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vascular peripheral anaesthesia

Langhit Kurar
INTRODUCTION: Ankle fractures in the osteoporotic patient are challenging injuries to manage, due to a combination of poor soft tissue, peripheral vascular disease and increased bone fragility, often resulting in more complex fracture patterns. I aim to audit current practice and introduce change by producing recommendations to help improve longer-term functional outcomes. PATIENTS AND METHODS: A retrospective 3-week audit was conducted reviewing results of ankle fracture management in 50 patients aged between 50 and 80 years...
March 2016: Annals of Medicine and Surgery
A Sonia Petronio, Cristina Giannini, Marco De Carlo, Francesco Bedogni, Antonio Colombo, Corrado Tamburino, Silvio Klugmann, Arnaldo Poli, Fabio Guarracino, Marco Barbanti, Azeem Latib, Nedy Brambilla, Claudia Fiorina, Giuseppe Bruschi, Paola Martina, Federica Ettori
AIMS: Transcatheter aortic valve implantation (TAVI) represents a valid therapeutic alternative for patients with severe aortic stenosis at high surgical risk. However, there is no general consensus regarding the role of anaesthesia in TAVI management. The goal of this clinical project was to assess the safety and non-inferiority of local anaesthesia (LA) versus general anaesthesia (GA) in a large cohort of patients undergoing TAVI. METHODS AND RESULTS: All 1,316 consecutive patients who underwent TAVI at seven high-volume Italian centres were enrolled...
June 20, 2016: EuroIntervention
L Biasco, O De Backer, S Holme, L Søndergaard, A Jönsson
AIM: to describe the procedural steps and to report the short term follow up of our initial experience with an axillarian bareback Dacron graft based technique that could potentially reduce the rate of vascular and ischemic complications during transcatheter aortic valve implantation in patients with contraindications to trans-femoral approach and with patent left internal mammary arterial graft to left anterior descending coronary artery (LIMA-LAD) or small caliber axillarian/subclavian arteries...
September 2015: Catheterization and Cardiovascular Interventions
Soile Ae Pakkanen, Marja R Raekallio, Anna K Mykkänen, Kati M Salla, Annemarie de Vries, Lauri Vuorilehto, Mika Scheinin, Outi M Vainio
OBJECTIVE: To investigate MK-467 as part of premedication in horses anaesthetized with isoflurane. STUDY DESIGN: Experimental, crossover study with a 14 day wash-out period. ANIMALS: Seven healthy horses. METHODS: The horses received either detomidine (20 μg kg(-1) IV) and butorphanol (20 μg kg(-1) IV) alone (DET) or with MK-467 (200 μg kg(-1) IV; DET + MK) as premedication. Anaesthesia was induced with ketamine (2...
September 2015: Veterinary Anaesthesia and Analgesia
M D Stoneham, D Stamou, J Mason
Summary Regional anaesthesia is a popular choice for patients undergoing carotid endarterectomy (CEA). Neurological function is easily assessed during carotid cross-clamping; haemodynamic control is predictable; and hospital stay is consistently shorter compared with general anaesthesia (GA). Despite these purported benefits, mortality and stroke rates associated with CEA remain around 5% for both regional anaesthesia and GA. Regional anaesthetic techniques for CEA have improved with improved methods of location of peripheral nerves including nerve stimulators and ultrasound together with a modification in the classification of cervical plexus blocks...
March 2015: British Journal of Anaesthesia
O G S Ayling, J Montbriand, J Jiang, S Ladak, L Love, N Eisenberg, J Katz, H Clarke, G Roche-Nagle
OBJECTIVES: Postoperative stump pain after major lower limb amputation is a significant impediment to the recovery of amputees. The vast majority of patients require opioid analgesics following surgery, which are associated with opioid-related side-effects. Here, we investigate whether intraoperative placement of a peripheral nerve stump catheter followed by continuous infusion of local anesthetic is as effective at pain control as current analgesic practices. If beneficial, this procedure could potentially reduce post-amputation opioid consumption and opioid-related adverse effects...
November 2014: European Journal of Vascular and Endovascular Surgery
Christoph Sponholz, Christoph Schelenz, Konrad Reinhart, Uwe Schirmer, Sebastian N Stehr
BACKGROUND: Management of cardiac surgery patients is a very standardized procedure in respective local institutions. Yet only very limited evidence exists concerning optimal indication, safety and efficacy of hemodynamic monitoring catecholamine and fluid therapy. METHODS: Between April and May 2013, all 81 German anaesthesia departments involved in cardiac surgery care were asked to participate in a questionnaire addressing the institutional specific current practice in hemodynamic monitoring, catecholamine and volume therapy...
