VACTERL syndrome presents many challenges related to anesthesia management due to multiple congenital malformations that may include vertebral, cardiac, tracheo-esophageal, renal and extremity anomalies. Continue reading
Although Computed Tomographic Angiography (CTA) is the established gold standard test for the detection of an aortic dissection, many researches and studies have proofed and established that transesophageal echocardiogram (TEE) can rule in or rule out the diagnosis of this catastrophic disorder, with greater accuracy. Continue reading
ΕΠΙΣΤΟΛΗ ΤΗΣ ΣΥΝΤΑΞΗΣ
ΜΑΙΕΥΤΙΚΗ ΑΙΜΟΡΡΑΓΙΑ ΚΑΙ ΔΙΑΤΑΡΑΧΕΣ ΑΙΜΟΣΤΑΣΗΣ: ΠΕΡΙΕΓΧΕΙΡΗΤΙΚΗ ΔΙΑΧΕΙΡΙΣΗ ΑΙΜΟΘΕΡΑΠΕΙΑΣ
ΔΙΕΓΧΕΙΡΗΤΙΚΗ ΔΙΑΧΕΙΡΙΣΗ ΤΗΣ ΑΛΓΑΙΣΘΗΣΙΑΣ: ΙΑΤΡΙΚΗ ΚΑΙ ΒΙΟΗΘΙΚΗ ΔΙΑΣΤΑΣΗ
HYPERTONIC SALINE RESUSCITATION IN ACUTE INTRAOPERATIVE HEMORRHAGE: CASE SERIES PRESENTATION
CHOLECYSTECTOMY MANAGEMENT UNDER DEXMEDETOMIDINE SEDATION WITH THORACIC EPIDURAL ANESTHESIA IN TWO HIGH-RISK GERIATRIC PATIENTS: CASE REPORTS AND LITERATURE REVIEW
PERITONEAL DIALYSIS IN ADULT INTENSIVE CARE UNIT: CASE REPORT AND LITERATURE REVIEW
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Dear colleagues,

The second issue of the Greek e-journal of Perioperative Medicine for 2022 presents various articles including Reviews Articles and Case Reports concerning perioperative medicine.

The review article of Varvarousi G et al. reviews the perioperative management of haemotherapy in obstetric patients with haemorrhage and coagulopathy abnormalities. Authors concluded that hypofibrinogenemia is the most common coagulation disorder in these patients. They also noted that point-of-care viscoelastic testing contributes to early identification and targeted treatment in obstetric bleeding and that timely administration of tranexamic acid is considered important in order to reduce blood loss for the treatment of postpartum haemorrhage.

The next review article of Zafeiriadis et al. describes the ethical and philosophical aspects of intraoperative pain management. The authors emphasize that these aspects are of great importance because the presence of complications, due to inadequate pain control during general anesthesia, comes mainly from the anesthetists’ unawareness about the patient’s exact nociceptive depth. They also noted that the need for efficient intraoperative monitoring of the patient’s nociception level is of extreme value, when considered through the bioethical and philosophical approach, in order the anesthetists to fulfil their preliminary duty, this of pain control.

The following article of Fyntanidou B et… Continue reading

Obstetric haemorrhage is the leading cause of mortality in parturients. In massive haemorrhage, fibrinogen is the first coagulation factor to decrease and a value < 2 gr/lt is a prognostic indicator of severe haemorrhage. A small decrease in fibrinogen leads to an increased effect on coagulability and continued haemorrhage. Coagulation disorders may be due to either consumption of coagulation factors or dilution. The type, severity and time of onset of the coagulation disorder depend on both the size and the cause of the haemorrhage. Early recognition of the cause of haemorrhage, low fibrinogen and its immediate correction are essential in the perioperative management of haemorrhage. Continue reading
According to IASP (International Association for the Study of Pain) the definition of pain is: An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. Furthermore, is expanded on: 1) Pain and nociception are different phenomena. Pain cannot be inferred solely from activity in sensory neurons and 2) Verbal description is only one of several behaviors to express pain; inability to communicate does not negate the possibility that a human or a nonhuman animal experiences pain. Continue reading

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