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Anaesthesia patient safety

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https://www.readbyqxmd.com/read/28339558/impact-of-sedation-vs-general-anaesthesia-on-percutaneous-epicardial-access-safety-and-procedural-outcomes
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28249993/moderate-sedation-in-cardiac-electrophysiology-laboratory-a-retrospective-safety-analysis
#5
V Sawhney, E Bacuetes, M Wray, M Dhinoja, M J Earley, R J Schilling, S Sporton
OBJECTIVE: Cardiac electrophysiology (EP) procedures can be performed under moderate sedation without the direct involvement of an anaesthetist. However, concerns have been raised over the safety of this approach. This study examines the use of a standardised nurse-led physician-directed sedation protocol for EP procedures to determine the safety of moderate sedation administered by non-anaesthesia personnel who have been trained in sedation techniques. METHODS AND RESULTS: Consecutive EP procedures done under moderate sedation over 12 years at our institution were evaluated...
March 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28240641/transcatheter-mitral-valve-replacement-with-a-novel-self-expandable-prosthesis-single-institutional-experience-procedural-outcomes-and-follow-up
#6
Gian Paolo Ussia, Valeria Cammalleri, Jawahar L Mehta, Kunal Sarkar, Saverio Muscoli, Pasquale de Vico, Giovanni Ruvolo, Francesco Romeo
AIMS: We report our experience with the CardiAQ prosthetic valve using both transapical and transseptal access. Aim of our study was proving the feasibility, safety and effectiveness of a novel transcatheter mitral valve bioprosthesis. METHODS: Four patients with severe mitral regurgitation, not eligible for mitral valve surgery, were treated with the CardiAQ valve. The procedures were performed under general anaesthesia, fluoroscopic and transesophageal echocardiographic guidance...
February 24, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28236348/fixed-time-interval-compared-with-on-demand-oral-analgesia-protocols-for-post-caesarean-pain-a-randomised-controlled-trial
#7
E Yefet, H Taha, R Salim, J Hasanein, Y Carmeli, N Schwartz, Z Nachum
OBJECTIVES: To compare the efficacy, safety and satisfaction from two modes of oral analgesia administration for the treatment of post-caesarean pain in the first 48 h following surgery: on-demand versus fixed time interval administration. DESIGN: Open label parallel-group, randomised-controlled trial from February to December 2013. SETTING: University-affiliated hospital in Israel. POPULATION: Two-hundred women who underwent caesarean delivery with regional anaesthesia...
February 25, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28194747/local-anaesthesia-with-analgosedation-in-patients-qualified-for-transcatheter-aortic-valve-implantation-tavi-first-institute-s-results-and-experiments
#8
Robert Musiał, Magdalena Lipińska-Strasik, Agnieszka Piątkiewicz, Jarosław Stoliński, Rafał Drwiła
BACKGROUND: The authors present their own experience of the treatment of patients qualified for transcatheter aortic valve implantation (TAVI) carried out in a modern hybrid operating room. The objective of the present study was to demonstrate the initial results of conducting anaesthesia in high-risk patients qualified for the TAVI procedure (transcatheter aortic valve implantation). In addition, the authors' aim was also to point out to the special challenges of an anaesthesiologist conducting local anaesthesia in such a type of procedures and to evaluate the safety and efficacy of the TAVI procedure conducted under remifentanil analgosedation...
February 14, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28183325/percutaneous-internal-fixation-with-y-strut%C3%A2-device-to-prevent-both-osteoporotic-and-pathological-hip-fractures-a-prospective-pilot-study
#9
François H Cornelis, Lambros Tselikas, Thibault Carteret, Bruno Lapuyade, Thierry De Baere, Jean Charles Le Huec, Frédéric Deschamps
BACKGROUND: We studied Y-STRUT® (Hyprevention, France), a new percutaneous internal fixation device, in combination with bone cementoplasty to prevent hip fracture. METHODS: Between February 2013 and February 2015, a total of 16 femoral necks in 4 osteoporotic and 12 oncologic patients have been considered for prophylactic consolidation in this prospective multicentre pilot study involving 4 different hospitals. These consolidations were performed percutaneously under fluoroscopic guidance using Y-STRUT®, a dedicated internal fixation device...
