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Anesthesia risk score

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https://www.readbyqxmd.com/read/28424861/s-ketamine-compared-to-etomidate-during-electroconvulsive-therapy-in-major-depression
#1
Maxim Zavorotnyy, Ina Kluge, Kathrin Ahrens, Thomas Wohltmann, Benjamin Köhnlein, Patricia Dietsche, Udo Dannlowski, Tilo Kircher, Carsten Konrad
Objective of the study was to compare two commonly used anesthetic drugs, S-ketamine and etomidate, regarding their influence on seizure characteristics, safety aspects, and outcome of electroconvulsive therapy (ECT) in major depression. Treatment data of 60 patients who underwent a total number of 13 ECTs (median) because of the severe or treatment-resistant major depressive disorder (DSM-IV) were analyzed. Etomidate, mean dosage (SD) = 0.25 (0.04) mg/kg, was used for anesthesia in 29 participants; 31 patients received S-ketamine, mean dosage (SD) = 0...
April 19, 2017: European Archives of Psychiatry and Clinical Neuroscience
https://www.readbyqxmd.com/read/28416429/-life-threatening-sleepwalking-elpenor-s-syndrome-in-a-10-year-old-child
#2
M-A Madigand-Tordjman, P-J Egler, F Bertran, M Jokic, F Guénolé
Though benign in the majority of cases, sleepwalking sometimes causes injuries due, among other causes, to falls. Such accidents can be life-threatening - a situation that has been termed Elpenor syndrome (in reference to an accident experienced by a character in Homer's epic The Odyssey) - in particular when entailing defenestration. This syndrome has been described in adults and adolescents; we report here a case in a child. OBSERVATION: This 10-year-old girl was admitted at night to our hospital after a 3-m fall at home...
April 14, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28409733/endovascular-management-of-acute-epidural-hematomas-clinical-experience-with-80-cases
#3
Carlos Michel A Peres, Jose Guilherme M P Caldas, Paulo Puglia, Almir F de Andrade, Igor A F da Silva, Manoel J Teixeira, Eberval G Figueiredo
OBJECTIVE Small acute epidural hematomas (EDHs) treated conservatively carry a nonmeasurable risk of late enlargement due to middle meningeal artery (MMA) lesions. Patients with EDHs need to stay hospitalized for several days, with neurological supervision and repeated CT scans. In this study, the authors analyzed the safety and efficacy of the embolization of the involved MMA and associated lesions. METHODS The study group consisted of 80 consecutive patients harboring small- to medium-sized EDHs treated by MMA embolization between January 2010 and December 2014...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28408081/-nondepolarizing-muscle-relaxant-improves-direct-laryngoscopy-view-with-no-effect-on-face-mask-ventilation
#4
Marwan S Rizk, Salah M Zeineldine, Mohamad F El-Khatib, Vanda G Yazbeck-Karam, Sophie D Ayoub, Pierre K Bou-Khalil, Elie Abi-Nader, Marc M Ghabach, Chakib M Ayoub
BACKGROUND: Difficult or impossible face mask ventilation complicated with difficult tracheal intubation during anesthesia induction occurs in 0.4% of adult anesthesia cases, possibly leading to life-threatening complications. Because of such catastrophes, muscle relaxants have been recommended to be administered after confirming adequate face mask ventilation without a solid scientific validation of this principal. METHODS: In this observational study, the ease of ventilation and the scores of direct laryngoscopy views before and after administration of cisatracurium were assessed in ninety young healthy adults, without anesthetic risks and without foreseen difficult intubation and who were scheduled for general elective surgeries...
April 10, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28399538/risk-factors-for-intraoperative-hypertension-during-the-surgery-of-primary-hyperparathyroidism
#5
Vera D Sabljak, Vladan R Zivaljevic, Biljana R Milicic, Ivan R Paunovic, Anka R Toskovic, Ksenija S Stevanovic, Katarina M Tausanovic, Dejan Z Markovic, Marina M Stojanovic, Mirko V Lakicevic, Milan D Jovanovic, Aleksandar D Diklic, Nevena K Kalezic
OBJECTIVE: To investigate the incidence and to identify risk factors for the occurrence of intraoperative hypertension (IOH) during the surgery of primary hyperparathyroidism (pHPT). SUBJECTS AND METHODS: The study included 269 patients surgically treated between January 2008 and January 2012 for pHPT. The IOH was defined as an increase in systolic blood pressure ≥ 20% compared to baseline values which lasted for 15 minutes. The investigated influence were demographic characteristics, surgical risk score related to physical status (based on American Society of Anesthesiologists - ASA classification), comorbidities, type and duration of surgery and duration of anesthesia on IOH occurrence...
