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Anaesthesia management

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https://www.readbyqxmd.com/read/29352622/anaesthesia-for-caesarean-section-in-a-patient-with-parkinson-s-disease
#1
V D Ward
Parkinson's disease is prevalent worldwide but mainly affects the elderly and is rarely seen in women of child-bearing age. The clinical signs and symptoms, the physiological changes of pregnancy, and drug interactions, pose unique challenges for the anaesthetic management of patients with Parkinson's disease who present for delivery. A 36-year-old primigravid woman at 36 weeks' gestation, with Parkinson's disease, presented for pre-anaesthesia assessment prior to elective caesarean section. Her Parkinson's disease had been diagnosed four years previously and was treated with Sinemet (levodopa/carbidopa) and pramipexole...
November 21, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29350412/surgical-repair-of-propagating-condylar-fractures-of-the-third-metacarpal-metatarsal-bones-with-cortical-screws-placed-in-lag-fashion-in-26-racehorses-2007-2015
#2
N Moulin, I François, N Coté, C Alford, O Cleary, M R Desjardins
BACKGROUND: Despite the recommendation of plate fixation for propagating condylar fractures of the third metacarpal (McIII) or third metatarsal bone (MtIII), lag screw fixation can be a viable surgical option. OBJECTIVES: To evaluate short-term outcome and long-term racing performance of horses that underwent lag screw fixation of long condylar fractures of the McIII/MtIII. STUDY DESIGN: Retrospective case series. METHODS: Medical records, post-surgical racing performance and outcome of 26 horses with propagating fractures of the medial and/or lateral condyle of McIII/MtIII were reviewed...
January 19, 2018: Equine Veterinary Journal
https://www.readbyqxmd.com/read/29343450/paediatric-physeal-sparing-posterior-cruciate-ligament-pcl-reconstruction-with-parental-donation-allograft-rationale-and-operative-approach
#3
R S Khakha, S K Yasen, A J Wilson
BACKGROUND: Paediatric PCL injuries are rare but constitute a significant management challenge. We describe a novel approach to the surgical management of an 11-year-old boy who presented with persisting symptomatic instability following 18months of failed conservative therapy. METHODS: PCL reconstruction was performed using a physeal sparing, all-inside technique under fluoroscopic control. This avoids the potential for iatrogenic growth injury. A parentally donated hamstrings allograft was used to ensure adequate graft size, and reinforced using a non-elastic two millimetre braided suture...
January 14, 2018: Knee
https://www.readbyqxmd.com/read/29330267/case-of-acute-severe-postpartum-urinary-incontinence-an-extravesical-subsphincteric-prolapsed-ureterocoele
#4
Jai H Seth, Roger Walker
A 32-year-old woman presents to outpatients 10 days postpartum, with symptoms of an intermittent vaginal lump and urinary incontinence. Vaginal examination revealed no demonstrable prolapse or stress incontinence. A swelling in the bladder was noted during an antenatal scan suggesting a ureterocoele. She was referred for pelvic floor physiotherapy in the first instance. Forty-eight hours later, she represented to casualty with discomforting vaginal lump symptoms and continuous urinary incontinence. At this stage on vaginal inspection, there was an evident dusky lump emerging from the urethra with continuous incontinence...
January 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29328847/an-anaesthesia-perspective-on-carotid-body-tumour-cbt-excision-a-twenty-year-case-series-at-the-singapore-general-hospital
#5
Deanna Wj Ng, Chris I Yam, Loong T Wong, Darren Lk Koh
Carotid body tumours (CBT) are extremely rare neoplasms that arise from chemoreceptor cells at the bifurcation of the carotid artery. This rarity poses a challenge for the anaesthetist when dealing with surgeries for the removal of CBT. Reports of associated perioperative morbidity range from twenty to forty percent. This paper reviews the perioperative anaesthetic management of CBT patients and challenges in our institution's 20 year experience on 13 surgical CBT resections.
October 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29328846/a-review-of-nausea-and-vomiting-in-the-anaesthetic-and-post-anaesthetic-environment
#6
Claire Matthews
Postoperative nausea and vomiting (PONV) has long been known as a complication of anaesthesia and surgery. This paper focuses on the assessment of the risk factors related to PONV along with the strategies and interventions which can be put in place to manage the condition. The pharmacological and multi-modal treatment methods of managing the risk factors that contribute to PONV are discussed.