February 9, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28171853/assessing-nursing-students-knowledge-and-skills-in-performing-venepuncture-and-inserting-peripheral-venous-catheters
#10
C Ahlin, B Klang-Söderkvist, E Johansson, M Björkholm, A Löfmark
Venepuncture and the insertion of peripheral venous catheters are common tasks in health care, and training in these procedures is included in nursing programmes. Evidence of nursing students' knowledge and skills in these procedures is limited. The main aim of this study was to assess nursing students' knowledge and skills when performing venepuncture and inserting peripheral venous catheters. Potential associations between level of knowledge and skills, self-training, self-efficacy, and demographic characteristics were also investigated...
January 27, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28151388/peri-operative-treatment-of-anaemia-in-major-orthopaedic-surgery-a-practical-approach-from-spain
#11
REVIEW
Elvira Bisbe, Misericordia Basora, María J Colomina
In patients undergoing major orthopaedic surgery, pre-operative anaemia, peri-operative bleeding and a liberal transfusion policy are the main risk factors for requiring red blood cell transfusion (RBCT). The clinical and economic disadvantages of RBCT have led to the development and implementation of multidisciplinary, multimodal, individualised strategies, collectively termed patient blood management, which aim to reduce RBCT and improve patients' clinical outcome and safety. Within a patient blood management programme, low pre-operative haemoglobin is one of the few modifiable risk factors for RBCT...
January 26, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28118164/quality-organization-and-risk-in-anaesthesia-the-french-perspective
#12
Jean Marty, Emmanuel Samain
PURPOSE OF REVIEW: Ensuring the quality and safety of anaesthesia in the face of budgetary restrictions and changing demographics is challenging. In France, the environment is regulated by the legislation, and it is often necessary to find solutions that seize opportunities to break with the traditional organization. RECENT FINDINGS: Postoperative mortality remains excessively high. The move towards ambulatory care is being adequately integrated into all the stages of patient management in the context of a single therapeutic plan that is mutually agreed upon by all caregivers...
April 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28107576/non-invasive-anaesthetic-methods-for-dermatological-laser-procedures-a-systematic-review
#13
REVIEW
K Greveling, E P Prens, L Liu, M B A van Doorn
Pain is a common side-effect of dermatological laser procedures. Non-invasive anaesthetic drugs and anaesthetic procedures can be used to provide pain relief and increase patient satisfaction and treatment efficacy. However, it remains unclear which method provides the best pain relief. The objective of this systematic review was therefore to assess the efficacy and safety of non-invasive anaesthetic methods during dermatological laser procedures. A systematic literature search was conducted. Randomized and non-randomized controlled clinical trials (RCTs and CCTs) were included...
January 20, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28078374/-anaesthesia-procedures-and-invasive-vascular-access-in-severely-injured-patients-at-trauma-room-admission-in-germany-an-online-survey
#14
M F Struck, P Hilbert-Carius, B Hossfeld, J Hinkelbein, M Bernhard, T Wurmb
BACKGROUND: The continuous monitoring of vital parameters and subsequent therapy belong to the core duties of anaesthetists during acute trauma resuscitation in the trauma room. Important procedures may include placement of arterial lines and central venous catheters (CVCs). Knowledge of indication, performance and localization of invasive catheterisation of trauma care in Germany is scarce. METHODS: After approval of the German Society of Anaesthesiology and Intensive Care Medicine we conducted an online survey about arterial and central venous catheterisation of severely injured patients with consideration of common practice used by anaesthetists in German trauma rooms...
