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Anaesthesia management

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https://www.readbyqxmd.com/read/28812959/periocular-manifestations-of-trigeminal-trophic-syndrome-a-case-series-and-literature-review
#1
Katherine A McVeigh, Morag Adams, Richard Harrad, Rebecca Ford
Trigeminal trophic syndrome (TTS) is a condition whereby persistent facial ulceration presents consequent to central or peripheral insult to the trigeminal nerve. Lesions are created by repetitive self-inflicted manipulation and trauma of dysaesthetic skin within the trigeminal dermatome. We discuss four cases with aetiologies varied from presumed microvascular compromise to resection of cerebral meningioma, cerebrovascular accident, and herpes zoster ophthalmicus. We discuss the management of the under-recognised associated periocular skin ulcerations that result from physical manipulation of dysesthic skin and prove to be persistent and challenging to treat...
August 16, 2017: Orbit
https://www.readbyqxmd.com/read/28805235/how-do-singapore-patients-view-post-anaesthesia-adverse-outcomes-a-single-centre-willingness-to-pay-study
#2
Xinqi Look, May Un Sam Mok, Yan Sheng Tay, Hairil Rizal Abdullah
INTRODUCTION: Knowing how patients value quality of anaesthesia helps anaesthesiologists to customise their service. However, generalising findings from Western population-based willingness-to-pay (WTP) studies across different cultures and societies might overlook several important contextualised understandings of anaesthesia experience for Singapore patients. This study aimed to capture the Singapore perspective of undesired post-anaesthesia outcomes. METHODS: 132 patients recruited in the pre-anaesthetic evaluation clinic were given questionnaires describing ten possible post-anaesthetic outcomes to rank for undesirability and assign relative value through proportioning hypothetical SGD 100 to avoid their occurrence...
August 14, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28803651/using-national-hip-fracture-registries-and-audit-databases-to-develop-an-international-perspective
#3
Antony Johansen, David Golding, Louise Brent, Jacqueline Close, Jan-Erik Gjertsen, Graeme Holt, Ami Hommel, Alma B Pedersen, Niels Dieter Röck, Karl-Göran Thorngren
Hip fracture is the commonest reason for older people to need emergency anaesthesia and surgery, and leads to prolonged dependence for many of those who survive. People with this injury are usually identified very early in their hospital care, so hip fracture is an ideal marker condition with which to audit the care offered to older people by health services around the world. We have reviewed the reports of eight national audit programmes, to examine the approach used in each, and highlight differences in case mix, management and outcomes in different countries...
August 2, 2017: Injury
https://www.readbyqxmd.com/read/28802606/comparison-of-lma-supreme%C3%A2-with-i-gel%C3%A2-and-lma-proseal%C3%A2-in-children-for-airway-management-during-general-anaesthesia-a-meta-analysis-of-randomized-controlled-trials
#4
Sulagna Bhattacharjee, Anirban Som, Souvik Maitra
STUDY OBJECTIVE: A few randomized trials have compared LMA Supreme™ with LMA ProSeal™ and i-gel™ in children but their conclusions varied widely. This systematic review and meta analysis has compared the former device with the latter two devices. DESIGN: Meta-analysis and systematic review using the Mantel-Haenszel method and pooled mean difference using inverse variance method. SETTING: Meta-analysis of published prospective randomized controlled trials...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28801130/prospective-implementation-of-enhanced-recovery-after-surgery-protocols-to-radical-cystectomy
#5
Karl H Pang, Ruth Groves, Suresh Venugopal, Aidan P Noon, James W F Catto
BACKGROUND: Multimodal enhanced recovery after surgery (ERAS) regimens have improved outcomes from colorectal surgery. OBJECTIVE: We report the application of ERAS to patients undergoing radical cystectomy (RC). DESIGN, SETTING, AND PARTICIPANTS: Prospective collection of outcomes from consecutive patients undergoing RC at a single institution. INTERVENTION: Twenty-six components including prehabilitation exercise, same day admission, carbohydrate fluid loading, targeted intraoperative fluid resuscitation, regional local anaesthesia, cessation of nasogastric tubes, omitting oral bowel preparation, avoiding drain use, early mobilisation, chewing gum use, and audit...
August 8, 2017: European Urology
https://www.readbyqxmd.com/read/28791448/the-cost-of-providing-district-level-surgery-in-malawi
#6
Dennis Cornelissen, Gerald Mwapasa, Jakub Gajewski, Tracey McCauley, Eric Borgstein, Ruairi Brugha, Leon Bijlmakers
BACKGROUND: Three district hospitals in Malawi that provide essential surgery, which for many patients can be lifesaving or prevent disability, formed the setting of this costing study. METHODS: All resources used at district hospitals for the delivery of surgery were identified and quantified. The hospital departments were divided into three categories of cost centres-the final cost centre, intermediate and ancillary cost centres. All costs of human resources, buildings, equipment, medical and non-medical supplies and utilities were quantified and allocated to surgery through step-down accounting...
