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https://www.readbyqxmd.com/read/29624026/preoperative-anxiety-and-implications-on-postoperative-recovery-what-we-can-do-to-change-our-history
#1
Dusica M Stamenkovic, Nemanja K Rancic, Milan B Latas, Vojislava Neskovic, Goran M Rondovic, Jennifer D Wu, Davide Cattano
Preoperative anxiety can influence the intensity of postoperative pain and anesthesia and analgesia requirement. In certain types of surgery, anxiety may even increase postoperative morbidity and mortality. The goal of this narrative review is to remind anesthesiologists that anxiety measurement using specific tools can be done in clinical practice, to present the implications of preoperative anxiety on postoperative patient recovery, and to acknowledge the importance of a dedicated anesthesia plan in the management of anxious adult patients...
April 5, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29608321/management-of-pregnancy-sensitized-with-anti-inb-with-monocyte-monolayer-assay-and-maternal-blood-donation
#2
Raj Shree, Kimberly K Ma, Lay S Er, Meghan Delaney
Maternal red blood cell (RBC) alloantibodies can cause hemolytic disease of the fetus and newborn (HDFN). Although much is described about common antibodies associated with HDFN, management of a pregnancy complicated by a maternal rare antibody presents several challenges related to assessment of fetal anemia risk, availability of blood for transfusion to the mother and/or the fetus or newborn if needed, and planning for delivery in the case of maternal hemorrhage. Here we report the laboratory medicine workup of a patient who presented for obstetrical care in the United States in the third trimester and had a rare antibody (anti-Inb)...
January 2018: Immunohematology
https://www.readbyqxmd.com/read/29607171/enhanced-recovery-after-thoracic-surgery-reduces-discharge-on-highly-dependent-narcotics
#3
Min P Kim, Edward Y Chan, Leonora M Meisenbach, Razvan Dumitru, Jessica K Brown, Faisal N Masud
Background: There is large prescription drug epidemic in United States. We want to determine if ERATS (enhanced recovery after thoracic surgery) program can reduce discharge on highly dependent narcotics. Methods: We performed a retrospective analysis of prospectively collected data on patients who underwent lung resection and foregut procedures on thoracic surgery service over an 8-month time period. Patients underwent preoperative conditioning instructions, multimodal non-narcotic pharmaceutical usage, total intravenous anesthesia (TIVA) and minimizing highly addictive narcotics during the post-operative period...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29588995/the-adjunctive-application-of-transcranial-direct-current-stimulation-in-the-management-of-de-novo-refractory-epilepsia-partialis-continua-in-adolescent-onset-polg-related-mitochondrial-disease
#4
Yi Shiau Ng, Henriette van Ruiten, H Ming Lai, Rebecca Scott, Venkateswaran Ramesh, Karen Horridge, Robert W Taylor, Doug M Turnbull, Gráinne S Gorman, Robert McFarland, Mark R Baker
Focal status epilepticus in POLG -related mitochondrial disease is highly refractory to pharmacological agents, including general anesthesia. We report the challenges in managing a previously healthy teenager who presented with de novo epilepsia partialis continua and metabolic stroke resulting from the homozygous p.Ala467Thr POLG mutation, the most common pathogenic variant identified in the Caucasian population. We applied transcranial direct current stimulation (tDCS; 2 mA; 20 min) daily as an adjunctive therapy because her focal seizures failed to respond to five antiepileptic drugs at maximal doses...
March 2018: Epilepsia Open
https://www.readbyqxmd.com/read/29580593/multimodal-perioperative-analgesia-regimen-to-improve-patient-outcomes-after-total-knee-arthroplasty-a-multidisciplinary-quality-improvement-project
#5
Rebecca E Donahue, George R Bradbury, Michael E Zychowicz, Virginia C Muckler
PURPOSE: The primary aim of this quality improvement project was to improve mobilization for patients after total knee arthroscopy by developing and implementing a standardized, evidence-based, multimodal analgesia regimen and patient-educational video. Secondary outcomes included opioid consumption, pain, and length of stay. DESIGN: A pre-post implementation design was used to compare two independent samples. METHODS: Patients were screened based on inclusion and exclusion criteria 1-2 weeks before surgery...
