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Journal of Clinical Anesthesia

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https://www.readbyqxmd.com/read/28081990/can-we-use-lower-volume-of-local-anesthetic-for-infraclavicular-brachial-plexus-nerve-block-under-ultrasound-guidance-in-children
#1
Ilker Ince, Mehmet Aksoy, Aysenur Dostbil, Kutsi Tuncer
OBJECTIVES: To determine if the infraclavicular brachial plexus block can be applied with lower volume of local anesthetic. DESIGN: Randomised, double-blinded clinical trial. PATIENTS: 60 patients aged 5-15years with ASA I-II who underwent emergent or elective arm, forearm or hand operations were included in the study. INTERVENTIONS: Patients were divided into two groups randomly; standard volume local anesthetic administered group (Group S, n=30) and low volume anesthetic administered group (Group L, n=30)...
January 9, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28077252/incorporating-body-type-apple-vs-pear-in-stop-bang-questionnaire-improves-its-validity-to-detect-osa
#2
Lisa Sangkum, Ikrita Klair, Chok Limsuwat, Sabrina Bent, Leann Myers, Supat Thammasitboon
STUDY OBJECTIVE: The aim of this study is to evaluate whether adding the item of "apple body type" to the STOP-BANG questionnaire enhances diagnostic performance of the questionnaire for detecting obstructive sleep apnea (OSA). DESIGN: Cross-sectional study. SETTING: Sleep center setting. PATIENTS: Two hundred and eight subjects who were referred for an evaluation of possible OSA at Tulane Comprehensive Sleep Center...
January 8, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183585/oblique-approach-for-ultrasound-guided-radial-artery-catheterization-vs-transverse-and-longitudinal-approaches-a-randomized-trial
#3
Usama Elsayed Mohammed Abdalla, Alaa Elmaadawey, AlRefaey Kandeel
STUDY OBJECTIVE: To investigate the value of using a new technique for ultrasound-guided radial artery catheterization; oblique approach; vs transverse and longitudinal views are the traditionally used approaches aiming to combine benefits and avoid drawbacks of aforementioned approaches. DESIGN: A prospective randomized nonblinded study. SETTING: Gastroenterology Center, Mansoura University, Egypt from February 2015 to August 2015. PATIENTS: One hundred twenty-six surgical and intensive care unit patients indicated for arterial catheterization...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183584/monitoring-of-the-intraoperative-analgesia-by-pupillometry-during-laparoscopic-splenectomy-for-splenic-hydatid-cyst
#4
Ana Abad-Torrent, Albert Sueiras-Gil, Miquel Martínez-Vilalta, Josep Vallet-Fernández, María Guisasola-Rabés
Echinococcosis causes a hydatid cyst, a worldwide disease. Human beings are intermediate hosts, but dogs complete the life cycle of the cestode. The most common presentation sites are the liver and lungs. We present an unusual case of a primary splenic hydatid cyst. Open splenectomy has traditionally been the treatment of choice for splenic hydatid cysts. In recent years, minimally invasive laparoscopic surgery has been used in appropriate cases. A healthy 48-year-old woman was scheduled for laparoscopic splenectomy...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183583/visual-emotional-stimuli-and-treatment-with-antidepressants-alter-numerical-rating-scale-score-in-patients-with-chronic-pain
#5
Akifumi Kanai, Shigehiro Matsumoto, Norihito Hayashi, Junko Shimao, Yuki Nagahara
STUDY OBJECTIVE: To examine the impact of visual stimulation (exciting red and tranquilizing green) on the score of the Numerical Rating Scale (NRS) questionnaire in patients with chronic pain. DESIGN: Prospective randomized study. SETTING: Outpatient pain clinic of a university hospital. PATIENTS: Two hundred outpatients with chronic pain. INTERVENTIONS: Patients were randomly assigned to receive the NRS questionnaire printed on either red paper (red group) or green paper (green group)...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183582/use-of-ultrasound-for-spinal-anesthesia-in-a-super-morbidly-obese-patient
#6
Yasuhiro Morimoto, Yoichiro Ihara, Yoko Shimamoto, Hiroko Shiramoto
We report the application of ultrasound prescans for spinal anesthesia to morbid obesity patient. A 38-year-old woman with a body mass index (BMI) of 50 (weight: 110 kg; height: 148 cm) was scheduled to undergo pilonidal cyst resection at the bottom of the tailbone. Spinal anesthesia was selected for the procedure, because the patient's position during the surgery was prone and the patient had morbid obesity. To determine the spinal needle insertion point and the distance between the skin and dura, we planned to use ultrasound...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183581/chemotherapy-alters-cisatracurium-induced-neuromuscular-blockade-characteristics-a-prospective-cohort-study
#7
Amir Poya Zanjani, Maziar Maghsoudloo, Jalil Makarem, Fahimeh Farokhnia, Morteza Fazli, Zahid Hussain Khan
STUDY OBJECTIVE: To compare the characteristics of NMDR induced muscle paralysis in breast cancer patients with and without a history of recent chemotherapy with cyclophosphamide, doxorubicin and 5-fluorouracil (CAF) regimen. DESIGN: This is a non-randomized prospective cohort study. SETTING: Operating room of a university-affiliated teaching hospital. PATIENTS: Out of a total of 50 patients who had undergone mastectomy, 22 patients were allocated to the "Chemo group" and 28 patients to the "Non-Chemo group", based on a valid history of recent chemotherapy...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183580/effect-of-total-intravenous-vs-volatile-anesthetics-on-intraoperatively-acquired-electrically-evoked-compound-action-potential-in-children-undergoing-cochlear-implant-surgery-a-randomized-prospective-study