April 10, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/28390888/liposomal-bupivacaine-mixture-has-similar-pain-relief-and-significantly-fewer-complications-at-less-cost-compared-to-indwelling-interscalene-catheter-in-total-shoulder-arthroplasty
#6
William J Weller, Michael G Azzam, Richard A Smith, Frederick M Azar, Thomas W Throckmorton
BACKGROUND: The efficacy and costs of indwelling interscalene catheter (ISC) and liposomal bupivacaine (LBC), with and without adjunctive medications, in patients with primary shoulder arthroplasty are a source of current debate. METHODS: In 214 arthroplasties, 156 patients had ISC and 58 had LBC injections that were mixed with morphine, ketorolac, and 0.5% bupivacaine with epinephrine. Charts were reviewed for visual analog scale pain scores, oral morphine equivalent (OME) usage, major complications, and costs...
March 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28379981/improved-costs-and-outcomes-with-conscious-sedation-vs-general-anesthesia-in-tavr-patients-time-to-wake-up
#7
William Toppen, Daniel Johansen, Sohail Sareh, Josue Fernandez, Nancy Satou, Komal D Patel, Murray Kwon, William Suh, Olcay Aksoy, Richard J Shemin, Peyman Benharash
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has become a commonplace procedure for the treatment of aortic stenosis in higher risk surgical patients. With the high cost and steadily increasing number of patients receiving TAVR, emphasis has been placed on optimizing outcomes as well as resource utilization. Recently, studies have demonstrated the feasibility of conscious sedation in lieu of general anesthesia for TAVR. This study aimed to investigate the clinical as well as cost outcomes associated with conscious sedation in comparison to general anesthesia in TAVR...
2017: PloS One
https://www.readbyqxmd.com/read/28377943/expert-evaluation-of-a-chicken-tissue-based-model-for-teaching-ultrasound-guided-central-venous-catheter-insertion
#8
Akiva Nachshon, John D Mitchell, Ariel Mueller, Valerie M Banner-Goodspeed, Jakob I McSparron
BACKGROUND: Ultrasound-guided central venous catheterization (CVC) is a commonly performed procedure which carries significant risks for complications. Current models used for simulation-based teaching are expensive and may not replicate tissue feel and ultrasound qualities of human tissues. We aimed to evaluate a tissue model composed of chicken breast and balloons and compare it to a commercially available mannequin. METHODS: Forty attending physicians from four departments with extensive CVC experience were enrolled...
January 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/28372932/relationship-between-the-incidence-and-risk-factors-of-postoperative-nausea-and-vomiting-in-patients-with-intravenous-patient-controlled-analgesia
#9
Myung Sub Yi, Hyun Kang, Min Kyoung Kim, Geun-Joo Choi, Yong-Hee Park, Chong Wha Baek, Yong Hun Jung, Young Cheol Woo
OBJECTIVE: This study aims to evaluate retrospectively the electronic medical records of surgical patients who received intravenous patient-controlled analgesia, to identify potential relationships between the incidence and risk factors of postoperative nausea and vomiting (PONV). METHODS: Records of 6773 adult patients who received fentanyl-based intravenous patient-controlled analgesia after surgery at Chung-Ang University Hospital between January 1, 2010 and December 31, 2015 were reviewed...
March 31, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28370645/outcomes-of-a-failure-mode-and-effects-analysis-for-medication-errors-in-pediatric-anesthesia
#10
Lizabeth D Martin, Eliot B Grigg, Shilpa Verma, Gregory J Latham, Sally E Rampersad, Lynn D Martin
The Institute of Medicine has called for development of strategies to prevent medication errors, which are one important cause of preventable harm. Although the field of anesthesiology is considered a leader in patient safety, recent data suggest high medication error rates in anesthesia practice. Unfortunately, few error prevention strategies for anesthesia providers have been implemented. Using Toyota Production System quality improvement methodology, a multidisciplinary team observed 133 h of medication practice in the operating room at a tertiary care freestanding children's hospital...