April 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29550366/using-animal-models-to-evaluate-the-functional-consequences-of-anesthesia-during-early-neurodevelopment
#6
Susan E Maloney, Catherine Creeley, Richard E Hartman, Carla M Yuede, Charles F Zorumski, Vesna Jevtovic-Todorovic, Krikor Dikranian, Kevin K Noguchi, Nuri B Farber, David F Wozniak
Fifteen years ago Olney and colleagues began using animal models to evaluate the effects of anesthetic and sedative agents (ASAs) on neurodevelopment. The results from ongoing studies indicate that, under certain conditions, exposure to these drugs during development induces an acute elevated apoptotic neurodegenerative response in the brain and long-term functional impairments. These animal models have played a significant role in bringing attention to the possible adverse effects of exposing the developing brain to ASAs when few concerns had been raised previously in the medical community...
March 14, 2018: Neurobiology of Learning and Memory
https://www.readbyqxmd.com/read/29547428/global-surgery-system-strengthening-it-is-all-about-the-right-metrics
#7
David A Watters, Glenn D Guest, Viliami Tangi, Mark G Shrime, John G Meara
Progress in achieving "universal access to safe, affordable surgery, and anesthesia care when needed" is dependent on consensus not only about the key messages but also on what metrics should be used to set goals and measure progress. The Lancet Commission on Global Surgery not only achieved consensus on key messages but also recommended 6 key metrics to inform national surgical plans and monitor scale-up toward 2030. These metrics measure access to surgery, as well as its timeliness, safety, and affordability: (1) Two-hour access to the 3 Bellwether procedures (cesarean delivery, emergency laparotomy, and management of an open fracture); (2) Surgeon, Anesthetist, and Obstetrician workforce >20/100,000; (3) Surgical volume of 5000 procedures/100,000; (4) Reporting of perioperative mortality rate; and (5 and 6) Risk rates of catastrophic expenditure and impoverishment when requiring surgery...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29547422/anesthesia-development-in-mongolia-strengthening-anesthesia-practice-in-mongolia-through-education-and-continuing-professional-development
#8
Ganbold Lundeg, Amanda Baric, David C Pescod, Keith Pescod
Anesthesia in Mongolia has undergone a period of major development over the past 17 years, thanks to the work of the Mongolian Society of Anesthesiologists (MSA) and the support of the World Federation of Societies of Anaesthesiologists and the Australian Society of Anaesthetists. The specialty has made major advances in training and in its standing among medical specialties in Mongolia. The MSA has produced members who are leaders in the development of anesthesia as well as emergency medicine and critical care...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29519719/oral-nitroglycerin-solution-may-be-effective-for-esophageal-food-impaction
#9
Benjamin A Willenbring, Callie K Schnitker, Samuel J Stellpflug
BACKGROUND: Esophageal food impaction is a common illness presenting to emergency departments (ED), and is frequently resistant to pharmacologic therapy. Several medications have been promoted for this indication, but so far have not proven effective. Endoscopic removal is frequently required to resolve the impaction, resulting in risks from anesthesia and the physical procedure, and in prolonged hospital stay for recovery. Oral nitroglycerin solution was recently used in two such cases and may represent a new therapeutic option...
March 5, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29513208/use-of-and-access-to-deep-sedation-and-general-anesthesia-for-dental-patients-a-survey-of-ontario-dentists
#10
Andrew Adams, Carilynne Yarascavitch, Carlos Quiñonez, Amir Azarpazhooh
OBJECTIVE: This study aims to assess barriers to the use of deep sedation/general anesthesia (DS/GA) identified by dentists in Ontario. METHODS: An email invitation to a web-based survey was distributed to all licensed dentists and specialists who have provided an email address to the provincial regulator (n = 5507). Descriptive and regression analyses were performed to explore practice and demographic factors associated with the use of DS/GA. RESULTS: The response rate was 18...
