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Anaesthesia

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https://www.readbyqxmd.com/read/29457291/does-sedation-offer-better-outcomes-than-local-anaesthesia-for-thyroid-fna-in-adult-patients
#1
R M Kholmatov, H S Khadra, F Murad, T M Ahmed, A B Sholl, E Kandil
OBJECTIVE: To examine the potential benefits of sedation in adults undergoing fine needle aspiration (FNA) of thyroid nodules. METHODS: This retrospective study compared the outcomes of sedated and non-sedated FNA patients. RESULTS: A total of 860 patients underwent 1698 FNAs of thyroid nodules. The mean patient age was 52.4±14.4 years, and 80.2% of patients were women. The non-sedated group consisted of 782 patients with 1543 (93.5%) FNA procedures...
February 18, 2018: Cytopathology: Official Journal of the British Society for Clinical Cytology
https://www.readbyqxmd.com/read/29457215/the-effect-of-anaesthetic-technique-during-primary-breast-cancer-surgery-on-neutrophil-lymphocyte-ratio-platelet-lymphocyte-ratio-and-return-to-intended-oncological-therapy
#2
A Ní Eochagáin, D Burns, B Riedel, D I Sessler, D J Buggy
Inflammation and immunosuppression contribute to the pathogenesis of cancer. An increased neutrophil-lymphocyte ratio reflects these processes and is associated with adverse cancer outcomes. Whether anaesthetic technique for breast cancer surgery influences these factors, and potentially cancer recurrence, remains unknown. We conducted a secondary analysis in patients enrolled in an ongoing trial of anaesthetic technique on breast cancer recurrence. The primary hypothesis was that postoperative neutrophil-lymphocyte ratio is lower in patients allocated to receive propofol-paravertebral rather than inhalational agent-opioid anaesthesia for primary breast cancer surgery...
February 19, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29456944/choanal-atresia-birth-without-breath
#3
Vikas Sinha, Samanth Talagauara Umesh, Sushil G Jha, Swati Dadhich
Bilateral Choanal atresia is a medical emergency. Corrective surgery is the mainstay of the treatment. Hegar's dilator was used in all cases to break the bony/membranous atretic plate. The 22 cases of choanal atresia all operated by the first author were included in this study. Eight cases were 1-5 year old with bilateral choanal atresia and all required immediate surgery as they had repeated attacks of respiratory distress and cycle of cyanosis. Eight cases were of CHARGE Syndrome. All the cases were operated under general anaesthesia...
March 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/29456834/a-retrospective-report-2003-2013-of-the-complications-associated-with-the-use-of-a-one-man-head-and-tail-rope-recovery-system-in-horses-following-general-anaesthesia
#4
Maria Chie Niimura Del Barrio, Florent David, J M Lynne Hughes, David Clifford, Hans Wilderjans, Rachel Bennett
Background: The mortality rate of horses undergoing general anaesthesia is high when compared to humans or small animal patients. One of the most critical periods during equine anaesthesia is recovery, as the horse attempts to regain a standing position. This study was performed in a private equine practice in Belgium that uses a purpose-designed one-man (head and tail) rope recovery system to assist the horse during the standing process.The main purpose of the retrospective study was to report and analyse complications and the mortality rate in horses during recovery from anaesthesia using the described recovery system...
2018: Irish Veterinary Journal
https://www.readbyqxmd.com/read/29455179/a-quintessential-syndrome-with-a-rare-marvelling-aetiology-rosai-dorfman-disease-presenting-as-conus-cauda-syndrome
#5
Bharath A Chhabria, Ram V Nampoothiri, Kaniyappan Nambiyar, Deepesh Lad
A 19-year-old woman presented with a history of severe lower backache and asymmetric proximal lower limb weakness during the past 3 months. In addition, she also suffered from lower motor neuron-type bladder and bowel symptoms. On examination, paraparesis was noted. Further, sensory examination suggested patchy asymmetric sensory loss in both lower limbs with saddle anaesthesia and areflexia. A clinical diagnosis of Conus-Cauda syndrome was made and contrast-enhanced MRI of the lumbar and sacral spine was done, which confirmed the presence of a mass lesion within the spinal canal involving the cauda equina extending up to the sacral level...
