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1. The Association of Cerebral Autoregulation Dysfunction and Postoperative Memory Impairment in Cardiac Surgery Patients

Author: Greta Kasputytė, Birutė Kumpaitienė, Milda Švagždienė, Judita Andrejaitienė, Mindaugas Gailiušas, Edmundas Širvinskas, Arūnas Gelmanas, Yasin Hamarat, Edvinas Chaleckas, Vilma Putnynaitė, Laimonas Bartušis, Rolandas Žakelis, Vytautas Petkus, Arminas Ragauskas, and Tadas Lenkutis
Subjects: cerebral autoregulation, memory impairment, cardiac surgery, Medicine (General), R5-920
Abstract: Background and Objectives: Cardiac surgery is associated with various durations of cerebral autoregulation (CA) impairment and can significantly impact cognitive function. Cognitive functions such as memory, psychomotor speed, and attention are significantly impacted after cardiac surgery, necessitating prioritization of these areas in cognitive function tests. There is a lack of research connecting cerebral autoregulation impairment to specific cognitive function domains after cardiac surgery. This study aimed to determine if impaired cerebral autoregulation is associated with postoperative memory impairment and to test the hypothesis that the duration of this impairment affects the development of postoperative memory issues. Materials and Methods: A prospective study was conducted in 2021–2023. After approval of the Ethics Committee and with patient’s written consent, 83 adult patients undergoing elective on-pump coronary artery bypass graft (CABG) surgery were enrolled. All patients were assessed for cognitive function 1 day before surgery using the Mini-Mental state examination (MMSE-2) test as a screening tool and the Hopkins Verbal Learning Test-Revised (HVLT-R) to assess memory specifically. To diagnose possible memory impairment (IM), all patients underwent a repeat assessment of cognitive function on the 7th–10th postoperative day. Cerebral autoregulation monitoring using transcranial Doppler was performed. Cerebral autoregulation status index (Mx) was recorded using Intensive Care Brain Monitoring System software, 9.1.5.23 (Cambridge, UK). Results: According to our research, the incidence of postoperative memory impairment is 30.1%. Temporary cerebral autoregulation impairment occurs in all patients undergoing elective in-pump CABG surgery. The duration of the single longest CA impairment event in seconds (LCAI) and the LCAI dose were higher in patients with postoperative memory impairment, p = 0.006 and p < 0.007, respectively. Conclusions: Cerebral autoregulation impairment is important in developing memory loss after cardiac surgery. The duration and dose of the LCAI event are predictive of postoperative memory impairment.
Published: 2024
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2. Low-Dose Ketamine for Acute Postoperative Pain Treatment

Author: Gelmanas, Arunas, primary, Vitartaite, Migle, additional, Tamosiunas, Ramunas, additional, and Macas, Andrius, additional
Published: 2022
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3. The Association of Cerebral Autoregulation Dysfunction and Postoperative Memory Impairment in Cardiac Surgery Patients.

Author: Kasputytė, Greta, Kumpaitienė, Birutė, Švagždienė, Milda, Andrejaitienė, Judita, Gailiušas, Mindaugas, Širvinskas, Edmundas, Gelmanas, Arūnas, Hamarat, Yasin, Chaleckas, Edvinas, Putnynaitė, Vilma, Bartušis, Laimonas, Žakelis, Rolandas, Petkus, Vytautas, Ragauskas, Arminas, and Lenkutis, Tadas
Subjects: COGNITIVE testing, CORONARY artery bypass, CEREBRAL circulation, COGNITIVE processing speed, MEMORY disorders, MINI-Mental State Examination
Abstract: Background and Objectives: Cardiac surgery is associated with various durations of cerebral autoregulation (CA) impairment and can significantly impact cognitive function. Cognitive functions such as memory, psychomotor speed, and attention are significantly impacted after cardiac surgery, necessitating prioritization of these areas in cognitive function tests. There is a lack of research connecting cerebral autoregulation impairment to specific cognitive function domains after cardiac surgery. This study aimed to determine if impaired cerebral autoregulation is associated with postoperative memory impairment and to test the hypothesis that the duration of this impairment affects the development of postoperative memory issues. Materials and Methods: A prospective study was conducted in 2021–2023. After approval of the Ethics Committee and with patient's written consent, 83 adult patients undergoing elective on-pump coronary artery bypass graft (CABG) surgery were enrolled. All patients were assessed for cognitive function 1 day before surgery using the Mini-Mental state examination (MMSE-2) test as a screening tool and the Hopkins Verbal Learning Test-Revised (HVLT-R) to assess memory specifically. To diagnose possible memory impairment (IM), all patients underwent a repeat assessment of cognitive function on the 7th–10th postoperative day. Cerebral autoregulation monitoring using transcranial Doppler was performed. Cerebral autoregulation status index (Mx) was recorded using Intensive Care Brain Monitoring System software, 9.1.5.23 (Cambridge, UK). Results: According to our research, the incidence of postoperative memory impairment is 30.1%. Temporary cerebral autoregulation impairment occurs in all patients undergoing elective in-pump CABG surgery. The duration of the single longest CA impairment event in seconds (LCAI) and the LCAI dose were higher in patients with postoperative memory impairment, p = 0.006 and p < 0.007, respectively. Conclusions: Cerebral autoregulation impairment is important in developing memory loss after cardiac surgery. The duration and dose of the LCAI event are predictive of postoperative memory impairment. [ABSTRACT FROM AUTHOR]
Published: 2024
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4. Can the inferior vena cava collapsibility index be useful in predicting hypotension during spinal anaesthesia in a spontaneously breathing patient? A mini fluid challenge

Author: Inna Jaremko, Asta Mačiulienė, Arūnas Gelmanas, Tautvydas Baranauskas, Ramūnas Tamošiūnas, Alfredas Smailys, and Andrius Macas
Subjects: spinal anaesthesia, hypotension, fluid therapy, inferior vena cava, collapsibility index, Medicine
Abstract: The study was performed at the Department of Orthopaedics and Traumatology of the Kauno Klinikos Hospital of Lithuanian University of Health Sciences. Background. Intravascular fluids are empirically administered to prevent hypotension induced by spinal anaesthesia. Ultrasound measurements of the inferior vena cava (IVC) and the IVC collapsibility index (IVC-CI) is a non-invasive method to evaluate the intravascular volume status. The aim of the study was to identify the prognostic value of the IVC collapsibility index in spontaneously breathing patients to predict severe intraoperative hypotension. Materials and methods. Sixty patients undergoing elective knee arthroplasty under spinal anaesthesia were included in the prospective study. The diameters of IVCex, IVCin, and IVC-CI were measured before and 15 min after spinal anaesthesia when administration of 500 ml of normal saline using infusion pump was finished. The haemodynamic parameters (heart rate, systolic, diastolic, and mean blood pressures, breathing rate) were collected. Results. Severe arterial hypotension was noticed in 18.3% of the patients. No statistically significant differences were detected between changes in IVCex, IVCin, and IVC-CI comparing hypotensive and non-hypotensive patients at the baseline and after the interventions (p > 0.005). According to receiver operating characteristic (ROC) analysis, IVC-CI is not effective in the prediction of severe hypotension during spinal anaesthesia in spontaneously breathing patients: the area under the ROC curve for IVC-CI was 0.05. Conclusions. IVC-CI is not an effective predictor of severe hypotension after induction of spinal anaesthesia followed by normal saline administration in spontaneously breathing patients undergoing elective knee arthroplasty. More trials, including different patient subgroups, will be needed.
Published: 2019
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5. FIBRINOGENO KONCENTRATO PANAUDOJIMAS DAUGINĘ TRAUMĄ PATYRUSIEMS PACIENTAMS

Author: Justina Barzdaitė, Karolina Skrabytė, and Arūnas Gelmanas
Abstract: Tikslas − apžvelgti fibrinogeno koncentrato panaudojimą dauginę traumą patyrusiems pacientams, remiantis publikuotais moksliniais šaltiniais. Nustatyta, kad Europoje dažniausiai dauginių traumų patiriama eismo įvykiuose [6]. Šių įvykių metu pagrindinė mirties priežastis − nekontroliuojamas kraujavimas. Tai viena iš išvengiamų mirties priežasčių, kai laiku skiriama kraujavimo kontrolė, siekiant palaikyti optimalią audinių perfuziją [4]. Viena iš pagrindinių kraujavimo stabdymą sutrikdančių ir pacientų išgyvenamumo prognozę bloginančių priežasčių yra ūminė koaguliopatija [5]. Traumos sukeltos koaguliopatijos korekcija, skiriant alogeninius kraujo produktus ir taip kompensuojant trūkstamus krešėjimo komponentus, yra vienas iš esminių tikslų, gydant daugines traumas patyrusius pacientus [1]. Tyrimų rezultatai parodė, kad fibrinogenas yra pagrindinis krešėjimo faktorius, reikalingas kraujavimo stabdymui bei pirmasis, kurio koncentracija ryškiai sumažėja kraujavimo metu [2]. Mokslininkų teigimu, ankstyvas fibrinogeno koncentrato panaudojimas pacientams, patyrusiems daugines traumas ir dėl to netekusiems daug kraujo, gali sumažinti mirties riziką bei pagerinti baigtį [2]. Tyrimai rodo, kad fibrinogeno koncentrato panaudojimas sukelia trumpalaikį (
Published: 2022
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6. Low-Dose Ketamine for Acute Postoperative Pain Treatment

Author: Migle Vitartaite, Andrius Macas, Arunas Gelmanas, and Ramunas Tamosiunas
Subjects: business.industry, Anesthesia, Low dose, medicine, Acute postoperative pain, Ketamine, business, medicine.drug
Abstract: Treatment of acute postoperative pain is an essential part of perioperative care and if left untreated could complicate the healing period. Ketamine blocks nociceptive pain and pain arising from inflammation. Therefore, it is potentially beneficial in the postoperative period. After systematic review using “MEDLINE/PubMed (NLM)” database, we analyzed 18 studies published during 2011–2020 and found that 0.5 mg/kg/h ketamine bolus and 0.1–0.25 mg/kg/h ketamine infusion to be the most effective dose to alleviate postoperative acute pain. Ketamine, when compared with a placebo, did not have any impact on patients’ satisfaction with postoperative pain management and overall well-being. Only three studies revealed more frequent adverse reactions to ketamine after surgery suggesting that ketamine did not have any impact on patients’ postoperational rehabilitation. So, it is the option to recommend low-dose ketamine to be part of multimodal analgesia in acute severe postoperative pain treatment. It can be used in both opioid-dependent and opioid-tolerant patients. Ketamine bolus should be ≤0.35 mg/kg and infusion ≤1 mg/kg/h. One should avoid the use of ketamine in pregnant women, people with cardiovascular diseases, acute psychosis, impaired liver function, increased intracranial, and intraocular pressure. Intranasal ketamine may be considered for children during procedures outside of the operation room.
Published: 2022
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7. B88 Comparison of suprainguinal fascia iliaca block with control group in patients undergoing total hip arthroplasty: a randomized, controlled study

Author: M Eidininkienė, A Gelmanas, and G Aldakauskaitė
Published: 2022
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8. B74 Postoperative effects of anterior femoral nerve branches block after total knee arthroplasty

Author: G Aldakauskaitė, M Eidininkienė, and A Gelmanas
Published: 2022
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9. Intraoperative transfusion practices and perioperative outcome in the European elderly: A secondary analysis of the observational ETPOS study

