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https://www.readbyqxmd.com/read/28727707/continuing-anti-thrombotic-medication-during-low-to-intermediate-risk-spinal-procedures-a-retrospective-evaluation
#1
Noud van Helmond, Wesley Day, Kenneth B Chapman
BACKGROUND: The current American Society of Regional Anesthesia (ASRA) guidelines recommend discontinuing anti-thrombotic therapy prior to any interventional spine procedures to decrease the incidence of bleeding complications. However, discontinuing anti-thrombotics may pose considerable danger in terms of cerebrovascular and cardiovascular events. Recent evidence suggests that some spinal interventions may still be performed safely with anti-thrombotics on board and some practitioners thus elect to continue certain anti-thrombotics for these procedures...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727704/evaluating-the-adjuvant-effect-of-dexamethasone-to-ropivacaine-in-transversus-abdominis-plane-block-for-inguinal-hernia-repair-and-spermatocelectomy-a-randomized-controlled-trial
#2
Robert Wegner, Duane Akwar, Sarah Guzman-Reyes, Greesha Pednekar, Rabail Chaudhry, Navneet Grewal, Naveen Kukreja, Omar L Mancillas, George W Williams, Omonele Nwokolo
BACKGROUND: The transversus abdominis plane (TAP) block is a relatively straightforward regional technique used for postoperative analgesia in patients undergoing abdominal surgeries. Various adjuvants have been used in past to prolong the duration of action of analgesia in peripheral nerve blocks. Several studies investigating the analgesic efficacy of dexamethasone added to local anesthetic agents, such as bupivacaine, have shown promising results. However, there are few studies comparing the efficacy of dexamethasone with ropivacaine...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727584/thoracic-epidural-catheter-placement-in-a-preoperative-block-area-improves-operating-room-efficiency-and-decreases-epidural-failure-rate
#3
Yehoshua Gleicher, Oskar Singer, Stephen Choi, Paul McHardy
BACKGROUND AND OBJECTIVES: The primary aim of this study was to review the impact of inserting thoracic epidural catheters in a preoperative block room setting on operating room efficiency. METHODS: We conducted a retrospective preintervention/postintervention review of thoracic epidurals inserted over a 12-month period. The review included 6 months of data prior to implementation of the regional anesthesia block room and 6 months of data following implementation...
July 20, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28727314/transperitoneal-rectus-sheath-block-and-transversus-abdominis-plane-block-for-laparoscopic-inguinal-hernia-repair-a-novel-approach
#4
Jun Nagata, Jun Watanabe, Masato Nagata, Yusuke Sawatsubashi, Masaki Akiyama, Takehide Tajima, Koichi Arase, Noritaka Minagawa, Takayuki Torigoe, Yoshifumi Nakayama, Reiko Horishita, Kentaro Kida, Kotaro Hamada, Keiji Hirata
INTRODUCTION: A laparoscopic approach for inguinal hernia repair is now considered the gold standard. Laparoscopic surgery is associated with a significant reduction in postoperative pain. Epidural analgesia cannot be used in patients with perioperative anticoagulant therapy because of complications such as epidural hematoma. As such, regional anesthetic techniques, such as ultrasound-guided rectus sheath block and transversus abdominis plane block, have become increasingly popular. However, even these anesthetic techniques have potential complications, such as rectus sheath hematoma, if vessels are damaged...
August 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28724861/carcinoma-of-maxillary-gingiva-with-non-specific-cervical-lymph-node-swelling
#5
Masashi Migita, Shiro Shigematsu, Hitoshi Ohata, Takahiko Shibahara
Swelling of the cervical lymph nodes may indicate lymphadenitis, malignant lymphoma, or metastasis. Lymph nodes larger than 10 mm on computed tomography (CT) are strongly indicative of postoperative metastasis from carcinoma. Here, we report a case of large, inflamed lymph nodes mimicking metastasis. The patient was a 76-year-old woman who experienced discomfort in the left-side maxillary gingiva commencing in August 2011. By September, the area had become painful, causing her to visit the Tokyo Dental College Chiba Hospital, at which time a 75×50-mm swollen ulcer was observed in the maxillary gingiva on the left side...
