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Anesthesia and Analgesia

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https://www.readbyqxmd.com/read/28099291/transcutaneous-carbon-dioxide-measurements-in-women-receiving-intrathecal-morphine-for-cesarean-delivery-a-prospective-observational-study
#1
Jeanette R Bauchat, Robert McCarthy, Paul Fitzgerald, Stephen Kolb, Cynthia A Wong
BACKGROUND: Neuraxial morphine is the most commonly used analgesic technique after cesarean delivery. The incidence of respiratory depression is reported to be very low (0%-1.2%) in this patient population as measured by pulse oximetry and respiratory rates. However, hypercapnia may be a more sensitive measure of respiratory depression. In the current study, the incidence of hypercapnia events (transcutaneous CO2 [TcCO2] >50 mm Hg) for ≥2-minute duration was evaluated using the Topological Oscillation Search with Kinematical Analysis monitor in women who received intrathecal morphine for postcesarean delivery analgesia...
January 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099290/increased-perinatal-morbidity-and-mortality-among-asian-american-and-pacific-islander-women-in-the-united-states
#2
Maryam Siddiqui, Mohammed Minhaj, Ariel Mueller, Avery Tung, Barbara Scavone, Sarosh Rana, Sajid Shahul
BACKGROUND: Asian American/Pacific Islanders (AAPIs) are the fastest-growing racial group in the United States. Despite a higher socioeconomic status, AAPI women experience higher rates of maternal morbidity and mortality. METHODS: Using the National Inpatient Sample, we performed a retrospective cohort analysis of women who were hospitalized for delivery from 2002 to 2013. The primary outcome variable was inpatient mortality rate, and the presence of severe maternal morbidities was estimated using the Bateman Comorbidity Index, a validated tool for predicting obstetric morbidity...
January 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099289/orthogonal-views-of-coronary-vessels-a-method-for-imaging-the-delivery-of-blood-cardioplegia-using-transesophageal-echocardiography
#3
Luiz F Maracaja Neto, Raj Modak, Robert B Schonberger
Coronary blood flow can be disrupted during cardiac interventions such as mitral valve surgeries, left atrial appendage ligation, transcatheter aortic valve implantation, and aortic procedures involving reimplantation of coronary buttons. Although difficult to accomplish, coronary imaging using transesophageal echocardiography can be performed by the use of orthogonal imaging with the ability for real-time tilt for angle adjustment. The technique described herein allows imaging of the right coronary artery, left main coronary artery bifurcation, left anterior descending, and circumflex coronary arteries...
January 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099288/assessing-the-agreement-between-radiologic-and-clinical-measurements-of-lumbar-and-cervical-epidural-depths-in-patients-undergoing-prone-interlaminar-epidural-steroid-injection
#4
James Harvey Jones, Naileshni Singh, Anna Nidecker, Chin-Shang Li, Scott Fishman
BACKGROUND: Fluoroscopy-guided epidural steroid injection (ESI) commonly is performed to treat radicular pain yet can lead to adverse events if the needle is not advanced with precision. Accurate preoperative assessment of the distance from the skin to the epidural space holds the potential for reducing the risks of adverse effects from ESI. It was hypothesized that the distance from the skin to the epidural space as measured on preoperative magnetic resonance imaging (MRI) would agree with the distance traveled by a Tuohy needle to reach the epidural space during midline, interlaminar ESI...
January 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099287/anesthetic-outcomes-of-children-with-arthrogryposis-syndromes-no-evidence-of-hyperthermia
#5
Stephen J Gleich, Michael Tien, Darrell R Schroeder, Andrew C Hanson, Randall Flick, Michael E Nemergut
BACKGROUND: Arthrogryposis syndromes are a heterogeneous group of disorders characterized by congenital joint contractures often requiring multiple surgeries during childhood to address skeletal and visceral abnormalities. Previous reports suggest that these children have increased perioperative risk, including hypermetabolic events discrete from malignant hyperthermia, difficult airway management, isolated hyperthermia, and difficult IV line placement. We sought to compare children with arthrogryposis multiplex congenita (AMC) versus the less severe, distal arthrogryposis syndromes (DAS) and to evaluate possible intraoperative hyperthermia of patients with AMC...
