Humans ; Pancreaticoduodenectomy ; Pathology, Clinical ; Perioperative Period ; Postoperative Period ; Preoperative Period

BACKGROUND: Serious pulmonary complications after lung surgery increase morbidity and mortality in perioperative period. Ketamine hydrochloride produces strong analgesic effect in spite of the psychomimetic effects. Intravenous anesthesia with ketamine was performed in lung surgery of patients with decreased pulmonary function and compared with inhalation anesthesia with enflurane. METHODS: Sixty patients, scheduled for elective lung surgery, were randomly assigned to two groups. Patients received either enflurane (Group 1, n=30) or ketamine (Group 2, n=30) as main anesthetic drug. Blood pressure and heart rate were compared in preinduction, postinduction, postintubation, postincision, intraoperative period (30 minutes, 60 minutes) and recovery room between groups, and in each group. Arterial blood gas analysis was compared in preoperative period, intraoperative period and recovery room between groups. Postoperative psychological complications evaluated in group 2. RESULTS: Blood pressure and heart rate were significantly different in postinduction, postintubation and recovery room between groups. PaO2 in group 2 was higher than in group 1 during intraoperative period and recovery room. Postoperative psychological complications occured in 4 patients (13%) in group 2. CONCLUSIONS: Ketamine affords advantage over enflurane anesthesia in terms of PaO2 during intraoperative period and recovery room in lung surgery of patients with decreased pulmonary function.
Anesthesia ; Anesthesia, Inhalation* ; Anesthesia, Intravenous* ; Blood Gas Analysis ; Blood Pressure ; Enflurane* ; Heart Rate ; Humans ; Inhalation* ; Intraoperative Period ; Ketamine* ; Lung* ; Mortality ; Perioperative Period ; Preoperative Period ; Recovery Room

Between May, 1994 and December, 1995, 122 adult cardiac surgical procedures requiring cardiopulmonary bypass were performed at Kang Dong Sacred Heart Hospital, including 18 cases(14.8%) that were associated with preoperative(n=9), intraoperative(n=7), postoperative(n=2) use of an IABP(intra-aortic balloon pump). The reasons for IABP were low cardiac output and PTCA(percutaneous transluminal coronary angioplasty) failure in preoperative period, CPB(cardiopulmonary bypass) weaning difficulty in intraoperative period, and intractable arrhythmia in postoperative period. The mean age of the IABP patients was 61.8+/-6.9 years(range, 39 to 75years). The overall hospital mortalities in patients with preoperative and intraoperative IABP insertion were 33.3 and 42.9% respectively. Two patients with postoperative IABP insertion are alive. The rate of IABP weaning is 66.7% for preoperative group, 85.7% for intraoperative group and 100% for postoperative group. In conclusion, if there were no irreversible myocardial damages, IABP could be used safely and emergently at any perioperative period for hemodynamic stability, CPB weaning, and to overcome low cardiac output syndrome.
Adult ; Arrhythmias, Cardiac ; Cardiac Output, Low ; Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Heart ; Hemodynamics ; Hospital Mortality ; Humans ; Intraoperative Period ; Perioperative Period ; Postoperative Period ; Preoperative Period ; Thoracic Surgery* ; Weaning

Aspiration pneumonia is considered to be a morbid complication of anesthesia, It was reported that several conditions are associated with an increased frequency of aspiration pneumonia, such as gastroenterological, neurological and, pulmonary diseases. The incidence is also higher in emergency situations than during elective surgery. We encountered aspiration pneumonia after emergency laparoscopic salpingectomy. The patient was 25 years old woman with no prior medical history but had fasted for only 5 h in the preoperative period. During the perioperative period, there were no signs of regurgitation of the gastric contents into the oral cavity. After surgery, the patient was transported to the recovery room in a fully awakened state. However, the patient became cyanotic without vomiting. After physiotherapy, a chest CT scan was performed, and she was diagnosed with aspiration pneumonia. She was admitted to intensive care. Ten days later, she was discharged in a healthy state.
Adult ; Anesthesia ; Emergencies* ; Female ; Humans ; Incidence ; Critical Care ; Laryngopharyngeal Reflux* ; Lung Diseases ; Mouth ; Perioperative Period* ; Pneumonia, Aspiration* ; Preoperative Period ; Recovery Room* ; Salpingectomy* ; Tomography, X-Ray Computed ; Vomiting

