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Anaesthesia patient safety

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https://www.readbyqxmd.com/read/29330080/use-of-a-pulsed-radiofrequency-energy-device-peak-plasmablade%C3%A2-in-neuromodulation-implant-revisions
#1
I Ughratdar, K A Kawsar, R Mitchell, R Selway, K Ashkan
BACKGROUND: Battery replacement or revision surgery for neuromodulation implants is conventionally performed using sharp dissection. Meticulous dissection within thick scar tissue is vital to avoid damage to surrounding lead(s) which could result in more extensive revision surgery. Traditional electrosurgery devices are contraindicated as the emitted energy can be transferred to the hardware resulting in implant or tissue damage with severe consequent complications. OBJECTIVE: We report our experience and potential applications of a novel, pulsed monopolar radiofrequency energy device (PEAK PlasmaBlade™, Medtronic plc) which facilitates dissection around implants without the risk of damaging or transmitting energy through the system...
January 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29284856/proseal-laryngeal-mask-airway-versus-cuffed-endotracheal-tube-for-laparoscopic-surgical-procedures-under-general-anesthesia-a-random-comparative-study
#2
Suchita Shailesh Parikh, Shivam Bipin Parekh, Chaula Doshi, Varsha Vyas
Context: The Proseal LMA(PLMA), which has been designed especially for positive pressure ventilation and protection against aspiration can act as an alternative to Endotracheal Tube (ETT) as an effective airway device for patients undergoing elective Laparoscopic surgeries. Aims: To compare the efficacy and safety of PLMA with ETT in patients undergoing Laparoscopic surgeries under general anaesthesia. Settings and Design: A prospective, randomized study was conducted in a tertiary care teaching hospital with 60 patients of ASA grade I/II undergoing elective Laparoscopic surgery under general anaesthesia...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29244156/percutaneous-increase-of-mitral-leaflet-coaptation-length-after-mitral-valve-repair-results-from-a-preclinical-study
#3
Piergiorgio Tozzi, Giuseppe Siniscalchi, Enrico Ferrari, Matthias Kirsch, Daniel Hayoz
OBJECTIVES: The failure of mitral repairs can be the result of inadequate leaflet coaptation length (CL< 8 mm at the A2-P2 level). A new annuloplasty ring conceived by the authors enables post-surgical CL increase using percutaneous balloon catheter technology. We conducted preclinical studies to assess the in vivo feasibility of the procedure and the safety of the postimplant deformable mitral ring. METHODS: The new annuloplasty ring allows the percutaneous and progressive displacement of each of the 3 anatomical regions of the posterior mitral annulus towards the anterior...
December 13, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29240057/-experience-with-using-cyanoacrylate-glue-in-endovascular-treatment-of-varicose-veins
#4
E V Shaĭdakov, A Zh Mel'tsova, O Ia Porembskaia, E A Kudinova, D É Korzhevskiĭ, O V Kirik, E G Sukhorukova
The method of cyanoacrylate-mediated obliteration of subcutaneous veins is known to be an alternative to thermal endovascular obliteration and eliminates the need for tumescent anaesthesia. This technique is based on glue-induced damage to the venous intima, followed by immune response according to the delayed-type hypersensitivity principle. The authors report herein their first experience with using cyanoacrylate-mediated embolization in treatment of patients presenting with varicose veins. The operation was carried out using the VenaSeal closure system (Medtronic)...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29234537/day-care-bipolar-transurethral-resection-vs-photoselective-vaporisation-under-sedoanalgesia-a-prospective-randomised-study-of-the-management-of-benign-prostatic-hyperplasia
#5
Rajeev Sood, T Manasa, Hemant Goel, Ritesh Kumar Singh, Rajpal Singh, Nikhil Khattar, Praveen Pandey
Objective: To conduct a prospective randomised study comparing the safety, effectiveness and treatment outcomes in patients undergoing bipolar transurethral resection of the prostate (bTURP) and photoselective vaporisation of the prostate (PVP) under sedoanalgesia, as sedoanalgesia is a safe and effective technique suitable for minimally invasive endourological procedures and although studies have confirmed that both TURP and PVP are feasible under sedoanalgesia there are none comparing the two...
