Apnea del sueño y anestesia / Sleep apnea and anaesthesia

Abril 13, 2017. No. 2658

Examen preoperatorio de la apnea obstructiva del sueño. Pre-operative screening for obstructive sleep apnoea. Verbraecken J1, Hedner J2, Penzel T3. Eur Respir Rev. 2017 Jan 3;26(143). pii: 160012. doi: 10.1183/16000617.0012-2016. Print 2017 Jan. Abstract Sleep disordered breathing, especially obstructive sleep apnoea (OSA), has a high and increasing prevalence. Depending on the apnoea and hypopnoea scoring criteria used, and depending on the sex and age of the subjects investigated, prevalence varies between 3% and 49% of the general population. These varying prevalences need to be reflected when considering screening for OSA. OSA is a cardiovascular risk factor and patients are at risk when undergoing medical interventions such as surgery. Screening for OSA before anaesthesia and surgical interventions is increasingly considered. Therefore, methods for screening and the rationale for screening for OSA are reviewed in this study. PDF Manejo anestésico de los adultos con apnea del sueño. Anaesthetic management of sleep-disordered breathing in adults. Hillman DR1,2, Chung F3. Respirology. 2017 Feb;22(2):230-239. doi: 10.1111/resp.12967. Epub 2016 Dec 17. Abstract Anaesthesia and sleep are different states of unconsciousness with considerable physiological common ground. Because of their shared depressant effects on muscle activation and ventilatory drive, patients with anatomically compromised airways will tend to obstruct in either state and those with impaired ventilatory capacity will tend to hypoventilate. Breathing behaviour in one state is predictive of that in the other. An essential difference is that while arousal responses are preserved during sleep, they are depressed during sedation and abolished by anaesthesia. This renders patients with sleep-related breathing disorders vulnerable to hypoventilation and asphyxia when deeply sedated. Addressing this vulnerability requires a systematic approach to identification of patients and circumstances that magnify this risk, and methods of managing it that seek to reconcile the need for safety with cost-effective use of resources. KEYWORDS: anaesthesia; obstructive sleep apnoea; perioperative management; sleep; sleep-disordered breathing PDF Una actualización de las diversas aplicaciones prácticas del cuestionario STOP-Bang en anestesia, cirugía y medicina perioperatoria. An update on the various practical applications of the STOP-Bang questionnaire in anesthesia, surgery, and perioperative medicine. Nagappa M1, Wong J, Singh M, Wong DT, Chung F. Curr Opin Anaesthesiol. 2017 Feb;30(1):118-125. doi: 10.1097/ACO.0000000000000426. Abstract PURPOSE OF REVIEW: The present review aims to provide an update on the various practical applications of the STOP-Bang questionnaire in anesthesia, surgery, and perioperative medicine. RECENT FINDINGS: The STOP-Bang questionnaire was originally validated as a screening tool to identify surgical patients who are at high-risk of obstructive sleep apnea (OSA).  SUMMARY: STOP-Bang at least 3 was recommended previously to identify the suspected or undiagnosed OSA. To reduce the false positive cases and to improve its specificity, a stepwise stratification is recommended to identify the patients at high risk of moderate-to-severe OSA. Because of its practical application, STOP-Bang is a useful screening tool for patients with suspected or undiagnosed OSA. PDF Vacante para Anestesiología Pediátrica El Hospital de Especialidades Pediátricas de León, Guanajuato México  ofrece un contrato laboral en el departamento de anestesiología  Informes con la Dra Angélica García Álvarez  angy.coachanestped@gmail.com o al teléfono 477 101 8700 Ext 1028

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Artroplastia Patelofemoral

http://www.altaespecialidadenortopedia.com.mx/academia/artroplastia-patelofemoral/

                                                                                                                                                     

Patellofemoral arthroplasty

Fuente
Este artículo es originalmente publicado en:

https://youtu.be/ZYsnqaV1W60

De y todos los derechos reservados para:

Courtesy: Dr Jack Farr MD

Joint Replacement and Cartilage Restoration Surgeon

OrthoIndy and OrthoIndy Hospital

1260 Innovation Pkwy Ste 100, Greenwood, IN 46143

Indianpolis, USAhttp://www.cartilagerestoration.org/

This is a video on a female patient with patellar (kneecap) knee pain from osteoarthritis. She underwent a patellofemoral arthroplasty on her knee.

