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Anaesthesia patient safety

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https://www.readbyqxmd.com/read/28528932/robot-assisted-gynaecological-cancer-surgery-complications-and-prevention
#1
REVIEW
Ka Yu Tse, Hextan Yuen Sheung Ngan, Peter Christopher Lim
Ever since the US Food and Drug Administration approval of the use of da Vinci surgical systems (Intuitive Surgical Inc., Sunnyvale, California) in gynaecology in 2005, robot-assisted surgery has been widely adopted in different countries. Some of the applications in benign and oncological gynaecology include myomectomy, sacrocolpopexy, tubal anastomosis, simple hysterectomy, radical hysterectomy, radical trachelectomy, pelvic and/or para-aortic lymphadenectomy and even debulking surgery for ovarian cancer and pelvic exenteration for recurrent cervical and vaginal cancer...
April 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28510742/drug-safety-in-paediatric-anaesthesia
#2
J Kaufmann, A R Wolf, K Becke, M Laschat, F Wappler, T Engelhardt
Life-threatening drug errors are more common in children than in adults. This is likely to be because of their variations in age and weight, combined with the occasional exposure of most anaesthetists to paediatric patients. Drug administration in anaesthesia is mostly undertaken by a single operator and thus represents a potentially greater risk compared with other areas of medicine. This increased risk is believed to be offset by anaesthetists working with only a limited number of drugs on a very frequent and repetitive basis...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28498927/efficacy-and-safety-of-carbetocin-given-as-an-intravenous-bolus-compared-with-short-infusion-for-caesarean-section-double-blind-double-dummy-randomized-controlled-non-inferiority-trial
#3
S Dell-Kuster, I Hoesli, O Lapaire, E Seeberger, L A Steiner, H C Bucher, T Girard
Background: Carbetocin is a synthetic oxytocin-analogue, which should be administered as bolus according to manufacturer's recommendations. A higher speed of oxytocin administration leads to increased cardiovascular side-effects. It is unclear whether carbetocin administration as short infusion has the same efficacy on uterine tone compared with bolus administration and whether haemodynamic parameters differ. Methods: In this randomized, double-blind, non-inferiority trial, women undergoing planned or unplanned Caesarean section (CS) under regional anaesthesia received a bolus and a short infusion, only one of which contained carbetocin 100 mcg (double dummy)...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28498903/efficacy-and-safety-of-inhaled-anaesthetic-for-postoperative-sedation-during-mechanical-ventilation-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#4
J Spence, E Belley-Côté, H K Ma, S Donald, J Centofanti, S Hussain, S Gupta, P J Devereaux, R Whitlock
The aim was to evaluate the efficacy and safety of volatile anaesthetic for postoperative sedation in adult cardiac surgery patients through a systematic review and meta-analysis. We retrieved randomized controlled trials from MEDLINE, EMBASE, CENTRAL, Web of Science, clinical trials registries, conference proceedings, and reference lists of included articles. Independent reviewers extracted data, including patient characteristics, type of intraoperative anaesthesia, inhaled anaesthetic used, comparator sedation, and outcomes of interest, using pre-piloted forms...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28495814/automated-control-of-mechanical-ventilation-during-general-anaesthesia-study-protocol-of-a-bicentric-observational-study-avas
#5
Dirk Schädler, Georg Miestinger, Tobias Becher, Inéz Frerichs, Norbert Weiler, Christoph Hörmann
INTRODUCTION: Automated control of mechanical ventilation during general anaesthesia is not common. A novel system for automated control of most of the ventilator settings was designed and is available on an anaesthesia machine. METHODS AND ANALYSIS: The 'Automated control of mechanical ventilation during general anesthesia study' (AVAS) is an international investigator-initiated bicentric observational study designed to examine safety and efficacy of the system during general anaesthesia...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28486890/efficacy-and-safety-of-ultra-rapid-iron-polymaltose-infusion-during-general-anaesthesia
#6
R M Browning, N Alakeson, E J O'Loughlin
To assess the efficacy and safety of ultra rapid (15 minute) infusion of iron polymaltose to iron deficient patients during general anaesthesia, we performed a prospective, interventional non-randomised study on 99 adult patients with iron deficiency with or without anaemia presenting for surgery under general anaesthesia. Over 15 minutes during the maintenance phase of anaesthesia, patients were given iron polymaltose, 500 mg if not anaemic, or 1,000 mg if anaemic. Haemodynamic stability, immediate or delayed iron-related side-effects and efficacy at six weeks were assessed...
