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https://www.readbyqxmd.com/read/28812959/periocular-manifestations-of-trigeminal-trophic-syndrome-a-case-series-and-literature-review
#1
Katherine A McVeigh, Morag Adams, Richard Harrad, Rebecca Ford
Trigeminal trophic syndrome (TTS) is a condition whereby persistent facial ulceration presents consequent to central or peripheral insult to the trigeminal nerve. Lesions are created by repetitive self-inflicted manipulation and trauma of dysaesthetic skin within the trigeminal dermatome. We discuss four cases with aetiologies varied from presumed microvascular compromise to resection of cerebral meningioma, cerebrovascular accident, and herpes zoster ophthalmicus. We discuss the management of the under-recognised associated periocular skin ulcerations that result from physical manipulation of dysesthic skin and prove to be persistent and challenging to treat...
August 16, 2017: Orbit
https://www.readbyqxmd.com/read/28811985/incidence-impact-and-risk-factors-for-30-day-wound-complications-following-elective-adult-spinal-deformity-surgery
#2
Nathan J Lee, John I Shin, Parth Kothari, Jun S Kim, Dante M Leven, Jeremy Steinberger, Javier Z Guzman, Branko Skovrlj, John M Caridi, Samuel K Cho
STUDY DESIGN: Case-control study. OBJECTIVE: To determine the incidence, impact, and risk factors for wound complications within 30 days following elective adult spinal deformity surgery. METHODS: Current Procedural Terminology and International Classification of Diseases, Ninth Edition, diagnosis codes were used to query the database for adults who underwent spinal deformity surgery from 2010 to 2014. Patients were separated into groups of those with and without wound complications...
August 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28810901/immediate-versus-delayed-surgery-for-hip-fractures-in-the-elderly-patients-a-protocol-for-a-systematic-review-and-meta-analysis
#3
Thomas Klestil, Christoph Röder, Christoph Stotter, Birgit Winkler, Stefan Nehrer, Martin Lutz, Irma Klerings, Gernot Wagner, Gerald Gartlehner, Barbara Nussbaumer-Streit
BACKGROUND: Hip fractures are a major public health problem in elderly populations and are accompanied by high-mortality rates. Whether timing of surgery has an impact on morbidity and mortality has been discussed controversially, numerous studies suggest that the delay of surgery can significantly increase the risk of morbidity and mortality; others report that achieving a stable medical condition is more important than early surgery. The goal of our systematic review is to assess the impact of timing of surgery on health outcomes in patients aged 60 years or older with acute hip fracture...
August 15, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28808946/perioperative-care-of-elderly-surgical-outpatients
#4
REVIEW
Xuezhao Cao, Paul F White, Hong Ma
The ambulatory setting offers potential advantages for elderly patients undergoing elective surgery due to the advancement in both surgical and anesthetic techniques resulting in quicker recovery times, fewer complications, higher patient satisfaction, and reduced costs of care. This review article aims to provide a practical guide to anesthetic management of elderly outpatients. Important considerations in the preoperative evaluation of elderly outpatients with co-existing diseases, as well as the advantages and disadvantages of different anesthetic techniques on a procedural-specific basis, and recommendations regarding the management of common postoperative complications (e...
August 14, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28808868/effect-of-multimodal-analgesia-on-opioid-use-after-open-ventral-hernia-repair
#5
Jeremy A Warren, Caroline Stoddard, Ahan L Hunter, Anthony J Horton, Carlyn Atwood, Joseph A Ewing, Steven Pusker, Vito A Cancellaro, Kevin B Walker, William S Cobb, Alfredo M Carbonell, Robert R Morgan
BACKGROUND: There is limited data on enhanced recovery after surgery (ERAS) protocols after ventral hernia repair (VHR). This study reports the impact of multimodal analgesia on opioid use after open VHR. METHODS: Retrospective review of open VHR treated during the initial 6 months after ERAS implementation. Protocol focused on opioid sparing using intraoperative ketamine and/or lidocaine infusion, selective epidural anesthesia, and postoperative ketamine infusion, ketorolac, and acetaminophen...
August 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28807061/the-incidence-of-hyperthermia-during-cochlear-implant-surgery-in-children
#6
A Schwartz, D Kaplan, V Rosenzweig, M Klein, B F Gruenbaum, S E Gruenbaum, M Boyko, A Zlotnik, E Brotfain
BACKGROUND: Inadvertent hyperthermia during anaesthesia is a rare but life-threatening complication. We have encountered several cases of severe hyperthermia in paediatric patients undergoing anaesthesia for cochlear implantation. METHODS: This study aimed to describe the clinical characteristics of children who developed hyperthermia while undergoing cochlear implantation, and to explore possible mechanisms and predisposing factors. The anaesthetic charts of all patients aged under 18 years who underwent cochlear implantation, or mastoid or ophthalmic surgery, between 1 January 2006 and 31 December 2009, at Soroka Medical Center in Beer Sheva, Israel, were reviewed...
