Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

4 results

  • 14 - Intra-Abdominal Surgery

  • from Section 3 - Practical Use
    • By
  • Edited by Alexandre Joosten, University of California, Los Angeles, Maxime Cannesson, University of California, Los Angeles, Robert G. Hahn, Karolinska Institutet, Stockholm
  • Book:
    Hemodynamic Monitoring and Fluid Therapy during Surgery
    Published online:
    11 April 2024
    Print publication:
    02 May 2024, pp 149-167

  • Summary

    This chapter considers perioperative fluid therapy in abdominal surgical patients.

    A fluid resembling the loss in quantity and electrolyte composition should replace both normal and pathological fluid losses.

    Elective surgical patients should eat up to 6 hours and drink up to 2 hours before surgery. Sugar- containing fluids (oral or IV) improve postoperative well-being and muscle strength, and decrease insulin resistance. Length of stay, complications, or mortality is not reduced.

    Surgery does not increase the normal fluid and electrolyte losses.

    It is not possible to treat a decrease in blood pressure caused by the use of epidural analgesia with fluid.

    The goal of <2 liter positive fluid balance is to reduce postoperative complications and risk of death in major abdominal surgery.

    A goal of near maximum stroke volume does not provide a better outcome.

    In outpatient surgery, 1 liter of IV fluid improves postoperative well-being. The role of glucose-containing fluid in this setting may be beneficial.

  • Effects of preoperative nutritional status on postoperative quality of recovery: a prospective observational study

  • Yuki Kinugasa, Mitsuru Ida, Shohei Nakatani, Kayo Uyama, Masahiko Kawaguchi
  • Journal:
    British Journal of Nutrition / Volume 130 / Issue 11 / 14 December 2023
    Published online by Cambridge University Press:
    05 May 2023, pp. 1898-1903
    Print publication:
    14 December 2023
    • Article
      • You have access
    • PDF
    • HTML
    • Export citation

  • Quality of Recovery-15 (QoR-15) has received attention as a postoperative patient-reported outcome measure. Preoperative nutritional status has negative effects on postoperative outcomes; however, these associations have not yet been investigated. We included inpatients aged ≥ 65 years who underwent elective abdominal cancer surgery under general anaesthesia between 1 June 2021 and 7 April 2022 at our hospital. Preoperative nutritional status was assessed using the Mini Nutritional Assessment Short-Form (MNA-SF), and patients with an MNA-SF score ≤ 11 were categorised into the poor nutritional group. The outcomes in this study were the QoR-15 scores at 2 d, 4 d and 7 d after surgery, which were compared between groups by unpaired t test. Multiple regression analysis was applied to assess the effects of poor preoperative nutritional status on the QoR-15 score on postoperative day 2 (POD 2). Of the 230 included patients, 33·9 % (78/230) were categorised into the poor nutritional status group. The mean QoR-15 value was significantly lower in the poor nutritional group than in the normal nutritional group at all postoperative time points (POD 2:117 v. 99, P = 0·002; POD 4:124 v. 113, P < 0·001; POD 7:133 v. 115, P < 0·001). Multiple analyses showed that poor preoperative nutritional status was associated with the QoR-15 score on POD 2 (adjusted partial regression coefficient, −7·8; 95 % CI −14·9, −0·72). We conclude that patients with a poor preoperative nutritional status were more likely to have a lower QoR-15 score after abdominal cancer surgery.

  • 19 - Anaesthesia for major abdominal and urological surgery

    • By Paul Myles, Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia, Kate Leslie, Department of Anaesthesia and Pain Management, Royal Melbourne Hospital and Department of Pharmacology, University of Melbourne, Melbourne, Australia
  • Edited by Ann Møller, KAS Herlev, Copenhagen, Tom Pedersen, Rigshospitalet, Copenhagen
  • Book:
    Evidence-based Anaesthesia and Intensive Care
    Published online:
    05 September 2009
    Print publication:
    09 October 2006, pp 223-246

  • Summary

    This chapter describes many evidence-based interventions relevant to anaesthesia for abdominal surgery. The two most common analgesic therapies after abdominal surgery are patient controlled analgesia (PCA) and epidural analgesia. It has been suggested that a strategy of targeting tissue oxygen delivery, so-called "optimisation" or "goal-directed" therapy, can improve postoperative outcome. Patients undergoing major abdominal surgery are particularly at risk of hypothermia, because of the potential for significant heat loss. There is substantial evidence in the literature that maintenance of normothermia during major abdominal surgery may lead to improved outcomes. Major abdominal surgery patients, in particular cancer patients, are at relatively high risk of deep venous thrombosis (DVT) and pulmonary embolism. There is a large amount of evidence derived from randomised trials and meta-analyses of trials in abdominal surgical practice to guide anaesthetic practice.