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Global anesthesia

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https://www.readbyqxmd.com/read/28619774/protocol-for-a-multicentre-multistage-prospective-study-in-china-using-system-based-approaches-for-consistent-improvement-in-surgical-safety
#1
Xiaochu Yu, Jingmei Jiang, Changwei Liu, Keng Shen, Zixing Wang, Wei Han, Xingrong Liu, Guole Lin, Ye Zhang, Ying Zhang, Yufen Ma, Haixin Bo, Yupei Zhao
INTRODUCTION: Surgical safety has emerged as a crucial global health issue in the past two decades. Although several safety-enhancing tools are available, the pace of large-scale improvement remains slow, especially in developing countries such as China. The present project (Modern Surgery and Anesthesia Safety Management System Construction and Promotion) aims to develop and validate system-based integrated approaches for reducing perioperative deaths and complications using a multicentre, multistage design...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28608275/robert-mathys-finger-prosthesis-of-the-proximal-interphalangeal-joint-a-retrospective-case-series-of-19-joints-in-17-patients
#2
J P Rijnja, P P G M Kouwenberg, S Ray, E T Walbeehm
INTRODUCTION: The Robert Mathys (RM) Finger is a hinged type of arthroplasty for the metacarpophalangeal and proximal interphalangeal (PIP) joint that compensates ligament instability. The aim of this study is to evaluate the outcomes and complications of RM Finger arthroplasty of the PIP joint. MATERIALS AND METHODS: A retrospective case series of 19 RM Finger arthroplasties of the PIP joint in 17 patients was performed with a median follow-up of 36 months. The active range of motion (AROM) was measured pre-operatively, at the 6-week follow-up, at the termination of hand therapy, and at the final follow-up...
June 12, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28603012/an-improved-three-vessel-occlusion-model-of-global-cerebral-ischemia-in-rats
#3
Dmitriy N Atochin, Galina A Chernysheva, Oleg I Aliev, Vera I Smolyakova, Anton N Osipenko, Sergey V Logvinov, Anna A Zhdankina, Tatiana M Plotnikova, Mark B Plotnikov
We developed an improved three-vessel occlusion model of global cerebral ischemia in rats. This method consists in cessation of cerebral blood flow by accessing a. carotis communis sinistra through the ventral surface of the neck as well as tr. brachiocephalicus and a. subclavia sinistra through the first intercostal space, bypassing the pleural cavity and excluding pneumothorax. After the occlusion of the vessels that resulted in interruption of their blood flow, according to laser-Doppler flowmetry, there was a sharp decline in local cerebral blood flow in the visual cortex to 4±1% of the initial level...
June 8, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28596491/intraoperative-use-of-dexmedetomidine-promotes-postoperative-sleep-and-recovery-following-radical-mastectomy-under-general-anesthesia
#4
Cunxian Shi, Jin Jin, Qiang Pan, Shan Song, Kezhong Li, Jiahai Ma, Tao Li, Zhi Li
Postoperative sleep disturbance and fatigue following radical mastectomy were high risks for prolonged convalescence in patients with breast cancer. The present study was designed to observe the effect of intraoperative use of dexmedetomidine on postoperative sleep, fatigue and recovery following radical mastectomy under general anesthesia. Forty-seven patients were randomized into two groups that were maintained with propofol/remifentanil/Ringer's solution (Control group), or propofol/remifentanil/Dexmedetomidine (DEX group) for surgery under general anesthesia...
May 24, 2017: Oncotarget
https://www.readbyqxmd.com/read/28593682/interactive-pediatric-emergency-checklists-to-the-palm-of-your-hand-how-the-pedi-crisis-app-traveled-around-the-world
#5
Jorge A Gálvez, Justin L Lockman, Laura E Schleelein, Allan F Simpao, Luis M Ahumada, Bryan A Wolf, Maully J Shah, Eugenie Heitmiller, Mohamed Rehman
BACKGROUND: Cognitive aids help clinicians manage critical events and have been shown to improve outcomes by providing critical information at the point of care. Critical event guidelines, such as the Society of Pediatric Anesthesia's Critical Events Checklists described in this article, can be distributed globally via interactive smartphone apps. From October 1, 2013 to January 1, 2014, we performed an observational study to determine the global distribution and utilization patterns of the Pedi Crisis cognitive aid app that the Society for Pediatric Anesthesia developed...
June 7, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28576279/-atypical-reaction-to-anesthesia-in-duchenne-becker-muscular-dystrophy
#6
Helga Cristina Almeida da Silva, Marcia Hiray, Mariz Vainzof, Beny Schmidt, Acary Souza Bulle Oliveira, José Luiz Gomes do Amaral
BACKGROUND AND OBJECTIVES: Duchenne/Becker muscular dystrophy affects skeletal muscles and leads to progressive muscle weakness and risk of atypical anesthetic reactions following exposure to succinylcholine or halogenated agents. The aim of this report is to describe the investigation and diagnosis of a patient with Becker muscular dystrophy and review the care required in anesthesia. CASE REPORT: Male patient, 14 years old, referred for hyperCKemia (chronic increase of serum creatine kinase levels - CK), with CK values of 7,779-29,040IU...