January 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099286/multicenter-study-validating-accuracy-of-a-continuous-respiratory-rate-measurement-derived-from-pulse-oximetry-a-comparison-with-capnography
#6
Sergio D Bergese, Michael L Mestek, Scott D Kelley, Robert McIntyre, Alberto A Uribe, Rakesh Sethi, James N Watson, Paul S Addison
BACKGROUND: Intermittent measurement of respiratory rate via observation is routine in many patient care settings. This approach has several inherent limitations that diminish the clinical utility of these measurements because it is intermittent, susceptible to human error, and requires clinical resources. As an alternative, a software application that derives continuous respiratory rate measurement from a standard pulse oximeter has been developed. We sought to determine the performance characteristics of this new technology by comparison with clinician-reviewed capnography waveforms in both healthy subjects and hospitalized patients in a low-acuity care setting...
January 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28098590/analgesia-and-sedation-requirements-in-mechanically-ventilated-trauma-patients-with-acute-preinjury-use-of-cocaine-and-or-amphetamines
#7
Bridgette Kram, Shawn J Kram, Michelle L Sharpe, Michael L James, Maragatha Kuchibhatla, Mark L Shapiro
BACKGROUND: The purpose of this study was to determine whether mechanically ventilated trauma patients with a positive urine drug screen (UDS) for cocaine and/or amphetamines have different opioid analgesic and sedative requirements compared with similar patients with a negative drug screen for these stimulants. METHODS: This retrospective, single-center cohort study at a tertiary care, academic medical and level 1 trauma center in the United States included patients ≥16 years of age who were admitted to an adult intensive care unit with a diagnosis of trauma between 2009 and 2013 with a UDS documented within 24 hours of admission, and were mechanically ventilated for >24 hours...
January 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28098589/can-mandibular-condylar-mobility-sonography-measurements-predict-difficult-laryngoscopy
#8
Weidong Yao, Yumei Zhou, Bin Wang, Tao Yu, Zhongbing Shen, Hao Wu, Xiaoju Jin, Yuanhai Li
BACKGROUND: Limited mandibular condylar mobility plays an important role in difficult laryngoscopy. Indirect assessment methods, such as mouth opening, have been proven to be useful predictors of difficult laryngoscopy. Sonography is a new direct assessment method for the limited mandibular condylar mobility. However, whether this method could be used in predicting difficult laryngoscopy still remains unknown. This study aimed to observe its ability to predict difficult laryngoscopy. METHODS: Adult patients who were administered tracheal intubations for elective surgery under general anesthesia were enrolled in the study...
January 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28098588/choice-of-anesthesia-for-cesarean-delivery-an-analysis-of-the-national-anesthesia-clinical-outcomes-registry
#9
Jeremy Juang, Rodney A Gabriel, Richard P Dutton, Arvind Palanisamy, Richard D Urman
Neuraxial anesthesia use in cesarean deliveries (CDs) has been rising since the 1980s, whereas general anesthesia (GA) use has been declining. In this brief report we analyzed recent obstetric anesthesia practice patterns using National Anesthesiology Clinical Outcomes Registry data. Approximately 218,285 CD cases were identified between 2010 and 2015. GA was used in 5.8% of all CDs and 14.6% of emergent CDs. Higher rates of GA use were observed in CDs performed in university hospitals, after hours and on weekends, and on patients who were American Society of Anesthesiologists class III or higher and 18 years of age or younger...
January 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28098587/reducing-the-shock-of-acute-respiratory-distress-syndrome-is-veno-venous-ecmo-a-viable-therapy-in-the-hemodynamically-unstable-patient
#10
Michael A Fierro, Raquel R Bartz
No abstract text is available yet for this article.
January 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079581/assessing-the-impact-of-the-anesthesia-medication-template-on-medication-errors-during-anesthesia-a-prospective-study
#11
Eliot B Grigg, Lizabeth D Martin, Faith J Ross, Axel Roesler, Sally E Rampersad, Charles Haberkern, Daniel K W Low, Kristen Carlin, Lynn D Martin
BACKGROUND: Medication errors continue to be a significant source of patient harm in the operating room with few concrete countermeasures. The organization and identification of medication syringes may have an impact on the commission of medication errors in anesthesia, so a team of physicians and designers at the University of Washington created the Anesthesia Medication Template (AMT) to define a formal way of organizing the anesthesia workspace. The purpose of this study is to assess the ability of the AMT to reduce perioperative medication errors by anesthesia providers...
