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Awareness under anesthesia

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https://www.readbyqxmd.com/read/28217389/management-of-parturients-in-active-labor-with-arnold-chiari-malformation-tonsillar-herniation-and-syringomyelia
#1
Ramsis F Ghaly, Tatiana Tverdohleb, Kenneth D Candido, Nebojsa Nick Knezevic
BACKGROUND: Arnold-Chiari malformation Type 1 (ACM-1) in parturients is a topic of ongoing discussion between obstetricians and anesthesiologists. The primary unanswered question remains; How should the anesthesia provider proceed with labor analgesia and anesthesia for cesarean section when confronted with an advanced, asymptomatic, or minimally symptomatic case of ACM-1 during labor? CASE DESCRIPTION: A 24-year-old, ASA II, G1P0 full-term parturient presented to Labor and Delivery for vaginal delivery...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28217066/subdural-hematoma-occurred-after-spinal-anesthesia-in-a-human-immunodeficiency-virus-infected-patient
#2
Kyung Tae Kim, Ji Yeon Kim, Eun Mi Kim, Jun Hyun Kim
A 25-year-old male patient who was infected with human immunodeficiency virus (HIV) underwent a condyloma excision under spinal anesthesia. The patient complained of suspicious postdural puncture headache. The patient did not respond to conservative management. Subsequently, the subdural hematoma (SDH) was found through magnetic resonance imaging. In response, an epidural blood patch was used to improve the symptoms and inhibit the enlargement of the SDH. The patient was discharged after it was confirmed that a headache had subsided without increasing SDH...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28203194/accidental-ingestion-of-nasal-packing-gauze-during-endonasal-endoscopic-dacryocystorhinostomy-under-local-anesthesia-a-case-report
#3
Yoshiyuki Kitaguchi, Jacqueline Mupas-Uy, Yasuhiro Takahashi, Kazushige Ishida, Hirohiko Kakizaki
PURPOSE: To report a case of accidental ingestion of a nasal packing gauze during endonasal endoscopic dacryocystorhinostomy (en-DCR) under local anesthesia. CASE REPORT: A 66-year-old female patient underwent an en-DCR for a right acquired nasolacrimal duct obstruction. The surgery was performed in a supine position under local anesthesia. An X-ray detectable ribbon gauze soaked in 0.02% epinephrine was placed in the middle meatus to prevent blood and liquid from flowing into the pharynx...
January 2017: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/28164043/pneumothorax-after-shoulder-arthroscopy-a-rare-but-life-threatening-complication
#4
Sven Bamps, Daan Renson, Stefaan Nijs, Sermon
INTRODUCTION: Arthroscopy has become a major diagnostic tool and treatment option for shoulder pathology. However rare, respiratory complications such as a pneumothorax have been reported in patients undergoing shoulder arthroscopy. Surgery - as well as anesthesiology-related factors and respiratory comorbidity have been hypothesized to intervene in the onset of respiratory complications. CASE REPORT: We report the case of a 42-year-old male patient who underwent an arthroscopy of the left shoulder...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28158169/pneumocephalus-following-unidentified-dural-puncture-a-case-report-with-an-unusual-neurological-presentation
#5
Helena Dutra Figueiera, Joana Guimaraes, Ana Luisa Sousa, Ana Margarida Regalado
Pneumocephalus is a rare consequence of epidural anesthesia, which may occur following inadvertent or unidentified dural puncture when the loss of resistance to air technique is applied to identify the epidural space. Headache is the most common symptom presented in this condition, usually with sudden onset. This case report describes an unusual presentation of diffuse pneumocephalus after an unidentified dural puncture. The patient (male, 67 years old) was submitted to epidural catheter placement for the treatment of acute exacerbation of ischemic chronic pain using loss of resistance to air technique...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28110742/comparison-of-fft-and-marginal-spectra-of-eeg-using-empirical-mode-decomposition-to-monitor-anesthesia
#6
Shih-Jui Chen, Chia-Ju Peng, Yi-Chun Chen, Yean-Ren Hwang, Ying-Sian Lai, Shou-Zen Fan, Kuo-Kuang Jen
BACKGROUND AND OBJECTIVE: Intraoperative awareness refers that patients can recall aspects of their surgery after being put under general anesthesia. This distressing complication causes affected patients to be conscious and probably feel pain, leading to emotional trauma or other sequelae. Monitoring and administrating the depth of anesthesia is necessary to prevent patients from awareness during a medical operation. In this paper, we analyzed the electroencephalograms (EEGs) of patients to characterize their anesthesia...