Author: Grusser L., Keszei A., Coburn M., Rossaint R., Ziemann S., Kowark A, Daniela Filipescu, Sibylle Kozek-Langenecker, Juan V Llau Pitarch, Susan Mallett, Peter Martus, Idit Matot, Jens Meier, Axel Unterrainer, Dieter Adelmann, Daniel von Langen, Petra Innerhofer, Nicole Innerhofer-Pompernigg, Stefan De Hert, Luc De Baerdemaeker, Jurgen van Limmen, Piet Wyffels, Björn Heyse, Margot Vanderlaenen, Maud Beran, David Kahn, Audrey Prospiech, Luc Jamaer, Freya Mulders, Stefan Jacobs, Wannes Baeten, Sofie Platteau, Isabelle Maquoi, Severine Lauwick, Marc Senard, Vincent Ninane, Jean-Pierre Lecoq, Pierre Boveroux, Grégory Hans, Marcel Vercauteren, Brigitte Leva, Benoit Plichon, Vojislav Vujanovič, Ismet Suljevic, Hened Kelle, Denis Gustin, Matea Bogdanovic Dvorscak, Tamara Lupis, Jadranka Pavičić Šarić, Nataša Paklar, Dagmar Oberhofer, Ira Skok, Borana Kirigin, Ikic Visnja, Marina Kresic, Slavica Kvolik, Renatas Krobot, Vladimir Cerny, Jana Striteska, Marcela Bilska, Petr Štourač, Hana Harazim, Olga Smékalová, Martina Kosinová, Jozef Klučka, Rita Pacasová, Kim Ekelund, Indrek Rätsep, Juri Oganjan, Nadezda Smirnova, Peeter Kivik, Juri Karjagin, Alar Rokk, Alar Sõrmus, Bertrand Rozec, Jean-Christophe Rigal, Jean-Pierre Gouraud, Anne-Marie Chupin, Xavier Ambrosi, Laurent Brisard, Sylvie Decagny, Charles Marc Samama, Lionel Lidzborski, Matthieu Boisson, Anne-Laure Arcade, Gilbert Lorre, Peter Rosenberger, Hannah Merz, Ulrich Goebel, Bettina Schnitter, Hartmut Buerkle, Roland Tomasi, Vera von Dossow-Hanfstingl, Florian Brettner, Andreas Bayer, André Gottschalk, Nicolas Jakobs, Mark Coburn, Ana Kowark, Rolf Rossaint, Rita Laufenberg, Marion Ferner, Michael Schuster, Lydia Strys, Susanne Mauff, Kornel Skitek, Ewa Zielinska-Skitek, Gregor Schittek, Andreas Hoeft, Andreas Fleischer, Maria Wittmann, Florian Kessler, Anne Rohner, Peter Kranke, Christian Wunder, Johanna Jokinen, Kristin Budow, Christopher Prasser, Eva Werner, Alina Balandin, Norbert Ahrens, Kai Zacharowski, Patrick Meybohm, Kassiani Theodoraki, George Giokas, Tasoulis Marios-Konstantinos, Ageliki Pandazi, Aikaterini Kyttari, Eygenia Koursoumi, Georgios Anthopoulos, Antonis Andreou, Athanasios Rantis, Dimitrios Valsamidis, Pelagia Klimi, Konstantinos Katsanoulas, Demetrios Korfiotis, Christos Soumelidis, Fotios Papaspyros, Olga Kiskira, Tilemachos Paraskeuopoulos, Donal Buggy, Mortimer Kelleher, Liz Coghlan, Vladimir Verenkin, Anat Cattan, Francesco Bona, Felicino Debernardi, Andrea Cortegiani, Santi Maurizio Raineri, Giuseppe Accurso, Elena Gramigni, Leonardo Cenni, Laura Campiglia, Irene Lorenzi, Maria Grazia Militello, Tamara Biscioni, Andrius Macas, Daiva Apanaviciute, Darius Trepenaitis, Arunas Gelmanas, Diana Bilshiene, Jurate Sipylaite, Gabija Tomkute, Egle Kontrimaviciut, Renatas Tikuisis, Francis Borg, Ion Chesov, Serghei Cobiletchi, Victoria Moghildea, Bas Verdouw, J F van Poorten, Nick van Dasselaar, Marcus Daniel Lance, Britta de Waal, Lucienne Kropman, Peter van Noord, Benedikt Preckel, Lena Koers, Markus W Hollmann, Holger Baumann, Ankie W M M Koopman-van Gemert, Tore Reikvam, Tore Hervig, Kasper Gymoese Berthelsen, Ingvild Hausberg Sørvoll, Mirosław Czuczwar, Michał Borys, Paweł Piwowarczyk, Suzana Parente, Diogo Martins, Gloria Tareco, Ligia Reis, Joana Amaral, Daniel Ferreira, José Manuel Gonçalves Aguiar, Zélia Moreira, Filipa Lagarto, Filipa Pereira, Maria Lina Miranda, Sofia Serra, Alexandre Carrilho, José Pinto, Sandra Dias, Rita Poeria, Filipe Linda, Silvia Pica, Helder Martinho, Francisco Matias, Claudia Alves, Valentina Almeida, Margarida Marques, Emilia Martires, Piedade Gomes, Elizabete Pereira, Joana Jesus, Claudia Carreira, Carlos Seco, Carlos Bento, Helena Vieira, Luciane Pereira, Fernando Pinto, Luisa Silva, Marta Azenha, Maged Zarif, Ana Bernardino, Ana Raimundo, Ana Lopes, Melissa Fernandes, Beatriz Campos, Ana Macedo, Filipe Pinheiro, Sonia Duarte, Alexandra Saraiva, Catia Real, Marilena Alina Paunescu, Alexandru Bogdan Prodan, Mihai Stefan, Cristian Boros, Marius Tifrea, Anca Dragan, Horhota Lucian, Alida Moise, Carmen Arion-Balescu, Natalia Mincu, Viorel Gherghina, Iulia Cindea, Dan Costea, Ravzan Popescu, Dana Tomescu, Ecaterina Scarlatescu, Esenia Calancea, Ruxandra Copotoiu, Sanda Maria Copotoiu, Victoria Barsan, Dan Corneci, Rely Manolescu, Toma Diana, Denisa Nitu, Georgian Popica, Gabriela Droc, Nicoleta Jipa Lavina, Roxana Ciobanasu, Anna Maria Munteanu, Denisa Anastase, Iona Grintescu, Liliana Mirea, Alexandra Manoleli, Ciobanu Elena, Mary Nicoleta Lupu, Madalina Nina Sandu, Bicolae Bacalbasa, Florenta Calarasu, Alexey Grytsan, Andrey Gasenkampf, Alexander Kulikov, Alexander Shmigelsky, Vojislava Nescovic, Rade Vukovic, Uros Petrovic, Milic Veljovic, Dragana Unic-Stojanovic, Gordana Jovanovic, Ivana Kvrgic, Dragana Rakic, Roman Záhorec, Daniel Cintula, Tomas Veselovsky, Katarina Galkova, Jordana Stevikova, Andrea Číková, Zora Flassikova, Anna Dobisova, Jasmina Markovic Bozic, Minca Voje, Andriy Grynyuk, Alenka Spindler Yesel, Sabina Stivan, Peter Poredos, Darja Kasnik, Jasna Uranjek, Raquel Ferrandis, Sofia Machado, Liliana Henao, Tania Moreno, Ana Izquierdo, Carlos Delgado, Angela Camps, Susana Manrique, Alejandro Arbelaez, Pilar Tormos, Helena Serrano, Irene Garcia, Elvira Bisbe Vives, Luís Moltó, Tania Villar, Enrique Moret, Raquel Tolós, Esther Martínez, Misericordia Basora, Beatriz Tena, Roger Pujol, Jorge Vera Bella, Thomas Mallor, Pablo Mondero, Luis Lopez, Francisco Hidalgo, Maria Bermudez Lopez, Ana Velasco, Begona Bascuas, Victoria Moral, Diana Gómez Martinez, Alfredo Merten, J A Fernández, Nadia Diana Kinast, A Font, Maggi Genaro, Emilia Guasch, Fernando Gilsanz, Raul Martinez, Renato Schiraldi, Ever Martinez, Marta Barquero López, Alexo Lopez Alvarez, Yvan Enrique Sanchez Sanchez, Adriana Roman Fernandez, Olalla Varela Garcia, Marian Angeles Orallo Moran, Veronica Gonzalez Monzon, Óscar Sánchez López, David Sanchez Perez, Pablo Molano Diaz, Concepcion Cassinello, Maria Pilar Jubera, Maria Soler Pedrola, Julio Belmonte Cuenca, Sören Söndergaard, Till Rudolph, Kristin Åkeröy, Monir Jawad, Yousif Saeed, Sergej Safonov, Mona Andersson, Jan Wernerman, Suzanne Odeberg-Wernerman, Tommi Blom, Nesil Deger Coskunfirat, Zekiye Bigat, Suat Sanlı, O Koray Coskunfirat, Atilla Ramazanoğlu, Neval Boztug Uz, Ali Emre Camci, Omur Aksoy, Esra Saka, Oguzhan Arun, Sevda Ozkardesler, Dilek Omur, Mert Akan, Zuleyha Kazak Bengisun, Hakan Yılmaz, Perihan Ekmekci, Onur Selvi, Neslihan Alkis, Çiğdem Yıldırım, Başak Ceyda Meço, Zekeriyye Alanoğlu, Sergiy Vorotyntsev, Yevgen Yakymenko, Galina Troyan, Mohammed Alousi, Sarah James, Paula Meale, Ahmed Chishti, Matt Garner, Rita Singh, Nicola Hirschauer, Charley Higham, Andrea Bell, Alistair Cain, Chris Perry, Katy Davies, Claire Leech, Verity Calder, Shaman Jhanji, Varma Sandeep, Karen Simeson, Philip Watt, Nigel Dunk, Rosemary Ferrie, Margaret Wright, Lynn Everett, Andrew Ferguson, Laura Espie, Gail Browne, Matthew Dickinson, Ashok Nair, Deborah Clements, Peter Carvalho, Thomas Collyer, Jens Bolten, Lajos Zsisku, Attila Petri, Mohammed Ramadan, Tracey Ellimah, Martus, Peter, Laufenberg, Rita, Ferner, Marion, Schuster, Michael, Strys, Lydia, Mauff, Susanne, Skitek, Kornel, Zielinska-Skitek, Ewa, Schittek, Gregor, Hoeft, Andreas, Fleischer, Andreas, Matot, Idit, Wittmann, Maria, Kessler, Florian, Rohner, Anne, Kranke, Peter, Wunder, Christian, Jokinen, Johanna, Budow, Kristin, Prasser, Christopher, Werner, Eva, Balandin, Alina, Meier, Jens, Ahrens, Norbert, Zacharowski, Kai, Meybohm, Patrick, Theodoraki, Kassiani, Giokas, George, Marios-Konstantinos, Tasoulis, Pandazi, Ageliki, Kyttari, Aikaterini, Koursoumi, Eygenia, Anthopoulos, Georgios, Unterrainer, Axel, Andreou, Antonis, Rantis, Athanasios, Valsamidis, Dimitrios, Klimi, Pelagia, Katsanoulas, Konstantinos, Korfiotis, Demetrios, Soumelidis, Christos, Papaspyros, Fotios, Kiskira, Olga, Paraskeuopoulos, Tilemachos, Adelmann, Dieter, Buggy, Donal, Kelleher, Mortimer, Coghlan, Liz, Verenkin, Vladimir, Cattan, Anat, Bona, Francesco, Debernardi, Felicino, Cortegiani, Andrea, Raineri, Santi Maurizio, Accurso, Giuseppe, von Langen, Daniel, Gramigni, Elena, Cenni, Leonardo, Campiglia, Laura, Lorenzi, Irene, Militello, Maria Grazia, Biscioni, Tamara, Macas, Andrius, Apanaviciute, Daiva, Trepenaitis, Darius, Gelmanas, Arunas, Innerhofer, Petra, Bilshiene, Diana, Sipylaite, Jurate, Tomkute, Gabija, Kontrimaviciut, Egle, Tikuisis, Renatas, Borg, Francis, Chesov, Ion, Cobiletchi, Serghei, Moghildea, Victoria, Verdouw, Bas, Innerhofer-Pompernigg, Nicole, van Poorten, J. F., van Dasselaar, Nick, Lance, Marcus Daniel, de Waal, Britta, Kropman, Lucienne, van Noord, Peter, Preckel, Benedikt, Koers, Lena, Hollmann, Markus W., Baumann, Holger, De Hert, Stefan, Koopman-van Gemert, Ankie W. M. M., Reikvam, Tore, Hervig, Tore, Berthelsen, Kasper Gymoese, Sørvoll, Ingvild Hausberg, Czuczwar, Mirosław, Borys, Michał, Piwowarczyk, Paweł, Parente, Suzana, Martins, Diogo, De Baerdemaeker, Luc, Tareco, Gloria, Reis, Ligia, Amaral, Joana, Ferreira, Daniel, Gonçalves Aguiar, José Manuel, Moreira, Zélia, Lagarto, Filipa, Pereira, Filipa, Miranda, Maria Lina, Serra, Sofia, van Limmen, Jurgen, Carrilho, Alexandre, Pinto, José, Dias, Sandra, Poeria, Rita, Linda, Filipe, Pica, Silvia, Martinho, Helder, Matias, Francisco, Alves, Claudia, Almeida, Valentina, Wyffels, Piet, Marques, Margarida, Martires, Emilia, Gomes, Piedade, Pereira, Elizabete, Jesus, Joana, Carreira, Claudia, Seco, Carlos, Bento, Carlos, Vieira, Helena, Pereira, Luciane, Heyse, Björn, Pinto, Fernando, Silva, Luisa, Azenha, Marta, Zarif, Maged, Bernardino, Ana, Raimundo, Ana, Lopes, Ana, Fernandes, Melissa, Campos, Beatriz, Macedo, Ana, Vanderlaenen, Margot, Pinheiro, Filipe, Duarte, Sonia, Saraiva, Alexandra, Real, Catia, Paunescu, Marilena Alina, Bogdan Prodan, Alexandru, Stefan, Mihai, Boros, Cristian, Tifrea, Marius, Dragan, Anca, Beran, Maud, Lucian, Horhota, Moise, Alida, Arion-Balescu, Carmen, Mincu, Natalia, Gherghina, Viorel, Cindea, Iulia, Costea, Dan, Popescu, Ravzan, Tomescu, Dana, Scarlatescu, Ecaterina, Kahn, David, Calancea, Esenia, Copotoiu, Ruxandra, Copotoiu, Sanda Maria, Barsan, Victoria, Corneci, Dan, Manolescu, Rely, Diana, Toma, Nitu, Denisa, Popica, Georgian, Droc, Gabriela, Prospiech, Audrey, Jipa Lavina, Nicoleta, Ciobanasu, Roxana, Munteanu, Anna Maria, Anastase, Denisa, Grintescu, Iona, Mirea, Liliana, Manoleli, Alexandra, Elena, Ciobanu, Lupu, Mary Nicoleta, Sandu, Madalina Nina, Jamaer, Luc, Bacalbasa, Bicolae, Calarasu, Florenta, Grytsan, Alexey, Gasenkampf, Andrey, Kulikov, Alexander, Shmigelsky, Alexander, Nescovic, Vojislava, Vukovic, Rade, Petrovic, Uros, Veljovic, Milic, Mulders, Freya, Unic-Stojanovic, Dragana, Jovanovic, Gordana, Kvrgic, Ivana, Rakic, Dragana, Záhorec, Roman, Cintula, Daniel, Veselovsky, Tomas, Galkova, Katarina, Stevikova, Jordana, Číková, Andrea, Jacobs, Stefan, Flassikova, Zora, Dobisova, Anna, Markovic Bozic, Jasmina, Voje, Minca, Grynyuk, Andriy, Spindler Yesel, Alenka, Stivan, Sabina, Poredos, Peter, Kasnik, Darja, Uranjek, Jasna, Baeten, Wannes, Ferrandis, Raquel, Machado, Sofia, Henao, Liliana, Moreno, Tania, Izquierdo, Ana, Delgado, Carlos, Camps, Angela, Manrique, Susana, Arbelaez, Alejandro, Tormos, Pilar, Platteau, Sofie, Serrano, Helena, Garcia, Irene, Bisbe