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Anaesthesia

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https://www.readbyqxmd.com/read/30242832/effects-of-repeated-anaesthesia-on-gill-and-general-health-of-atlantic-salmon-salmo-salar
#1
R J Chance, G A Cameron, M Fordyce, P Noguera, T Wang, C Collins, C J Secombes, B Collet
Fish are the second most widely utilized vertebrate group used for scientific procedures in the United Kingdom, but the development and application of 3Rs (the principles of replacement, reduction, and refinement) in aquaculture disease research lags behind methodologies in place for mammalian studies. With a need for individual monitoring and non-lethal sampling, the effect of repeat anaesthesia on experimental fish needs to be better understood. This study to analyses the effect of repeat anaesthesia with MS-222, metomidate and AQUI-S upon the gill and general health of post-smolt Atlantic salmon Salmo salar...
September 22, 2018: Journal of Fish Biology
https://www.readbyqxmd.com/read/30241559/impact-of-drug-and-equipment-preparation-on-pre-hospital-emergency-anaesthesia-phea-procedural-time-error-rate-and-cognitive-load
#2
Paul Swinton, Alasdair R Corfield, Chris Moultrie, David Percival, Jeffrey Proctor, Neil Sinclair, Zane B Perkins
BACKGROUND: We examined the effect of advanced preparation and organisation of equipment and drugs for Pre-hospital Emergency Anaesthesia (PHEA) and tracheal intubation on procedural time, error rates, and cognitive load. METHODS: This study was a randomised, controlled experiment with a crossover design. Clinical teams (physician and paramedic) from the Emergency Medical Retrieval Service and the Scottish Air Ambulance Division were randomised to perform a standardised pre-hospital clinical simulation using either unprepared (standard practice) or pre-prepared (experimental method) PHEA equipment and drugs...
September 21, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30238445/the-effects-of-general-anaesthesia-on-oxygen-consumption-a-meta-analysis-guiding-future-studies-on-perioperative-oxygen-transport
#3
REVIEW
Julia Jakobsson, Sofia Vadman, Eva Hagel, Sigridur Kalman, Erzsébet Bartha
BACKGROUND: Increased oxygen extraction, the ratio of consumption to delivery, has been associated with poor outcome after surgery. Oxygen consumption (VO2) can change in several ways in the perioperative period, but is seldom monitored directly in routine care. This study investigates the effects of general anaesthesia on VO2. METHODS: We searched PubMed, EMBASE, and Cochrane Library 1946-2018 for studies including VO2 measurements before and after anaesthesia induction...
September 20, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/30237598/foetal-surgery-anaesthetic-implications-and-strategic-management
#4
REVIEW
Bhavani Shankar Kodali, Shobana Bharadwaj
Intrauterine surgery is being performed with increasing frequency. Correction of foetal anomalies in utero can result in normal growth of foetus and a healthier baby at delivery. Intrauterine surgery can also improve the survival of babies who would have otherwise died at delivery, or in the neonatal period. There are three commonly used approaches to correct foetal anomalies: open surgery, where the foetus is exposed through hysterotomy; percutaneous approach, where needle or foetoscope is inserted through the abdominal wall and the uterine wall; finally, ex utero intrapartum treatment (EXIT) surgery, where the intervention is performed on the baby before terminating the maternal umbilical support to the baby...
September 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/30237597/anaesthesia-for-non-obstetric-surgery-in-obstetric-patients
#5
REVIEW
G L Ravindra, Abhinava S Madamangalam, Shwetha Seetharamaiah
Anaesthesia for pregnant patients presenting for non-obstetric surgery needs a thorough understanding of the physiological changes and altered pharmacokinetics of pregnancy. Considering the effects of surgery and anaesthesia on the foetus, only essential and emergency surgeries are performed during pregnancy. Surgical procedures in second trimester have the advantage of better foetal outcome. The primary concerns of maternal and foetal safety are achieved by a focused multidisciplinary team-based approach with respect to the surgical condition...
September 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/30237596/anaesthetic-management-of-obstetric-emergencies
#6
REVIEW
Pradeep A Dongare, Madagondapalli S Nataraj
Obstetric emergencies are a challenge both for the obstetrician and the anaesthesiologist. The incidence of caesarean sections as per the National Family Health Survey published in 2015-16 was 17.2%. In 7.6% of cases, the decision to conduct a caesarean section was taken after the onset of labour pains. Caesarean sections are classified depending on the urgency into four categories. The target decision to delivery interval for category 1 caesarean section is less than 30 min. This is used as an audit tool for the efficiency of an obstetric service...
