. Histomorphometrical analyses were performed on the microradiographed plates and on the ground sections. On average there was a bone area of about 54% calculated on the microradiographed plates (the 100-microns sections) versus a mean bone area of 62% light microscopically (the 10-microns sections). Bone lengths were calculated on the 10-microns sections in the central part (mid-line) and on each side of the mid-line, revealing a mean of 58% in the former case and a mean of 61% in the latter case. The amount of bone varied between individuals and in different locations of the same jaw. The postoperative healing period following fixture installation is standardized regardless of bone structure. It may in the future be appropriate to more individualize this healing period based on an objective bone quality score.

Adult↗
PubMed1988

Supraventricular tachyarrhythmias after coronary bypass surgery--a double blind randomized trial of prophylactic low dose propranolol.

In the present study 75 patients were double blind randomized either to receive 10 mg propranolol orally 4 times a day (35 patients) or a placebo (40 patients). Episodes of clinically important supraventricular tachyarrhythmias were recorded in the first 4 postoperative days. They appeared in 5 of 35 patients receiving propranolol and in 5 of 40 patients receiving placebo (no statistically significant difference). In conclusion this study indicates the need for further evaluation to clarify if low-dose propranolol or any other drug is effective in reducing the frequency of SVT in the early postoperative period after coronary artery bypass surgery.

Adrenergic beta-Antagonists↗
PubMed1994

Pseudoaneurysm of the femoral artery after cardiac catheterisation: diagnosis and treatment by manual compression guided by Doppler colour flow imaging.

OBJECTIVE: To assess the value of Doppler colour flow imaging for diagnosing and guiding non-surgical treatment of pseudoaneurysm of the femoral artery complicating cardiac catheterisation. DESIGN: A prospective study. SETTING: Cardiac department in a teaching hospital. PATIENTS: 9 patients (8 female, 1 male) who presented with pseudoaneurysm 1-15 days after cardiac catheterisation. INTERVENTIONS: The femoral arterial communication to the false aneurysm was localised by Doppler colour flow imaging. Manual pressure was then applied to the ultrasound transducer which was positioned directly over the site of the arterial communication. Pressure was progressively increased until it was sufficient to prevent colour flow from the artery into the false aneurysm cavity while allowing Doppler flow to continue within the arterial lumen. MAIN OUTCOME MEASURES: Characteristics of pseudoaneurysm, duration of manual compression, success rate, follow up. RESULTS: The pseudoaneurysms ranged from 1.3 to 5.5 cm in length. Six pseudoaneurysms were 1.3-2.0 cm away from the arterial puncture. The pseudoaneurysm was closed in 8/9 patients by compression exerted manually through the transducer for 25-40 minutes (3 successful cases required two or three periods of compression within 48 hours). No pseudoaneurysm recurred during 14-61 days of follow up. CONCLUSIONS: Most pseudoaneurysms of the femoral artery can be treated by a period of manual pressure applied with an ultrasound transducer and guided by Doppler colour flow.

Adult↗
PubMed2002

[Randomized controlled trial for the effect of amrinone and aprotinin on expression leukocyte adhesion molecule in patients with prosthetic valve replacement during perioperative period].

OBJECTIVE: To explore the effect of amrinone and aprotinin on expression of leukocyte adhesion molecule in patients with prosthetic valve replacement during perioperative period. METHODS: Thirty-two patients undergoing valve replacement were randomized to control group, the first aprotinin group, the second aprotinin group, and amrinone combined with aprotinin group; each group consisted of eight cases. In the first aprotinin group, 3 x 10(6) units of aprotinin was added to the priming solution of the extracorporeal circulation (ECC). In the second aprotinin group, 3 x 10(6) units of aprotinin was added to the priming solution of ECC, which was combined with 1 x 10(6) units of aprotinin for intravenous bolus. In the amrinone combined with aprotinin group, 3 x 10(6) units aprotinin was added to the priming solution of the ECC and amrinone began with a bolus of 1 mg/kg followed by a maintenance intrusion of 8 micrograms/kg.min. The control group received an equivalence without aprotinin. Venous blood samples were drawn before the operation, at the end of the ECC, 1 hour after the end of the ECC, and one day after the operation, respectively. Flow cytometry was used to demonstrate the expression of leukocyte adhesion molecule CD11b/CD18. RESULTS: Before ECC, there were no differences of the levels of CD11b+/CD18+ in all groups (P > 0.05). One hour after the ECC, the level of CD11b+/CD18+ in group B was lower than that in group A, the level of CD11b+/CD18+ in group C was lower than that in group B, and the level of CD11b+/CD18+ in group D was higher than that in group C, but no significant difference between groups was noted (P > 0.05). CONCLUSION: Although amrinone and aprotinin have anti-inflammatory activity, the pump prime which was added aprotinin alone or aprotinin combined with amrinone might fail in preventing the expression of leukocyte adhesion molecule CD11b/CD18 completely in patients with prosthetic valve replacement during ECC perioperative period.

Adult↗
PubMed2004

[Impact of cardiopulmonary bypass on free amino acid spectrum in plasma for patients with prosthetic valve replacement during the perioperative period].

OBJECTIVE: To investigate the impact of cardiopulmonary bypass (CPB) on free amino acid spectrum in plasma for patients with prosthetic valve replacement. METHODS: The concentrations of the free amino acid in plasma for 22 patients with prosthetic valve replacement were measured with pre-column derivatization of high-performance liquid chromatography. RESULTS: Compared with the preoperative data, the concentrations of some free amino acid in plasma decreased after the operation of cardiopulmonary bypass (CPB), especially some of the glucogenic amino acid and branch chain amino acid decreased significantly (P<0.05). CONCLUSION: The operation of cardiopulmonary bypass (CPB) can decrease the concentrations of some free amino acid in plasma for patients with prosthetic valve replacement. It is essential to give these patients proper nutrition support during perioperative period.

Adult↗
PubMed1990

Vasoactive pressure hormones during and after cardiopulmonary bypass.

The differences in the pattern of the vasoactive hormone release in response to the stress of surgery and cardiopulmonary bypass (CPB) (pulsatile n = 15 and non pulsatile n = 23) were studied in the adult patients with mitral valve disease (MVD), aortic valve disease (AVD), and the coronary artery disease (CAD). A differential stimulation of the osmoreceptors, baroceptors, renin-angiotensin and the sympathetico-adrenal systems in these patients, resulted in the variations in the pattern of hormone release. Patients with MVD showed a greater stimulation of osmoreceptors, baroceptors and release of Arginine vasopressin (AVP). Renin-angiotensin system was more easily triggered in patients with AVD or CAD; and sympathetico-adrenal system in patients with CAD. The renin-angiotensin-aldosterone axis was better preserved in patients with CAD (r = 0.49, p less than 0.001) than in the patients with MVD (r = 0.38, p less than 0.02). Plasma renin release showed a significant correlation with noradrenaline release in the patients with MVD (r = 0.47, p less than 0.01); but this relationship was lost in the patients with the CAD, due to an excessive noradrenaline release. Pulsatile bypass reduced but did not abolish this response. Under unfavourable conditions, the stress response may persist in the early post-operative period.

Aortic Valve↗