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Regional, anesthesia

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https://www.readbyqxmd.com/read/28344528/surgical-approach-and-anesthetic-modality-for-carpal-tunnel-release-a-nationwide-database-study-with-health-care-cost-implications
#1
Brock D Foster, Lakshmanan Sivasundaram, Nathanael Heckmann, Jeremiah R Cohen, William C Pannell, Jeffrey C Wang, Alidad Ghiassi
Background: Carpal tunnel release (CTR) is commonly performed for carpal tunnel syndrome once conservative treatment has failed. Operative technique and anesthetic modality vary by surgeon preference and patient factors. However, CTR practices and anesthetic trends have, to date, not been described on a nationwide scale in the United States. Methods: The PearlDiver Patient Records Database was used to search Current Procedural Terminology codes for elective CTR from 2007 to 2011. Anesthetic modality (eg, general and regional anesthesia vs local anesthesia) and surgical approach (eg, endoscopic vs open) were recorded for this patient population...
March 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#2
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting.:  Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective.:  To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
October 6, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28337530/chronic-sialadenitis-due-to-the-stone-inside-the-accessory-duct-of-submandibular-gland
#3
Murat Binar, Mert Cemal Gokgoz, Umit Aydin, Ibrahim Yavan, Serdar Karahatay
PURPOSE: Sialolithiasis is the most common cause of chronic sialadenitis. In this case report, intraoperative finding of an accessory submandibular duct, obstructed with stone, originating from the same gland nearby the main Warthon's duct, is presented. CASE REPORT: A 22-year-old male patient, suffering from eating-related pain and swelling in his left submandibular region, was diagnosed with left sublandibular gland sialadenitis with radiologically manifested sialolithiasis, and gland excision was advised...
March 23, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28333442/photoaffinity-ligand-for-the-inhalational-anesthetic-sevoflurane-allows-mechanistic-insight-into-potassium-channel-modulation
#4
Kellie A Woll, Wesley Peng, Qiansheng Liang, Lianteng Zhi, Jack A Jacobs, Lina Maciunas, Natarajan Bhanu, Benjamin A Garcia, Manuel Covarrubias, Patrick J Loll, William P Dailey, Roderic G Eckenhoff
Sevoflurane is a commonly used inhaled general anesthetic. Despite this, its mechanism of action remains largely elusive. Compared to other anesthetics, sevoflurane exhibits distinct functional activity. In particular, sevoflurane is a positive modulator of voltage-gated Shaker-related potassium channels (Kv1.x), which are key regulators of action potentials. Here, we report the synthesis and validation of azisevoflurane, a photoaffinity ligand for the direct identification of sevoflurane binding sites in the Kv1...
March 23, 2017: ACS Chemical Biology
https://www.readbyqxmd.com/read/28331362/anesthesia-for-the-patient-undergoing-total-knee-replacement-current-status-and-future-prospects
#5
REVIEW
Zachary A Turnbull, Dahniel Sastow, Gregory P Giambrone, Tiffany Tedore
Total knee arthroplasty (TKA) has become one of the most common orthopedic surgical procedures performed nationally. As the population and surgical techniques for TKAs have evolved over time, so have the anesthesia and analgesia used for these procedures. General anesthesia has been the dominant form of anesthesia utilized for TKA in the past, but regional anesthetic techniques are on the rise. Multiple studies have shown the potential for regional anesthesia to improve patient outcomes, such as a decrease in intraoperative blood loss, length of stay, and patient mortality...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28328616/borderline-tuberculoid-leprosy-masquerading-as-granuloma-annulare-a-clinical-and-histological-pitfall
#6
Tian Hao Zhu, Faranak Kamangar, Marc Silverstein, Maxwell A Fung
INTRODUCTION: Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae, an intracellular acid-fast bacillus that tends to infect the skin and peripheral nerves. Because of the wide array of cutaneous manifestation, diagnosis is not always straightforward, especially in nonendemic regions of the world such as the United States. CASE REPORT: The authors report an unusual case of borderline tuberculoid leprosy in an 80-year-old white woman from California...
