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Arquivos Brasileiros de Cirurgia... 2018Considering the practice of preoperative fasting based on observations on the gastric emptying delay after induction and the time of this fast is closely linked to... (Review)
Review
INTRODUCTION
Considering the practice of preoperative fasting based on observations on the gastric emptying delay after induction and the time of this fast is closely linked to organic response to trauma, arise the question about preoperative fasting period necessary to minimize such response and support the professional with clinical and scientific evidence.
AIM
To review the aspects related to the abbreviation of preoperative fasting from the metabolic point of view, physiology of gastric emptying, its clinical benefits and the currently recommendations.
METHOD
Literature review was based on articles and guidelines published in English and Portuguese, without restriction of time until January 2017, in PubMed, SciELO and Cochrane with the descriptors: surgery, preoperative fasting, carbohydrate. From the universe consulted, 31 articles were selected.
RESULTS
The literature suggests that the abbreviation of fasting with beverage added carbohydrates until 2 h before surgery, can bring benefits on glycemic and functional parameters, reduces hospitalization, and does not present aspiration risk of healthy patients undergoing elective surgery. Another nutrient that has been added to the carbohydrate solution and has shown promising results is glutamine.
CONCLUSION
The abbreviation of preoperative fasting with enriched beverage with carbohydrates or carbohydrate and glutamine seems to be effective in the care of the surgical patient, optimizing the recovery from of postoperative period.
Topics: Fasting; Humans; Preoperative Care; Time Factors
PubMed: 29972405
DOI: 10.1590/0102-672020180001e1377 -
British Journal of Hospital Medicine... Dec 2017
Review
Topics: Exercise Therapy; Humans; Postoperative Complications; Preoperative Care; Surgical Procedures, Operative
PubMed: 29240494
DOI: 10.12968/hmed.2017.78.12.729 -
Neurology India 2017This review traces the evolution of epilepsy surgery from its early beginnings in the 20th century with the development of neurophysiology, and later the identification... (Review)
Review
This review traces the evolution of epilepsy surgery from its early beginnings in the 20th century with the development of neurophysiology, and later the identification of pathology in surgical specimens, to the tremendous boost given by direct brain imaging in the late 20th century. This resulted in the sophisticated methods of presurgical investigation, surgical techniques, and postsurgery care available from the millennium. In parallel, functional surgery, which modifies the nervous system's behaviour, available throughout, has attained a greater place by the use of stimulation.
Topics: Brain; Brain Mapping; Epilepsy; Humans; Neurosurgical Procedures; Preoperative Care; Treatment Outcome
PubMed: 28281495
DOI: 10.4103/neuroindia.NI_1028_16 -
Journal of Visceral Surgery Aug 2015Nutrition is part of the treatment plan. Nutritional support as well as immunonutrition have been shown to decrease the rate of postoperative complications. Many issues... (Review)
Review
Nutrition is part of the treatment plan. Nutritional support as well as immunonutrition have been shown to decrease the rate of postoperative complications. Many issues remain to be investigated to better understand underlying mechanisms and to offer patients a personalized approach.
Topics: Digestive System Surgical Procedures; Gastrointestinal Neoplasms; Humans; Nutritional Status; Nutritional Support; Postoperative Complications; Preoperative Care
PubMed: 26315576
DOI: 10.1016/S1878-7886(15)30007-2 -
Journal of Visceral Surgery Aug 2015Based on a grade A level of evidence, immunonutrition should be given to all patients operated on for a digestive cancer 5 to 7 days prior to surgery whatever could be... (Review)
Review
Based on a grade A level of evidence, immunonutrition should be given to all patients operated on for a digestive cancer 5 to 7 days prior to surgery whatever could be the patient nutritional status. Immunonutrition should be continued in the postoperative phase in malnourished patients for 5 to 7 days or until patients are able to recover oral feeding covering at least 60% of their needs.
Topics: Enteral Nutrition; Gastrointestinal Neoplasms; Guidelines as Topic; Humans; Nutritional Status; Postoperative Complications; Preoperative Care
PubMed: 26315574
DOI: 10.1016/S1878-7886(15)30005-9 -
BMC Musculoskeletal Disorders Oct 2019Degenerative lumbar spine disorders are common among musculoskeletal disorders. When disabling pain and radiculopathy persists after adequate course of rehabilitation... (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of pre-surgery physiotherapy on walking ability and lower extremity strength in patients with degenerative lumbar spine disorder: Secondary outcomes of the PREPARE randomised controlled trial.