2017: Bulletin of Tokyo Dental College
https://www.readbyqxmd.com/read/28720187/experiences-with-regional-anesthesia-for-analgesia-during-prolonged-aeromedical-evacuation
#6
Jeffrey M Carness, Melissa A Wilson, Mark J Lenart, Danny E Smith, Susan F Dukes
INTRODUCTION: There is much debate regarding the appropriate analgesic management of patients undergoing medical evacuation following combat trauma. Our primary objective was to review the utility of regional anesthetic techniques in patients undergoing aeromedical evacuation following surgical limb amputation as treatment for combat trauma. METHODS: This study was conducted as an observational retrospective cohort whereby acutely injured amputee patients were identified via the U...
August 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28719457/regional-anesthesia-in-diabetic-peripheral-neuropathy
#7
Werner Ten Hoope, Marjolein Looije, Philipp Lirk
PURPOSE OF REVIEW: The aim of this review is to summarize recent relevant literature regarding regional anesthesia in the diabetic neuropathic patient and formulate recommendations for clinical practice. RECENT FINDINGS: Diabetic neuropathic nerves, but not nerves of diabetic patients per se, exhibit complex functional changes. As a result, they seem more sensitive to local anesthetics, and are more difficult to stimulate. When catheters are used postoperatively, diabetes is an independent risk factor for infection...
July 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28718350/tourniquet-deflation-prior-to-20-minutes-in-upper-extremity-intravenous-regional-anesthesia
#8
Richard W Gurich, Justin W Langan, Robert J Teasdall, Stephanie L Tanner, John L Sanders
BACKGROUND: Bier blocks, or intravenous regional anesthesia (IVRA), are a method of anesthesia for upper extremity surgeries. This study reports our experience with tourniquet deflation prior to 20 minutes with upper extremity IVRA. METHODS: This study was designed as a retrospective cohort analysis. Records, including intraoperative and immediate postoperative anesthesia notes, of 430 patients who underwent IVRA with an upper extremity Bier block and a corresponding tourniquet time of less than 20 minutes were reviewed...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28716961/the-structural-basis-of-large-scale-functional-connectivity-in-the-mouse
#9
Joanes Grandjean, Valerio Zerbi, Joshua Balsters, Nicole Wenderoth, Markus Rudina
Translational neuroimaging requires approaches and techniques that can bridge between multiple different species and disease states. One candidate method, which offers insights into the brain's functional connectivity (FC), is resting state fMRI (rs-fMRI). In both humans and non-human primates, patterns of functional connectivity (often referred to as the functional connectome) have been related to the underlying structural connectivity (structural connectome). Given the recent rise in pre-clinical neuroimaging of mouse models it is an important question whether the mouse functional connectome conforms to the underlying structural connectivity...
July 17, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28716684/a-comparison-of-retrobulbar-and-two-peribulbar-regional-anesthetic-techniques-in-dog-cadavers
#10
Yael Shilo-Benjamini, Peter J Pascoe, Erik R Wisner, Nili Kahane, Philip H Kass, David J Maggs
OBJECTIVE: To compare injectate distribution and likelihood of regional anesthesia to the orbit following retrobulbar (RB) or peribulbar (PB) injections in dog cadavers. STUDY DESIGN: Randomized, masked study. ANIMALS: Twenty-four dog cadavers (aged 5.5-17 years, 2.0-36.3 kg). METHODS: Orbits underwent one of three injection techniques with bupivacaine 0.5% and iohexol (1:1): ventrolateral RB injection (1-2 mL; 15 orbits), medial canthal PB injection (2-8 mL; PB-1; 16 orbits), or dorsomedial and ventrolateral PB injections (each 1-4 mL; PB-2; 16 orbits)...
