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Щоб переглянути інші типи публікацій з цієї теми, перейдіть за посиланням: Postoperative risk.

Книги з теми "Postoperative risk"

Автор: Grafiati

Опубліковано: 3 червня 2025

Оновлено: 31 липня 2025

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1

1952-, Weir Matthew R., ed. Medical management of kidney transplantation. Lippincott Williams & Wilkins, 2005.

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2

Ljungman, Christer. Acute arterial occlusion and chronic arterial insufficiency: Incidence, risk factors for amputation, limb-survival and postoperative mortality. Uppsala Universitet, 1992.

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3

W, Millikan Keith, Saclarides Theodore J. 1956-, and SpringerLink (Online service), eds. Common Surgical Diseases: An Algorithmic Approach to Problem Solving. Springer Science+Business Media, LLC, 2008.

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4

Borodulina, Elena, Aleksandr Kolsanov, and Petr Rogozhkin. Surgical interventions in the complex treatment of pulmonary tuberculosis. Preoperative planning with 3D modeling. INFRA-M Academic Publishing LLC., 2022. http://dx.doi.org/10.12737/1859979.

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The monograph is devoted to an important medical and social problem - improving the effectiveness of treatment of tuberculosis patients with surgical interventions. Evaluation of the effectiveness of surgical treatment in the long-term period made it possible to establish the main controllable risk factors for reactivation of the tuberculosis process in the postoperative period. The influence of the timing of surgical treatment on the long-term results of surgical treatment and the formation of drug resistance of Mycobacterium tuberculosis has been proved. An innovative approach of preop

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5

Lee, Lorri A. Postoperative Visual Loss. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0064.

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Postoperative visual loss (POVL) has multiple diagnoses and contributory causes including emboli, direct globe compression, prolonged elevation of venous pressure in the head with associated large fluid shifts, prolonged hypotension, periorbital trauma, preexisting ophthalmologic anatomic risk factors, and many other associated factors. It frequently results in permanent injury and severe disability. Though any loss of vision postoperatively should prompt an emergent or urgent ophthalmologic consultation, some of the rarer causes of POVL are considered true medical or surgical emergencies. Thi

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6

Aminian, Ali. Online Preoperative Risk Assessment Tools. Edited by Tomasz Rogula, Philip Schauer, and Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0006.

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Despite the presence of robust data on safety and efficacy of bariatric and metabolic surgery, many patients and physicians do not consider surgery to treat obesity, diabetes, and metabolic syndrome. One reason may be inaccurate beliefs about the risk-benefit ratios of medical and surgical treatments of obesity. Estimating the risk of postoperative complications can improve surgical decision-making and informed patient consent. Furthermore, there would be a considerable benefit in identifying modifiable preoperative conditions that are associated with increased risk of postoperative adverse ev

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7

Traul, David E. Postoperative Visual Loss in Spine Surgery. Edited by David E. Traul and Irene P. Osborn. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190850036.003.0026.

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Postoperative visual loss (POVL) is a rare but devastating condition associated with many types of nonocular surgery. In spine surgery, the most common causes of POVL are ischemic optic neuropathy (ION), central retinal artery occlusion (CRAO), and cortical blindness. Although the association of POVL with spine surgery has long been recognized, the low incidence of this complication hinders the identification of patient and perioperative risk factors and limits our understanding of the causes of POVL. In adult spine surgery, POVL is most frequently attributed to ION whereas CRAO is more common

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8

Saberski, Ean, and Lloyd Saberski. Management of Neuropathic Postoperative Pain. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457006.003.0019.

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Pain following surgery is routine and unavoidable but expected to resolve with time. In some cases, postoperative pain persists as the result of a neuropathic process such as a neuroma or nerve entrapment. Postoperative neuropathic pain is physiologically distinct from acute pain, but the mechanisms by which pain is transduced, transmitted, decoded, and modulated are shared. Effective treatment regimens for postoperative neuropathic pain employ a deliberate strategy to disrupt the aberrant nociceptive signal. Some surgeries are high risk for chronic postoperative pain with postherniorrhaphy pa

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9

Mick, Gérard, and Virginie Guastella. Chronic Postsurgical Pain. Springer London, Limited, 2014.

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10

Mick, Gérard, and Virginie Guastella. Chronic Postsurgical Pain. Springer, 2014.

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11

Mick, Gérard, and Virginie Guastella. Chronic Postsurgical Pain. Springer, 2016.

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12

Rao, Shilpa, and Jerrold Lerman. Postoperative Nausea and Vomiting in Patients with Prolonged QTc. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199764495.003.0070.