2014: PloS One
Craig Nesbitt, Rachel Bedenis, Vish Bhattacharya, Gerard Stansby
BACKGROUND: Minimally invasive techniques to treat great saphenous varicose veins include ultrasound-guided foam sclerotherapy (UGFS), radiofrequency ablation (RFA) and endovenous laser therapy (EVLT). Compared with flush saphenofemoral ligation with stripping, also referred to as open surgery or high ligation and stripping (HL/S), proposed benefits include fewer complications, quicker return to work, improved quality of life (QoL) scores, reduced need for general anaesthesia and equivalent recurrence rates...
2014: Cochrane Database of Systematic Reviews
Eric F Lucking, Ken D O'Halloran, James F X Jones
Chronic intermittent hypoxia (CIH) in animal models has been shown to result in hypertension and elevation of sympathetic nervous system activity. Sympathetically mediated vasoconstriction is believed to be the primary mechanism underpinning CIH-induced hypertension; however, the potential contribution of the heart is largely overlooked. We sought to determine the contribution of cardiac output (CO) and lumbar sympathetic control of the hindlimb circulation to CIH-induced hypertension. Male Wistar rats (n = 64) were exposed to 2 weeks of CIH [cycles of 90 s hypoxia (5% O2 nadir) and 210 s normoxia] or normoxia for 8 h day(-1)...
October 2014: Experimental Physiology
Tienush Rassaf, Jan Balzer, Tobias Zeus, Christos Rammos, Sascha Shayganfar, Silke V Hall, Rabea Wagstaff, Malte Kelm
OBJECTIVE: To characterize the safety and efficacy of deep sedation (DS) as compared to general anaesthesia (GA) in percutaneous mitral valve repair (PMVR) using the MitraClip system. BACKGROUND: PMVR with the MitraClip system has emerged as a therapeutic alternative to surgical valve repair in high-risk patients. The PMVR procedure is typically performed under GA. Due to their high surgical risk, avoidance of GA in many of those patients would be desirable. METHODS: In an open-label observational study 21 patients with severe mitral regurgitation were randomized to either GA or DS using propofol...
October 1, 2014: Catheterization and Cardiovascular Interventions
T Dylan Olver, Kenneth N Grisé, Matthew W McDonald, Adwitia Dey, Matti D Allen, Charles L Rice, James C Lacefield, Cw James Melling, Earl G Noble, J Kevin Shoemaker
Peripheral nerve blood flow (NBF) does not autoregulate but, instead, responds passively to changes in mean arterial pressure (MAP). How this relationship is impacted by insulin-treated experimental diabetes (ITED) is unknown. We tested the hypothesis that ITED will reduce NBF across a range of MAP in Sprague Dawley rats. Following 10 weeks of control or ITED conditions, conscious MAP (tail-cuff) was measured, and under anaesthesia, the MAP (carotid artery catheter, pressure transducer) and NBF (Doppler ultrasound, 40 MHz) responses to sodium nitroprusside (60 µg/kg) and phenylephrine (12 µg/kg) infusion were recorded (regression equations for MAP vs NBF were created for each rodent)...
May 22, 2014: Diabetes & Vascular Disease Research
K Urbášek, L Plánka
PURPOSE OF THE STUDY: The aim of the study was to retrospectively evaluate the treatment outcomes of displaced supracondylar humerus fractures, including potential complications, in children treated at the Department of Paediatric General Surgery, Orthopaedics and Trauma Surgery of the Faculty of Medicine in Brno between 2000 and 2011. MATERIAL AND METHODS: The study comprised 564 children, 321 (57%) boys and 243 (43%) girls, who were allocated to two groups according to the method of primary treatment...
2014: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Adam Denes, Jesus M Pradillo, Caroline Drake, Hannah Buggey, Nancy J Rothwell, Stuart M Allan
Acute brain injury results in peripheral inflammatory changes, although the impact of these processes on neuronal death and neuroinflammation is currently unclear. To facilitate the translation of experimental studies to clinical benefit, it is vital to characterize the mechanisms by which acute brain injury induces peripheral inflammatory changes, and how these are affected by surgical manipulation in experimental models. Here we show that in mice, even mild surgical manipulation of extracranial tissues induced marked granulocyte mobilization (300%) and systemic induction of cytokines...