April 13, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28716031/a-rare-case-of-intradural-and-extramedullary-epidermoid-cyst-after-repetitive-epidural-anesthesia-case-report-and-review-of-the-literature
#11
Haruki Funao, Norihiro Isogai, Kenshi Daimon, Yuichiro Mima, Hitoshi Sugiura, Takahiro Koyanagi, Masaya Nakamura, Morio Matsumoto, Ken Ishii
BACKGROUND: Spinal epidermoid cysts are benign tumors, which are rarely seen as an intradural extramedullary spinal cord tumor in the conus medullaris region. Acquired spinal epidermoid cysts are mostly caused by iatrogenic procedures, such as lumbar puncture, and the majority of acquired spinal epidermoid cysts have been reported below the L1 level, because lumbar puncture is usually performed around the iliac crest. Here, we report an extremely rare case of an epidermoid cyst that occurred as an intradural and extramedullary spinal cord tumor attached to the conus medullaris after repetitive epidural anesthesia...
July 17, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28713758/two-concurrent-large-epidermoid-cysts-in-sublingual-and-submental-region-resembling-plunging-ranula-report-of-a-rare-case
#12
Ranjan Kumar Sahoo, Pradyumna Kumar Sahoo, Debahuti Mohapatra, Santosh Subudhi
An elderly female patient presented to surgical outpatient clinic with complaint of gradual onset of painless submental and sublingual midline swellings for 6 months of duration. The swellings were noncompressible, nontranslucent, nonpulsatile, and nontender on palpation. Clinical diagnosis was plunging ranula or dermoid cysts. Ultrasound examination of sublingual swelling showed cystic lesion with particulate content. Submental swelling showed cystic swelling with few echogenic floating lobules inside suggesting possibility of epidermoid/dermoid cyst...
January 2017: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28713258/relationship-of-topology-multiscale-phase-synchronization-and-state-transitions-in-human-brain-networks
#13
Minkyung Kim, Seunghwan Kim, George A Mashour, UnCheol Lee
How the brain reconstitutes consciousness and cognition after a major perturbation like general anesthesia is an important question with significant neuroscientific and clinical implications. Recent empirical studies in animals and humans suggest that the recovery of consciousness after anesthesia is not random but ordered. Emergence patterns have been classified as progressive and abrupt transitions from anesthesia to consciousness, with associated differences in duration and electroencephalogram (EEG) properties...
2017: Frontiers in Computational Neuroscience
https://www.readbyqxmd.com/read/28708768/transcranial-cerebral-oxymetric-monitoring-reduces-brain-hypoxia-in-obese-and-elderly-patients-undergoing-general-anesthesia-for-laparoscopic-cholecystectomy
#14
Tomislav Ružman, Boris Mraović, Tatjana Šimurina, Danijela Gulam, Nataša Ružman, Maja Miškulin
The aims of this prospective, observational study were to evaluate the changes of the regional cerebral saturation (rSO2) measured by near-infrared spectroscopy during elective laparoscopic cholecystectomy under total intravenous anesthesia and the association between patient's characteristics and critical decline of rSO2. Hemodynamics, rSO2, and oxygen saturation were recorded in different time points: before the anesthesia (Tbas), 2 minutes after the induction (supine position) (Tind), 2 minutes after CO2 insufflation (supine) (TCO2), 10 minutes after CO2 insufflation (reverse Trendelenburg) (TrevT), and 2 minutes after deflation (supine) (Tpost)...
July 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28706621/pediatric-laparoscopy-and-adaptive-oxygenation-and-hemodynamic-changes
#15
Gloria Pelizzo, Veronica Carlini, Giulio Iacob, Noemi Pasqua, Giuseppe Maggio, Marco Brunero, Simonetta Mencherini, Annalisa De Silvestri, Valeria Calcaterra
Adaptive changes in oxygenation and hemodynamics are evaluated during pediatric laparoscopy. The children underwent laparoscopy (LAP Group, n=20) or open surgery (Open Group, n=10). Regional cerebral (rScO2) and peripheral oxygen saturation (SpO2), heart rate (HR), diastolic (DP) and systolic pressure (SP) were monitored at different intervals: basal (T0); anesthesia induction (T1); CO2PP insufflation (T2); surgery (T3); CO2PP cessation (T4); before extubation (T5). At T1, in both the LAP and Open groups significant changes in rScO2, DP and SP were recorded compared with T0; a decrease in SatO2 was also observed at T5...
