Why surgeons need to know about anaesthesia

Rosenberg, Jacob; Fuchs‐Buder, Thomas

doi:10.1007/s00464-016-5075-7

Cited by 10 publications

(8 citation statements)

References 15 publications

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“…Thus, a tailor-made approach to neuromuscular block management becomes possible as any degree of neuromuscular block, including deep or intense levels, may now be reversed in less than 10 min. 4 . This led to an increased interest to evaluate the potential clinical benefit of such a deep neuromuscular blockade, especially for laparoscopic surgery 5 -11 .…”

Section: Introductionmentioning

confidence: 99%

Deep neuromuscular blockade improves surgical conditions during gastric bypass surgery for morbid obesity

Fuchs‐Buder

Schmartz

Baumann

et al. 2019

European Journal of Anaesthesiology

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Background: There is a controversy in the literature whether deep compared with moderate neuromuscular block (NMB) improves surgical conditions for laparoscopic surgery. Objectives: The primary outcome measure was to examine whether switching from moderate to deep NMB improves surgical conditions for laparoscopic obese surgery; secondary outcome measures were changes in intraabdominal pressure, duration to perform gastro-jejunal anastomosis, and perioperative surgical complications.Design: A single center, randomized controlled study. Each patient was taken as its own control and examined twice: at the first evaluation (E1) all patients had a moderate NMB, thereafter patients were randomized to deep or moderate block and a second evaluation (E2) was performed within 10 min. Patients with excellent rating at E1 were excluded from E2 as they could not further improve their surgical conditions. Setting: University Hospital FrancePatients: Patients undergoing laparoscopic gastric bypass surgery under general anaesthesia were included. Main exclusion criteria were hypersensitivity to drugs used and absence of written informed consent.Interventions: According to the group assignment patients received bolus doses of rocuronium or 0.9% saline.Main Outcome Measures: Surgical conditions were assessed with a 4-point rating scale. Intraoperative adverse events were assessed with the Kaafarani-classification and postoperative complications with the Clavien-Dindo-classification.Results: 89 patients were initially included and data from 85 patients could assessed at E1; surgical rating was excellent in 20, good in 35, acceptable in 18, poor in 12. After excluding those with excellent rating, the remaining 65 patients were randomly assigned to deep or moderate block. At E2 an improvement of surgical conditions was observed in 29/34 patients with deep block and in 4/31 with moderate block; p< 0.0001.Poor surgical conditions were more frequently associated with surgical complications (61.5% versus 15.3%; p<0.001). Conclusion:Switching from moderate to deep block improves surgical conditions. Poor surgical conditions were associated with a higher incidence of surgical complications.

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Section: Introductionmentioning

confidence: 99%

Deep neuromuscular blockade improves surgical conditions during gastric bypass surgery for morbid obesity

Fuchs‐Buder

Schmartz

Baumann

et al. 2019

European Journal of Anaesthesiology

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“…It is important to underline that the issue of surgical stillness is an issue of patient safety especially for laparoscopic surgery as well as many other surgical procedures close to delicate structures. This calls for better collaboration between surgeons and anaesthesiologists to improve patient outcome (10, 11). Other areas where a closer collaboration is beneficial include the increased involvement of anaesthesiologists in perioperative care of the surgical patient (12–15).…”

Section: Resultsmentioning

confidence: 99%

Surgical Stillness—When, Why, and How?

Rosenberg

Fuchs‐Buder

2019

Front. Surg.

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“…The term general anaesthesia refers to a state of unconsciousness under control using pharmacological agents. Patient reflexes are compeletely or partially lost including airway control, response to physical or verbal contact is lost (4). In a study conducted by Nunn et al, it is described that 340 patients with varying ages had undergone general anaesthesia for their dental treatments between 1983 to 1993.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Selection Criteria of Dental Patients for General Anaesthesia and Conscious Sedation

Aydın

Demirel

2020

Clinical and Experimental Health Sciences

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Objective:The term general anaesthesia refers to a state of unconsciousness under control using pharmacological or non pharmacological agents in which patient reflexes are compeletely or partially lost. Concious sedation is a drug-induced state in which the conscious patient is rendered free of fear, anxiety, and apprehension while remaining comfortably relaxed. Both of these methods are used for various reasons in dental clinics for many years and their use in dentistry practice is increasing. Aim of this study is to quantify the number and demographic data of patients that received a dental general anaesthesia (DGA) or conscious sedation (CS) following referral from a general dental practice. Study also aimed to determine the reasons of referral and dental treatment modalities performed during the sessions. Methods: This study includes patient records who had undergone dental general anaesthesia and conscious sedation in Medipol University Dental Hospital General Anaesthesia Clinic. Data were collected from records of the University Dental Hospital. The collected information included gender, age, type of DGA/ CS, reason for DGA, treatment modalities as tooth extraction, restorative, endodontics, periodontics and pedodontics. Results: 896 patients were referred for DGA/CS during the two-year period. The mean age was 15.5 years and 27.3% were underaged children. The most common reason for DGA was dental anxiety (46.5%). 79.4% of patientd received DGA, while only 20.6% received CS. The highest mean in treatments is for decidious pulp capping (4.57) followed by decidious pulp amputation (3.57). Conclusion:Majority of the patients receiving DGA/CS are formed by dental anxiety patients. Also, the rate of underaged children were very high (27.3%).

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Why surgeons need to know about anaesthesia

Abstract: Background During laparoscopic surgery,

Cited by 10 publications

References 15 publications

Deep neuromuscular blockade improves surgical conditions during gastric bypass surgery for morbid obesity

Deep neuromuscular blockade improves surgical conditions during gastric bypass surgery for morbid obesity

Surgical Stillness—When, Why, and How?

Analysis of Selection Criteria of Dental Patients for General Anaesthesia and Conscious Sedation

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