Articles: general-anesthesia.
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Arch Orthop Trauma Surg · Aug 2023
Operative room time comparison between general and spinal anesthesia in total hip arthroplasty: an institutional study.
A relatively high expense with any procedure is total operative time; two components being the time spent anesthetizing the patient and time spent transferring the patient out of the operating room (OR). Both times can be affected by the anesthetic method used. This study compares different operative time intervals for both spinal anesthesia (SA) and general anesthesia (GA), in patients undergoing a primary total hip arthroplasty (THA), to identify the most appropriate and cost-effective anesthetic method. ⋯ III.
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Case Reports
Regurgitation under anesthesia in a fasted patient prescribed semaglutide for weight loss: a case report.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) such as semaglutide are a class of medications prescribed to treat type 2 diabetes mellitus, and more recently, as an adjunct for weight loss because of its effects of delaying gastric emptying and suppressing appetite. Semaglutide is a long-acting agent with a half-life of approximately one week, and there are currently no guidelines that address the perioperative management of such agents. ⋯ Patients taking long-acting GLP-1 RAs such as semaglutide may be at risk of pulmonary aspiration under anesthesia. We propose strategies to mitigate this risk including holding the medication four weeks prior to a scheduled procedure when feasible and considering full stomach precautions.
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We report a case of a woman who experienced unexplained recurrent rashes of varying severity after multiple exposures to anesthesia, and then 2 successful surgeries under general anesthesia with no resultant rashes after removing propofol from her anesthetic plans. We infer her previous postanesthetic rashes were likely associated with drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) triggered by propofol.
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Relying on original, primary source documentation from the National Archives, we describe the practice of anesthesia in mobile army surgical hospital (MASH) units and the 171st Evacuation Hospital during the latter part of the Korean War in 1953. Values were scaled and reported as percentages. These Essential Technical Medical Data Sheets reveal a surprising proportion (12.9%) of men received spinal anesthetics, despite official recommendations to the contrary. ⋯ Utilizing primary source documentation, we found that general anesthesia was the most common type utilized. Newer techniques were not as commonly adopted, despite official recommendations and data from the time. The care provided closely resembled that delivered in the Second World War but inspired a series of technological and pedagogical reforms through the 1950s to improve military anesthesia for the next conflict.
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Awake craniotomy (AC) is a common neurosurgical procedure for the resection of lesions in eloquent brain areas, which has the advantage of avoiding general anesthesia to reduce associated complications and costs. A significant resource limitation in low- and middle-income countries constrains the usage of AC. ⋯ Despite many constraints, AC is being safely performed in low-resource settings. International collaborations among centers are a move forward, but adequate resources and management are essential to make AC an accessible procedure in many more African neurosurgical centers.