August 15, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28806470/efficacy-and-safety-of-sugammadex-versus-neostigmine-in-reversing-neuromuscular-blockade-in-adults
#7
REVIEW
Ana-Marija Hristovska, Patricia Duch, Mikkel Allingstrup, Arash Afshari
BACKGROUND: Acetylcholinesterase inhibitors, such as neostigmine, have traditionally been used for reversal of non-depolarizing neuromuscular blocking agents. However, these drugs have significant limitations, such as indirect mechanisms of reversal, limited and unpredictable efficacy, and undesirable autonomic responses. Sugammadex is a selective relaxant-binding agent specifically developed for rapid reversal of non-depolarizing neuromuscular blockade induced by rocuronium. Its potential clinical benefits include fast and predictable reversal of any degree of block, increased patient safety, reduced incidence of residual block on recovery, and more efficient use of healthcare resources...
August 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28805984/self-medication-misuse-in-the-middle-east-a-systematic-literature-review
#8
REVIEW
Malak M Khalifeh, Nicholas D Moore, Pascale R Salameh
Regulations usually distinguish between prescription-only (POM) and over-the-counter (OTC) medicines. The former requires medical prescription; the latter are available for SM of common minor or easily treated ailments. However, in the Eastern Mediterranean countries, theoretical prescription medicines can easily be purchased without a prescription, as self-medication (SM) resulting in potential misuse and unnecessary risk for patients. The magnitude of this activity is uncertain. The aim of this article, therefore, is to undertake a comprehensive review to identify the different types of medicines that can easily be purchased as SM in Middle East and recognized as misused...
August 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28803811/office-operative-hysteroscopy-an-update
#9
REVIEW
Christina Alicia Salazar, Keith Isaacson
Hysteroscopy is considered the gold standard for evaluation of intracavitary pathology associated with both pre- and postmenopausal patients with abnormal uterine bleeding as well as part of the evaluation of infertility patients with suspected cavity abnormalities. Office-based operative hysteroscopy allows patients to resume activities immediately and successfully integrates clinical practice into a "see and treat" modality, avoiding the added risks of undergoing anesthesia and the inconvenience of going to the operating room...
August 10, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28803771/perioperative-management-of-patients-with-end-stage-renal-disease
#10
REVIEW
Hirotsugu Kanda, Yuji Hirasaki, Takafumi Iida, Megumi Kanao-Kanda, Yuki Toyama, Takashi Chiba, Takayuki Kunisawa
End-stage renal disease (ESRD) is associated with significant alterations in cardiovascular function; homeostasis of body fluid, electrolytes, and acid-base equilibrium; bone metabolism, erythropoiesis; and blood coagulation. The prevalence of ESRD is increasing rapidly worldwide, as is the number of patients requiring surgery under general anesthesia. Patients with ESRD have significantly higher risks of perioperative morbidity and mortality due to multiple comorbidities. The perioperative management of patients with ESRD under general anesthesia therefore requires special considerations and a careful multidisciplinary approach...
April 13, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28803651/using-national-hip-fracture-registries-and-audit-databases-to-develop-an-international-perspective
#11
Antony Johansen, David Golding, Louise Brent, Jacqueline Close, Jan-Erik Gjertsen, Graeme Holt, Ami Hommel, Alma B Pedersen, Niels Dieter Röck, Karl-Göran Thorngren
Hip fracture is the commonest reason for older people to need emergency anaesthesia and surgery, and leads to prolonged dependence for many of those who survive. People with this injury are usually identified very early in their hospital care, so hip fracture is an ideal marker condition with which to audit the care offered to older people by health services around the world. We have reviewed the reports of eight national audit programmes, to examine the approach used in each, and highlight differences in case mix, management and outcomes in different countries...
August 2, 2017: Injury
https://www.readbyqxmd.com/read/28802790/vascular-air-embolism-a-silent-hazard-to-patient-safety
#12
REVIEW
Sorin J Brull, Richard C Prielipp
PURPOSE: To narratively review published information on prevention, detection, pathophysiology, and appropriate treatment of vascular air embolism (VAE). MATERIALS AND METHODS: MEDLINE, SCOPUS, Cochrane Central Register and Google Scholar databases were searched for data published through October 2016. The Manufacturer and User Facility Device Experience (MAUDE) database was queried for "air embolism" reports (years 2011-2016). RESULTS: VAE may be introduced through disruption in the integrity of the venous circulation that occurs during insertion, maintenance, or removal of intravenous or central venous catheters...
