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https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#1
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306679/the-american-college-of-surgeons-children-s-surgery-verification-and-quality-improvement-program-implications-for-anesthesiologists
#2
Constance S Houck, Jayant K Deshpande, Randall P Flick
PURPOSE OF REVIEW: The Task Force for Children's Surgical Care, an ad-hoc multidisciplinary group of invited leaders in pediatric perioperative medicine, was assembled in May 2012 to consider approaches to optimize delivery of children's surgical care in today's competitive national healthcare environment. Over the subsequent 3 years, with support from the American College of Surgeons (ACS) and Children's Hospital Association (CHA), the group established principles regarding perioperative resource standards, quality improvement and safety processes, data collection, and verification that were used to develop an ACS-sponsored Children's Surgery Verification and Quality Improvement Program (ACS CSV)...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28298800/a-case-of-subclavian-artery-aneurysm-with-history-of-ischemic-heart-disease-operated-under-cervical-epidural-anesthesia
#3
Amrita Rath, J Abhinay, Sandeep Loha, Atul Kumar Singh
Subclavian artery aneurysm is usually operated under general anesthesia (GA), but in specific situations, it can also be conducted under regional anesthesia (RA) such as cervical epidural anesthesia (CEA). A 48-year-old male presented with chief complaint of progressive swelling in the right side of the neck for the past 3 months following trauma. He was diagnosed as subclavian artery aneurysm, and surgical intervention was advised. He had previous history of angina 4 months back for which tablet aspirin 75 mg and tablet clopidogrel 75 mg once daily was prescribed...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28290972/malignant-hyperthermia-susceptibility-and-fitness-for-duty
#4
Michael A Lee, Erin B McGlinch, Maria C McGlinch, John F Capacchione
INTRODUCTION: Malignant hyperthermia (MH) is an inherited hypermetabolic condition characterized by uncontrolled calcium release from the sarcoplasmic reticulum of skeletal muscle, usually from exposure to inhaled general anesthetics and/or the depolarizing neuromuscular blocking agent succinylcholine. Multiple case reports now reveal that crises may be precipitated by environmental factors such as exercise or high ambient temperatures. Common signs of an MH crisis include life-threatening hyperthermia, metabolic acidosis, muscle rigidity, and tachycardia...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28279774/conscious-sedation-versus-general-anesthesia-for-the-treatment-of-cerebral-aneurysms-with-flow-diversion-a-matched-cohort-study
#5
Christoph J Griessenauer, Hussain Shallwani, Nimer Adeeb, Raghav Gupta, Leonardo Rangel-Castilla, Adnan H Siddiqui, Elad I Levy, Myles D Boone, Ajith J Thomas, Christopher S Ogilvy
INTRODUCTION: Flow diversion has become a popular treatment option for a variety of cerebral aneurysms. We sought to compare conscious sedation and general anesthesia for flow diverter placement in a matched cohort study. MATERIALS AND METHODS: Patients who underwent flow diverter placement under conscious sedation were matched on the basis of age, sex, American Society of Anesthesiologists (ASA) classification, aneurysm location, and aneurysm size with patients who received general anesthesia...
March 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28261683/botox-combined-with-myofascial-release-physical-therapy-as-a-treatment-for-myofascial-pelvic-pain
#6
Gabriela E Halder, Lauren Scott, Allison Wyman, Nelsi Mora, Branko Miladinovic, Renee Bassaly, Lennox Hoyte
PURPOSE: To report the effects of combined onabotulinumtoxinA (Botox) injections and myofascial release physical therapy on myofascial pelvic pain (MFPP) by comparing pre- and posttreatment average pelvic pain scores, trigger points, and patient self-reported pelvic pain. Secondary outcomes were to examine posttreatment complications and determine demographic differences between patients with/without an improvement in pain. MATERIALS AND METHODS: This was an Institutional Review Board approved retrospective case series on women over 18 years with MFPP who received Botox and physical therapy between July 2006 and November 2014...
March 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28255948/what-adverse-events-and-injuries-are-cited-in-anesthesia-malpractice-claims-for-nonspine-orthopaedic-surgery
#7
Christopher D Kent, Linda S Stephens, Karen L Posner, Karen B Domino
BACKGROUND: Malpractice claims that arise during the perioperative care of patients receiving orthopaedic procedures will frequently involve both orthopaedic surgeons and anesthesiologists. The Anesthesia Closed Claims database contains anesthesia malpractice claim data that can be used to investigate patient safety events arising during the care of orthopaedic patients and can provide insight into the medicolegal liability shared by the two specialties. QUESTIONS/PURPOSES: (1) How do orthopaedic anesthetic malpractice claims differ from other anesthesia claims with regard to patient and case characteristics, common events and injuries, and liability profile? (2) What are the characteristics of patients who had neuraxial hematomas after spinal and epidural anesthesia for orthopaedic procedures? (3) What are the characteristics of patients who had orthopaedic anesthesia malpractice claims for central ischemic neurologic injury occurring during shoulder surgery in the beach chair position? (4) What are the characteristics of patients who had malpractice claims for respiratory depression and respiratory arrests in the postoperative period? METHODS: The Anesthesia Closed Claims Project database was the source of data for this study...