May 30, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28572583/perioperative-and-anesthesia-related-cardiac-arrests-in-geriatric-patients-a-systematic-review-using-meta-regression-analysis
#7
Karen S Braghiroli, José R C Braz, Bruna Rocha, Regina El Dib, José E Corrente, Mariana G Braz, Leandro G Braz
The worldwide population is aging, and the number of surgeries performed in geriatric patients is increasing. This systematic review evaluated anesthetic procedures to assess global data on perioperative and anesthesia-related cardiac arrest (CA) rates in geriatric surgical patients. Available data on perioperative and anesthesia-related CA rates over time and by the country's Human Development Index (HDI) were evaluated by meta-regression, and a pooled analysis of proportions was used to compare perioperative and anesthesia-related CA rates by HDI and time period...
June 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28537981/development-of-education-and-research-in-anesthesia-and-intensive-care-medicine-at-the-university-teaching-hospital-in-lusaka-zambia-a-descriptive-observational-study
#8
Anna Janowicz, Tuma Kasole, Emily Measures, Meg Langley, Fastone M Goma, Feruza Ismailova, John A Kinnear, M Dylan Bould
BACKGROUND: Data from 2006 show that the practice of anesthesia at the University Teaching Hospital in Lusaka, Zambia was underdeveloped by international standards. Not only was there inadequate provision of resources related to environment, equipment, and drugs, but also a severe shortage of staff, with no local capability to train future physician anesthetic providers. There was also no research base on which to develop the specialty. This study aimed to evaluate patient care, education and research to determine whether conditions had changed a decade later...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28537976/interest-of-urinary-timp-2-%C3%A3-igfbp-7-for-predicting-the-occurrence-of-acute-kidney-injury-after-cardiac-surgery-a-gray-zone-approach
#9
Toufic Finge, Sebastien Bertran, Claire Roger, Damien Candela, Bruno Pereira, Christopher Scott, Laurent Muller, Benjamin Louart, Jean-Yves Lefrant
BACKGROUND: This study assessed the ability of 3-hour postoperative urinary tissue inhibitor of metalloproteinases-2 × insulin-like growth factor binding protein-7 ([TIMP-2] × [IGFBP-7]) to predict postoperative acute kidney injury (AKI) in patients undergoing cardiopulmonary bypass during cardiac surgery. METHODS: Patients undergoing cardiac surgery with cardiopulmonary bypass were eligible for this study. Patients with initial chronic renal insufficiency requiring renal replacement therapy, patients <18 years of age, and parturients were not included...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28530215/takotsubo-cardiomyopathy-after-intravenous-epinephrine-administration-following-cardiac-arrest-provoked-by-pneumoperitoneum-a-case-report
#10
Waldemar Elikowski, Malgorzata Małek-Elikowska, Jacek Karoń, Maria Mrozińska, Alina Baszko, Karolina Horbacka
In stress-induced takotsubo cardiomyopathy (TC) high levels of catecholamines, including epinephrine, may be detected in blood. On the other hand, administration of exogenous epinephrine may occasionally result in TC. A CASE REPORT: The authors describe a case of a 58-year-old, otherwise healthy female, with TC which occurred after intravenous injection of 1 mg of epinephrine against cardiac arrest provoked by pneumoperitoneum performed before planned laparoscopic cholecystectomy. She was admitted 3 days earlier due to biliary colic following a dietary mistake...
April 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28525513/an-observational-assessment-of-anesthesia-capacity-in-madagascar-as-a-prerequisite-to-the-development-of-a-national-surgical-plan
#11
Linden S Baxter, Vaonandianina A Ravelojaona, Hasiniaina N Rakotoarison, Alison Herbert, Emily Bruno, Kristin L Close, Vanessa Andean, Hery H Andriamanjato, Mark G Shrime, Michelle C White
BACKGROUND: The global lack of anesthesia capacity is well described, but country-specific data are needed to provide country-specific solutions. We aimed to assess anesthesia capacity in Madagascar as part of the development of a Ministry of Health national surgical plan. METHODS: As part of a nationwide surgical safety quality improvement project, we surveyed 19 of 22 regional hospitals, representing surgical facilities caring for 75% of the total population. The assessment was divided into 3 areas: anesthesia workforce density, infrastructure and equipment, and medications...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28491126/developing-obstetric-medicine-training-in-latin-america
#12
José Rojas-Suarez, Niza Suarez, Oier Ateka-Barrutia
Maternal mortality is an important indicator of health in populations around the world. The distribution of maternal mortality ratio globally shows that middle- and low-income countries have ∼99% of the mortality burden. Most countries of Latin America are considered to be middle- or low-income countries, as well as areas of major inequities among the different social classes. Medical problems in pregnancy remain an important cause of morbidity and mortality in this region. Previous data indicate the need for a call to action for adequate diagnosis and care of medical diseases in obstetric care...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28484371/state-dependent-modulation-of-slow-wave-motifs-towards-awakening
#13
Daisuke Shimaoka, Chenchen Song, Thomas Knöpfel
Slow cortical waves that propagate across the cerebral cortex forming large-scale spatiotemporal propagation patterns are a hallmark of non-REM sleep and anesthesia, but also occur during resting wakefulness. To investigate how the spatial temporal properties of slow waves change with the depth of anesthetic, we optically imaged population voltage transients generated by mouse layer 2/3 pyramidal neurons across one or two cortical hemispheres dorsally with a genetically encoded voltage indicator (GEVI). From deep barbiturate anesthesia to light barbiturate sedation, depolarizing wave events recruiting at least 50% of the imaged cortical area consistently appeared as a conserved repertoire of distinct wave motifs...
