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Anaesthesia management

Nehat Baftiu, Islam Krasniqi, Kastriot Haxhirexha, Rudin Domi
BACKGROUND: Tracheal extubations may be performed before or after awakening from anaesthesia. The advantage of extubation during anaesthesia may avoid all the unpleasant effects of fully awake extubation such as severe hypertension and tachycardia, malignant dysrhythmias, myocardial ischemia laryngospasm, and cough induced high intraocular and intracranial pressure. AIM: To show the current practice of performing extubations in Kosovo, as well as the advantage and disadvantage in performing this procedure in an awake patient or inpatient in light anaesthesia...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
Mustafa Kir, Gulay Kir
OBJECTIVE: Postoperative pain is a frequently problem after orthopedic procedures like hallux valgus surgery. The aim of this study was to evaluate whether ankle block improves early and mid-term functional outcomes and postoperative pain management after hallux valgus surgery in patients receiving general anesthesia. SUBJECTS AND METHODS: This randomized controlled trial investigated 60 patients who underwent hallux valgus surgery under general anesthesia. Patients were prospectively randomized into two groups; general anesthesia only (Group A) and ankle block added to general anesthesia (Group B)...
March 12, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Volker Gebhardt, Vera Zawierucha, Oliver Schöffski, Anke Schwarz, Christel Weiss, Marc D Schmittner
BACKGROUND: Both general and spinal anaesthesia with short-acting local anaesthetics are suitable and reliable for knee arthroscopy as an ambulatory procedure. Chloroprocaine (CP) 1% seems to be the ideal spinal local anaesthetic for this indication. OBJECTIVE: The aim of this study was to compare spinal anaesthesia using CP 1% with general for outpatient knee arthroscopy with regard to procedure times, occurrence of pain, patient satisfaction and recovery, and also costs...
March 7, 2018: European Journal of Anaesthesiology
A Pym, E Ben-Menachem
Postoperative nausea and vomiting (PONV) is a common and distressing problem for patients and increases the burden of care in post-anaesthesia care units (PACU). As such it has been a recent focus for quality improvement. Evidence-based guidelines have demonstrated the benefit of PONV risk stratification and prophylaxis, but may be underutilised in clinical practice. This prospective pre-/post-intervention study was conducted at an adult tertiary hospital in non-cardiac adult surgical patients at higher-risk of PONV...
March 2018: Anaesthesia and Intensive Care
Ann Lögde, Gudrun Rudolfsson, Roma Runesson Broberg, Anna Rask-Andersen, Robert Wålinder, Erebouni Arakelian
The lack of specialist nurses in operating theatres is a serious problem. The aim of this study was to describe reasons why specialist nurses in perioperative care chose to leave their workplaces and to describe the process from the thought to the decision. Twenty specialist nurses (i.e. anaesthesia, NA, and operating room nurses) from seven university- and county hospitals in Sweden participated in qualitative individual in-depth interviews. Data were analysed by systematic text condensation. We identified four themes of reasons why specialist nurses quitted their jobs: the head nurses' betrayal and dismissive attitude, and not feeling needed; inhumane working conditions leading to the negative health effects; not being free to decide about one's life and family life being more important than work; and, colleagues' diminishing behaviour...
March 6, 2018: International Journal for Quality in Health Care
Gerardo Cortese, Gabriele Sales, Giorgia Maiolo, Mario Morino, Martina Scanu, Luca Brazzi
BACKGROUND: The feasibility and safety of transanal endoscopic microsurgery (TEM) performed under spinal anaesthesia (SA) has been recently demonstrated. This retrospective study compared the differences in opioid consumption and postoperative recovery in patients undergoing TEM under GA and SA. METHODS: All consecutive patients who underwent TEM at 'Città della Salute e della Scienza' hospital of Turin (Italy) between January 2012 and December 2015 were enrolled...
