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Postoperative Phase (postoperative + phase)
Selected AbstractsMRI-based evaluation of locus and extent of neurotoxic lesions in monkeys ,HIPPOCAMPUS, Issue 4 2001e Málková Abstract To minimize the variability in the extent of lesions made by injections of the excitotoxin ibotenic acid in rhesus monkeys, we developed and validated an MRI-based method to determine the efficacy of the injections soon after surgery. T2-weighted MR images were obtained 6,11 days after surgery from 17 brain hemispheres of monkeys that had received bilateral lesions of either the hippocampal formation (HF), perirhinal cortex, or parahippocampal cortex. The extent of lesion estimated from the hypersignal that appeared in and outside of the targeted area on these MR images was compared with the extent of damage assessed histologically after survival periods ranging from 120,370 days. Highly significant correlations (r values between 0.85,0.99) were found between these two measures for several regions in the medial temporal lobe. Based on this finding, lack of hypersignal in the targeted area of some Ss was followed by successful reinjection of the neurotoxin to create more complete cell loss prior to the postoperative phase of the study. We also assessed the relationship between a postoperative reduction in HF volume, measured from T1-weighted MR images, and the extent of damage determined histologically in 14 hemispheres of monkeys with bilateral excitotoxic HF lesions. The HF volume decreases sharply after surgery until 40,50 days postoperatively, after which there is only a minor further decrease. Based on this finding, we obtained T1-weighted MR images at least 44 days but in most cases close to 1 year after surgery. A highly significant positive correlation (r = 0.95, P < 0.001) was found between neuronal damage and volume reduction, with nearly complete neuronal damage (96,99%) corresponding to a volume reduction of 68,79%. These MRI-based methods thus provide an accurate in vivo evaluation of the locus and extent of neurotoxic lesions. Application of these methods can ensure that each animal in the experiment is used effectively. Hippocampus 2001;11:361,370. Published 2001 Wiley-Liss, Inc. [source] Postoperative behavioral changes following anesthesia with sevofluranePEDIATRIC ANESTHESIA, Issue 10 2004Aideen Keaney MB FRCA Summary Background :,Behavioral disturbance following hospitalization is a relatively frequent event, some children still having negative behavioral changes (NBC) 1 month following their operation. Sevoflurane has a propensity to induce ,excitement' during induction of anaesthesia, and delirium in the immediate postoperative phase. The aim of this study was to evaluate whether this translates into prolonged behavioral change. Methods :,A total of 120 children presenting for daycase surgical procedures under anesthesia were included in the study. Children were randomized to induction and maintenance of anesthesia with sevoflurane or halothane. No additional sedative drugs were administered. Postoperative behavioral change was assessed using the Post-Hospital Behavior Questionnaire (PHBQ) on postoperative days 1, 7 and 30. Results :,The Sevoflurane group (n = 63) were more distressed on emergence of anesthesia than the Halothane group (n = 57) (P < 0.05). About 58.3, 46.8 and 38.3% of all children exhibited NBC on postoperative days 1, 7 and 30, respectively. There was no association between anesthetic agent and behavior. There was a significant relationship between decreasing age and NBC (P < 0.005). Conclusions :,Children anesthetized with sevoflurane exhibit more immediate postoperative distress than those anesthetized with halothane. This difference is not carried over into the longer posthospital period. Negative behavioral changes occur more frequently with decreasing age. [source] Segmental Differences of Impaired Diastolic Relaxation Following Cardiopulmonary Bypass Surgery in Children: A Tissue Doppler StudyARTIFICIAL ORGANS, Issue 11 2009Linda B. Pauliks Abstract Impaired myocardial relaxation is an important aftereffect of cardiopulmonary bypass (CPB). Infants with their immature calcium metabolism may be particularly vulnerable. However, it has been difficult to quantitate diastolic dysfunction clinically. This study used tissue Doppler to measure regional diastolic myocardial velocities in 31 pediatric patients undergoing open heart surgery. Color tissue Doppler images were acquired in the operating room before and 8 and 24 h post CPB surgery. Early (E) and atrial (A) diastolic velocities were determined. Long axis motion was assessed from apical views near the mitral and tricuspid rings and radial wall motion from the parasternal view. The study included 31 children aged 3.6 ± 4.4 years (6 days to 16 years), with a mean weight of 14.7 ± 13.7 kg and body surface area of 0.59 ± 0.35 m2. Tissue Doppler analysis of regional wall motion revealed abnormal left ventricle (LV) and right ventricle (RV) diastolic relaxation in the early postoperative phase after CPB. Initially, all segments were significantly altered, but by 24 h, regional differences became apparent: LV radial wall motion was recovered, while longitudinal fibers in LV and RV appeared to be less resilient. RV myocardial mechanics were most abnormal. Tissue Doppler analysis may deepen our understanding of myocardial recovery and offers a sensitive tool to compare different cardioprotective strategies. [source] A protocol is not enough to implement an enhanced recovery programme for colorectal resection,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2007J. Maessen Background: Single-centre studies have suggested that enhanced recovery can be achieved with multimodal perioperative care protocols. This international observational study evaluated the implementation of an enhanced recovery programme in