Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Operating Tables”

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 811 records · Page 45Linked to original sources

[Morphofunctional manifestations of rat adrenal cortical reaction to the administration of sodium bromide under conditions of hypodynamic stress].

Experiments conducted on rats by employing functional and morphological methods of investigation showed bromine to weaken the function of the adrenal cortex in intach rats, producing changes analogous to those of a hypodynamic stress (2-hour immobilization on the operating table). A combined preliminary introduction of bromine and immobilization is attended by a less pronounced stress reaction and brings about normalization of the ascorbic acid content in the adrenals with the appearance of well-marked morphological signs pointing to the compensation of the adrenal cortex functions.

Adrenal Cortex↗

[Anesthesiological aspects of early activation of patients after aortocoronary bypass surgery].

The specific features of the course of anesthesia and the time of extubation were studied in 142 patients suffering from coronary heart disease who had undergone myocardial revascularization. All the patients were divided into 3 groups in accordance with the type of anesthesia. Group 1 patients (n = 48) received routine anesthesia with ketamine, benzodiazepines, and large-dose fentanyl. Group 2 (n = 45) had combined anesthesia with inhalational and intravenous anesthetics having their better pharmacodynamics (such as isoflurane, diprivan, tracrium). In Group 3 (n = 49), the authors employed another developed modality of anesthesia using high thoracic (TII-TIV) epidural anesthesia as a basic component of anesthesiological maintenance. The two developed modalities of anesthesia almost halved the use of total dose opioids, which promoted patients' early postoperative recovery of consciousness and respiration. The time before extubation was 9.9 +/- 2.1, 4.5 +/- 1.1, and 1.5 +/- 1.2 hours in Groups 1, 2, and 3, respectively (p < 0.05). The developed anesthesia procedure using isoflurane, midazolam, propofol, and small-dose fentanyl ensures safe and early (up to 6-hour) extubation in 73% of the patients undergone aortocoronary bypass surgery. The developed anesthesiological protocol based on thoracic epidural anesthesia enables extubation to be carried out on the operating table within an hour in 75% of patients after aortocoronary bypass surgery. A comparative intraoperative analysis of hemodynamics, the incidence of myocardial ischemia, arrhythmias, glucose levels has indicated that the anesthesia techniques aimed at a patient's early activation are not inferior in the degree of protection to routine anesthesia using large doses of opioids, ketamine, and diazepam. When used in combination with thoracic epidural block, the methods are superior to the latter.

Aged↗

[Endoluminal diode laser vein damage: preclinic study for vein insufficiency].

BACKGROUND: The ex-vivo phase of this research aims to define fibre laser activity ranges with the intent of using a safety protocol on the operating table to ensure maximum results in occluding the vein lumen with minimum necessary energy parameters. METHODS: The study was performed on 20 human saphenous veins removed during phlebological surgery. A 1 mm diameter optical fibre was inserted in the vein to the proximal extremity where administration of laser energy began along the vein axis. The veins were subdivided into three groups based on the parameters used: Group 1: treated with 20 Watt power; Group 2, treated with 15 Watt power; Group 3, treated with 10 Watt power. On conclusion of the procedure the veins were immersed in formalin and sent for histological examination. RESULTS: The greatest endothelial damage was observed in the group of veins treated with fluence above 300 J/cm(2), in which carbonisation of the endothelium was observed; in those treated with lower fluence (200-100 J/cm(2)) damage consisted in coagulation necrosis and interstitial oedema; at fluence of 100 J/cm(2) endothelial damage was less uniform. CONCLUSIONS: Experimental evidence would appear to support the hypothesis that the optimal protocol is below 300 J/cm(2) fluence with 15 Watt power and pulse train 100-300 ms.

Adult↗

Hip arthroscopy: the supine position.

