Articles: surgery.
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Spinal cord stimulation (SCS) is an efficient means for treatment of the postsurgical lumbar spine condition known as failed back surgery syndrome (FBSS). Although the devices and the implantation techniques are well established and the technology is sophisticated, there are some complications caused by hardware failures. This study was aimed at identifying the most frequent types of hardware failures and their causes in FBSS patients treated with SCS. ⋯ Second in frequency were receiver (model 3470) failures due to insulation leakage at the plug connection site (n= 2). In one case, extension cable breakage caused dysfunction of the system, and another dysfunction was caused by distal extension cable disconnection. In conclusion, SCS is a low-complication procedure for treatment of benign low-back pain, but seems to be prone to lead and insulation failures.
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Journal of anesthesia · Jan 2000
Continuous intra-arterial blood gas monitoring during thoracic surgery.
This study was undertaken to assess the clinical usefulness of a continuous intra-arterial blood gas (CIABG) monitoring system, Paratrend 7, during thoracic surgery. ⋯ The agreement between CIABG and ABG measurements was better for PCO(2) and pH than for PO(2). The PO(2) value displayed on the CIABG monitor may not always be reliable during thoracic surgical procedures.
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Journal of anesthesia · Jan 2000
Effects of sevoflurane and isoflurane on the ratio of cerebral blood flow/metabolic rate for oxygen in neurosurgery.
To examine the changes in cerebral blood flow (CBF) equivalent (CBF divided by cerebral metabolic rate for oxygen) during craniotomy under isoflurane and sevoflurane anesthesia in patients with intracranial disorders. ⋯ Deepening anesthesia from 0.5 to 1.0 MAC was maintained with no difference between the two agents during 4h of neurosurgery.
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The surgical management of thoracic disc disease remains challenging. Outcomes after laminectomy had been poor, and modern posterolateral, lateral, and anterior approaches have evolved to replace this older procedure. Each has its own set of complications, and all are hampered, to varying degrees, by the limited visualization of the ventral disc space and spinal cord during decompression. ⋯ Four patients enjoyed good or excellent outcomes, with return of ambulation. One patient experienced only mild improvement in her severe paraparesis. Image-guidance was invaluable in planning the corpectomy and aiding visualization in situations in which the dura or disc were obscured; its use allowed successful surgical excisions in the most challenging circumstances.
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Elderly patients may be at greater risk for perioperative complications and mortality due to an increased prevalence of age-related concomitant diseases, often more than one at a time, and a basic decline in organ functioning over time. Risks associated with age in the plastic surgery population may be minimized by a better understanding of the physiologic changes as well as the preoperative and postoperative considerations in caring for this special group of patients. The purpose of this article is to review the changes that occur with aging and the nursing care implications necessary to minimize the associated risks with anesthesia and plastic surgery.