five European centres and examined the determinants affecting recovery and length of hospital stay. Methods: Four hundred and twenty-five consecutive patients undergoing elective open colorectal resection above the peritoneal reflection between January 2001 and January 2004 were enrolled in a protocol that defined multiple perioperative care elements. One centre had been developing multimodal perioperative care for 10 years, whereas the other four had previously undertaken traditional care. Results: The case mix was similar between centres. Protocol compliance before and during the surgical procedure was high, but it was low in the immediate postoperative phase. Patients fulfilled predetermined recovery criteria a median of 3 days after operation but were actually discharged a median of 5 days after surgery. Delay in discharge and the development of major complications prolonged length of stay. Previous experience with fast-track surgery was associated with a shorter hospital stay. Conclusion: Functional recovery in 3 days after colorectal resection could be achieved in daily practice. A protocol is not enough to enable discharge of patients on the day of functional recovery; more experience and better organization of care may be required. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Fibrin glue for preventing immediate postoperative hypotony following glaucoma drainage implant surgeryACTA OPHTHALMOLOGICA, Issue 3 2006Juha Välimäki Abstract. Purpose:,To prevent a leak of aqueous around the tube in the immediate postoperative period after glaucoma drainage implant (GDI) surgery. Methods:,A total of 42 eyes of 34 consecutive patients with refractory glaucoma requiring single-plate Molteno implantation were retrospectively reviewed. Peritubular filtration was checked intraoperatively in all filtered eyes. Fibrin glue was used over the scleral flap intraoperatively in every eye with peritubular leakage. All Molteno tubes were completely closed with an absorbable ligature. Results:,Peritubular filtration was detected in 11 eyes of 11 patients. All 11 eyes maintained intraocular pressure (IOP) ,,16 mmHg in the immediate postoperative phase. The mean IOP on the first postoperative day was 30.5 ± 10 mmHg. After an average follow-up of 6 months, the mean IOP in these 11 eyes was 19.1 ± 6 mmHg. No complications or Seidel-positive aqueous leak were observed during the follow-up period. Conclusions:,Results suggest that intraoperative use of fibrin glue is a viable option for reducing peritubular filtration and preventing immediate postoperative hypotony after GDI surgery. [source] Family involvement in perioperative nursing of adult patients undergoing emergency surgeryJOURNAL OF CLINICAL NURSING, Issue 2 2001Eija Paavilainen PhD ,,The purpose of this study was to describe how adult patients undergoing emergency surgery experience family centredness in perioperative nursing practice. The central aim was to generate knowledge to be used while developing the practice, education and management of perioperative nursing. ,,Data were collected using a questionnaire with emergency surgical patients in five regional hospitals in Southern Finland. The number of distributed questionnaires was 132. The response rate was 85% (n=112). ,,The results were mainly described as frequencies and percentages. The open-ended sections of the answers were analysed using qualitative content analysis. The findings from the open-ended questions were used for deepening and complementing the quantitative description of the results. ,,In the preoperative phase, ascertaining the family situation and informing the family member chosen by the patient were not achieved systematically. Family situation was also rarely examined in the intraoperative and postoperative phases, although it is central to coping after surgery, especially in home care. ,,The results support the view of earlier research about the importance of individuality of patients and their families during the perioperative care process and hence enhance the endeavour to develop nursing based on families' real needs. [source] Safety of cesarean myomectomyJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 5 2009Byung-Joon Park Abstract Aim:, To examine the safety and appropriateness of uterine myomectomy during cesarean section. Methods:, We conducted a retrospective analysis of 97 patients who underwent myomectomy during cesarean section and 60 patients who had uterine myomas, but underwent cesarean section only, between January 2000 and December 2007. Based on the patients' medical records, we conducted an analysis of the characteristics of the uterine myomas, hematologic changes that occurred between the preoperative and postoperative phases, complications, and length of hospital stay. Results:, Changes in hemoglobin values between the preoperative and postoperative phases, indicating the degree of intraoperative bleeding, were evaluated. There were no significant differences between the two groups (cesarean myomectomy group [1.2 ± 1.2 g/dL] versus control group [1.1 ± 1.3 g/dL]). There were no significant differences in the frequency of blood transfusion, incidence of postoperative fever, duration of surgery, and length of hospital stay between the two groups. In patients who received a blood transfusion intraoperatively, the increased amount was added to the hemoglobin changes between the preoperative and postoperative phases (adjusted value). The difference in the adjusted value of hemoglobin change did not reach statistical significance (cesarean myomectomy group [1.3 ± 1.2 g/dL] versus control group [1.2 ± 1.1 g/dL]). When the size of the uterine myoma exceeded 6 cm, the operative time was longer in the cesarean myomectomy group. Conclusion:, Cesarean myomectomy is a safe surgical option with no significant complications if performed by an experienced practitioner. [source] | ||||||||||