Hip arthroscopy performed with the patient in the supine position is an effective, reproducible procedure. Advantages include ease and simplicity of patient positioning, use of a standard fracture table, operating room layout that is user friendly, familiar joint orientation, and optimal access for all portal placements. All technical aspects of performing the procedure are detailed, including necessary equipment, patient positioning, landmarks, portal placement, and arthroscopic anatomy. Effective and safe performance of this procedure is dependent on careful attention to every detail of the operation.

Arthroscopy↗

Rhabdomyolysis in lumbar spine surgery: a case report.

STUDY DESIGN: The case of a complication sustained by an obese patient undergoing a lumbar spine fusion is reported. OBJECTIVES: To minimize further complications by reporting on this case complicated by rhabdomyolysis in a lumbar fusion, and to include a review of the literature. SUMMARY OF BACKGROUND DATA: Rhabdomyolysis has been described as a clinical syndrome initially characterized by darker urine, muscle pain, and weakness from prolonged muscle compression, as in intoxicated patients or after a seizure. Rhabdomyolysis and myoglobinuria have also been reported in the prolonged positions of some surgical procedures. METHODS: A 40-year-old man developed progressively incapacitating lumbar pain above a previous fusion from L4 to S1, with a severe decline in his functional capacities and a large weight gain. Revision surgery removing the previous instrumentation and performing an instrumented fusion from L2 to L4 was complicated by rhabdomyolysis. RESULTS: After an unremarkable surgery, this patient was hemodynamically unstable when transferred from the operating table to the supine position and required aggressive treatment of severe rhabdomyolysis, which has not previously been reported in this setting. CONCLUSION: Patients undergoing lumbar spine surgery require decompression of the abdomen, and in this case, a Jackson table was used. Unfortunately, his abdominal girth, even on a Jackson table, was not fully decompressed and resulted in this complication. Further consideration should be given to modifications of positioning for morbidly obese patients.

Adult↗

Pulmonary embolism during pregnancy and the postpartum period: report of 2 cases.

OBJECTIVE: To investigate the high risk factors, clinical features, diagnosis and treatment of pulmonary embolism (PE) during pregnancy and the postpartum period. METHODS: Two cases of PE during pregnancy and postpartum period were reported retrospectively. RESULTS: The first case was a pregnant woman with congenital heart disease at 39-week gestation. She underwent a successful cesarean section (CS) because of heart disease, but she manifested tachycardia, tachypnea, cyanosis, and dyspnea suddenly on the 10th day after CS and died soon after the onset of these symptoms. The diagnosis of PE was highly suspected clinically. The second case was a twin-pregnancy woman at 35-week gestation. Because of severe perinatal myocardiopathy, cesarean section was performed. Unfortunately, the patient died abruptly on the operation table. The diagnosis of PE was confirmed by autopsy. CONCLUSIONS: The maternal mortality of PE during pregnancy and postpartum period is quite high. Whenever there is any doubt, objective examinations for PE should be started early in order to strive for the chances of the anticoagulant therapy.

Adult↗

Intraoperative and postoperative monitoring of microsurgical free tissue transfers.

Numerous techniques have been described for monitoring the postoperative viability of microsurgical free tissue transfers, and their sensitivity and reliability continue to be evaluated in animal experiments and clinical trials. Relative advantages and disadvantages of these various postoperative monitoring techniques are discussed. The concept of intraoperative monitoring of the microsurgical anastomoses during closure and inset of a free flap is introduced because many free flaps may fail on the operating table, but this only becomes clinically apparent several hours later in the early postoperative period.

Animals↗

Stab wounds to the pericardium and heart: an analysis of 85 consecutive patients.

OBJECTIVE: To audit all stab wounds of the pericardium and heart treated by a policy of immediate exploration over a period of 17 years, and identify any factors predictive of outcome. DESIGN: Retrospective study. SETTING: Urban referral centre. SUBJECTS: 85 consecutive patients with stab wounds of pericardium and heart. INTERVENTIONS: Immediate exploration. MAIN OUTCOME MEASURES: Mortality and morbidity. RESULTS: Eleven patients died (13%), 10 of them on the operating table. No powerful predictor of outcome was identified, but measurable blood pressure on admission (p = 0.04) and a low cardiac trauma index score (p = 0.07) seemed to be associated with survival. CONCLUSION: Some unrecordable factors--for example, the skill of the team on duty--may have had a considerable influence on outcome.

