Anestesia para cirugía de invasión mínima / Anaesthesia for minimally invasive surgery

Septiembre 10, 2017. No. 2807

Anestesia para cirugía de invasión mínima Anaesthesia for minimally invasive surgery. Dec M1, Andruszkiewicz P1. Author information Wideochir Inne Tech Maloinwazyjne. 2016 Jan;10(4):509-14. doi: 10.5114/wiitm.2015.56411. Epub 2015 Dec 15. Abstract Minimally invasive surgery (MIS) is rising in popularity. It offers well-known benefits to the patient. However, restricted access to the surgical site and gas insufflation into the body cavities may result in severe complications. From the anaesthetic point of view MIS poses unique challenges associated with creation of pneumoperitoneum, carbon dioxide absorption, specific positioning and monitoring a patient to whom the anaesthetist has often restricted access, in a poorly lit environment. Moreover, with refinement of surgical procedures and growing experience the anaesthetist is presented with patients from high-risk groups (obese, elderly, with advanced cardiac and respiratory disease) who once were deemed unsuitable for the laparoscopic technique. Anaesthetic management is aimed at getting the patient safely through the procedure, minimizing the specific risks arising from laparoscopy and the patient's coexisting medical problems, ensuring quick recovery and a relatively pain-free postoperative course with early return to normal function. KEYWORDS: general anaesthesia; minimally invasive surgery; perioperative management PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Video informativo Convocatoria para el Curso de Posgrado en Medicina del Dolor y Paliativa 2018 para Mexicanos y extranjeros. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Informes (52) 55 5487 0900 ext. 5011 de lunes a viernes de 9.00 a 14 h (hora de Ciudad de México).  Informes / Information California Society of Anesthesiologists Reuniones / Events Informacion / Information

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

Fracturas de antebrazo. Manejo Quirúrgico

http://www.manoytrauma.com.mx/academia/fracturas-de-antebrazo-manejo-quirurgico/

Forearm fractures – Surgical treatment

Fuente

Este artículo y/o video es originalmente publicado en:

https://youtu.be/L_xDI7tFFHA

De y Todos los derechos reservados para:

Courtesy: Saqib Rehman MD

Director of Orthopaedic Trauma

Temple University

Philadelphia

Pennsylvania

USA

www.orthoclips.com

OrthoClips

Publicado el 28 feb. 2016

Narrated, annotated lecture 2 of 3 on forearm fractures from the OTA resident lecture se

#fracturas#antebrazo#Manejo quirúrgico

Anestesia ambulatoria / Ambulatory anesthesia

Septiembre 11, 2017. No. 2808

Anestesia para cirugía ambulatoriaAnesthesia for ambulatory surgery. Lee JH1. Author information Korean J Anesthesiol. 2017 Aug;70(4):398-406. doi: 10.4097/kjae.2017.70.4.398. Epub 2017 May 19. Abstract Ambulatory anesthesia allows quick recovery from anesthesia, leading to an early discharge and rapid resumption of daily activities, which can be of great benefit to patients, healthcare providers, third-party payers, and hospitals. Recently, with the development of minimallyinvasive surgical techniques and short-acting anesthetics, the use of ambulatory surgery has grown rapidly. Additionally, as the indications for ambulatory surgery have widened, the surgical methods have become more complex and the number of comorbidities has increased. For successful and safe ambulatory anesthesia, the anesthesiologist must consider various factors relating to the patient. Among them, appropriate selection of patients and surgical and anesthetic methods, as well as postoperative management, should be considered simultaneously. Patient selection is a particularly important factor. Appropriate surgical and anesthetic techniques should be used to minimize postoperative complications, especially postoperative pain, nausea, and vomiting. Patients and their caregivers should be fully informed of specific care guidelines and appropriate responses to emergency situations on discharge from the hospital. During this process, close communication between patients and medical staff, as well as postoperative follow-up appointments, should be ensured. In summary, safe and convenient methods to ensure the patient's return to function and recovery are necessary. KEYWORDS: Ambulatory surgical procedures; Anesthesia; Patient safety; Patient selection PDF La seguridad del paciente durante sedación mediante monitorización de capnografía: una revisión sistemática y meta-análisis. Patient safety during procedural sedation using capnography monitoring: a systematic review and meta-analysis. Saunders R1,2, Struys MMRF3,4, Pollock RF2, Mestek M5, Lightdale JR6,7. Author information BMJ Open. 2017 Jun 30;7(6):e013402. doi: 10.1136/bmjopen-2016-013402. Abstract OBJECTIVE: To evaluate the effect of capnography monitoring on sedation-related adverse events during procedural sedation and analgesia (PSA) administered for ambulatory surgery relative to visual assessment and pulse oximetry alone.  CONCLUSIONS: Meta-analysis of 13 RCTs published between 2006 and 2016 showed a reduction in respiratory compromise (from respiratory insufficiency to failure) during PSA with the inclusion of capnography monitoring. In particular, use of capnography was associated with less mild and severe oxygen desaturation, which may have helped to avoid the need for assisted ventilation. KEYWORDS: Ambulatory surgery; Capnography; Meta-analysis; Procedural sedation PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Video informativo Convocatoria para el Curso de Posgrado en Medicina del Dolor y Paliativa 2018 para Mexicanos y extranjeros. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Informes (52) 55 5487 0900 ext. 5011 de lunes a viernes de 9.00 a 14 h (hora de Ciudad de México).  Informes / Information