March 7, 2018: Minerva Anestesiologica
Angela Briganti, Flavia Evangelista, Paola Centonze, Annaliso Rizzo, Francesco Bentivegna, Antonio Crovace, Francesco Staffieri
BACKGROUND: Haemodynamic variations normally occur in anaesthetized animals, in relation to the animal status, administered drugs, sympathetic and parasympathetic tone, fluid therapy and surgical stimulus. The possibility to measure some cardiovascular parameters, such as cardiac output (CO), during anaesthesia would be beneficial for both the anaesthesia management and its outcome. New techniques for the monitoring of CO are aimed at finding methods which are non invasive, accurate and with good trending ability, which can be used in a clinical setting...
March 6, 2018: BMC Veterinary Research
Susan C Lee, Megan E Atkinson, Charles G Minard, Alice O'Brien
BACKGROUND: Handovers in patient care are increasingly common occurrences in medicine and are highly susceptible to communication failures. Intraoperative anaesthesiology handovers are especially challenging because of concurrent management of the patient. Our goal was to develop and use an electronic handover checklist as an educational tool to teach anaesthesiology trainees a standardised method of handing over a case intraoperatively. We hypothesised that the use of the checklist would systematically enhance the transfer of accurate and complete information...
March 6, 2018: Clinical Teacher
Faith Jelagat Lelei-Mailu, Charles Muriuki Mariara
This case report is of a 32-year-old woman of African descent on follow-up for pregnancy in the background of portal hypertension due to liver cirrhosis. She had initially been treated for chronic hepatitis B infection with lamivudine and tenofovir, complicated by portal hypertension and variceal bleeding that thrice required banding. Her pregnancy was uneventful until 31 weeks gestation when she presented with dyspnoea. On examination and investigation, she had oedema, bilateral pleural effusions and ascites...
March 5, 2018: BMJ Case Reports
Karima Karam Khan, Robyna Irshad Khan
BACKGROUND: Pain after laparoscopic cholecystectomy is mild to moderate in intensity. Several modalities are employed for achieving safe and effective postoperative analgesia, the benefits of which adds to the early recovery of the patients. As a part of multimodal analgesia, various approaches of Transversus abdominis plane (TAP) block has been used for management of parietal and incisional components of pain after laparoscopic cholecystectomy. This study was designed to compare the analgesic efficacy of two different approaches of ultrasound guided TAP block, i...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Mário Moreira, Gabriel Anacleto, Óscar Gonçalves
Anastomotic aneurysm is a possible complication after arterial reconstruction with highest incidence at femoral anastomosis; open surgery is the standard treatment but endovascular exclusion can be useful in selected cases. The authors report a case of femoral anastomotic aneurysm, 19 years after aortobifemoral grafting, treated successfully using stents grafts, under local anaesthesia and percutaneous brachial access. Review of published papers regarding endovascular management of femoral anastomotic aneurysm were performed...
March 1, 2018: Annals of Vascular Surgery
Despina Afroditi Lalou, Marek Czosnyka, Joseph Donnelly, Andrea Lavinio, John D Pickard, Matthew Garnett, Zofia Czosnyka
OBJECTIVES: Slow waves of intracranial pressure (ICP) are spontaneous oscillations with a frequency of 0.3-4 cycles/min. They are often associated with pathological conditions, following vasomotor activity in the cranial enclosure. This study quantifies the effects of general anaesthesia (GA) on the magnitude of B-waves compared with natural sleep and the conscious state. MATERIALS AND METHODS: Four groups of 30 patients each were formed to assess the magnitude of slow waves...
2018: Acta Neurochirurgica. Supplement
Amar Nandhakumar, Amritha Nair, V Kiran Bharath, Sriraam Kalingarayar, Balaji P Ramaswamy, D Dhatchinamoorthi
Uncontrolled pain in patients with rib fracture leads to atelectasis and impaired cough which can progress to pneumonia and respiratory failure necessitating mechanical ventilation. Of the various pain modalities, regional anaesthesia (epidural and paravertebral) is better than systemic and oral analgesics. The erector spinae plane block (ESPB) is a new modality in the armamentarium for the management of pain in multiple rib fractures, which is simple to perform and without major complications. We report a case series where ESPB helped in weaning the patients from mechanical ventilation...