Adult↗

[Injuries of the lower cervical vertebrae--the monocortical stabilization technique].

PURPOSE OF THE STUDY: In contrast to the thoracolumbal spine, the cervical spine bears a lower biomechanical load and, therefore, anterior stabilization of a fracture is a definitive procedure in the majority of cases. What remains the matter of choice is screw fixation in the body of the vertebra involved. This may be either monocortical or bicortical. In this study, we evaluate a group of patients in whom fractures of the lower cervical spine were treated using the CSLP monocortical system (Synthes). MATERIAL: We included 68 patients in whom complete radiographic data were available and the surgery was performed more than 6 months earlier. This group comprised 49 men and 19 women with the mean age of 37.6 years and range of 12 to 79 years. In the first stage, all patients were operated on from the anterior approach. In 11 (16.2%) patients with type B or C injury, according to the AO classification, the procedure was completed by dorsal stabilization. The definite indication for surgery was any involvement of nerve structures or open fractures; kyphosis greater than 15 degrees, reduction by more that 50% of the proximal edge of the vertebral body, narrowing of the spinal canal by more than 50%, multiple wedge fractures and disc and ligament injuries associated with instability were considered conditional indications. METHODS: Any locked dislocation was reduced manually under X-ray guidance in the shortest possible time. Subluxations or fractures of the vertebral body were reduced by positioning the patient's body on the operating table. The standard procedure for subluxation management was distraction of the segment by applying a Caspar's distractor and subsequent microscopic discectomy up to the posterior longitudinal ligament. A tricortical bone graft was collected from the iliac crest. After its implantation, the distractor was released and the segment was fixed by a CSLP system (Synthes) with monocortical screws 14 mm long, usually used in a 2 + 2 configuration. In locked dislocation, in addition, the discission of the posterior longitudinal ligament and inspection of the dural sac were performed, and completed by dorsal stabilization with hook plates or a Cervifix fixator (Synthes) in one procedure under anesthesia. When the body of the vertebra was fractured, either partial or subtotal excision of it was carried out according to the type of fracture or when displaced fragments protruded into the spinal canal. A tricortical graft taken from the iliac crest was larger than in the treatment of subluxation but a plate was applied as in monosegmental fixation. In addition, the graft was fixed with special screws that had a porous surface and holes in the shank. Dorsal stabilization with hook plates or a Cervifix fixator was used for severe instability in type B or C injury. RESULTS: The normal range of cervical spine motion (flexion, extension, inclination, rotation) was found in 44 patients. Slightly limited movement (75% to 90% normal motion) was in 17 patients and seven were affected more seriously (50% to 75% normal motion). Of the 19 patients with neurological deficit, 13 showed improvement by 1, 2 or 3 grades of Frankel's classification in seven, four and two patients, respectively. The first signs of bone remodeling between the graft and covering plate, usually at the distal graft border, were found in 16 patients at 6 weeks and in the remaining 52 patients at 12 weeks. By 6 months postoperatively, all patients showed complete healing and incorporation of the tricortical graft. The cranial screws broke in one case (1.5%) but this had no effect on the treatment outcome. No complication related to the surgical procedure occurred intraoperatively. DISCUSSION: The very good results achieved with the use of the CSLP monocortical system in this study (98.5% fusion without broken screws or plates) are in agreement with relevant data reported in the Czech and foreign literature. The principal condition is a careful preparation of both the endplates of vertebral bodies and the graft. After insertion, this should stay in place without any tendency to extrude. If the graft is too long, it imposes an increased load on plates or screws that consequently act ventrally. CONCLUSION: Our experience and literature data suggest that the CSLP monocortical system is fully capable to stabilize the lower cervical spine after injury, supposing all procedures described above are completed. In more serious trauma and type B or C instability, the additional dorsal instrumented fusion is indicated.

