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https://www.readbyqxmd.com/read/29031048/trends-in-perinatal-health-in-metropolitan-france-from-1995-to-2016-results-from-the-french-national-perinatal-surveys
#1
B Blondel, B Coulm, C Bonnet, F Goffinet, C Le Ray
OBJECTIVE: To study trends in the main indicators of perinatal health, medical practices and risk factors in France since 1995. POPULATION AND METHOD: All live births during one week in 1995 (n=13,318), 2003 (n=14,737), 2010 (n=14,903) and 2016 (n=13,384). Data were from interviews of women in postpartum wards and from medical records and were compared between years. RESULTS: Between 1995 and 2016, maternal age and body mass index increased steadily...
October 9, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/29029368/who-accesses-surgery-at-district-level-in-sub-saharan-africa-evidence-from-malawi-and-zambia
#2
Jakub Gajewski, Rachel Dharamshi, Michael Strader, John Kachimba, Eric Borgstein, Gerald Mwapasa, Mweene Cheelo, Tracey McCauley, Leon Bijlmakers, Ruairi Brugha
OBJECTIVES: To examine age and gender distribution for the most common types of surgery in Malawi and Zambia. METHODS: Data were collected from major operating theatres in 8 district hospitals in Malawi and 9 in Zambia. Raw data on surgical procedures were coded by specialist surgeons for frequency analyses. RESULTS: In Malawi, female surgical patients had a mean age of 25 years, with 91% aged 16-40 years. Females accounted for 85%, and obstetric cases for 75%, of all surgical patients...
October 13, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29029042/does-pharmacokinetic-pharmacodynamic-model-guided-anaesthesia-improve-outcome-after-hip-fracture-surgery
#3
M Coburn, R D Sanders
No abstract text is available yet for this article.
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028983/guidelines-on-informed-consent-in-anaesthesia-unrealistic-unethical-untenable%C3%A2
#4
A M Cyna, S W Simmons
No abstract text is available yet for this article.
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028933/novel-method-for-intraoperative-assessment-of-cerebral-autoregulation-by-paced-breathing
#5
N H Sperna Weiland, J Hermanides, M W Hollmann, B Preckel, W J Stok, J J van Lieshout, R V Immink
Background: Cerebral autoregulation (CA) is the mechanism that maintains constancy of cerebral blood flow (CBF) despite variations in blood pressure (BP). Patients with attenuated CA have been shown to have an increased incidence of peri-operative stroke. Studies of CA in anaesthetized subjects are rare, because a simple and non-invasive method to quantify the integrity of CA is not available. In this study, we set out to improve non-invasive quantification of CA during surgery. For this purpose, we introduce a novel method to amplify spontaneous BP fluctuations during surgery by imposing mechanical positive pressure ventilation at three different frequencies and quantify CA from the resulting BP oscillations...
October 6, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028932/surgical-pleth-index-prediction-of-postoperative-pain-in-children
#6
T Ledowski, D Sommerfield, L Slevin, J Conrad, B S von Ungern-Sternberg
Background: Surgical Pleth Index (SPI) is a non-invasive, dimensionless score (0-100) aimed to allow an estimate of intraoperative nociception. Thus, it may be a useful tool to guide intraoperative analgesia. However, no optimum SPI target range for the use in children has yet been defined. It was the aim of this study to define a clinically appropriate SPI target to predict moderate-severe postoperative pain in children. Methods: After ethics approval 105 children (2-16 yr) undergoing elective sevoflurane/opioid-based anaesthesia were included...
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028930/use-of-a-hand-held-digital-cognitive-aid-in-simulated-crises-the-max-randomized-controlled-trial
#7
R Lelaidier, B Balança, S Boet, A Faure, M Lilot, F Lecomte, J-J Lehot, T Rimmelé, J-C Cejka
Background: Cognitive aids improve the technical performance of individuals and teams dealing with high-stakes crises. Hand-held electronic cognitive aids have rarely been investigated. A randomized controlled trial was conducted to investigate the effects of a smartphone application, named MAX (for Medical Assistance eXpert), on the technical and non-technical performance of anaesthesia residents dealing with simulated crises. Methods: This single-centre randomized, controlled, unblinded trial was conducted in the simulation centre at Lyon, France...
September 27, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028921/smartpilot%C3%A2-view-guided-anaesthesia-improves-postoperative-outcomes-in-hip-fracture-surgery-a-randomized-blinded-controlled-study
#8
D Leblanc, M Conté, G Masson, F Richard, A Jeanneteau, G Bouhours, J M Chrétien, L Rony, E Rineau, S Lasocki
Background: Both under-dosage and over-dosage of general anaesthetics can harm frail patients. We hypothesised that computer-assisted anaesthesia using pharmacokinetic/pharmacodynamic models guided by SmartPilot® View (SPV) software could optimise depth of anaesthesia and improve outcomes in patients undergoing hip fracture surgery. Methods: This prospective, randomized, single-centre, blinded trial included patients undergoing hip fracture surgery under general anaesthesia...