March 28, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28367285/are-frailty-scales-better-than-anesthesia-or-surgical-scales-to-determine-risk-in-cardiac-surgery
#11
Judit Kovacs, Liviu Moraru, Krisztina Antal, Adrian Cioc, Septimiu Voidazan, Attila Szabo
BACKGROUND: In the last year there has been an increasing interest for using frailty scales for risk stratification of elderly patients undergoing major surgery. We planned to compare two frailty scales with risk scales already used in cardiac surgery, to study which of these scores have better prognostic value predicting postoperative outcome in open heart surgery. METHODS: We conducted a prospective clinical trial, including 57 patients over 65 years. We calculated Cardiac Anesthesia Risk Evaluation score, EuroScore II, Clinical Frailty Scale, Edmonton Frail Scale for each patient and followed the postoperative complications, length of mechanical ventilation, length of stay in the intensive care unit and hospital, and in-hospital death related to these risk and frailty scores...
April 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28362214/a-systematic-multidisciplinary-initiative-for-reducing-the-risk-of-complications-in-adult-scoliosis-surgery
#12
Rajiv Sethi, Quinlan D Buchlak, Vijay Yanamadala, Melissa L Anderson, Eric A Baldwin, Robert S Mecklenburg, Jean-Christophe Leveque, Alicia M Edwards, Mary Shea, Lisa Ross, Karen J Wernli
OBJECTIVE Systematic multidisciplinary approaches to improving quality and safety in complex surgical care have shown promise. Complication rates from complex spine surgery range from 10% to 90% for all surgeries, and the overall mortality rate is 1%-4%. These rates suggest the need for improved perioperative complex spine surgery processes designed to minimize risk and improve quality. METHODS The Group Health Research Institute and Virginia Mason Medical Center implemented a systematic multidisciplinary protocol, the Seattle Spine Team Protocol, in 2010...
March 31, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28362032/randomized-comparative-study-of-the-effectiveness-of-three-different-techniques-of-interscalene-brachial-plexus-block-using-0-5-ropivacaine-for-shoulder-arthroscopy
#13
Michał Kolny, Michał J Stasiowski, Marek Zuber, Radosław Marciniak, Ewa Chabierska, Aleksandra Pluta, Przemysław Jałowiecki, Tomasz Byrczek
BACKGROUND: Interscalene brachial plexus block is an effective regional anesthesia technique for shoulder surgeries. The superiority of the popular ultrasound-guided blocks over peripheral nerve stimulator-confirmed blocks remains unclear. In this study the efficacy of these different block techniques was compared. METHODS: This prospective, randomized, clinical study included 109 patients (ASA grades I-III) who receive 20 mL 0.5% ropivacaine with ultrasound-guided blocks (U group), peripheral nerve stimulator-confirmed blocks (N group), or ultrasound-guided and peripheral nerve stimulator-confirmed blocks (dual guidance; NU group) for elective shoulder arthroscopy...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28356445/diagnosis-treatment-and-long-term-management-of-kawasaki-disease-a-scientific-statement-for-health-professionals-from-the-american-heart-association
#14
REVIEW
Brian W McCrindle, Anne H Rowley, Jane W Newburger, Jane C Burns, Anne F Bolger, Michael Gewitz, Annette L Baker, Mary Anne Jackson, Masato Takahashi, Pinak B Shah, Tohru Kobayashi, Mei-Hwan Wu, Tsutomu T Saji, Elfriede Pahl
BACKGROUND: Kawasaki disease is an acute vasculitis of childhood that leads to coronary artery aneurysms in ≈25% of untreated cases. It has been reported worldwide and is the leading cause of acquired heart disease in children in developed countries. METHODS AND RESULTS: To revise the previous American Heart Association guidelines, a multidisciplinary writing group of experts was convened to review and appraise available evidence and practice-based opinion, as well as to provide updated recommendations for diagnosis, treatment of the acute illness, and long-term management...