BACKGROUND
Degenerative lumbar spine disorders are common among musculoskeletal disorders. When disabling pain and radiculopathy persists after adequate course of rehabilitation and imaging confirms compressive pathology, surgical decompression is indicated. Prehabilitation aiming to augment functional capacity pre-surgery may improve physical function and activity levels pre and post-surgery. This study aims to evaluate the effect and dose-response of pre-surgery physiotherapy on quadriceps femoris strength and walking ability in patients with degenerative lumbar spine disorders compared to waiting-list controls and their association with postoperative physical activity level.
METHOD
In this single blinded, 2-arm randomised controlled trial, 197 patients were consecutively recruited. Inclusion criteria were: MRI confirmed diagnosis and scheduled for surgery due to disc herniation, lumbar spinal stenosis, degenerative disc disease or spondylolisthesis, ages 25-80 years. Patients were randomised to 9 weeks of pre-surgery physiotherapy or to waiting-list. Patient reported physical activity level, walking ability according to Oswestry Disability Index item 4, walking distance according to the SWESPINE national register and physical outcome measures including the timed ten-meter walk test, maximum voluntary isometric quadriceps femoris muscle strength, patient-rated were collected at baseline and follow-up. Parametric or non-parametric within and between group comparisons as well as multivariate regression was performed.
RESULTS
Patients who received pre-surgery physiotherapy significantly improved in all variables from baseline to follow-up (p < 0.001 - p < 0.05) and in comparison to waiting-list controls (p < 0.001 - p < 0.028). Patients adhering to ≥12 treatment sessions significantly improved in all variables (p < 0.001 - p < 0.032) and those receiving 0-11 treatment session in only normal walking speed (p0.035) but there were no significant differences when comparing dosages. Physical outcome measures after pre-surgery physiotherapy together significantly explain 27.5% of the variation in physical activity level 1 year after surgery with pre-surgery physical activity level having a significant multivariate association.
CONCLUSION
Pre-surgery physiotherapy increased walking ability and lower extremity strength in patients with degenerative lumbar spine disorders compared to waiting-list controls. A clear treatment dose-response response relationship was not found. These results implicate that pre-surgery physiotherapy can influence functional capacity before surgical treatment and has moderate associations with maintained postoperative physical activity levels mostly explained by physical activity level pre-surgery.
TRIAL REGISTRATION
NCT02454400 . Trial registration date: August 31st 2015, retrospectively registered.
Topics: Adult; Aged; Aged, 80 and over; Exercise Therapy; Female; Humans; Lower Extremity; Lumbar Vertebrae; Male; Middle Aged; Muscle Strength; Neurodegenerative Diseases; Physical Therapy Modalities; Preoperative Care; Single-Blind Method; Treatment Outcome; Walking
PubMed: 31651299
DOI: 10.1186/s12891-019-2850-3 -
Anaesthesiology Intensive Therapy 2024The current literature indicates that routine evaluation of preoperative anxiety, its determinants, and patient-specific concerns is universally advocated. This aligns... (Review)
Review
The current literature indicates that routine evaluation of preoperative anxiety, its determinants, and patient-specific concerns is universally advocated. This aligns with the increasingly acknowledged importance of prehabilitation - a comprehensive process preparing patients for surgery. A crucial component of prehabilitation is assessing patients' mental health. Recommendations for psychological evaluations in prehabilitation encompass, inter alia, determining the severity of anxiety. This work builds on a 2019 article, which presented scales for preoperative anxiety assessment: the State Trait Anxiety Inventory (STAI), the Hospital Anxiety and Depression Scale (HADS), the Amsterdam Preoperative Anxiety and Information Scale (APAIS), and the Visual Analogue Scale (VAS). This article extends the possibilities of preoperative anxiety assessment by introducing four additional methods: the Surgical Fear Questionnaire (SFQ), the Anxiety Specific to Surgery Questionnaire (ASSQ), the Surgical Anxiety Questionnaire (SAQ), and Anesthesia- and Surgery-dependent Preoperative Anxiety (ASPA). The authors provide comprehensive details on these instruments, including scoring, interpretation, availability, and usefulness both in scientific research and clinical practice. The authors also provide the data on the availability of Polish versions of the presented methods and preliminary data on the reliability of SFQ in patients awaiting cardiac surgery. This review seems relevant for professionals in multiple disciplines, including anesthesiology, surgery, clinical psychology, nursing, primary care and notably prehabilitation. It emphasizes the necessity of individualizing anxiety assessment and acknowledging patient subjectivity, which the presented methods facilitate through a thorough evaluation of specific patient concerns. The literature review also identifies concerns and future research avenues in this area. The importance of qualitative studies and those evaluating prehabilitation intervention is emphasized.
