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https://www.readbyqxmd.com/read/27907956/intensive-care-management-of-the-endovascular-stroke-patient
#1
Julian Bösel
Acute ischemic stroke caused by the occlusion of large brain vessels can be treated effectively by mechanical thrombectomy, as proved by recent strong and consistent evidence from high-quality randomized trials. This new era of endovascular stroke treatment, however, poses particular challenges that go far beyond the so far gold standard of intravenous thrombolysis alone. Because these stroke patients usually present with severe neurologic deficits, may be unstable from cardiac or pulmonary instability, have to endure an invasive intervention of sometimes long duration, may suffer complications and require close postinterventional follow-up, they often demand intensive care measures...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27902657/the-assessment-of-the-risk-of-unplanned-extubation-in-an-adult-intensive-care-unit
#2
Semine Aydoğan, Nurten Kaya
BACKGROUND: In order to plan and implement nursing intervention to reduce the incidence rate of unplanned extubation problem in the intensive care unit (ICU), it is necessary to determine the risk factors of unplanned extubation and the patients under risk. AIMS: This study was undertaken with the aim of evaluating the risk of unplanned extubation of endotracheal tube in adult ICU. DESIGN: This was a case-control study. METHODS: The population constituted patients hospitalized in the adult ICU during 1-year period in a university hospital...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27896323/intra-articular-lidocaine-versus-intravenous-sedative-and-analgesic-for-reduction-of-anterior-shoulder-dislocation
#3
Parvin Kashani, Fatemeh Asayesh Zarchi, Hamid Reza Hatamabadi, Abbas Afshar, Marzieh Amiri
OBJECTIVE: This prospective clinical trial was performed to compare the safety and efficiency of intra-articular lidocaine (IAL) versus intravenous sedative and analgesic (IVSA) in reduction of anterior shoulder dislocation. MATERIALS AND METHODS: Patients with anterior shoulder dislocation were randomly divided into 2 groups to receive IAL and IVSA. One group patients received an intravenous dose of 0.05 mg/kg midazolam and 1 μg/kg fentanyl, while the other group received 20 mL intra-articular lidocaine (1%)...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27891424/a-study-on-the-efficacy-of-the-addition-of-low-dose-dexmedetomidine-as-an-adjuvant-to-lignocaine-in-intravenous-regional-anaesthesia-ivra
#4
Esha Nilekani, Yvonne Menezes, Shirley Ann D'souza
INTRODUCTION: Intravenous Regional Anaesthesia (IVRA) is a simple, effective method of providing anaesthesia for short duration surgical procedures on the extremities, its chief drawbacks are tourniquet pain, short duration of block and absence of post-operative analgesia. Dexmedetomidine is known to reduce anaesthetic requirements and also provide analgesia to the patient. AIM: To evaluate the efficacy of dexmedetomidine as an adjuvant to lignocaine in IVRA with respect to the quality of the block, tourniquet pain and post-operative analgesia...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27883323/association-of-single-nucleotide-polymorhism-c3435t-in-the-abcb1-gene-with-opioid-sensitivity-in-treatment-of-postoperative-pain
#5
Vanja Dzambazovska-Trajkovska, Jordan Nojkov, Andrijan Kartalov, Biljana Kuzmanovska, Tatjana Spiroska, Redzep Seljmani, Gjorgji Trajkovski, Nadica Matevska-Geshkovska, Aleksandar Dimovski
BACKGROUND: The minimal effective analgesic concentration of opioids required for satisfactory analgesia may differ significantly among the patients. Genetic factors may contribute to the variable response to opioids by affecting their pharmacokinetics or pharmacodynamics. METHODS: Ninety nine patients undergoing abdominal surgery with colorectal anastomosis because of colorectal carcinoma were enrolled in the present study. C34535T was genotyped in all subjects and the patients were divided into three groups according to their genotype: CC-wild type homozygous, CT-mutant heterozygous and TT-mutant homozygous...
November 1, 2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27882094/the-protective-and-hemodynamic-effects-of-dexmedetomidine-on-hypertensive-cerebral-hemorrhage-patients-in-the-perioperative-period
#6
Junhui Zhao, Chuixian Zhou
The aim of the present study was to analyze the protective and hemodynamic effects of dexmedetomidine in hypertensive cerebral hemorrhage (HCH) patients during perioperative period. In total, 50 HCH patients were selected and randomly divided into two groups, one group was administered with dexmedetomidine and the other groups with midazolam. The mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO2) were monitored in the two groups of patients before and during the operation. The MAP, HR, SpO2 and PETCO2 recorded 5 min after admission into the operation room was considered T1, the same parameters recorded 10 min after drug administration were considered T2, just after starting the operation were considered T3 and 30 min after start of operation were considered T4...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27874185/translating-delirium-prevention-strategies-for-elderly-adults-with-hip-fracture-into-routine-clinical-care-a-pragmatic-clinical-trial
#7
Susan Freter, Katalin Koller, Michael Dunbar, Chris MacKnight, Kenneth Rockwood
OBJECTIVES: To compare the feasibility (adherence) and effectiveness (prevalence of delirium, length of stay, mortality, discharge site) of delirium-friendly preprinted postoperative orders (PPOs) for individuals with hip fracture, administered by regular orthopedic nurses, with routine postoperative orders. DESIGN: Pragmatic clinical trial to evaluate a quality improvement intervention. SETTING: Tertiary care hospital. PARTICIPANTS: Individuals aged 65 and older admitted for hip fracture repair (N = 283)...
