Outcome of preoperative cefazolin use for infection prophylaxis in patients with self-reported penicillin allergy.

Background: Cephalosporins are the preferred antibiotics for prophylaxis against surgical site infections. Most studies give a rate of combined IgE and non-IgE penicillin allergy yet it is recommended that cephalosporins be avoided in patients having the former but can be used in those with the latter. Some studies use penicillin allergy while others penicillin family allergy rates.

Cancellation of elective surgery: rates, reasons and effect on patient satisfaction.

Background: The cancellation of elective surgeries is a major problem that increases wait times, exacerbates costs and can negatively affect patients, both psychologically and physically. Our objectives were to investigate the reasons for cancellations across specialties at a single centre, to compare these reasons with previous data from the same centre between 2005 and 2009 and to examine how cancellations affected patients' lives and views of the medical system in cases when the cancellations were potentially preventable.

Methods: Cancellation records of all elective surgeries scheduled between June 1, 2012, and Jan.

[Knowledge retention after focused cardiac ultrasound training: a prospective cohort pilot study].

Background And Objectives: Focused Cardiac Ultrasound (FoCUS) has proven instrumental in guiding anesthesiologists’ clinical decision-making process. Training residents to perform and interpret FoCUS is both feasible and effective. However, the degree of knowledge retention after FoCUS training remains a subject of debate.

Periarticular Morphine-Induced Sphincter of Oddi Spasm Causing Severe Pain and Bradycardia in an Awake Patient Under Spinal Anesthesia: An Important Diagnostic Consideration.

Sphincter of Oddi spasm from opioids has been documented, presenting as severe epigastric pain and potentially overlooked in a differential diagnosis. We present a case of sphincter of Oddi spasm from periarticular morphine in a patient under spinal anesthesia, causing severe distress and treated effectively with glucagon. It is important for anesthesiologists using opioids to consider it as a cause of perioperative pain and be familiar with treatment as it may be refractory by conventional use of opioids for pain relief.

Effects of transdermal magnesium chloride on quality of life for patients with fibromyalgia: a feasibility study.

Background: Fibromyalgia is a syndrome characterized by chronic pain, fatigue, depression, and sleep disturbances. Its primary cause is unclear. Several studies have reported decreased intracellular magnesium levels in patients with fibromyalgia and have found negative correlation between magnesium levels and fibromyalgia symptoms.

Massage therapy alone and in combination with meditation for breast cancer patients undergoing autologous tissue reconstruction: A randomized pilot study.

This study explored whether massage combined with meditation is more helpful than massage alone for women recovering from autologous tissue reconstruction after mastectomy for breast cancer. Forty patients were randomly assigned to either massage therapy or massage plus meditation on postoperative days 1 through 3. Outcome measures were 1) visual analog scale (VAS) scores for stress, anxiety, relaxation, insomnia, alertness, fatigue, tension, pain, mood, and energy, and 2) Perceived Stress Scale-14 scores.

Evaluating efficacy and feasibility of transcutaneous electrical nerve stimulation for postoperative pain after video-assisted thoracoscopic surgery: A randomized pilot trial.

Background: Transcutaneous electrical nerve stimulation (TENS) has been applied for pain relief after surgical procedures. This study evaluated whether TENS after video-assisted thoracoscopic surgery (VATS), in addition to opioid administration, decreased postoperative pain and pain medication use.

Methods: In a controlled trial, 56 patients scheduled to undergo VATS were randomly assigned to TENS plus opioids (Group 1) or opioids alone (Group 2) for 48 h.

Inpatient rehabilitation outcomes for patients receiving left ventricular assist device.

Objective: The aim of this study was to evaluate outcomes of patients participating in inpatient rehabilitation program after left ventricular assist device (LVAD) implantation.

Design: Medical records of 94 patients who received LVADs between January 1, 2008, and June 30, 2010, at the Mayo Clinic in Rochester, MN, were retrospectively reviewed for demographic data, and inpatient rehabilitation functional outcomes were measured by the Functional Independence Measure scale.

Results: After successful implantation of LVAD, the patients were either discharged directly home from acute care (44%) or admitted to inpatient rehabilitation (56%).

Magnetic resonance imaging-guided cryoablation of recurrent prostate cancer after radical prostatectomy: initial single institution experience.

Objective: To establish the feasibility of magnetic resonance imaging (MRI)-guided cryoablation in patients with previous radical prostatectomy and MRI visualized biopsy-proven local recurrence of prostate adenocarcinoma.

Materials And Methods: Eighteen postprostatectomy patients (mean 67, 57-78 years) were treated with MRI-guided cryoablation for recurrent prostate carcinoma. Patients were found to have a hyperenhancing nodule using multiparametric MRI with endorectal coil followed by a positive transrectal ultrasound-guided biopsy.

Predicting operative bleeding in elective pediatric surgeries using the Pediatric Bleeding Questionnaire (PBQ).

To test the Pediatric Bleeding Questionnaire's (PBQ) utility for predicting excessive bleeding during elective surgery, we retrospectively evaluated 60 pediatric patients who had been preoperatively investigated for von Willebrand disease. Of 58 patients with bleeding scores (BS) ≤2 (within normal range), 1 hemorrhaged during surgery. Two had a BS of >2 (positive BS); however, neither bled excessively during surgery.

