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Awareness under anesthesia

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https://www.readbyqxmd.com/read/29772562/using-neuroimaging-to-uncover-awareness-in-brain-injured-and-anesthetized-patients
#1
Mackenzie Graham, Adrian M Owen, Charles Weijer, Lorina Naci
We cast a novel perspective on two distinct populations: patients who become accidentally intraoperatively aware after receiving general anesthesia and severely brain-injured patients who are diagnosed as being in a vegetative state. In both cases, patients are behaviorally non-responsive -and on this basis presumed to lack consciousness- yet, retain covert awareness. In both contexts, detecting consciousness is highly challenging, yet highly important for ensuring adequate patient care. Although great strides have been made in the development of depth-of-anesthesia monitors, these monitors have significant limitations...
June 1, 2018: Frontiers in Bioscience (Scholar Edition)
https://www.readbyqxmd.com/read/29696118/anesthetic-considerations-for-angelman-syndrome-case-series-and-review-of-the-literature
#2
Mary Ellen Warner, David P Martin, Mark A Warner, Ralitza H Gavrilova, Juraj Sprung, Toby N Weingarten
Background: Angelman syndrome is a rare neurodevelopmental disorder characterized by intellectual disability, severe speech impairment, ataxia, seizures, happy demeanor, distinctive craniofacial features, high vagal tone, and gamma-amino butyric acid receptor abnormalities. The aim of this report is to review our experience of patients with Angelman syndrome undergoing anesthetic management. Methods: We retrospectively reviewed perioperative course of patients with Angelman syndrome who underwent procedures under anesthesia from 2000 to 2016...
October 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29683929/18f-fdg-pet-ct-in-the-evaluation-of-cancer-cervix-where-do-we-stand-today
#3
Shanmuga S Palaniswamy, Chaitanya R Borde, Padma Subramanyam
The incidence of gynecological malignancies is on the rise partly because of the availability of screening programmes, awareness, higher technological advancements, and availability of better medical care. Early diagnosis of any malignancy leads to prompt treatment. Use of 18Fluorine-Fluorodeoxyglucose (F-FDG) PET/CT in the treatment and follow-up of patients with Ca cervix considerably improves patient management. The primary diagnosis of Ca cervix is made either by biopsy of a visible tumor on the cervix or by a cone biopsy of a nonvisible malignant cervical focus...
April 20, 2018: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/29652012/nature-and-pattern-of-primary-teeth-extractions-in-a-tertiary-care-hospital-setting-in-south-india
#4
Shini Susan Samuel, Daniel Sathiya Sundaram Selvaraj, Jagadish Ebenezer, Grace Rebekah, Santosh Koshy
Background: Many studies have been carried out on the prevalence of dental diseases in children although not much information is available regarding its outcome among Indian children. Aim: The aim of the present study was to analyze the type of primary tooth extracted and the reasons for the extraction among children attending a tertiary care hospital in the Southern part of India. Materials and Methods: The dental records of pediatric patients who had visited the dental clinic of a tertiary care hospital located in Tamil Nadu, South India from December 2013 to November 2016 were reviewed...
March 2018: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
https://www.readbyqxmd.com/read/29643795/ocular-injury-due-to-potassium-permanganate-granules
#5
Chareenun Chirapapaisan, Pinnita Prabhasawat, Sabong Srivannaboon, Vatookarn Roongpoovapatr, Piyada Chitsuthipakorn
Purpose: We report a rare case of ocular injury due to potassium permanganate (KMnO4 ) granules in a child. Methods: This is a retrospective case report. Results: A 2-year-old boy was transferred to our emergency room with severe pain in his right eye, inflamed eyelids, and brownish stains on his fingers. Chemical injury was suspected. Copious eye irrigation was immediately performed. Diffuse brownish splotches were then observed at the inferior bulbar conjunctiva...
January 2018: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/29629894/pulmonary-aspiration-in-adjustable-gastric-banding-carriers-undergoing-a-second-surgical-procedure-considerations-on-personal-experience-and-review-of-the-literature
#6
Contardo Vergani, Marco Venturi, Sara Badiali, Barbara Chella, Enrico Mozzi
BACKGROUND: The observation of a relatively high number of pulmonary aspirations (PA) among gastric band (GB) carriers undergoing a second surgery, prompted us to modify our strategy for GB patients candidate to further operation under general anesthesia. MATERIAL OF STUDY AND RESULTS: In January 2013, following the occurrence of PA at the induction of general anesthesia in 1 GB carrier undergoing a further operation, we reviewed our Data Base between January 2005 and 2013, to explore the rate of pulmonary aspiration in patients GB carriers undergoing a second surgery...