Adolescent↗

Primary Casualty Reception Ship: the hospital within--Operation Granby.

As the build-up of Operation Granby forces developed in the Gulf, casualty estimates indicated the need for a 100-bed hospital facility to care for the possible maritime casualties. RFA Argus, the Air Training Ship, was identified as the potential Primary Casualty Reception Ship (PCRS) and at the end of September 1990 plans were drawn up to convert the forward hangar into a two-storey 100-bed hospital in collective protection (COLPRO). In the three weeks prior to deployment, the hospital was designed, built, equipped and staffed. Argus arrived in the Gulf in mid-November as the PCRS with, all in COLPRO, a 10-bed intensive care unit (ICU), a 14-bed high dependency unit (HDU), a 76-bed low dependency unit (LDU) plus four operating tables in two theatres with full support services. The hospital was staffed by a medical team of 136 personnel and supported by the Air department with four casualty evacuation helicopters, an RN Party and the staff of the RFA. One hundred and five patients were treated of which 78 were returned to duty. Argu as PCRS spent longer in the northern Persian Gulf than any other ship, UK or US.

Emergency Medical Services↗

[Laparoscopic ileal conduit].

The authors describe an experimental model for performing the Bricker procedure endoscopically. After placing the operating table in the Trendelenburg position, the trocars are inserted through the incisions at the level of the umbilicus, the right and left flanks and the hypogastrium. Both ureters are dissected free from the inferior pole of the kidney up to a short distance from the bladder, clamped and cut. The right flank incision is extended a few cms longitudinally and the right ureter and ileal loop are brought out through the incision. Once exteriorized, a segment of the ileum is separated and intestinal continuity reestablished. The right ureter is then attached to the distal end of the ileal segment. The other end of the loop is brought to the left flank and exteriorized together with the left ureter, as described above. Once the ureter has been attached, they are passed inside. The incisions are sutured and a stoma is created in the right flank. The authors recommend the application of this simple technique in the clinical setting.

Animals↗

Damage control surgery for abdominal trauma.

OBJECTIVE: To review the physiology, indications, technical aspects, morbidity, and mortality of damage control surgery. DESIGN: Retrospective study of published papers. SETTING: Teaching hospital, United Arab Emirates. INTERVENTIONS: A MEDLINE search on damage control surgery for the years 1981-2001. Further articles were retrieved from the references of the original articles. RESULTS: The indications for damage control surgery are: the need to terminate a laparotomy rapidly in an exsanguinating, hypothermic patient who had developed a coagulopathy and who is about to die on the operating table; inability to control bleeding by direct haemostasis; and inability to close the abdomen without tension because of massive visceral oedema and a tense abdominal wall. The principles of damage control surgery are: Phase I: laparotomy to control haemorrhage by packing; shunting, or balloon tamponade, or both; control of intestinal spillage by resection or ligation of damaged bowel, or both. Phase II: physiological resuscitation to correct hypothermia, metabolic acidosis, and coagulopathy. Phase III: planned reoperation for definitive repair. Damage control surgery is appropriate in a small number of critically ill patients who are likely to require substantial hospital resources; it has a high mortality (mean 45%, range (10%-69%). CONCLUSION: Damage control surgery offers a simple effective alternative to the traditional surgical management of complex or multiple injuries in critically injured patients. Phases I and II can be done at a rural hospital before transfer to a major trauma centre for definitive repair.

Abdominal Injuries↗

Intraoperative tracking of the trunk during posterior instrumentation of the scoliotic spine: a feasibility study.