September 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/30237594/approach-to-failed-spinal-anaesthesia-for-caesarean-section
#7
REVIEW
Ketan S Parikh, Shwetha Seetharamaiah
Failure of spinal anaesthesia for caesarean section may have deleterious consequences for the mother as well as the newborn baby. In this article, we discuss the mechanisms of failure of spinal anaesthesia as well as the approach to a failed block. We performed a literature search in Google Scholar, PubMed, and Cochrane databases for original and review articles concerning failed spinal anaesthesia and caesarean section. Strategies for a failed spinal anaesthetic include manoeuvers to salvage the block, repeating the block, epidural anaesthesia or a combined spinal-epidural (CSE) technique, or resorting to general anaesthesia...
September 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/30237593/neuraxial-anaesthesia-in-parturient-with-cardiac-disease
#8
REVIEW
Minati Choudhury
Parturient with corrected or uncorrected cardiac problem may undergo neuraxial anaesthesia for several reasons and in different trimesters. The altered physiological state in a parturient is further deranged in the presence of a cardiovascular lesion, producing the added risk to the parturient undergoing a neuraxial block. A detailed evaluation, knowledge regarding cardiovascular disease state, more vigilant monitoring, and a team approach can lead to a successful outcome.
September 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/30237592/hypertensive-disorders-in-pregnancy
#9
REVIEW
Madhusudan Upadya, Sumesh T Rao
Hypertensive disorders of pregnancy (HDP) remain among the most significant and intriguing unsolved problems in obstetrics. In India, the prevalence of HDP was 7.8% with pre-eclampsia in 5.4% of the study population. The anaesthetic problems in HDP may be due to the effects on the cardiovascular, respiratory, neurologic, renal, haematologic, hepatic and uteroplacental systems. The basic management objectives should be facilitating the birth of an infant who subsequently thrives and completes restoration of health to the mother, or the termination of pregnancy with the least possible trauma to mother and foetus in severe pre-eclampsia...
September 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/30237591/management-of-anaesthesia-for-elective-low-risk-category-4-caesarean-section
#10
REVIEW
Komal Anil Gandhi, Kajal Jain
An increasing number of caesarean sections are being performed for both elective as well as emergency cases. Category 4 caesarean section refers to a planned elective surgery after 39 weeks of gestation at a time suitable to the mother and the maternity team. For a safe conduct of anaesthesia, the updated obstetric anaesthesia guidelines recommend administration of neuraxial anaesthesia, whenever feasible. The management should include adequate postoperative pain relief, early ambulation, and thromboprophylaxis to ensure early recovery...
September 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/30237589/physiological-and-anatomical-changes-of-pregnancy-implications-for-anaesthesia
#11
REVIEW
Pradeep Bhatia, Swati Chhabra
During pregnancy, the body goes through various anatomical and physiological changes to provide suitable environment for foetal development, to cater to the increased metabolic demands and to prepare for the childbirth. These changes have notable anaesthetic implications in determining the optimal anaesthetic technique, while also keeping in mind the gestational age, type of procedure and any coexisting medical condition. It is important to note that these changes revert to baseline (pre-pregnancy) levels at different time intervals during the postpartum period which is important while managing postpartum patients...
September 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/30236474/obstetric-anaesthesia-dynamic-and-multidirectional-research-approaches-to-ultimately-improve-parturient-management
#12
EDITORIAL
Frédéric J Mercier, Dan Benhamou
No abstract text is available yet for this article.
October 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30236472/training-and-teaching-in-anaesthesia-and-critical-care-towards-excellence
#13
EDITORIAL
Benoît Plaud, Pierre Bouzat, Mathieu Raux
No abstract text is available yet for this article.
October 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/30236276/erratum-to-nociceptive-activation-in-spinal-cord-and-brain-persists-during-deep-general-anaesthesia-br-j-anaesth-2018-121-291-302
#14
G Lichtner, R Auksztulewicz, H Velten, D Mavrodis, M Scheel, F Blankenburg, F von Dincklage
No abstract text is available yet for this article.
October 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/30236254/comparison-between-neurally-assisted-controlled-and-physiologically-variable-ventilation-in-healthy-rabbits
#15
M Walesa, S Bayat, G Albu, A Baudat, F Petak, W Habre
BACKGROUND: Various ventilation strategies have been proposed to reduce ventilation-induced lung injury that occurs even in individuals with healthy lungs. We compared new modalities based on an individualised physiological variable ventilation model to a conventional pressure-controlled mode. METHODS: Rabbits were anaesthetised and ventilated for up to 7 h using pressure-controlled ventilation with (Group PCS, n=10), and without (Group PC, n=10) regular sighs...