March 29, 2017: Circulation
https://www.readbyqxmd.com/read/28327900/awake-craniotomy-vs-craniotomy-under-general-anesthesia-for-perirolandic-gliomas-evaluating-perioperative-complications-and-extent-of-resection
#15
Chikezie I Eseonu, Jordina Rincon-Torroella, Karim ReFaey, Young M Lee, Jasvinder Nangiana, Tito Vivas-Buitrago, Alfredo Quiñones-Hinojosa
BACKGROUND: A craniotomy with direct cortical/subcortical stimulation either awake or under general anesthesia (GA) present 2 approaches for removing eloquent region tumors. With a reported higher prevalence of intraoperative seizures occurring during awake resections of perirolandic lesions, oftentimes, surgery under GA is chosen for these lesions. OBJECTIVE: To evaluate a single-surgeon's experience with awake craniotomies (AC) vs surgery under GA for resecting perirolandic, eloquent, motor-region gliomas...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28301208/measures-to-prevent-air-embolism-in-transthoracic-biopsy-of-the-lung
#16
Bernhard Glodny, Elisabeth Schönherr, Martin C Freund, Melanie Haslauer, Johannes Petersen, Alexander Loizides, Astrid E Grams, Florian Augustin, Franz J Wiedermann, Rafael Rehwald
OBJECTIVE: Systemic air embolism (AE) is a rare but feared complication of transthoracic biopsy with potentially fatal consequences. The aim of the study was to assess the effect of patient positioning during transthoracic biopsy on preventing systemic AE. MATERIALS AND METHODS: We compared a historical control group of 610 patients (group 1) who underwent transthoracic biopsy before the implementation of measures to prevent systemic AE during transthoracic biopsy and a group of 1268 patients (group 2) who underwent biopsy after the measures were implemented...
May 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28272228/comparison-of-surgical-conditions-in-2-different-anesthesia-techniques-of-esmolol-induced-controlled-hypotension-in-breast-reduction-surgery
#17
RANDOMIZED CONTROLLED TRIAL
Ahmet Besir, Bahanur Cekic, Dilek Kutanis, Ali Akdogan, Murat Livaoglu
BACKGROUND: Breast reduction surgery is a common cosmetic surgery with a high incidence of blood loss and transfusion. In this surgery, the reduction of blood loss related to surgical manipulation and the volume of resected tissue is a target. In the present study, we compared the effects of esmolol-induced controlled hypotension on surgical visibility, surgical bleeding, and the duration of surgery in patients anesthetized with propofol/remifentanil (PR) or sevoflurane/remifentanil (SR)...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28261768/percutaneous-cholecystostomy-a-curative-treatment-modality-forelderly-and-high-asa-score-acute-cholecystitis-patients
#18
Hüseyin Kerem Tolan, Aslıhan Semiz Oysu, Fatih Başak, İbrahim Atak, Mustafa Özbağrıaçık, Adnan Özpek, Mert Kaskal, Fikret Ezberci, Gürhan Baş
BACKGROUND: Acute cholecystitis (AC) is a common emergency seen by general surgeons. Optimal treatment is laparoscopic cholecystectomy (LC); however, in cases where surgery cannot be performed due to high risk of morbidity and mortality, such as in elderly patients with comorbid diseases, other treatment modalities may be used. Percutaneous cholecystostomy (PC) is one alternative method to treat AC. PC can be used to provide drainage of the gall bladder and control infection. Subsequently, interval cholecystectomy can be performed when there are better conditions...
January 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28257309/patient-centered-anesthesia-triage-system-predicts-asa-physical-status
#19
F Kayser Enneking, Nila S Radhakrishnan, Kent Berg, Saharsh Patel, Judith M Wishin, Terrie Vasilopoulos
BACKGROUND: The purpose of this study was to validate a patient-centered anesthesia triage system (PCATS) by examining its association with, and predictive value of, ASA physical status (PS) classification. ASA PS classification is a widely used indicator of health status and the predictor of risk of perioperative complications. Thus, ASA PS is a good triage point such that healthy surgical patients (ASA PS I and II) undergoing low-complexity surgery are assessed by telephone, whereas less-healthy patients (ASA PS III and IV) or those patients undergoing highly complex surgery are seen in person at a presurgical clinic...
March 2, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28249306/mini-craniotomy-under-local-anesthesia-to-treat-acute-subdural-hematoma-in-deteriorating-elderly-patients
#20
Alessandro Di Rienzo, Maurizio Iacoangeli, Lorenzo Alvaro, Roberto Colasanti, Lucia Giovanna Maria Di Somma, Niccolo Nocchi, Maurizio Gladi, Massimo Scerrati
Background and Study Aims Surgical treatment for acute subdural hematomas (ASDHs) in elderly patients is still considered unsatisfactory. Series focusing on the use of conventional craniotomy or decompressive craniectomy in such patients report discouraging results. Glasgow Coma Scale (GCS) score at admission seems to be crucial in the decision-making process. Deteriorating patients with a GCS score between 9 and 11 are those who would benefit most from the surgical treatment. Unfortunately, elderly patients often present other comorbidities that greatly increase the risk of severe complications after major neurosurgical procedures under general anesthesia...
March 1, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
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