Quantification of perioperative changes in von Willebrand factor and factor VIII during elective orthopaedic surgery in normal individuals.

von Willebrand's disease (VWD) patients undergoing major surgery are prophylactically treated to promote haemostasis. There is variability in perioperative clinical practice; however, most guidelines suggest replacing the deficient factor to a level of 1.0 IU mL(-1) (or 100%).

How well are prebooked surgical step-down units utilized?

Study Objective: To evaluate the utilization of the surgical step-down unit (SSDU) by a sample of patients who were preoperatively booked for admission to the unit, and to identify those patient characteristics and perioperative variables that are associated with an intervention in the unit.

Design: Retrospective chart review.

Setting: Canadian tertiary-care facility.

Feasibility and effect of chair massage offered to nurses during work hours on stress-related symptoms: a pilot study.

This study assessed feasibility and effect of weekly, 15-min chair massages during work for 38 nurses. Mean Perceived Stress Scale-14 (PSS-14), Smith Anxiety Scale (SAS), linear analog self-assessment scale (LASA), and symptom visual analog scale (SX-VAS) scores were tracked at baseline, 5 weeks, and 10 weeks. Of 400 available massage appointments, 329 were used.

Cefazolin use in patients who report a non-IgE mediated penicillin allergy: a retrospective look at adverse reactions in arthroplasty.

Background: A large number of patients presenting for total hip and knee arthroplasty report an allergy to penicillin. the reported incidence of cross reactions with cephalosporins in patients with penicillin allergy ranges from 3% to 18%. Perioperative antibiotic prophylaxis practices range from using cephalosporins to substituting clindamycin or vancomycin.

Feasibility and effectiveness of massage therapy for symptom relief in cardiac catheter laboratory staff: a pilot study.

A pilot study was conducted to assess the feasibility and efficacy of massage therapy for cardiac catheterization laboratory staff. Staff members (N = 50) were randomly assigned to 5 or 10 weekly 30-min massages, followed by outcomes assessment. A control group (n = 10) receiving no massage therapy underwent comparable assessment.

Early intraoperative blood collection does not affect complete blood counts, von Willebrand factor or factor VIII levels in normal children.

Background: Obtaining blood from children for research studies can be difficult, particularly for controls. One solution is to obtain samples during elective surgery; however, consideration must be given to the potential effects of the timing of phlebotomy.

Observations: Ten children were recruited and phlebotomy was carried out during a preoperative clinic visit and intraoperatively immediately after the induction of anesthesia but before the start of surgery.

The effect of chair massage on muscular discomfort in cardiac sonographers: a pilot study.

Background: Cardiac sonographers frequently have work-related muscular discomfort. We aimed to assess the feasibility of having sonographers receive massages during working hours in an area adjacent to an echocardiography laboratory and to assess relief of discomfort with use of the massages with or without stretching exercises.

Methods: A group of 45 full-time sonographers was randomly assigned to receive weekly 30-minute massage sessions, massages plus stretching exercises to be performed twice a day, or no intervention.

Effect of massage therapy on pain, anxiety, and tension in cardiac surgical patients: a pilot study.

Objectives: To assess the role of massage therapy in the cardiac surgery postoperative period. Specific aims included determining the difference in pain, anxiety, tension, and satisfaction scores of patients before and after massage compared with patients who received standard care.

Design: A randomized controlled trial comparing outcomes before and after intervention in and across groups.

Effect of massage therapy on pain, anxiety, and tension after cardiac surgery: a randomized study.

Integrative therapies such as massage have gained support as interventions that improve the overall patient experience during hospitalization. Cardiac surgery patients undergo long procedures and commonly have postoperative back and shoulder pain, anxiety, and tension. Given the promising effects of massage therapy for alleviation of pain, tension, and anxiety, we studied the efficacy and feasibility of massage therapy delivered in the postoperative cardiovascular surgery setting.

Is en-bloc resection of locally recurrent rectal carcinoma involving the urinary tract indicated?

Background: This study investigated morbidity, mortality, and long-term survival after multimodality management of locally recurrent rectal carcinoma involving the urinary tract.

Methods: A total of 82 patients (63 males) were identified during 1987 to 2000. Data sources were a prospectively collected database of intraoperative radiotherapy, institutional tumor registry, and chart review.

A demand-based assessment of the Canadian anesthesia workforce - 2002 through 2007.

Purpose: The number of anesthesia providers required by the Canadian health care system remains controversial. Questions persist regarding both the adequacy of the current supply and what the future demand will be. The purpose of this study was to quantify the number and adequacy of anesthesia providers in 2002, and predict the same for the year 2007.

Sonographically guided percutaneous radio frequency ablation of a renal cell carcinoma in a transplanted kidney.

Radio frequency ablation is an effective treatment for focal renal cell carcinoma (RCC). We report a patient with RCC in a transplanted kidney that was successfully treated with percutaneous sonographically guided radio frequency ablation.