2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29628852/anesthetic-and-psychiatric-implications-of-accidental-awareness-under-general-anesthesia-during-electroconvulsive-therapy
#7
Hetal Acharya, Atul Gaur, Girish Kunigiri
Accidental awareness under general anesthesia (AAGA) is a well-known phenomenon. However, little literature exists in its relation to the psychiatric field, particularly within the electroconvulsive therapy (ECT) setting. This report explores the case of a 52-year-old woman that describes her own experience of AAGA during ECT. Relevant anesthetic details are also provided along with its possible implications in AAGA. The aim of this case report is to increase awareness among clinicians in regard to AAGA and its occurrence during ECT...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29568123/non-instrumental-clinical-monitoring-does-not-guarantee-an-adequate-course-of-general-anesthesia-a-prospective-clinical-study
#8
Katarzyna Szostakiewicz, Zbigniew Rybicki, Dariusz Tomaszewski
BACKGROUND: Clinical monitoring is the most common method of adjusting the appropriate level of general anesthesia. However, episodes of intraoperative awareness (AWR) are still reported, suggesting that clinical observations may not be sufficient in some cases. The objective of this study was to compare the efficacy of clinical and instrumental neuromonitoring with auditory evoked potentials (AEP) in an intraoperative analysis of the proper level of general anesthesia. METHODS: Patients scheduled for elective surgery were randomly divided into two groups...
March 21, 2018: Biomedical Papers of the Medical Faculty of the University Palack├Ż, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29524200/prevalence-of-discordant-elevations-of-state-entropy-and-bispectral-index-in-patients-at-amnestic-sevoflurane-concentrations-a-historical-cohort-study
#9
Richard H Epstein, Joni M Maga, Michael E Mahla, Eric S Schwenk, Marc J Bloom
BACKGROUND: Processed electroencephalogram (EEG) monitors help assess the hypnotic state during general anesthesia or sedation. Maintaining the bispectral index (BIS) or state entropy (SE) between 40 and 60 has been recommended to mitigate anesthesia awareness. Nonetheless, SEs > 70 were frequently observed at end-tidal sevoflurane concentrations unlikely to allow awareness. We sought to determine the prevalence of elevated discordant measurements during BIS and SE monitoring. METHODS: Electronic data collected over 11 months at two academic hospitals were retrospectively reviewed...
May 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesth├ęsie
https://www.readbyqxmd.com/read/29503045/thermal-injuries-from-exploding-electronic-cigarettes
#10
Sean Hickey, Jeremy Goverman, Jonathan Friedstat, Robert Sheridan, John Schulz
INTRODUCTION: There are an estimated 2.75 million electronic cigarette (EC) users in the United States. ECs have become the most commonly used nicotine-containing product in young adults ages 18-24 years. Thermal, blast, and missile injuries from EC explosions has grown rapidly in recent years. Burn surgeons must remain up to date regarding management and treatment of burn injuries related to EC device ignition. METHODS: An IRB approved retrospective review of all patients admitted to the Massachusetts General Hospital Burn Center from January 2015 to April 2017 was performed...
March 1, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29497484/comparing-the-efficacy-and-safety-of-laryngeal-mask-airway-streamlined-liner-of-the-pharyngeal-airway-and-i-gel-following-tracheal-extubation
#11
Hesameddin Modir, Esmail Moshiri, Bijan Yazdi, Abolfazl Mohammadbeigi, Amirreza Modir
Adverse events following surgical operations are common complications due to removal of tracheal tube in contrast to the tracheal intubation. Awareness about the new methods and strategies for tracheal tube extubation is necessary for a safe and successful extubation. Therefore, we aimed to assess the safety and efficacy of laryngeal mask airway (LMA), streamlined liner of the pharyngeal airway (SLIPA) and I-gel in extubation time of tracheal tube. A one-single randomized clinical trial was conducted in 105 eligible patients in three groups including LMA, SLIPA and I-gel...
October 2017: Medical Gas Research
https://www.readbyqxmd.com/read/29384955/a-rare-case-report-of-complications-in-craniofacial-injuries-cavernous-sinus-carotid-fistula
#12
Dong Wang, Xiao-Mei Sun, Jin Wu
RATIONALE: Cavernous sinus-carotid fistula (CCF) is a rare complication of craniofacial injuries in patients receiving oral and maxillofacial surgical care. PATIENT CONCERNS: A retrospective review of 15 patients with CCF records was conducted. In addition, we present a rare case of a 32-year-old Chinese woman with CCF receiving oral and maxillofacial surgical care. DIAGNOSES: Digital subtraction angiography (DSA) confirmed a diagnosis of CCF...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#13
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
February 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29248305/state-of-the-art-transforaminal-percutaneous-endoscopic-lumbar-surgery-under-local-anesthesia-discectomy-foraminoplasty-and-ventral-facetectomy
#14
REVIEW
Koichi Sairyo, Takashi Chikawa, Akihiro Nagamachi
Transforaminal (TF) percutaneous endoscopic surgery for the lumbar spine under the local anesthesia was initiated in 2003 in Japan. Since it requires only an 8-mm skin incision and damage of the paravertebral muscles would be minimum, it would be the least invasive spinal surgery at present. At the beginning, the technique was used for discectomy; thus, the procedure was called PELD (percutaneous endoscopic lumbar discectomy). TF approach can be done under the local anesthesia, there are great benefits. During the surgery patients would be in awake and aware condition; thus, severe nerve root damage can be avoided...