December 2016: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28096574/awareness-during-general-anesthesia-an-indian-viewpoint
#7
Reshma P Ambulkar, Vandana Agarwal, Priya Ranganathan, Jigeeshu V Divatia
BACKGROUND AND AIMS: The incidence of intra-operative awareness with explicit recall in the Western world has been reported to be between 0.1% and 0.2% in the general surgical population and up to 1-2% of patients at high risk for this complication. Awareness in the Indian population has never been studied; we therefore wanted to detect the incidence of awareness in patients who were at high risk of experiencing awareness during surgery in our population. MATERIAL AND METHODS: We conducted a prospective single-center observational study at a 600-bedded tertiary cancer care referral hospital...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28059836/neurally-mediated-syncope-during-cesarean-delivery-a-case-report
#8
Seiko Sato, Erisa Nakamori, Go Kusumoto, Kenji Shigematsu, Ken Yamaura
A 28-year-old woman with preeclampsia at 32 weeks of gestation underwent a cesarean delivery under spinal anesthesia. Administration of nitroglycerin at 200 μg to relax uterine smooth muscles and the application of fundal pressure led to severe bradycardia and loss of consciousness, followed by cardiac arrest. Delivery was completed immediately and recovery was achieved 10 seconds later following cardiopulmonary resuscitation. Neurally mediated syncope was considered the cause of cardiac arrest. Anesthetists should be aware of the potential risk during cesarean delivery following the administration of nitroglycerin, fundal pressure, regional anesthesia, and hypovolemia because of preeclampsia...
January 4, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28038759/-medication-errors-in-anesthesia-unacceptable-or-unavoidable
#9
Ira Dhawan, Anurag Tewari, Sankalp Sehgal, Ashish Chandra Sinha
Medication errors are the common causes of patient morbidity and mortality. It adds financial burden to the institution as well. Though the impact varies from no harm to serious adverse effects including death, it needs attention on priority basis since medication errors' are preventable. In today's world where people are aware and medical claims are on the hike, it is of utmost priority that we curb this issue. Individual effort to decrease medication error alone might not be successful until a change in the existing protocols and system is incorporated...
December 27, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28035515/anesthesia-of-torek-s-operation-the-first-successful-resection-of-a-cancer-in-the-thoracic-esophagus-an-abridged-translation-of-an-essay-in-japanese
#10
REVIEW
Hiromasa Fujita
The first successful resection of a cancer in the thoracic esophagus was performed by Franz Torek around one hundred years ago. Awareness of developments in surgery and the early history can stimulate and foster innovation among surgeons, as well as promote a deeper appreciation of the pioneers of the methods still used today. Here we report the conditions leading to Torek's operation performed in 1913. In the operation, anesthesia was achieved by tracheal insufflation. Ernst Sauerbruch, a surgeon in Germany, first developed a negative-pressure chamber for anesthesia in 1903 and subsequently used this in many open-chest operations...
February 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27993571/delayed-tongue-necrosis-simultaneous-with-bilateral-osteoradionecrosis-of-the-jaw-secondary-to-head-and-neck-irradiation
#11
Marcos Martins Curi, Camila Lopes Cardoso, Anthony Froy Condezo Benites, Patrícia Martins Bueno
We present a rare case of massive tongue necrosis occurring simultaneously with bilateral osteoradionecrosis (ORN) of the jaw in a patient with a history of treatment, including surgery and postoperative radiotherapy, for a retromolar trigone carcinoma 8 years earlier. There is a distinct possibility that the extractions and administration of local anesthesia with a vasoconstrictor contributed to the onset of ORN; together, these events may have influenced the blood supply to the tongue. A glossectomy was performed after hyperbaric oxygen therapy...
February 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/27939561/phakic-intraocular-collamer-lens-visian-icl-implantation-for-correction-of-myopia-in-spectacle-aversive-special-needs-children
#12
Lawrence Tychsen, Nicholas Faron, James Hoekel
PURPOSE: A subset of children with high anisometropia or isoametropia and neurobehavioral disorders have chronic difficulties with spectacle or contact lens wear. We report the results of refractive surgery in a series of these children treated using bilateral or unilateral intraocular collamer lens (Visian ICL) implantation for moderate to high myopia. DESIGN: Prospective non-randomized cohort study. METHODS: Clinical course and outcome data were collated prospectively for 40 implanted eyes in 23 children (mean age 10...
December 6, 2016: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/27932200/the-seroprevalence-of-hepatitis-b-hepatitis-c-and-human-immunodeficiency-virus-in-patients-undergoing-septoplasty
#13
Ozlem Onerci Celebi, Ela Araz Server, Bahtiyar Hamit, Özgür Yiğit
INTRODUCTION: Worldwide, hepatitis B virus, hepatitis C virus, and human immunodeficiency virus are major health problems. Healthcare workers are at risk of transmitting blood-borne viruses, and surgeons have a higher risk of exposure to blood and higher rates of percutaneous injury than other healthcare workers. Septoplasty is among the 3 most commonly performed otolaryngological surgeries worldwide. OBJECTIVE: To determine the seroprevalence of Hepatitis B surface antigen, Hepatitis C virus antibody, and Human Immunodeficiency Virus antibody in patients undergoing septoplasty with and without turbinate surgery under general anesthesia, and to determine if preoperative testing should be performed in such patients...
