Intestinal Obstruction ; Preoperative Care

Introduction: Preanesthetic evaluation is a basic element of anesthesia care which aims to reduce the risks associated with anesthesia and increase quality of perioperative care. As part of the preanesthetic evaluation, questionnaires allow the anesthesiologist to quickly review a structured list and focus on pertinent findings thus ensuring a more focused evaluation. The objective of this study is to develop a self-administered preoperative assessment questionnaire in Filipinos that can be used for patients scheduled to undergo anesthesia and to determine if the questionnaire can help in risk stratification of these patients. Methods: Adult patients undergoing anesthesia were asked to fill up a 24-item questionnaire written in Filipino and English that emphasized the cardiovascular, respiratory, neurologic, endocrine, gastrointestinal, hematologic, and homeostatic status of the patient. Questions were answerable by "yes", "no", or "I don't know". A "yes" was counted as two points, "no" one point, "I don't know" as 0. Scores were then added for each patient. An anesthesia resident unaware of the results of the questionnaire validated the patient's responses by doing a routine preoperative evaluation. 'Results from the two were compared. Results: Eighty-four patients were included in the study. No significant difference was noted between the results of the questionnaire and the standard preoperative form. Tweny one patients were included in the high index group because their perioperative course was marked by previously defined adverse events while the remaining 63 were in the low index group because of an unremarkable perioperative course. Mean cumulative score of patients in the high index group was significantly higher than the low index group (30.48 vs. 27.42; p<0.05, Sig). A score of 29 or higher was also found to be associated with adverse events during the perioperative period. Conclusion: This self-administered form in Filipino was comparable to the standard evaluation done by a resident and was helpful in detecting potential problem areas for patients undergoing anesthesia and surgery. (Author)
Human ; ANESTHESIA ; SURGERY ; PREOPERATIVE CARE

Humans ; Preoperative Exercise ; Preoperative Care ; Postoperative Complications/prevention & control*

BACKGROUND: Children and parents experience significant anxiety and distress during the preoperative period. This is important because preoperative anxiety in children is associated with adverse postoperative outcome. So we suggest behaviorally oriented preoperative anxiety intervention program based on the anesthesia and psychology with smartphone application, world-widely used. METHODS: A total 120 patients (aged 1-10 years old) who were scheduled for elective surgery under general anesthesia was included in this randomized controlled trial. We randomized the patients into three groups, with using intravenous (IV) midazolam sedation (M group), with using smartphone application program (S group), and with using low dose IV midazolam plus smartphone application program (SM group). And the child anxiety was assessed using the modified Yale Preoperative Anxiety Scale (mYPAS) at holding area, 5 min after intervention, entrance to operating room. RESULTS: In all three groups, mYPAS after intervention were lower than the preoperative holding area (M group 52.8 +/- 11.8 vs 41.0 +/- 7.0, S group 59.2 +/- 17.6 vs 36.4 +/- 7.3, SM group 58.3 +/- 17.5 vs 26.0 +/- 3.4). A comparison of mYPAS scores between each group showed that the S group reduced anxiety lower than M group (P < 0.01), and the SM group exhibited significantly lower anxiety than the two other groups (P < 0.01). CONCLUSIONS: The preoperative preparation program using smartphone application is simple and customized by individual development that effective in the reduction of preoperative anxiety.
Anesthesia ; Anesthesia, General ; Anxiety* ; Child ; Humans ; Midazolam ; Operating Rooms ; Parents ; Preoperative Care ; Preoperative Period ; Psychology

INTRODUCTION: Prehabilitation may benefit older patients undergoing major surgeries. Currently, its efficacy has not been conclusively proven. This is a retrospective review of a multimodal prehabilitation programme. METHODS: Patients aged 65 years and above undergoing major abdominal surgery between May 2015 and December 2019 in the National University Hospital were included in our institutional programme that incorporated aspects of multimodal prehabilitation and Enhanced Recovery After Surgery concepts as 1 holistic perioperative pathway to deal with issues specific to older patients. Physical therapy, nutritional advice and psychosocial support were provided as part of prehabilitation. RESULTS: There were 335 patients in the prehabilitation cohort and 256 patients whose records were reviewed as control. No difference in postoperative length of stay ( CONCLUSION The current study found no differences in traditional surgical outcome measures with and without prehabilitation. An increase in patient mobility in the immediate postoperative period was noted with prehabilitation, as well as an association between prehabilitation and increased adherence to postoperative adjuvant therapy. Larger prospective studies will be needed to validate the findings of this retrospective review.
Humans ; Postoperative Complications/prevention & control* ; Preoperative Care ; Preoperative Exercise ; Prospective Studies ; Retrospective Studies