March 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29239148/effects-of-closed-loop-intravenous-anesthesia-guided-by-the-bispectral-index-in-adult-patients-on-emergence-delirium-a-randomized-controlled-study
#15
Antonella Cotoia, Lucia Mirabella, Renata Beck, Pompeo Matrella, Valentina Assenzo, Thierry Chazot, Gilda Cinnella, Ngai Liu, Michele Dambrosio
BACKGROUND: Emergence delirium (ED) is an acute change in cognition after general anesthesia (GA) occurring in operative room, recovery room or in postanesthesia care. The automated propofolremifentanil titration by Bispectral index (BIS) (AutoTIVA) avoids period of deep (BIS<40) anesthesia and could potentially decrease the ED. The aim of this study was to evaluate ED in surgical patients under AutoTIVA, manual titration of propofol-remifentanil (ManualTIVA) or volatile BIS-guided GA...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29229347/postoperative-stridor-and-acute-respiratory-failure-after-parkinson-disease-deep-brain-stimulator-placement-case-report-and-review-of-literature
#16
Mi Wang, Wael Saasouh, Thomas Botsford, Allen Keebler, Andrew Zura, Michael S Benninger, Rafi Avitsian
BACKGROUND: Parkinson disease (PD), a neurodegenerative disorder characterized by loss of dopaminergic neurons in the substantia nigra of the midbrain, is commonly thought of as a motion disorder, but it can have significant effect on the respiratory system. Respiratory failure is the most common cause of death in these patients, but it can also affect laryngeal function causing dysphonia, dysphagia, and dysarthric speech. Acute upper airway obstruction is a rare finding in PD, especially in the perioperative settings...
March 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29225156/performance-of-tci-propofol-using-the-schnider-model-for-cardiac-surgery-on-cardiopulmonary-bypass-a-pilot-study
#17
Aaron Kwang Yang Lee, Aaron Yik Hang Kong, Chee Fai Kong
OBJECTIVE: This pilot study aimed to evaluate the performance of target-controlled infusion (TCI) of propofol using the Schnider pharmacokinetic model in patients undergoing cardiac surgery requiring cardiopulmonary bypass. DESIGN: This was a prospective pharmacokinetic study. SETTING: A tertiary care hospital. PARTICIPANTS: This study is comprised of 10 patients, aged between 46 and 81, who underwent elective cardiac surgery requiring the use of cardiopulmonary bypass...
April 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29200480/stitchless-percutaneous-endoscopic-cervical-discectomy-are-we-moving-towards-day-care-discectomy-procedure
#18
Sunil M Nadkarni, Pavankumar Kohli, Bhupesh Patel, Satishchandra Gore, Bhagyashree S Kulkarni
Background: STITCHLESS percutaneous endoscopic cervical discectomy s[PECD] is safe, precise, targeted, and a complete endoscopic procedure to treat soft cervical disc herniation with unilateral radiculopathy. It allows direct visualization of herniated fragment and its removal, inspection of decompressed nerve root in an awake and aware patient. It reduces the risk related to general anesthesia and to the neurological structures. However, all the patients treated with PECD can be candidates for anterior cervical discectomy and fusion (ACDF)...
November 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29184740/can-friedberg-s-triad-solve-persistent-anesthesia-problems-over-medication-pain-management-postoperative-nausea-and-vomiting
#19
Barry L Friedberg
Friedberg's Triad is (1) measure the brain; (2) preempt the pain; (3) emetic drugs abstain. Persistent anesthesia problems include over- and under-medication, postoperative pain management, and postoperative nausea and vomiting. Inspired by Vinnik's diazepam-ketamine paradigm, Friedberg's propofol ketamine paradigm was first published in 1993. The 1997 addition of the bispectral (BIS) index brain monitor made the propofol ketamine paradigm numerically reproducible. The 1998 addition of the frontalis electromyogram (EMG) as a secondary trend to the BIS transformed the time-delayed BIS monitor into a real-time, extremely useful device...
October 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29160244/pulmonary-aspiration-in-adjustable-gastric-banding-carriers-undergoing-a-second-surgical-procedure-considerations-on-personal-experience-and-review-of-the-literature
#20
Contardo Vergani, Marco Venturi, Sara Badiali, Barbara Chella, Enrico Mozzi
BACKGROUND: The observation of a relatively high number of pulmonary aspirations (PA) among gastric band (GB) carriers undergoing a second surgery, prompted us to modify our strategy for GB patients candidate to further operation under general anesthesia. MATERIAL OF STUDY AND RESULTS: In January 2013, following the occurrence of PA at the induction of general anesthesia in 1 GB carrier undergoing a further operation, we reviewed our Data Base between January 2005 and 2013, to explore the rate of pulmonary aspiration in patients GB carriers undergoing a second surgery...
November 7, 2017: Annali Italiani di Chirurgia
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