February 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29455035/sustainability-of-anaesthesia-components-of-an-enhanced-recovery-program-erp-in-colorectal-and-orthopaedics-surgery
#6
Helene Beloeil, Karem Slim, The Francophone Group Of Enhanced Recovery After Surgery
BACKGROUND: Sustainability of ERP is a challenge and data are scarce on the subject. The aim of this study was to assess if application of enhanced recovery elements through the Francophone Group of Enhanced Recovery after Surgery (Grace) in the anaesthesia management was sustainable 2 years after its implementation. MATERIALS AND METHODS: We conducted a retrospective analysis of the prospective Grace database between October 2014 and October 2016. The evolution of each recommendation item over time was analysed using non-parametric Spearman correlation coefficient...
February 15, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29454333/comparative-study-of-ultrasound-guided-paravertebral-block-versus-intravenous-tramadol-for-postoperative-pain-control-in-percutaneous-nephrolithotomy
#7
Zehra Hatipoglu, Ersel Gulec, Mediha Turktan, Volkan Izol, Atilla Arıdogan, Yasemin Gunes, Dilek Ozcengiz
BACKGROUND: Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure for renal calculi, and nephrostomy tubes lead to postoperative pain after PCNL. Regional techniques (e.g., epidural analgesia and peripheral blocks) and opioids are applied for postoperative pain treatment. The aim of this study was to compare effectiveness of ultrasound-guided paravertebral block (PVB) and tramadol on postoperative pain in patients who underwent PCNL. METHOD: Fifty-three patients were included in this prospective randomized study...
February 17, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29454121/complications-of-impulse-generator-exchange-surgery-for-deep-brain-stimulation-a-single-centre-retrospective-study
#8
Ann-Kristin Helmers, Isabel Lübbing, Falk Birkenfeld, Karsten Witt, Michael Synowitz, Hubertus Maximilian Mehdorn, Daniela Falk
OBJECTIVE: Non-rechargeable deep brain stimulation (DBS) impulse generators (IG) with a low or empty battery status require surgical IG exchange several years after initial implantation. Complication rates in patients undergoing DBS surgery range from 7.6% to 25.3%. The aim of this study was to investigate the complication rates after IG exchange surgery and to identify risk factors for complications. METHODS: We retrospectively analysed complications following IG exchange surgery from 2008 to 2015 in a single-centre university hospital setting...
February 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29453466/effects-of-intrathecal-dexmedetomidine-as-an-adjuvant-to-hyperbaric-bupivacaine-for-spinal-anaesthesia-in-adults-undergoing-elective-infra-umbilical-surgery
#9
Binod Gautam, Sujata Niroula, Mona Sharma, Sushila Moktan Lama
INTRODUCTION: Various adjuvants to local anaesthetic are used to improve quality and duration of spinal anaesthesia. Dexmedetomidine, a novel alpha-2 adrenergic agonist, has been proposed to augment local anaesthetic effects. This study aims to investigate effects of intrathecal Dexmedetomidine on duration of analgesia and duration of sensory block during spinal anaesthesia. METHODS: In this randomized double-blind study 38 patients were allocated into each of two groups...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29452891/effect-of-topical-application-of-2-lidocaine-gel-on-corneal-sensitivity-of-clinically-normal-equine-eyes
#10
Alain Regnier, Iris Berton, Didier Concordet, Jean-Yves Douet
OBJECTIVE: To assess the degree and duration of corneal anaesthesia provided by topical application of a non-ophthalmic 2% lidocaine gel in horses. STUDY DESIGN: Experimental, 'blinded', randomized prospective study. ANIMALS: Twelve adult horses without relevant ocular abnormalities. METHODS: Baseline corneal touch threshold (CTT) measurements were obtained bilaterally by use of a Cochet-Bonnet aesthesiometer just prior to topical treatment...
