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Anaesthesia regional

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https://www.readbyqxmd.com/read/28431821/near-infrared-spectroscopy-as-a-predictor-for-shunt-requirement-during-carotid-endarterectomy
#1
M Jonsson, D Lindström, A Wanhainen, K Djavani Gidlund, P Gillgren
OBJECTIVE/BACKGROUND: Near infrared spectroscopy (NIRS) continuously monitors regional cerebral oxygenation (rSO2) in the frontal lobes. This method may be used in patients during carotid endarterectomy to indicate the need for shunting. The aim of the study was to evaluate the value of NIRS in determining the need for selective shunting during CEA. A secondary aim was to compare NIRS with stump pressure. METHODS: Between January 2013 and October 2016, 185 patients from two vascular units, undergoing CEA under local anaesthesia were prospectively included...
April 18, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28429926/the-efficacy-of-intraurethral-lidocaine-in-optical-internal-urethrotomy-for-anterior-urethral-stricture-a-multicenter-study
#2
Nedim Y Cem, Yıldız Yildiray, Cem Ö Berat, Melih S Mehmet, Gökhan D Ömer, Metin H Ahmet, Özyuvalı Ekrem, Ayyıldız Ali
BACKGROUND: Male anterior urethral strictures can be treated successfully with the help of optical internal urethrotomy (OIU) and is usually performed under general or regional anaesthesia. In this study, we determined the efficacy of intraurethral lidocaine in OIU for anterior urethral stricture in an outpatient setting. METHODS: 157 patients with anterior urethral strictures underwent OIU under local urethral anaesthesia with lidocaine. Optical urethrotomy was performed with a cold-cutting knife...
April 20, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28421731/intraoperative-dexmedetomidine-sedation-reduces-the-postoperative-agitated-behaviour-in-elderly-patients-undergoing-orthopaedic-surgery-compared-to-the-propofol-sedation-a-retrospective-analysis-of-855-patients
#3
Hyun-Jung Shin, Bon-Wook Koo, Seung-Uk Bang, Jin-Hee Kim, Jung-Won Hwang, Sang-Hwan DO, Hyo-Seok Na
BACKGROUND: Postoperative agitation or confusion is one of the symptoms of hyperactive delirium in elderly patients. We retrospectively evaluated the incidence of postoperative abnormal psychomotor behaviour in elderly surgical patients according to the use of different intraoperative sedative agents: dexmedetomidine vs. propofol. METHODS: The medical records of 855 elderly patients, who underwent orthopaedic surgery with regional anaesthesia between July 2012 and September 2015, were divided into two groups-the dexmedetomidine group (n=263) and the propofol group (n=592)-and evaluated...
April 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28417038/anomalous-innervation-of-the-median-nerve-in-the-arm-in-the-absence-of-the-musculocutaneous-nerve
#4
Khursheed Raza, Seema Singh, Neerja Rani, Raghav Mishra, Kamakshi Mehta, Saroj Kaler
The brachial plexus innervates the upper extremities. While variations in the formation of the brachial plexus and its terminal branches are quite common, it is uncommon for the median nerve to innervate the muscles of the arm. During the dissection of an elderly male cadaver at the Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India, in 2016, the coracobrachialis muscle was found to be supplied by a direct branch from the lateral root of the median nerve and the musculocutaneous nerve was absent...
February 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/28412984/facial-carbuncle-a-new-method-of-conservative-surgical-management-plus-irrigation-with-antibiotic-containing-solution
#5
L X Ngui, L S Wong, G Shashi, M N Abu Bakar
OBJECTIVE: This paper reports on a non-conventional method for the management of facial carbuncles, highlighting its superiority over conventional surgical treatment in terms of cosmetic outcome and shorter duration of wound healing. BACKGROUND: The mainstay of treatment for carbuncles involves the early administration of antibiotics in combination with surgical intervention. The conventional saucerisation, or incision and drainage, under normal circumstances results in moderate to large wounds, which may need secondary surgery such as skin grafting, resulting in a longer duration of wound healing and jeopardising cosmetic outcome...
April 17, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28396932/comparison-of-analgaesia-with-lumbar-epidurals-and-lumbar-plexus-nerve-blocks-in-patients-receiving-multimodal-analgaesics-following-primary-total-hip-arthroplasty-a-retrospective-analysis
#6
N Robert Harvey, Bethany J Wolf, Eric D Bolin, Sylvia H Wilson
PURPOSE: Significant post-operative pain occurs after hip arthroplasty. In a prior study, lumbar plexus nerve blocks provided comparable analgaesia to lumbar epidurals; however, multimodal analgaesics were not used consistently. METHODS: This study assessed a randomly selected cohort of 48 patients undergoing primary hip arthroplasty who received a regional anaesthesia technique for post-operative pain. Twenty-four patients with lumbar epidurals and 24 with single-injection lumbar plexus nerve blocks were reviewed using electronic medical records...