Recent advances in medical and surgical therapy were achieved during the last two decades in the management of Crohn's disease (CD). Anti-tumor necrosis factor (anti-TNF) agents are widely used worldwide. However, a significant proportion of patients still need surgical resections. The impact of previous exposure to these agents on the perioperative and postoperative outcomes is still controversial. In this critical review, we aimed to position the strategy of intentional preoperative use of anti-TNF agents in the management of CD. The indications and contraindications for this strategy are detailed, and despite scarce evidence, the possible advantages and disadvantages of the intentional use of anti-TNF agents before abdominal surgery in CD are discussed.
Crohn Disease* ; Humans ; Necrosis* ; Preoperative Care ; Tumor Necrosis Factor-alpha

Recently, accumulation of knowledge on cerebrovascular microanatomy and its hemodynamics and advances in interventional equipments, especially microcatheters, could make superselective embolization as well as for an adjunctive preoperative procedures The authors performed superselective angiography and embolization with Tracker microcatheter in 25 procedures out of 15 patients with brain arteriovenous malformations (AVMs). Complete embolization was done in 7 prtients (46.7%), nearly complete embolization in 6 patients(40.4%), and partial embolization in 2 patients (13.3%). The overall curative success rate of embolization was 86.7%. Five patients showed no complication at all. Mild complications, however, were observed in 7 patients (46.8%). Severe complications such as AVM or Tracker rupture were observed in 3 patients (20%). In conclusion, superselective embolization is and effective method for the treatment of brain AVMs, and multiple session embolizations could reduce the complication rate and increase the success rate.
Angiography ; Arteriovenous Malformations* ; Brain* ; Hemodynamics ; Humans ; Methods ; Preoperative Care ; Rupture

OBJECTIVETo observe the effective of presurgical nasoalveolar molding (PNAM) therapy in the treatment of complete cleft lip and palate infant.

METHODSPNAM was performed as presurgical orthodontic treatment in 45 infants (aged 18.33 d) with nonsyndromic complete cleft lip and palate. The columella deviation, columella length, nostril width, nostril height and width of alveolar cleft were measured before and after treatment. The data were analyzed by SPSS 10.0.

RESULTSAfter PNAM treatment, the columella deviation, columella length, nostril width and width of alveolar cleft obviously decreased, while the nostril height increased. Except for smaller cleft nostril width of bilateral complete cleft lip and palate infant, other measurement items had statistics difference (P<0.05).

CONCLUSIONPNAM can improve nasal profile of complete cleft lip and palate infant and decrease the width of alveolar cleft, and make it easy for the operation of cleft lip and palate.

OBJECTIVETo study the changes of palate cleft gap of complete unilateral cleft lip and palate (UCLP) infants before and after presurgical orthodontic and cheiloplasty.

METHODSThe sample consisted of 18 complete UCLP infants who were treated using presurgical nasoalveolar molding (PNAM) appliance and cheiloplasty. The maxillary models were obtained at the initial visit, after PNAM treatment 1 month before cheiloplasty, and 2 months after cheiloplasty. The change of palate cleft gap were compared.

RESULTSAfter PNAM treatment and cheiloplasty, the lip profile was obviously improved, cleft gap was reduced, and the height of ala nasi fornix was recovered.

CONCLUSIONPNAM treatment can improve the lip shape and nasal deformity degree of UCLP patient. The cleft gap and upper lip tension are reduced.

Acupuncture Therapy ; Female ; Humans ; Middle Aged ; Preoperative Care ; Tachycardia ; therapy