June 26, 2017: Pediatric Reports
https://www.readbyqxmd.com/read/28706418/naringenin-prevents-experimental-liver-fibrosis-by-blocking-tgf%C3%AE-smad3-and-jnk-smad3-pathways
#16
Erika Hernández-Aquino, Natanael Zarco, Sael Casas-Grajales, Erika Ramos-Tovar, Rosa E Flores-Beltrán, Jonathan Arauz, Mineko Shibayama, Liliana Favari, Víctor Tsutsumi, José Segovia, Pablo Muriel
AIM: To study the molecular mechanisms involved in the hepatoprotective effects of naringenin (NAR) on carbon tetrachloride (CCl4)-induced liver fibrosis. METHODS: Thirty-two male Wistar rats (120-150 g) were randomly divided into four groups: (1) a control group (n = 8) that received 0.7% carboxy methyl-cellulose (NAR vehicle) 1 mL/daily p.o.; (2) a CCl4 group (n = 8) that received 400 mg of CCl4/kg body weight i.p. 3 times a week for 8 wk; (3) a CCl4 + NAR (n = 8) group that received 400 mg of CCl4/kg body weight i...
June 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28700368/regional-anesthesia-and-analgesia-in-cancer-care-is-it-time-to-break-the-bad-news
#17
Mir W Sekandarzad, André A J van Zundert, Chris W Doornebal, Markus W Hollmann
PURPOSE OF REVIEW: There is ongoing controversy regarding the tumor-protective effects of regional anesthesia in patients undergoing cancer surgery. Evidence of up-to-date systematic reviews will be presented alongside recent updates on the effects of opioids and local anesthetics. RECENT FINDINGS: In recent years, the literature regarding the effects of regional anesthesia techniques on cancer recurrence has raised many unanswered questions. Ongoing randomized controlled trials may not be able to shed light on the controversial discussion regarding the tumor protective effects of regional anesthesia because the expected effect size and event rate in those studies may be overstated...
July 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28699416/interview-with-david-tauben-university-of-washington-chief-of-the-division-of-pain-medicine
#18
David Tauben
Dr Tauben is Clinical Professor jointly appointed in the Departments of Medicine and Anesthesia & Pain Medicine, and is the Hughes M & Katherine G Blake Endowed Professor, board certified in both Internal Medicine and Pain Medicine. He is also University of Washington (UW) Director of Medical Student and Resident Education in Pain Medicine, and Medical Director of UW TelePain, a tele-video-conferencing program intended to provide innovative pain education and consultative support to a five-state northwest regional primary care providers...
July 12, 2017: Pain Management
https://www.readbyqxmd.com/read/28699371/minocycline-attenuates-high-mobility-group-box-1-translocation-microglial-activation-and-thalamic-neurodegeneration-after-traumatic-brain-injury-in-postnatal-day-17-rats
#19
Dennis William Simon, Rajesh K Aneja, Henry Alexander, Michael J Bell, Hulya Bayir, Patrick M Kochanek, Robert S B Clark
In response to cell injury the danger signal high mobility group box-1 (HMGB) is released, activating macrophages by binding pattern recognition receptors. We investigated the role of the anti-inflammatory drug minocycline in attenuating HMGB1 translocation, microglial activation, and neuronal injury in a rat model of pediatric traumatic brain injury (TBI). Postnatal day 17 Sprague-Dawley rats were subjected to moderate-severe controlled cortical impact (CCI). Animals were randomized to treatment with minocycline (90 mg/kg, i...
July 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28696947/regional-blocks-carried-out-during-general-anesthesia-or-deep-sedation-myths-and-facts
#20
Peter Marhofer
PURPOSE OF REVIEW: More patients will accept regional blocks if these are performed during sedation or general anesthesia. This review discusses regional anesthesia in sedated or anesthetized patients. RECENT FINDINGS: As complications of regional blocks are rare, regional anesthesia can be considered aswell-tolerated. Awake patients will notice only a minority of needle-to-nerve contacts, that renders the notion of a 'live monitor' obsolete. Using high-resolution ultrasound, the needle can be advanced to an extraepineural position for injection, thus strictly avoiding needle-to-nerve contact or intraepineural injection of local anesthetic...
July 10, 2017: Current Opinion in Anaesthesiology
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