May 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28465832/randomized-crossover-study-showing-nurse-led-same-day-review-replacing-next-day-review-in-uneventful-phacoemulsification-to-be-safe-and-efficacious
#7
Jennifer W H Shum, Janice J C Cheung, Monica M N Lee, Oscar G W Wong, Kenneth K W Li
Purpose. To study whether nurse led same-day review (SDR) after uneventful phacoemulsification can replace next-day review (NDR) in terms of safety and efficacy. Setting. Patients are recruited from an ophthalmology outpatient clinic in Hong Kong. Design. A prospective, randomized crossover study conducted from November 2012 to 2014. Methods. Inclusion criteria include cataract surgery naïve patients undergoing phacoemulsification under local anaesthesia. All patients were seen by our ophthalmic nurse 2 hours after surgery...
2017: Journal of Ophthalmology
https://www.readbyqxmd.com/read/28462732/anaesthesia-for-electroconvulsive-therapy-new-tricks-for-old-drugs-a-systematic-review
#8
Tobias Kvist Stripp, Martin Balslev Jorgensen, Niels Vidiendal Olsen
OBJECTIVE: The objective of this review is to investigate existing literature in order to delineate whether the use of anaesthesia and timing of seizure induction in a new and optimised way may improve the efficacy of electroconvulsive therapy (ECT). METHODS: PubMed/MEDLINE was searched for existing literature, last search on 24 June 2015. Relevant clinical studies on human subjects involving choice of anaesthetic, ventilation and bispectral index (BIS) monitoring in the ECT setting were considered...
May 2, 2017: Acta Neuropsychiatrica
https://www.readbyqxmd.com/read/28452427/results-of-an-innovative-bulking-agent-in-patients-with-stress-urinary-incontinence-who-are-not-optimal-candidates-for-mid-urethral-sling-surgery
#9
Claudia R Kowalik, Fenne M Casteleijn, Hugo W F van Eijndhoven, Sandra E Zwolsman, Jan-Paul W R Roovers
AIMS: To assess the efficacy and safety of peri-urethral bulking injections (PBI) with an innovative bulking material (PDMS-U) in women with stress-urinary incontinence (SUI) who are not optimal candidates for mid-urethral sling surgery. METHODS: A prospective study was performed in women with SUI who, for several reasons, have a relative contraindication for a mid-urethral sling procedure. These reasons include: (i) recurrent SUI after a prior SUI surgical procedure; (ii) a history of oncologic gynaecological surgery; (iii) a history of neurologic disease resulting in voiding problems; (iv) a maximal flow rate of less than 15 mL per second or; (v) women with a contraindication for surgery with general or regional anaesthesia...
April 28, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28451694/production-pressures-among-anaesthesiologists-in-singapore
#10
Jia Xin Chai, Shin Yuet Chong
INTRODUCTION: Production pressure is the pressure on personnel to prioritise production ahead of safety. We assessed the prevalence of production pressures among anaesthesiologists in Singapore. METHODS: A random online survey was conducted among local anaesthesiologists. Questions were asked about attitudes to production pressures in the work environment, occurrence of situations involving unsafe actions, and rating on the intensity of external and internal sources of pressure...