#8
Ala A Alhowary, Khaled El-Radaideh, Anas Al-Rusan, Diab Bani Hani, Wail Khraise, Ahmad Al Omari, Firas Alzoubi
OBJECTIVE: The purpose of the present study was to compare the effects of inhalational anesthesia to those of total intravenous anesthesia on intraoperative electrically evoked compound action potential (e-ECAP) thresholds in children undergoing cochlear implantation. STUDY DESIGN: Randomized prospective study. SETTING: Tertiary referral teaching hospital. PATIENTS: Forty children aged 6 months to 17years with bilateral severe-to-profound sensorineural hearing loss and undergoing cochlear implantation were enrolled in the study...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183579/determination-of-insertion-depth-of-flexible-laryngeal-mask-airway-in-pediatric-population-a-prospective-observational-study
#9
Ji-Hyun Lee, Hye-Won Oh, In-Kyung Song, Jin-Tae Kim, Chong-Sung Kim, Hee-Soo Kim
STUDY OBJECTIVE: The purpose of this study was to determine the ideal insertion depth of the flexible laryngeal mask airway (FLMA) by elucidating the relationships between insertion depth and patient's age, body weight, height, and other parameters. We also evaluated an insertion technique that uses the change in intracuff pressure for proper positioning of the FLMA in cases where it is difficult to sense resistance during FLMA insertion. DESIGN: This study was a prospective observational study...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183578/a-case-of-central-diabetes-insipidus-after-ketamine-infusion-during-an-external-to-internal-carotid-artery-bypass
#10
Sharib Gaffar, Jonathan P Eskander, Burton D Beakley, Brian P McClure, Peter Amenta, Nakeisha Pierre
STUDY OBJECTIVE: We report the first teenage case of ketamine-induced transient central diabetes insipidus. CASE SUMMARY: The patient was an 18-year-old woman with moyamoya disease undergoing an external carotid to internal carotid bypass and given a low-dose ketamine infusion. After approximately 2 hours in the supine position, with 0.5 Minimum Alveolar Concentration (MAC) of sevoflurane, a propofol infusion at 50 μg/kg/min, a remifentanil infusion at 0.5 μg/kg/min, and a ketamine infusion at a dose of 10 μg/kg/min, this patient had an excessive urine output...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183577/sonoanatomic-indices-of-lumbar-facet-joints-in-patients-with-facetogenic-back-pain-in-comparison-to-healthy-subjects
#11
Poupak Rahimzadeh, Hamid Reza Faiz, Ali Reza Baghaee, Nader D Nader
BACKGROUND: Nowadays, ultrasound is increasingly used with a great accuracy in performing nerve blocks for facet joint disease. OBJECTIVES: To measure sonoanatomic characteristics for the facet joints of lumbar vertebras in patients with facetogenic pain and healthy volunteers. STUDY DESIGN: Cross-sectional, observational study. SETTING: University-affiliated Specialty Clinic for Pain Management. PATIENTS: Twenty patients with facet joint disease (FJD) and 40 healthy volunteers (HVGs) were matched for age and sex, height, and weight...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183576/the-benefits-of-ultrasound-guided-continuous-sensory-nerve-blockade-in-the-setting-of-burn-injury-a-case-report-of-bilateral-continuous-superficial-peroneal-nerve-blockade-in-a-patient-with-severe-sleep-apnea
#12
Vladislav Shick, Evan E Lebovitz, Emerson Conrad
The management of pain after burn injuries is a clinical challenge magnified in patients with significant comorbidities. Presently, burn pain is treated via a wide variety of modalities, including systemic pharmacotherapy and regional analgesia. Although the latter can provide effective pain control in patients with burn injuries, it is relatively underused. Furthermore, the development of ultrasound guidance has allowed for novel approaches and sparing of motor nerve blockade with preference toward sensory-specific analgesia that has not been possible previously...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183575/choreoathetotic-syndrome-following-cardiac-surgery
#13
Michela Bisciglia, Frédéric London, Jonathan Hulin, André Peeters, Adrian Ivanoiu, Anne Jeanjean
Movement disorders following heart surgery are very unusual. Post-pump chorea is mainly a pediatric complication of heart surgery, typically manifesting after a latent period of normality and is usually related with long extracorporeal circulation time and deep hypothermia. We report a 73-year-old woman, without risk factors predisposing to paroxysmal movement disorders, presenting acute choreoathetoid movements 5 days after aortic valvular replacement with normal extracorporeal circulation time and perioperative normothermia...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183574/the-effects-of-dynamic-airway-photographs-on-preoperative-airway-planning-among-a-panel-of-anesthetists
#14
M Tariq Hanifi, Marc Philip T Pimentel, Christine Motzkus, James Gosnell, Linda S Aglio