October 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29326765/pneumocephalus-following-combined-spinal-epidural-anaesthesia-for-total-knee-arthroplasty-a-case-report
#7
Y W Chew, V K Suppan, S R Ashutosh, M M Tew, J H Jimmy-Tan
The authors describe a case of pneumocephalus following epidural anaesthesia for total knee arthroplasty. Multiple attempts in locating the epidural space for the anaesthesia and the use of loss of resistance to air (LORA) technique were identified as the source of air entry. Supportive management was given including high flow oxygenation therapy and spontaneous reabsorption of air was noted five days after surgery. The presence of pneumocephalus should be kept in mind if patient develops neurological complications postoperatively following epidural anaesthesia...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29313907/adverse-drug-reactions
#8
REVIEW
K Patton, D C Borshoff
Adverse drug reactions are a cause of significant morbidity and mortality to patients and a source of financial burden to the healthcare system. Of the wide spectrum of adverse drug reactions, the most concerning to the anaesthetist remain anaphylaxis and malignant hyperthermia. Although the incidence of anaphylaxis under anaesthesia is difficult to ascertain, it occurs commonly enough that most anaesthetists will manage at least one case in their career. The wide range of drugs given in the peri-operative period and the variable presentation in the anaesthetised patient can delay diagnosis and treatment, and adversely affect outcome...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29313905/renal-complications-of-anaesthesia
#9
REVIEW
J McKinlay, E Tyson, L G Forni
Peri-operative acute kidney injury is common, accounting for 30-40% of all in-hospital cases of acute kidney injury. It is associated with clinically significant morbidity and mortality even with what was hitherto regarded as relatively trivial increases in serum creatinine, and carries over a 12-fold relative risk of death following major abdominal surgery. Comorbid conditions such as diabetes, hypertension, liver disease and particularly pre-existing chronic kidney disease, as well as the type and urgency of surgery, are major risk factors for the development of postoperative acute kidney injury...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29313904/peripheral-nerve-injury-arising-in-anaesthesia-practice
#10
REVIEW
D W Hewson, N M Bedforth, J G Hardman
In this article, we will discuss the pathophysiology of peripheral nerve injury in anaesthetic practice, including factors which increase the susceptibility of nerves to damage. We will describe a practical and evidence-based approach to the management of suspected peripheral nerve injury and will go on to discuss major nerve injury patterns relating to intra-operative positioning and to peripheral nerve blockade. We will review the evidence surrounding particular strategies to reduce the incidence of peripheral nerve injury during nerve blockade, including nerve localisation methods, timing of blocks, needle techniques and design, injection pressure-monitoring and local anaesthetic and adjunct choice...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29313881/stiripentol-for-the-treatment-of-super-refractory-status-epilepticus-with-cross-sensitivity
#11
Y Uchida, K Terada, Y Madokoro, T Fujioka, M Mizuno, T Toyoda, D Kato, N Matsukawa
BACKGROUND: Cross-sensitivity of rash has been reported between various antiepileptic drugs (AEDs). However, few studies have determined the frequency and management of cross-sensitivity in patients with super-refractory status epilepticus (SRSE). AIMS OF THE STUDY: To examine the optimal AED for treating SRSE with cross-sensitivity. METHODS: We performed a retrospective review of adult patients with SRSE treated at Nagoya City University Hospital, in which we investigated the frequency of cross-sensitivity among patients with SRSE and their clinical and medical profiles...
January 3, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29304181/public-opinion-towards-castration-without-anaesthesia-and-lack-of-access-to-pasture-in-beef-cattle-production
#12
Dayane Lemos Teixeira, Rafael Larraín, Oscar Melo, María José Hötzel
Recent publications have shown that citizens in developing nations are gaining interest in farm animal welfare. The aims of this study were to assess the opinion of Chilean citizens about surgical castration without anaesthesia and lack of access to pasture in beef cattle production, to investigate how involvement in livestock production influences opinions, and to evaluate if different types of information would affect their opinion towards these management practices. The study was carried out in the Metropolitan Region of Santiago, Chile, and consisted of two surveys with 400 participants in each study...
2018: PloS One
https://www.readbyqxmd.com/read/29300271/obstructive-sleep-apnoea-in-adults-peri-operative-considerations-a-narrative-review
#13
Martin Roesslein, Frances Chung
: Obstructive sleep apnoea (OSA) is a common breathing disorder of sleep with a prevalence increasing in parallel with the worldwide rise in obesity. Alterations in sleep duration and architecture, hypersomnolence, abnormal gas exchange and also associated comorbidities may all feature in affected patients.The peri-operative period poses a special challenge for surgical patients with OSA who are often undiagnosed, and are at an increased risk for complications including pulmonary and cardiovascular, during that time...
January 2, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29299973/how-anaesthesiologists-understand-difficult-airway-guidelines-an-interview-study
#14
Kati Knudsen, Ulrika Pöder, Ulrica Nilsson, Marieann Högman, Anders Larsson, Jan Larsson
BACKGROUND: In the practice of anaesthesia, clinical guidelines that aim to improve the safety of airway procedures have been developed. The aim of this study was to explore how anaesthesiologists understand or conceive of difficult airway management algorithms. METHODS: A qualitative phenomenographic design was chosen to explore anaesthesiologists' views on airway algorithms. Anaesthesiologists working in three hospitals were included. Individual face-to-face interviews were conducted...
