ABSTRACT
Background and Objective: Patients presenting for surgical procedures often get undiagnosed for obstructive sleep apnea(OSA), thus increasing the incidence of perioperative adverse outcomes. Hence, early diagnosis of this disease is importantin formulating anesthetic management and specific means which may decrease the complications and improve outcome,and therefore, the study was conducted to evaluate the prevalence of OSA in patients presenting in our institute for surgicalprocedures.Materials and Methods: A total of 600 patients of aged >18 years, American Society of Anesthesiologists I-III scheduled forelective surgeries under anesthesia, were randomly enrolled in the study. Their demographic data, anthropometric measurementswere noted. They were screened for OSA by STOP-BANG questionnaire and were followed to assess correlation betweenOSA and perioperative morbidity.Results: We observed that out of a total of 600 patients, 23 patients had moderate and severe OSA. Hence, the prevalence ofmoderate-to-severe OSA was 3.8% in our study. Mean age of subjects was 43.1 years and female predominance was seen inthis study. Out of a total of 600 patients, 23 patients had moderate and severe OSA. There was a significant correlation betweenseverity of OSA and anthropometric measurements and perioperative morbidity.Conclusion: Early screening can help in detecting the OSA among patients and thus help in alleviating perioperative morbidity
ABSTRACT
The many benefits of laparoscopy, including smaller incision, reduced length of hospital stay and more rapid return to normal function, have seen its popularity grow in recent years. With concurrent improvements in non-surgical cancer management the importance of accurate staging is becoming increasingly important. There are two main applications of laparoscopic surgery in managing hepato-pancreatico-biliary (HPB) malignancy: accurate staging of disease and resection. We aim to summarize the use of laparoscopy in these contexts. The role of staging laparoscopy has become routine in certain cancers, in particular T2 staged, locally advanced gastric cancer, hilar cholangiocarcinoma and non-Hodgkin’s lymphoma. For other cancers, in particular colorectal, laparoscopy has now become the gold standard management for resection such that there is no role for stand-alone staging laparoscopy. In HPB cancers, although staging laparoscopy may play a role, with ever improving radiology, its role remains controversial.
ABSTRACT
Los niños con parálisis cerebral con frecuencia necesitan anestesia, bien sea debido a intervenciones quirúrgicas, para tratamientos estomatológicos o estudios imaginológicos; no obstante, debido a sus particularidades, estos pacientes tienen un riesgo incrementado de presentar complicaciones durante el período perioperatorio. Por tal motivo se realizó una revisión de la literatura, con el objetivo de esclarecer algunos aspectos a tener en cuenta en el manejo anestésico perioperatorio en niños con parálisis cerebral. Para ello, se llevó a cabo una revisión no sistemática sobre este tema en libros, documentos impresos y en línea, a partir de una búsqueda en las siguientes bases de datos: Pubmed, Registro Cochrane Central, Bireme, Ebsco, Mediclatina y Lilacs. Se concluyó que el manejo de los niños con parálisis cerebral es complejo. Las complicaciones perioperatorias se pueden minimizar si se tienen en cuenta las particularidades de estos pacientes. Es necesario estar atentos a las comorbilidades que se presentan con mayor frecuencia. La medicación habitual con anticonvulsivantes y antiespásticos debe mantenerse durante el período perioperatorio. Para la cirugía electiva es necesario que los pacientes se encuentren en condiciones favorables. No existe una técnica anestésica ideal: la elección del método anestésico depende de diversos factores. Durante el período postoperatorio es necesaria una vigilancia constante y el control del dolor. El éxito en el manejo de estos pacientes depende del trabajo en equipo.
Children with cerebral palsy often need anesthesia, either due to surgical interventions, for dentistry treatments or imaging studies; however, due to their particularities, these patients have an increased risk of complications during the peri-operative period. That's why we conducted a literature review, with the objective of clarifying some aspects to consider in the perioperative anesthetic management in children with cerebral palsy. For this purpose, we carried out a non-systematic review on this subject in books, printed and online documents, based on a search in the following databases: Pubmed, Cochrane Central Registry, Bireme, Ebsco, Mediclatina and LilaCS. It is concluded that the management of children with cerebral palsy is complex. Perioperative complications can be minimized if the particularities of these patients are taken into account. It is necessary to be mindful of the more frequently occurring co-morbidities. The usual medication with anticonvulsants and anti-spasticity drugs must be kept during the peri-operative period. For elective surgery, it is necessary the patients being in favorable conditions. There is no ideal anesthetic technique: the choice of the anesthetic method depends on several factors. During the postoperative period it is required a constant surveillance and the pain control. Success in the management of these patients depends on the cooperative effort by all the team.