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Awareness under anesthesia

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https://www.readbyqxmd.com/read/28806208/systemic-hypotension-following-intravenous-administration-of-nonionic-contrast-medium-during-computed-tomography-iopromide-versus-iodixanol
#1
Gerlig Widmann, Reto Bale, Hanno Ulmer, Daniel Putzer, Peter Schullian, Franz-Josef Wiedermann, Wolfgang Lederer
BACKGROUND: In light of the increasing number of radiologic interventions performed under general anesthesia, the effects of contrast media (CM) on circulation and organ perfusion are of paramount importance. The objectives of this study were to systematically quantify effects on blood pressure, heart rate, and kidney function following intravenous administration of nonionic CM with normal and low osmolality. METHODS: In this controlled, double-blinded phase IV clinical trial, 40 consecutive patients were randomly assigned to receive repeated measures of either low-osmolar iopromide or iso-osmolar iodixanol...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28756145/limb-shaking-transient-ischemic-attack-induced-by-middle-cerebral-artery-dissection-after-lung-surgery
#2
Daisuke Taniguchi, Yutaka Oji, Yuji Ueno, Shunki Hirayama, Mariko Fukui, Nobukazu Miyamoto, Kazuo Yamashiro, Ryota Tanaka, Kenji Suzuki, Nobutaka Hattori
We report a case of limb-shaking transient ischemic attack (TIA) caused by a dissection of the middle cerebral artery (MCA) following lung surgery under general anesthesia. An 81-year-old male patient who underwent lobectomy for lung cancer suddenly developed transient shaking movements of the neck and the left upper distal limb on postoperative day 1. On the basis of the double-barrel appearance of the right M1 segment of the MCA, a diagnosis of MCA dissection was made. Physicians should be aware that limb-shaking TIA is sometimes caused by MCA dissection and could be precipitated by any condition, including lung surgery under general anesthesia...
July 26, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28743752/thalamocortical-synchronization-during-induction-and-emergence-from-propofol-induced-unconsciousness
#3
Francisco J Flores, Katharine E Hartnack, Amanda B Fath, Seong-Eun Kim, Matthew A Wilson, Emery N Brown, Patrick L Purdon
General anesthesia (GA) is a reversible drug-induced state of altered arousal required for more than 60,000 surgical procedures each day in the United States alone. Sedation and unconsciousness under GA are associated with stereotyped electrophysiological oscillations that are thought to reflect profound disruptions of activity in neuronal circuits that mediate awareness and cognition. Computational models make specific predictions about the role of the cortex and thalamus in these oscillations. In this paper, we provide in vivo evidence in rats that alpha oscillations (10-15 Hz) induced by the commonly used anesthetic drug propofol are synchronized between the thalamus and the medial prefrontal cortex...
July 25, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28665830/undiagnosed-pheochromocytoma-simulating-malignant-hyperthermia
#4
Nisha S Ramani, Robert Stoppacher, Ajaykumar C Morani, Charles Catanese
INTRODUCTION: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. They are surgically curable but can be lethal if remain undiagnosed. We report a patient earlier diagnosed with malignant hyperthermia but later found to have pheochromocytoma on autopsy. CASE REPORT: After a preprocedural pain block for elective right shoulder arthroscopy, a 53-year-old hypertensive white man developed chest pain. In the operating room, he had increased blood pressure...
September 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28663647/incidence-of-awareness-with-recall-under-general-anesthesia-in-rural-india-an-observational-study
#5
Deepak Singla, Mishu Mangla
CONTEXT: Awareness under anesthesia is a rare but extremely unpleasant phenomenon. There are very few studies in the developing world and none from rural areas where incidence of intraoperative awareness may be higher due to increased patient load, limited patient knowledge and lack of trained hospital staff, reliance on older, cheaper but less effective drugs, and lack of proper equipment both for providing anesthesia, as well as monitoring the patient. AIMS: To assess the incidence of intraoperative awareness during general anesthesia among patients in rural India and any factors associated with the same...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28601422/exposure-to-surgery-and-anesthesia-after-concussion-due-to-mild-traumatic-brain-injury
#6
Arnoley S Abcejo, Rodolfo Savica, William L Lanier, Jeffrey J Pasternak
OBJECTIVE: To describe the epidemiology of surgical and anesthetic procedures in patients recently diagnosed as having a concussion due to mild traumatic brain injury. PATIENTS AND METHODS: Study patients presented to a tertiary care center after a concussion due to mild traumatic brain injury from July 1, 2005, through June 30, 2015, and underwent a surgical procedure and anesthesia support under the direct or indirect care of a physician anesthesiologist. RESULTS: During the study period, 1038 patients met all the study inclusion criteria and subsequently received 1820 anesthetics...