April 28, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28433509/transcutaneous-aortic-valve-implantation-using-the-carotid-artery-access-feasibility-and-clinical-outcomes
#11
Zacharenia Kallinikou, Alexandre Berger, Patrick Ruchat, Gregory Khatchatourov, Isabelle Fleisch, Branislav Korkodelovic, Emmanuel Henchoz, René-Andréas Marti, Stéphane Cook, Mario Togni, Jean-Jacques Goy
BACKGROUND: Transcarotid access is an alternative route for transcutaneous aortic valve implantation (TAVI) in patients with impossible transfemoral access. AIMS: We evaluated the safety, effectiveness and early and late clinical outcomes of CoreValve(®) implantation via the common carotid artery. METHODS: Eighteen patients (10 men, 8 women; mean age 84±5 years) at high surgical risk (mean EuroSCORE II 16±13%) with significant peripheral artery disease underwent TAVI via common carotid artery access under general anaesthesia...
April 19, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28419883/feasibility-and-safety-of-foam-sclerotherapy-followed-by-a-multiple-subcutaneously-interrupt-ligation-under-local-anaesthesia-for-outpatients-with-varicose-veins
#12
Yan Sun, Xin Li, Zhong Chen, Xianlun Li, Shiyan Ren
PURPOSE: To prospectively evaluate the feasibility and safety of foam sclerotherapy and ligation (FSL) for outpatients with varicose veins under local anaesthesia. METHODS: 136 outpatients with varicose veins who were unwilling to be hospitalized underwent FSL. FSL is a technique in which the dilated varicose veins were ligated subcutaneously after foam sclerotherapy with an absorbable suture. Patients were reviewed at 1, 3, 6 and 12 months after FSL. Pain scores were recorded after FSL...
April 15, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28405039/disinfection-of-laryngoscopes-a-survey-of-practice
#13
Vaishali Prabhakar Chaskar, Nandini Malay Dave, Raylene Dias, Priyanka Karnik
BACKGROUND AND AIMS: The laryngoscope is a common piece of equipment used by anaesthesiologists. It has been identified as a potential source of cross infection. Although guidelines exist regarding appropriate disinfection practices, recent reviews suggest ineffectiveness of current methods of disinfection and poor compliance with the established protocols. We conducted a questionnaire-based survey to study the current disinfection practices being followed by a cross section of anaesthesiologists...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28405035/safety-and-efficacy-of-transdermal-buprenorphine-versus-oral-tramadol-for-the-treatment-of-post-operative-pain-following-surgery-for-fracture-neck-of-femur-a-prospective-randomised-clinical-study
#14
Sameer N Desai, Santhoshi V Badiger, Shreesha B Tokur, Prashanth A Naik
BACKGROUND: Transdermal buprenorphine, which is used in chronic pain management, has rarely been studied for use in acute pain management. The aim of this study was to compare the safety and efficacy of transdermal buprenorphine patch to oral tramadol for post-operative analgesia, following proximal femur surgeries. METHODOLOGY: Fifty adult patients undergoing surgery for hip fracture under spinal anaesthesia were included in this study. One group (Group TDB) received transdermal buprenorphine 10 mcg/h patch applied a day before the surgery and other group received oral tramadol 50 mg three times a day for analgesia (Group OT)...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28358179/perioperative-cardiac-arrest-in-the-operating-room-environment-a-review-of-the-literature
#15
Jochen Hinkelbein, Janusz Andres, Karl-Christian Thies, Edoardo De Robertis
Cardiac arrest in the operating room (OR) environment is a rare but potentially catastrophic event with mortality rates of more than 50%. Cardiac arrest during anaesthesia and the immediate postoperative period is distinct from non-operative settings or other in-hospital cardiac arrests since it is almost always witnessed and often anticipated. Contributing factors are known, and the event is generally rapidly recognized, as patients are usually under full monitoring. The nature of the cardiac arrest in the OR environment is also different as it is not only related to the patient's conditions but likewise to the anaesthetic and the surgical procedure...