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A panoply of pharmacological and nonpharmacological strategies are currently employed to attenuate the risk of postoperative nausea and vomiting (PONV) in children, including 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists. 5-HT3 receptor antagonists can prolong the QT interval, which can be a precursor of torsades de pointes (TdP), particularly in children with congenital or acquired prolonged QT interval. This chapter summarizes the causes of prolonged QT interval, the potential interactions of prolonged QT interval with antiemetics and anesthetics, and strategies to prevent PONV.

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13

Bosack, Robert C., and Stuart Lieblich. Anesthesia Complications in the Dental Office. Wiley & Sons, Limited, John, 2015.

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14

Metzger, U., and F. Largiader. Perioperative Chemotherapy: Rationale, Risk and Results (Recent Results in Cancer Research). Springer-Verlag, 1985.

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15

Rovner, Michelle Sher. Post-Tonsillectomy Bleeding. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0080.

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Post-tonsillectomy bleeding is a well-described complication that can rapidly evolve into one of the most challenging clinical situations in anesthesia. Tonsillectomy and adenoidectomy is one of the most common pediatric surgical procedures. A frequent indication for this procedure is adenotonsillar hyperplasia associated with obstructive sleep apnea. These children may be very challenging to care for and may have significant respiratory and fluid management issues postoperatively. This situation requires immediate attention and action with regard to resuscitation in a hypovolemic patient in c

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16

Squire, Peter. Obstructive Sleep Apnea. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199764495.003.0012.

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Adenotonsillectomy has become first-line treatment for obstructive sleep apnea (OSA) and it is increasingly performed as a day-case procedure. A diagnosis of OSA increases the risk for postoperative respiratory morbidity from 1% to approximately 20% and unfortunately, the clinical history may be unreliable at distinguishing which children are at greatest risk. The gold standard investigation is overnight polysomnography (PSG), but this is a scarce resource considering the number of procedures performed. Fortunately, overnight home pulse oximetry also provides a useful stratification of severit

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17

Thompson, Norris B., and SreyRam Kuy. Multivariable Predictors of Postoperative Surgical Site Infection after General and Vascular Surgery. Edited by SreyRam Kuy. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199384075.003.0013.

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This landmark study proposed a model for predicting surgical site infections (SSI). Using logistic regression analysis, variables independently associated with increased risk of SSI were identified, which included smoking, alcohol use, comorbidities, disseminated cancer, weight loss greater than 10%, emergency surgery, and length of operative time. This chapter describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and

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18

Elmofty, Dalia H. Opioid-Induced Hyperalgesia, Tolerance, and Chronic Postsurgical Pain: A Dilemma Complicating Postoperative Pain Management. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0037.

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Perioperative pain management continues to be a challenge for physicians. Postoperative pain can compromise patient progress and lead to poor outcomes or chronic pain. Opioid medications, the mainstay of treatment for perioperative pain, can cause opioid-induced hyperalgesia and opioid tolerance. Attempts should be made to modify factors that increase the risk for chronic postsurgical pain. Certain patient factors and anesthetic and surgical techniques have been implicated. Incorporating multimodal methods for perioperative pain management using nonconventional opioids, such as methadone, cycl

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19

Jones, Bryn. Complications of total knee replacement. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.008007.

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♦ 81–89% overall patient satisfaction following total knee replacement♦ 1 in 8 patients experience unexplained postoperative pain♦ Obesity, increasing age, and medical comorbidities increase the risk of postoperative complications♦ Prosthetic infection rate at 1 year is 1–2%♦ Preoperative range of movement often determines postoperative range♦ Low risk of acute vascular event and neurological and ligamentous injury♦ Duration and method of venous thromboprophylaxis remains controversial♦ Periprosthetic femoral and tibial fractures require stabilisation. Fixation of periprosthetic patella fractu

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20

Ryan, Laura, and Paul Hopkins. Obstructive Sleep Apnea. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0011.

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Adenotonsillectomy is one of the most commonly performed surgeries in children and is the mainstay treatment for obstructive sleep apnea (OSA). Children with OSA have a higher risk of perioperative respiratory morbidity. Diagnosis of OSA is made by overnight polysomnography, but this resource is rare and expensive so children at risk for OSA must be identified based on parental history. Patients with risk factors for postoperative respiratory complications may need to be monitored in the hospital overnight. Anesthetic challenges associate with adenotonsillectomy include perioperative analgesia

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21

Jakobsson, Jan. Anaesthesia for day-stay surgery. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0068.