March 2, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28255469/differential-diagnosis-of-parotid-lipoma-in-a-breast-ca-patient
#8
Melda Misirlioglu, Yagmur Yilmaz Akyil, Mehmet Zahit Adisen, Alime Okkesim
Lipomas are common benign tumors usually detected on the torso, neck, upper thighs, and upper arms. However, they are rarely found in the parotid gland region. Because of their rarity at this site, they are not often considered in the differential diagnosis of parotid tumors. This report describes a rare case of a lipoma in the superficial lobe of parotid gland. A 71-year-old female patient admitted to our department complaining about swelling and pain in the posterior area of the left mandibular region since one month...
2017: Case Reports in Dentistry
https://www.readbyqxmd.com/read/28254101/electroacupuncture-assisted-craniotomy-on-an-awake-patient
#9
Amritpal Sidhu, Trushna Murgahayah, Vairavan Narayanan, Hari Chandran, Vicknes Waran
Although acupuncture has existed for over 2000 years, its application as an anesthetic aid began in the 1950s in China. The first surgical procedure performed under acupuncture anesthesia was a tonsillectomy. Soon thereafter, major and minor surgical procedures took place with electroacupuncture alone providing the anesthesia. The procedures performed were diverse, ranging from cardiothoracic surgery to dental extractions. Usage of acupuncture anesthesia, specifically in neurosurgery, has been well documented in hospitals across China, especially in Beijing, dating back to the 1970s...
January 2017: Journal of Acupuncture and Meridian Studies
https://www.readbyqxmd.com/read/28250606/successful-removal-of-foreign-body-bronchus-using-c-arm-guided-insertion-of-fogarty-catheter-through-plastic-bead
#10
Ravindra Ganuji Wankhede, Gaurab Maitra, Subhabrata Pal, Anirban Ghoshal, Soumen Mitra
Foreign body aspiration is still a cause of significant morbidity in children. Complications occur due to difficulty in diagnosis and treatment. An eight-year-old child presented with a history of recurrent cough for 3 days. Rigid bronchoscopy under general anesthesia revealed plastic bead occupying right main bronchus. Removal with grasping forceps failed for several times due to spherical, smooth, and large bead. Finally, Fogarty catheter was passed through bead under C-arm guidance and successfully removed...
February 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28247115/pregnancy-and-delivery-after-myelomeningocele-repair-ventriculoperitoneal-shunt-implantation-and-augmentation-cystoplasty
#11
Masahiro Kameda, Etsuko Takahara, Motomu Kobayashi, Katsumi Sasaki, Ryuta Morihara, Isao Date
INTRODUCTION: Management of pregnancy and delivery of a patient with a history of myelomeningocele requires a multidisciplinary team approach. CASE REPORT: We report a case of pregnancy and delivery by a patient who had a history of myelomeningocele surgical repair, ventriculoperitoneal (VP) shunt, and bladder augmentation enterocystoplasty. Regarding types of delivery style, anesthesiologists recommended a Cesarean section under general anesthesia. However, urologists recommended a vaginal delivery because they were concerned that she would require a nephrostomy because of severe adhesion between her uterus and the neobladder if she had a Cesarean section...
February 28, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28244622/perioperative-considerations-for-the-food-allergic-pediatric-patient
#12
REVIEW
Patrick G Fernandez, Marco Mikhael
Patients with a history of food allergy and food intolerance are common in the pediatric population and are encountered frequently in the perioperative setting by pediatric anesthesiologists. Perioperatively, food allergy can present on a spectrum ranging from minor acute urticaria to more severe hypovolemia and anaphylactic shock. Allergy to foods including fruits, fish, egg, soy, and peanut are most concerning for their potential to cross-react with perioperative medications. There is little in the anesthesia literature that focuses on the perioperative management of children with food allergies...
February 28, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28238392/quantitative-representation-of-eustachian-tube-component-movements-during-swallowing
#13
Selma Cetin, Miriam S Teixeira, Cuneyt M Alper
OBJECTIVE: Describes a method of dynamic video-endoscopy of the Eustachian tube (ET) orifice at the nasopharynx to quantitatively represent ET component movements during swallowing using a graphic function and analyze their importance to its opening mechanics. METHODS: This was a pilot study of relational event capture using a polar coordinate system applied to trans-nasal video-endoscopic recordings of the ET during 3 swallows in 5 adults. After topical anesthesia of the nose, a 45° telescope was introduced unilaterally and focused on the ipsilateral ET orifice...