August 8, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28777159/icu-admission-after-surgery-who-benefits
#7
Sadia Ghaffar, Rupert M Pearse, Michael A Gillies
PURPOSE OF REVIEW: Death following surgery remains a major cause of death worldwide, and ICU admission following major surgery is considered a standard of care in many healthcare systems. However, ICU resources are finite and expensive, thus identifying those most likely to benefit is of great importance. RECENT FINDINGS: Advances in surgical and perioperative management have moved the focus of postoperative care to preventing complications and reducing duration of hospitalisation...
August 1, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28774246/iatrogenic-injuries-of-the-palmar-branch-of-the-median-nerve-following-volar-plate-fixation-of-the-distal-radius
#8
Deepak Samson, Dominic M Power
BACKGROUND: Our aims were to identify iatrogenous injuries to the palmar branch of the median nerve sustained during volar plate fixation of the distal radius, make the clinician aware of this relatively uncommon complication of distal radius fixation, to emphasise common threads in symptomatology and to propose an algorithm for evaluation and management. METHODS: Retrospectively interrogating our database over a 5 year period, the case records, neurophysiology records, operative records, therapy records were reviewed...
September 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28764270/feasibility-and-complications-of-spinal-anaesthesia-in-percutaneous-nephrolithotomy-our-experience
#9
Manoj Kamal, Pradeep Sharma, Geeta Singariya, Rajesh Jain
INTRODUCTION: Percutaneous Nephrolithotomy (PCNL) is the treatment modality used for the extraction of large renal stones, or multiple calculi or stones resistant to shock wave lithotripsy. The General Anaesthesia (GA) is the standard modality for PCNL. However, few studies conclude that Spinal Anaesthesia (SA) can be an alternative method of anaesthesia with similar incidence of complications. AIM: In our study we evaluated the feasibility of spinal anaesthesia in terms of intraoperative and postoperative results in patients undergoing PCNL...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28764269/analysis-of-clinical-indicators-of-quality-in-patients-with-endotracheal-intubation
#10
Sulochana Dash, Sreelatha Balasubramanian
INTRODUCTION: Quality and safety in anaesthesia is usually monitored by analysis of perioperative mortality-morbidity and are influenced by anaesthetic and non-anaesthetic factors. AIM: This study was conducted to analyse the incidence of clinical indicators of quality in endotracheally intubated patients undergoing general abdominal surgeries and obstetric and gynaecological procedures under general anaesthesia and to determine contributing factors for the same...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28761644/an-extensive-swelling-in-the-anterior-mandible-a-case-report
#11
Nikhil M Kurien, L K Surej Kumar, P B Uma, V Vivek, Anna P Joseph
INTRODUCTION: Glandular odontogenic cyst is a rare developmental odontogenic cyst, which often pose a challenge to diagnose it clinically. PRESENTATION OF A CASE: A 32 year old female patient was referred to the oral and maxillofacial surgery department with a chief complaint of a painless swelling in the anterior mandible, extending from mandibular left premolar to right first molar region, with fluctuancy and egg shell crackling at right premolar region. The associated teeth were firm...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28755885/supraclavicular-block-versus-interscalene-brachial-plexus-block-for-shoulder-surgery-a-meta-analysis-of-clinical-control-trials
#12
REVIEW
C W Guo, J X Ma, X L Ma, B Lu, Y Wang, A X Tian, L Sun, Y Wang, B C Dong, Y B Teng
BACKGROUND: The ultrasound-guided interscalene block (ISB) has been considered a standard technique in managing pain after shoulder surgery. However, this method was associated with the incidence of hemi-diaphragmatic paresis. In contrast to ISB, supraclavicular block (SCB) was suggested to provide effective anaesthesia for shoulder surgery with a low rate of side-effects. Thus, we performed a meta-analysis of randomised controlled trials (RCTs) to compare SCB with ISB for evaluating the efficacy and safety...
July 26, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28751978/intracerebral-haemorrhage-following-uncontrolled-autonomic-dysreflexia-post-suprapubic-catheter-placement-surgery
#13
Mazatulfazura Sf Salim, Mazlina Mazlan, Nazirah Hasnan
INTRODUCTION: We describe a case of intracerebral haemorrhage (ICH) following uncontrolled episodes of autonomic dysreflexia (AD) within 24 h of a minor urological procedure. CASE PRESENTATION: A 33-year-old active paraplegic patient T1 Association Impairment Scale A underwent an elective suprapubic catheter (SPC) placement for bladder management. The surgery was done under general anaesthesia and was uneventful. Four hours after surgery, he developed haematuria and multiple blood clots in the urine, which eventually caused blockage of the SPC and resulted in symptomatic AD...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28751003/follow-up-of-children-or-teenagers-with-paroxysmal-supraventricular-tachycardia-but-without-pre-excitation-syndrome
#14
Béatrice Brembilla-Perrot, Arnaud Olivier, Thibaut Villemin, Vladimir Manenti, Julie Vincent, Anne Moulin-Zinsch, Jean-Paul Lethor, Anne Tisserant, François Marçon, Sellal Jean Marc
BACKGROUND: Paroxysmal supraventricular tachycardia (SVT) is considered benign in children if the electrocardiogram in sinus rhythm is normal, but causes anxiety in parents, children and doctors. AIMS: To report on the clinical and electrophysiological data from children with SVT, their follow-up and management. METHODS: Overall, 188 children/teenagers (mean age 15±2.8 years) with a normal electrocardiogram in sinus rhythm were studied for SVT, and followed for 2...