November 22, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27871553/fascia-iliaca-block-associated-only-with-deep-sedation-in-high-risk-patients-taking-p2y12-receptor-inhibitors-for-intramedullary-femoral-fixation-in-intertrochanteric-hip-fracture-a-series-of-3-cases
#8
Carlos Rodrigues Almeida, Emília Milheiro Francisco, Vítor Pinho-Oliveira, José Pedro Assunção
OBJECTIVE: We present a series of 3 cases in which the impact in outcome was, first of all, related to the capacity to offer early and safer treatment to some hip fracture high-risk patients using a fascia iliaca block (FIB; ropivacaine 0,5% 20 cc and mepivacaine 1,3% 15 cc, given 30 minutes before incision) associated only with deep sedation, contributing to better practice and outcome. CASE REPORTS: All elderly patients were American Society of Anesthesiologists IV patients, under P2Y12 receptor inhibitors, suffering from an intertrochanteric fracture, and purposed for intramedullary femoral fixation (IMF)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27866507/simulation-and-web-based-learning-increases-utilization-of-bier-block-for-forearm-fracture-reduction-in-the-pediatric-emergency-department
#9
Brett Burstein, Emmanuelle Fauteux-Lamarre, Adam Cheng, Dominic Chalut, Adam Bretholz
OBJECTIVES: Bier block (BB) is a safe and effective alternative to procedural sedation for analgesia during forearm fracture reductions, yet remains infrequently used in the pediatric emergency department (PED). No standardized methods of BB training have previously been described. The objective of this study was to determine whether a multimodal instructional course increases comfort with BB and translates to increased use of this technique. METHODS: A novel interdisciplinary simulation and Web-based training course was developed to teach the use of BB for forearm fracture reduction at a tertiary PED...
November 21, 2016: CJEM
https://www.readbyqxmd.com/read/27859317/effects-of-dexmedetomidine-administered-at-acupuncture-point-gv20-compared-to-intramuscular-route-in-dogs
#10
A Pons, S Canfrán, J Benito, R Cediel-Algovia, I A Gómez de Segura
OBJECTIVE: To compare the sedative effects produced by dexmedetomidine in dogs, administered either intramuscularly or into the Governing Vessel 20 acupuncture point. MATERIALS AND METHODS: Six dogs were sedated with 125 µg/m(2) dexmedetomidine injected either intramuscularly in the gluteal muscles or subcutaneously into the acupuncture point and in random order. Sedation and analgesia were assessed blindly before and after treatments at regular intervals for 90 minutes or until the dogs fully recovered...
November 14, 2016: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/27853748/effect-of-audio-and-visual-distraction-on-patients-undergoing-colonoscopy-a-randomized-controlled-study
#11
A P De Silva, M A Niriella, Y Nandamuni, S D Nanayakkara, K R P Perera, S K Kodisinghe, K C E Subasinghe, A Pathmeswaran, H J de Silva
: Background and study aims: Colonoscopy can cause anxiety and discomfort in patients. Sedation and analgesia as premedication can lead to complications in the elderly and those with comorbidities. This has led to an interest in the use of audio-visual distraction during the colonoscopy. We compared the effects of audio (AD) versus visual distraction (VD) in reducing discomfort and the need for sedation during colonoscopy. Patients and methods: Consecutive patients undergoing colonoscopy were randomized into three groups: one group was allowed to listen to the music of their choice (AD), the second group was allowed to watch a movie of their choice (VD), and the third group was not allowed either distraction during colonoscopy and acted as a control (C)...