September 15, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29452816/transnasal-humidified-rapid-insufflation-ventilatory-exchange-for-oxygenation-of-children-during-apnoea-a-prospective-randomised-controlled-trial
#11
T Riva, T H Pedersen, S Seiler, N Kasper, L Theiler, R Greif, M Kleine-Brueggeney
BACKGROUND: Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) comprises the administration of heated, humidified, and blended air/oxygen mixtures via nasal cannula at rates of ≥2 litres kg -1 min -1 . The aim of this randomized controlled study was to evaluate the length of the safe apnoea time using THRIVE with two different oxygen concentrations (100% vs 30% oxygen) compared with standard low-flow 100% oxygen administration. METHODS: Sixty patients, aged 1-6 yr, weighing 10-20 kg, undergoing general anaesthesia for elective surgery, were randomly allocated to receive one of the following oxygen administration methods during apnoea: 1) low-flow 100% oxygen at 0...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452814/deep-or-awake-removal-of-laryngeal-mask-airway-in-children-at-risk-of-respiratory-adverse-events-undergoing-tonsillectomy-a-randomised-controlled-trial
#12
A Ramgolam, G L Hall, G Zhang, M Hegarty, B S von Ungern-Sternberg
BACKGROUND: Laryngeal mask airways (LMA) are widely used during tonsillectomies. Contrasting evidence exists regarding the timing of the removal and the risk of perioperative respiratory adverse events. We assessed whether the likelihood of perioperative respiratory adverse events is influenced by the timing of LMA removal in children with at least one risk factor for these events. METHODS: Participants (n=290, 0-16 yr) were randomised to have their LMA removed either deep (in theatre by anaesthetist at end-tidal sevoflurane >1 minimum alveolar concentration) or awake (in theatre by anaesthetist or in postanaesthesia care unit by anaesthetist or trained nurse)...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452813/incidence-characteristics-and-predictive-factors-for-medication-errors-in-paediatric-anaesthesia-a-prospective-incident-monitoring-study
#13
C Gariel, B Cogniat, F-P Desgranges, D Chassard, L Bouvet
BACKGROUND: Medication errors are not uncommon in hospitalized patients. Paediatric patients may have increased risk for medication errors related to complexity of weight-based dosing calculations or problems with drug preparation and dilution. This study aimed to determine the incidence of medication errors in paediatric anaesthesia in a university paediatric hospital, and to identify their characteristics and potential predictive factors. METHODS: This prospective incident monitoring study was conducted between November 2015 and January 2016 in an exclusively paediatric surgical centre...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452811/effects-on-adult-cognitive-function-after-neonatal-exposure-to-clinically-relevant-doses-of-ionising-radiation-and-ketamine-in-mice
#14
S Buratovic, B Stenerlöw, S Sundell-Bergman, A Fredriksson, H Viberg, T Gordh, P Eriksson
BACKGROUND: Radiological methods for screening, diagnostics and therapy are frequently used in healthcare. In infants and children, anaesthesia/sedation is often used in these situations to relieve the patients' perception of stress or pain. Both ionising radiation (IR) and ketamine have been shown to induce developmental neurotoxic effects and this study aimed to identify the combined effects of these in a murine model. METHODS: Male mice were exposed to a single dose of ketamine (7...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452810/interleukin-6-is-both-necessary-and-sufficient-to-produce-perioperative-neurocognitive-disorder-in-mice
#15
J Hu, X Feng, M Valdearcos, D Lutrin, Y Uchida, S K Koliwad, M Maze
BACKGROUND: Perioperative neurocognitive disorders (PND) result in long-term morbidity and mortality with no effective interventions available. Because interleukin-6 (IL-6), a pro-inflammatory cytokine, is consistently up-regulated by trauma, including after surgery, we determined whether IL-6 is a putative therapeutic target for PND in a mouse model. METHODS: Following institutional approval, adult (12-14 weeks) male C57/Bl6 mice were pretreated with the IL-6 receptor (IL6R) blocking antibody tocilizumab prior to open tibia fracture with internal fixation under isoflurane anaesthesia...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452809/test-of-neural-inertia-in-humans-during-general-anaesthesia
