miércoles, 11 de abril de 2018

Dolor persistente postcirugía / Persistent postsurgical pain

Marzo 27, 2018. No. 3035

Dolor persistente y anomalías sensoriales después de la abdominoplastia.
Persistent Pain and Sensory Abnormalities after Abdominoplasty.
Plast Reconstr Surg Glob Open. 2015 Dec 9;3(11):e561. doi: 10.1097/GOX.0000000000000542. eCollection 2015 Nov.
Abstract
BACKGROUND: Persistent postsurgical pain is a well-recognized problem after a number of common surgical procedures, such as amputation, thoracotomy, and inguinal hernia repair. Less is known about persistent pain after cosmetic surgical procedures. We, therefore, decided to study the incidence and characteristics of persistent pain after abdominoplasty, which is one of the most frequent cosmetic surgical procedures. METHODS: In September 2014, a link to a web-based questionnaire was mailed to 217 patients who had undergone abdominoplastybetween 2006 and 2014 at the Department of Plastic Surgery, Aalborg University Hospital, Denmark. The questionnaire included questions about pain and sensory abnormalities located to the abdominal skin, and physical and psychological function; patient satisfaction with surgery was rated on a 4-point scale. RESULTS: One hundred seventy patients answered the questionnaire. Fourteen patients (8.2%) reported pain within the past 7 days related to the abdominoplasty. Abnormal abdominal skin sensation was common and reported by 138 patients (81%). Sensory hypersensitivity was associated with the presence of persistent pain. Satisfaction with the procedure was reported by 149 (88%) patients. The majority of patients reported improvement on all physical and psychological factors. Patients with pain were more often disappointed with the surgery and unwilling to recommend the surgery. CONCLUSIONS: Overall, patients were satisfied with the procedure, although abnormal abdominal skin sensation was common. However, there is a risk of developing persistent neuropathic pain after abdominoplasty, and patients should be informed about this before surgery.
Dolor postquirúrgico persistente en niños y jóvenes: predicción, prevención y manejo.
Persistent postsurgical pain in children and young people: prediction, prevention, and management.
Pain Rep. 2017 Aug 21;2(5):e616. doi: 10.1097/PR9.0000000000000616. eCollection 2017 Sep.
Abstract
Ensuring optimum preoperative and postoperative pain management should always be a priority in children.
KEYWORDS:
Pediatrics; Postsurgical pain; Surgery
La asociación entre la esperanza, el estado civil, la depresión y el dolor persistente en hombres y mujeres después de una cirugía cardíaca.
The association between hope, marital status, depression and persistent pain in men and women following cardiac surgery.
BMC Womens Health. 2018 Jan 2;18(1):2. doi: 10.1186/s12905-017-0501-0.
Abstract
BACKGROUND: Cardiac surgery is a major life event, and outcomes after surgery are associated with men's and women's ability to self-manage and cope with their cardiac condition in everyday life. Hope is suggested to impact cardiac health by having a positive effect on how adults cope with and adapt to illness and recommended lifestyle changes. ....  CONCLUSION: Addressing pain and depression, and promoting hope, particularly for women living alone may be important targets for interventions to improve outcomes following cardiac surgery.
KEYWORDS: Cardiac surgery; Depression; Hope; Marital status; Persistent pain
Safe Anaesthesia Worldwide
Delivering safe anaesthesia to the world's poorest people
Like us on Facebook   Follow us on Twitter   Find us on Google+   View our videos on YouTube 
Anestesiología y Medicina del Dolor

