Primary perioperative haemodynamic effects of ß-receptor blockade in patients with catecholamine-secreting tumours.

Introduction: Guidelines for the treatment of catecholamine-producing tumours strictly recommend starting ß-receptor blocking medication only after α-receptor blockade has been established. This recommendation is supported only by non-surgical case reports. However, in clinical practice ß-receptor blockade is often started before the diagnosis of a phaeochromocytoma is made.

Perioperative lung function following flow controlled ventilation for robot-assisted prostatectomies in steep trendelenburg position: an observational study.

Background: Steep Trendelenburg position combined with capnoperitoneum can lead to pulmonary complications and prolonged affection of postoperative lung function. Changes in pulmonary function occur independent of different modes of ventilation and levels of positive end-expiratory pressure (PEEP). The effect of flow-controlled ventilation (FCV) has not been evaluated yet.

The KORE-INNOVATION trial, a prospective controlled multi-site clinical study to implement and assess the effects of an innovative peri-operative care pathway for patients with ovarian cancer: rationale, methods and trial design.

Background: Advanced ovarian cancer is managed by extensive surgery, which could be associated with high morbidity. A personalized pre-habilitation strategy combined with an 'enhanced recovery after surgery' (ERAS) pathway may decrease post-operative morbidity.

Primary Objective: To analyze the effects of a combined multi-modal pre-habilitation and ERAS strategy on severe post-operative morbidity for patients with ovarian cancer (primary diagnosis or first recurrence) undergoing cytoreductive surgery.

The role of factor XIII in surgery for advanced stage of epithelial ovarian cancer.

Introduction: Hereditary factor (F) XIII-deficiency is a known risk factor for postoperative complications, but data of acquired FXIII-deficiency in malignancies are limited. Therefore, we evaluated the role of acquired FXIII-deficiency in surgery for advanced epithelial ovarian cancer (EOC).

Materials And Methods: We performed a retrospective analysis of patients with known serum FXIII status and treatment between 2011 and 2018 at our center.

Anesthetic considerations for tracheobronchial surgery.

Tracheobronchial pathology can be related to trauma, infection, tumor, or a combination of these. Per definition, planning for tracheobronchial surgery can be complicated by the overlap of anesthesiological interests in airway management and the primary surgical field. Therefore, following a detailed description of the stenosis, management of tracheobronchial surgery requires an interdisciplinary discussion and individualized planning of the procedure.

International multicenter observational study on assessment of ventilatory management during general anaesthesia for robotic surgery and its effects on postoperative pulmonary complication (AVATaR): study protocol and statistical analysis plan.

Introduction: Robotic-assisted surgery (RAS) has emerged as an alternative minimally invasive surgical option. Despite its growing applicability, the frequent need for pneumoperitoneum and Trendelenburg position could significantly affect respiratory mechanics during RAS. AVATaR is an international multicenter observational study aiming to assess the incidence of postoperative pulmonary complications (PPC), to characterise current practices of mechanical ventilation (MV) and to evaluate a possible association between ventilatory parameters and PPC in patients undergoing RAS.

Minimally Invasive Surgery (MIS) in Children and Adolescents with Pheochromocytomas and Retroperitoneal Paragangliomas: Experiences in 42 Patients.

Background: Pheochromocytomas (PH) and paragangliomas (PGL) are rare tumours in children accounting for about 1% of the paediatric hypertension. While minimally invasive surgical techniques are well established in adult patients with PH, the experience in children is extremely limited. To the best of our knowledge, we herewith present the largest series of young patients operated on chromaffin tumours by minimally invasive access.

The impact of type and number of bowel resections on anastomotic leakage risk in advanced ovarian cancer surgery.

Objective: To identify risk factors for anastomotic leakage (AL) in patients undergoing primary advanced ovarian cancer surgery and to evaluate the prognostic implication of AL on overall survival in these patients.

Methods: We analyzed our institutional database for primary EOC and included all consecutive patients treated by debulking surgery including any type of full circumferential bowel resection beyond appendectomy between 1999 and 2015. We performed logistic regression models to identify risk factors for AL and log-rank tests and Cox proportional hazards models to evaluate the association between AL and survival.