2013: Frontiers in Neuroscience
Marcelo Calil Burihan
BACKGROUND: Minimally invasive techniques to treat great saphenous varicose veins include ultrasound-guided foam sclerotherapy (USGFS), radiofrequency ablation (RFA) and endovenous laser therapy (EVLT). Compared with conventional surgery (high ligation and stripping (HL/S)), proposed benefits include fewer complications, quicker return to work, improved quality of life (QoL) scores, reduced need for general anaesthesia and equivalent recurrence rates. OBJECTIVE: To review available randomized controlled clinical trials (RCT) data comparing USGFS, RFA, EVLT to HL/S for the treatment of great saphenous varicose veins...
2014: São Paulo Medical Journal, Revista Paulista de Medicina
Alexandre Azmoun, Nicolas Amabile, Ramzi Ramadan, Saïd Ghostine, Christophe Caussin, Sahbi Fradi, François Raoux, Philippe Brenot, Remi Nottin, Philippe Deleuze
OBJECTIVES: Trans-femoral and transapical are the most commonly used accesses for transcatheter aortic valve implantation (TAVI). However, when these approaches are unsuitable, alternative accesses are needed. We report a series of 19 patients undergoing TAVI through common carotid artery (CCA) access under local anaesthesia in order to assess its feasibility and safety. METHODS: From November 2008 to September 2013, 361 patients underwent TAVI at our institution...
October 2014: European Journal of Cardio-thoracic Surgery
David Green, Heena Bidd, Hisham Rashid
Recent guidelines from the National Institute of Health and Care Excellence (NICE) and the UK National Health Service (NHS) have stipulated that intraoperative flow monitoring should be used in high-risk patients undergoing major surgery to improve outcomes and reduce costs. Depth of anaesthesia monitoring is also recommended for patients where excessive anaesthetic depth is poorly tolerated, along with cerebral oximetry in patients with proximal femoral fractures. The aims of this descriptive case series were to evaluate the impact of a multimodal intraoperative strategy and its effect on mortality and amputation rate for patients with critical leg ischaemia...
2014: International Journal of Surgery
Carl van Walraven, Reilly Musselman
BACKGROUND: Surgical site infections (SSI) are an important cause of peri-surgical morbidity with risks that vary extensively between patients and surgeries. Quantifying SSI risk would help identify candidates most likely to benefit from interventions to decrease the risk of SSI. METHODS: We randomly divided all surgeries recorded in the National Surgical Quality Improvement Program from 2010 into a derivation and validation population. We used multivariate logistic regression to determine the independent association of patient and surgical covariates with the risk of any SSI (including superficial, deep, and organ space SSI) within 30 days of surgery...
2013: PloS One
A V Diordiev, V L Aizenberg
Haemodynamics of 58 Pediatric patients with cerebral palsy was studied during combined anaesthesia based on sevoflurane and peripheral nerve block. Sevoflurane and peripheral nerve block with infusion support 14-15 ml/kg/ hr provide stable cardiac output during orthopedic surgeries in Pediatric patients with cerebral palsy. Excessive arterial hypotension and total peripheral vascular resistance decrease were registered in older patients as results of more pronounced vascular effect of anaesthetics in patients with decreased adaptive-compensatory possibilities and insufficient infusion support...
January 2013: Anesteziologiia i Reanimatologiia
S V Kinzhalova, R A Makarov, N S Davydova
RESEARCH OBJECTIVE: To study influence of various anaesthesia methods on key central haemodynamics parameters in patients with heavy preeclampsia during surgical delivery. MATERIALS AND METHODS: Prospective randomized comparative research was carried out. 60 pregnant women were included in research with a heavy preeclampsia after Cesarean section. Patients were randomized (a method of envelopes) in 2 groups (30 patients each): group with spinal anesthesia and general anaesthesia...
November 2012: Anesteziologiia i Reanimatologiia
M Benedetti Valentini, P Farsetti, O Martinelli, A Laurito, E Ippolito
Of 48 consecutive children with Gartland III supracondylar fractures, 11 (23%) had evidence of vascular injury, with an absent radial pulse. The hand was pink and warm in eight and white and cold in the other three patients. They underwent colour-coded duplex scanning (CCDS) and ultrasound velocimetry (UV) to investigate the patency of the brachial artery and arterial blood flow. In seven patients with a pink pulseless hand, CCDS showed a displaced, kinked and spastic brachial artery and a thrombosis was present in the other...
May 2013: Bone & Joint Journal
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