February 2018: Indian Journal of Anaesthesia
Lafi Olayan, Abdulaleem Alatassi, Jaimin Patel, Sherran Milton
Background: Airway management is a core clinical skill in anaesthesia. Pre-oxygenation prior to induction of anaesthesia is a standard practice to prevent desaturation. Apnoeic oxygenation in adults is effective and prolongs the time to desaturation. The effectiveness of apnoeic oxygenation in the adult is well documented; however, evidence in the paediatric is lacking. Therefore, the aim of this study was to investigate the effectiveness of apnoeic oxygenation during airway management in children...
2018: Perioperative Medicine
M Grindefjord, J Persson, L Jansson, G Tsilingaridis
AIM: This was to examine healthy children and adolescents treated under general anaesthesia (GA) and a matched control group not receiving GA to compare treatment and preventive care received prior to GA treatment. METHODS: This retrospective cohort study included 71 healthy subjects and 213 age- and gender-matched control subjects. The treatment group had been consecutively referred from the Public Dental Health Service (PDS) in Stockholm to the Department of Paediatric Dentistry, Eastman Institute, Stockholm during 2006-2007...
February 26, 2018: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
S A Colgan, L A Green
OBJECTIVE: To develop a technique for permanent sterilisation of female eastern grey kangaroos (Macropus giganteus) and red kangaroos (M. rufus) as part of a large-scale macropod management program on an enclosed 1545-ha site in western Sydney. METHODS: Free-ranging female kangaroos (n = 1409: 1285 eastern grey kangaroos, 124 red kangaroos) were anaesthetised via remote anaesthetic drug delivery of tiletamine/zolazepam, medetomidine and acepromazine prior to inhalational anaesthesia using isoflurane-oxygen...
March 2018: Australian Veterinary Journal
W S El Masri Y
The controversy about surgical vs conservative treatment of the injured spine with cord damage is centuries old. Until the end of the Second World War the majority of patients died or lived a short miserable life. Subsequently, Guttmann, an experienced neurosurgeon, realised surgery was not beneficial and sometimes detrimental to the person with spinal cord injury. Guttman, Frankel and others demonstrated with expert conservative management of the spine and the multi-system consequences of cord damage most patients made some neurological recovery and most with incomplete cord injury recovered ambulation regardless of X-ray findings...
2018: Spinal Cord Series and Cases
Jeremy Furyk, Robin Ray, Kerriane Watt, Stuart R Dalziel, Ed Oakely, Mark Mackay, Gabriel Dabscheck, Kate Riney, Franz E Babl
PURPOSE: Status epilepticus (SE) is a paediatric emergency with significant morbidity and mortality. Recommendations beyond first line care are not based on high quality evidence. Emergency physicians and neurologists are key stakeholders in managing this condition. A collaborative, widely consulted approach to identifying priorities can help direct limited research funds appropriately. The objectives of this study are to identify consensus research priorities in paediatric SE among experts and health consumers...
February 5, 2018: Seizure: the Journal of the British Epilepsy Association
Rajesh M Shetty, Antonio Bellini, Dhuleep S Wijayatilake, Mark A Hamilton, Rajesh Jain, Sunil Karanth, ArunKumar Namachivayam
BACKGROUND: Patients admitted to intensive care and on mechanical ventilation, are administered sedative and analgesic drugs to improve both their comfort and interaction with the ventilator. Optimizing sedation practice may reduce mortality, improve patient comfort and reduce cost. Current practice is to use scales or scores to assess depth of sedation based on clinical criteria such as consciousness, understanding and response to commands. However these are perceived as subjective assessment tools...
February 21, 2018: Cochrane Database of Systematic Reviews
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
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