March 28, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28347552/learning-outcomes-evaluation-of-a-simulation-based-introductory-course-to-anaesthesia
#16
J L Rábago, M López-Doueil, R Sancho, P Hernández-Pinto, N Neira, E Capa, E Larraz, C G Redondo-Figuero, J M Maestre
OBJECTIVE: An increased number of errors and reduced patient safety have been reported during the incorporation of residents, as this period involves learning new skills. The objectives were to evaluate the learning outcomes of an immersive simulation boot-camp for incoming residents before starting the clinical rotations. Airway assessment, airway control with direct laryngoscopy, and epidural catheterization competencies were evaluated. MATERIAL AND METHOD: Twelve first-year anaesthesiology residents participated...
March 24, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28339558/impact-of-sedation-vs-general-anaesthesia-on-percutaneous-epicardial-access-safety-and-procedural-outcomes
#17
Ammar M Killu, Alan Sugrue, Thomas M Munger, David O Hodge, Siva K Mulpuru, Christopher J McLeod, Douglas L Packer, Samuel J Asirvatham, Paul A Friedman
Aims: Patient movement while under moderate/deep sedation may complicate percutaneous epicardial access (EpiAcc), mapping and ablation. We sought to compare procedural outcomes in patients undergoing EpiAcc under sedation vs. general anaesthesia (GA) for ablation. Methods and results: Patients undergoing EpiAcc between January 2004 and July 2014 were included. Safety, procedural, and clinical outcomes were compared between patients undergoing EpiAcc under sedation or GA for ventricular tachycardia or premature ventricular complex ablation...
November 15, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28289667/laparoscopic-cholecystectomy-under-spinal-epidural-anesthesia-vs-general-anaesthesia-a-prospective-randomised-study
#18
Turgut Donmez, Vuslat Muslu Erdem, Sinan Uzman, Dogan Yildirim, Huseyin Avaroglu, Sina Ferahman, Oguzhan Sunamak
PURPOSE: Laparoscopic cholecystectomy (LC) is usually performed under the general anesthesia (GA). Aim of the study is to investigate the availability, safety and side effects of combined spinal/epidural anesthesia (CSEA) and comparison it with GA for LC. METHODS: Forty-nine patients who have a LC plan were included into the study. The patients were randomly divided into GA (n = 25) and CSEA (n = 24) groups. Intraoperative and postoperative adverse events, postoperative pain levels were compared between groups...
March 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28272587/-ocular-complications-of-local-anaesthesia-in-dentistry
#19
S A Steenen, L Dubois, J de Lange
An estimated 1 in 1,000 local anaesthetic injections in the maxilla or the mandible lead to unwanted effects on the ipsilateral eye. We have seen a case with diplopia and lateral rectus palsy following bimaxillary anaesthesia. A systematic literature review of reports on this type of complication resulted in a total of 144 documented cases published between 1936 and 2016. The most frequently reported symptoms included diplopia (72%), partial or full ophthalmoplegia (26%), ptosis (22%), mydriasis (18%), amaurosis (13%) and orbital pain (12%)...
March 2017: Nederlands Tijdschrift Voor Tandheelkunde
https://www.readbyqxmd.com/read/28250480/efficacy-of-intranasal-dexmedetomidine-versus-oral-midazolam-for-paediatric-premedication
#20
Lakshmi Kumar, Ajay Kumar, Ramkumar Panikkaveetil, Bindu K Vasu, Sunil Rajan, Suresh G Nair
BACKGROUND AND AIMS: Premedication is an integral component of paediatric anaesthesia which, when optimal, allows comfortable separation of the child from the parent for induction and conduct of anaesthesia. Midazolam has been accepted as a safe and effective oral premedicant. Dexmedetomidine is a selective alpha-2 agonist with sedative and analgesic effects, which is effective through the transmucosal route. We compared the efficacy and safety of standard premedication with oral midazolam versus intranasal dexmedetomidine as premedication in children undergoing elective lower abdominal surgery...
February 2017: Indian Journal of Anaesthesia
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