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Awareness under anesthesia

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https://www.readbyqxmd.com/read/27891392/a-study-of-evaluation-and-management-of-rare-congenital-breast-diseases
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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...
2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27465194/malignant-melanoma-beyond-the-basics
#7
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
#8
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
#9
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
#10
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...
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
#11
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...
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
#12
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
#13
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
https://www.readbyqxmd.com/read/27016647/locked-volar-distal-radioulnar-joint-dislocation
#14
Fadi Bouri, Mazhar Fuad, Ayman Elsayed Abdolenour
INTRODUCTION: Volar dislocation of the distal radioulnar joint is a rare injury which is commonly missed in the emergency departments. A thorough review of literature showed very few reported cases and the cause for irreducibility varied in different cases, Lack of suspicion and improper X-ray can delay the diagnosis. CASE PRESENTATION: Our article discusses a case 40 year old construction worker, who presented to the Emergency with work-related injury, complaining of left wrist pain, deformity and inability to rotate his forearm...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/26985238/autonomic-hyperreflexia-after-spinal-cord-injury-managed-successfully-with-intravenous-lidocaine-a-case-report
#15
Pedro Leão, Paulo Figueiredo
BACKGROUND: Some paraplegic patients may wish undergo some surgical procedures, like urological procedures, without anesthesia. However, these patients can develop autonomic hyperreflexia if cystoscopy is performed without anesthesia. CASE PRESENTATION: We present a case of severe autonomic hyperreflexia in a 44-year-old male with spinal cord injury at the level of T4 during urologic procedure under sedation and analgesia successfully treated with intravenous lidocaine...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/26982116/the-obese-patient-undergoing-nonbariatric-surgery
#16
Thomas Bluth, Paolo Pelosi, Marcelo Gama de Abreu
PURPOSE OF REVIEW: This article provides the reader with recent findings on the pathophysiology of comorbidities in the obese, as well as evidence-based treatment options to deal with perioperative respiratory challenges. RECENT FINDINGS: Our understanding of obesity-associated asthma, obstructive sleep apnea, and obesity hypoventilation syndrome is still expanding. Routine screening for obstructive sleep apnea using the STOP-Bang score might identify high-risk patients that benefit from perioperative continuous positive airway pressure and close postoperative monitoring...
June 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/26967459/effects-of-acupuncture-in-anesthesia-for-craniotomy-a-meta-analysis
#17
Sven Asmussen, Dirk M Maybauer, Jiande D Chen, John F Fraser, Michael H Toon, Rene Przkora, Kristofer Jennings, Marc O Maybauer
BACKGROUND: Acupuncture treatment has been used in China for >2500 years, and at present it is used worldwide as a form of analgesia in patients with acute and chronic pain. Furthermore, acupuncture is regularly used not only as a single anesthetic technique but also as a supplement or in addition to general anesthesia (GA). OBJECTIVES: The aim of this systematic review and meta-analysis was to assess the level of evidence for the clinical use of acupuncture in addition to GA in patients undergoing craniotomy...
March 10, 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/26925157/controversies-and-advances-in-the-management-of-congenital-ptosis
#18
Ali Mokhtarzadeh, Andrew R Harrison
The management issues associated with pediatric ptosis begin with determining the etiology of the ptosis, and considering how the eyelid position affects the child's visual and psychosocial development. These ultimately determine if and when surgical management should be undertaken. Surgical challenges include the lack of intraoperative feedback regarding the dynamic eyelid height and contour under general anesthesia. When the eyelid elevators do not function or if there is little drive to lift the involved eyelid, obtaining good surgical outcomes can be extremely challenging...
January 2, 2015: Expert Review of Ophthalmology
https://www.readbyqxmd.com/read/26918105/primary-vaginal-non-hodgkin-s-lymphoma-report-of-a-rare-clinical-entity
#19
Vera Silva, Paulo Correia, Nuno Oliveira, Luís Sá
A 52-year-old woman was referred to the gynecology outpatient clinic with a 2 months history of vaginal bleeding with intercourse, and no other symptoms. Vaginal examination revealed a firm, non-tender, mass in the posterior vaginal wall. The initial clinical impression was that of a vaginal carcinoma and a biopsy under local anesthesia was performed, but the result was inconclusive. A deeper biopsy, under general anesthesia, was performed and a histological diagnosis of non-Hodgkin's lymphoma was done. The staging workup permitted to exclude any other site of the body affected by the malignancy...
November 5, 2015: Clinics and Practice
https://www.readbyqxmd.com/read/26899514/horner-s-syndrome-after-scalene-block-and-carotid-dissection
#20
Amit S Padaki, R Warne Fitch, Lawrence B Stack, R Jason Thurman
BACKGROUND: Horner's syndrome refers to the clinical triad of ptosis, miosis, and anhidrosis resulting from disruption of the ocular and facial sympathetic pathways. A myriad of etiologies can lead to Horner's syndrome; awareness of the underlying anatomy can assist physicians in identifying potential causes and initiating appropriate care. CASE REPORT: Two patients presented to our Nashville-area hospital in 2014. Patient 1 was a 26-year-old man who noticed facial asymmetry one day after an outpatient orthopedic procedure...
May 2016: Journal of Emergency Medicine
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