Scoliosis involves spine and trunk deformities. However, during posterior instrumentation of the scoliotic spine, only the exposed spine is currently seen or tracked using navigation systems. A technique for intraoperative tracking of the trunk was developed in order to optimize the surgical correction of the scoliotic trunk deformity. The feasibility of this technique was assessed by comparing the trunk geometry between 19 normal and 21 scoliotic subjects, using an experimental set-up simulating the position adopted during posterior scoliosis surgery. Eleven magnetic sensors placed on anatomical landmarks of the trunk were used to compute nine geometric indices. The geometric indices were closer to zero for normal subjects. Therefore, indices approaching zero during the surgical manoeuvres would indicate a reduction of the trunk asymmetry. Only three of the nine indices were significantly different between normal and scoliotic subjects. This result indicates that the positioning of the subjects on the Relton-Hall frame tends to "normalize" the trunk geometry since the standing position gives more significant differences between normal and scoliotic subjects. The real-time quantification of the trunk geometry during surgical correction of scoliosis may allow the surgeon to improve the correction of both spinal and trunk deformities or to optimize the positioning of the patients on the operating table.

Adolescent↗

Surgical approach to C1-C2 nerve sheath tumors.

BACKGROUND: C1 and C2 nerve sheath tumors (NST) are unique in presentation, relationship to neighbouring structures and surgical approaches when compared to their counterparts in other regions of the spine. AIM: The strategies involved in the surgery for C1-C2 NST are discussed SETTING AND DESIGN: Retrospective study. METHODS: 21 patients with C1 (n=6) and C2 (n=15) NST were operated based on their position with respect to the cord i.e. anterior (4), anterolateral (10), posterolateral (5), and posterior (2). The tumors had extra- and intradural components in 20 patients; while in one, the tumor was purely intradural. The operative approaches included the extreme lateral transcondylar approach (3); laminectomy with partial facetectomy (5); laminectomy (11); and, suboccipital craniectomy and laminectomy (2). RESULTS: Total excision was performed in 13 patients; while in 7, a partial extraspinal component, and in 1, a small intradural component were left, in situ. Thirteen patients showed improvement by one or more grades in the Harsh myelopathy score; 2 patients with normal power had significant decrease in spasticity; while 5 maintained their grade. One poor-grade patient succumbed to septicemia. CONCLUSIONS: C1-C2 NST may have exuberant growth due to the capacious spinal canal and the absence of a "true" intervertebral foramen at this level. Surgical approaches are determined by its relationship to the cord. A "T incision" on the dura, the partial drilling of the facets, sectioning of the denticulate ligament, rotating the operating table 15 to 30 degrees, and at times sectioning the posterior nerve roots are all useful adjuncts for facilitating access.

Adolescent↗

An audit of intraoperative frozen section in Johor.

A 4-year-review was carried out on intraoperative frozen section consultations in Sultanah Aminah Hospital, Johor Bahru. Two hundred and fifteen specimens were received from 79 patients in the period between January 1999 and December 2002. An average of 2.72 specimens per patient was received. The overall diagnostic accuracy was high, 97.56%. The diagnoses were deferred in 4.65% of the specimens. False positive diagnoses were made in 3 specimens (1.46%) and false negative diagnoses in 2 specimens (0.98%). This gave an error rate of 2.44%. The main cause of error was incorrect interpretation of the pathologic findings. In the present study, frozen sections showed good sensitivity (97.98%) and specificity (97.16%). Despite its limitations, frozen section is still generally considered to be an accurate mode of intraoperative consultation to assist the surgeon in deciding the best therapeutic approach for his patient at the operating table. The use of frozen section with proper indications was cost-effective as it helped lower the number of reoperations. An audit of intraoperative frozen section from time to time serves as part of an ongoing quality assurance program and should be recommended where the service is available.

False Negative Reactions↗

[Spinal operations performed in prone position: pulmonary gas exchange, hemodynamics, and possible complications].

Invasive and non-invasive studies have been used to study the cardiac and respiratory systems in 93 patients during prolonged prone surgical interventions into the vertebral column. Pronounced hemodynamic changes have been found to be absent at the stage of anesthetic anesthesia and while turning the patient with to the prone position. Gas exchange is determined by the increase in alveolar dead space, PaCO2, and PaO2. The position complications during these interventions are caused by errors while placing the patient on an operating table.