July 24, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28744777/-recent-standards-in-management-of-obstetric-anesthesia
#15
REVIEW
Maximiliaan van Erp, Clemens Ortner, Stefan Jochberger, Klaus Ulrich Klein
The following article contains information not only for the clinical working anaesthesiologist, but also for other specialists involved in obstetric affairs. Besides a synopsis of a German translation of the current "Practice Guidelines for Obstetric Anaesthesia 2016" [1], written by the American Society of Anesthesiologists, the authors provide personal information regarding major topics of obstetric anaesthesia including pre-anaesthesia patient evaluation, equipment and staff at the delivery room, use of general anaesthesia, peridural analgesia, spinal anaesthesia, combined spinal-epidural anaesthesia, single shot spinal anaesthesia, and programmed intermittent epidural bolus...
July 25, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28743150/-anesthesiology-and-outcome-impact-of-the-perioperative-process
#16
Jörg Zieger, Helene A Häberle
In recent years, the role of the anesthesiologist has turned tremendously from the "anaesthesia doctor" into a perioperative physician and risk specialist. Patients are older, multimorbid, and are called up for more and more extensive surgery and interventions. Socioeconomic aspects have grown in importance. The anesthesiologist, paving the way for a good outcome, is involved in nearly all perioperative processes: preoperative evaluation, definition and optimization of preoperative and intraoperative conditions, management of modern intraoperative anesthesia as well as postoperative medically indicated, effective and efficient treatment of partially highly complex patients...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28743148/-impact-of-cardiac-anaesthesia-on-patient-outcome
#17
Martina Nowak-Machen
The perioperative management of complex patients in a highly technical and subspecialized environment is the domain of the cardiac anesthesiologist. Evidence suggests that hemodynamic management using goal directed hemodynamic therapy (GDHT) improves patient outcome. Organ protection remains a main concern during cardiac surgery using extracorporeal circulation. Mortality can be decreased when remote ischemic preconditioning techniques (RIPC) are being used. Neurological outcomes can be improved with near-infrared-spectometry (NIRS), volatile anesthetics increase myocardial protection through preconditioning and perioperative echocardiography increases overall patient survival...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28743147/-development-of-anaesthesia-related-mortality-and-impact-on-perioperative-outcome
#18
Peter Rosenberger, Berthold Drexler
Achievements in anaesthesiology form the basis for the tremendous development of surgical therapy. Reliable monitoring technology, which is scrutinized on a regular basis using checklists, is allowing anaesthesia at the borders of physiology. During the last decades, anaesthesia-related mortality has been decreasing considerably. Well-trained anaesthesiology staff, who considers patient- and procedure-specific risks in anaesthetic management, is of major importance. Furthermore, postoperative care in specialised units and intensive care wards is a key factor of improved patient outcome after surgery...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28735634/management-of-upper-and-lower-molars-that-are-displaced-into-the-neighbouring-spaces
#19
P Bozkurt, E Erdem
Our aim was to describe our experience of retrieval of accidental displacements of upper and lower molars into neighbouring anatomical spaces. Thirteen patients were evaluated retrospectively in terms of age, sex, affected side, jaw (mandible or maxilla), surgeon's experience, whether the extracted teeth had erupted, which portion of the tooth or teeth was displaced, the anatomical space into which the fragment was displaced, postoperative complaints, timing of the retrieval, type of anaesthesia, and surgical approach...
July 20, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28734706/emerging-minimally-invasive-treatment-options-for-male-lower-urinary-tract-symptoms
#20
REVIEW
Giuseppe Magistro, Christopher R Chapple, Mostafa Elhilali, Peter Gilling, Kevin T McVary, Claus G Roehrborn, Christian G Stief, Henry H Woo, Christian Gratzke
CONTEXT: Lower urinary tract symptoms (LUTS) are one of the most common and troublesome nonmalignant conditions affecting quality of life in aging men. A spectrum of established medical and surgical options is available to provide relief of bothersome LUTS. Both the adverse events of medication and the morbidity with surgical treatment modalities have to be counterbalanced against efficacy. Novel minimally invasive treatment options aim to be effective, ideally to be performed in an ambulatory setting under local anaesthesia and to offer a more favourable safety profile than existing reference techniques...
July 19, 2017: European Urology
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