November 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27853681/sedative-and-analgesic-effects-of-propofol-fentanyl-versus-propofol-ketamine-during-endoscopic-retrograde-cholangiopancreatography-a-double-blind-randomized-clinical-trial
#12
Fakhroddin Bahrami Gorji, Parviz Amri, Javad Shokri, Hakimeh Alereza, Ali Bijani
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a painful procedure that requires analgesia and sedation. OBJECTIVES: In this study, we compared the analgesic and sedative effects of propofol-ketamine versus propofol-fentanyl in patients undergoing ERCP. METHODS: In this clinical trial, 72 patients, aged 30 - 70 years old, who were candidates for ERCP were randomly divided into two groups. Before the start of ERCP, both groups received midazolam 0...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27850600/962-use-of-order-sets-to-improve-sedation-and-analgesia-practices-in-an-oncology-intensive-care-unit
#13
Mary Lou Warren, Sam Yerramsetti, Nick Holton, Jeffrey Bruno, Neetha Jawe, April Finnigan, Nisha Rathi, Lei Feng
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850555/917-evaluation-of-appropriate-analgesia-sedation-pre-versus-post-analgosedation-protocol-implementation
#14
Lesly Jurado, Micheal Strein, Lisa Hall Zimmerman, Joshua Steelman, Steven Nakajima, Charleen Gnisci, Zachery Bullard
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849721/41-impact-of-titration-to-bispectral-index-on-sedation-and-analgesia-exposure-in-ards
#15
Mark Vance, Seth Bauer, Abhijit Duggal, Anita Reddy, Erin Roach, Heather Torbic, Sarah Welch, Stephanie Bass
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849239/importance-of-the-use-of-protocols-for-the-management-of-analgesia-and-sedation-in-pediatric-intensive-care-unit
#16
Emiliana Motta, Michele Luglio, Artur Figueiredo Delgado, Werther Brunow de Carvalho
Introduction: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols...
September 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27847704/treatment-of-postoperative-pain-in-pediatric-operations-comparing-the-efficiency-of-bupivacaine-bupivacaine-dexmedetomidine-and-bupivacaine-fentanyl-for-caudal-block
#17
Hashem Jarineshin, Fereydoon Fekrat, Aida Kargar Kermanshah
BACKGROUND: Caudal analgesia is a common method for postoperative pain management in pediatric patients. Additive agents such as opioids and α2 agonists have been used to enhance the analgesic effects of local anesthetics for caudal block. OBJECTIVES: The aim of this study was to compare the additive effects of dexmedetomidine and fentanyl on bupivacaine-induced caudal analgesia in pediatric patients who had undergone elective inguinal hernia repair. METHODS: This randomized, double-blind clinical trial included children aged 1 - 5 years who were divided into three groups: the bupivacaine group (Group B) received 0...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27847695/combined-ketamine-tramadol-subcutaneous-wound-infiltration-for-multimodal-postoperative-analgesia-a-double-blinded-randomized-controlled-trial-after-renal-surgery
#18
Mohammad Reza Khajavi, Marzieh Navardi, Reza Shariat Moharari, Pejman Pourfakhr, Narjes Khalili, Farhad Etezadi, Farsad Imani
BACKGROUND: Pain is an important consideration after renal surgery. A multimodal approach to postoperative pain management could enhance analgesia by risking fewer side effects after surgery. OBJECTIVES: The aim of this study was to evaluate the clinical efficacy of the subcutaneous infiltration of ketamine and tramadol at the incision site to reduce postoperative pain. METHODS: Sixty-four patients between 18 and 80 years old who were scheduled for elective renal surgery were enrolled in a double-blind randomized controlled study...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27834984/effect-of-preoperative-intravenous-oxycodone-administration-on-sufentanil-consumption-after-retroperitoneal-laparoscopic-nephrectomy
#19
Jinguo Wang, Haichun Ma, Honglan Zhou, Yang Gao, Yaowen Fu, Na Wang
BACKGROUND: The aim of this study was to evaluate the efficacy of preoperative intravenous oxycodone administration on postoperative sufentanil consumption in patients undergoing retroperitoneal laparoscopic nephrectomy. METHODS: Fifty patients scheduled for retroperitoneal laparoscopic nephrectomy were enrolled and randomly assigned to two groups - patients in Group O (n = 25) received intravenously 0.1 mg kg⁻¹ oxycodone; while the patients in Group C (n = 25) received 0...
November 11, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27833559/the-opioid-sparing-effect-of-perioperative-dexmedetomidine-plus-sufentanil-infusion-during-neurosurgery-a-retrospective-study
#20
Shiyu Su, Chunguang Ren, Hongquan Zhang, Zhong Liu, Zongwang Zhang
Background: Approximately 60% of patients experience moderate-to-severe pain after neurosurgery, which primarily occurs in the first 24-72 h. Despite this, improved postoperative analgesia solutions after neurosurgery have not yet been devised. This retrospective study was conducted to evaluate the effect of intra- and post-operative infusions of dexmedetomidine (DEX) plus sufentanil on the quality of postoperative analgesia in patients undergoing neurosurgery. Methods: One hundred and sixty-three post-neurosurgery patients were divided into two groups: Group D (DEX infusion at 0...
2016: Frontiers in Pharmacology
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