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adjuvants general anesthesia

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https://www.readbyqxmd.com/read/27842565/regional-anesthesia-for-painful-injuries-after-disasters-rapid-study-protocol-for-a-randomized-controlled-trial
#1
Adam C Levine, Carrie Teicher, Adam R Aluisio, Tess Wiskel, Pola Valles, Miguel Trelles, Justin Glavis-Bloom, Rebecca F Grais
BACKGROUND: Lower extremity trauma during earthquakes accounts for the largest burden of disaster-related injuries. Insufficient pain management is common in resource-limited disaster settings, and regional anesthesia (RA) may reduce pain in injured patients beyond current standards of care. To date, no controlled trials have been conducted to evaluate the use of RA for pain management in a disaster setting. METHODS/DESIGN: The Regional Anesthesia for Painful Injuries after Disasters (RAPID) study aims to evaluate whether regional anesthesia (RA), either with or without ultrasound (US) guidance, can reduce pain from earthquake-related lower limb injuries in a disaster setting...
November 14, 2016: Trials
https://www.readbyqxmd.com/read/27833486/a-comparative-study-of-dexmedetomidine-and-fentanyl-as-adjuvants-to-levobupivacaine-for-caudal-analgesia-in-children-undergoing-lower-limb-orthopedic-surgery
#2
S M Elfawal, W A Abdelaal, M R Hosny
BACKGROUND: Levobupivacaine is an effective local anesthetic agent with less systemic toxicity than racemic bupivacaine, but it has short postoperative analgesic duration. Dexmedetomidine and fentanyl are promising adjuncts to provide excellent and prolonged postoperative caudal analgesia. This study compared the effects of caudal levobupivacaine plus dexmedetomidine and levobupivacaine plus fentanyl for postoperative analgesia and sedation in children undergoing lower limb orthopedic surgery...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27821836/effects-of-combined-general-epidural-anesthesia-on-hemodynamics-respiratory-function-and-stress-hormone-levels-in-patients-with-ovarian-neoplasm-undergoing-laparoscopy
#3
Qiang Xu, Hao Zhang, Yan-Mei Zhu, Nian-Jun Shi
BACKGROUND The aim of this study was to evaluate the influence of combined general/epidural anesthesia (GEA) on hemodynamics, respiratory function and stress hormone levels in patients with ovarian neoplasm undergoing laparoscopy. MATERIAL AND METHODS A total of 177 patients with ovarian neoplasm (screened by inclusion/exclusion criteria) receiving laparoscopy were divided into groups G (general anesthesia alone), L1.0 (GEA with 1.0% lidocaine), and L1.5 (GEA with 1.5% lidocaine). Hemodynamics, respiratory parameters and stress hormone levels in the 3 groups were recorded and analyzed...
November 8, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27812971/efficacy-and-safety-of-dexmedetomidine-as-an-adjuvant-in-epidural-analgesia-and-anesthesia-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#4
REVIEW
Xu Zhang, Dong Wang, Min Shi, YuanGuo Luo
BACKGROUND AND OBJECTIVE: Several clinical trials have examined and indicated the usefulness of epidural dexmedetomidine therapy. However, there has been no systematic analysis of the findings of these trials to date. We undertook this systematic review and meta-analysis to investigate the efficacy and safety of epidural dexmedetomidine adjunctive therapy in different surgical procedures. MATERIALS AND METHODS: We searched EMBASE, PubMed, the Cochrane Library, and the Clinical Trials...
November 4, 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27778056/-unilateral-spinal-anesthesia-literature-review-and-recommendations
#5
B Büttner, A Mansur, M Bauer, J Hinz, I Bergmann
Unilateral spinal anesthesia is a cost-effective and rapidly performed anesthetic technique. An exclusively unilateral block only affects the sensory, motor and sympathetic functions on one side of the body and offers the advantages of a spinal block without the typical adverse side effects seen with a bilateral block. The lack of hypotension, in particular, makes unilateral spinal anesthesia suitable for patients with cardiovascular risk factors e. g. aortic valve stenosis or coronary artery disease. Increasing numbers of surgical procedures are now being performed on an outpatient basis...