April 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28385614/review-of-hypoxaemia-in-anaesthetized-horses-predisposing-factors-consequences-and-management
#7
REVIEW
Adam Auckburally, Görel Nyman
OBJECTIVE: To discuss how hypoxaemia might be harmful and why horses are particularly predisposed to developing it, to review the strategies that are used to manage hypoxaemia in anaesthetized horses, and to describe how successful these strategies are and the adverse effects associated with them. DATABASES USED: Google Scholar and PubMed, using the search terms horse, pony, exercise, anaesthesia, hypoxaemia, oxygen, mortality, morbidity and ventilation perfusion mismatch...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28384894/ear-nose-and-throat-foreign-bodies-removed-under-general-anaesthesia-a-retrospective-study
#8
Neizekhotuo Brian Shunyu, Hanifa Akhtar, Habib Md Rezaul Karim, Nari M Lyngdoh, Md Yunus, Md Jamil
INTRODUCTION: For Otorhinolaryngologist, removal of Foreign Bodies (FB) from the ear, nose and throat is one of the common emergency procedures done. Most of the cases especially of the ear and nose can be managed without General Anaesthesia (GA). But in some cases GA may be needed. There are very few studies that address the scenario of ear, nose and throat foreign body that required GA for its removal and the complications associated with it. AIM: This study was conducted with the aim to study the patient's profile, types and distribution of FB removed under GA, and the associated complications...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28374467/changes-from-2012-to-2015-in-intravenous-fluid-solutions-issued-to-hospital-departments
#9
A B Jonsson, A Perner
BACKGROUND: In recent years, large trials have increased the level of evidence for intravenous (IV) fluid therapy, at least in the intensive care setting. It is less clear whether this change in the evidence base has been associated with changes in IV fluid use in different hospital departments. METHODS: We obtained details from the regional pharmacy regarding IV fluids issued to hospital departments in the Danish Capitol Region from January 2012 to May 2015. We used paired Wilcoxon's signed-rank test to analyse changes in the issuing in different departments...
May 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28363848/perioperative-use-of-gabapentinoids-in-france
#10
Valéria Martinez, Michel Carles, Emmanuel Marret, Hélène Beloeil
BACKGROUND: Gabapentinoids have governmental health agency approval for "chronic neuropathic pain." Over the last decade, however, the perioperative prescription of gabapentinoids has become more popular among anaesthesiologists due to their anxiolytic and antihyperalgesic proprieties, despite weak scientific evidence supporting the risk/benefit ratio for this indication. METHODS: Our aim was to extensively describe the use of perioperative gabapentinoids by French anaesthesiologists...
March 28, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28363725/incidence-of-severe-critical-events-in-paediatric-anaesthesia-apricot-a-prospective-multicentre-observational-study-in-261-hospitals-in-europe
#11
Walid Habre, Nicola Disma, Katalin Virag, Karin Becke, Tom G Hansen, Martin Jöhr, Brigitte Leva, Neil S Morton, Petronella M Vermeulen, Marzena Zielinska, Krisztina Boda, Francis Veyckemans
BACKGROUND: Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. METHODS: The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures...
March 28, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28363327/prevalence-and-characterization-of-postoperative-pain-in-the-postanaesthesia-care-unit
#12
N Cabedo, R Valero, A Alcón, C Gomar
INTRODUCTION: Immediate postoperative pain occurs initially after surgery, while the patient is in the Post-Anaesthesia Recovery Unit. Very few studies assess this pain in this most immediate phase. OBJECTIVE: Cross-sectional study of the prevalence and characteristics of immediate postoperative pain in patients after surgery. MATERIAL AND METHODS: Between August 2014 and February 2015, a sample of 503 patients from the Post-Anaesthesia Recovery Unit was followed...
March 28, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28347551/multimodal-analgesia-and-regional-anaesthesia
#13
C Tornero Tornero, L E Fernández Rodríguez, J Orduña Valls
Multimodal analgesia provides quality analgesia, with fewer side effects due to the use of combined analgesics or analgesic techniques. Regional anaesthesia plays a fundamental role in achieving this goal. The different techniques of regional anaesthesia that include both peripheral and central blocks in either a single dose or in continuous infusion help to modulate the nociceptive stimuli that access the central level. The emergence of the ultrasound as an effective system to perform regional anaesthesia techniques has allowed the development of new regional anaesthesia techniques that formerly could not be carried out since only neurostimulation or skin references were used...