July 2017: Journal—Canadian Dental Association, Journal de L'Association Dentaire Canadienne
https://www.readbyqxmd.com/read/29496300/a-retrospective-analysis-of-factors-associated-with-anesthetic-case-duration-for-cesarean-deliveries
#11
M J Harris, R A Gabriel, R P Dutton, R D Urman
INTRODUCTION: Accurately predicting cesarean delivery case duration is an integral component of designing appropriate workflow protocols and ensuring adequate provider availability. Our primary objective was to describe the variability of case duration, based on factors that we hypothesized would be influential, such as hospital facility type, United States region, time of day, case volume, and patient and provider characteristics. METHODS: We analyzed hospital-, patient-, and provider-level variables from the National Anesthesia Clinical Outcomes Registry, a voluntary registry created to share anesthesia-related data and outcomes...
January 13, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29485967/report-of-the-third-heart-surgery-forum-scientific-sessions-zagreb-croatia-december-6-8-2017-conference-highlights
#12
Michael S Firstenberg, Tom C Nguyen, Harold Roberts, Mark M Levinson, Igo Rudez
The Heart Surgery Forum is an online community dedicated to topics related to all aspects of cardiothoracic surgery. It consists of an informative website (www.hsforum.com), a traditional indexed journal both in print and online, and an email-based "list-serv" for discussion of surgical cases and techniques. The email list-serv, "OpenHeart-L" (The Forum) is composed of surgeons and allied specialties (perfusion, anesthesia, nursing). Dr. Mark Levinson (USA) started The Forum originally in 1995...
February 26, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29411032/association-of-preoperatively-diagnosed-patent-foramen-ovale-with-perioperative-ischemic-stroke
#13
Pauline Y Ng, Andrew K-Y Ng, Balachundhar Subramaniam, Sara M Burns, Fanny Herisson, Fanny P Timm, Cand Med, Maira I Rudolph, Cand Med, Flora Scheffenbichler, Cand Med, Sabine Friedrich, Cand Med, Timothy T Houle, Deepak L Bhatt, Matthias Eikermann
Importance: Perioperative stroke is a major complication for patients undergoing surgery. Patent foramen ovale (PFO) represents a possible anatomical link between venous thrombosis and stroke. Objective: To determine whether a preoperatively diagnosed PFO is associated with increased risk of perioperative ischemic stroke. Design, Setting, and Participants: Retrospective cohort study from Massachusetts General Hospital and 2 affiliated community hospitals between January 1, 2007, and December 31, 2015...
February 6, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29398380/a-retrospective-analysis-of-the-variability-in-case-duration-for-aortic-valve-replacement-and-association-with-hospital-facility-types
#14
Rodney A Gabriel, Byron D Fergerson, Ethan Y Brovman, Richard P Dutton, Richard D Urman
OBJECTIVE: Currently, there are no large-scale studies that compare differences in case duration of aortic valve replacements (AVRs). The primary objective of this study was to determine associations of hospital facility type, geographic location, case volume per year, and time of day with duration of valve replacement surgery. DESIGN: Retrospective. SETTING: Data from the National Anesthesia Clinical Outcomes Registry. PARTICIPANTS: National data from university and non-university hospitals...
June 23, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29377127/dental-therapists-linked-to-improved-dental-outcomes-for-alaska-native-communities-in-the-yukon-kuskokwim-delta
#15
Donald L Chi, Dane Lenaker, Lloyd Mancl, Matthew Dunbar, Michael Babb
OBJECTIVES: Dental Health Aide Therapists (DHATs) have been part of the dental workforce in Alaska's Yukon-Kuskokwim (YK) Delta since 2006. They are trained to provide preventive and restorative care such as filling and extractions. In this study, we evaluated community-level dental outcomes associated with DHATs. METHODS: This was a secondary data analysis of Alaska Medicaid and electronic health record data for individuals in Alaska's YK Delta (2006-2015). The independent variable was the number of DHAT treatment days in each community...