January 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079580/a-predictive-model-for-extended-postanesthesia-care-unit-length-of-stay-in-outpatient-surgeries
#12
Rodney A Gabriel, Ruth S Waterman, Jihoon Kim, Lucila Ohno-Machado
BACKGROUND: A predictive model that can identify patients who are at an increased risk for prolonged postanesthesia care unit (PACU) stay could help optimize resource utilization and case sequencing. Although previous studies identified some predictors, there is not a model that only utilizes various patients demographic and comorbidities, that are already known preoperatively, and that may affect PACU length of stay for outpatient procedures requiring the care of an anesthesiologist...
January 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079579/detailed-2-dimensional-and-3-dimensional-transesophageal-evaluation-of-the-aortic-root-and-aortic-valve-in-complex-type-a-dissections
#13
J Kirk Edwards, Bradley G Leshnower, Michael Duggan, Kathryn E Glas
No abstract text is available yet for this article.
January 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079578/the-liability-of-a-glowing-reference
#14
Victoria I Smith, Sophia T Cisler, Ronald S Litman
No abstract text is available yet for this article.
January 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079589/in-vogue-ketamine-for-neuroprotection-in-acute-neurologic-injury
#15
Josh D Bell
Neurologic deterioration following acute injury to the central nervous system may be amenable to pharmacologic intervention, although, to date, no such therapy exists. Ketamine is an anesthetic and analgesic emerging as a novel therapy for a number of clinical entities in recent years, including refractory pain, depression, and drug-induced hyperalgesia due to newly discovered mechanisms of action and new application of its known pharmacodynamics. In this focused review, the evidence for ketamine as a neuroprotective agent in stroke, neurotrauma, subarachnoid hemorrhage, and status epilepticus is highlighted, with a focus on its applications for excitotoxicity, neuroinflammation, and neuronal hyperexcitability...
January 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079588/the-cricoid-force-necessary-to-occlude-the-esophageal-entrance-is-there-a-gender-difference
#16
Ahed M Zeidan, M Ramez Salem, Munir Bamadhaj, Jean-Xavier Mazoit, Hussein Sadek, Hassan Houjairy, Kamal Abdulkhaleq, Nabil Bamadhaj
BACKGROUND: We tested the hypothesis whether gender differences exist in the applied cricoid force necessary to prevent regurgitation. Real-time visual and dynamic means were used to assess the effectiveness of different applied cricoid forces in occluding the esophageal entrance in men (group 1) and in women (group 2). METHODS: In anesthetized and paralyzed patients, the glottis and esophageal entrance were visualized with a Glidescope video laryngoscope. Trained operators performed cricoid pressure (CP) and gastric tube insertion trials...
January 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079587/review-of-the-alternatives-to-epidural-blood-patch-for-treatment-of-postdural-puncture-headache-in-the-parturient
#17
Daniel Katz, Yaakov Beilin
Labor neuraxial anesthesia is commonly used in the parturient, and postdural puncture headache is the most common complication of the technique. Although epidural blood patch is the best treatment, there are some patients in whom this treatment is refused or contraindicated. The goal of this article is to review the efficacy of the most studied alternate modalities to treat postdural puncture headache. This will include a discussion of the various oral or intravenous therapies and the non-blood-containing epidural injections...
January 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079586/surveying-the-literature-synopsis-of-recent-key-publications
#18
Eugene A Hessel
No abstract text is available yet for this article.
January 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079585/lecture-notes-clinical-anesthesia
#19
Abigail M Walsh
No abstract text is available yet for this article.
January 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079584/the-development-and-implementation-of-cognitive-aids-for-critical-events-in-pediatric-anesthesia-the-society-for-pediatric-anesthesia-critical-events-checklists
#20
Anna Clebone, Barbara K Burian, Scott C Watkins, Jorge A Gálvez, Justin L Lockman, Eugenie S Heitmiller
Cognitive aids such as checklists are commonly used in modern operating rooms for routine processes, and the use of such aids may be even more important during critical events. The Quality and Safety Committee of the Society for Pediatric Anesthesia (SPA) has developed a set of critical-event checklists and cognitive aids designed for 3 purposes: (1) as a repository of the latest evidence-based and expert opinion-based information to guide response and management of critical events, (2) as a source of just-in-time information during critical events, and (3) as a method to facilitate a shared understanding of required actions among team members during a critical event...
January 10, 2017: Anesthesia and Analgesia
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