Dexmedetomidine's inhibitory effects on acetylcholine release from cholinergic nerves in guinea pig trachea: a mechanism that accounts for its clinical benefit during airway irritation.

Background: Airway instrumentation can evoke upper airway reflexes including bronchoconstriction and cough which can cause serious complications including airway trauma, laryngospasm or bronchospasm which may in turn lead to difficulty with ventilation and hypoxemia. These airway events are mediated in part by irritant-induced neuronal modulation of airway tone and cough responses. We investigated whether the commonly used anesthetic agents dexmedetomidine, lidocaine or remifentanil attenuated neuronal and airway smooth muscle responses in the upper airways of guinea pigs.

Airway Resistance in Patients with Obstructive Sleep Apnea Syndrome Following Robotic Prostatectomy.

Background: Because minimally invasive surgery can improve postoperative recovery, it became the preferred technique for patients with significant comorbidities. However, steep Trendelenburg position and abdominal CO-insufflation can lead to a significant increase in upper airway resistance and an alteration of overall lung function. In particular, patients who already suffer from an obstructive airway disease like obstructive sleep apnea syndrome (OSAS) might be at risk for postoperative airway complications.

Pattern of and reason for postoperative residual disease in patients with advanced ovarian cancer following upfront radical debulking surgery.

Objective: Describing the pattern of and reasons for post-operative tumor residuals in patients with advanced epithelial ovarian cancer (AOC) operated in a specialized gynecologic cancer center following a strategy of maximum upfront debulking followed by systemic chemotherapy.

Methods: All consecutive AOC-patients treated between 2005 and 2015 due to stages FIGO IIIB/IV were included in this single-center analysis.

Results: 739 patients were included in this analysis.

Effects of parecoxib on analgesia benefit and blood loss following open prostatectomy: a multicentre randomized trial.

Background: This multi-centre, prospective, randomized, double-blind, placebo-controlled study was designed to test the hypotheses that parecoxib improves patients' postoperative analgesia without increasing surgical blood loss following radical open prostatectomy.

Methods: 105 patients (64 ± 7 years old) were randomized to receive either parecoxib or placebo with concurrent morphine patient controlled analgesia. Cumulative opioid consumption (primary objective) and the overall benefit of analgesia score (OBAS), the modified brief pain inventory short form (m-BPI-sf), the opioid-related symptom distress scale (OR-SDS), and perioperative blood loss (secondary objectives) were assessed.

Age and bupivacaine plasma concentrations following radical cystectomy.

Purpose: Continuous epidural analgesia with bupivacaine for postoperative analgesia can increase its plasma concentrations. Whether this effect can be aggravated with increasing age is unknown. Therefore, bupivacaine concentrations were prospectively monitored in patients undergoing radical cystectomies.

Simulated life-threatening emergency during robot-assisted surgery.

Background: With the increasing use of robot-assisted techniques for urologic and gynecologic surgery in patients with severe comorbidities, the risk of a critical incidence during surgery increases. Due to limited access to the patient the start of effective measures to treat a life-threatening emergency could be delayed. Therefore, we tested the management of an acute emergency in an operating room setting with a full-size simulator in six complete teams.

[Anaesthesia for urological surgery - Anaesthesia for robotic assisted prostatectomies].

Because of excellent results, high patient satisfaction, and extraordinary surgical conditions robotic assisted prostatectomies have found a wide spread acceptance. Trendelenburg positioning, CO2-Insufflation, and installation of the robot system cause moderate hemodynamic and respiratory changes. Respiration can be compromised by significantly reduced pulmonary compliance during surgery and a marked CO2 load.

Levobupivacaine plasma concentrations following major liver resection.

Purpose: Levobupivacaine is metabolized hepatically. Whether postoperative epidural analgesia with levobupivacaine can lead to critical accumulation in patients undergoing major hepatic resection is unknown. Therefore, levobupivacaine concentrations were prospectively monitored in patients undergoing major liver resection and compared to patients undergoing rectal resection, who served as controls.