August 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28802606/comparison-of-lma-supreme%C3%A2-with-i-gel%C3%A2-and-lma-proseal%C3%A2-in-children-for-airway-management-during-general-anaesthesia-a-meta-analysis-of-randomized-controlled-trials
#13
Sulagna Bhattacharjee, Anirban Som, Souvik Maitra
STUDY OBJECTIVE: A few randomized trials have compared LMA Supreme™ with LMA ProSeal™ and i-gel™ in children but their conclusions varied widely. This systematic review and meta analysis has compared the former device with the latter two devices. DESIGN: Meta-analysis and systematic review using the Mantel-Haenszel method and pooled mean difference using inverse variance method. SETTING: Meta-analysis of published prospective randomized controlled trials...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28802605/laparoscopic-cholecystectomy-under-neuraxial-anesthesia-compared-with-general-anesthesia-systematic-review-and-meta-analyses
#14
REVIEW
Marcelo A Longo, Bárbara T Cavalheiro, Getúlio R de Oliveira Filho
BACKGROUND: Pneumoperitoneum during laparoscopic cholecystectomy (LC) can cause hypercapnia, hypoxemia, hemodynamic changes and shoulder pain. General anesthesia (GA) enables the control of intraoperative pain and ventilation. The need for GA has been questioned by studies suggesting that neuraxial anesthesia (NA) is adequate for LC. STUDY OBJECTIVE: To quantify the prevalence of intraoperative pain and to verify whether evidence on the maintenance of ventilation, circulation and surgical anesthesia during NA compared with GA is consistent...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28802384/retrospective-study-of-intranasal-dexmedetomidine-as-a-prophylactic-against-emergence-delirium-in-pediatric-patients-undergoing-ear-tube-surgery
#15
Lisgelia Santana, Katherine Mills
OBJECTIVES: This study evaluated the effect of intranasal dexmedetomidine on emergence delirium (ED) in pediatric patients who underwent ear tube surgeries. Due to the brief nature of the surgery and low levels of pain experienced, an IV is rarely needed, limiting the medications available to anesthesiologists to manage postoperative delirium that may arise during recovery from inhalational anesthesia. Intravenous dexmedetomidine is an alpha-2 agonist anesthetic that is used in pediatric patients for the management of ED in various surgical procedures...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28802376/hypovolemic-shock-after-labial-and-lingual-frenulectomy-a-report-of-two-cases
#16
Lauren F Tracy, Gabriel Gomez, Lewis J Overton, Wade G McClain
Lingual and labial frenulectomy are commonly performed as an outpatient procedure, either in an office setting or under general anesthesia. Frenulectomy is generally regarded by both otolaryngologists and dentists as a straightforward and low-risk procedure with limited evidence-based indications and similarly few contraindications. We describe two cases of hypovolemic shock occurring after outpatient frenulectomy requiring emergent interventions of cardiopulmonary resuscitation and blood transfusion. These rare, but life-threatening outcomes warrant recognition as potential complications for the presumed benign labial and lingual frenulectomy...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28802029/immediate-hypersensitivity-reaction-to-ketamine-in-children-with-history-of-atopic-disease
#17
Seunghee Ki, Sehun Lim, Myoung-Hun Kim, Younghan Kim
Many investigators have demonstrated that a large number of patients who experience anaphylaxis during anesthesia have a history of atopic disease or allergy to a specific substance. Here, we review a hypersensitivity reaction to ketamine in a nine-year-old child with a history of atopic disease.
August 8, 2017: Asian Pacific Journal of Allergy and Immunology
https://www.readbyqxmd.com/read/28801969/anesthetic-management-for-intestinal-transplantation-a-decade-of-experience
#18
Jeron Zerillo, Sang Kim, Bryan Hill, David Shapiro, Hung-Mo Lin, Alyssa Burnham, Jang Moon, Kishore Iyer, Samuel DeMaria
BACKGROUND: Intestinal transplantation (ITx) is the definitive therapy for patients suffering from intestinal failure. Previous published reports suggest that these cases should be managed peri-operatively with the same intensive monitors and techniques as in liver transplantation. METHODS: We retrospectively reviewed the anesthetic management of sixty-seven isolated intestinal, intestinal-pancreas and intestinal-kidney transplants over the previous decade (2005-2015) in our tertiary care institution...
August 12, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28800992/new-approaches-to-airway-management-in-tracheal-resections-a-systematic-review-and-meta-analysis
#19
Mark Schieren, Andreas Böhmer, Fabian Dusse, Aris Koryllos, Frank Wappler, Jerome Defosse
OBJECTIVES: Although endotracheal intubation, surgical crossfield intubation, and jet ventilation are standard techniques for airway management in tracheal resections, there are also reports of new approaches, ranging from regional anesthesia to extracorporeal support. The objective was to outline the entire spectrum of new airway techniques. DESIGN: The literature databases PubMed/Medline and the Cochrane Library were searched systematically for prospective and retrospective trials as well as case reports on tracheal resections...
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28800981/near-infrared-spectroscopy-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#20
Matthew J Chan, Tricia Chung, Neil J Glassford, Rinaldo Bellomo
OBJECTIVES: To identify the normal baseline preoperative range of cerebral tissue oxygen saturation (SctO2) derived using near-infrared spectroscopy (NIRS) and the efficacy of perioperative interventions designed to modulate SctO2 in cardiac surgical patients. DESIGN: Systematic review and meta-analysis of relevant randomized controlled trials (RCTs) extracted from the Medline, Embase, and Cochrane Central Register of Controlled Trials databases. SETTING: Hospitals performing cardiac surgery...
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
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