July 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28579714/neumann-s-tumor-a-case-report
#7
Kashi Nataraj Vinay, Lidetu Afework Anjulo, Prabhakar Nitin, Kashi Vinay Neha, Dwivedi Dhara
BACKGROUND: The congenital granular cell tumour of the newborn, also known as congenital epulis or Neumann's tumor, is rare. It occurs on the gingiva of the anterior alveolar ridge of the jaws. This lesion behaves in a benign manner and no recurrent or metastatic lesions have been reported. CASE REPORT: We are reporting a 2-day-old female neonate, who came to our unit with a well defined, solitary, firm mass arising from the maxillary anterior region measuring about 3...
March 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28566868/oral-subcutaneous-midline-leiomyomatous-hamartoma-presenting-as-congenital-incisive-papilla-overgrowth-in-a-toddler
#8
Ashish Loomba, Shalini Garg, Abhishek Dhindsa, Harshaminder Kaur, Neetu Jain, Promila Dhindsa
Congenital soft-tissue tumors of oral cavity are mostly hyperplastic and benign in nature. This article presents an unusual case of congenital subcutaneous hamartoma of incisive papilla in a 2-year-old female child causing feeding and breathing difficulty. Total excisional biopsy was done under local anesthesia. Histopathology of tissue in reticulin-stained slide showed the presence of immature muscle fibers whereas Masson's trichrome stain revealed collagen fibers and smooth muscles confirming the diagnosis of oral midline subcutaneous smooth muscle (leiomyomatous) hamartoma of incisive papilla...
January 2017: Contemporary Clinical Dentistry
https://www.readbyqxmd.com/read/28472777/anesthetic-dreaming-anesthesia-awareness-and-patient-satisfaction-after-deep-sedation-with-propofol-target-controlled-infusion-a-prospective-cohort-study-of-patients-undergoing-day-case-breast-surgery
#9
Marco Cascella, Roberta Fusco, Domenico Caliendo, Vincenza Granata, Domenico Carbone, Maria Rosaria Muzio, Giuseppe Laurelli, Stefano Greggi, Francesca Falcone, Cira Antonietta Forte, Arturo Cuomo
BACKGROUND: Anesthetic dreaming and anesthesia awareness are well distinct phenomena. Although the incidence of intraoperative awareness is more common among patients who reported a dream after surgery, the exact correlation between the two phenomena remains an unsolved rebus. The main purpose of this study was to investigate anesthetic dreaming, anesthesia awareness and psychological consequences eventually occurred under deep sedation. Intraoperative dreaming experiences were correlated with dream features in natural sleep...
April 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/28458576/continuous-postoperative-infusion-of-remifentanil-inhibits-the-stress-responses-to-tracheal-extubation-of-patients-under-general-anesthesia
#10
Guoliang Zhao, Xiaoyue Yin, Ya Li, Jianlin Shao
PURPOSE: The study aimed to assess the combined effects of parecoxib with three different doses of remifentanil and its effect on the stress and cough responses following tracheal extubation under general anesthesia. METHODS: A total of 120 patients with American Society of Anesthesiologists (ASA) scores of I or II, undergoing selective thyroidectomy with total intravenous anesthesia (propofol-remifentanil) and tracheal intubation, were randomly allocated to be treated with an intravenous injection of parecoxib and a continuous infusion of remifentanil at 0...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28452603/effects-of-music-therapy-under-general-anesthesia-in-patients-undergoing-abdominal-surgery
#11
Mohamed Kahloul, Salah Mhamdi, Mohamed Said Nakhli, Ahmed Nadhir Sfeyhi, Mohamed Azzaza, Ajmi Chaouch, Walid Naija
BACKGROUND: Music therapy, an innovative approach that has proven effectiveness in many medical conditions, seems beneficial also in managing surgical patients. The aim of this study is to evaluate its effects, under general anesthesia, on perioperative patient satisfaction, stress, pain, and awareness. METHODS: This is a prospective, randomized, double-blind study conducted in the operating theatre of visceral surgery at Sahloul Teaching Hospital over a period of 4 months...
