Objective: To assess the capacity of different techniques to reduce non-operative times during parathyroid surgery. The impact of monitored anesthesia care (MAC) instead of general anesthesia, and the pre-operative placement of a second peripheral intravenous catheter (PIV) were analyzed.
Methods: A retrospective case series at an academic medical center was performed to study patients undergoing parathyroidectomy by a single surgeon between November 2013 and October 2016. Three operating room (OR) time measurements were compared: pre-incision time, post-closure time, and total OR time.
Results: Surgeries performed under MAC (n = 21) had statistically shorter pre-incision (33.2 min vs. 39.7 min, p < .001), post-closure (10.1 min vs. 16.2 min, p = .002), and total operative times (113.0 min vs. 151.5 min, p < .001) compared to those in which general anesthesia (n = 169) was used. Of the 169 patients who underwent general anesthesia, 25 had a second PIV placed preoperatively and 144 had only a single PIV. All 3 time periods were statistically shorter in patients who had a second PIV versus those who had only a single PIV (pre-incision 32.2 min vs. 41.0 min, p < .001; post-closure 12.2 min vs. 16.9 min, p < .001; total 117.9 min vs. 157.4 min, p < .001).
Conclusions: In patients undergoing parathyroid surgery in which ioPTH levels will be used, the placement of a second PIV in the pre-operative holding area and performance of surgery under MAC can significantly shorten non-operative and total OR time.
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http://dx.doi.org/10.1016/j.amjoto.2019.102292 | DOI Listing |
Acta Neurochir (Wien)
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Department of Neurosurgery, College of Medicine, University of Michigan, Ann Arbor, MI, USA.
Background: Wall shear stress (WSS) plays a crucial role in the natural history of intracranial aneurysms (IA). However, spatial variations among WSS have rarely been utilized to correlate with IAs' natural history. This study aims to establish the feasibility of using spatial patterns of WSS data to predict IAs' rupture status (i.
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Division of Orthopaedic Surgery, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
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View Article and Find Full Text PDFArthroplast Today
February 2025
Adult Reconstruction and Joint Replacement Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
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February 2025
Université de Franche-Comté, Laboratoire SINERGIES, F-25000 Besançon, France.
Human amniotic membrane (hAM) has been extensively used for several decades as a bioactive scaffold for regenerative medicine. In its cryopreserved form-one of the main storage formats-the presence of viable cells has often been questioned. Furthermore, there is little published evidence of the role of endogenous amniotic cells from cryopreserved hAM in tissue repair.
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December 2024
Surgery, Norfolk and Norwich University Hospital, Norwich, GBR.
Surgeon fatigue significantly affects cognitive and motor functions, increasing the risk of errors and adverse patient outcomes. Traditional fatigue management methods, such as structured breaks and duty-hour limits, are insufficient for real-time fatigue detection in high-stakes surgeries. With advancements in artificial intelligence (AI), there is growing potential for AI-driven technologies to address this issue through continuous monitoring and adaptive interventions.
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