Surgery in the patient with diabetes mellitus is relatively common, as the numbers of persons with diabetes is increasing and diabetes predisposes to medical conditions that require surgical intervention. An estimated 25% of diabetic patients will require surgery, and advances in perioperative care of these patients allow them to safely undergo the most complicated surgical procedures. We will ...

Inflammatory bowel disease can have reproductive consequences depending on severity at the time of conception and antepartum management. A 37-year-old G1 with ulcerative pancolitis initially did not disclose her medical history to obstetrics providers. She developed worsening hematochezia microcytic anemia declined treatment colitis. then a rectovaginal fistula, underwent cesarean delivery but ...

OBJECTIVE To assess the effectiveness of two mechanical methods of blood conservation in reducing the need for allogeneic red blood cells or coagulation products during cardiac surgery. DESIGN Randomised controlled trial. SETTING Regional cardiac centre in a teaching hospital in Southampton. PARTICIPANTS 263 adults aged 18-80 years undergoing elective coronary artery bypass surgery entere...

STUDY OBJECTIVE To evaluate the postoperative hemodynamic and thermoregulatory consequences of intraoperative core hypothermia. DESIGN Prospective, randomized clinical trial. SETTING Operating room and postanesthesia care unit of a university hospital. PATIENTS 74 healthy, ASA status I, II, and III patients (average age 58 yrs) undergoing elective colon surgery. INTERVENTIONS Patients w...

The present study used a meta-analysis to examine 4 questions about intraoperative hypothermia. The questions addressed were as follows: (1) Is the difference in adverse patient outcomes between normothermic and mildly hypothermic patient groups significant across studies and within studies? (2) What is the magnitude of the difference in adverse patient outcomes across studies? (3) What are the...

Background Umbilical hernia repair is a common pediatric surgical procedure. While opioid analgesics are a feasible option and have long been a mainstay in the pharmacological intervention for pain, the effort to improve care and limit opioid-related adverse effects has led to the use of alternative techniques, including regional anesthesia. The current study prospectively compares the analgesi...

BACKGROUND Intraoperative transoesophageal echocardiography is increasingly used for guiding intraoperative management decisions during non-cardiac surgery. Transthoracic echocardiography (TTE) equipment and training is becoming more available to anaesthetists, and its point-of-care application may facilitate real-time haemodynamic management and preoperative screening. METHODS We conducted a...

conclusions preemptive clonidine has many marvelous advantages over midazolam, including better sedation inside the operating room and then in the post-operative care unit, lower fentanyl doses are required during surgery, more stable heart rate and blood pressure are observed during the procedure, and patients report lower post-operative pain scores. objectives to compare the effect of preempt...

OBJECTIVE We conducted a retrospective 4-year study of patients undergoing laparoscopic cholecystectomy at a freestanding ambulatory surgery center. Data on rates of hospital admission, conversion to open surgery, bile duct injury, postoperative bile leakage, and incidence of choledocholithiasis were analyzed. The success rate for dynamic fluoroscopic intraoperative cholangiography was computed...