December 2017: Arab Journal of Urology
https://www.readbyqxmd.com/read/29169646/development-of-an-intelligent-surgical-training-system-for-thoracentesis
#6
Hirenkumar Nakawala, Giancarlo Ferrigno, Elena De Momi
Surgical training improves patient care, helps to reduce surgical risks, increases surgeon's confidence, and thus enhances overall patient safety. Current surgical training systems are more focused on developing technical skills, e.g. dexterity, of the surgeons while lacking the aspects of context-awareness and intra-operative real-time guidance. Context-aware intelligent training systems interpret the current surgical situation and help surgeons to train on surgical tasks. As a prototypical scenario, we chose Thoracentesis procedure in this work...
November 20, 2017: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/29169162/application-of-electrocautery-needle-knife-combined-with-balloon-dilatation-versus-balloon-dilatation-in-the-treatment-of-tracheal-fibrotic-scar-stenosis
#7
Liyan Bo, Congcong Li, Min Chen, Deguang Mu, Faguang Jin
BACKGROUND: Electrocautery needle knives can largely reduce scar and granulation tissue hyperplasia and play an important role in treating patients with benign stricture. OBJECTIVE: The aim of this retrospective study was to evaluate the efficacy and safety of electrocautery needle knife combined with balloon dilatation versus balloon dilatation alone in the treatment of tracheal stenosis caused by tracheal intubation or tracheotomy. METHODS: We retrospectively analysed the clinical data of 43 patients with tracheal stenosis caused by tracheotomy or tracheal intubation in our department from January 2013 to January 2016...
November 23, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29161393/quality-safety-and-outcomes-in-anaesthesia-what-s-to-be-done-an-international-perspective
#8
C J Peden, M Campbell, G Aggarwal
This article reviews of some of the key topics and challenges in quality, safety, and the measurement and improvement of outcomes in anaesthesia. The topics were selected based on the perspective of an individual with quality and safety expertise and recent experience of the specialty in both the UK and USA. The review does not seek to be exhaustive or systematic, but to highlight current areas of concern and potential solutions. The topic is subdivided into sections where the system of health care is viewed from different levels...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161386/to-err-is-human-use-of-simulation-to-enhance-training-and-patient-safety-in-anaesthesia
#9
H Higham, B Baxendale
Human beings who work in complex, dynamic, and stressful situations make mistakes. This is as true for anaesthetists as for any other health-care professional, but we face unique challenges in the many roles and responsibilities we have in diverse clinical contexts. As a profession, we are well versed in the development and utilization of improvement techniques and technologies that prioritize high-quality, safe care for patients. This article focuses on one particular domain of patient safety in which anaesthetists have been pre-eminent, the use of simulation in training to improve both professional capabilities and patient safety in anaesthetic practice...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29156298/european-research-on-electrochemotherapy-in-head-and-neck-cancer-eureca-project-results-from-the-treatment-of-mucosal-cancers
#10
Christina Caroline Plaschke, Giulia Bertino, James A McCaul, Juan J Grau, Remco de Bree, Gregor Sersa, Antonio Occhini, Ales Groselj, Cristobal Langdon, Derrek A Heuveling, Maja Cemazar, Primoz Strojan, C Rene Leemans, Marco Benazzo, Francesca De Terlizzi, Irene Wessel, Julie Gehl
AIM: Electrochemotherapy is an effective local treatment for cutaneous tumours and metastases. In this prospective trial, six European institutions investigated electrochemotherapy in recurrent, mucosal head and neck tumours. PATIENT AND METHODS: Forty-three patients with recurrent mucosal head and neck tumours and no further curative or reasonably effective palliative treatment options were enrolled and treated with electrochemotherapy. Patients were treated in general anaesthesia using intravenous or local injection of bleomycin followed by delivery of electric pulses to the tumour area...