October 24, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27746567/effect-of-dexmedetomidine-bolus-dose-on-isoflurane-consumption-in-surgical-patients-under-general-anesthesia
#6
Reshma B Muniyappa, Geetha C Rajappa, Suresh Govindswamy, Prathima P Thamanna
BACKGROUND AND OBJECTIVE: Various adjuvants have been introduced to decrease the dose of volatile agents and their side effects. Dexmedetomidine a potent alpha-2 adrenoreceptor agonist is one such agent. Our objective is to assess the effect of preanesthetic dexmedetomidine on isoflurane consumption and its effect on intraoperative hemodynamic stability and recovery profile. SETTING AND DESIGN: This prospective, randomized controlled, double-blind study was done in a tertiary care hospital...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746524/evaluation-of-clonidine-as-an-adjuvant-to-bupivacaine-in-wound-infiltration-for-providing-postoperative-analgesia-after-abdominal-hysterectomy
#7
Venkatesh Selvaraj
BACKGROUND: Clonidine is an effective adjuvant to local anesthetics in peripheral nerve blocks. We studied the effect of clonidine as an adjuvant in wound infiltration for postoperative analgesia. AIM: To evaluate the role of clonidine as an adjuvant to bupivacaine in wound infiltration in terms of quality and duration of postoperative analgesia in patients undergoing total abdominal hysterectomy. SETTINGS AND STUDY DESIGN: Prospective, randomized, double-blinded study...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27708377/postoperative-hormonal-therapy-prevents-recovery-of-neurological-damage-after-surgery-in-patients-with-breast-cancer
#8
Atsushi Sekiguchi, Chiho Sato, Izumi Matsudaira, Yuka Kotozaki, Rui Nouchi, Hikaru Takeuchi, Masaaki Kawai, Hiroshi Tada, Takanori Ishida, Yasuyuki Taki, Noriaki Ohuchi, Ryuta Kawashima
Cancer survivors are exposed to several risk factors for cognitive dysfunction, such as general anesthesia, surgical trauma, and adjuvant therapies. In our recent study we showed that thalamic volume reduction and attentional dysfunction occurred shortly after surgery. Here, we examined the 6-month prognosis of the 20 patients with breast cancer who underwent surgery. Seven patients did not receive any adjuvant therapy after the surgery and 13 patients received a hormonal therapy after the surgery. We assessed their attentional functions, and thalamic volumes shortly after and 6 months after surgery...
October 6, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27591461/paravertebral-block-for-management-of-acute-postoperative-pain-and-intercostobrachial-neuralgia-in-major-breast-surgery
#9
Mercedes Fernández Gacio, Ana Maria Agrelo Lousame, Susana Pereira, Clara Castro, Juliana Santos
BACKGROUND: Several locoregional techniques have been described for the management of acute and chronic pain after breast surgery. The optimal technique should be easy to perform, reproducible, with little discomfort to the patient, little complications, allowing good control of acute pain and a decreased incidence of chronic pain, namely intercostobrachial neuralgia for being the most frequent entity. OBJECTIVES: The aim of this study was to evaluate the paravertebral block with preoperative single needle prick for major breast surgery and assess initially the control of postoperative nausea and vomiting (PONV) and acute pain in the first 24h and secondly the incidence of neuropathic pain in the intercostobrachial nerve region six months after surgery...
September 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27575449/hypnosis-and-anesthesia-back-to-the-future
#10
Enrico Facco
Hypnosis is a physiological mind activity characterized by focused attention, absorption, dissociation and plastic imagination. In the early 19th century, several hundred surgical interventions were described with hypnosis as the sole anesthetic, in an epoch when no anesthetic drugs were available; then hypnosis was prejudicially abandoned and forgotten after their introduction. In the past two decades, an increasing number of studies on hypnosis has shown its capacity to modify the activity of the prefrontal cortex, default mode network and pain neuromatrix (including the anterior cingulate cortex, amygdala, thalamus, insula and somatosensory cortex) and increase pain threshold up to the level of surgical anesthesia...