April 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/28328587/bedside-breath-wise-visualization-of-bronchospasm-by-electrical-impedance-tomography-could-improve-perioperative-patient-safety-a-case-report
#7
Pedro de la Oliva, Andreas D Waldmann, Stephan H Böhm, Cristina Verdú-Sánchez, Antonio Pérez-Ferrer, Elena Alvarez-Rojas
Bronchospasm appears in up to 4% of patients with obstructive lung disease or respiratory infection undergoing general anesthesia. Clinical examination alone may miss bronchospasm. As a consequence, subsequent (mis)treatment and ventilator settings could lead to pulmonary hyperinflation, hypoxia, hypercapnia, hypotension, patient-ventilator asynchrony, volutrauma, or barotrauma. Electrical impedance tomography (EIT), a new noninvasive technique, can potentially identify bronchospasms by determining regional expiratory time constants (τ) for each one of the pixels of a functional EIT image...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28328583/case-report-of-a-patient-with-idiopathic-hypersomnia-and-a-family-history-of-malignant-hyperthermia-undergoing-general-anesthesia-an-overview-of-the-anesthetic-considerations
#8
Sena Aflaki, Sally Hu, Rami A Kamel, Frances Chung, Mandeep Singh
The pathophysiologic underpinnings of idiopathic hypersomnia and its interactions with anesthetic medications remain poorly understood. There is a scarcity of literature describing this patient population in the surgical setting. This case report outlines the anesthetic considerations and management plan for a 55-year-old female patient with a known history of idiopathic hypersomnia undergoing an elective shoulder arthroscopy in the ambulatory setting. In addition, this case offers a unique set of considerations and conflicts related to the patient having a family history of malignant hyperthermia...
March 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28327904/the-cost-of-brain-surgery-awake-vs-asleep-craniotomy-for-perirolandic-region-tumors
#9
Chikezie I Eseonu, Jordina Rincon-Torroella, Karim ReFaey, Alfredo Quiñones-Hinojosa
BACKGROUND: Cost effectiveness has become an important factor in the health care system, requiring surgeons to improve efficacy of procedures while reducing costs. An awake craniotomy (AC) with direct cortical stimulation (DCS) presents one method to resect eloquent region tumors; however, some authors assert that this procedure is an expensive alternative to surgery under general anesthesia (GA) with neuromonitoring. OBJECTIVE: To evaluate the cost effectiveness and clinical outcomes between AC and GA patients...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327900/awake-craniotomy-vs-craniotomy-under-general-anesthesia-for-perirolandic-gliomas-evaluating-perioperative-complications-and-extent-of-resection
#10
Chikezie I Eseonu, Jordina Rincon-Torroella, Karim ReFaey, Young M Lee, Jasvinder Nangiana, Tito Vivas-Buitrago, Alfredo Quiñones-Hinojosa
BACKGROUND: A craniotomy with direct cortical/subcortical stimulation either awake or under general anesthesia (GA) present 2 approaches for removing eloquent region tumors. With a reported higher prevalence of intraoperative seizures occurring during awake resections of perirolandic lesions, oftentimes, surgery under GA is chosen for these lesions. OBJECTIVE: To evaluate a single-surgeon's experience with awake craniotomies (AC) vs surgery under GA for resecting perirolandic, eloquent, motor-region gliomas...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28326794/urothelial-tumors-and-dual-band-imaging-a-new-concept-in-confocal-laser-endomicroscopy
#11
Arnaud Marien, Aurélien Rock, Khaled El Maadarani, Catherine Francois, Pierre Gosset, Brigitte Mauroy, Jean-Louis Bonnal
OBJECTIVES: Confocal laser endomicroscopy (CLE) uses a low-energy laser light source to obtain microscopic histology images of bladder tissue exposed to a fluorescent dye. To evaluate the feasibility of using CLE with two fluorophores: fluorescein (FLUO) and hexylaminolevulinate (HAL) to determine histologic and cytologic bladder cancer criteria. METHODS: Patients eligible for HAL-photodynamic diagnosis-assisted transurethral resection of bladder tumor were included...
March 22, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28326663/a-morphometric-study-of-the-canine-skull-and-periorbita-and-its-implications-for-regional-ocular-anesthesia
#12
Paulo Roberto Klaumann, Juan Carlos Duque Moreno, Fabiano Montiani-Ferreira
OBJECTIVE: A hypothetical relationship between canine cranial length and the length of the periorbita could be used for intraconal anesthetic volume estimation. STUDY SUBJECTS: Forty-one canine cadaver heads and one macerated dog skull. PROCEDURES: Inion and nasion points were recognized in the macerated skull and used as landmarks for cranial length measure. Thirty cadavers classified as dolichocephalic, mesaticephalic and brachycephalic were distributed in three study groups...
March 22, 2017: Veterinary Ophthalmology
https://www.readbyqxmd.com/read/28321983/chloroprocaine-for-epidural-anesthesia-in-infants-and-children
#13
REVIEW
Giorgio Veneziano, Joseph D Tobias
Continuous epidural infusions are an effective and safe method of providing anesthesia and postoperative analgesia in infants and children with multiple advantages over systemic medications, including earlier tracheal extubation, decreased perioperative stress response, earlier return of bowel function, and decreased exposure to volatile anesthetic agents with uncertain long-term neurocognitive effects. Despite these benefits, local anesthetic toxicity remains a concern in neonates and infants because of their decreased metabolic capacity for amide local anesthetics...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28319187/the-impact-of-high-grade-glial-neoplasms-on-human-cortical-electrophysiology
#14
S Kathleen Bandt, Jarod L Roland, Mrinal Pahwa, Carl D Hacker, David T Bundy, Jonathan D Breshears, Mohit Sharma, Joshua S Shimony, Eric C Leuthardt
OBJECTIVE: The brain's functional architecture of interconnected network-related oscillatory patterns in discrete cortical regions has been well established with functional magnetic resonance imaging (fMRI) studies or direct cortical electrophysiology from electrodes placed on the surface of the brain, or electrocorticography (ECoG). These resting state networks exhibit a robust functional architecture that persists through all stages of sleep and under anesthesia. While the stability of these networks provides a fundamental understanding of the organization of the brain, understanding how these regions can be perturbed is also critical in defining the brain's ability to adapt while learning and recovering from injury...