Adolescent↗

[Treatment of injuries and scar strictures of extrahepatic bile ducts].

Results of treatment of 118 patients with trauma of bile ducts during cholecystectomy are analyzed. Rate of this complication ranges from 0.25 to 0.68%. Reconstructive surgeries on bile ducts were performed in 111 of 118 patients. Non-drainage variant of reconstruction of bile ducts was used only in 18 patients. Hepaticojejunostomy on removable transhepatic drainage was performed in the majority of cases. It is demonstrated that reconstructive surgeries on bile ducts must be performed early after trauma, just after arrest of bile peritonitis and other purulent complications. The best long-term results were achieved in patients who underwent reconstruction of bile ducts just after diagnosis of their iatrogenic injury on operation table. Postoperative lethality was 8.5%. Good long-term results were achieved in 81.4% patients. Repeated surgeries due to recurrences of bile ducts strictures were performed in 11.9% patients with good short-term results.

Adult↗

[Effects of Pingyangmycin albumin microspheres on sclerostenosis of the rabbit central auricular arteries].

PURPOSE: The aim of this study was to investigate the mechanism of Pingyangmycin-albumin microspheres (PYM-AMS) acted on the rabbit central auricular arteries. METHODS: In the study of randomized block design, 24 Japanese white rabbits were divided into 4 groups, 6 rabbits in each group. The animals were put on the operation table after being anaesthetized by intramuscular injection of Xumianxin (0.2 ml/Kg) and the interior division was blocked to stop drug liquid get into the interior ear. After being sterilized with 75% alcohol, No.1(PYM hydrochloride injection+0.9% NaCl), No.2(PYM+soybean oil), No.3(PYM-AMS+soybean oil) liquids which contained PYM 5mg/ml were injected into the central auricular arteries of the animals about 30 seconds (0.26 ml/per ear), respectively. Then these vessels were examined histologically after 2,7, 14, 21 days respectively. RESULTS: After injection, in PYM+0.9% NS control group (No.1 liquid), the ears and vessels had no significant changes. In PYM+soybean oil control group (No.2 liquid), at the 2nd day, the endothelial cells were mild swollen. At the 7th day, some endothelial cells were dropped off. At the 14th day, the central auricular arteries had mild change, but the blood flow was not blocked. At the 21st day, the wall of the central auricular artery had more layers, especially on the intima, but the lumen was still obvious. A few of endothelial cells were proliferative. In PYM-AMS group(No.3 liquid), the blood was not resumed at once, and there was some oil in the vessels. At the 1st day, the injection site was mild swollen, and small thrombosis was observed in small vessels. At the 7th-14th day, the central auricular arteries were narrowed, but the blood could be observed. At the 21st day, the vessels had sclerostenosis, and the blood flow was blocked, but no scar and necrosis were observed. Under light microscopy, at the 2nd day, the endothelial cells were mild swollen and small vessels were embolized by PYM-AMS. At the 7th day, the endothelial cells were mild swollen. At the 14th day, the endothelial cells were proliferative and the wall of the central auricular artery had more layers. The lumen of the central artery changed mildly, while the surface of PYM-AMS was absorbed. At the 21st day, the wall of the central auricular artery was proliferative obviously and the artery became sclerostenosed, while cell division was observed. The PYM-AMS was obviously absorbed and some artery was sclerostenosed, while the wall of small vein was proliferative, too. The proliferative intima was proved to be muscle cells with Masson stain and van Gieson's stain. There were many smooth muscle cells, fibroblasts, myofibroblasts in the original blood vascular lumen on the 21st day under electron microscopy. CONCLUSION: Pingyangmycin nonspecifically made the endothelia and vessels injured, and induced proliferation of endothelial cells and smooth muscle cells, and gradually the vessels became sclerostenosed. PYM-AMS had both sustained-releasing effect and embolization effect. PYM-AMS may be a better drug for treatment of large venous malformations and arteriovenous malformations.

Albumins↗