August 30, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27532615/anesthetic-practices-for-laser-rehabilitation-of-pediatric-hypertrophic-burn-scars
#11
Brendan M Wong, Jeffrey Keilman, Jennifer Zuccaro, Charis Kelly, Jason T Maynes, Joel S Fish
The use of ablative fractional carbon dioxide laser therapy and pulsed dye laser therapy has led to significant improvements in the rehabilitation of hypertrophic burn scars. However, laser procedures are associated with appreciable pain among pediatric patients. Clinical consensus suggests using general anesthesia for pediatric laser procedures; however, guidelines for perioperative care are lacking. The objective of this quality improvement study is to determine whether a difference exists in postoperative pain outcomes in pediatric patients who receive intraoperative opioid regimens compared with patients who receive opioid-sparing regimens for laser therapy of hypertrophic burn scars...
August 15, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27464972/the-effect-of-preoperative-pregabalin-on-postoperative-nausea-and-vomiting-a-meta-analysis
#12
Michael C Grant, Matthew Betz, Matthew Hulse, Andres Zorrilla-Vaca, Deborah Hobson, Elizabeth Wick, Christopher L Wu
BACKGROUND: Nonopioid adjuvant medications are increasingly included among perioperative Enhanced Recovery After Surgery protocols. Preoperative pregabalin has been shown to improve postoperative pain and limit reliance on opioid analgesia. Our group investigated the ability of preoperative pregabalin to also prevent postoperative nausea and vomiting (PONV). METHODS: Our group performed a meta-analysis of randomized trials that report outcomes on the effect of preoperative pregabalin on PONV endpoints in patients undergoing general anesthesia...
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27442394/effect-of-adding-dexamethasone-as-a-ropivacaine-adjuvant-in-ultrasound-guided-transversus-abdominis-plane-block-for-inguinal-hernia-repair
#13
RANDOMIZED CONTROLLED TRIAL
Andrijan Kartalov, Nikola Jankulovski, Biljana Kuzmanovska, Milka Zdravkovska, Mirjana Shosholcheva, Tatjana Spirovska, Aleksandra Panovska Petrusheva, Marija Tolevska, Marija Srceva, Vesna Durnev, Gjorgji Jota, Redzep Selmani, Atanas Sivevski
BACKGROUND: The transverses abdominals plane block (TAP) is a regional anesthesia technique that provided analgesia to the parietal peritoneum, skin and muscles of the anterior abdominal wall. The aim of this randomized double-blind study was to evaluate postoperative analgesia on patients undergoing open inguinal hernia repair under general anesthesia (GA), (GA + TAP) block preformed with ropivacaine and (GA + TAP-D) block preformed with ropivacaine and 4 mg dexamethasone. METHODS: 90 (ASA I-II) adult patients for unilateral open inguinal hernia repair were included in this study...
2015: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27375383/intraoperative-effect-of-dexmedetomidine-infusion-during-living-donor-liver-transplantation-a-randomized-control-trial
#14
E Sayed, K A Yassen
BACKGROUND: Dexmedetomidine hydrochloride (Dex) is a useful adjuvant for general anesthesia. The aim was to evaluate the effects of Dex infusion during living donors liver transplantation (LDLT) on the general anesthetic requirements, hemodynamics, oxygen consumption (VO2), and CO2 production (VCO2). MATERIALS AND METHODS: Forty LDLT recipients were allocated randomly to receive either Dex (0.2-0.7 μg/kg/h) or placebo (control [C]). Patient state index (PSI), SEDLine monitored anesthesia depth (25-50) with desflurane (Des) % and fentanyl altered accordingly...