2017: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/28482650/obesity-and-perioperative-noninvasive-ventilation-in-bariatric-surgery
#14
Michele Carron, Francesco Zarantonello, Giovanna Ieppariello, Carlo Ori
The incidence and prevalence of obesity continues to increase globally. Physicians will therefore provide care for an increasing number of obese patients in their clinical practice. Optimal management of these patients is required to minimize the risk of perioperative complications that increase morbidity and mortality. Obesity affects the respiratory function. It is generally associated with reduced lung volume with increased atelectasis, decreased lung and chest wall compliance, increased airway resistance, and moderate to severe hypoxemia...
June 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28468999/ketamine-induced-converged-synchronous-gamma-oscillations-in-the-cortico-basal-ganglia-network-of-non-human-primates
#15
Maya Slovik, Boris Rosin, Shay Moshel, Rea Mitelman, Eitan Schechtman, Renana Eitan, Aeyal Raz, Hagai Bergman
NMDA (N-methyl-D-aspartate) antagonists are widely used in anesthesia, pain management, schizophrenia animal model studies and recently as potential antidepressants. However the mechanisms underlying their anesthetic, psychotic, cognitive and emotional effects are still elusive. The basal-ganglia (BG) integrate input from different cortical domains through its dopamine modulated connections, to achieve optimal behavior control. NMDA antagonists have been shown to induce gamma oscillations in human EEG recordings and in rodents cortical and BG networks...
May 3, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28461059/high-resolution-functional-mri-identified-distinct-global-intrinsic-functional-networks-of-nociceptive-posterior-insula-and-s2-regions-in-squirrel-monkey-brain
#16
Ruiqi Wu, Feng Wang, Pai-Feng Yang, Li Min Chen
Numerous functional imaging and electrophysiological studies in humans and animals indicate that the two contiguous areas of secondary somatosensory cortex (S2) and posterior insula (pIns) are core regions in nociceptive processing and pain perception. In this study, we tested the hypothesis that the S2-pIns connection serves as a hub for connecting distinct sensory and affective nociceptive processing networks in the squirrel monkey brain. At 9.4T, we first mapped the brain regions that respond to nociceptive heat stimuli with high-resolution fMRI, and then used seed-based resting-state fMRI (rsfMRI) analysis to delineate and refine the global intrinsic functional connectivity circuits of the proximal S2 and pIns regions...
April 28, 2017: NeuroImage
https://www.readbyqxmd.com/read/28452818/the-need-for-a-global-perspective-on-task-sharing-in-anesthesia
#17
Michael S Lipnick, Fred Bulamba, Stephen Ttendo, Adrian W Gelb
No abstract text is available yet for this article.
April 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28426446/providing-anesthesia-in-resource-limited-settings
#18
Lena E Dohlman
PURPOSE OF REVIEW: The article reviews the reality of anesthetic resource constraints in low and middle-income countries (LMICs). Understanding these limitations is important to volunteers from high-income countries who desire to teach or safely provide anesthesia services in these countries. RECENT FINDINGS: Recently published information on the state of anesthetic resources in LMICs is helping to guide humanitarian outreach efforts from high-income countries. The importance of using context-appropriate anesthesia standards and equipment is now emphasized...
April 19, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28424861/s-ketamine-compared-to-etomidate-during-electroconvulsive-therapy-in-major-depression
#19
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/28400499/the-coherence-of-macrocirculation-microcirculation-and-tissue-metabolic-response-during-nontraumatic-hemorrhagic-shock-in-swine
#20
Halvor Langeland, Oddveig Lyng, Petter Aadahl, Nils-Kristian Skjærvold
Hemorrhagic shock is clinically observed as changes in macrocirculatory indices, while its main pathological constituent is cellular asphyxia due to microcirculatory alterations. The coherence between macro- and microcirculatory changes in different shock states has been questioned. This also applies to the hemorrhagic shock. Most studies, as well as clinical situations, of hemorrhagic shock include a "second hit" by tissue trauma. It is therefore unclear to what extent the hemorrhage itself contributes to this lack of circulatory coherence...
April 2017: Physiological Reports
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