WikiAnesthesia - User contributions [en]

Open reduction internal fixation

2021-05-19T21:38:14Z

Jessica.Leung: Labs and studies

{{Infobox surgical case reference
| anesthesia_type =
| airway =
| lines_access =
| monitors =
| considerations_preoperative =
| considerations_intraoperative =
| considerations_postoperative =
}}

Provide a brief summary of this surgical procedure and its indications here.

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Respiratory
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|Other trauma-related injuries
|}

=== Labs and studies ===

* CBC
* BMP
* Type and Screen

=== Operating room setup ===

*

=== Patient preparation and premedication ===

=== Regional and neuraxial techniques ===

== Intraoperative management ==

=== Monitoring and access ===

* Consider foley placement if expecting surgical blood loss to better monitor hemodynamics
* If ORIF on upper extremity, consider BP cuff placement in lower extremities

=== Induction and airway management ===

=== Positioning ===

* Potential head away
* Potential 90 degrees rotation
* Left lateral (if operating on RUE) or right lateral position (if operating on LUE)

=== Maintenance and surgical considerations ===

*

=== Emergence ===

== Postoperative management ==

=== Disposition ===

* PACU

=== Pain management ===

=== Potential complications ===

== Procedure variants ==

{| class="wikitable"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]

Open reduction internal fixation

2021-05-19T21:34:35Z

Jessica.Leung: template, patient evaluation

{{Infobox surgical case reference
| anesthesia_type =
| airway =
| lines_access =
| monitors =
| considerations_preoperative =
| considerations_intraoperative =
| considerations_postoperative =
}}

Provide a brief summary of this surgical procedure and its indications here.

== Preoperative management ==

=== Patient evaluation ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Respiratory
|
|-
|Gastrointestinal
|
|-
|Hematologic
|Potential blood loss
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}

=== Labs and studies ===

=== Operating room setup ===

*

=== Patient preparation and premedication ===

=== Regional and neuraxial techniques ===

== Intraoperative management ==

=== Monitoring and access ===

=== Induction and airway management ===

=== Positioning ===

* Potential head away
* Potential 90 degrees rotation
* Left lateral (if operating on RUE) or right lateral position (if operating on LUE)

=== Maintenance and surgical considerations ===

=== Emergence ===

== Postoperative management ==

=== Disposition ===

* PACU

=== Pain management ===

=== Potential complications ===

== Procedure variants ==

{| class="wikitable"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

== References ==

[[Category:Surgical procedures]]

Roux-en-Y gastric bypass

2021-05-17T20:34:09Z

Jessica.Leung:

{{Infobox surgical case reference
| anesthesia_type = General
| airway = ETT
| lines_access = PIV
OG tube
| monitors = Standard, nasal temp
| considerations_preoperative = Potential difficult ventilation and airway management
| considerations_intraoperative = Rapid sequence, ramped position
| considerations_postoperative = PONV, IV tylenol
}}

A procedural variant for gastric partitioning for morbid obesity where the stomach is partitioned into a proximal and distal pouch with an anastomosis to the jejunum to drain the proximal pouch.

==Preoperative management==

===Patient evaluation===
{| class="wikitable"
|+
!System
!Considerations
|-
|Neurologic
|
|-
|Cardiovascular
|Evaluate for hypertension
OSA causing pulmonary arterial hypertension
|-
|Respiratory
|Evaluate BMI for decreased FRC

Evaluate OSA status for difficult mask ventilation
|-
|Gastrointestinal
|Consider delayed gastric emptying with diabetes mellitus
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|Consider delayed gastric emptying with diabetes mellitus
|-
|Other
|
|}

===Labs and studies===

*Sleep study (AHI score if available) for OSA

===Operating room setup===

*Consider ramp for airway management
*Consider video laryngoscopy
*OG tube
*Methylene Blue and 60mL syringe

===Patient preparation and premedication===

*Minimize perioperative sedation

===Regional and neuraxial techniques===

* Consider post-operative TAP block

==Intraoperative management==

===Monitoring and access===

*Standard ASA monitors

===Induction and airway management===

*Consider rapid sequence induction
*Video laryngoscopy can be helpful for anticipated difficult airways

===Positioning===

*Supine
*Extreme reverse Trendelenburg (place baseboard by feet)

===Maintenance and surgical considerations===

*OG tube is advanced through the surgical anastomosis to prevent backwall suturing of anastomosis
**Surgical and anesthesia communication and coordination is important to guide OGT through anastomosis
*Methylene blue 60mL used at the end of the case to pressurize the proximal pouch and look for leaks across the staple line of the anastomosis.