September 27, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028917/comparative-usability-of-modern-anaesthesia-ventilators-a-human-factors-study
#9
J Spaeth, T Schweizer, A Schmutz, H Buerkle, S Schumann
Background: The anaesthesia ventilator represents the key equipment for intraoperative respiratory care. Improper operation of this device may threaten a patient's health. A self-explanatory interface facilitates handling and decreases the risk of operating errors. This study systematically evaluates the usability of user interfaces in four modern anaesthesia ventilators. Methods: Twenty naïve operators were asked to execute 20 tasks on each of four different anaesthesia ventilators (Avance CS2™, GE Healthcare; Flow-i™, Maquet; and Perseus™ and Primus™, Dräger) in a randomized order...
October 3, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028916/hypertension-and-cataract-surgery-under-loco-regional-anaesthesia-not-to-be-ignored
#10
C M Kumar, E Seet, T Eke, G P Joshi
No abstract text is available yet for this article.
September 28, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028915/point-of-care-paediatric-gastric-sonography-can-antral-cut-off-values-be-used-to-diagnose-an-empty-stomach
#11
J J Moser, A M Walker, A O Spencer
Background: Gastric sonography is emerging as a valuable clinical point-of-care tool to assess aspiration risk. A recent study proposed that a single cut-off cross-sectional area (CSA) in the supine position could diagnose an empty stomach in the parturient. This study establishes the sensitivity and specificity of a single CSA cut-off measurement in both supine and right lateral decubitus (RLD) positions in the diagnosis of an empty antrum in paediatric patients. Methods: Following induction of anaesthesia, antral sonography was performed in supine and RLD positions in 100 fasted paediatric patients prior to upper endoscopic evaluation...
September 27, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29027777/immobilisation-during-anaesthesia-for-vitrectomy-using-a-laryngeal-mask-without-neuromuscular-blockade-versus-endotracheal-intubation-and-neuromuscular-blockade
#12
Axel Fudickar, Matthias Gruenewald, Beate Fudickar, Moritz Hill, Martin Wallenfang, Julia Hüllemann, Dana Voss, Amke Caliebe, Johann B Roider, Markus Steinfath, Felix Treumer
BACKGROUND: For intraocular surgery, most authors recommend general anaesthesia including intubation and neuromuscular blockade to avoid complications by patient movements. However, anaesthesia using a laryngeal mask and avoidance of muscle relaxants is common clinical practice. Purpose of this prospective observational study was to compare the incidence of eye movement and deviation of the eye axis during general anaesthesia adjusted to minimal alveolar concentration (MAC) for pars plana-vitrectomy (PPV) using a laryngeal mask without neuromuscular blockade (LM) versus endotracheal intubation and neuromuscular blockade (INT)...
October 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29026817/comparing-the-use-of-3d-photogrammetry-and-computed-tomography-in-assessing-the-severity-of-single-suture-nonsyndromic-craniosynostosis
#13
Olivia A Ho, Nikoo Saber, Derek Stephens, April Clausen, James Drake, Christopher Forrest, John Phillips
PURPOSE: Single-suture nonsyndromic craniosynostosis is diagnosed using clinical assessment and computed tomography (CT). With increasing awareness of the associated risks of radiation exposure, the use of CT is particularly concerning in patients with craniosynostosis since they are exposed at a younger age and more frequently than the average child. Three-dimensional (3D) photogrammetry is advantageous-it involves no radiation, is conveniently obtainable within clinic, and does not require general anaesthesia...
May 2017: Plastic Surgery
https://www.readbyqxmd.com/read/29026686/pain-prediction-from-ecg-in-vascular-surgery
#14
Tricia Adjei, Wilhelm Von Rosenberg, Valentin Goverdovsky, Katarzyna Powezka, Usman Jaffer, Danilo P Mandic
Varicose vein surgeries are routine outpatient procedures, which are often performed under local anaesthesia. The use of local anaesthesia both minimises the risk to patients and is cost effective, however, a number of patients still experience pain during surgery. Surgical teams must therefore decide to administer either a general or local anaesthetic based on their subjective qualitative assessment of patient anxiety and sensitivity to pain, without any means to objectively validate their decision. To this end, we develop a 3-D polynomial surface fit, of physiological metrics and numerical pain ratings from patients, in order to model the link between the modulation of cardiovascular responses and pain in varicose vein surgeries...