January 4, 2018: Upsala Journal of Medical Sciences
https://www.readbyqxmd.com/read/29295777/hereditary-haemorrhagic-telangiectasia-in-pregnancy-regional-and-general-anaesthesia
#15
M Crawford, R Burns, S Cooper, T Mackay
Hereditary haemorrhagic telangiectasia, also known as Osler-Weber-Rendu disease, is a rare autosomal dominant multisystem disorder, characterised by mucocutaneous telangiectases and arteriovenous malformations affecting any organ. The physiological changes in pregnancy pose significant obstetric and anaesthetic challenges for women affected by the disease. The optimal timing and mode of delivery requires careful consideration; and the benefits and risks of both regional and general anaesthetic techniques must be carefully considered, depending on the organs affected...
November 13, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29286529/unanticipated-difficult-airway-management-in-children-the-consensus-statement-of-the-paediatric-anaesthesiology-and-intensive-care-section-and-the-airway-management-section-of-the-polish-society-of-anaesthesiology-and-intensive-therapy-and-the-polish-so
#16
Wojciech Walas, Dawid Aleksandrowicz, Maria Borszewska-Kornacka, Tomasz Gaszyński, Ewa Helwich, Marek Migdał, Andrzej Piotrowski, Grażyna Siejka, Tomasz Szczapa, Alicja Bartkowska-Śniatkowska
Tracheal intubation may be defined as an artificial airway established in order to provide mechanical ventilation of the lungs during surgical procedures under general anaesthesia, treatment in an intensive care unit, as well as in emergency situations. Difficulties encountered during intubation may cause hypoxia, hypoxic brain injury and, in extreme situations, may result in the patient's death. There may be unanticipated and anticipated difficult airway. Children form a specific group of patients as there are significant differences in both anatomy and physiology...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29284856/proseal-laryngeal-mask-airway-versus-cuffed-endotracheal-tube-for-laparoscopic-surgical-procedures-under-general-anesthesia-a-random-comparative-study
#17
Suchita Shailesh Parikh, Shivam Bipin Parekh, Chaula Doshi, Varsha Vyas
Context: The Proseal LMA(PLMA), which has been designed especially for positive pressure ventilation and protection against aspiration can act as an alternative to Endotracheal Tube (ETT) as an effective airway device for patients undergoing elective Laparoscopic surgeries. Aims: To compare the efficacy and safety of PLMA with ETT in patients undergoing Laparoscopic surgeries under general anaesthesia. Settings and Design: A prospective, randomized study was conducted in a tertiary care teaching hospital with 60 patients of ASA grade I/II undergoing elective Laparoscopic surgery under general anaesthesia...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284075/atraumatic-restorative-treatment-versus-conventional-restorative-treatment-for-managing-dental-caries
#18
REVIEW
Mojtaba Dorri, Maria José Martinez-Zapata, Tanya Walsh, Valeria Cc Marinho, Aubrey Sheiham Deceased, Carlos Zaror
BACKGROUND: Dental caries is a sugar-dependent disease that damages tooth structure and, due to loss of mineral components, may eventually lead to cavitation. Dental caries is the most prevalent disease worldwide and is considered the most important burden of oral health. Conventional treatment methods (drill and fill) involve the use of rotary burs under local anaesthesia. The need for an electricity supply, expensive handpieces and highly trained dental health personnel may limit access to dental treatment, especially in underdeveloped regions...
December 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29249272/successful-spinal-anaesthesia-in-a-patient-with-a-tarlov-cyst
#19
N Pfund, A Oh, A Cyna
Perineural (Tarlov) cysts are cerebrospinal fluid-containing perineural sacs that are usually located in the sacral spine. While often asymptomatic, they can cause progressive neurological symptoms including pain, paraesthesia and weakness. We present a case of a 24-year-old patient who had uneventful spinal anaesthesia at the L3-4 level for an elective caesarean section. Prior to her procedure, she had reported a two-year history of intermittent back pain and lower-limb paraesthesia, secondary to an S1 segment perineural cyst...
December 14, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29242749/setting-the-research-and-implementation-agenda-for-equitable-access-to-surgical-care-in-south-africa
#20
REVIEW
Sarah Rayne, Sule Burger, Stephanie Van Straten, Bruce Biccard, Mathume Joseph Phaahla, Martin Smith
South Africa is an upper-middle-income country with widespread social and geographical inequality of surgical provision. The National Forum on Surgery and Anaesthesia in South Africa brought together various stakeholders, including government, societies, academic clinicians and the biomedical industry, to define the core strategy for a national surgical plan. During the forum, presentations and breakaway workshops explored and reported the challenges and opportunities these stakeholders may have in sustaining and improving surgical provision in South Africa...
2017: BMJ Global Health
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