#16
M H Kuizenga, P J Colin, K M E M Reyntjens, D J Touw, H Nalbat, F H Knotnerus, H E M Vereecke, M M R F Struys
BACKGROUND: Neural inertia is defined as the tendency of the central nervous system to resist transitions between arousal states. This phenomenon has been observed in mice and Drosophila anaesthetized with volatile anaesthetics: the effect-site concentration required to induce anaesthesia in 50% of the population (C50 ) was significantly higher than the effect-site concentration for 50% of the population to recover from anaesthesia. We evaluated this phenomenon in humans using propofol or sevoflurane (both with or without remifentanil) as anaesthetic agents...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452806/steroid-administration-after-anaesthetic-induction-with-etomidate-does-not-reduce-in-hospital-mortality-or-cardiovascular-morbidity-after-non-cardiac-surgery
#17
R Komatsu, J You, S Rajan, Y Kasuya, D I Sessler, A Turan
BACKGROUND: We tested the primary hypothesis that corticosteroid administration after etomidate exposure reduces a composite of in-hospital mortality and cardiovascular morbidity after non-cardiac surgery. METHODS: We evaluated ASA physical status III and IV patients who had non-cardiac surgery with general anaesthesia at the Cleveland Clinic. Amongst 4275 patients in whom anaesthesia was induced with etomidate, 804 were also given steroid intraoperatively, mostly dexamethasone at a median dose of 6 mg...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452803/preoperative-fasting-in-children-review-of-existing-guidelines-and-recent-developments
#18
REVIEW
P Frykholm, E Schindler, R Sümpelmann, R Walker, M Weiss
The current guidelines for preoperative fasting recommend intervals of 6, 4, and 2 h (6-4-2) of fasting for solids, breast milk, and clear fluids, respectively. The objective is to minimize the risk of pulmonary aspiration of gastric contents, but also to prevent unnecessarily long fasting intervals. Pulmonary aspiration is rare and associated with nearly no mortality in paediatric anaesthesia. The incidence may have decreased during the last decades, judging from several audits published recently. However, several reports of very long fasting intervals have also been published, in spite of the implementation of the 6-4-2 fasting regimens...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29451906/brain-changes-due-to-hypoxia-during-light-anaesthesia-can-be-prevented-by-deepening-anaesthesia-a-study-in-rats
#19
Setayesh R Tasbihgou, Mina Netkova, Alain F Kalmar, Janine Doorduin, Michel M R F Struys, Regien G Schoemaker, Anthony R Absalom
In anaesthetic practice the risk of cerebral ischemic/hypoxic damage is thought to be attenuated by deep anaesthesia. The rationale is that deeper anaesthesia reduces cerebral oxygen demand more than light anaesthesia, thereby increasing the tolerance to ischemia or hypoxia. However, evidence to support this is scarce. We thus investigated the influence of light versus deep anaesthesia on the responses of rat brains to a period of hypoxia. In the first experiment we exposed adult male Wistar rats to deep or light propofol anaesthesia and then performed [18F]- Fludeoxyglucose (FDG) Positron Emission Tomography (PET) scans to verify the extent of cerebral metabolic suppression...
2018: PloS One
https://www.readbyqxmd.com/read/29451416/refinement-of-in-vivo-optical-imaging-development-of-a-real-time-respiration-monitoring-system
#20
Ana L Gomes, Stuart Gilchrist, Veerle Kersemans, Marcus Westcott, Sean Smart
In vivo optical imaging enables detection and quantification of light-emitting compounds from the whole body in small animals such as the mouse, but it typically requires the use of anaesthetics for subject immobilisation due to long exposure times. Excessively deep anaesthesia can result in unacceptably compromised physiology, whilst excessively light anaesthesia can result in animals waking up. Here we report a respiratory monitoring setup for an in vivo bioluminescence and fluorescence imaging device which simultaneously allows real-time adaptive control of anaesthesia depth in multiple animals to (i) potentially increase the consistency between animals, (ii) ensure animals are maintained within minimally intrusive, adequate anaesthetic plane and (iii) provide a valuable refinement strategy for a common challenge within animal-based research...
January 1, 2018: Laboratory Animals
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