February 18, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28235538/perioperative-opioid-administration-in-children-with-and-without-developmental-delay-undergoing-outpatient-dental-surgery
#14
Erin R Conner, Erica D Musser, Kelsey M Colpitts, Dean L Laochamroonvorapongse, Jeffrey L Koh
STUDY OBJECTIVE: Prior research has indicated that children with developmental delay (DD) experience qualitative and quantitative differences in health care (Boulet et al., 2009). In the perioperative setting, there is concern that children with DD may be more likely to experience postoperative complications including agitation and nausea/vomiting than typically developing patients (TDP). Differences in the administration and dosage of perioperative opioids may contribute to this, however, empirical investigations are lacking...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28219086/first-report-of-awake-craniotomy-of-a-famous-musician-suprasellar-tumor-surgery-of-pianist-clara-haskil-in-1942
#15
Elena Romana Gasenzer, Ayhan Kanat, Edmund A M Neugebauer
Clara Haskil (January 7, 1895-December 7, 1960) was one of the most famous female pianists of the 20th century. In her life and work she set new standards in piano playing. However, her career was beset by poor health and the adversities of two world wars. In her lifetime Haskil had three major disorders: juvenile scoliosis requiring treatment in her adolescence, a tumor of the sellar region requiring surgery at age 47 years, and a traumatic brain injury causing her death at the age of 65. Her medical history illustrates the development of surgical methods and rehabilitation in medicine before and after World War II...
February 20, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28217067/septo-optic-dysplasia-de-morsier-s-syndrome
#16
Pedro Reis, Joana Mourão
Septo-optic dysplasia (SOD)/de Morsier's syndrome is characterized by optic nerve hypoplasia, pituitary endocrine dysfunction, and midline brain abnormalities. Hypopituitarism, hypothyroidism, hypogonadism, and adrenal insufficiency can lead to severe hypoglycemia, adrenal crisis, seizures, and sudden death. Anesthetic management of SOD was associated with high perioperative mortality. A 9-year-old male child proposed for dental treatments/extractions. Medical history of SOD with hypopituitarism, hypothyroidism, and delayed psychomotor development was observed...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28217065/unsuspected-subglottic-web-in-a-child-managed-for-severe-respiratory-obstruction
#17
Reena, Arun Kumar, Shrawin Kumar Singh, Vineet Agrawal
Subglottic stenosis is a known complication of a traumatic and prolonged intubation. In a child, subglottic area is narrower and more prone to damage by an oversized or overinflated endotracheal tube. The stenosis can present with complaints of change in voice, croup, or respiratory obstruction. Those presenting with respiratory obstruction require immediate diagnosis under direct laryngoscopy and timely corrective intervention under general anesthesia. A 4-year-old child came to the emergency department with severe respiratory obstruction...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28216859/prevalence-of-phantom-limb-pain-stump-pain-and-phantom-limb-sensation-among-the-amputated-cancer-patients-in-india-a-prospective-observational-study
#18
Arif Ahmed, Sushma Bhatnagar, Seema Mishra, Deepa Khurana, Saurabh Joshi, Syed Mehmood Ahmad
INTRODUCTION: The phantom limb pain (PLP) and phantom limb sensation (PLS) are very common among amputated cancer patients, and they lead to considerable morbidity. In spite of this, there is a lack of epidemiological data of this phenomenon among the Asian population. This study was done to provide the data from Indian population. METHODS: The prevalence of PLP, stump pain (SP), and PLS was prospectively analyzed from the amputated cancer patients over a period of 2 years in Dr...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28214338/sciatic-neuropathy-due-to-popliteal-fossa-nerve-block
#19
Adam Aubuchon, W David Arnold, Anna Bracewell, J Chad Hoyle
INTRODUCTION: Sciatic neuropathy following popliteal nerve block (PNB) for regional anesthesia is considered uncommon but has been increasingly recognized in the literature. We identified a case of sciatic neuropathy that occurred after bunionectomy during which a PNB had been performed. METHODS: To understand the frequency of PNB-related sciatic neuropathy we performed a retrospective review of sciatic neuropathies at our center over a five year period. RESULTS: Forty-five cases of sciatic neuropathy were reviewed...
February 18, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28213848/intraoperative-blood-pressure-changes-during-cemented-versus-uncemented-bipolar-hemiarthroplasty-for-displaced-femoral-neck-fracture-a-multi-center-cohort-study-the-effect-of-bone-cement-for-bipolar-hemiarthroplasty-in-elderly-patients
#20
Shuichi Miyamoto, Junichi Nakamura, Satoshi Iida, Tomonori Shigemura, Shunji Kishida, Isao Abe, Munenori Takeshita, Yoshitada Harada, Sumihisa Orita, Seiji Ohtori
INTRODUCTION: The purpose of this study was to compare the cemented bipolar hemiarthroplasty with uncemented about the change of intraoperative blood pressure and the incidence of major complications in elderly patients with femoral neck fracture. MATERIALS AND METHODS: This multiple center prospective cohort study included only patients with acute displaced femoral neck fracture (Garden stage III or IV). All patients were treated with cemented or uncemented bipolar hemiarthroplasty using modified Hardinge or Watson-Jones approach in the lateral decubitus position...
February 17, 2017: Archives of Orthopaedic and Trauma Surgery
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