Evaluation of postoperative pain after minimally invasive video-assisted and conventional thyroidectomy: results of a prospective study. ESES Vienna presentation.

Background: One of the advocated benefits of minimally invasive video-assisted thyroidectomy (MIVAT) is reduction of postoperative pain. We compared in a prospective study pain after video-assisted and conventional thyroidectomy (CT).

Methods: One hundred sixty-nine patients (56 men, 113 women, mean age: 50 ± 14 years) operated between November 2007 and February 2008 were included.

Single-access retroperitoneoscopic adrenalectomy (SARA) versus conventional retroperitoneoscopic adrenalectomy (CORA): a case-control study.

Background: Stimulated by the concept of Natural Orifice Transluminal Endoscopic Surgery (NOTES), minimizing the access even further has become a new trend in minimally invasive surgery. We compare our recently described new method of endoscopic single-access adrenalectomy with the conventional retroperitoneoscopic approach in a matched-pairs study.

Methods: Fifty single-access retroperitoneoscopic adrenalectomies (SARA) were performed in 47 selected patients suffering from Conn's adenomas (n = 20), pheochromocytomas (n = 15), Cushing's adenomas (n = 6), and other diseases (n = 6).

Laryngoscopy via Macintosh blade versus GlideScope: success rate and time for endotracheal intubation in untrained medical personnel.

Background: Tracheal intubation is the preferred technique to secure the airway and apply mechanical ventilation. However, when performed by untrained medical personnel, tracheal intubation via direct laryngoscopy has a high rate of failure. The GlideScope (Verathon Medical Europe, Ijsselstein, Netherlands) technique improves the success rate for difficult tracheal intubation performed by experienced physicians; whether this technique improves the success rate for normal intubations when performed by inexperienced personnel as well is unknown.

Different mechanisms of atelectasis formation require different treatment strategies.

Several strategies have been developed to treat atelectasis, including positive end-expiratory pressure and deep inspirations. However, in some patients these recruitment strategies fail to improve lung function. Therefore, the authors studied whether recruitment maneuvers could resolve atelectasis following either passive airway closure or active bronchconstriction.

Posterior retroperitoneoscopic adrenalectomy--results of 560 procedures in 520 patients.

Background: The posterior retroperitoneoscopic adrenalectomy is less popular than the laparoscopic transabdominal method. Due to the direct approach to the adrenal glands, however, the posterior retroperitoneal access is easy to use and may offer advantages not available with other endoscopic procedures for adrenalectomy.

Methods: Between July 1994 and March 2006, we performed 560 adrenalectomies (right side: n = 258; left side: n = 302) by the posterior retroperitoneoscopic approach in 520 patients (200 male, 320 female; age, 10 to 83 years).

Intravenous lidocaine after tracheal intubation mitigates bronchoconstriction in patients with asthma.

Background: Although prophylactic IV administration of lidocaine attenuates the response to a variety of inhalation challenges, its effect on airway resistance after endotracheal intubation in patients with asthma is unclear. We tested the hypothesis that IV lidocaine attenuates intubation-evoked bronchoconstriction in patients with asthma.

Methods: Thirty patients with asthma (age 49.

Epidural anesthesia and pulmonary function.

The epidural administration of local anesthetics can provide anesthesia without the need for respiratory support or mechanical ventilation. Nevertheless, because of the additional effects of epidural anesthesia on motor function and sympathetic innervation, epidural anesthesia does affect lung function. These effects, i.

Heritable and pharmacological influences on pauses and apneas in inbred mice during anesthesia and emergence.

Inherited differences in response to hypercapnia are augmented by volatile anesthetics. Therefore, the authors tested the hypotheses that (1) the incidence of pauses and apneas also increase under anesthesia; (2) there is a difference in the incidence between mouse strains; and (3) there is a difference in the incidence of pauses and apneas depending on the volatile agent. The authors assessed respiratory pauses and apneas at rest; during anesthesia with isoflurane, sevoflurane, and desflurane; and at recovery in C3, B6, and F1 mice.