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

Osteotomía femoral supracondílea y reemplazo de articulación de rodilla durante el mismo procedimiento quirúrgico en un paciente hemofílico de tipo A con deformidad en la flexión de rodilla y anquilosis

http://www.cirugiarticular.com.mx/academia/osteotomia-femoral-supracondilea-y-reemplazo-de-articulacion-de-rodilla-durante-el-mismo-procedimiento-quirurgico-en-un-paciente-hemofilico-de-tipo-a-con-deformidad-en-la-flexion-de-rodilla-y-anquilos/

Supracondylar femoral osteotomy and knee joint replacement during the same surgical procedure in a type A haemophiliac patient with knee flexion deformity and ankylosis

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/27919671

http://www.thekneejournal.com/article/S0968-0160(16)30196-X/fulltext

De:

Osma Rueda JL1,Oliveros Vargas A2,Sosa CD2.

Knee.

2017 Mar;24(2):477-481. doi: 10.1016/j.knee.2016.

Todos los derechos reservados para:

Copyright © 2016 Elsevier B.V. All rights reserved.

Abstract

BACKGROUND:

Haemophilia A is the cause of diverse musculoskeletal disorders such as ankylosis, arthritis and associated angular deformity. There are few reported cases in patients with haemophilia A in which simultaneous supracondylar femoral osteotomy and knee joint replacement has been performed to treat knee angular deformity and ankylosis. Here we present the case of an 18year old male patient, with an evolution of two years, who was unable to walk due to the presence of an untreated supracondylar fracture in the left femur and ipsilateral haemophilic arthropathy which led him to develop an ankylosis in flexion close to 70°.

METHODS AND RESULTS:

Supracondylar osteotomy of the femur and of the left knee joint was performed in the same surgical procedure. Bleeding control was achieved with a protocol of factor VIII supply. The patient was followed up for eight years, and recovered a 0 to 90° range of motion and regained his gait pattern.

CONCLUSIONS:

This case potentially provides a new alternative approach for haemophilia patients presenting with angular deformities and complex ankylosis. We suggest that mixed lesions of intra- and extra-articular deformity in haemophiliac patients can be corrected during the same surgical intervention. In addition, interdisciplinary management including haematology for operative and immediately postoperative control of intra-bleeding using factor VIII supply and control, combined with a controlled rehabilitation plan, can yield good functional outcomes in patients with haemophilic arthropathy.

Copyright © 2016 Elsevier B.V. All rights reserved.

KEYWORDS:

Ankylosis; Haemophilia A; Knee prosthesis; Osteotomy

Resumen

ANTECEDENTES:

La hemofilia A es la causa de diversos trastornos musculoesqueléticos tales como anquilosis, artritis y deformidad angular asociada. Hay pocos casos reportados en pacientes con hemofilia A en los que se realizó osteotomía femoral supracondílea simultánea y reemplazo de articulación de rodilla para tratar la deformidad angular de la rodilla y la anquilosis. Aquí presentamos el caso de un paciente de 18 años de edad, con una evolución de dos años, incapaz de caminar debido a la presencia de una fractura supracondílea no tratada en el fémur izquierdo y artropatía hemofílica ipsilateral que le llevó a desarrollar una anquilosis en flexión cerca de 70 °.

MÉTODOS Y RESULTADOS:
La osteotomía supracondílea del fémur y de la articulación de la rodilla izquierda se realizó en el mismo procedimiento quirúrgico. El control de sangrado se logró con un protocolo de suministro de factor VIII. El paciente fue seguido durante ocho años, y recuperó un rango de 0 a 90 ° de movimiento y recuperó su patrón de marcha.

CONCLUSIONES:
Este caso potencialmente proporciona un nuevo enfoque alternativo para los pacientes con hemofilia que presentan deformidades angulares y anquilosis complejas. Sugerimos que las lesiones mixtas de deformidad intra y extraarticular en pacientes hemofílicos pueden ser corregidas durante la misma intervención quirúrgica. Además, la gestión interdisciplinaria, incluida la hematología para el control quirúrgico e inmediatamente postoperatorio de la hemorragia intrauterina utilizando el suministro y el control del factor VIII, combinada con un plan de rehabilitación controlado, puede producir buenos resultados funcionales en pacientes con artropatía hemofílica.

Copyright © 2016 Elsevier B.V. Todos los derechos reservados.

PALABRAS CLAVE:
Anquilosis; Hemofilia A; Prótesis de rodilla; Osteotomía

PMID: 27919671   DOI:  

10.1016/j.knee.2016.11.007

#anquilosis#hemofilia A#prótesis de rodilla#osteotomía