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Leister N, Wendt S, Hedergott A, Heindl LM, Rokohl AC, Stoll SE, Gordon E, Böttiger BW, Fricke J, Schick VC. Anaesthesia Concepts in Patients with Chronic Progressive External Ophthalmoplegia Undergoing Ophthalmic Surgery-A Retrospective Cohort Analysis. J Clin Med 2024; 13:4710. [PMID: 39200852 PMCID: PMC11355925 DOI: 10.3390/jcm13164710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Revised: 07/28/2024] [Accepted: 08/09/2024] [Indexed: 09/02/2024] Open
Abstract
BACKGROUND Chronic progressive external ophthalmoplegia (CPEO) belongs to the group of mitochondrial encephalomyopathies. Anaesthesia for patients with CPEO may be associated with an increased risk due to known drug effects on mitochondrial metabolism. Therefore, the aim of this analysis was to evaluate anaesthesiological concepts in patients with CPEO requiring ophthalmic surgery. METHODS This is a retrospective, monocentric cohort analysis of eleven patients with CPEO undergoing ophthalmic surgery either with general anaesthesia or local anaesthesia in a German university hospital from January 2012 to February 2022. RESULTS A total of twelve ophthalmic surgery procedures were performed in eleven adult patients with CPEO. Six patients underwent surgery after receiving local anaesthesia (LA cohort). Five patients underwent six surgical procedures under general anaesthesia (GA cohort). In five cases within the GA cohort, propofol and remifentanil were used for the maintenance of anaesthesia. In one case, balanced anaesthesia with desflurane and remifentanil was used. The median duration of general anaesthesia was 37.5 min (range, 25-65 min). Patients stayed in the recovery room for a median of 48.5 min (range, 35-70 min). All patients were discharged on the first postoperative day. No relevant complications occurred in either the LA or GA cohort. CONCLUSION Both local and general anaesthesia are feasible concepts for patients with CPEO undergoing ophthalmic surgery. Propofol, at least with a short duration (less than one hour) of use, appears to be a feasible hypnotic drug in CPEO patients.
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Affiliation(s)
- Nicolas Leister
- Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Köln, Germany; (S.E.S.); (B.W.B.); (V.C.S.)
| | - Stefanie Wendt
- Department of Cardiothoracic Surgery and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Köln, Germany;
| | - Andrea Hedergott
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Köln, Germany; (A.H.); (L.M.H.); (A.C.R.); (E.G.); (J.F.)
| | - Ludwig M. Heindl
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Köln, Germany; (A.H.); (L.M.H.); (A.C.R.); (E.G.); (J.F.)
| | - Alexander C. Rokohl
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Köln, Germany; (A.H.); (L.M.H.); (A.C.R.); (E.G.); (J.F.)
| | - Sandra E. Stoll
- Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Köln, Germany; (S.E.S.); (B.W.B.); (V.C.S.)
| | - Erik Gordon
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Köln, Germany; (A.H.); (L.M.H.); (A.C.R.); (E.G.); (J.F.)
| | - Bernd W. Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Köln, Germany; (S.E.S.); (B.W.B.); (V.C.S.)
| | - Julia Fricke
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Köln, Germany; (A.H.); (L.M.H.); (A.C.R.); (E.G.); (J.F.)
| | - Volker C. Schick
- Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Köln, Germany; (S.E.S.); (B.W.B.); (V.C.S.)
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Janoudi G, Uzun (Rada) M, Boyd ST, Fell DB, Ray JG, Foster AM, Giffen R, Clifford TJ, Walker MC. Do Case Reports and Case Series Generate Clinical Discoveries About Preeclampsia? A Systematic Review. Int J Womens Health 2023; 15:411-425. [PMID: 36974131 PMCID: PMC10039711 DOI: 10.2147/ijwh.s397680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
Background Preeclampsia is a leading cause of maternal and perinatal mortality and morbidity. The management of preeclampsia has not changed much in more than two decades, and its aetiology is still not fully understood. Case reports and case series have traditionally been used to communicate new knowledge about existing conditions. Whether this is true for preeclampsia is not known. Objective To determine whether recent case reports or case series have generated new knowledge and clinical discoveries about preeclampsia. Methods A detailed search strategy was developed in consultation with a medical librarian. Two bibliographic databases were searched through Ovid: Embase and MEDLINE. We selected case reports or case series published between 2015 and 2020, comprising pregnant persons diagnosed with hypertensive disorders of pregnancy, including preeclampsia. Two reviewers independently screened all publications. One reviewer extracted data from included studies, while another conducted a quality check of extracted data. We developed a codebook to guide our data extraction and outcomes assessment. The quality of each report was determined based on Joanna Briggs Institute (JBI) critical appraisal checklist for case reports and case series. Results We included 104 case reports and three case series, together comprising 118 pregnancies. A severe presentation or complication of preeclampsia was reported in 81% of pregnancies, and 84% had a positive maternal outcome, free of death or persistent complications. Only 8% of the case reports were deemed to be of high quality, and 53.8% of moderate quality; none of the case series were of high quality. A total of 26 of the 107 publications (24.3%) included a novel clinical discovery as a central theme. Conclusion Over two-thirds of recent case reports and case series about preeclampsia do not appear to present new knowledge or discoveries about preeclampsia, and most are of low quality.
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Affiliation(s)
- Ghayath Janoudi
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Stephanie T Boyd
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Deshayne B Fell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Joel G Ray
- Departments of Medicine, Health Policy Management and Evaluation, and Obstetrics and Gynecology, St Michael’s Hospital, University of Toronto, Toronto, ON, Canada
| | - Angel M Foster
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | | | - Tammy J Clifford
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Canadian Institute of Health Research, Government of Canada, Ottawa, ON, Canada
| | - Mark C Walker
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- International and Global Health Office, University of Ottawa, Ottawa, ON, Canada
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
- Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, Ottawa, ON, Canada
- BORN Ontario, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
- Correspondence: Mark C Walker, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Centre for Practice Changing Research, Box 241, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada, Tel +1 613-798-5555 x76655, Email
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Talaván Serna J, Belmonte Bayo L, Gutiérrez Rueda E, Rodríguez Martínez S. Anesthetic management of Kearns-Sayre syndrome. Case report. ACTA ACUST UNITED AC 2020; 68:232-234. [PMID: 33160688 DOI: 10.1016/j.redar.2020.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/11/2020] [Accepted: 04/17/2020] [Indexed: 11/25/2022]
Abstract
Kearns-Sayre syndrome is a mitochondrial myopathy characterized by ophthalmoplegia, pigmentary retinopathy and cardiac conduction abnormalities. This article describes the clinical management of a 50-year-old patient with Kearns-Sayre syndrome who underwent subarachnoid anesthesia for a traumatic femoral fracture surgery.
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Affiliation(s)
- J Talaván Serna
- Servicio de Anestesiología y Reanimación, Hospital Obispo Polanco, Teruel, España.
| | - L Belmonte Bayo
- Servicio de Anestesiología y Reanimación, Hospital Obispo Polanco, Teruel, España
| | - E Gutiérrez Rueda
- Servicio de Anestesiología y Reanimación, Hospital Obispo Polanco, Teruel, España
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