Topics: Humans; Anxiety; Preoperative Care; Surveys and Questionnaires; Reproducibility of Results; Psychiatric Status Rating Scales
PubMed: 38741439
DOI: 10.5114/ait.2024.136508 -
Anesthesiology Sep 2020
Review
Topics: Anesthesiologists; Anesthesiology; Enhanced Recovery After Surgery; Humans; Patient Compliance; Preoperative Care
PubMed: 32358253
DOI: 10.1097/ALN.0000000000003331 -
Neurosurgery Clinics of North America Jul 2020The past decade has seen a significant shift in the number of centers performing intracranial electroencephalography from subdural grids and strips to... (Review)
Review
The past decade has seen a significant shift in the number of centers performing intracranial electroencephalography from subdural grids and strips to stereoelectroencephalography (SEEG). Unlike grid and strip insertion or other stereotactic procedures in which the cortical surface is visualized, SEEG involves insertion of an electrode through a bolt anchored into the skull. Due to the multidisciplinary nature of SEEG trajectory planning, it often is time-consuming and iterative. Computer-assisted planning improves time taken and efficacy of SEEG trajectory planning. This article provides an overview of the considerations, controversies, and practicalities of implementing an automated computer-assisted planning solution for SEEG planning.
Topics: Electrodes, Implanted; Electroencephalography; Epilepsy; Humans; Neurosurgical Procedures; Preoperative Care; Stereotaxic Techniques; Surgery, Computer-Assisted
PubMed: 32475489
DOI: 10.1016/j.nec.2020.03.005 -
Journal of Thoracic Imaging Sep 2016Medical 3-dimensional (3D) printing is emerging as a clinically relevant imaging tool in directing preoperative and intraoperative planning in many surgical specialties... (Review)
Review
Medical 3-dimensional (3D) printing is emerging as a clinically relevant imaging tool in directing preoperative and intraoperative planning in many surgical specialties and will therefore likely lead to interdisciplinary collaboration between engineers, radiologists, and surgeons. Data from standard imaging modalities such as computed tomography, magnetic resonance imaging, echocardiography, and rotational angiography can be used to fabricate life-sized models of human anatomy and pathology, as well as patient-specific implants and surgical guides. Cardiovascular 3D-printed models can improve diagnosis and allow for advanced preoperative planning. The majority of applications reported involve congenital heart diseases and valvular and great vessels pathologies. Printed models are suitable for planning both surgical and minimally invasive procedures. Added value has been reported toward improving outcomes, minimizing perioperative risk, and developing new procedures such as transcatheter mitral valve replacements. Similarly, thoracic surgeons are using 3D printing to assess invasion of vital structures by tumors and to assist in diagnosis and treatment of upper and lower airway diseases. Anatomic models enable surgeons to assimilate information more quickly than image review, choose the optimal surgical approach, and achieve surgery in a shorter time. Patient-specific 3D-printed implants are beginning to appear and may have significant impact on cosmetic and life-saving procedures in the future. In summary, cardiothoracic 3D printing is rapidly evolving and may be a potential game-changer for surgeons. The imager who is equipped with the tools to apply this new imaging science to cardiothoracic care is thus ideally positioned to innovate in this new emerging imaging modality.
Topics: Diagnostic Imaging; Heart Diseases; Humans; Intraoperative Care; Models, Anatomic; Preoperative Care; Printing, Three-Dimensional
PubMed: 27149367
DOI: 10.1097/RTI.0000000000000217