Vives, Elvira, Moltó, Luís, Villar, Tania, Moret, Enrique, Tolós, Raquel, Martínez, Esther, Basora, Misericordia, Tena, Beatriz, Maquoi, Isabelle, Pujol, Roger, Vera Bella, Jorge, Mallor, Thomas, Mondero, Pablo, Lopez, Luis, Hidalgo, Francisco, Bermudez Lopez, Maria, Velasco, Ana, Bascuas, Begona, Moral, Victoria, Lauwick, Severine, Gómez Martinez, Diana, Merten, Alfredo, Fernández, J. A., Kinast, Nadia Diana, Font, A., Genaro, Maggi, Guasch, Emilia, Gilsanz, Fernando, Martinez, Raul, Schiraldi, Renato, Senard, Marc, Martinez, Ever, Barquero López, Marta, Lopez Alvarez, Alexo, Sanchez Sanchez, Yvan Enrique, Roman Fernandez, Adriana, Varela Garcia, Olalla, Orallo Moran, Marian Angeles, Gonzalez Monzon, Veronica, Sánchez López, Óscar, Sanchez Perez, David, Ninane, Vincent, Molano Diaz, Pablo, Cassinello, Concepcion, Pilar Jubera, Maria, Soler Pedrola, Maria, Belmonte Cuenca, Julio, Söndergaard, Sören, Rudolph, Till, Åkeröy, Kristin, Jawad, Monir, Saeed, Yousif, Lecoq, Jean-Pierre, Safonov, Sergej, Andersson, Mona, Wernerman, Jan, Odeberg-Wernerman, Suzanne, Blom, Tommi, Deger Coskunfirat, Nesil, Bigat, Zekiye, Sanlı, Suat, Coskunfirat, O. Koray, Ramazanoğlu, Atilla, Boveroux, Pierre, Boztug Uz, Neval, Camci, Ali Emre, Aksoy, Omur, Saka, Esra, Arun, Oguzhan, Ozkardesler, Sevda, Omur, Dilek, Akan, Mert, Bengisun, Zuleyha Kazak, Yılmaz, Hakan, Hans, Grégory, Ekmekci, Perihan, Selvi, Onur, Alkis, Neslihan, Yıldırım, Çiğdem, Ceyda Meço, Başak, Alanoğlu, Zekeriyye, Vorotyntsev, Sergiy, Yakymenko, Yevgen, Troyan, Galina, Alousi, Mohammed, Vercauteren, Marcel, James, Sarah, Meale, Paula, Chishti, Ahmed, Garner, Matt, Singh, Rita, Hirschauer, Nicola, Higham, Charley, Bell, Andrea, Cain, Alistair, Perry, Chris, Leva, Brigitte, Davies, Katy, Leech, Claire, Calder, Verity, Jhanji, Shaman, Sandeep, Varma, Simeson, Karen, Watt, Philip, Dunk, Nigel, Ferrie, Rosemary, Wright, Margaret, Plichon, Benoit, Everett, Lynn, Ferguson, Andrew, Espie, Laura, Browne, Gail, Dickinson, Matthew, Nair, Ashok, Clements, Deborah, Carvalho, Peter, Collyer, Thomas, Bolten, Jens, Vujanovič, Vojislav, Zsisku, Lajos, Petri, Attila, Ramadan, Mohammed, Ellimah, Tracey, Suljevic, Ismet, Kelle, Hened, Gustin, Denis, Bogdanovic Dvorscak, Matea, Lupis, Tamara, Pavičić Šarić, Jadranka, Paklar, Nataša, Oberhofer, Dagmar, Skok, Ira, Kirigin, Borana, Visnja, Ikic, Kresic, Marina, Kvolik, Slavica, Krobot, Renatas, Cerny, Vladimir, Striteska, Jana, Bilska, Marcela, Filipescu, Daniela, Štourač, Petr, Harazim, Hana, Smékalová, Olga, Kosinová, Martina, Klučka, Jozef, Pacasová, Rita, Ekelund, Kim, Rätsep, Indrek, Oganjan, Juri, Smirnova, Nadezda, Kozek-Langenecker, Sibylle, Kivik, Peeter, Karjagin, Juri, Rokk, Alar, Sõrmus, Alar, Rozec, Bertrand, Rigal, Jean-Christophe, Gouraud, Jean-Pierre, Chupin, Anne-Marie, Ambrosi, Xavier, Brisard, Laurent, Llau Pitarch, Juan V., Decagny, Sylvie, Samama, Charles Marc, Lidzborski, Lionel, Boisson, Matthieu, Arcade, Anne-Laure, Lorre, Gilbert, Rosenberger, Peter, Merz, Hannah, Goebel, Ulrich, Schnitter, Bettina, Mallett, Susan, Buerkle, Hartmut, Tomasi, Roland, von Dossow-Hanfstingl, Vera, Brettner, Florian, Bayer, Andreas, Gottschalk, André, Jakobs, Nicolas, Coburn, Mark, Kowark, Ana, Rossaint, Rolf, Grusser L., Keszei A., Coburn M., Rossaint R., Ziemann S., Kowark A, Daniela Filipescu, Sibylle Kozek-Langenecker, Juan V Llau Pitarch, Susan Mallett, Peter Martus, Idit Matot, Jens Meier, Axel Unterrainer, Dieter Adelmann, Daniel von Langen, Petra Innerhofer, Nicole Innerhofer-Pompernigg, Stefan De Hert, Luc De Baerdemaeker, Jurgen van Limmen, Piet Wyffels, Björn Heyse, Margot Vanderlaenen, Maud Beran, David Kahn, Audrey Prospiech, Luc Jamaer, Freya Mulders, Stefan Jacobs, Wannes Baeten, Sofie Platteau, Isabelle Maquoi, Severine Lauwick, Marc Senard, Vincent Ninane, Jean-Pierre Lecoq, Pierre Boveroux, Grégory Hans, Marcel Vercauteren, Brigitte Leva, Benoit Plichon, Vojislav Vujanovič, Ismet Suljevic, Hened Kelle, Denis Gustin, Matea Bogdanovic Dvorscak, Tamara Lupis, Jadranka Pavičić Šarić, Nataša Paklar, Dagmar Oberhofer, Ira Skok, Borana Kirigin, Ikic Visnja, Marina Kresic, Slavica Kvolik, Renatas Krobot, Vladimir Cerny, Jana Striteska, Marcela Bilska, Petr Štourač, Hana Harazim, Olga Smékalová, Martina Kosinová, Jozef Klučka, Rita Pacasová, Kim Ekelund, Indrek Rätsep, Juri Oganjan, Nadezda Smirnova, Peeter Kivik, Juri Karjagin, Alar Rokk, Alar Sõrmus, Bertrand Rozec, Jean-Christophe Rigal, Jean-Pierre Gouraud, Anne-Marie Chupin, Xavier Ambrosi, Laurent Brisard, Sylvie Decagny, Charles Marc Samama, Lionel Lidzborski, Matthieu Boisson, Anne-Laure Arcade, Gilbert Lorre, Peter Rosenberger, Hannah Merz, Ulrich Goebel, Bettina Schnitter, Hartmut Buerkle, Roland Tomasi, Vera von Dossow-Hanfstingl, Florian Brettner, Andreas Bayer, André Gottschalk, Nicolas Jakobs, Mark Coburn, Ana Kowark, Rolf Rossaint, Rita Laufenberg, Marion Ferner, Michael Schuster, Lydia Strys, Susanne Mauff, Kornel Skitek, Ewa Zielinska-Skitek, Gregor Schittek, Andreas Hoeft, Andreas Fleischer, Maria Wittmann, Florian Kessler, Anne Rohner, Peter Kranke, Christian Wunder, Johanna Jokinen, Kristin Budow, Christopher Prasser, Eva Werner, Alina Balandin, Norbert Ahrens, Kai Zacharowski, Patrick Meybohm, Kassiani Theodoraki, George Giokas, Tasoulis Marios-Konstantinos, Ageliki Pandazi, Aikaterini Kyttari, Eygenia Koursoumi, Georgios Anthopoulos, Antonis Andreou, Athanasios Rantis, Dimitrios Valsamidis, Pelagia Klimi, Konstantinos Katsanoulas, Demetrios Korfiotis, Christos Soumelidis, Fotios Papaspyros, Olga Kiskira, Tilemachos Paraskeuopoulos, Donal Buggy, Mortimer Kelleher, Liz Coghlan, Vladimir Verenkin, Anat Cattan, Francesco Bona, Felicino Debernardi, Andrea Cortegiani, Santi Maurizio Raineri, Giuseppe Accurso, Elena Gramigni, Leonardo Cenni, Laura Campiglia, Irene Lorenzi, Maria Grazia Militello, Tamara Biscioni, Andrius Macas, Daiva Apanaviciute, Darius Trepenaitis, Arunas Gelmanas, Diana Bilshiene, Jurate Sipylaite, Gabija Tomkute, Egle Kontrimaviciut, Renatas Tikuisis, Francis Borg, Ion Chesov, Serghei Cobiletchi, Victoria Moghildea, Bas Verdouw, J F van Poorten, Nick van Dasselaar, Marcus Daniel Lance, Britta de Waal, Lucienne Kropman, Peter van Noord, Benedikt Preckel, Lena Koers, Markus W Hollmann, Holger Baumann, Ankie W M M Koopman-van Gemert, Tore Reikvam, Tore Hervig, Kasper Gymoese Berthelsen, Ingvild Hausberg Sørvoll, Mirosław Czuczwar, Michał Borys, Paweł Piwowarczyk, Suzana Parente, Diogo Martins, Gloria Tareco, Ligia Reis, Joana Amaral, Daniel Ferreira, José Manuel Gonçalves Aguiar, Zélia Moreira, Filipa Lagarto, Filipa Pereira, Maria Lina Miranda, Sofia Serra, Alexandre Carrilho, José Pinto, Sandra Dias, Rita Poeria, Filipe Linda, Silvia Pica, Helder Martinho, Francisco Matias, Claudia Alves, Valentina Almeida, Margarida Marques, Emilia Martires, Piedade Gomes, Elizabete Pereira, Joana Jesus, Claudia Carreira, Carlos Seco, Carlos Bento, Helena Vieira, Luciane Pereira, Fernando Pinto, Luisa Silva, Marta Azenha, Maged Zarif, Ana Bernardino, Ana Raimundo, Ana Lopes, Melissa Fernandes, Beatriz Campos, Ana Macedo, Filipe Pinheiro, Sonia Duarte, Alexandra Saraiva, Catia Real, Marilena Alina Paunescu, Alexandru Bogdan Prodan, Mihai Stefan, Cristian Boros, Marius Tifrea, Anca Dragan, Horhota Lucian, Alida Moise, Carmen Arion-Balescu, Natalia Mincu, Viorel Gherghina, Iulia Cindea, Dan Costea, Ravzan Popescu, Dana Tomescu, Ecaterina Scarlatescu, Esenia Calancea, Ruxandra Copotoiu, Sanda Maria Copotoiu, Victoria Barsan, Dan Corneci, Rely Manolescu, Toma Diana, Denisa Nitu, Georgian Popica, Gabriela Droc, Nicoleta Jipa Lavina, Roxana Ciobanasu, Anna Maria Munteanu, Denisa Anastase, Iona Grintescu, Liliana Mirea, Alexandra Manoleli, Ciobanu Elena, Mary Nicoleta Lupu, Madalina Nina Sandu, Bicolae Bacalbasa, Florenta Calarasu, Alexey Grytsan, Andrey Gasenkampf, Alexander Kulikov, Alexander Shmigelsky, Vojislava Nescovic, Rade Vukovic, Uros Petrovic, Milic Veljovic, Dragana Unic-Stojanovic, Gordana Jovanovic, Ivana Kvrgic, Dragana Rakic, Roman Záhorec, Daniel Cintula, Tomas Veselovsky, Katarina Galkova, Jordana Stevikova, Andrea Číková, Zora Flassikova, Anna Dobisova, Jasmina Markovic Bozic, Minca Voje, Andriy Grynyuk, Alenka Spindler Yesel, Sabina Stivan, Peter Poredos, Darja Kasnik, Jasna Uranjek, Raquel Ferrandis, Sofia Machado, Liliana Henao, Tania Moreno, Ana Izquierdo, Carlos Delgado, Angela Camps, Susana Manrique, Alejandro Arbelaez, Pilar Tormos, Helena Serrano, Irene Garcia, Elvira Bisbe Vives, Luís Moltó, Tania Villar, Enrique Moret, Raquel Tolós, Esther Martínez, Misericordia Basora, Beatriz Tena, Roger Pujol, Jorge Vera Bella, Thomas Mallor, Pablo Mondero, Luis Lopez, Francisco Hidalgo, Maria Bermudez Lopez, Ana Velasco, Begona Bascuas, Victoria Moral, Diana Gómez Martinez, Alfredo Merten, J A Fernández, Nadia Diana Kinast, A Font, Maggi Genaro, Emilia Guasch, Fernando Gilsanz, Raul Martinez, Renato Schiraldi, Ever Martinez, Marta Barquero López, Alexo Lopez Alvarez, Yvan Enrique Sanchez Sanchez, Adriana Roman Fernandez, Olalla Varela Garcia, Marian Angeles Orallo Moran, Veronica Gonzalez Monzon, Óscar Sánchez López, David Sanchez Perez, Pablo Molano Diaz, Concepcion Cassinello, Maria Pilar Jubera, Maria Soler Pedrola, Julio Belmonte Cuenca, Sören Söndergaard, Till Rudolph, Kristin Åkeröy, Monir Jawad, Yousif Saeed, Sergej Safonov, Mona Andersson, Jan Wernerman, Suzanne Odeberg-Wernerman, Tommi Blom, Nesil Deger Coskunfirat, Zekiye Bigat, Suat Sanlı, O Koray Coskunfirat, Atilla Ramazanoğlu, Neval Boztug Uz, Ali Emre Camci, Omur Aksoy, Esra Saka, Oguzhan Arun, Sevda Ozkardesler, Dilek Omur, Mert Akan, Zuleyha Kazak Bengisun, Hakan Yılmaz, Perihan Ekmekci, Onur Selvi, Neslihan Alkis, Çiğdem Yıldırım, Başak Ceyda Meço, Zekeriyye Alanoğlu, Sergiy Vorotyntsev, Yevgen Yakymenko, Galina Troyan, Mohammed Alousi, Sarah James, Paula Meale, Ahmed Chishti, Matt Garner, Rita Singh, Nicola Hirschauer, Charley Higham, Andrea Bell, Alistair Cain, Chris Perry, Katy Davies, Claire Leech, Verity Calder, Shaman Jhanji, Varma Sandeep, Karen Simeson, Philip Watt, Nigel Dunk, Rosemary Ferrie, Margaret Wright, Lynn Everett, Andrew Ferguson, Laura Espie, Gail Browne, Matthew Dickinson, Ashok Nair, Deborah Clements, Peter Carvalho, Thomas Collyer, Jens Bolten, Lajos Zsisku, Attila Petri, Mohammed Ramadan, Tracey Ellimah, Anesthesiology, ACS - Diabetes & metabolism, APH - Quality of Care, ACS - Heart failure & arrhythmias, APH - Global Health, and ACS - Microcirculation
Subjects: Clinical Oncology, Male, Science, Clinical Decision-Making, Cancer Treatment, Surgical and Invasive Medical Procedures, Geographical Locations, Diagnostic Medicine, Outcome Assessment, Health Care, Medicine and Health Sciences, Humans, Blood Transfusion, Prospective Studies, Aged, Aged, 80 and over, Intraoperative Care, Multidisciplinary, Transfusion Medicine, Anemia, Hematology, Clinical Laboratory Sciences, Health Care, Europe, Surgical Oncology, Oncology, Age Groups, Elective Surgical Procedures, People and Places, Medicine, Population Groupings, Female, Geriatric Care, Clinical Medicine, Erythrocyte Transfusion, Research Article
Abstract: PLOS ONE 17(1), e0262110 (2022). doi:10.1371/journal.pone.0262110, Published by PLOS, San Francisco, California, US
Published: 2022
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10. Anaesthesia for Liver Transplantation