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Day-stay surgery is becoming increasingly common the world over. There are several benefits of avoiding in-hospital care. Early ambulation reduces the risk for thromboembolic events, facilitates wound healing, and avoiding admission reduces the risk for hospital-related infection. Additionally, the risk of neurocognitive side-effects can be avoided by returning the elderly patient to their home environment. Day-stay anaesthesia calls for adequate and structured preoperative assessment and patient evaluation, and the potential risk associated with surgery and anaesthesia should be assessed on a

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22

Bonnet, Francis, Marc E. Gentili, and Christophe Aveline. Post-surgical analgesia and acute pain management. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0046.

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Postoperative and acute pain remains uncontrolled in many instances, leading to the risk of development of chronic pain syndromes. After tissue damage, activation of postsynaptic NMDA receptors, also induced by opioid administration, plays a key role in postoperative pain sensitization, allodynia, and hyperalgesia. Pain intensity may depend on sex, age, anxiety, and genetic factors but in clinical practice, surgical procedure is the main determinant of pain, although pain may vary from one patient to one another. Serial pain measurements are mandatory to assess pain intensity and to guide pain

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23

Dodds, Chris, Chandra M. Kumar, and Frédérique Servin. Anaesthesia for major abdominal surgery in the elderly. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198735571.003.0008.

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Major abdominal surgery and laparotomy are common procedures that are associated with a high risk of mortality and morbidity, especially in the elderly. Outcomes can be improved by formal risk stratification, appropriate perioperative resuscitation and optimization, early surgery, senior anaesthetist involvement, and careful postoperative critical. Assessment of dehydration is imperative because fluid losses are very common and may be difficult to measure. Hypothermia is common, and measures should be instituted to conserve heat loss. Use of nitrous oxide can cause bowel distension and should

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24

Meigh, Abigail E., Ingrid A. Fitz-James Antoine, and Veronica Carullo. Pediatric Spine Surgery. Edited by David E. Traul and Irene P. Osborn. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190850036.003.0016.

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In children, the most common indication for spinal fusion is significant scoliotic curvature, either idiopathic or as a result of neuromuscular disease. Spinal fusion is high-risk surgery, which can be further complicated by comorbid disease. It carries substantial risk for significant fluid shifts, high intraoperative blood loss, physiologic strain secondary to duration and positioning, severe postoperative pain, and potential spinal cord injury. To mitigate risk and optimize outcomes, these patients should be carefully evaluated by the anesthetic team preoperatively and a comprehensive perio

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25

Alvis, Bret D., and Christopher G. Hughes. Delirium. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0061.

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Delirium in the postoperative period, characterized by inattention, disorganized thinking, disorientation, and/or altered levels of consciousness within the first few days after surgery, has been associated with significant increases in hospital stay, functional decline, prolonged cognitive dysfunction, and mortality. It is underdiagnosed without routine assessments with validated tools such as the Confusion Assessment Method (CAM), the 4AT, the Confusion Assessment Method for Intensive Care Unit (CAM-ICU), or the Intensive Care Delirium Screening Checklist (ICDSC). Prevention strategies for p

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26

Stolker, Robert Jan, and Felix van Lier. Choice and interpretation of preoperative investigations. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0041.

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Preoperative risk assessment is one of the most important steps in perioperative management. In the last decades, considerable progress has been achieved. However, as more high-risk procedures are performed in more aged patients, suffering more morbidity, this may lead to an increased risk of adverse outcomes. The goal of preoperative assessment is to identify patients at extreme risk and discuss whether they should be operated on, or undergo an alternative procedure with a lower risk profile, or if conservative treatment should be continued. Furthermore, it gives the opportunity to optimize p

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27

Toner, Andrew, Mark Hamilton, and Maurizio Cecconi. Post-surgery, post-anaesthesia complications. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0047.

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Postoperative complications are common in high-risk surgical populations and are associated with poor short-term and long-term outcomes. Morbidity can be identified using prospective assessment of pathological criteria, or deviations from the ideal postoperative course requiring clinical intervention. While infections are the most prevalent complication type, morbidity affecting the heart, lungs, kidneys, or brain carry the worst prognosis. Specific pathophysiological processes drive morbidity in each organ system. In addition, dysfunction of the cardiovascular and immune systems can lead to m

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28

Burger, Christina F., Melissa L. Bellomy, and Joseph J. Schlesinger. Coagulation System. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0091.

