ISSN:0020-5907    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

In most men the prostate gland progressively enlarges after the age of 40, leading to the diagnosis of benign prostatic hypertrophy (BPH). Cancer of the prostate gland is a common tumor in men and has been found microscopically at autopsy in about 60% of men over 80 years old [1]. Up to 75% of men older than 50 years of age present with symptoms secondary to BPH or prostate cancer. As a result more than 350,000 transurethral prostatic resections are performed annually in the United States, making this one of the most commonly performed procedures [2].

ISSN:0020-5907    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Development and implementation of lithotripsy for treatment of renal and ureteral stone disease in the early 1980s was a major advance in patient care. Prior to the use of extracorporeal lithotripsy, surgical removal was the most common therapy for retained stones in the ureter and the kidney. Development and worldwide acceptance of an effective and noninvasive therapy for urinary tract stone disease represented a monumental step in the reduction of patient morbidity and economic costs.

ISSN:0020-5907    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0020-5907    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Patient positioning during anesthesia continues to be an important factor in anesthesia morbidity and mortality. The success of many urological and other surgical procedures depends on the satisfactory exposure of the operative area, which is often achieved by placing patients in various surgical positions that would be resisted if the patient was awake. These positions affect the respiratory, circulatory, and neurological systems.It is the anesthesiologist's responsibility to assure that patients are properly positioned so that the likelihood of avoidable complications may be reduced to the lowest possible degree. Vigilance and the use of the anesthesiologist's senses are essential to detect early untoward events and to take measures to reverse them [1].

ISSN:0020-5907    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Autonomic hyperreflexia is an acute syndrome characterized by widespread reflex sympathetic discharge in patients with chronic spinal cord lesions. It has also been described as autonomic dysreflexia, hypertensive autonomic crisis [1], and neurovegetative syndrome of visceral dysfunction [1], as well as “mass reflex” because of its unchecked, excessive, and generalized reaction.It appears in 85% of patients 2 to 3 weeks after the initial episode of an acute spinal lesion above the level of T7. It is produced, sometimes with remarkable ease, in response to stimuli below the level of the spinal cord lesion. These stimuli include distention of the viscera such as bladder, bowel, or intestine, cutaneous stimulation [2], such as tight clothing and strapping, uterine contractions, lower extremity and even upper extremity surgery [3], sexual intercourse [1], and urogenital pathology [1,4]. Urological procedures resulting in autonomic hyperreflexia include cystoscopy, urodynamic studies, extracorporeal lithotripsy, percutaneous nephrolithotomy [5], renal pelvic stone removal [6], electroejaculation [7], and nephrectomy [8].

ISSN:0020-5907    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This section profiles the developing pediatric kidney and makes some comparisons with renal function in the adult. Although ultimately responsible for fluid and electrolyte balance after birth, the kidneys are also critical to the fetus in helping to produce amniotic fluid in the womb.

ISSN:0020-5907    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Anesthesia for pediatric urological surgery comprises a wide spectrum of clinical involvement, ranging from short periods of monitored care or sedation for brief outpatient procedures such as urethral meatotomy or urodynamic studies, to formidable cases such as repair of bladder exstrophy or resection of a Wilms' tumor, which requires general anesthesia with additional invasive monitoring and which may be associated with significant blood loss, fluid shifts, heat loss, or derangements in other organ systems. The anesthesiologist must be familiar with specific considerations for each of the commonly encountered urological lesions, including the feasibility of applying regional techniques for intraoperative anesthesia as well as for postoperative analgesia, the assessment of preexisting renal function, the implications of patient positioning, and the psychological aspects of genitourinary surgery for the pediatric patient.

ISSN:0020-5907    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Urological surgery, particularly genitourinary surgery, is associated with considerable postoperative pain in children [1]. In the past little attention was paid to the management of pain in the pediatric age group. This was due mainly to lack of information and fear of narcotic use in children, in addition to the misconception that neonatal and pediatric patients do not experience pain as severely as adults do [2, 3]. During the last decade, there has been growing interest in denning safe and effective techniques for intraoperative anesthesia and postoperative analgesia for infants and children. This has led to investigating how to safely care for the increasing numbers of premature infants undergoing surgery, and to defining the safety and efficacy of a variety of regional techniques and narcotic use in children of all ages [4–6].

ISSN:0020-5907    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The incidence of intraoperative anaphylactic reactions has been estimated to be between 1 in 1,500 and 1 in 5,000; approximately 5 to 10% of patients developing intraoperative anaphylaxis die as a direct result [1]. Triggering agents implicated in these reactions include neuromuscular blocking drugs, intravenous anesthetics, intraoperative antibiotics, radiocontrast material, blood products, and protamine. No etiology is identified, however, in approximately 16% of these cases [2]. In the past 10 years, case reports have been published in the literature linking latex exposure to severe, immediate, type I allergic reactions in the operating room [3]. At present, this linkage is inferred and direct proof is lacking. However, latex-mediated immune reactions appear to be real and warrant consideration whenever unexplained anaphylactic or allergic reactions occur in the operating room.

ISSN:0020-5907    

出版商:OVID    

年代:1993

数据来源: OVID