Author: Zykute, Dalia, primary, Gelmanas, Arūnas, additional, Trepenaitis, Darius, additional, and Macas, Andrius, additional
Published: 2022
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11. B88 Comparison of suprainguinal fascia iliaca block with control group in patients undergoing total hip arthroplasty: a randomized, controlled study

Author: Eidininkienė, M, primary, Gelmanas, A, additional, and Aldakauskaitė, G, additional
Published: 2022
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12. B74 Postoperative effects of anterior femoral nerve branches block after total knee arthroplasty

Author: Aldakauskaitė, G, primary, Eidininkienė, M, additional, and Gelmanas, A, additional
Published: 2022
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13. Measurements of Inferior Vena Cava Diameter for Prediction of Hypotension and Bradycardia during Spinal Anesthesia in Spontaneously Breathing Patients during Elective Knee Joint Replacement Surgery

Author: Asta Mačiulienė, Arūnas Gelmanas, Inna Jaremko, Ramūnas Tamošiūnas, Alfredas Smailys, and Andrius Macas
Subjects: spinal anesthesia, hypotension, bradycardia, intravascular volume, inferior vena cava, Medicine (General), R5-920
Abstract: Background and objective: Hypotension and bradycardia are the most common hemodynamic disorders and side effects of spinal anesthesia (SA) on the cardiovascular system. SA-induced sympathetic denervation causes peripheral vasodilatation and redistribution of central blood volume that may lead to decreased venous return to the heart. The aim of the study was to evaluate the changes of inferior vena cava collapsibility index (IVC-CI) during SA in spontaneously breathing patients during elective knee joint replacement surgery to prognose manifestation of intraoperative hypotension and bradycardia. Materials and methods: 60 patients (American Society of Anesthesiologists (ASA) physical status I or II, no clinically significant cardiovascular pathology) of both sexes undergoing elective knee joint replacement surgery under SA were included in the prospective study. Inspiratory and expiratory inferior vena cava (IVCin, IVCex) diameters were measured using an ultrasound device in supine position before and immediately after SA, then 15 min, 30 min, and 45 min after SA was performed. The heart rate, along with systolic, diastolic, and mean arterial blood pressures were collected. The parameters were measured at the baseline and at the next four time points. Results: There were no significant changes in IVCin, IVCex, and IVC-CI compared to baseline and other time point measurements in hypotensive versus nonhypotensive and bradycardic versus nonbradycardic patients (p > 0.05). Changes in IVC diameter do not prognose hypotension and/or bradycardia during SA: the area under the curve (AUC) of the receiver operating characteristic (ROC) curve for IVC-CI at all measuring points was 0.05. Conclusions: Reduction in IVC diameters and increase in IVC-CI do not predict hypotension and bradycardia during SA in spontaneously breathing patients undergoing elective knee joint replacement surgery.
Published: 2018
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14. FIBRINOGENO KONCENTRATO PANAUDOJIMAS DAUGINĘ TRAUMĄ PATYRUSIEMS PACIENTAMS

Author: Barzdaitė, Justina, primary, Skrabytė, Karolina, additional, and Gelmanas, Arūnas, additional
Published: 2022
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15. Comparison of 2 Peripheral Nerve Blocks Techniques for Functional Recovery and Postoperative Pain Management After Total Knee Arthroplasty: A Prospective, Double-Blinded, Randomized Trial

Author: Inna Jaremko, Karina Lukaševič, Šarūnas Tarasevičius, Arūnas Gelmanas, Andrius Macas, and Linas Zeniauskas
Subjects: Male, Knee Joint, Adductor canal, medicine.medical_treatment, Anesthesia and Analgesia, Total knee arthroplasty, law.invention, Patient satisfaction, Randomized controlled trial, law, Clinical Research, medicine, Humans, Pain Management, Prospective Studies, Arthroplasty, Replacement, Knee, Aged, Pain Measurement, Pain, Postoperative, business.industry, Nerve Block, General Medicine, Recovery of Function, Middle Aged, Osteoarthritis, Knee, Arthroplasty, Analgesics, Opioid, medicine.anatomical_structure, Opioid, Femoral triangle, Patient Satisfaction, Anesthesia, Nerve block, Female, business, medicine.drug
Abstract: BACKGROUND Methods of pain management that have less effect on motor function after total knee arthroplasty (TKA) are needed to ensure early mobilization. We investigated whether the distal femoral triangle and distal adductor canal blocks are superior to the femoral nerve block regarding motor blockade at early postoperative hours. MATERIAL AND METHODS Patients scheduled for TKA under spinal anesthesia were blindly assigned into 2 groups. One group received the distal femoral triangle and distal adductor canal blocks and the other group received the femoral nerve block. In both groups, at 3, 6, 24, and 48 h after surgery motor blockade was evaluated with the Bromage scale. Secondary outcomes such as pain control efficacy and patient satisfaction were evaluated at 6, 24, and 48 h postoperatively using either the VAS scale or a 10-point scale. RESULTS We analyzed the outcomes of 77 patients. Better motor function at 3 and 6 h after TKA was observed in the distal femoral triangle and the distal adductor canal blocks group (37.7% vs 23.4%, p=0.032 and 49.4% vs 32.5%, p=0.002, respectively). At 24 h after the surgery, patients from the femoral nerve block group consumed significantly more rescue opioid analgesics (p=0.016). We found no significant differences in pain intensity and patient satisfaction at any timepoints after the surgery. CONCLUSIONS The distal femoral triangle and distal adductor canal blocks resulted in significantly better motor function at the first 3 and 6 h after total knee arthroplasty. At 24 h after surgery, rescue opioid doses in the femoral nerve block group were significantly higher.
Published: 2021

