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https://www.readbyqxmd.com/read/28936915/review-of-the-evidence-best-analgesic-regimen-for-shoulder-surgery
#1
Yolanda Huang, Felicia Chiu, Christopher Aj Webb, Paul David Weyker
Multimodal pain management has been advocated in patients experiencing acute pain after surgical procedures due to tissue damage and the subsequent inflammatory response. For patients undergoing shoulder surgeries, studies have definitively shown that interscalene blocks (ISBs) via single-injection or continuous infusion can reduce the total opioid consumption and can lower pain scores after surgery. In some cases, ISBs can be used as the sole anesthetic during shoulder surgeries and spare patients of receiving general anesthesia...
September 22, 2017: Pain Management
https://www.readbyqxmd.com/read/28922230/optimal-dose-of-perineural-dexamethasone-to-prolong-analgesia-after-brachial-plexus-blockade-a-systematic-review-and-meta-analysis
#2
Kyle Robert Kirkham, Alain Jacot-Guillarmod, Eric Albrecht
BACKGROUND: Perineural dexamethasone has gained popularity in regional anesthesia to prolong analgesia duration. However, uncertainty remains regarding the optimal perineural dose. Clarification of this characteristic is of significant importance as the administration of dexamethasone may lead to dose-dependent complications. The objective of this meta-analysis was to define the optimal perineural dexamethasone dose to prolong analgesia after brachial plexus blockade for adult patients undergoing upper limb surgery...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28914647/effect-of-an-intravenous-dexamethasone-added-to-caudal-local-anesthetics-to-improve-postoperative-pain-a-systematic-review-and-meta-analysis-with-trial-sequential-analysis
#3
Hiromasa Kawakami, Takahiro Mihara, Nobuhito Nakamura, Koui Ka, Takahisa Goto
BACKGROUND: Caudal anesthesia has been used for postoperative pain control in pediatric surgical patients, but the duration of the analgesic effect is occasionally unsatisfactory. Intravenous steroids have been shown to be effective for postsurgical pain management after certain surgeries. The aim of this meta-analysis with trial sequential analysis (TSA) was to evaluate the analgesic effect of steroids in patients administered with caudal anesthesia. METHODS: This study was a systematic review and meta-analysis...
September 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28893702/risk-factors-associated-with-perioperative-myocardial-infarction-in-major-open-vascular-surgery
#4
Danielle C Sutzko, Elizabeth A Andraska, Andrea T Obi, Peter K Henke, Nicholas H Osborne
BACKGROUND: Among patients undergoing non-cardiac surgery, major vascular surgery is associated with a high risk of perioperative myocardial infarction (MI). Currently there are no perioperative MI risk calculators accounting for intraoperative and postoperative risk factors in vascular surgery patients. We aimed to investigate specific risk factors for perioperative MI after major open vascular surgery to determine which patients are at highest risk of MI, and the association of perioperative MI with perioperative transfusion...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28891910/descriptive-statistics-reporting-the-answers-to-the-5-basic-questions-of-who-what-why-when-where-and-a-sixth-so-what
#5
Thomas R Vetter
Descriptive statistics are specific methods basically used to calculate, describe, and summarize collected research data in a logical, meaningful, and efficient way. Descriptive statistics are reported numerically in the manuscript text and/or in its tables, or graphically in its figures. This basic statistical tutorial discusses a series of fundamental concepts about descriptive statistics and their reporting. The mean, median, and mode are 3 measures of the center or central tendency of a set of data. In addition to a measure of its central tendency (mean, median, or mode), another important characteristic of a research data set is its variability or dispersion (ie, spread)...
September 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28890413/persistent-postherniorrhaphy-pain-following-inguinal-hernia-repair-a-cross-sectional-study-of-prevalence-pain-characteristics-and-effects-on-quality-of-life
#6
Tolga Ergönenç, Serbülent Gökhan Beyaz, Hande Özocak, Onur Palabıyık, Fatih Altıntoprak
INTRODUCTION: Chronic inguinal pain due to the inguinal hernia repair is still a serious consideration, and its incidence is evident in approximately 3%-6% of the patients. The purpose of this study was performed to assess the prevalence of chronic pain after inguinal hernia repair and the effects on the quality of life in our patient. METHODS: The records of the patients who were 18 years of age or older and had had an inguinal hernia repair under spinal anesthesia after receiving a diagnosis of inguinal hernia at this hospital from 2009 to 2015 were accessed through the hospital's data system...