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Anticoagulation is increasingly prevalent in the general population and poses a significant risk of increased bleeding in patients needing urgent or emergent surgical procedures. There are two main classes of direct or anticoagulants: direct thrombin inhibitors and factor Xa inhibitors. Management of these patients requires assessment of bleeding risk, possible reversal of anticoagulation, and subsequent management after surgery to prevent postoperative complications associated with either bleeding or clot formation (due to cessation of anticoagulants). This chapter covers the proper assessmen

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29

Frawley, Geoff. Former Premature Infant for Hernia Repair. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0047.

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Inguinal hernia repair is the most common surgery in ex-premature infants. These infants have demonstrated a significantly higher incidence of postoperative apnea with risk inversely related to gestational age. Both awake regional anesthesia without sedation and general anesthesia have been described in this age group, and each has advantages and drawbacks. In the case of awake regional techniques, the major drawback is the block failure rate which is directly related to provider experience. In the case of general anesthesia, the limiting factor is the much higher rate of postoperative respira

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30

Lazar, Alina. Chronic Abdominal Pain in Children. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0019.

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Abdominal pain in the pediatric population is mostly functional. Patients with chronic abdominal pain (typically young females) have a high risk of anxiety, depression, and dysfunctional coping, which are also risk factors for postoperative pain and persistent postsurgical pain. In these patients, peripheral and central sensitization contribute to possible visceral hyperalgesia. When patients with chronic abdominal pain and visceral hyperalgesia undergo surgical procedures, perioperative pain can be difficult to treat. To manage the chronic pain of such patients, their complex biopsychosocial

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31

Roscoe, Andrew, and Peter Slinger. Anaesthesia for thoracic surgery. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0057.

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The conduct of thoracic anaesthesia requires an understanding of respiratory anatomy and physiology in order to optimize patient care whilst facilitating intrathoracic surgery. The preoperative assessment focuses on the underlying diagnosis, with emphasis on the impact of the surgical procedure on the patient’s cardiovascular and respiratory systems. Intraoperative care frequently necessitates lung isolation and proficiency at the variety of techniques available is essential. Additionally, adept management of one-lung ventilation and correction of hypoxaemia is fundamental to providing favoura

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32

Hoskin, Peter. Vulva and vagina. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199696567.003.0014.

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Chapter 9b discusses carcinoma of the vulva, which is primarily a surgical disease best treated by wide surgical resection, radical vulvectomy, and inguinal lymph node dissection based on presenting stage. Rarely, locally advanced primary disease may be presented for primary radiotherapy treatment. Postoperative radiotherapy is recommended for tumours invading >7 mm in a vertical direction. The first station regional lymph nodes in the inguinal region are best treated by radical surgical dissection, but fixed inoperable lymph nodes may benefit from primary radiotherapy which may be followed

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33

Craig, Anne, and Anthea Hatfield. The Complete Recovery Room Book. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198846840.001.0001.

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New technologies are increasingly available for patient care but simple ‘tried and true’ old fashioned methods are still essential. The care that a patient receives in the first hours after surgery is crucial to minimizing the risk of complications such as heart attacks, pneumonia, and blood clots. As the patient awakes from their drug-induced coma, it takes time for them to metabolize and excrete drugs. They remain unable to care for themselves, and are at increased risk of harm. The recovery room staff must manage both comatose and physiologically unstable patients and deal with the immediat

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34

Marx, Gernot, and Michael Fries. Acute illness in the postoperative period. Edited by Neil Soni and Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0089.

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As more complex and risky surgical procedures are carried out in industrialized countries, anaesthetists are confronted with higher incidences of acute life-threatening conditions during the perioperative period. This is especially true for older patients with concomitant morbidities. Sepsis, cardiovascular complications including myocardial infarction, pulmonary embolism, and stroke, as well as massive bleeding are among the most severe complications that may arise during any time in the postoperative period starting as early as in the post-anaesthesia care unit. Early identification along wi

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35

Menon, Ashok, Olga Lavryk, Haris A. Khwaja, John R. Bartholomew, and Zubaidah Nor Hanipah. Thromboembolic Complications after Bariatric Surgery. Edited by Tomasz Rogula, Philip Schauer, and Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0012.

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Venous thromboembolism (VTE) is a major cause of early death after bariatric surgery, even in the laparoscopic era, accounting for up to a third of early deaths. While risk factors associated with the development of postoperative VTE in nonbariatric surgery are relevant in bariatric patients, it is now clear that both obesity and obesity-related diseases, such as obesity hypoventilation syndrome, pose an additional risk. Attempts have been made to standardize VTE prophylaxis for patients undergoing bariatric surgery, and early ambulation, mechanical compression devices, chemoprophylaxis, and i

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36

Duncan, Roderick. Arthrogryposis. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.013009.