March 24, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28344950/impalement-head-injury-with-a-spear
#14
B I Akhiwu, A S Adoga, O P Binitie, C C Ani, M Iweagwu, O Adetutu, T Ureme, D D George, P D Didamson, E Oseni-Momodu, B T Ugwu
Impalement injuries to the craniofacial region are uncommon due to the fact that the face is a smaller target in relation to the rest of the body. We report a case of a 26-year old man who was attacked on the face with a spear. He was promptly evaluated and resuscitated; the blade of the spear was successfully extracted under general anaesthesia. He was discharged home after 2 weeks hospitalization; he has been followed up for three months with good outcome.
April 2016: Journal of the West African College of Surgeons
https://www.readbyqxmd.com/read/28341344/propofol-affinity-to-mitochondrial-membranes-does-not-alter-mitochondrial-function
#15
Luís M Félix, Fernando Correia, Pedro A Pinto, Sónia P Campos, Telma Fernandes, Romeu Videira, M M Oliveira, Francisco P Peixoto, Luís M Antunes
The molecular mechanisms of hepatotoxicity after propofol anaesthesia have not been fully elucidated, although there is a relation with mitochondrial dysfunction. The action of propofol on mitochondrial hepatic functions in a rat model was evaluated by infusion for 4h with 25 and 62.5mg/kg/h propofol or 3.125ml/kg/h (vehicle). Liver mitochondrial respiratory rates were evaluated as well as mitochondrial transmembrane potential (ΔΨ), calcium fluxes, mitochondrial enzymatic activities (Complex I-V) and oxidative stress biomarkers (superoxide dismutase, catalase, glutathione reductase, glutathione S-transferase, lipid peroxidation and the oxidised/reduced glutathione ratio)...
May 15, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28298758/comparison-of-analgesic-efficacy-of-dexmedetomidine-and-midazolam-as-adjuncts-to-lignocaine-for-intravenous-regional-anesthesia
#16
Bharti Gupta, Ravinder Kumar Verma, Sudershan Kumar, Geeta Chaudhary
BACKGROUND: Intravenous regional anesthesia (IVRA) is safe, technically simple, and cost-effective technique compared to general anesthesia with success rates of 94-98% for upper and lower limb surgeries. The main disadvantage of this procedure is its limited duration for surgery, lack of postoperative analgesia, and tourniquet pain. To overcome this disadvantage, various adjuvants to lignocaine have been studied from time to time. AIM: To compare the analgesic efficacy of dexmedetomidine and midazolam as adjuncts to lignocaine for IVRA for forearm and hand surgeries...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28292564/commentary-on-regional-versus-local-anaesthesia-for-haemodialysis-arteriovenous-fistula-formation-a-systematic-review-and-meta-analysis
#17
J H M Tordoir
No abstract text is available yet for this article.
March 11, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28285956/regional-versus-local-anaesthesia-for-haemodialysis-arteriovenous-fistula-formation-a-systematic-review-and-meta-analysis
#18
REVIEW
R Cerneviciute, S M Sahebally, K Ahmed, M Murphy, W Mahmood, S R Walsh
BACKGROUND: Arteriovenous fistula (AVF) formation is the most common vascular access procedure for patients requiring haemodialysis. However, it is associated with high failure rates, influenced by vessel diameter and arterial inflow. Mode of anaesthesia may affect these factors, and subsequently AVF maturation rates. OBJECTIVE: To perform a systematic review and meta-analysis to assess the effect of anaesthesia type for autologous primary radiocephalic or brachiocephalic AVF creation on subsequent fistula failure rates...
March 10, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28251606/a-randomised-trial-of-peri-operative-positive-airway-pressure-for-postoperative-delirium-in-patients-at-risk-for-obstructive-sleep-apnoea-after-regional-anaesthesia-with-sedation-or-general-anaesthesia-for-joint-arthroplasty
#19
J W Nadler, J L Evans, E Fang, X A Preud'Homme, R L Daughtry, J B Chapman, M P Bolognesi, D E Attarian, S S Wellman, A D Krystal
Previous pilot work has established an association between obstructive sleep apnoea and the development of acute postoperative delirium , but it remains unclear to what extent this risk factor is modifiable in the 'real world' peri-operative setting. In a single-blind randomised controlled trial, 135 elderly surgical patients at risk for obstructive sleep apnoea were randomly assigned to receive peri-operative continuous positive airway pressure (CPAP) or routine care. Of the 114 patients who completed the study, 21 (18...
March 2, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28250487/anaesthetic-management-of-a-patient-with-severe-pulmonary-arterial-hypertension-for-renal-transplantation
#20
Mn Chidananda Swamy, Aninditha Mukherjee, Latha L Rao, Sushmitha Pandith
We describe a patient with severe pulmonary arterial hypertension scheduled to undergo live-related renal transplantation. We emphasise on meticulous anaesthetic management and early renal transplantation to prevent the progression of disease which would become refractory to treatment, leading to right ventricular failure. Regional (continuous epidural) anaesthesia has been used as technique of choice, where the selective advantages of this technique have been put to good use.
February 2017: Indian Journal of Anaesthesia
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