December 2017: Libyan Journal of Medicine
https://www.readbyqxmd.com/read/28450776/brainstem-anesthesia-after-retrobulbar-block-a-case-report-and-review-of-literature
#12
Kumale Tolesa, Girum W Gebreal
BACKGROUND: Retro-bulbar anesthesia is one of the most common regional blocks used for intraocular surgeries. Complications associated with regional blocks may be limited to the eye or may be systemic. CASE REPORT: After a retro-bulbar block for glaucoma surgery, a 60-year-old man developed loss of consciousness, apnea with hypotension and bradycardia-features of brainstem anesthesia. We present the clinical features, treatment and comments on how to prevent the problem as well as a review of the literature on reported cases...
November 2016: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28393059/tapia-s-syndrome-after-corrective-jaw-surgery-under-general-anesthesia-a-case-report
#13
Farzad Izadi, Aslan Ahmadi, Ali Daneshvar, Mahdi Safdarian
INTRODUCTION: Tapia's syndrome is a rare complication of recurrent laryngeal and hypoglossal nerve paralysis due to anesthetic airway mismanagement or malpositioning of the patient's head during surgery. CASE REPORT: Here we present a case of Tapia's syndrome in a 22-year-old male after corrective jaw surgery under general anesthesia, with a long period of recovery, related to airway management procedures and/or overstretching of the neck during positioning for surgery...
March 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28337530/chronic-sialadenitis-due-to-the-stone-inside-the-accessory-duct-of-submandibular-gland
#14
Murat Binar, Mert Cemal Gokgoz, Umit Aydin, Ibrahim Yavan, Serdar Karahatay
PURPOSE: Sialolithiasis is the most common cause of chronic sialadenitis. In this case report, intraoperative finding of an accessory submandibular duct, obstructed with stone, originating from the same gland nearby the main Warthon's duct, is presented. CASE REPORT: A 22-year-old male patient, suffering from eating-related pain and swelling in his left submandibular region, was diagnosed with left sublandibular gland sialadenitis with radiologically manifested sialolithiasis, and gland excision was advised...
March 23, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28256332/-anesthesia-management-by-residents-does-not-alter-the-incidence-of-recall-of-tracheal-extubation-a-teaching-hospital-based-propensity-score-analysis
#15
Satoki Inoue, Ryuichi Abe, Yuu Tanaka, Masahiko Kawaguchi
BACKGROUND AND OBJECTIVES: The memory of emergence from anesthesia is recognized as one type of anesthesia awareness. Apart from planed awake extubation, unintentional recall of tracheal extubation is thought to be the results of inadequate anesthesia management; therefore, the incidence can be related with the experience of anesthetists. To assess whether the incidence of recall of tracheal extubation is related to anesthetists' experience, we compared the incidence of recall of tracheal extubation between patients managed by anesthesia residents or by experienced anesthetists...
February 27, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28236867/medication-errors-in-anesthesia-unacceptable-or-unavoidable
#16
REVIEW
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...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28224632/scoping-review-awareness-of-neurotoxicity-from-anesthesia-in-children-in-otolaryngology-literature
#17
REVIEW
Marisa A Earley, Liem T Pham, Max M April
OBJECTIVE: Review otolaryngology literature for awareness of neurotoxicity from general anesthesia in children. Recently, there has been increasing focus in anesthesia literature on the long-term effects of general anesthesia on neurodevelopment. Multiple animal models have demonstrated evidence of neurotoxicity from both inhalational and intravenous anesthetics. Cohort studies also have revealed modestly increased risk of adverse neurodevelopmental outcomes in children exposed to a single episode of general anesthesia prior to 3 to 4 years of age, with stronger evidence for multiple exposures in this age range...
February 22, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28217389/management-of-parturients-in-active-labor-with-arnold-chiari-malformation-tonsillar-herniation-and-syringomyelia
#18
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
#19
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
#20
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
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