162 research outputs found
Does Transfusion of Blood and Blood Products Increase the Length of Stay in Hospital?
No full textWe aimed to analyze the use of blood products in cardiac surgery and to investigate its effect on clinical outcomes. Perioperative transfusion requirement, survival and complication rates and the duration of hospitalization were noted. Patients were divided into two groups considering the duration of hospital and intensive care unit (ICU) stay. The cardiopulmonary bypass time and the cross clamp time, and the amount of used cryoprecipitate, fresh frozen plasma, platelet, red blood cell and the bleeding amount were significantly higher in groups that stayed at the hospital for >7days and at the ICU for >2days (p>0.05). In the univariate model, to predict the patients who might stay at the hospital for more than 1week and who might stay at the ICU for more than 3days, we considered the significant efficacy of postoperative blood transfusion, bleeding amount, and the cardiopulmonary bypass time (p<0.05). In the reduced multivariate model, however, we analyzed the significant-independent efficacy of the postoperative fresh frozen plasma use to determine the patients who would stay at the hospital for more than 1week and who would stay at the ICU for more than 3days (p<0.05). We have concluded that increased use of blood products was associated with the cross clamp and cardiopulmonary bypass time and prolonged duration of hospital and ICU stays. In open cardiac surgeries, the use of blood products due to bleeding was identified as a predictor for staying longer than 3days at the ICU and longer than 7days at the hospital
Comparative study of fentanyl and morphine in addition to hyperbaric or isobaric bupivacaine in combined spinal anaesthesia for caesarean section
No full textIntroduction: The aim of our study was to compare the effects of isobaric and hyperbaric bupivacaine combined with morphine or fentanyl in patients undergoing caesarean section. We assessed quality and spread of analgesia and anaesthesia, postoperative analgesic requirement and side effects. Material and methods: Hundred patients with American Society of Anesthesiologists physical status (ASA) I-II, age 18 to 40 years, were randomized to 4 groups. The intrathecal solutions were isobaric bupivacaine + morphine (group A), isobaric bupivacaine + fentanyl (group B), heavy bupivacaine + + morphine (group C) and heavy bupivacaine + fentanyl (group D). Mean arterial pressure, heart rate, oxygen saturation, ephedrine consumption, analgesic requirement time and additional analgesic needs were recorded. Results: The 1(st) min value of mean arterial pressure was the lowest one in all groups. Heart rate decreased significantly in group A at the 10(th) min but not in the other groups. The decrease of visual analogue scale (VAS) pain scores began in the groups after the 4(th) postoperative h (p < 0.05) and the VAS value of group B at the 8(th) h was significantly higher than the other groups. The first analgesic requirement time in the postoperative period was longer in patients who had intrathecal morphine than those who had fentanyl. The duration of analgesia with isobaric bupivacaine and morphine was the longest one. Conclusions: We concluded that intrathecal morphine provides a long duration of postoperative analgesia but the duration gets longer when it is combined with plain bupivacaine instead of heavy bupivacaine
European Airway Management Society (EAMS) structure and activities
No full textEuropean Airway Management Society (EAMS) was created as a multi-disciplinary society to provide a forum for health professionals interested in airway management. The foundation meeting was held during the European Society of Anesthesiology (ESA) Congress in June 2003. Since 2009, the EAMS Hands-on Airway Workshop has been organized during the annual congresses of the European Society of Anaesthesiologists (Euroanaesthesia congress) as a one-day precongress course. EAMS is eager to create a learning environment with small groups custom-made training in advanced airway management using simulated airway scenarios. By this way participants gain practice skills and strategies for the management of airway emergencies. EAMS created 6 committees: Committee on EAMS Development and Communication, Annual Meeting & Sponsoring Committee, Education & Trainee Committee, Advisory Committee, Science Committee and Airway Management in Special Circumstances Committee, and in all committees are Board of Directors (BOD) members represented. In conclusion EAMS is a growing non-profit society aiming to disseminate and promote the exchange of information in regard to airway management. EAMS is open for new members, new ideas and concepts, new scientific approaches to airway management and educational strategies to teach and learn airway management. (c) 2017 Published by Elsevier Ltd
