Articles: postoperative.
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Minerva anestesiologica · Jun 2014
Assessment of Perioperative Transfusion Requirement for Cirrhotic Patients Undergoing Elective Hepatectomy.
The possibility of outlining a risk profile for perioperative blood transfusion of cirrhotic patients submitted to hepatic resection can help to rationalize transfusion policy. ⋯ The risk profile for transfusion of cirrhotic patients undergoing hepatectomy can be better assessed with a model that combines already known clinical factors and hepatic function indexes.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2014
Case Reports[Hemorrhage after accidental overdosage of enoxaparin: monitoring and therapy].
At the morning of the sixth postoperative day after a complex cardiac surgery procedure, a patient accidentally received a subcutaneous injection of 450 mg Enoxaparin sodium (Clexane®, Sanofi GmbH, Frankfurt, Germany). A few hours later an excessive coagulopathy developed and necessitated the transfusion of allogenic blood products. The present case report describes and discusses our diagnostic and therapeutic approaches.
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The management of atrial fibrillation has seen marked changes in recent years. This is the result of better knowledge of the pathophysiology and risks factors for atrial fibrillation, better stratification for thromboembolic and bleeding risks, changing practices in anticoagulation management, and the development of new antiarrhythmic drugs. This article focuses on these new issues, with particular attention to their relevance in the perioperative period. ⋯ Better knowledge of the pathophysiology of atrial fibrillation and improved awareness of the risks associated with this frequent arrhythmia are continuing to improve the management of patients with chronic atrial fibrillation and new-onset atrial fibrillation in the perioperative period. As with most complex disease processes, treatment decisions must be individualized for each patient and clinical context.
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J Pain Palliat Care Pharmacother · Jun 2014
Case ReportsSubacute pain after total knee arthroplasty.
Acute pain during and immediately after total knee arthroplasty (TKA) can be well controlled by spinal anesthesia, local infiltration analgesia, and peripheral nerve blocks; this enables early or fast-track rehabilitation. However, about half of patients have clinically significant pain in the following weeks. ⋯ Intensive analgesic and antihyperalgesic treatment during the first few weeks after TKA surgery may reduce the risk of chronic pain after this operation, which is itself intended to remove the patient's chronic osteoarthritis pain. Spinal cord stimulation may be an effective option for patients with mainly neuropathic pain after TKA surgery.
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Curr Opin Anaesthesiol · Jun 2014
ReviewDetection and management of perioperative myocardial ischemia.
To review the current evidence for detection and management of perioperative myocardial ischemia. ⋯ Perioperative physicians should refrain from the use of nonsurgical diagnostic criteria for myocardial infarction and adopt the clinical entity known as myocardial injury after noncardiac surgery in order to allow for better determination of the prevalence of this perioperative complication. Studies should focus on establishing the feasibility of broad postoperative troponin surveillance following noncardiac surgery. Clinical trials of potential therapies for myocardial injury after noncardiac surgery are urgently needed.