September 7, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28877110/predictors-of-intraoperative-pressure-injury-in-patients-undergoing-major-hepatobiliary-surgery
#7
Yan Chen, Li He, Wei Qu, Chen Zhang
PURPOSE: The purpose of this study was to identify risk factors associated with pressure injury (PI) development in patients undergoing major hepatobiliary surgery requiring general anesthesia. DESIGN: Retrospective medical review and analysis. SUBJECTS AND SETTING: Medical records from 803 patients undergoing hepatobiliary surgery from October 2015 to October 2016 were reviewed. The study setting was a 3400-bed military academic medical center in the northeast region of China...
September 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28869902/acute-effects-of-anesthetic-lumbar-spine-injections-on-temporal-spatial-parameters-of-gait-in-individuals-with-chronic-low-back-pain-a-pilot-study
#8
Carl L Herndon, MaryBeth Horodyski, Heather K Vincent
This study examined whether epidural injection-induced anesthesia acutely and positively affected temporal spatial parameters of gait in patients with chronic low back pain (LBP) due to lumbar spinal stenosis. Twenty-five patients (61.7±13.6years) who were obtaining lumbar epidural injections for stenosis-related LBP participated. Oswestry Disability Index (ODI) scores, Medical Outcomes Short Form (SF-36) scores, 11-point Numerical pain rating (NRSpain) scores, and temporal spatial parameters of walking gait were obtained prior to, and 11-point Numerical pain rating (NRSpain) scores, and temporal spatial parameters of walking gait were obtained after the injection...
August 31, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28865733/anesthesia-assistance-in-outpatient-colonoscopy-and-risk-of-aspiration-pneumonia-bowel-perforation-and-splenic-injury
#9
Barbara Bielawska, Lawrence C Hookey, Rinku Sutradhar, Marlo Whitehead, Jianfeng Xu, Lawrence F Paszat, Linda Rabeneck, Jill Tinmouth
BACKGROUND & AIMS: The increase in use of anesthesia assistance (AA) to achieve deep sedation with propofol during colonoscopy has significantly increased colonoscopy costs without evidence for increased quality and with possible harm. We investigated the effects of AA on colonoscopy complications, specifically bowel perforation, aspiration pneumonia, and splenic injury. METHODS: In a population-based cohort study using administrative databases, we studied adults in Ontario, Canada undergoing outpatient colonoscopy from 2005 through 2012...
August 30, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28860790/evaluation-of-pain-during-endovenous-laser-ablation-of-the-great-saphenous-vein-with-ultrasound-guided-femoral-nerve-block
#10
Abdullah M Al Wahbi
BACKGROUND: Endoluminal laser ablation is now considered the method of choice for treating greater saphenous vein insufficiency. General anesthesia and peripheral nerve blocks with sedation have the risk of post-procedural delay in discharge and prolonged immobilization with the risk of deep vein thrombosis. The main pain experienced by patients during the procedure is during the laser ablation and the multiple needle punctures given along and around the great saphenous vein. The aim of our study was to evaluate the safety and efficacy of blocking the femoral nerve only under ultrasound-guidance without sedation, to reduce or prevent pain during injectable tumescent anesthesia in endovenous laser ablation of the greater saphenous vein...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28857813/risk-factors-and-mitigation-strategies-for-pancreatic-fistula-after-distal-pancreatectomy-analysis-of-2026-resections-from-the-international-multi-institutional-distal-pancreatectomy-study-group
#11
Brett L Ecker, Matthew T McMillan, Valentina Allegrini, Claudio Bassi, Joal D Beane, Ross M Beckman, Stephen W Behrman, Euan J Dickson, Mark P Callery, John D Christein, Jeffrey A Drebin, Robert H Hollis, Michael G House, Nigel B Jamieson, Ammar A Javed, Tara S Kent, Michael D Kluger, Stacy J Kowalsky, Laura Maggino, Giuseppe Malleo, Vicente Valero, Lavanniya K P Velu, Amarra A Watkins, Christopher L Wolfgang, Amer H Zureikat, Charles M Vollmer
OBJECTIVE: To identify a clinical fistula risk score following distal pancreatectomy. BACKGROUND: Clinically relevant pancreatic fistula (CR-POPF) following distal pancreatectomy (DP) is a dominant contributor to procedural morbidity, yet risk factors attributable to CR-POPF and effective practices to reduce its occurrence remain elusive. METHODS: This multinational, retrospective study of 2026 DPs involved 52 surgeons at 10 institutions (2001-2016)...