2017: PloS One
https://www.readbyqxmd.com/read/28315459/dynamic-reorganization-of-intrinsic-functional-networks-in-the-mouse-brain
#15
Joanes Grandjean, Maria Giulia Preti, Thomas A W Bolton, Michaela Buerge, Erich Seifritz, Christopher R Pryce, Dimitri Van De Ville, Markus Rudin
Functional connectivity (FC) derived from resting-state functional magnetic resonance imaging (rs-fMRI) allows for the integrative study of neuronal processes at a macroscopic level. The majority of studies to date have assumed stationary interactions between brain regions, without considering the dynamic aspects of network organization. Only recently has the latter received increased attention, predominantly in human studies. Applying dynamic FC (dFC) analysis to mice is attractive given the relative simplicity of the mouse brain and the possibility to explore mechanisms underlying network dynamics using pharmacological, environmental or genetic interventions...
March 14, 2017: NeuroImage
https://www.readbyqxmd.com/read/28306578/selective-low-volume-nerve-block-for-the-open-surgical-fixation-of-a-midshaft-clavicle-fracture-in-a-conscious-high-risk-patient-a-case-report
#16
Carlos I Salvadores de Arzuaga, José M Naya Sieiro, Oscar Salmeron Zafra, Miguel A González Posada, Esther Marquez Martínez
We report a case of successful intraoperative management using only low-volume regional anesthesia for the open surgical fixation of a traumatic clavicle fracture in a conscious 69-year-old man with severe chronic obstructive pulmonary disease. To avoid general anesthesia, we provided low-volume C5 and C6 nerve root blocks along with a superficial cervical plexus block using only 9 mL of anesthetic solution to avoid the often encountered complications of higher volume injections. Throughout the procedure, the patient remained comfortable and cooperative with stable hemodynamics and respiration...
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28303363/test-retest-reliability-of-scotopic-full-field-electroretinograms-in-rabbits
#17
Jan Luebke, Alexandra Anton, Michael Bach
PURPOSE: To explore test-retest reliability of standard scotopic full-field ERG measurements in New Zealand White rabbits. The ERG is widely used for testing of retinal integrity after any ocular treatment. We here present detailed stimulus-response dependencies for single healthy and untreated animals, concentrating on test-retest reproducibility. MATERIALS AND METHODS: Five New Zealand White rabbits (aged 8-10 weeks, weight about 2.0-2.5 kg) underwent binocular ERG measurements after intramuscular anesthesia and pharmaceutical pupillary dilatation at a baseline day and 10 days later...
March 16, 2017: Documenta Ophthalmologica. Advances in Ophthalmology
https://www.readbyqxmd.com/read/28303086/anesthesia-provision-in-disasters-and-armed-conflicts
#18
REVIEW
Miguel Trelles Centurion, Rafael Van Den Bergh, Henry Gray
PURPOSE OF REVIEW: Disasters and armed conflicts are characterized by high numbers of trauma cases, and occur mainly in developing countries where the healthcare response is already impaired, resulting in an inadequate response. Aside of the trauma cases, other surgical health conditions are also still present and require urgent care. Surgical care needs are different from context to context and depend on local means and capabilities. RECENT FINDINGS: Doctors without Borders (MSF) has proven that even in precarious situations, safe administration of anesthesia is possible, and the "do no harm" principle can and must be upheld...
2017: Current Anesthesiology Reports
https://www.readbyqxmd.com/read/28298800/a-case-of-subclavian-artery-aneurysm-with-history-of-ischemic-heart-disease-operated-under-cervical-epidural-anesthesia
#19
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/28298799/case-of-neurological-complication-following-subarachnoid-block-in-a-patient-with-unsuspected-coagulopathy
#20
Arun Mathur, C Venkatesh Nagappa
Subarachnoid block (SAB) is an extensively used regional anesthesia technique for many surgeries. Neurological complications are rare following spinal anesthesia. We are reporting neurological complication in a patient the following appendectomy under SAB with unsuspected coagulopathy. The complication was noticed early and managed conservatively with a high dose of intravenous steroid and improved drastically in a short period.
January 2017: Anesthesia, Essays and Researches
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