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Awareness under anesthesia

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https://www.readbyqxmd.com/read/28096574/awareness-during-general-anesthesia-an-indian-viewpoint
#1
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
#2
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
#3
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
#4
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...
December 29, 2016: 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
#5
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...
October 15, 2016: 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
#6
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
#7
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
#8
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
#9
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...
November 22, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27871554/evaluation-of-ph-on-removed-tracheal-tubes-after-general-anesthesia-a-prospective-observational-study
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/27228360/cognitive-dysfunction-in-children-with-heart-disease-the-role-of-anesthesia-and-sedation
#15
REVIEW
Danton Char, Chandra Ramamoorthy, Lisa Wise-Faberowski
As physicians and caregivers of children with congenital heart disease, we are aware of the increasing need for procedures requiring anesthesia. While these procedures may be ideal for medical and cardiac surgical management, the risks and benefits must be assessed carefully. There are well known risks of cardiovascular and respiratory complications from anesthesia and sedation and a potentially under-appreciated risk of neurocognitive dysfunction. Both animal and human studies support the detrimental effects of repeated anesthetic exposure on the developing brain...
May 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27188115/-anesthetic-management-of-an-adrenoleukodystrophy-patient-for-intrathecal-baclofen-therapy
#16
Yuichi Hashimoto, Kei Takahashi, Yuko Yamamoto, Tokiko Ogata, Takero Arai, Yasuhisa Okuda
A 34-year-old man with adrenoleukodystrophy (ALD) was scheduled for pump system insertion of intrathecal baclofen therapy under general anesthesia. ALD, a rare genetic disorder, is associated with a total body increase in long chain fatty acids caused by defective degradation, and includes various nervous system abnormalities, muscular weakness, in addition to adrenal insufficiency. He had contracture of the both legs, and muscular weakness of the left hand, and Mallampati class III, but no respiratory disability...
April 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/27165640/a-diffuse-traumatic-neuroma-in-the-palate-a-case-report
#17
Takanori Eguchi, Rikuma Ishida, Hironori Ara, Yoshiki Hamada, Ikuyo Kanai
BACKGROUND: A traumatic neuroma is not a true neoplasm but a reactive proliferation of neural tissue that commonly occurs after the transection or damage of a nerve bundle. Traumatic neuromas are rare in the oral region and usually occur as a solitary nodule of the mental foramen, lower lip, or tongue. This is the first report of a diffuse traumatic neuroma of the palate. CASE PRESENTATION: A 30-year-old Japanese man was referred to our clinic complaining of painful swelling of the left side of his palate...
May 11, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27130218/inverted-stress-induced-cardiomyopathy-as-a-unusual-variant-of-acute-heart-failure-after-cesarean-delivery-a-case-report
#18
Anna Ledakowicz-Polak, Jarosław Bartodziej, Agata Majos, Marzenna Zielińska
BACKGROUND: Stress- induced cardiomyopathy is acute, reversible left ventricle mainly apical dysfunction in patients with normal coronary angiography. Rarely it regards basal segments, therefore defined as "inverted stress- induced cardiomyopathy". While classic form mostly affects postmenopausal women, inverted variant occurs essentially in younger females, always triggered by stress. It can also develop after medical procedures and surgery. Herein we report such unique case of 36- year old woman after cesarean delivery...
April 29, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27111691/anesthetic-management-of-877-pediatric-patients-undergoing-muscle-biopsy-for-neuromuscular-disorders-a-20-year-review
#19
Frederic Shapiro, Umeshkumar Athiraman, David J Clendenin, Monica Hoagland, Navil F Sethna
BACKGROUND: The objectives are to review the anesthetic management and anesthetic-related adverse events in patients undergoing muscle biopsy for a broad spectrum of neuromuscular disorders (NMD). AIM: The study aims to assess the hypothesis that perceived awareness of potential anesthesia-induced hyperkalemia and MH in patients with NMD reduces the frequency of such events. METHODS: A 20-year retrospective review of 877 consecutive patients undergoing muscle biopsy to establish diagnoses of NMD has been performed...
July 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27097709/ophthalmomyiasis-caused-by-sheep-nasal-botfly-oestrus-ovis
#20
Ghazanfar Abbas, Umer Farid Amla
Ophthalmomyiasis is a parasitic eye infection. Ayoung male went on a picnic with his family. After sudden blow of wind, he had a feeling of something struck in the eye, which quickly became swollen with severe itching and lacrimation. Atotal of 19 larvae in their instar stage were removed with fine forceps under topical anesthesia and slides were prepared for their identification, which came out to be Oestrus ovisbelonging to Oestridae family. Recently, cases are being reported from rural and urban areas of Sindh...
April 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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