February 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28050474/technique-efficiency-and-safety-of-different-nerve-blocks-for-analgesia-in-laser-ablation-and-sclerotherapy-for-lower-limb-superficial-venous-insufficiency-a-multicentre-experience
#15
Krishna Prasad Premnath Bellam, Binu Joy, Abhilash Sandhyala, Kiran Naiknaware, Brijesh Ray, Vijayakumar
INTRODUCTION: Laser ablation and sclerotherapy, as minimally invasive alternatives to surgery for varicose veins, have good efficacy, safety and cosmetic result. Some form of anaesthesia is generally used for pain control. AIM: To describe the technique and evaluate the efficacy and safety of femoral, saphenous and sciatic nerve blocks in isolation or in combination for analgesia during laser ablation and sclerotherapy for lower limb varicose veins. MATERIALS AND METHODS: In this prospective observational study, over a period of 33 months, in 856 limbs of 681 patients with varicose veins, ultrasound guided femoral, saphenous and sciatic nerve blocks for analgesia were performed in 769, 808 and 52 instances respectively; following which, endovenous laser ablation, sclerotherapy or combination of both were carried out using standard practice...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28050391/comparison-of-efficacy-and-safety-of-intramuscular-piroxicam-and-tramadol-for-post-operative-pain-in-patients-undergoing-caesarean-delivery
#16
Tejashree Thippeswamy, Bhuvana Krishnaswamy, Girish M Bengalorkar, Narayanaswamy Mariyappa
INTRODUCTION: Post-caesarean section pain can be both stressful and unfavourable. Effective and rapid reduction of pain facilitates early ambulation and care of the new born. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and opioids are used for pain relief but they are associated with adverse effects both in the mother and the child. AIM: To evaluate efficacy and safety of piroxicam and tramadol in post-caesarean section pain. MATERIALS AND METHODS: Primigravidae who underwent elective caesarean section received either piroxicam 20mg or tramadol 100mg intra-muscularly, following recovery from anaesthesia...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28044334/monitoring-the-anaesthetist-in-the-operating-theatre-professional-competence-and-patient-safety
#17
REVIEW
J Larsson
This article about competence and patient safety in anaesthesia was inspired by a statement in the 2015 AAGBI guidelines on monitoring during anaesthesia: 'the presence of an appropriately trained and experienced anaesthetist is important for patient safety during anaesthesia'. The review starts with a structured description of competence, presenting five dimensions of it; the first two dimensions are identical with the two classical attributes of competence, practical skills and theoretical knowledge. Concerning skills, the value of aiming for a high level of proficiency early in a traning programme is pointed out, and deliberate practice is given as an example of a pedagogical model where aiming for excellence is a core idea...
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28039240/medication-safety-in-the-operating-room-literature-and-expert-based-recommendations
#18
J A Wahr, J H Abernathy, E H Lazarra, J R Keebler, M H Wall, I Lynch, R Wolfe, R L Cooper
Human error poses significant risk for hospitalized patients causing an estimated 100,000 to 400,000 deaths in the USA annually. Medication errors contribute, with error occurring in 5.3% of medication administrations during surgery. In this study 70.3% of medication errors were deemed preventable. Given the paucity of randomized controlled studies, we undertook a rigorous review of the literature to identify recommendations supported by expert opinions. An extensive literature search pertaining to medication error, medication safety, operating room, and anaesthesia was performed...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28029669/safety-and-efficacy-of-spinal-anaesthesia-in-percutaneous-nephrolithotomy
#19
R Shah, A S Thapa, N Lamichhane, S R Kc
INTRODUCTION: Renal stone is one of the common entities occurring in our population. There are different treatment modalities of stones; out of those percutaneous nephrolithotomy is one of the most popular and effective for the renal and upper tract stones. This study is based to compare the safety and efficacy of spinal anaesthesia and general anaesthesia in PCNL. METHODS: In a randomized prospective study 60 patients were divided in two groups; group 1 (n=30) underwent PCNL in general anaesthesia and group 2 (n=30) underwent PCNL in spinal anaesthesia in prone position with the conventional technique...
October 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28003691/all-india-difficult-airway-association-2016-guidelines-for-the-management-of-unanticipated-difficult-tracheal-intubation-in-obstetrics
#20
Venkateswaran Ramkumar, Ekambaram Dinesh, Sumalatha Radhakrishna Shetty, Amit Shah, Pankaj Kundra, Sabyasachi Das, Sheila Nainan Myatra, Syed Moied Ahmed, Jigeeshu Vasishtha Divatia, Apeksh Patwa, Rakesh Garg, Ubaradka S Raveendra, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh
The various physiological changes in pregnancy make the parturient vulnerable for early and rapid desaturation. Severe hypoxaemia during intubation can potentially compromise two lives (mother and foetus). Thus tracheal intubation in the pregnant patient poses unique challenges, and necessitates meticulous planning, ready availability of equipment and expertise to ensure maternal and foetal safety. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for the safe management of the airway in obstetric patients...
December 2016: Indian Journal of Anaesthesia
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