January 29, 2018: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/29366746/how-cardiac-anesthesiology-can-help-stem-the-tide-of-under-representation-of-minorities-in-science-and-medicine
#16
Elliott Woodward, Yvonne Lai, Christyanna Egun, Michael G Fitzsimons
The field of medicine is built upon science, technology, engineering, and math (STEM), yet the United States is rapidly falling behind when it comes to educating the next generation in these disciplines, especially under-represented populations. The authors reflect on existing educational literature surrounding efforts to promote interest in STEM among students and under-represented populations. The authors advocate for greater efforts toward the development of youth programing. Cardiac anesthesia is uniquely positioned as a subspecialty to advance the goal of promoting interest in STEM in diverse groups of young students...
April 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29356773/the-third-american-society-of-regional-anesthesia-and-pain-medicine-practice-advisory-on-local-anesthetic-systemic-toxicity-executive-summary-2017
#17
Joseph M Neal, Michael J Barrington, Michael R Fettiplace, Marina Gitman, Stavros G Memtsoudis, Eva E Mörwald, Daniel S Rubin, Guy Weinberg
The American Society of Regional Anesthesia and Pain Medicine's Third Practice Advisory on local anesthetic systemic toxicity is an interim update from its 2010 advisory. The advisory focuses on new information regarding the mechanisms of lipid resuscitation, updated frequency estimates, the preventative role of ultrasound guidance, changes to case presentation patterns, and limited information related to local infiltration anesthesia and liposomal bupivacaine. In addition to emerging information, the advisory updates recommendations pertaining to prevention, recognition, and treatment of local anesthetic systemic toxicity...
February 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29285834/evidence-for-increased-use-of-the-society-of-pediatric-anesthesia-critical-events-checklist-in-resource-limited-environments-a-retrospective-observational-study-of-app-data
#18
Vikas N O'Reilly-Shah, Jamie Kitzman, Craig S Jabaley, Grant C Lynde
BACKGROUND: Electronic decision support tools in anesthesiology practice have great value, including the potential for mobile applications to simplify delivery of best-practice guidelines. AIMS: We sought to combine demographics with usage information to elucidate important patterns in the rate of use of the Society of Pediatric Anesthesia Critical Events Checklist, as measured by in-app accesses of the checklist via the freely available anesthesia calculator app anesthesiologist...
February 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29239956/the-anesthesia-workstation-quo-vadis
#19
Jan F A Hendrickx, Andre M De Wolf
Ensuring adequate ventilation and oxygenation and delivering inhaled anesthetic agent to the patient remain core responsibilities of the anesthesia provider during general anesthesia. Because of the emphasis placed on physiology, pharmacology, clinical sciences, and administrative duties, the stellar anesthesia workstation technology may be underutilized by the anesthesia community. Target-controlled O2 and agent delivery and automated end-expired CO2 control have entered the clinical arena, with only cost, luddism, and administrative hurdles preventing their more widespread use...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29177107/treatment-of-morbidly-adherent-placentation-utilizing-a-standardized-multidisciplinary-approach-in-the-community-hospital-private-practice-setting
#20
Mahsa Mansouri, Kim DeStefano, Brian Monks, Jasbir Singh, Mollie McDonnold, Jamison Morgan, Richard Hale, Jasvant Adusumalli, Amanda Horton, Sina Haeri
Objective  Morbidly adherent placentation is associated with increased maternal morbidity and mortality. Recently, there has been mounting evidence supporting the benefits of a standardized multidisciplinary approach at tertiary teaching hospitals. Our objective was to estimate the impact of the implementation of a similar program at a high-volume private community hospital. Study Design  In this retrospective cohort study, we evaluated maternal outcomes in all cases of histopathologically confirmed morbidly adherent placentation since the initiation of our multidisciplinary program (2012-2016)...
October 2017: American Journal of Perinatology Reports
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