52 664 6848905

Oxigenación en prematuros / Oxygen in premature neonates

Abril 11, 2018. No. 3050
Una revisión de la fisiología del oxígeno y el manejo apropiado de los niveles de oxígeno en neonatos prematuros.
A Review of Oxygen Physiology and Appropriate Management of Oxygen Levels in PrematureNeonates.
Adv Neonatal Care. 2018 Apr;18(2):98-104. doi: 10.1097/ANC.0000000000000434.
Abstract
BACKGROUND: Although oxygen is the most widely used therapeutic agent in neonatal care, optimal oxygen management remains uncertain. PURPOSE: We reviewed oxygen physiology and balance, key studies evaluating oxygen saturation targets, and strategies for oxygen use in the neonatal intensive care unit. RESULTS: Oxygen is a potent vasodilator involved in the transition at birth to breathing. Supplemental oxygen is administered to reverse/prevent hypoxia; however, excessive oxygen can be toxic owing to the formation of reactive oxygen species. Current neonatal resuscitation guidelines recommend using room air for term infants in need of support, with titration to achieve oxygen saturation levelssimilar to uncompromised term infants. In premature infants, targeting a higher oxygen saturation range (eg, 91%-95%) may be safer than targeting a lower range (eg, 85%-89%), but more evidence is needed. In combined analyses, lower oxygen saturation levels increased mortality, suggesting that the higher target may be safer, but higher targets are associated with an increased risk of developing disorders of oxidative stress. IMPLICATIONS FOR PRACTICE: Need for supplemental oxygen should be assessed according to the American Heart Association guidelines. If appropriate, oxygen should be administered using room air, with the goal of preventing hypoxia and avoiding hyperoxia. Use of oximeter alarms may help achieve this goal. Pulmonary vasodilators may improve oxygenation and reduce supplemental oxygen requirements. IMPLICATIONS FOR RESEARCH: Implementation of wider target ranges for oxygen saturation may be more practical and lead to improved outcomes; however, controlled trials are necessary to determine the impact on mortality and disability.
Efectos de las saturaciones de oxígeno arterial más bajas versus más altas en la muerte o la discapacidad en los recién nacidos prematuros.
Effects of targeting lower versus higher arterial oxygen saturations on death or disability in preterm infants.
Cochrane Database Syst Rev. 2017 Apr 11;4:CD011190. doi: 10.1002/14651858.CD011190.pub2.


Congresos Médicos por Especialidades en todo Mundo

Medical Congresses by Specialties around the World

Safe Anaesthesia Worldwide
Delivering safe anaesthesia to the world's poorest people
Like us on Facebook   Follow us on Twitter   Find us on Google+   View our videos on YouTube 
Anestesiología y Medicina del Dolor

52 664 6848905

martes, 10 de abril de 2018

Guías pediátricas / Pediatric guidelines

Marzo 31, 2018. No. 3039

Guías para la cirugía pediátrica diurna de las Sociedades Italianas de Cirugía Pediátrica (SICP) y Anestesiología Pediátrica (SARNePI).
Guidelines on pediatric day surgery of the Italian Societies of Pediatric Surgery (SICP) and Pediatric Anesthesiology (SARNePI).
Ital J Pediatr. 2018 Mar 12;44(1):35. doi: 10.1186/s13052-018-0473-1.Abstract
The Italian Society of Pediatric Surgery (SICP) together with The Italian Society of Pediatric Anesthesia (SARNePI) through a systematic analysis of the scientific literature, followed by a consensus conference held in Perugia on 2015, have produced some evidence based guidelines on the feasibility of day surgery in relation to different pediatric surgical procedures. The main aspects of the pre-operative assessment, appropriacy of operations and discharge are reported.
KEYWORDS: Ambulatory surgery; Day case surgery; Day surgery; Guidelines; Outpatient
Safe Anaesthesia Worldwide
Delivering safe anaesthesia to the world's poorest people
Like us on Facebook   Follow us on Twitter   Find us on Google+   View our videos on YouTube 
Anestesiología y Medicina del Dolor

52 664 6848905

Pancreatitis aguda / Acute pancreatitis

Abril 2, 2018. No. 3041
Guía del American Gastroenterological Association Institute sobre el manejo inicial de la pancreatitis aguda.
American Gastroenterological Association Institute Guideline on Initial Management of AcutePancreatitis.
Gastroenterology. 2018 Mar;154(4):1096-1101. doi: 10.1053/j.gastro.2018.01.032. Epub 2018 Feb 3.
Pancreatitis aguda: perspectivas actuales sobre diagnóstico y tratamiento.
Acute pancreatitis: current perspectives on diagnosis and management.
J Inflamm Res. 2018 Mar 9;11:77-85. doi: 10.2147/JIR.S135751. eCollection 2018.
Abstract
The last two decades have seen the emergence of significant evidence that has altered certain aspects of the management of acute pancreatitis. While most cases of acute pancreatitis are mild, the challenge remains in managing the severe cases and the complications associated with acute pancreatitis. Gallstones are still the most common cause with epidemiological trends indicating a rising incidence. The surgical management of acute gallstone pancreatitis has evolved. In this article, we revisit and review the methods in diagnosing acute pancreatitis. We present the evidence for the supportive management of the condition, and then discuss the management of acute gallstone pancreatitis. Based on the evidence, our local institutional pathways, and clinical experience, we have produced an outline to guide clinicians in the management of acute gallstone pancreatitis.
KEYWORDS: acute pancreatitis; diagnostic imaging; management of gallstone pancreatitis; severity scoring
Safe Anaesthesia Worldwide
Delivering safe anaesthesia to the world's poorest people
Like us on Facebook   Follow us on Twitter   Find us on Google+   View our videos on YouTube 
Anestesiología y Medicina del Dolor

52 664 6848905