October 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/30236252/intraoperative-ventilation-settings-and-their-associations-with-postoperative-pulmonary-complications-in-obese-patients
#16
L Ball, S N T Hemmes, A Serpa Neto, T Bluth, J Canet, M Hiesmayr, M W Hollmann, G H Mills, M F Vidal Melo, C Putensen, W Schmid, P Severgnini, H Wrigge, M Gama de Abreu, M J Schultz, P Pelosi
BACKGROUND: There is limited information concerning the current practice of intraoperative mechanical ventilation in obese patients, and the optimal ventilator settings for these patients are debated. We investigated intraoperative ventilation parameters and their associations with the development of postoperative pulmonary complications (PPCs) in obese patients. METHODS: We performed a secondary analysis of the international multicentre Local ASsessment of VEntilatory management during General Anesthesia for Surgery' (LAS VEGAS) study, restricted to obese patients, with a predefined composite outcome of PPCs as primary end-point...
October 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/30236248/validity-and-reliability-of-an-objective-structured-assessment-tool-for-performance-of-ultrasound-guided-regional-anaesthesia
#17
A Shafqat, M Rafi, V Thanawala, N M Bedforth, J G Hardman, R A McCahon
BACKGROUND: We examined the validity and reliability of the previously developed criterion-referenced assessment checklist (AC) and global rating scale (GRS) to assess performance in ultrasound-guided regional anaesthesia (UGRA). METHODS: Twenty-one anaesthetists' single, real-time UGRA procedures (total: 21 blocks) were assessed using a 22-item AC and a 9-item GRS scored on 3-point and 5-point Likert scales, respectively. We used one-way analysis of variance to compare the assessment scores between three groups (Group 1: ≤30 blocks in the preceding year; Group 2: 31-100; and Group 3: >100)...
October 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/30236245/neuraxial-anaesthesia-techniques-and-postoperative-outcomes-among-joint-arthroplasty-patients-is-spinal-anaesthesia-the-best-option
#18
S M Weinstein, L R Baaklini, J Liu, L Poultsides, C Cozowicz, J Poeran, J N Saleh, S G Memtsoudis
BACKGROUND: Neuraxial anaesthesia is frequently used for lower limb arthroplasty but it is unclear whether benefits vary among patients receiving different subtypes of neuraxial anaesthesia. We evaluated whether differences in risk for adverse postoperative outcomes exist between patients receiving combined spinal and epidural (CSE), epidural, or spinal anaesthesia. METHODS: In this retrospective cohort study, we identified 40 852 patients who underwent total hip and knee arthroplasty (THA and TKA) procedures under neuraxial anaesthesia (34 301 CSE, 2464 epidural, 4087 spinal) between 2005 and 2014 at a single institution...
October 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/30236244/local-anaesthetic-induced-myotoxicity-in-regional-anaesthesia-a-systematic-review-and-empirical-analysis
#19
REVIEW
N Hussain, C J L McCartney, J M Neal, J Chippor, L Banfield, F W Abdallah
Recent reports of local-anaesthetic (LA)-induced myotoxicity after peripheral nerve blocks have increased the interest in this less commonly known complication. Basic science evidence investigating LA-induced myotoxicity seems to demonstrate a pattern, but findings from human studies vary. This systematic review summarises the existing myotoxicity evidence and empirically examines its implications. Databases were searched for all in vitro animal and human studies evaluating LA-induced myotoxicity. Studies were stratified by design...
October 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/30236240/diurnal-variations-in-recovery-times-after-general-anaesthesia-in-children
#20
J Szolnoki, D M Polaner, T Eckle
BACKGROUND: Circadian rhythms coordinate almost all physiological functions and are implicated in major disease development. Even though circadian rhythms have a major impact on human health, little is known about how they affect general anaesthesia. The purpose of this study was to understand if the time of day affects the length of time a child needs to achieve readiness for discharge after general anaesthesia for brain MRI. METHODS: A retrospective analysis over a 3 yr period (2013-5) on the length of stay in the postanaesthesia care unit (PACU) before discharge was performed for children (age <18 yr) undergoing brain magnetic resonance imaging as outpatients...
October 2018: British Journal of Anaesthesia
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