July 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27347302/the-analgesic-effect-of-clonidine-as-an-adjuvant-in-dorsal-penile-nerve-block
#15
Jarraya Anouar, Smaoui Mohamed, Abidi Sofiene, Zouari Jawhar, Elleuch Sahar, Kolsi Kamel
INTRODUCTION: Dorsal penile nerve block (DPNB) is a commonly performed regional anesthetic technique for male circumcision. The aim of this study was to assess the analgesic effect of the adjunction of clonidine to bupivacaine 0.5% in this block. METHODS: It was a prospective randomized double-blind clinical trial including 40 ASA1 boys aged from 1 to 4 years undergoing elective circumcision. Dorsal penile nerve block was performed under general Anesthesia. Patients were randomized in two groups: Group 1 (G1): received 0...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27246129/-tracheal-resection-and-primary-anastomosis-for-adenoid-cystic-carcinoma-using-an-extracorporeal-membrane-oxygenation
#16
Tomoo Yuba, Yoshinori Yamashita, Hiroaki Harada, Norifumi Tsubokawa, Hideki Nagata, Taiichi Takasaki, Shigeaki Kurita, Kiyoshi Fujii
We report a case of tracheal resection and primary anastomosis for adenoid cystic carcinoma using an extracorporeal membrane oxygenation (ECMO). A 45-year-old female was referred to our hospital because of a tracheal tumor that occupied most of the tracheal lumen. In case of airway obstruction by the tracheal tumor during anesthesia and operation, we decided to use ECMO before induction of general anesthesia. Under secure respiratory control using ECMO, tracheal resection and primary anastomosis was performed...
June 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27242951/office-based-management-of-recurrent-respiratory-papilloma
#17
Kevin M Motz, Alexander T Hillel
This review will highlight the indications and benefits of office-based therapy for recurrent respiratory papillomatosis (RRP) and discuss the utilization of photo-dynamic lasers and adjuvant medical therapy in office-based settings. Office-based management of RRP allows for more timely interventions, is preferred by the majority of patients, and negates the risk of general anesthesia. Current literature argues for the utilization of KTP laser over CO2 laser for office-based treatment of RRP. Medical therapies for RRP are limited, but agents such as bevacizumab are promising and have been shown to reduce disease burden...
June 2016: Current Otorhinolaryngology Reports
https://www.readbyqxmd.com/read/27212761/effects-of-dexmedetomidine-on-perioperative-monitoring-parameters-and-recovery-in-patients-undergoing-laparoscopic-cholecystectomy
#18
Shirishkumar G Chavan, Gourish P Shinde, Swati P Adivarekar, Sandhya H Gujar, Surita Mandhyan
BACKGROUND: Dexmedetomidine, an α2 agonist, when used as an adjuvant in general anesthesia attenuates stress response to various noxious stimuli, maintains perioperative hemodynamic stability and provides sedation without adversely affecting recovery in postoperative period. MATERIALS AND METHODS: Sixty patients were randomly divided into two groups of 30 each. In Group A, dexmedetomidine was given intravenously as loading dose of 1 μg/kg over 10 min, and normal saline was given in Group B patients...
May 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/26914135/pregabalin-administered-as-an-anxiolytic-agent-in-ultrasound-guided-infraclavicular-block-a-controlled-double-blind-dose-ranging-trial
#19
M B Cegin, L Soyoral, N Yuzkat, V Baydi, U Goktas
OBJECTIVE: Adjuvant agents, given with local anesthetics or via venous, oral, or rectal routes for peripheral nerve blocking, have been in use for a long time. Literature studies about pregabalin usage in peripheral nerve blocking are limited in number. In this study, we aimed to reveal the blocking quality of pregabalin administered orally in various doses as an anxiolytic agent and its effective dose range. PATIENTS AND METHODS: Eighty patients who underwent upper extremity bone surgery were included in the study...
2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/26892620/-paravertebral-block-for-management-of-acute-postoperative-pain-and-intercostobrachial-neuralgia-in-major-breast-surgery
#20
Mercedes Fernández Gacio, Ana Maria Agrelo Lousame, Susana Pereira, Clara Castro, Juliana Santos
BACKGROUND: Several locoregional techniques have been described for the management of acute and chronic pain after breast surgery. The optimal technique should be easy to perform, reproducible, with little discomfort to the patient, little complications, allowing good control of acute pain and a decreased incidence of chronic pain, namely intercostobrachial neuralgia for being the most frequent entity. OBJECTIVES: The aim of this study was to evaluate the paravertebral block with preoperative single needle prick for major breast surgery and assess initially the control of postoperative nausea and vomiting (PONV) and acute pain in the first 24hours and secondly the incidence of neuropathic pain in the intercostobrachial nerve region six months after surgery...
September 2016: Revista Brasileira de Anestesiologia
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