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#artroplastia patelofemoral#artroplastia#patelofemoral

Aloinjerto osteocondral

http://www.cirugiarticular.com.mx/academia/aloinjerto-osteocondral/

Osteochondral Allograft

Fuente

Este artículo es originalmente publicado en:

https://youtu.be/XAcxovrwZfs

De y todos los derechos reservados para:

Courtesy: Brian J Cole MD Sports Medicine and Cartilage Restoration Surgeon Rush University, Chicago, Illinois www.briancolemd.com

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Control de Daños en Ortopedia

http://www.cirugiadepieytobillo.com.mx/academia/control-de-danos-en-ortopedia/

                                                                                                                                                          

Damage Control Orthopaedics

Fuente
Este artículo es originalmente publicado en:

https://youtu.be/qUTxEUfUc2I

De y todos los derechos reservados para:

Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA

Dr. Ebraheim’s educational animated video describes information associated with damage control orthopaedics.

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Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund:
https://www.utfoundation.org/foundati…

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Obesidad mórbida y artroplastia total de rodilla: un problema creciente

http://www.artroscopiayreemplazos.com.mx/academia/obesidad-morbida-y-artroplastia-total-de-rodilla-un-problema-creciente/

Morbid Obesity and Total Knee Arthroplasty: A Growing Problem

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28146438

http://insights.ovid.com/crossref?an=00124635-201703000-00003

http://journals.lww.com/jaaos/pages/articleviewer.aspx?year=2017&issue=03000&article=00003&type=abstract

De:

Martin JR1,Jennings JM,Dennis DA.

J Am Acad Orthop Surg.

2017 Mar;25(3):188-194. doi: 10.5435/JAAOS-D-15-00684

Todos los derechos reservados para:

© 2017 by American Academy of Orthopaedic SurgeonsAbstract

Obesity is an epidemic, with approximately 35% of the US population affected. This rate is unlikely to decline and may increase the demand for total knee arthroplasty (TKA). Data regarding the risks, benefits, and potential complications of TKA in this patient population are conflicting. Preoperative considerations are optimization of nutritional status, safe weight loss strategies, and bariatric surgery. Intraoperative concerns unique to this population include inadequate exposure, implant alignment, and durable implant fixation; postoperative issues include tibial loosening, wound complications, cardiovascular events, and respiratory complications. A thorough understanding of the medical and surgical complications associated with TKA in the obese patient will facilitate research efforts and improve outcomes.

Resumen
La obesidad es una epidemia, con aproximadamente el 35% de la población estadounidense afectada. Esta tasa es poco probable que disminuya y puede aumentar la demanda de artroplastia total de rodilla (TKA). Los datos relativos a los riesgos, beneficios y posibles complicaciones de TKA en esta población de pacientes son conflictivos. Las consideraciones preoperatorias son la optimización del estado nutricional, estrategias seguras de pérdida de peso y cirugía bariátrica. Las preocupaciones intraoperatorias exclusivas de esta población incluyen exposición inadecuada, alineación del implante y fijación duradera del implante; Las cuestiones postoperatorias incluyen aflojamiento tibial, complicaciones de la herida, eventos cardiovasculares y complicaciones respiratorias. Una comprensión completa de las complicaciones médicas y quirúrgicas asociadas con TKA en el paciente obeso facilitará los esfuerzos de investigación y mejorar los resultados.

PMID:   28146438   DOI:  

10.5435/JAAOS-D-15-00684

#obesidad#artroplastia total de rodilla#rodilla#paciente obeso#TKA