BACKGROUND: The type and regimen of anesthesia may affect perioperative hyperglycemia following major surgical stress. This study compared the effects of sevoflurane and propofol on the incidence of hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.METHODS: This retrospective study included 176 patients with type 2 diabetes mellitus who had undergone lung surgery. Blood glucose levels and clinical outcomes from the preoperative period to the first 2 postoperative days (PODs) were retrospectively examined in patients who received sevoflurane (group S, n= 87) and propofol (group P, n=89) for maintenance of general anesthesia. The primary endpoint was the incidence of persistent hyperglycemia (2 consecutive blood glucose levels > 180 mg/dL [10.0 mmol/L]) during the perioperative period. The secondary composite endpoint was the incidence of major postoperative complications and 30-day mortality rate after surgery.RESULTS: Blood glucose levels similarly increased from the preoperative period to the second POD in both groups (p=0.857). Although blood glucose levels at 2 hours after surgery were significantly lower in group P than in group S (p=0.022; 95% confidence interval for mean difference, −27.154 to −2.090), there was no difference in the incidence of persistent hyperglycemia during the perioperative period (group S, 70%; group P, 69%; p=0.816). The composite of major postoperative complications and all-cause in-hospital and 30-day mortality rates were also comparable between the two groups.CONCLUSION: Sevoflurane and propofol were associated with a comparable incidence of perioperative hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.
Anesthesia ; Anesthesia, General ; Blood Glucose ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Humans ; Hyperglycemia ; Incidence ; Lung ; Mortality ; Perioperative Period ; Postoperative Complications ; Preoperative Period ; Propofol ; Retrospective Studies

To investigate the effect of the aroma therapy and music intervention on anxious and pain for the breast cancer patients in the perioperative period and the potential mechanisms.
 Methods: A total of 100 breast cancer patients who received surgical treatment in the comprehensive hospitals of Hunan province were recruited for this study. Patients were assigned randomly into a control group, an aroma therapy group, a music intervention group, and a joint-therapy group (n=25 per group). The patients in the control group received regular post-surgical nursery, while the patients from other groups received aroma therapy, music intervention, or both in addition to the regular nursery. The scale of anxiety and pain were measured. The measurements were carried at three time points, namely 30 min before the surgery (T1), 30 min after the recovery period of anesthesia (T2), and 4 hours after the removal of anesthesia tubing (T3). Repeated ANOVA was used to perform statistic analysis.
 Results: The scale of pain was significantly increased at the post-operation (T2, T3) compared to pre-surgery (T1). The therapeutic group showed significant decrease in pain at post-operation (T3) comparing with the control group (P<0.05). The scale of anxiety was the highest at pre-surgery (T1). During anaesthesia recovery, the anxiety of patients at post-operation T2 and T3 in the therapeutic groups significantly decreased compared with the control group (P<0.05).
 Conclusion: Both the aroma therapy and the music therapy can decrease the stress-responsive anxiety and pain for the breast cancer patients in the perioperative period.
Analysis of Variance ; Anxiety ; therapy ; Aromatherapy ; Breast Neoplasms ; nursing ; psychology ; surgery ; Female ; Humans ; Music Therapy ; Pain, Postoperative ; therapy ; Perioperative Period ; Preoperative Care ; Time Factors

BACKGROUND: Fasting during the preoperative period is known to be a risk of perioperative hypoglycemia. Also, the administration of fluids containing glucose often causes postoperative hyperglycemia. So, we investigated what is the ideal fluid which does not lead to hyperglycemia as well as hypoglycemia in fasted children. METHODS: Eighty ASA physical status I and II pediatric patients (1-7 years) were randomly divided into the four groups; Group I, II, III, and IV with twenty patients of each group. Patients in Group I, II, III, and IV received lactated Ringer's solution, 1 : 2 : 3 SD solution, 1 : 2 SD solution, and 1 : 3 SD solution, respectively during the perioperative period. Blood glucose levels were checked at pre-induction, 1 hr after induction and 1 hr, 4 hr, 8 hr after end of operation. NPO time and total amounts of fluids administered were measured. RESULTS: There was no patient with preoperative hypoglycemia. There were no significant differences in the perioperative blood glucose level among the groups. There was no relationship between blood glucose level and fasting time or age. CONCLUSIONS: We conclude that all of the four fluids with different glucose concentrations in this study were appropriate to the fasted children.
Blood Glucose ; Child ; Fasting ; Glucose ; Humans ; Hyperglycemia ; Hypoglycemia ; Isotonic Solutions ; Perioperative Period ; Preoperative Period