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♦ A rare condition with the potential to cause serious physical disability♦ Early recognition and treatment reduces the impact of the condition on the individual♦ Physiotherapists, occupational therapists, and orthotists play a pivotal role in patient management and a coordinated multidisciplinary team is required♦ Many children need orthopaedic surgery but the treatment principles differ from those applied to unaffected children with similar individual deformities♦ Prolonged postoperative splinting reduces the risk of recurrent deformities♦ Individuals with amyoplasia or distal arthrogryposis

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37

Khorgami, Zhamak, and Ali Aminian. Readmissions after Bariatric Surgery. Edited by Tomasz Rogula, Philip Schauer, and Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0016.

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Readmission after bariatric surgery occurs in about 5% of cases and increases the average costs up to 2.5-fold. Risk factors for readmission are dependent functional status, diabetes mellitus, steroid or immunosuppressant use, cardiac disease with intervention, bleeding disorders, longer operative time, concurrent splenectomy, high preoperative creatinine, low serum albumin, and occurrence of postoperative complications during index admission. The most common reasons for readmissions are procedure-related complications, including dehydration, abdominal pain, bleeding, anastomotic leak, gastroi

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38

Economou, S. G., Theodore J. Saclarides, Keith W. Millikan, and Jonathan A. Myers. Common Surgical Diseases: An Algorithmic Approach to Problem Solving. Springer, 2013.

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39

Hylton, Jared, and Sarah Deverman. Necrotizing Enterocolitis. Edited by Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi, and Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0001.

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Necrotizing enterocolitis (NEC) is a potentially life-threatening condition that affects mainly preterm infants. It is one of the most common surgical emergencies in the neonatal intensive care unit. While medical management is the first line of treatment, if that fails, NEC becomes a surgical emergency, and the pediatric anesthesiologist must be prepared. This chapter covers the pathogenesis, risk factors, clinical presentation and diagnosis, prevention, medical and surgical management, pre- and intraoperative anesthetic assessment, and postoperative management of NEC. Topics covered include

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40

Chen, Martin, and Muoi Trinh. Cardiogenic Shock. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0010.

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Heart failure and cardiogenic shock are important causes of perioperative morbidity and mortality that require prompt recognition prior to the institution of specialized monitoring and treatment, including the consideration of circulatory assist devices. Patients at risk for perioperative heart failure require special consideration with respect to preoperative evaluation, medical optimization prior to proceeding with surgery, and monitoring throughout the perioperative period. The intraoperative and postoperative management need to be carefully planned in order to avoid the development of acut

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41

Machado, Sandra. Deep Brain Stimulation/Stereotaxic Surgery. Edited by David E. Traul and Irene P. Osborn. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190850036.003.0019.

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Deep brain stimulation (DBS) is now a widely accepted treatment option for patients with movement disorders such as parkinsonism and essential tremor. DBS surgery presents challenges to the anesthesiologist as often these patients are required to be awake for accurate placement of the stimulators. Additionally, patients with movement disorders often have comorbidities that increase their risk of perioperative and postoperative complications. DBS surgery is often divided into two stages (1) stereotactic implantation of the DBS leads and (2) internalization of the pulse generator, with each of t

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42

Chen, Grace, and Ashley Valentine. Neuraxial Analgesia and Anesthesia in Chronic Opioid Users and Patients with Pre-existing Pain. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457006.003.0007.

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Neuraxial anesthesia and analgesia are effective modalities for surgery and perioperative pain management, respectively. These techniques may have nonanalgesic benefits as well, including improved 30-day mortality benefit, decreased risk of perioperative pneumonia, decreased risk of persistent postoperative pain, and attenuation of the stress response to surgery with improved survival in certain cancers. Post-operative pain control with epidural can be especially beneficial for opioid tolerant chronic pain patients compared to enteral or parenteral analgesics alone. In patients with previous b

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43

Eldar, Shai Meron, and Ofer Eldar. Complications and Challenges of Bariatric Surgery in Super-Obese Patients. Edited by Tomasz Rogula, Philip Schauer, and Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0017.