November 16, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/29125697/vocal-fold-augmentation-under-local-anesthesia-using-autologous-fascia
#11
Teemu J Kinnari, Petra Pietarinen, Ahmed Geneid
Vocal fold augmentation by injection of autologous fascia has been used since the 1990s with excellent safety record in 500 operations done under general anaesthesia. It is safe from risks arising from allergic or other foreign body adverse reactions. Fascia provides long-term augmentation and remains stable 3-10 years after injection. Vocal fold augmentation under local anaesthesia is excellent alternative for those unfit for general anaesthesia, providing aid to fragile and weak persons with vocal fold paralysis...
November 10, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29114410/can-sevoflurane-induce-micronuclei-formation-in-nasal-epithelial-cells-of-adult-patients
#12
Elvin Kesimci, Erdem Çoşkun, Gökçer Uğur, Togay Müderris, Seval İzdeş, Bensu Karahalil
Objective: Volatile anaesthetics can inhibit the bronchociliary clearence in a dose- and time-dependend way. Moreover, they can have potential mutagenic/carcinogenic effects under chronic exposure. A genotoxicity test -micronuclei assay- was carried out in nasal epithelial cells to analyze the genotoxic effect of sevoflurane in adult patients undergoing general anesthesia. Methods: In this study, micronucleus (MN) assay was conducted using nasal epithelial cells of 37 adult patients (age, 18-65 years) who underwent elective, minor, short surgical procedures under general anaesthesia with sevoflurane...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29096029/safety-and-efficacy-of-minimalist-approach-in-transfemoral-transcatheter-aortic-valve-replacement-insights-from-the-optimized-transcatheter-valvular-intervention-transcatheter-aortic-valve-implantation-ocean-tavi-registry
#13
Soh Hosoba, Masanori Yamamoto, Kayoko Shioda, Mitsuru Sago, Yutaka Koyama, Tetsuro Shimura, Ai Kagase, Norio Tada, Toru Naganuma, Motoharu Araki, Futoshi Yamanaka, Shinichi Shirai, Yusuke Watanabe, Kentaro Hayashida
OBJECTIVES: Favourable results have been reported for monitored anaesthesia care that includes local anaesthesia and conscious sedation [minimalist approach (MA)] for transfemoral transcatheter aortic valve replacement (TAVR). However, the efficacy of MA is still controversial in Japan. We describe our experience from a Japanese multicentre registry. METHODS: Between October 2013 and April 2016, 1215 consecutive Japanese patients with symptomatic, severe aortic stenosis undergoing TAVR with self-expandable or balloon-expandable valves were prospectively included in the Optimized transCathEter vAlvular intervention-Transcatheter Aortic Valve Implantation (OCEAN-TAVI) registry...
October 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29094529/how-to-administer-lidocaine-in-wounds
#14
Jeanette Welsh, Graham Rowe
RATIONALE AND KEY POINTS: Before a wound can be cleaned and/or closed, the use of a local anaesthetic such as lidocaine is often required to enable the nurse to assess the wound thoroughly and plan the optimal method of repair. This article explains how to administer lidocaine safely and effectively, including how to infiltrate a wound with lidocaine before cleaning or suturing. There are potentially serious consequences associated with the use of local anaesthesia, but careful preparation will ensure patient safety and contribute towards a positive patient experience...
September 20, 2017: Nursing Standard
https://www.readbyqxmd.com/read/29090262/conus-medullaris-trauma-is-there-a-greater-risk-in-parturients
#15
Julie Verkooijen, Hilde Coppejans, Els Mertens, Vera Saldien, Marcel Vercauteren
BACKGROUND: There is some evidence that anaesthetists often perform neuraxial blocks at a higher lumbar interspace than intended. It may be questioned whether parturients are at greater risk for neurological damage when the dura is perforated at a more cephalad interspace than L2-L3. METHODS: Thirty-six patients scheduled for elective Caesarean delivery under CSE anaesthesia were selected for study. Using a B-D Durasafe Adjustable needle combination, the skin-to-epidural distance and the width of the epidural space were measured and matched with 36 female patients undergoing the same anaesthetic technique for orthopaedic procedures...