August 29, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28857799/age-at-exposure-to-surgery-and-anesthesia-in-children-and-association-with-mental-disorder-diagnosis
#12
Caleb Ing, Ming Sun, Mark Olfson, Charles J DiMaggio, Lena S Sun, Melanie M Wall, Guohua Li
BACKGROUND: Animals exposed to anesthetics during specific age periods of brain development experience neurotoxicity, with neurodevelopmental changes subsequently observed during adulthood. The corresponding vulnerable age in children, however, is unknown. METHODS: An observational cohort study was performed using a longitudinal dataset constructed by linking individual-level Medicaid claims from Texas and New York from 1999 to 2010. This dataset was evaluated to determine whether the timing of exposure to anesthesia ≤5 years of age for a single common procedure (pyloromyotomy, inguinal hernia, circumcision outside the perinatal period, or tonsillectomy and/or adenoidectomy) is associated with increased subsequent risk of diagnoses for any mental disorder, or specifically developmental delay (DD) such as reading and language disorders, and attention deficit hyperactivity disorder (ADHD)...
August 29, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28852345/outside-in-vs-anteromedial-portal-drilling-during-primary-acl-reconstruction-comparison-at-two-years
#13
Tyler CarlLee, Zach Ries, Kyle Duchman, Yubo Gao, Brian Wolf, Annunziato Amendola, Carolyn Hettrich, Matthew Bollier
BACKGROUND: Anteromedial (AM) and outside-in (OI) are two commonly used techniques for drilling the femoral tunnel during anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to compare clinical and radiographic outcomes of patients undergoing primary ACLR using either AM or OI femoral drilling with minimum two year follow-up. METHODS: Overall, 138 prospectively enrolled patients undergoing primary ACLR underwent AM or OI femoral drilling...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28836342/single-trans-septal-access-technique-for-left-atrial-intracardiac-echocardiography-to-guide-left-atrial-appendage-closure
#14
Daniel Aguirre, Christian Pincetti, Luis Perez, Carlos Deck, Mario Alfaro, Maria Jesus Vergara, Gabriel Maluenda
OBJECTIVE: This registry aimed to describe the safety and feasibility of a single trans-septal (TS) access technique for left intracardiac echocardiography (ICE) guidance of left-atrial appendage (LAA) closure procedure. BACKGROUND: LAA closure is currently accepted as an alternative to oral anticoagulation (OAC) in patients with non-valvular atrial fibrillation (NVAF) who are at high-risk for bleeding. Currently, LAA closure procedure is typically performed under trans-esophageal echocardiogram (TEE) guidance...
August 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28818054/comparison-of-the-trapezius-and-the-adductor-pollicis-muscle-as-predictor-of-good-intubating-conditions-a-randomized-controlled-trial
#15
Stefan Soltesz, Christian Stark, Karl G Noé, Michael Anapolski, Thomas Mencke
BACKGROUND: Adequate muscle relaxation is important for ensuring optimal conditions for intubation. Although acceleromyography of the adductor pollicis muscle is commonly used to assess conditions for intubation, we hypothesized that acceleromyography of the trapezius is more indicative of optimal intubating conditions. The primary outcome was the difference between both measurement sites with regard to prediction of good or acceptable intubating conditions. METHODS: Neuromuscular blockade after injection of rocuronium 0...
August 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28806216/psoas-versus-femoral-blocks-a-registry-analysis-of-risks-and-benefits
#16
Hagen Bomberg, Andrea Huth, Stefan Wagenpfeil, Paul Kessler, Hinnerk Wulf, Thomas Standl, André Gottschalk, Jens Döffert, Werner Hering, Jürgen Birnbaum, Claudia Spies, Bernd Kutter, Jörg Winckelmann, Gerald Burgard, Oliver Vicent, Thea Koch, Daniel I Sessler, Thomas Volk, Alexander Raddatz
BACKGROUND AND OBJECTIVES: Psoas blocks are an alternative to femoral nerve blocks and have the potential advantage of blocking the entire lumbar plexus. However, the psoas muscle is located deeply, making psoas blocks more difficult than femoral blocks. In contrast, while femoral blocks are generally easy to perform, the inguinal region is prone to infection. We thus tested the hypothesis that psoas blocks are associated with more insertion-related complications than femoral blocks but have fewer catheter-related infections...