Postoperative thrombotic effects of tranexamic acid in open heart surgery
No full textBackground Following the administration of tranexamic acid, the occurrence of thromboembolic events is a controversial issue. Aims In this retrospective cohort study, we aimed to determine the possible thromboembolic complications due to tranexamic acid as a prophylactic method in patients undergoing open heart surgery. Methods The data of 172 adult patients undergoing open heart surgery were analyzed. All patients received tranexamic acid at a dose of 50 mg/kg. The patients were divided into 3 groups as multiple-valve surgery (group 1), coronary bypass alone (group 2), and coronary bypass with valve surgery (group 3). The amount of blood transfusion, bleeding in intra- and postoperative period, and the presence of thromboembolic events including myocardial infarction, stroke, pulmonary embolism, and deep vein thrombosis were investigated. Results Patient demographics and duration of surgery were not significantly different in groups (p > 0.05). Hb, Htc, INR, and platelet levels of all groups did not differ significantly (p > 0.05). In total, 7 patients underwent reexploration. Postoperative DVT, stroke, and seizure were not seen at all. There was no statistically significant difference between groups in terms of the amount of blood transfusion, drainage, or peritoneal hematoma. The length of hospital stay and the mortality rate did not differ (p > 0.05). Conclusions In patients receiving tranexamic acid infusion at 50 mg/kg dose, reexploration rates remained at 4.1% even after major cardiac surgeries. No thrombosis, stroke, or seizure were reported. Our findings support that tranexamic acid is a safe drug which has positive effect on reducing perioperative bleeding
Factor VII and thromboembolism
No full textRecombinant activated factor VIIa (rFVIIa) is a potent hemostatic agent originally developed for the treatment of haemophilia patients with inhibitors against factor FVIII or FIX. In approved indications, the safety profile of rFVIIa is favourable without major concerns. The prevalence of thromboembolic (TE) complications is less than 4/100.000 with fatal events being extremely rare. Also, the majority of reported events occurred in elderly patients with predisposing factors for TE complications. Currently, off-label use of rFVIIa has become much more common with intracerebral haemorrhage and major surgical procedures being one of the most investigated areas. However, the literature had controversial results with a dubious safety profile. While in intracerebral haemorrhage and cardiac surgery the administration of rFVIIa appears to increase the risk for TE adverse events, in trauma patients, variceal bleeding and liver transplantation the risk doesn't seem to be higher. Besides, no significant difference was reported in mortality rates. Moreover, a close monitoring for signs and symptoms of TE episodes is essential in patients treated with rFVIIa, especially the elderly and other patients with predisposing risk factors for thrombosis. In this opinion article, we aimed to review the current literature about the potential TE adverse events of rFVIIa in different clinical and surgical scenarios. (c) 2018 Published by Elsevier Ltd
Comparative study of intravenous opioid consumption in the postoperative period
No full textBackground. Intravenous patient-controlled analgesia (IV PCA) using opiods is an accepted method for delivering postoperative analgesia. The aim of this study was to compare fentanyl and tramadol with IV PCA after spinal anesthesia (SA) and general anesthesia (GA) following cesarean section (C/S). Methods. Ninety women were randomly assigned to three groups (n=30). Group 1 was treated with IV fentanyl PCA after SA. Groups 2 and 3 were treated with IV fentanyl PCA and IV tramadol PCA after GA. Outcome measures were recorded for the first 24 h post-anesthesia. Results. PCA use was significantly lower after SA (P<0.05). Eighteen patients in the SA Group and 27 patients and 24 patients from the GA groups required additional opioid. Opioid consumption and patient satisfaction were similar for groups after GA (P>0.05). 638.4 +/- 179.1 mu g fentanyl was consumed by patients of Group 2, 356.3 +/- 87.0 mu g fentanyl and 559.5 +/- 207.0 mg tramadol was consumed by Group 1 and Group 3 respectively. There was no significant difference in the overall severity and incidence of nausea, drowsiness or pruritus. Conclusion. Our study shows that analgesic consumption and post-operative pain scores after SA in C/S decreased, without increase in adverse reactions
- …