===Emergence===

==Postoperative management==

===Disposition===

*PACU

===Pain management===

*Moderate pain: IV and oral narcotics

===Potential complications===

*Bleeding
*Thromboemobolic events
*Aspiration
*Backwall suture of anastamosis

==Procedure variants==

{| class="wikitable"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

==References==

[[Category:Surgical procedures]]

Roux-en-Y gastric bypass

2021-05-17T20:09:32Z

Jessica.Leung: started the page. Added patient evaluation. Edited pre-operative and intraoperative management.

{{Infobox surgical case reference
| anesthesia_type = General
| airway = ETT
| lines_access = PIV
OG tube
| monitors = Standard, nasal temp
| considerations_preoperative = Potential difficult airway and ventilation
| considerations_intraoperative = Rapid sequence, ramped position
| considerations_postoperative = PONV, IV tylenol
}}

A procedural variant for gastric partitioning for morbid obesity where the stomach is partitioned into a proximal and distal pouch with an anastamosis to the jejunum to drain the proximal pouch.

==Preoperative management==

===Patient evaluation===
{| class="wikitable"
|+
!System
!Considerations
|-
|Neurologic
|
|-
|Cardiovascular
|Evaluate for hypertension
OSA causing pulmonary arterial hypertension
|-
|Respiratory
|Evaluate BMI for decreased FRC

Evaluate OSA status for difficult mask ventilation
|-
|Gastrointestinal
|Consider delayed gastric emptying with diabetes mellitus
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|Consider delayed gastric emptying with diabetes mellitus
|-
|Other
|
|}

===Labs and studies===

*Sleep study (AHI score if available) for OSA

===Operating room setup===

*Consider ramp for airway management
*Consider video laryngoscopy
*OG tube

===Patient preparation and premedication===

*Minimize perioperative sedation

===Regional and neuraxial techniques===

==Intraoperative management==

===Monitoring and access===

*Standard ASA monitors

===Induction and airway management===

*Consider rapid sequence induction
*Video laryngoscopy can be helpful for anticipated difficult airways

===Positioning===

*Supine
*Extreme reverse Trendelenburg (place baseboard by feet)

===Maintenance and surgical considerations===

*OG tube is advanced through the surgical anastamosis to prevent backwall suturing of anastamosis
**Surgical and anesthesia communication and coordination is important to guide OGT through anastamosis

===Emergence===

==Postoperative management==

===Disposition===

*PACU

===Pain management===

*Moderate pain: IV and oral narcotics

===Potential complications===

*Bleeding
*Thromboemobolic events
*Aspiration
*Backwall suture of anastamosis

==Procedure variants==

{| class="wikitable"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

==References==

[[Category:Surgical procedures]]

Roux-en-Y gastric bypass

2021-05-17T19:39:47Z

Jessica.Leung: started the page. Added patient evaluation. Edited pre-operative and intraoperative management.

{{Infobox surgical case reference
| anesthesia_type = General
| airway = ETT
| lines_access = PIV
OG tube
| monitors = Standard, nasal temp
| considerations_preoperative = Potential difficult airway and ventilation
| considerations_intraoperative = Rapid sequence, ramped position
| considerations_postoperative = PONV, IV tylenol
}}

Provide a brief summary of this surgical procedure and its indications here.

==Preoperative management==

===Patient evaluation===
{| class="wikitable"
|+
!System
!Considerations
|-
|Neurologic
|
|-
|Cardiovascular
|Evaluate for hypertension
OSA causing pulmonary arterial hypertension
|-
|Respiratory
|Evaluate BMI for decreased FRC

Evaluate OSA status for difficult mask ventilation
|-
|Gastrointestinal
|Consider delayed gastric emptying with diabetes mellitus
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|Consider delayed gastric emptying with diabetes mellitus
|-
|Other
|
|}

===Labs and studies===

* sleep study (AHI score if available) for OSA

===Operating room setup===

* Consider ramp for airway management
* Consider video laryngoscopy
* OG tube

===Patient preparation and premedication===

* Minimize perioperative sedation

===Regional and neuraxial techniques===

==Intraoperative management==

===Monitoring and access===

* Standard ASA monitors

===Induction and airway management===

* Consider rapid sequence induction
* Video laryngoscopy can be helpful for anticipated difficult airways

===Positioning===

* Supine
* Extreme reverse Trendelenburg (place baseboard by feet)

===Maintenance and surgical considerations===

* OG tube is advanced through the surgical anastamosis to prevent backwall suturing of anastamosis
** Surgical and anesthesia communication and coordination is important to guide OGT through anastamosis

===Emergence===

==Postoperative management==

===Disposition===

* PACU

===Pain management===

* Moderate pain: IV and oral narcotics

===Potential complications===

* Bleeding
* Thromboemobolic events
* Aspiration
* Backwall suture of anastamosis

==Procedure variants==

{| class="wikitable"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

==References==

[[Category:Surgical procedures]]