August 11, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28803768/assessment-of-preoperative-anxiety-in-cardiac-surgery-patients-lacking-a-history-of-anxiety-contributing-factors-and-postoperative-morbidity
#17
Joaquín Hernández-Palazón, Diego Fuentes-García, Luis Falcón-Araña, María José Roca-Calvo, Sebastián Burguillos-López, Paloma Doménech-Asensi, Rubén Jara-Rubio
OBJECTIVES: The aim of this study was to measure the level of preoperative anxiety in patients scheduled for cardiac surgery, identify any influencing clinical factors, and assess the relationship between anxiety and postoperative morbidity. DESIGN: A prospective and consecutive study. SETTING: A single university hospital. PARTICIPANTS: The study comprised 200 patients scheduled for cardiac surgery. INTERVENTIONS: Each patient was asked to grade his or her preoperative anxiety level using the Visual Analogue Scale for Anxiety, Amsterdam Preoperative Anxiety and Information Scale, and set of specific anxiety-related questions...
April 26, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28797982/identification-of-preoperative-and-intraoperative-risk-factors-for-complications-in-the-elderly-undergoing-elective-craniotomy
#18
Stephen J Johans, Jonathan R Garst, Daniel J Burkett, Kurt Grahnke, Brendan Martin, Tarik F Ibrahim, Douglas E Anderson, Vikram C Prabhu
BACKGROUND: Neurosurgical patients are aging as the general population is getting older. METHODS: A retrospective review of patients ≥ 65 years of age who underwent an elective craniotomy from 2007-2015 to identify risk factors for 30-day morbidity/mortality was conducted. Key preoperative variables included age, co-morbidities, and functional status based on the Karnofsky Performance Status (KPS) score and modified Rankin Scale (mRS) score. Outcome variables included long-term care (LTC) complications, neurologic complications, systemic/infectious complications, length of stay (LOS), functional outcomes, and mortality...
August 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28795214/derivation-validation-and-application-of-a-pragmatic-risk-prediction-index-for-benchmarking-of-surgical-outcomes
#19
Richard T Spence, David C Chang, Haytham M A Kaafarani, Eugenio Panieri, Geoffrey A Anderson, Matthew M Hutter
BACKGROUND: Despite the existence of multiple validated risk assessment and quality benchmarking tools in surgery, their utility outside of high-income countries is limited. We sought to derive, validate and apply a scoring system that is both (1) feasible, and (2) reliably predicts mortality in a middle-income country (MIC) context. METHODS: A 5-step methodology was used: (1) development of a de novo surgical outcomes database modeled around the American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) in South Africa (SA dataset), (2) use of the resultant data to identify all predictors of in-hospital death with more than 90% capture indicating feasibility of collection, (3) use these predictors to derive and validate an integer-based score that reliably predicts in-hospital death in the 2012 ACS-NSQIP, (4) apply the score in the original SA dataset and demonstrate its performance, (5) identify threshold cutoffs of the score to prompt action and drive quality improvement...
August 9, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28777814/prevalence-of-preoperative-anemia-abnormal-mean-corpuscular-volume-and-red-cell-distribution-width-among-surgical-patients-in-singapore-and-their-influence-on-one-year-mortality
#20
Yilin Eileen Sim, Hide Elfrida Wee, Ai Leen Ang, Niresh Ranjakunalan, Biauw Chi Ong, Hairil Rizal Abdullah
INTRODUCTION: Preoperative anemia and high red cell distribution width (RDW) are associated with higher perioperative mortality. Conditions with high RDW levels can be categorized by mean corpuscular volume (MCV). The relationship between RDW, anemia and MCV may explain causality between high RDW levels and outcomes. We aim to establish the prevalence of preoperative anemia and distribution of RDW and MCV among pre-surgical patients in Singapore. In addition, we aim to investigate the association between preoperative anemia, RDW and MCV levels with one-year mortality after surgery...
2017: PloS One
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