2017: IEEE Journal of Translational Engineering in Health and Medicine
https://www.readbyqxmd.com/read/29026387/the-effect-of-a-preanaesthesia-clinic-consultation-on-adult-patient-anxiety-at-a-tertiary-hospital-in-kenya-a-cohort-study
#15
Anthony Kamau, Vitalis Mung'ayi, Gerald Yonga
BACKGROUND: Preoperative anxiety is a common perioperative complication seen in approximately 11-80% of adults undergoing surgery. One of the goals of the preanaesthesia clinic is to allay anxiety. A preanaesthesia clinic evaluation has been shown to reduce anxiety however current studies on anxiety and the preanaesthesia clinic have not quantified this reduction. OBJECTIVE: To determine the reduction in anxiety in patients evaluated in the clinic versus those evaluated in the ward...
March 2017: African Health Sciences
https://www.readbyqxmd.com/read/29026385/a-randomized-controlled-trial-to-assess-the-effect-of-a-ketamine-infusion-on-tourniquet-hypertension-during-general-anaesthesia-in-patients-undergoing-upper-and-lower-limb-surgery
#16
Joyce Ongaya, Vitalis Mung'ayi, Thikra Sharif, Jimmie Kabugi
BACKGROUND: Tourniquet hypertension arising from tourniquet inflation remains a primary concern to the anaesthetist. One drug commonly used to manage tourniquet hypertension is ketamine. No studies have examined the effect of ketamine on tourniquet hypertension for a period of more than one hour or an infusion of the same. OBJECTIVE: To compare the effect of an intravenous infusion of ketamine versus placebo on tourniquet induced hypertension in patients undergoing upper and lower limb surgery under general anaesthesia...
March 2017: African Health Sciences
https://www.readbyqxmd.com/read/29025825/comparison-of-the-cerebroprotective-effect-of-inhalation-anaesthesia-and-total-intravenous-anaesthesia-in-patients-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-a-systematic-review-and-meta-analysis
#17
Feng Chen, Guangyou Duan, Zhuoxi Wu, Zhiyi Zuo, Hong Li
OBJECTIVE: Neurological dysfunction remains a devastating postoperative complication in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), and previous studies have shown that inhalation anaesthesia and total intravenous anaesthesia (TIVA) may produce different degrees of cerebral protection in these patients. Therefore, we conducted a systematic literature review and meta-analysis to compare the neuroprotective effects of inhalation anaesthesia and TIVA. DESIGN: Searching in PubMed, EMBASE, Science Direct/Elsevier, China National Knowledge Infrastructure and Cochrane Library up to August 2016, we selected related randomised controlled trials for this meta-analysis...
October 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/29025452/management-of-failed-spinal-anaesthesia-for-caesarean-section
#18
Gavin Wyndham Jones, Raphael Anthony Samuel, Bruce McClure Biccard
BACKGROUND: Failed spinal anaesthesia for caesarean section (CS) may be partial or complete and the subsequent discomfort is the most commonly cited cause of litigation in obstetric anaesthesia. OBJECTIVES: To determine if there is a standardised approach to: (i) testing the level of block of spinal anaesthesia; and (ii) the management of failed spinal anaesthesia for CS. METHODS: A structured questionnaire to ascertain the current practice of testing the level of block and management of three different scenarios of failed spinal anaesthesia was distributed to 51 government hospitals in KwaZulu-Natal, South Africa (SA)...
June 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29023246/effect-of-various-durations-of-smoking-cessation-on-postoperative-outcomes-a-retrospective-cohort-analysis
#19
Alparslan Turan, Onur Koyuncu, Cameron Egan, Jing You, Kurt Ruetzler, Daniel I Sessler, Jacek B Cywinski
BACKGROUND: Preoperative smoking cessation is commonly advised in an effort to improve postoperative outcomes. However, it remains unclear for how long smoking cessation is necessary, and even whether a brief preoperative period of abstinence is helpful and well tolerated. OBJECTIVE: We evaluated associations between various periods of preoperative smoking cessation and major morbidity and death. DESIGN: Retrospective cohort analysis. SETTING: Adults who had noncardiac surgery at the Cleveland Clinic Main Campus between May 2007 and December 2013...
October 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29022797/surgery-performed-by-supervised-registrars-does-not-adversely-affect-medium-term-functional-outcomes-after-total-knee-replacement
#20
N Beattie, J F Maempel, S Roberts, H B Waterson, G Brown, I J Brenkel, P J Walmsley
Introduction Although total knee arthroplasty (TKA) is an index procedure for orthopaedic registrars, there is a lack of published research as to the effects of surgery when performed by supervised trainees. The aim of this study was to compare functional outcomes up to five years after primary TKA performed by consultants and trainee surgeons. Methods A retrospective analysis was conducted of prospectively collected data for 609 consecutive patients (339 female, 270 male) undergoing TKA. Patients were assessed preoperatively as well as at 18 months, three years and five years postoperatively, and American Knee Society objective knee and functional scores (AKSK and AKSF) were recorded...
September 15, 2017: Annals of the Royal College of Surgeons of England
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