16. Intraoperative transfusion practices in Europe

Author: Meier, J., Filipescu, D., Kozek-Langenecker, S., Llau Pitarch, J., Mallett, S., Martus, P., Matot, I., Accurso, Giuseppe, Ahrens, Norbert, Akan, Mert, Åkeröy, Kristin, Aksoy, Omur, Alanoğlu, Zekeriyye, Alfredo, Merten, Alkis, Neslihan, Almeida, Valentina, Alousi, Mohammed, Alves, Claudia, Amaral, Joana, Ambrosi, Xavier, Ana, Izquierdo, Anastase, Denisa, Andersson, Mona, Andreou, Antonis, Anthopoulos, Georgios, Apanaviciute, Daiva, Arbelaez, Alejandro, Arcade, Anne-Laure, Arion-Balescu, Carmen, Arun, Oguzhan, Azenha, Marta, Bacalbasa, Nicolae, Baeten, Wannes, Balandin, Alina, Barquero López, Marta, Barsan, Victoria, Bascuas, Begona, Basora, Misericordia, Baumann, Holger, Bayer, Andreas, Bell, Andrea, Belmonte Cuenca, Julio, Bengisun, Zuleyha Kazak, Bento, Carlos, Beran, Maud, Bermudez Lopez, Maria, Bernardino, Ana, Berthelsen, Kasper Gymoese, Bigat, Zekiye, Bilshiene, Diana, Bilska, Marcela, Bisbe Vives, Elvira, Biscioni, Tamara, Björn, Heyse, Blom, Tommi, Bogdan Prodan, Alexandru, Bogdanovic Dvorscak, Matea, Boisson, Matthieu, Bolten, Jens, Bona, Francesco, Borg, Francis, Boros, Cristian, Borys, Michał, Boveroux, Pierre, Boztug Uz, Neval, Brettner, Florian, Brisard, Laurent, Britta, De Waal, Browne, Gail, Budow, Kristin, Buerkle, Hartmut, Buggy, Donal, Cain, Alistair, Calancea, Esenia, Calarasu, Florenta, Calder, Verity, Camci, Ali Emre, Campiglia, Laura, Campos, Beatriz, Camps, Angela, Carlos, Delgado, Carreira, Claudia, Carrilho, Alexandre, Carvalho, Peter, Cassinello, Concepcion, Cattan, Anat, Cenni, Leonardo, Cerny, Vladimir, Ceyda Meço, Başak, Chesov, Ion, Chishti, Ahmed, Chupin, Anne-Marie, Cikova, Andrea, Cindea, Iulia, Cintula, Daniel, Ciobanasu, Roxana, Clements, Deborah, Cobiletchi, Serghei, Coburn, Mark, Coghlan, Liz, Collyer, Thomas, Copotoiu, Sanda Maria, Copotoiu, Ruxandra, Corneci, Dan, Cortegiani, Andrea, Coskunfirat, O.Koray, Costea, Dan, Czuczwar, Mirosław, Davies, Katy, De Baerdemaeker, Luc, De Hert, Stefan, Debernardi, Felicino, Decagny, Sylvie, Deger Coskunfirat, Nesil, Diana, Toma, Diana, Gómez Martinez, Dias, Sandra, Dickinson, Matthew, Dobisova, Anna, Dragan, Anca, Droc, Gabriela, Duarte, Sonia, Dunk, Nigel, Ekelund, Kim, Ekmekçi, Perihan, Elena, Ciobanu, Ellimah, Tracey, Espie, Laura, Everett, Lynn, Ferguson, Andrew, Fernandes, Melissa, Fernández, J.A., Ferner, Marion, Ferreira, Daniel, Ferrie, Rosemary, Filipescu, Daniela, Flassikova, Zora, Fleischer, Andreas, Font, A., Galkova, Katarina, Garcia, Irene, Garner, Matt, Gasenkampf, Andrey, Gelmanas, Arunas, Gherghina, Viorel, Gilsanz, Fernando, Giokas, George, Goebel, Ulrich, Gomes, Piedade, Gonçalves Aguiar, José Manuel, Gonzalez Monzon, Veronica, Gottschalk, André, Gouraud, Jean-Pierre, Gramigni, Elena, Grintescu, Ioana, Grynyuk, Andriy, Grytsan, Alexey, Guasch, Emilia, Gustin, Denis, Hans, Grégory, Harazim, Hana, Hervig, Tore, Hidalgo, Francisco, Higham, Charley, Hirschauer, Nicola, Hoeft, Andreas, Innerhofer, Petra, Innerhofer-Pompernigg, Nicole, Jacobs, Stefan, Jakobs, Nicolas, Jamaer, Luc, James, Sarah, Jawad, Monir, Jesus, Joana, Jhanji, Shaman, Jipa Lavina, Nicoleta, Jokinen, Johanna, Jovanovic, Gordana, Jubera, Maria Pilar, Kahn, David, Karjagin, Juri, Kasnik, Darja, Katsanoulas, Konstantinos, Kelle, Hened, Kelleher, Mortimer, Kessler, Florian, Kirigin, Borana, Kiskira, Olga, Kivik, Peeter, Klimi, Pelagia, Klučka, Jozef, Koers, Lena, Kontrimaviciut, Egle, Koopman-van Gemert, A.W.M.M., Korfiotis, Demetrios, Kosinová, Martina, Koursoumi, Eygenia, Kozek Langenecker, Sibylle, Kranke, Peter, Kresic, Marina, Krobot, Renatas, Kropman, Lucienne, Kulikov, Alexander, Kvolik, Slavica, Kvrgic, Ivana, Kyttari, Aikaterini, Lagarto, Filipa, Lance, Marcus D., Laufenberg, Rita, Lauwick, Severine, Lecoq, Jean-Pierre, Leech, Leech, lidzborski, Lionel, Liliana, Henao, Linda, Filipe, Llau Pitarch, Juan Vicente, Lopes, Ana, Lopez, Luis, Lopez Alvarez, Alexo, Lorenzi, Irene, Lorre, Gilbert, Lucian, Horhota, Lupis, Tamara, Lupu, Mary Nicoleta, Macas, Andrius, Macedo, Ana, Maggi, Genaro, Mallett, Susan, Mallor, Thomas, Manoleli, Alexandra, Manolescu, Rely, Manrique, Susana, Maquoi, Isabelle, Marios-Konstantinos, Tasoulis, Markovic Bozic, Jasmina, Markus W., Hollmann, Marques, Margarida, Martinez, Raul, Martinez, Ever, Martínez, Esther, Martinho, Helder, Martins, Diogo, Martires, Emilia, Martus, Peter, Matias, Francisco, Matot, Idit, Mauff, Susanne, Meale, Paula, Meier, Jens, Merz, Hannah, Meybohm, Patrick, Militello, Maria Grazia, Mincu, Natalia, Miranda, Maria Lina, Mirea, Liliana, Moghildea, Victoria, Moise, Alida, Molano Diaz, Pablo, Moltó, Luís, Monedero, Pablo, Moral, Victoria, Moreira, Zélia, Moret, Enrique, Mulders, Freya, Munteanu, Anna Maria, Nadia Diana, Kinast, Nair, Ashok, Neskovic, Vojislava, Ninane, Vincent, Nitu, Denisa, Oberhofer, Dagmar, Odeberg-Wernerman, Suzanne, Oganjan, Juri, Omur, Dilek, Orallo Moran, Marian Angeles, Ozkardesler, Sevda, Pacasová, Rita, Paklar, Nataša, Pandazi, Ageliki, Papaspyros, Fotios, Paraskeuopoulos, Tilemachos, Parente, Suzana, Paunescu, Marilena Alina, Pavičić Šarić, Jadranka, Pereira, Filipa, Pereira, Elizabete, Pereira, Luciane, Perry, Chris, Petri, Attila, Petrovic, Uros, Pica, Silvia, Pinheiro, Filipe, Pinto, José, Pinto, Fernando, Piwowarczyk, Paweł, Platteau, Sofie, Poeira, Rita, Popescu, Ravzan, Popica, Georgian, Poredos, Peter, Prasser, Christopher, Preckel, Benedikt, Prospiech, Audrey, Pujol, Roger, Raimundo, Ana, Raineri, Santi Maurizio, Rakic, Dragana, Ramadan, Mohammed, Ramazanoğlu, Atilla, Rantis, Athanasios, Raquel, Ferrandis, Rätsep, Indrek, Real, Catia, Reikvam, Tore, Reis, Ligia, Rigal, Jean-Christophe, Rohner, Anne, Rokk, Alar, Roman Fernandez, Adriana, Rosenberger, Peter, Rossaint, Rolf, Rozec, Bertrand, Rudolph, Till, Saeed, Yousif, Safonov, Sergej, Saka, Esra, Samama, Charles Marc, Sánchez López, Óscar, Sanchez Perez, David, Sanchez Sanchez, Yvan Enrique, Sandeep, Varma, Sandu, Madalina Nina, Sanl, Suat, Saraiva, Alexandra, Scarlatescu, Ecaterina, Schiraldi, Renato, Schittek, Gregor, Schnitter, Bettina, Schuster, Michael, Seco, Carlos, Selvi, Onur, Senard, Marc, Serra, Sofia, Serrano, Helena, Shmigelsky, Alexander, Silva, Luisa, Simeson, Karen, Singh, Rita, Sipylaite, Jurate, Skitek, Kornel, Skok, Ira, Smékalová, Olga, Smirnova, Nadezda, Sofia, Machado, Soler Pedrola:, Maria, Söndergaard, Sören, Sõrmus, Alar, Sørvoll, Ingvild Hausberg, Soumelidis, Christos, Spindler Yesel, Alenka, Stefan, Mihai, Stevanovic, Ana, Stevikova, Jordana, Stivan, Sabina, Štourač, Petr, Striteska, Jana, Strys, Lydia, Suljevic, Ismet, Tania, Moreno, Tareco, Gloria, Tena, Beatriz, Theodoraki, Kassiani, Tifrea, Marius, Tikuisis, Renatas, Tolós, Raquel, Tomasi, Roland, Tomescu, Dana, Tomkute, Gabija, Tormos, Pilar, Trepenaitis, Darius, Troyan, Galina, Unic-Stojanovic, Dragana, Unterrainer, Axel, Uranjek, Jasna, Valsamidis, Dimitrios, van Dasselaar, Nick, Van Limmen, Jurgen, van Noord, Peter, van Poorten, J.F., Vanderlaenen, Margot, Varela Garcia, Olalla, Velasco, Ana, Veljovic, Milic, Vera Bella, Jorge, Vercauteren, Marcel, Verdouw, Bas, Verenkin, Vladimir, Veselovsky, Tomas, Vieira, Helena, Villar, Tania, Visnja, Ikic, Voje, Minca, von Dossow-Hanfstingl, Vera, Von Langen, Daniel, Vorotyntsev, Sergiy, Vujanovič, Vojislav, Vukovic, Rade, Watt, Philip, Werner, Eva, Wernerman, Jan, Wittmann, Maria, Wright, Margaret, Wunder, Christian, Wyffels, Piet, Yakymenko, Yevgen, Yldrm, Çiğdem, Ylmaz, Hakan, Zacharowski, Kai, Záhorec, Roman, Zarif, Maged, Zielinska-Skitek, Ewa, and Zsisku, Lajos
Published: 2016
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17. Comparison of 2 Peripheral Nerve Blocks Techniques for Functional Recovery and Postoperative Pain Management After Total Knee Arthroplasty: A Prospective, Double-Blinded, Randomized Trial

Author: Jaremko, Inna, primary, Lukaševič, Karina, additional, Tarasevičius, Šarūnas, additional, Zeniauskas, Linas, additional, Macas, Andrius, additional, and Gelmanas, Arūnas, additional
Published: 2021
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18. Postoperative cognitive dysfunction in geriatric patients after orthopedic surgery

Author: Arūnas Gelmanas, Tomas Bukauskas, Andrius Macas, Giedrė Žarskienė, and Ainius Žarskus
Subjects: postoperative cognitive dysfunction, orthopedic surgery, complication, geriatric patient, Mini-mental State Examination, 6 Item Cognitive Impairment test, Medicine
Abstract: The aim of our study was to find out the changes of cognitive functions of geriatric patients after orthopedic surgery and when these differen ces are marked. We also tried to find out factors, which have influence on the results of common mental activity, to estimate the dynamics of mental activity and to choose the most optimal intervals of estimation. The population of our investigation consisted of 25 consecutive adult patients, undergoing orthopedic operation, applying regional anesthesia. Neurophysiological assessment where all patients underwent neurophysiological tests consisted of the Mini-mental State Examination (MMSE), 6 Item Cognitive Impairment test (6CIT), Trail-making test – a neuropsychological test of visual attention and task switching. Patients were tested the day before the surgery (MMSE1, 6CIT1, TMT1), on the day of the surgery (MMSE2, 6CIT2, TMT2) and on the third day after the surgery (MMSE3, 6CIT3, TMT3). The day before the surgery reveals that results of MMSE1, 6CIT1 tests were better in a group of younger patients. We found that the results of the MMSE test were significantly worse 3 days after the surgery than those before the procedure in the A group, p = 0.016. The biggest digression was fixed in “copying” and “repeating” after the surgery intervention, p = 0.01, p = 0.04. The orientation in time significantly decreased in the group B after the surgery, p = 0.00. MMSE, 6CIT, TMT test results were significantlt worse in older patients rather than younger ones 3 days after the surgery. We set that the elderly have a significantly shorter duration of education. Younger patients and patients with a longer studying period achieved better results of tests. The results mean that age and lasting of education are significant predictors of POCD. Our pilot study confirmed that POCD develops for older patients, undergoing neuroaxial anesthesia for orthopedic surgery. It is very important to continue studies and reveal how to decrease POCD events, keep the quality of life.
Published: 2012
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19. Intracapsular Pressure and Elasticity of the Hip Joint Capsule in Osteoarthritis

Author: Tarasevicius, Sarunas, Kesteris, Uldis, Gelmanas, Arunas, Smailys, Alfredas, and Wingstrand, Hans
Published: 2007
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20. Can the inferior vena cava collapsibility index be useful in predicting hypotension during spinal anaesthesia in a spontaneously breathing patient? A mini fluid challenge