STUDY OBJECTIVE: To determine whether having preoperative airway photographs will change the preanesthetic airway plan. DESIGN: Questionnaire. SETTING: American academic medical center (Brigham and Women's Hospital, Boston MA). SUBJECTS: Twenty-five test subjects (American Society of Anesthesiologists 1-4) were enrolled to have their preoperative airway photographs taken as well as to have a customary preoperative history and physical examination...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183573/glycopyrrolate-it-s-time-to-review
#15
REVIEW
Jonathan Howard, Jason Wigley, Gerald Rosen, Jay D'mello
Medication shortages have become an all-too-common inconvenience that has forced anesthesia providers to examine our administering practices. Because of these shortages, commonly used medications are at the greatest risk. Glycopyrrolate (Robinul), which has been in short supply in recent years, is one of the most widely used anticholinergic agents, especially in conjunction with the anticholinesterase neostigmine, for reversal of neuromuscular blockade (NMB) drugs. Here we review multiple studies from 1972 through 1986 that used varying methods of patient selection and dosage and drug combination criteria, and which noted that glycopyrrolate had a superior efficacy and adverse effect profile when compared with atropine in NMB reversal...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183572/cervical-sympathetic-blockade-for-the-management-of-electrical-storm
#16
Rehan Ali, Jeffrey Ciccone, Victor Tseng
A 75-year-old man presented with dizziness and fatigue secondary to ventricular and supraventricular arrhythmias. He underwent an elective ablation but continued to suffer from ventricular tachycardia with cardiovascular instability despite antiarrhythmic therapy with multiple agents. The patient continued to develop episodes of ventricular tachycardia and an episode of ventricular fibrillation. Electrical storm encompasses a situation of cardiac instability which may present as several episodes of ventricular tachycardia or ventricular fibrillation in a short period...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183571/perioperative-anesthetic-management-for-renal-cell-carcinoma-with-vena-caval-thrombus-extending-into-the-right-atrium-case-series
#17
Yoshihisa Morita, Kengo Ayabe, Michael Nurok, Jerry Young
Renal cell carcinoma has a tendency for vascular invasion and may extend into the inferior vena cava and even into the right-sided cardiac chambers. It has been reported that nephrectomy with thrombectomy can provide immediate palliation of symptoms with 5-year survival rates of up to 72% in the absence of nodal or distant metastasis. The location of the tumor dictates the anesthetic and surgical approach, as extension into the heart often necessitates cardiac surgical involvement. Renal cell carcinoma with vena cava tumor thrombus extending into the right cardiac chamber usually requires cardiopulmonary bypass and occasionally deep hypothermic circulatory arrest for surgical resection, and anesthetic approach should be tailored to each individual case...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183570/unusual-presentation-of-local-anesthetic-toxicity
#18
Nitin Hayaran, Rashi Sardana, Hamse Nandinie, Aruna Jain
The local anesthetic systemic toxicity can be due to increased blood lignocaine levels or due to increased sensitivity to lignocaine. Several cases of lignocaine-induced central nervous system toxicity have been noted, but none have reported only loss of consciousness without any seizure-like activity. Intravenous lipid emulsion administration for the treatment of local anesthetic systemic toxicity is an emerging topic of discussion, and there are case reports where they had successfully been used. However, majority of them were used in the treatment of cardiovascular manifestations of local anesthetic toxicity...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183569/gastric-regurgitation-in-patients-undergoing-gynecological-laparoscopy-with-a-laryngeal-mask-airway-a-prospective-observational-study
#19
Jeconias Lemos, Gildasio S De Oliveira, Hugo Eckner Dantas de Pereira Cardoso, Lavínia Dantas Cardoso Neiva Lemos, Lígia Raquel de Carvalho, Norma Suely Pinheiro Módolo
OBJECTIVE: The use of pneumoperitonium and the placement of patients in Trendelenburg position are commonly cited reasons for the potential development of intraoperative regurgitation of gastric contents and the need for an endotracheal tube in laparoscopic surgery. The main objective of the current investigation was to evaluate the presence of regurgitation of gastric contents in the oropharynx of patients having laparoscopic gynecological surgery with a laryngeal mask airway (LMA). DESIGN: Prospective, observational clinical investigation...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183568/the-effect-of-play-distraction-on-anxiety-before-premedication-administration-a-randomized-trial
#20
Gözde Bumin Aydın, Serhat Yüksel, Jülide Ergil, Reyhan Polat, Fatma Kavak Akelma, Musa Ekici, Murat Sayın, Öner Odabaş
STUDY OBJECTIVE: The majority of children scheduled to undergo surgery experience substantial anxiety in the preoperative holding area before induction of anesthesia. Pharmacological interventions aimed at reducing perioperative anxiety are paradoxically a source of stress for children themselves. Midazolam is frequently used as premedication, and the formula of this drug in Turkey is bitter. We aimed to assess the role of distraction in the form of playing with play dough (Play-Doh) on reducing premedication anxiety in children...
February 2017: Journal of Clinical Anesthesia
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