October 2017: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29084236/derivation-and-validation-of-a-preoperative-risk-model-for-postoperative-mortality-sampe-model-an-approach-to-care-stratification
#16
Luciana Cadore Stefani, Claudia De Souza Gutierrez, Stela Maris de Jezus Castro, Rafael Leal Zimmer, Felipe Polgati Diehl, Leonardo Elman Meyer, Wolnei Caumo
Ascertaining which patients are at highest risk of poor postoperative outcomes could improve care and enhance safety. This study aimed to construct and validate a propensity index for 30-day postoperative mortality. A retrospective cohort study was conducted at Hospital de Clínicas de Porto Alegre, Brazil, over a period of 3 years. A dataset of 13524 patients was used to develop the model and another dataset of 7254 was used to validate it. The primary outcome was 30-day in-hospital mortality. Overall mortality in the development dataset was 2...
2017: PloS One
https://www.readbyqxmd.com/read/29071161/outcome-analysis-of-transrectal-ultrasonography-guided-aspiration-versus-transurethral-resection-of-prostatic-abscess-10%C3%A2-years-experience-from-a-tertiary-care-hospital
#17
Bimalesh Purkait, Manoj Kumar, Ashok Kumar Sokhal, Ankur Bansal, Satya Narayan Sankhwar, Ved Bhaskar
OBJECTIVE: To compare the effectiveness and safety of two minimally invasive methods (transrectal aspiration vs transurethral resection (TUR)/deroofing) of treating prostatic abscess. PATIENTS AND METHODS: A retrospective study was conducted, from 2007 to 2016, of patients with prostatic abscesses not responding to antibiotics and/or with large (>2 cm) or multiple abscesses. Patients were divided into two groups depending on treatment received: Group A, transrectal aspiration; and Group B, TUR/deroofing of abscess...
September 2017: Arab Journal of Urology
https://www.readbyqxmd.com/read/29056227/intravenous-regional-anaesthesia-bier-s-block-for-pediatric-forearm-fractures-in-a-pediatric-emergency-department-experience-from-2003-to-2014
#18
Ivan S Y Chua, S L Chong, Gene Y K Ong
STUDY OBJECTIVES: To evaluate the efficacy (length of stay in the emergency department and failure rate of Bier's block) and safety profile (death and major complications) of Bier's block in its use for manipulation and reduction of paediatric forearm fractures. METHODS: This is a retrospective cohort study of pediatric patients in KKWomen's and Children's Hospital Children's Emergency Department with forearm fractures between Jan 2003 and Dec 2014 who underwent manipulation and reduction using Bier's block...
October 16, 2017: Injury
https://www.readbyqxmd.com/read/29034840/non-anaesthetic-effects-of-volatile-anaesthetics-a-short-trip-on-the-sea-of-translational-medicine
#19
Lukasz J Krzych, Anna J Szczepanska
BACKGROUND: Volatile anaesthetics (VA) are commonly used worldwide for induction and/or maintenance of general anaesthesia. They act in the central nervous system to reduce sensation and motor response during surgical and invasive diagnostic procedures. VAs also have some non-anaesthetic properties in the brain when administrated to patients at the extremes of age. Their biological impact on other organs should be taken into account during administration of anaesthesia. OBJECTIVE: In this review we summarize the recent knowledge on the non-anaesthetic effects of inhaled halogenic ethers on cells and tissues...
October 13, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29028917/comparative-usability-of-modern-anaesthesia-ventilators-a-human-factors-study
#20
J Spaeth, T Schweizer, A Schmutz, H Buerkle, S Schumann
Background: The anaesthesia ventilator represents the key equipment for intraoperative respiratory care. Improper operation of this device may threaten a patient's health. A self-explanatory interface facilitates handling and decreases the risk of operating errors. This study systematically evaluates the usability of user interfaces in four modern anaesthesia ventilators. Methods: Twenty naïve operators were asked to execute 20 tasks on each of four different anaesthesia ventilators (Avance CS2™, GE Healthcare; Flow-i™, Maquet; and Perseus™ and Primus™, Dräger) in a randomized order...
November 1, 2017: British Journal of Anaesthesia
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