Author: Arūnas Gelmanas, Inna Jaremko, Ramūnas Tamošiūnas, Tautvydas Baranauskas, Andrius Macas, Alfredas Smailys, and Asta Mačiulienė
Subjects: hypotension, Respiratory rate, collapsibility index, business.industry, lcsh:R, Hemodynamics, lcsh:Medicine, Blood volume, General Medicine, spinal anaesthesia, Inferior vena cava, fluid therapy, medicine.vein, Anesthesia, Heart rate, Intravascular volume status, Breathing, cardiovascular system, Infusion pump, Medicine, business, inferior vena cava, Research Article
Abstract: The study was performed at the Department of Orthopaedics and Traumatology of the Kauno Klinikos Hospital of Lithuanian University of Health Sciences. Background. Intravascular fluids are empirically administered to prevent hypotension induced by spinal anaesthesia. Ultrasound measurements of the inferior vena cava (IVC) and the IVC collapsibility index (IVC-CI) is a non-invasive method to evaluate the intravascular volume status. The aim of the study was to identify the prognostic value of the IVC collapsibility index in spontaneously breathing patients to predict severe intraoperative hypotension. Materials and methods. Sixty patients undergoing elective knee arthroplasty under spinal anaesthesia were included in the prospective study. The diameters of IVCex, IVCin, and IVC-CI were measured before and 15 min after spinal anaesthesia when administration of 500 ml of normal saline using infusion pump was finished. The haemodynamic parameters (heart rate, systolic, diastolic, and mean blood pressures, breathing rate) were collected. Results. Severe arterial hypotension was noticed in 18.3% of the patients. No statistically significant differences were detected between changes in IVCex, IVCin, and IVC-CI comparing hypotensive and non-hypotensive patients at the baseline and after the interventions (p > 0.005). According to receiver operating characteristic (ROC) analysis, IVC-CI is not effective in the prediction of severe hypotension during spinal anaesthesia in spontaneously breathing patients: the area under the ROC curve for IVC-CI was 0.05. Conclusions. IVC-CI is not an effective predictor of severe hypotension after induction of spinal anaesthesia followed by normal saline administration in spontaneously breathing patients undergoing elective knee arthroplasty. More trials, including different patient subgroups, will be needed.
Published: 2019

21. Anaesthesia for Liver Transplantation

Author: Zykute, Dalia, Gelmanas, Arūnas, Trepenaitis, Darius, and Macas, Andrius
Abstract: Since the first liver transplantation at the Kaunas Clinic of the Hospital of Lithuanian University of Health Sciences (LUHS), in 2000, many changes have been implemented and an increasing number of cases led to the development of expertise. The aim of this article was to summarise 12-years out of liver transplantation experience. Data was obtained retrospectively from inpatient medical records at the Hospital of LUHS, Kaunas Clinic. All cases of liver transplantations from November 2009 to September 2021 were included (n = 96). The median age of transplant recipients was 50 years (IQR 46–56). Two-thirds of recipients were male (n = 66, 69%). The mean Model for End-Stage Liver Disease (MELD) score was 23 (SD 6). The most common indication for liver transplantation was hepatitis C virus-related end-stage liver disease (n = 24, 25%). Immediate extubation was performed with a median of 63% of cases (IQR 14.3–75.7%). We further compared data between the early (November 2009 – December 2015) and late phases (January 2016 – September 2021) of experience: the number of liver transplantation cases increased by 66% from 36 to 60), MELD scores stayed similar (an average of 22 vs 24, p = 0.282), and mean intraoperative time did not change significantly (543 minutes vs 496 minutes, p = 0.078). Liver transplantation has been gaining momentum in Lithuania. Increasing experience enables our centre to meet an increasing demand for liver transplantations.
Published: 2022
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22. Role of Multimodal Analgesia in the Evolving Enhanced Recovery after Surgery Pathways

Author: Albinas Naudžiūnas, Diana Bilskienė, Andrius Macas, Ramūnas Tamošiūnas, Saulius Sadauskas, David Gelman, Dalia Urbanaitė, Rimantas Benetis, Arūnas Gelmanas, and Edmundas Širvinskas
Subjects: medicine.medical_specialty, NSAIDs, Postoperative pain, Organ function, Postoperative recovery, Review, Fight-or-flight response, 03 medical and health sciences, 0302 clinical medicine, Health care, medicine, Humans, Pain Management, multimodal analgesia, 030212 general & internal medicine, Anesthesia, general, methods, Anesthesia recovery period, Pain, postoperative, Pain management, Anti-inflammatory agents, non-steroidal, pharmacology, Intensive care medicine, Enhanced recovery after surgery, Acetaminophen, Postoperative Care, Pain, Postoperative, business.industry, Anti-Inflammatory Agents, Non-Steroidal, General Medicine, Perioperative, Analgesia, Epidural, Analgesics, Opioid, 617-089.5 [udc], enhanced recovery after surgery, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Analgesia, business, postoperative pain, Surgical interventions
Abstract: Enhanced recovery after surgery (ERAS) are specially designed multimodal perioperative care pathways which are intended to attain and improve rapid recovery after surgical interventions by supporting preoperative organ function and attenuating the stress response caused by surgical trauma, allowing patients to get back to normal activities as soon as possible. Evidence-based protocols are prepared and published to implement the conception of ERAS. Although they vary amongst health care institutions, the main three elements (preoperative, perioperative, and postoperative components) remain the cornerstones. Postoperative pain influences the quality and length of the postoperative recovery period, and later, the quality of life. Therefore, the optimal postoperative pain management (PPM) applying multimodal analgesia (MA) is one of the most important components of ERAS. The main purpose of this article is to discuss the concept of MA in PPM, particularly reviewing the use of opioid-sparing measures such as paracetamol, nonsteroid anti-inflammatory drugs (NSAIDs), other adjuvants, and regional techniques.
Published: 2018

23. Measurements of Inferior Vena Cava Diameter for Prediction of Hypotension and Bradycardia during Spinal Anesthesia in Spontaneously Breathing Patients during Elective Knee Joint Replacement Surgery

Author: Andrius Macas, Asta Mačiulienė, Inna Jaremko, Alfredas Smailys, Arūnas Gelmanas, and Ramūnas Tamošiūnas
Subjects: Bradycardia, Male, medicine.medical_specialty, hypotension, Supine position, Hemodynamics, Vena Cava, Inferior, Inferior vena cava, Anesthesia, Spinal, bradycardia, Article, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Predictive Value of Tests, Heart rate, medicine, Intravascular volume status, Humans, intravascular volume, Prospective Studies, Arthroplasty, Replacement, Knee, Intraoperative Complications, spinal anesthesia, Aged, Ultrasonography, lcsh:R5-920, business.industry, 030208 emergency & critical care medicine, General Medicine, Middle Aged, Surgery, medicine.vein, inferior vena cava, ROC Curve, Elective Surgical Procedures, cardiovascular system, Arterial blood, Female, medicine.symptom, lcsh:Medicine (General), business, Venous return curve
Abstract: Background and objective: Hypotension and bradycardia are the most common hemodynamic disorders and side effects of spinal anesthesia (SA) on the cardiovascular system. SA-induced sympathetic denervation causes peripheral vasodilatation and redistribution of central blood volume that may lead to decreased venous return to the heart. The aim of the study was to evaluate the changes of inferior vena cava collapsibility index (IVC-CI) during SA in spontaneously breathing patients during elective knee joint replacement surgery to prognose manifestation of intraoperative hypotension and bradycardia. Materials and methods: 60 patients (American Society of Anesthesiologists (ASA) physical status I or II, no clinically significant cardiovascular pathology) of both sexes undergoing elective knee joint replacement surgery under SA were included in the prospective study. Inspiratory and expiratory inferior vena cava (IVCin, IVCex) diameters were measured using an ultrasound device in supine position before and immediately after SA, then 15 min, 30 min, and 45 min after SA was performed. The heart rate, along with systolic, diastolic, and mean arterial blood pressures were collected. The parameters were measured at the baseline and at the next four time points. Results: There were no significant changes in IVCin, IVCex, and IVC-CI compared to baseline and other time point measurements in hypotensive versus nonhypotensive and bradycardic versus nonbradycardic patients (p &gt, 0.05). Changes in IVC diameter do not prognose hypotension and/or bradycardia during SA: the area under the curve (AUC) of the receiver operating characteristic (ROC) curve for IVC-CI at all measuring points was &lt, 0.7, p &gt, 0.05. Conclusions: Reduction in IVC diameters and increase in IVC-CI do not predict hypotension and bradycardia during SA in spontaneously breathing patients undergoing elective knee joint replacement surgery.
Published: 2018

24. International Fragility Fracture Network Delphi consensus statement on the principles of anaesthesia for patients with hip fracture

Author: Maggie Parker, Derek Dillane, Iain K. Moppett, A. Gelmanas, M. Kluger, J.-H. Kim, F. Sieber, S. McManus, P.-W. Lau, C. Shelton, O. Porrill, M. Coburn, Anjan Trikha, Fernando R. Altermatt, Robert D. Sanders, I. Matot, G. Karpetas, L. F. Montoya-Pelaez, M. McBrien, F. Coluzzi, B. Ben-David, N. B. Foss, J. Barry, X. Xuebing, M. Degoli, Richard E. Griffiths, and Stuart M. White
Subjects: medicine.medical_specialty, anesthesiology and pain medicine, Consensus, Delphi Technique, Statement (logic), Time-to-Treatment, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, medicine, Humans, Pain Management, Anesthesia, 030212 general & internal medicine, computer.programming_language, Aged, Hip fracture, Fragility fracture, business.industry, Hip Fractures, anaesthesia, medicine.disease, Anesthesiologists, consensus guidelines, hip fracture, Physical therapy, hip fracture management, Clinical Competence, business, computer, Delphi
Published: 2018

25. Can the inferior vena cava collapsibility index be useful in predicting hypotension during spinal anaesthesia in a spontaneously breathing patient? A mini fluid challenge

Author: Jaremko, Inna, primary, Mačiulienė, Asta, additional, Gelmanas, Arūnas, additional, Baranauskas, Tautvydas, additional, Tamošiūnas, Ramūnas, additional, Smailys, Alfredas, additional, and Macas, Andrius, additional
Published: 2019
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26. Short rotator tendons do not increase intracapsular pressure in severe osteoarthritic hips

Author: Robertsson Otto, Smailys Alfredas, Gelmanas Arunas, Tarasevicius Sarunas, and Wingstrand Hans
Subjects: Diseases of the musculoskeletal system, RC925-935
Abstract: Abstract Background While a relation between pain and intracapsular pressure in the hip joint has previously been reported by some of the present authors, a newly published study including patients with severe osteoarthritis was not able to confirm this finding. This stimulated us to investigate the role of short rotators in relation to intracapsular pressure and pain in osteoarthritic hips. Methods We measured the intracapsular hydrostatic pressure peroperatively in 25 total hip arthroplasty patients with severe osteoarthritis in various positions of the hip joint before and after short rotator release, and correlated these pressures to pain. Results Release of the short rotators did not change the intracapsular pressure in any position except in 45° flexion, in which the pressure increased (p = 0.002). We found no correlation between intracapsular pressure and pain before or after short rotator release. Conclusion We could not show that the rotators directly affected the pressure nor could we find a relation between pressure and pain.
Published: 2009
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27. Pooperacinio skausmo malšinimo metodų įtaka ankstyvai kelio sąnario funkcijai, lėtiniam skausmui ir gyvenimo kokybei po pilno kelio sąnario endoprotezavimo operacijos

Author: Ramūnas Tamošiūnas, Arūnas Vertelis, Janis Zinkus, Andrius Macas, Dalia Urbanaitė, and Arūnas Gelmanas
Subjects: Knee function, medicine.medical_specialty, business.industry, Gold standard, Chronic pain, Osteoarthritis, medicine.disease, Quality of life, Anesthesia, medicine, Physical therapy, Geriatric Depression Scale, business, Control methods, Depression (differential diagnoses)
Abstract: Pilna kelio sąnario endoportezavimo (PKSE) operacija – viena iš dažniausiai pasaulyje atliekamų ortopedinių operacijų, sąlygojančių lėtinio pooperacinio skausmo išsivystymą [1-3], kuris turi įtakos pacientų gyvenimo kokybei. Skausmo malšinimas po šių operacijų yra tikras iššūkis gydančiajam personalui visame pasaulyje [1-8]. Paprastai taikoma multimodalinė analgezija, kuri apima įvairius nuskausminimo metodus, pvz.: intraveniniai opioidai, periferinių nervų blokados, epidurinė analgezija, vidusąnarinės blokados, peroraliniai analgetikai ir kt. [1, 2]. Tačiau “auksinio standarto” vis dar nėra. Mūsų tyrimo tikslas buvo išsiaiškinti ūmaus pooperacinio skausmo malšinimo metodo, taikyto po pilno kelio sąnario endoprotezavimo (PKSE) operacijos, įtaką pacientų gyvenimo kokybei bei vėlyvam pooperaciniam skausmo atsiradimui po PKSE operacijų. Buvo atliktas perspektyvinis tyrimas, į kurį įtraukti 54 pacientai, kuriems atliktos PKSE operacijos. Pagal operacijos dieną atliktą randomizaciją, pacientai buvo suskirstyti į dvi lygias grupes: I grupę (taikyta juomeninio rezginio blokada) ir II grupę (taikyta vidusąnarinė blokada). Kelio sąnario funkcija bei lėtinio skausmo (LS) įtaka gyvenimo kokybei vertinta pagal VAS skalę ir specialų KOOS (ang. Knee injury and osteoarthritis outcome score) klausimyną bei prieš operaciją pildytą Yesavage’o geriatrinės depresijos skalės anketą. Tyrimo rezultatai parodė, jog pooperacinis nuskausminimo metodas neturėjo įtakos LS išsivystymui, o depresija galėjo sąlygoti lėtinį pooperacinį skausmą. Kelio sąnario funkcija II grupės pacientams per pirmą mėnesį po PKSE operacijos gerėjo greičiau. Gyvenimo kokybė, nepaisant galimos depresijos, reikšmingai pagerėjo abiejų grupių pacientams.
Published: 2015
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28. Torakaliumbalinės fascijos pakitimų vertinimas ultragarso tyrimo pagalba esant paauglių idiopatinei skoliozei – bandomasis tyrimas