The best management strategy for angiographically intermediated coronary artery diseases remains controversial. Lesions, when coupled with spasm, can lead to catastrophic results and cardiogenic shock. We report a case of a 62-year-old man who had an intermediate coronary artery disease presenting with cardiogenic shock due to coronary spasm during a preoperative period.
Coronary Artery Disease* ; Coronary Vasospasm ; Humans ; Middle Aged ; Perioperative Period ; Preoperative Period ; Shock, Cardiogenic* ; Spasm*

STUDY DESIGN: The comparison was based on the radiographc and clinically differences of 96 vertebroplasty cases. PURPOSE: This study evaluated the clinical and radiological results of performing percutaneous vertebroplasty for acute or subacute osteoporotic vertebral compression fracture (group A) and for posttraumatic vertebral collapse (Kummell's disease) (group B). SUMMARY OF LITERATURE REVIEW: Percutaneous vertebroplasty is a minimal invasive procedure for the treatment of a painful collapsed vertebral body MATERIALS AND METHODS: We experienced 67 cases of group A and 29 cases of group B, and we followed these patients for 2 years or more. We evaluated the clinical results by using the serial visual analogue scale (VAS) and the radiological results were evaluated by measuring the restoration of the anterior vertebral height and the change of the kyphotic angle. We also compared both groups for their bone mineral density (BMD) and new fracture rate. RESULTS: Statistically significant pain relief was obtained by both groups in the perioperative period. The average VAS change was 6.5 (from 8.7 preoperatively to 2.2 postoperatively) in group A, and 7.1 (from 9.1 preoperatively to 2.0 postoperatively) in group B on a 10 point pain scale. The anterior vertebral height increased an average of 4.9mm (16.5%), (from 16.8mm preoperatively to 21.7 mm postoperatively) in group A, and 6.5 mm (21%) (from 12.8 mm preoperatively to 19.3 mm postoperatively) in group B on the perioperative period. But the height was minimally decreased more that it was measured at the immediate postoperative period: 18.7 mm in group A, and 16.2 mm in group B on the last follow up. The kyphotic angle was restored an average of 5.2 degrees (from 32.4 degrees preoperatively to 27.2 degrees postoperatively) in group A, and 4.9 degrees (from 39.5 degrees preoperatively to 34.6 degrees postoperatively) in group B on the perioperative period. But the angle was increased more than that measured preoperatively: about 1.7 degree in group A and group B on the last follow up. There's no significant difference in the BMD between the groups. New fracture developed in 17.9% (12) of group A, and 20.7% (6) of group B. We did this procedure for 15 cases of new fracture, and then the VAS change was an average 5.0 immediately after the operation. CONCLUSIONS: Percutaneous vertebroplasty was an effective treatment method for both groups and there were no statistically significant differences in the clinical and radiological results. Care must be taken due to the relatively high rate of new fracture and this can be resolved by repeat vertebroplasty
Bone Density ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Osteoporosis ; Perioperative Period ; Postoperative Period ; Vertebroplasty*

PURPOSE: The purpose of this study was to identify the relationship of quality of life (QoL) with body weight, anxiety, and depression according to perioperative period. METHODS: Data were secondarily analyzed from 30 gastric cancer patients. RESULTS: There were positive relationships of anxiety with depression (r=.42, p=.019) and appetite symptoms of QoL (r=.41, p=.023) at preoperative day one. There were negative relationships of body weight with physical function of QoL (r=-.40, p=.026), and positive relationships of anxiety with depression (r=.37, p=.044) and constipation symptom of QoL (r=.38, p=.034) at postoperative day 7. Also, at postoperative one month, there were positive relationships of body weight with physical function (r=-.45, p=.011) and constipation symptom (r=.37, p=.039). There was a negative relationship of anxiety with emotional function (r=-.39, p= .035), a negative relationship of depression with physical function (r=-.43, p= .018), and a positive relationship of depression with finance (r=.39, p=.034). CONCLUSION: Oncology nurses should consider diverse factors during the early postoperative period to increase QoL. Also, appropriate and timely interventions should be provided to minimize the negative influence on QoL.
Anxiety* ; Appetite ; Body Weight* ; Constipation ; Depression* ; Gastrectomy* ; Humans ; Perioperative Period* ; Postoperative Period ; Quality of Life* ; Stomach Neoplasms