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While the lower weight limits for bariatric surgery are already strictly set, the upper weight limits are still undetermined. The extremely obese patient deserves special consideration: significant comorbidities, technical difficulties, and increased postoperative morbidity and mortality are all expected in this patient population.In view of these factors, how should super-obese patients (BMI > 50 kg/m2) be approached, and is there any preferred procedure? Is there a point where operative risk outweighs surgical benefits? Bariatric surgery for super-obese and super-super-obese patients, inc

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44

Helling, Kevin D., and Scott A. Shikora. Intestinal Complications of Roux-en-Y Gastric Bypass. Edited by Tomasz Rogula, Philip Schauer, and Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0029.

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Roux-en-Y gastric bypass is a commonly performed bariatric operation, but it is a formidable procedure performed in technically challenging, medically high-risk patients. Although it is highly successful for achieving meaningful and durable weight loss, a variety of intestinal complications may occur. These include small bowel obstructions from a number of sources (internal hernias, adhesions, intussusception, incisional hernias, intestinal volvulus), anastomotic strictures, dumping syndrome, portal vein thrombosis, Roux-en-O construction, and small bowel diverticulitis. This chapter reviews s

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45

van Lier, Felix, and Robert Jan Stolker. Preoperative assessment and optimization. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0040.

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Perioperative cardiovascular complications (including myocardial ischaemia and myocardial infarction) are the predominant cause of morbidity and mortality in patients undergoing non-cardiac surgery. The pathophysiology of perioperative myocardial infarction is complex. Prolonged myocardial ischaemia due to the stress of surgery in the presence of a haemodynamically significant coronary lesion, leading to subendocardial ischaemia, and acute coronary artery occlusion after plaque rupture and thrombus formation contribute equally to these devastating events. Perioperative management aims at optim

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46

Vallejo, Ricardo, and Ramsin Benyamin. Vertebral Augmentation: Fluoroscopy and CT. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199908004.003.0026.

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Osteoporosis, an age-related condition, is becoming a major public health problem. Vertebral compression fractures (VCFs) constitute the most frequent complication of osteoporosis. The pain and immobility caused by osteoporotic VCFs are linked to significant morbidities and impaired quality of life. Percutaneous techniques such as vertebroplasty and vertebral augmentation have emerged as viable treatments for acutely painful VCFs over the last several decades. Vertebroplasty (PV) and balloon kyphoplasty (KP) are minimally invasive vertebral augmentation procedures involving injection of polyme

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Aina, Titilopemi A. O., and Miguel Prada. Kidney Transplantation. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0024.

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Patients with end-stage renal disease (ESRD) can be managed with kidney transplantation, hemodialysis, or peritoneal dialysis. The most common organ transplanted in the United States is the kidney. Kidney transplantation surgery can be divided into the following stages: incision/dissection of vessels, cross-clamping vessels, vascular anastomosis, unclamping of vessels, ureter anastomosis to bladder, and closing. The size of recipient and donor kidneys as well as the size of recipient blood vessels will determine the position of graft implantation—either intraperitoneal or extraperitoneal. At t

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48

Felberg, Mary A. Mitochondrial Disease and Anesthesia. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0042.

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Mitochondrial disease is a genetically, biochemically, and clinically heterogeneous group of disorders that arise from defects in cellular oxidative phosphorylation, most commonly within the electron transport chain. All mitochondrial diseases involve disruption in energy production; clinical symptoms usually manifest in tissues with high energy demands although all organs may be affected. The extent of disease depends not only on the mitochondrial defect but on the numbers of dysfunctional mitochondria present in each tissue. Despite in vitro evidence that almost every anesthetic agent studie

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Moore, Laurel E. Acute Stroke. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0063.

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Stroke is the leading cause of disability in the United States, and in terms of mortality is second only to ischemic heart disease worldwide. Medical management for acute ischemic stroke (AIS) was limited to supportive care until 1995, when the National Institute of Neurological Disorders and Stroke (NINDS) trial demonstrated improved outcomes with systemic thrombolysis for AIS. Since December 2014, four major articles have been published in support of endovascular intervention for AIS, making this a central focus of this chapter. Other related topics for this chapter include the timing of ele

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Gill, Steven J., and Michael H. Nathanson. Central nervous system pathologies and anaesthesia. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0081.

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Anaesthesia induces changes in many organ systems within the body, though clearly none more so than the central nervous system. The physiology of the normal central nervous system is complex and the addition of chronic pathology and polypharmacy creates a significant challenge for the anaesthetist. This chapter demonstrates a common approach for the anaesthetist and specific considerations for a wide range of neurological conditions. Detailed preoperative assessment is essential to gain understanding of the current symptomatology and neurological deficit, including at times restrictions on mov

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