Author: Dalia Urbanaitė, Arūnas Gelmanas, Janis Zinkus, Ramūnas Tamošiūnas, Andrius Macas, and Arūnas Vertelis
Abstract: Radiologiškai įrodyta, kad fascijos vaidina svarbų vaidmenį lėtinių juosmens ir kaklo miofascialinių skausmų patogenezėje, konstatuoti jų morfologiniai pakitimai. Taikant reabilitacijos priemones užfiksuotas fascijų normalizavimasis ir simptomų sumažėjimas. Paauglių idiopatinės skoliozės priežastis yra neaiški, tikėtina ji polietiologinės kilmės. Torakoliumbalinės fascijos vaidmuo idiopatinės skoliozės atveju nežinomas ir radiologiškai nebuvo tirtas. Idiopatinės skoliozės atveju tikėtinas panašus patofiziologinis fascijų pažeidimo mechanizmas kaip ir esant miofascialiniams skausmams. Šio bandomojo tyrimo tikslas buvo sužinoti, ar yra skirtumas tarp torakoliumbalinės fascijos radiologinių charakteristikų (storis, sluoksniuotumas) sveikiems ir idiopatinę skoliozę turintiems paaugliams. Vaikų ligoninėje, VšĮ Vilniaus universiteto ligoninės Santariškių klinikų filiale, nuo 2015 lapkričio mėnesio iki 2016 sausio mėnesio atliktas bandomasis palyginamasis stebėjimas. Sergančių idiopatine skolioze ir kontrolinę sveikų vaikų grupę sudarė po 9 vaikus. Torakoliumbalinės fascijos ultragarso tyrimui atlikti ir įvertinti taikyta Langevin aprašyta metodika. Torakoliumbalinė fascija storesnė idiopatine skolioze sergantiems vaikams lyginant su kontrolinės grupės vaikais. Sergančių vaikų grupėje torakoliumbalinės fascijos storio vidurkis buvo 0,96 cm kairėje ir 0,91 cm dešinėje stuburo pusėje. Sveikų vaikų grupėje torakoliumbalinės fascijos storis buvo 0,77 cm kairėje ir 0,73 cm dešinėje stuburo pusėje. Sergančių vaikų grupėje fascija sustorėjusi supramuskulinės dalies sąskaita: kairėje pusėje vidurkis – 0,44 cm, kontrolinėje grupėje kairėje pusėje vidurkis – 0,26 cm (p=0,001); panašus skirtumas gautas ir dešinėje pusėje tiriamoje grupėje: vidurkis – 0,46 cm, kontrolinėje grupėje: vidurkis – 0,24 cm (p
Published: 2015
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29. International Fragility Fracture Network Delphi consensus statement on the principles of anaesthesia for patients with hip fracture

Author: White, S M, Altermatt, F, Barry, J, Ben-David, B, Coburn, M, Coluzzi, F, Degoli, M, Dillane, D, Foss, N B, Gelmanas, A, Griffiths, R, Karpetas, G, Kim, J-H, Kluger, M, Lau, P-W, Matot, I, McBrien, M, McManus, S, Montoya-Pelaez, L F, Moppett, I K, Parker, M, Porrill, O, Sanders, R D, Shelton, C, Sieber, F, Trikha, A, Xuebing, X, White, S M, Altermatt, F, Barry, J, Ben-David, B, Coburn, M, Coluzzi, F, Degoli, M, Dillane, D, Foss, N B, Gelmanas, A, Griffiths, R, Karpetas, G, Kim, J-H, Kluger, M, Lau, P-W, Matot, I, McBrien, M, McManus, S, Montoya-Pelaez, L F, Moppett, I K, Parker, M, Porrill, O, Sanders, R D, Shelton, C, Sieber, F, Trikha, A, and Xuebing, X
Published: 2018

30. ŪMAUS SKAUSMO MALŠINIMAS PO TOTALINĖS KELIO SĄNARIO ARTROPLASTIKOS: EPIDURINĖ ANALGEZIJA AR NERVŲ BLOKADA?

Author: Janis Zinkus, Greta Masiliūnienė, Ramūnas Tamošiūnas, Julius Masiliūnas, Arūnas Gelmanas, and Andrius Macas
Subjects: Plexus, medicine.medical_specialty, business.industry, Chronic pain, Total knee arthroplasty, Hemodynamics, medicine.disease, Bromage scale, Surgery, Motor block, Lumbar, Quality of life, Anesthesia, medicine, business
Abstract: Pooperacinis skausmas po totalinės kelio sąnario artroplastikos iki šių dienų išlieka aktuali problema pacientams bei gydančiajam personalui visame pasaulyje [1]. Ūmaus pooperacinio skausmo intensyvumas tiesiogiai koreliuoja su lėtinio skausmo išsivystymo rizika [3]. Todėl tinkamai parinktas anestezijos metodas su galimybe tęsti regioninį nuskausminimą yra viena iš sąlygų, garantuojančių adekvatų pooperacinio skausmo malšinimą bei tolimesnę gijimo eigą. Mūsų tyrimo tikslas buvo įvertinti pooperacinio skausmo malšinimo efektyvumą, papildomų analgetikų poreikį, motorinės blokados, hemodinamikos rodiklių bei pašalinių reiškinių išraišką po kelio sąnario totalinės artroplastikos operacijų, po kurių taikyta tęstinis epidūrinis skausmo malšinimas arba tęstinė juosmeninio rezginio blokada. Buvo atliktas perspektyvinis tyrimas, į kurį įtraukti 36 pacientai, kuriems atliktos pirminės kelio sąnario protezavimo operacijos. Pagal randomizaciją, atliktą operacijos dieną, pacientai buvo suskirstyti į dvi grupes– kontrolinę ir tiriamąją (juosmeninio rezginio blokada). Visi pacientai buvo prašomi įvertinti skausmą pirmąją, 3, 6 ir 24 val. po operacijos. Registruotas subjektyvus skausmas pagal VAS (dešimt balų), motorinė blokada pagal Bromage skalę, papildomų analgetikų poreikis, hemodinaminiai rodikliai, pašaliniai reiškiniai. Rezultatai parodė, kad ūminio skausmo malšinimas pirmosiomis 24 val. po operacijos buvo vienodai efektyvus pacientams, kuriems atlikta epidūrinė analgezija ir juosmeninio rezginio blokada (p> 0,05). Motorinės blokados, papildomų analgetikų poreikio, pašalinių reiškinių dažnio bei hemodinamikos rodiklių išraiška tarp grupių nesiskyrė.
Published: 2014
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31. Abstracts and Highlight Papers of the 33rd Annual European Society of Regional Anaesthesia & Pain Therapy (ESRA) Congress 2014

Author: Ramūnas Tamošiūnas and Arūnas Gelmanas
Subjects: medicine.medical_specialty, medicine.diagnostic_test, business.industry, medicine.medical_treatment, General Medicine, Blockade, Impedance cardiography, Anesthesiology and Pain Medicine, Internal medicine, medicine, Cardiology, Nerve block, business, Brachial plexus
Published: 2014
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32. Measurements of Inferior Vena Cava Diameter for Prediction of Hypotension and Bradycardia during Spinal Anesthesia in Spontaneously Breathing Patients during Elective Knee Joint Replacement Surgery

Author: Mačiulienė, Asta, primary, Gelmanas, Arūnas, additional, Jaremko, Inna, additional, Tamošiūnas, Ramūnas, additional, Smailys, Alfredas, additional, and Macas, Andrius, additional
Published: 2018
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33. Role of Multimodal Analgesia in the Evolving Enhanced Recovery after Surgery Pathways

Author: Gelman, David, primary, Gelmanas, Arūnas, additional, Urbanaitė, Dalia, additional, Tamošiūnas, Ramūnas, additional, Sadauskas, Saulius, additional, Bilskienė, Diana, additional, Naudžiūnas, Albinas, additional, Širvinskas, Edmundas, additional, Benetis, Rimantas, additional, and Macas, Andrius, additional
Published: 2018
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34. International Fragility Fracture Network Delphi consensus statement on the principles of anaesthesia for patients with hip fracture

Author: White, S. M., primary, Altermatt, F., additional, Barry, J., additional, Ben-David, B., additional, Coburn, M., additional, Coluzzi, F., additional, Degoli, M., additional, Dillane, D., additional, Foss, N. B., additional, Gelmanas, A., additional, Griffiths, R., additional, Karpetas, G., additional, Kim, J.-H., additional, Kluger, M., additional, Lau, P.-W., additional, Matot, I., additional, McBrien, M., additional, McManus, S., additional, Montoya-Pelaez, L. F., additional, Moppett, I. K., additional, Parker, M., additional, Porrill, O., additional, Sanders, R. D., additional, Shelton, C., additional, Sieber, F., additional, Trikha, A., additional, and Xuebing, X., additional
Published: 2018
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35. Sergančiųjų portopulmonine hipertenzija diagnostikos, medikamentinio gydymo ir kepenų transplantacijos ypatumai

Author: Aurimas Pečkauskas, Linas Pieteris, Janis Zinkus, Arūnas Gelmanas, Darius Trepenaitis, Martynas Gedminas, Alina Vilkė, and Andrius Macas
Subjects: business.industry, Medicine, business
Published: 2012
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36. Comparison of 2 Analgesia Modalities in Total Knee Replacement Surgery: Is There an Effect on Knee Function Rehabilitation?

Author: Zinkus, Janis, primary, Mockutė, Lina, additional, Gelmanas, Arūnas, additional, Tamošiūnas, Ramūnas, additional, Vertelis, Arūnas, additional, and Macas, Andrius, additional
Published: 2017
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37. Intracapsular Pressure and Elasticity of the Hip Joint Capsule in Osteoarthritis

Author: Arunas Gelmanas, Uldis Kesteris, Hans Wingstrand, Sarunas Tarasevicius, and Alfredas Smailys
Subjects: musculoskeletal diseases, medicine.medical_specialty, Rotation, Radiography, medicine.medical_treatment, Hydrostatic pressure, Osteoarthritis, Osteoarthritis, Hip, Joint capsule, Hydrostatic Pressure, medicine, Humans, Orthopedics and Sports Medicine, Range of Motion, Articular, Elasticity (economics), Saline, Ultrasonography, business.industry, medicine.disease, Elasticity, Biomechanical Phenomena, Surgery, medicine.anatomical_structure, Orthopedic surgery, Hip Joint, business, Range of motion, Joint Capsule
Abstract: We investigated intracapsular pressure and elasticity of the hip joint capsule in osteoarthritis. HOOS hip score, sonography of the hip joint, and radiographic assessment of osteoarthritis were performed in 31 patients before total hip arthroplasty. The intracapsular hydrostatic pressure was measured perioperatively, and 0.9% saline solution was then injected in the hip joint, 1 mL at a time, with continuous pressure recording up to 300 mm Hg. The mean radiographic grade of severity of osteoarthritis was 8 (SD, 2.4). The mean hydrostatic intracapsular pressure in 45 degrees of flexion was 2.2 mm Hg (SD, 10.0); in extension, 15.8 mm Hg (SD, 33.0); in inward rotation, 13.7 mm Hg (SD, 26.0); and in outward rotation, 12.1 mm Hg (SD, 24.3). Severe osteoarthritis was associated with lower intracapsular pressure and lower elasticity of the joint capsule.
Published: 2007
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38. [Pattern and causes of hemodynamic changes during hepatic resection]