November 17, 2016: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/27891392/a-study-of-evaluation-and-management-of-rare-congenital-breast-diseases
#14
Rikki Singal, Sudhir Kumar Mehta, Jyoti Bala, Muzzafar Zaman, Amit Mittal, Guarav Gupta, Samer Rudra, Samita Singal
INTRODUCTION: Polymastia and polythelia may be asymptomatic or cause pain, restriction of arm movement, milk discharge, cosmetic problems or anxiety. Cosmesis is the main indication for surgical excision of accessory breasts in axilla. In addition it also confirms the diagnosis and allays the patient's fear of harbouring a malignancy. AIM: To evaluate the presentation of symptoms, investigations required for diagnosis and the management to improve the treatment protocols in patients with breast diseases...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27887758/blind-nasal-intubation-revisited-no-longer-a-blind-technique
#15
Prakash K Dubey, Preksha Dubey, Niranjan Kumar, Gautam Bhardwaj, Neeraj Kumar
BACKGROUND: Advancements in airway management have made the practice of blind nasal intubation obsolete. We report on successful blind nasal intubation performed with the help of capnography and real-time ultrasonography in two patients with tempormandibular joint ankylosis. CASE REPORT: Blind nasal intubation was performed in a 12-year-old patient and a 17-year old patient under general anesthesia with spontaneous respiration. Capnography was used as an aid during insertion and dynamic ultrasonography was performed to guide and confirm proper tracheal tube placement...
February 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27871554/evaluation-of-ph-on-removed-tracheal-tubes-after-general-anesthesia-a-prospective-observational-study
#16
Shiho Deguchi, Nobuyasu Komasawa, Takeshi Ueno, Michi Omori, Toshiaki Minami
STUDY OBJECTIVE: Aspiration pneumonia is a complication of tracheal intubation and mechanical ventilation. We hypothesized that tracheal tubes removed after anesthesia that have an acidic pH may reflect latent regurgitation of gastric fluid. DESIGN: A prospective observational study. SETTING: Operating room. PATIENTS: Tracheal tubes removed from 200 patients (age range, 20-85 years) who had undergone general anesthesia with tracheal intubation and gastric tube placement were examined...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27687355/entropy-vs-standard-clinical-monitoring-using-total-intravenous-anesthesia-during-transvaginal-oocyte-retrieval-in-patients-for-in-vitro-fertilization
#17
Saipriya Tewari, Poonam Bhadoria, Sonia Wadhawan, Sudha Prasad, Amit Kohli
STUDY OBJECTIVE: Day care surgery is an important arena for monitors of anesthetic depth where minimizing drug use is essential for rapid turnover. Underdosage, on the other hand, carries the risks of intraoperative awareness and pain. Transvaginal oocyte retrieval (TVOR), often performed under total intravenous anesthesia using propofol and fentanyl in Indian patients, is a procedure of special interest because, in addition to the above concerns, toxic effects of propofol on oocytes have been described...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27590919/a-delayed-functional-observer-predictor-with-bounded-error-for-depth-of-hypnosis-monitoring
#18
Neda Eskandari, Z Jane Wang, Guy A Dumont
With the motivation of providing safety for a patient under anesthesia, this paper suggests conditions for evaluating the correctness of an available user interface for systems under shared control based on observability and predictability requirements. Situation awareness is necessary for the user to make correct decisions about the inputs. In this article, we develop a technique to investigate the conditions under which an anesthetists can attain situation awareness about a limited but important aspect of anesthesia, namely depth of hypnosis (DOH)...
September 2, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27578311/successful-management-of-intraoperative-acute-bilateral-pulmonary-embolism-in-a-high-grade-astrocytoma-patient
#19
Wail N Khraise, Mohammed Z Allouh, Mohammad Y Hiasat, Raed S Said
BACKGROUND Intraoperative pulmonary embolism (PE) is a rare life-threatening complication in patients undergoing surgical intervention. Generally, cancer patients have a higher risk for developing this complication. Unfortunately, there is no standard procedure for its management. CASE REPORT We report the case of a 39-year-old woman with high-grade glioma in the right frontal lobe who was admitted to the surgical theater for craniotomy and excision of the tumor. During the general anesthesia procedure and just before inserting the central venous line, her end-tidal CO2 and O2 saturation dropped sharply...
August 31, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27465194/malignant-melanoma-beyond-the-basics
#20
Sabrina N Pavri, James Clune, Stephan Ariyan, Deepak Narayan
LEARNING OBJECTIVES: After reading this article, the participant should be able to: 1. Discuss the initial management of cutaneous malignant melanoma with regard to diagnostic biopsy and currently accepted resection margins. 2. Be familiar with the management options for melanoma in specific situations such as subungual melanoma, auricular melanoma, and melanoma in the pregnant patient. 3. Discuss the differentiating characteristics of desmoplastic melanoma and its treatment options. 4...
August 2016: Plastic and Reconstructive Surgery
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