Author: Arūnas, Gelmanas, Juozas, Pundzius, Antanas, Gulbinas, Alfredas, Smailys, and Andrius, Macas
Subjects: Vena Cava, Superior, Liver, Hemodynamics, Humans, Vena Cava, Inferior, Prospective Studies, Hypotension, Intraoperative Complications
Abstract: The aim of this study was to determine the causes and pattern of hemodynamic changes during hepatic resection, performed without vascular exclusion technique, and to select the most appropriate methods for monitoring patient's condition during the surgery.This prospective study included 55 ASA class I-III patients who had undergone hepatic resection surgery at the Clinic of Surgery, Hospital of the Lithuanian University of Health Sciences (former Kaunas University of Medicine) in 2003-2008. Additional monitoring of central hemodynamic parameters, arterial blood pressure, central venous pressure, and pressure in the inferior vena cava using invasive methods was performed.During the surgery, hypotension episodes (n=186) occurred in 53 out of 55 patients with a mean of 3.4 (SD, 2.0) episodes per patient. Changes (n=262) in femoral vein pressure were observed in 54 out of the 55 patients with a mean of 4.8 (SD, 3.2) episodes per patient. During the hypotension episode, significant changes in the mean arterial blood pressure, femoral vein pressure, cardiac output, cardiac index, systemic vascular resistance index, and central venous pressure were documented. There was a significant positive correlation between blood loss and number of changes in femoral vein pressure (r=0.5; P0.001). Blood loss of more than 450 mL was observed in 69.0% of patients with increasing and 38.2% of patients with decreasing central venous pressure (P0.01). Less than half (41.6%) of patients in the group of negative change in femoral vein pressure and 88.0% in the group of positive change in femoral vein pressure lost more than 450 mL of blood (P0.001).The most common hemodynamic changes during hepatic surgery include hypotension, decreased cardiac output and cardiac index, and elevated pressure in the inferior vena cava. More common cause of hypotension was clamping of the inferior vena cava, and less common was blood loss. Blood loss was related to the number of clamps of the inferior vena cava and increasing pressure in the superior vena cava. A cause of hypotension during hepatic resection may be determined by pressure monitoring in the superior and inferior vena cava.
Published: 2011

39. Hemodinaminių pokyčių pobūdis ir priežastys atliekant kepenų rezekcijas

Author: Andrius Macas, Arūnas Gelmanas, Juozas Pundzius, Alfredas Smailys, and Antanas Gulbinas
Subjects: hemodinaminiai pokyčiai, kepenų chirurgija, kepenų rezekcijos, General Medicine
Abstract: Tyrimo tikslas. Nustatyti kepenų rezekcinių operacijų metu vykstančių hemodinaminių pokyčių priežastis bei jų pobūdį, kai nenaudojamos kepenų kraujotakos sustabdymo metodikos, bei parinkti labiausiai tinkamus paciento stebėsenos metodus. Metodai. Į prospektyvųjį tyrimą įtraukti 55 pacientai, kuriems 2003–2008 m. Lietuvos sveikatos mokslų universiteto ligoninės Kauno klinikose (tuometinėse KMUK) Chirurgijos klinikoje buvo atliktos kepenų rezekcinės operacijos. Papildomai buvo stebimi pacientų centrinės hemodinamikos rodmenys, arterinis kraujo spaudimas, centrinis veninis spaudimas ir slėgis apatinėje tuščiojoje venoje invaziniais metodais. Rezultatai. 53 pacientams operacijos metu konstatuoti hipotenzijos epizodai (iš viso 186) – 3,4 (2,0) vienam pacientui. Slėgio šlaunies venoje pokyčiai, nustatyti 54 pacientams (iš viso 262) – 4,8 (3,2) vienam pacientui. Hipotenzijos epizodo metu reikšmingai kito, atsižvelgiant į pradines reikšmes, slėgis šlaunies venoje, širdies minutinis tūris, širdies indeksas, sisteminis periferinių kraujagyslių priešinimosi indeksas, centrinis veninis slėgis. Netekto kraujo kiekis ir slėgio šlaunies venoje pokyčių skaičius tarpusavyje koreliavo teigiamai reikšmingai (r=0,5, p&lt, 0,001). Daugiau kaip 450 ml kraujo neteko 69,0 proc., jei centrinis veninis spaudimas didėjo, 38,3 proc., jei jis mažėjo (p&lt, 0,01). Daugiau kaip 450 ml kraujo neteko 41,6 proc. neigiamo slėgio šlaunies venoje pokyčio grupėje, 88,0 proc. – teigiamo pokyčio grupėje (p&lt, 0,001). Išvados. Kepenų operacijų metu dažniausiai stebimi hemodinaminiai pokyčiai yra hipotenzija, širdies indekso sumažėjimas ir slėgio apatinėje tuščiojoje venoje padidėjimas. Hipotenzijos priežastis dažniau yra apatinės tuščiosios venos perspaudimas, rečiau – kraujo netekimas. Kraujo netekimas susijęs su apatinės tuščiosios venos perspaudimų skaičiumi ir su didėjančiu slėgiu viršutinėje tuščiojoje venoje. Hipotenzijos priežastį kepenų rezekcinių operacijų metu galima nustatyti stebint slėgius viršutinėje bei apatinėje tuščiojoje venoje.
Published: 2010
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40. Hemodinamikos pokyčių priežastys ir jų kontrolė darant kepenų operacijas

Author: Gelmanas, Arūnas, Pundzius, Juozas, Gulbinas, Antanas, Barauskas, Giedrius, Marchertienė, Irena, Babarskienė, Rūta, Svilainis, Linas, Sederavičius, Antanas, Jonaitis, Laimas, Riškevičienė, Vita, and Lithuanian University of Health Sciences
Subjects: Hipotenzija, Hemodinamika, cardiovascular system, Hemodynamics, Medicine, cardiovascular diseases, Hypotension, Hepatic surgery, hepatic surgery, hypotension, Kepenų chirurgija
Abstract: Hemodinamikos pokyčiai kepenų operacijų metu yra svarbūs perioperacinėms išeitims. Tyrimo tikslas: išsiaiškinus hemodinaminių pokyčių pobūdį bei priežastis parinkti optimalią pacientų monitoravimo metodiką darant kepenų rezekci¬nes operacijas. Tikslui pasiekti iškelti šie uždaviniai: palyginti širdies minutinio tūrio monitoravimo neinvaziniu impe¬dan¬so kardiografijos būdu vertę su invaziniu intermituojančios termodiliucijos būdu pacientams, kuriems daromos kepenų rezek¬cijos, nustatyti dažniausiai kintančius hemodinaminius parametrus kepe¬nų operacijų metu, nustatyti hemodinaminių rodiklių pokyčių priežastis, rasti hemodinaminius veiksnius, įtakojančius didesnį kraujo nete¬kimą operacijos metu. Remiantis tyrimo rezultatais, daromos šios išvados: siekiant sumažinti perioperacinį sergamumą ir mirštamumą darant kepenų rezekcijas būtina monitoruoti centrinės hemodinamikos ro¬dik¬lius. Širdies minutinio tūrio monitoravimui tinka saugus, nebrangus ir tikslus neinvazinis impedanso kardiografijos metodas. Kepenų rezekcinių operacijų metu stebimi hemodinaminiai pokyčiai yra vidurinio arterinio kraujo spaudimo sumažėjimas (hipotenzija), susijęs su širdies indekso su¬ma¬žėjimu, ir slėgio apatinėje tuščiojoje venoje padidėjimas. Hipotenzijos bei širdies indekso sumažėjimo priežastis dažniau yra apatinės tuščiosios venos perspaudimas, pasireiškiantis didėjančiu slėgiu šlaunies venoje, kurį sąlygoja chirurginės manipuliacijos. Hipotenzijos priežastį kepenų rezekcinių operacijų metu galima... [toliau žr. visą tekstą] Aim of the study: select optimal methods for patient’s monitoring du¬ring hepatic resection after evaluation the character, causes and rate of hemodynamic changes. Main goals: to compare the value of non-invasive impedance cardiography for moni¬toring of cardiac output to invasive intermittent thermodilution method in patients undergoing hepatic resection, to determine mostly changing hemodynamic parameters during the hepatic surgery, to determine the causes of hemodynamic changes, to determine hemodynamic factors, influencing increase in blood loss during the surgery. Conclusions: non-invasive ICG method may be used to monitor cardiac output during the hepatic resection surgery, most common hemodynamic changes during hepatic resection surgery include the reduction in mean arterial blood pressure (hypotension), decreased cardiac index, and elevated pressure in the inferior vena cava, more common cause of hypotension is clamping of the inferior vena cava, which is caused by surgical manipulations; less common – blood loss. Cause of hypotension during hepatic resection surgery may be determined by pressure monitoring in the superior and inferior vena cava, blood loss is related to the number of clamping of the inferior vena cava and increasing pressure in the superior vena cava. Practical recommendations: in order to reduce the number of hemodynamic changes during the surgery, it is essential to monitor arterial blood pressure, cardiac output and pressures in the superior and... [to full text]
Published: 2010

41. Pooperacinio skausmo malšinimo metodų įtaka ankstyvai kelio sąnario funkcijai, lėtiniam skausmui ir gyvenimo kokybei po pilno kelio sąnario endoprotezavimo operacijos

Author: Zinkus, Janis, primary, Urbanaitė, Dalia, additional, Gelmanas, Arūnas, additional, Tamošiūnas, Ramūnas, additional, Vertelis, Arūnas, additional, and Macas, Andrius, additional
Published: 2015
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42. Short rotator tendons do not increase intracapsular pressure in severe osteoarthritic hips

Author: Otto Robertsson, Alfredas Smailys, Hans Wingstrand, Arunas Gelmanas, and Sarunas Tarasevicius
Subjects: musculoskeletal diseases, medicine.medical_specialty, lcsh:Diseases of the musculoskeletal system, Sports medicine, genetic structures, Hydrostatic pressure, Osteoarthritis, Preoperative care, Osteoarthritis, Hip, Tendons, Rheumatology, Internal medicine, Joint capsule, Preoperative Care, Synovial Fluid, medicine, Hydrostatic Pressure, Humans, Orthopedics and Sports Medicine, Orthopedic Procedures, Intracapsular hydrostatic pressure, Range of Motion, Articular, Muscle, Skeletal, Postoperative Care, business.industry, Synovial Membrane, medicine.disease, Arthralgia, Surgery, Causality, medicine.anatomical_structure, Treatment Outcome, Orthopedic surgery, Disease Progression, Hip Joint, sense organs, lcsh:RC925-935, business, Joint Capsule, Research Article
Abstract: Background While a relation between pain and intracapsular pressure in the hip joint has previously been reported by some of the present authors, a newly published study including patients with severe osteoarthritis was not able to confirm this finding. This stimulated us to investigate the role of short rotators in relation to intracapsular pressure and pain in osteoarthritic hips. Methods We measured the intracapsular hydrostatic pressure peroperatively in 25 total hip arthroplasty patients with severe osteoarthritis in various positions of the hip joint before and after short rotator release, and correlated these pressures to pain. Results Release of the short rotators did not change the intracapsular pressure in any position except in 45° flexion, in which the pressure increased (p = 0.002). We found no correlation between intracapsular pressure and pain before or after short rotator release. Conclusion We could not show that the rotators directly affected the pressure nor could we find a relation between pressure and pain.
Published: 2009

43. ŪMAUS SKAUSMO MALŠINIMAS PO TOTALINĖS KELIO SĄNARIO ARTROPLASTIKOS: EPIDURINĖ ANALGEZIJA AR NERVŲ BLOKADA?

Author: Zinkus, Janis, primary, Masiliūnienė, Greta, primary, Gelmanas, Arūnas, primary, Tamošiūnas, Ramūnas, primary, Masiliūnas, Julius, primary, and Macas, Andrius, primary
Published: 2014
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44. Sergančiųjų portopulmonine hipertenzija diagnostikos, medikamentinio gydymo ir kepenų transplantacijos ypatumai

Author: Macas, Andrius, primary, Pečkauskas, Aurimas, additional, Gedminas, Martynas, additional, Vilkė, Alina, additional, Trepenaitis, Darius, additional, Gelmanas, Arūnas, additional, Zinkus, Janis, additional, and Pieteris, Linas, additional
Published: 2012
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45. Postoperative cognitive dysfunction in geriatric patients after orthopedic surgery

Author: Gelmanas, Arūnas, primary, Bukauskas, Tomas, additional, Macas, Andrius, additional, Žarskienė, Giedrė, additional, and Žarskus, Ainius, additional
Published: 2012
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46. Hemodinaminių pokyčių pobūdis ir priežastys atliekant kepenų rezekcijas

Author: Gelmanas, Arūnas, primary, Pundzius, Juozas, additional, Gulbinas, Antanas, additional, Smailys, Alfredas, additional, and Macas, Andrius, additional
Published: 2010
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47. Short rotator tendons do not increase intracapsular pressure in severe osteoarthritic hips

Author: Tarasevicius, Sarunas, primary, Gelmanas, Arunas, additional, Smailys, Alfredas, additional, Robertsson, Otto, additional, and Wingstrand, Hans, additional
Published: 2009
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48. 193. The Effectivenes of Pericapsular and Wound Infiltration With Bupivacaine After Hip Arthroplasty for Postoperative Pain Relief

Author: Gelmanas, A., primary and Karbonskiene, A., additional
Published: 2008
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49. The Effectivenes of Pericapsular and Wound Infiltration With Bupivacaine After Hip Arthroplasty for Postoperative Pain Relief

Author: Gelmanas, A., primary and Karbonskiene, A., additional
Published: 2008
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50. 388: Continuous Postoperative Epidural Analgesia (CPEA) - Experience of Tertiary Care University Hospital in Lithuania

Author: KARBONSKIENE, A, primary, BAGDONAITE, Z, additional, PAURYTE, J, additional, GUDAITYTE, J, additional, and GELMANAS, A, additional
Published: 2008
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