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https://www.readbyqxmd.com/read/29782399/frozen-in-time-a-history-of-the-synthesis-of-nitrous-oxide-and-how-the-process-remained-unchanged-for-over-2-centuries
#1
Alexander Buslov, Matthew Carroll, Manisha S Desai
Three major factors have contributed to the unrivaled popularity of nitrous oxide (N2O) among anesthetists in the 20th century and beyond: its impressive safety profile, its affordability, and its rapid induction and emergence times. These 3 characteristics of N2O have been discussed and written about extensively throughout the medical literature. Nonetheless, the characteristic that contributed most to N2O's initial discovery-the elegance and simplicity of its synthesis-has received substantially less attention...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782016/in-vivo-gene-transfer-to-the-rabbit-common-carotid-artery-endothelium
#2
Bradley K Wacker, Lianxiang Bi, David A Dichek
The goal of this method is to introduce a transgene into the endothelium of isolated segments of both rabbit common carotid arteries. The method achieves focal endothelial-selective transgenesis, thereby allowing an investigator to determine the biological roles of endothelial-expressed transgenes and to quantify the in vivo transcriptional activity of DNA sequences in large artery endothelial cells. The method uses surgical isolation of rabbit common carotid arteries and an arteriotomy to deliver a transgene-expressing viral vector into the arterial lumen...
May 6, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29781847/identification-of-the-critical-nontechnical-skills-for-surgeons-needed-for-high-performance-in-a-variable-resource-context-notss-vrc
#3
John W Scott, Yihan Lin, Georges Ntakiyiruta, Zeta Mutabazi, William A Davis, Megan A Morris, Douglas S Smink, Robert Riviello, Steven Yule
OBJECTIVE: To identify the critical nontechnical skills (NTS) required for high performance in variable-resource contexts (VRC). BACKGROUND: As surgical training and capacity increase in low- and middle-income countries (LMICs), new strategies for improving surgical education and care in these settings are required. NTS are critical for high performance in surgery around the world. However, the essential NTS used by surgeons operating in LMICs to overcome the challenges specific to their contexts have never been described...
May 17, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29778249/a-preoperative-cotininury-test-for-abdominoplasty-reduces-peri-operative-complications
#4
F Delaunay, D Coquerel-Beghin, G Magalon, S R Cohen, D Casanova, J Niddam, P-Y Milliez, C Peillon, V Delpierre, I Auquit-Auckbur
BACKGROUND: Smoking induces complications in plastic surgery, in particular wound healing delays. Despite a 4-weeks' abstinence asking before and after surgery, some patients denied or hid their consumption. The aim of this study was to evaluate the effectiveness of a cotininury detection test in terms of improvement in outcomes after an abdominoplasty. MATERIAL AND METHODS: This retrospective cohort study included patients who underwent an abdominoplasty with umbilical transposition and lipoaspiration...
May 16, 2018: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29776768/-topical-anesthesia-without-the-use-of-an-anesthesiologist-in-adult-outpatient-cataract-surgery-assessment-of-selection-criteria-on-consultation-report-of-248-cases
#5
M Pepin, E Rineau, A Caignard, S Leruez, P Gohier
INTRODUCTION: This work aims to evaluate selection criteria used during the cataract surgery scheduling visit, to choose whether or not there will be an anesthesiologist available during the surgery, depending upon the patient's comorbidities. MATERIALS AND METHODS: Retrospective study performed in 2016 in Angers university medical center. Two groups were established on the cataract surgery scheduling visit, based on patients' comorbidities and vital signs (blood pressure, heart rate)...
May 15, 2018: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/29772984/pain-upon-inserting-a-peripheral-intravenous-catheter-size-does-not-matter
#6
Fredericus Hj van Loon, Lisette Apm Puijn, Wesly H van Aarle, Angelique Tm Dierick-van Daele, Arthur Ra Bouwman
BACKGROUND: Approximately 1.2 billion peripheral intravenous catheters are inserted across the world annually. It is known that intravenous cannulation may be a painful procedure, which affects cognitive abilities by increasing anxiety and discomfort. AIM: We hypothesized that inserting a smaller sized peripheral intravenous catheter has a lower level of pain sensation compared to a larger sized catheter. METHODS: This observational, cross-sectional study was conducted between May and October 2016, in which surgical patients, aged 18 years or older, were eligible to participate...
May 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29757122/dead-on-the-table-a-theoretical-expansion-of-the-vicarious-trauma-that-operating-room-clinicians-experience-when-their-patients-die
#7
Heather Hartley, David Kenneth Wright, Brandi Vanderspank-Wright, Pamela Grassau, Mary Ann Murray
The practice of operating room (OR) clinicians - nurses, surgeons, and anesthetists - is fundamentally about preserving life. Some patients, however, die in the OR. Clinicians are therefore vulnerable to moral and emotional trauma. In this paper, we discuss three forces that shape clinicians' moral and emotional experiences in OR care: biomedical values, normative death discourse, and socially (un)sanctioned grief. We suggest how each of these forces increases clinicians' vulnerability to feel traumatized when their patients die...
May 14, 2018: Death Studies
https://www.readbyqxmd.com/read/29753669/does-the-weekend-effect-for-postoperative-mortality-stand-up-to-scrutiny-association-for-cardiothoracic-anesthesia-and-critical-care-cohort-study-of-110-728-cardiac-surgical-patients
#8
Olympia Papachristofi, Andrew A Klein, John Mackay, Samer Nashef, Nick S Fletcher, Linda D Sharples
OBJECTIVE: Ongoing debate focuses on whether patients admitted to the hospital on weekends have higher mortality than those admitted on weekdays. Whether this apparent "weekend effect" reflects differing patient risk, care quality differences, or inadequate adjustment for risk during analysis remains unclear. This study aimed to examine the existence of a "weekend effect" for risk-adjusted in-hospital mortality after cardiac surgery. DESIGN: Retrospective analysis of prospectively collected cardiac registry data...
April 5, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29750692/trainability-of-cricoid-pressure-force-application-a-simulation-based-study
#9
Eric Noll, Shivam Shodhan, Arnavi Varshney, Christopher Gallagher, Pierre Diemunsch, F Barry Florence, Jamie Romeiser, Elliott Bennett-Guerrero
BACKGROUND: Aspiration of gastric contents is a leading cause of airway management-related mortality during anesthesia practice. Cricoid pressure (CP) is widely used during rapid sequence induction to prevent aspiration. National guidelines for CP suggest a target force of 10 N before and 30 N after loss of consciousness. However, few studies have rigorously assessed whether clinicians can be trained to consistently achieve these levels of force. We hypothesized that clinicians can be trained effectively to deliver 10-30 N during application of CP...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29728246/quality-and-accuracy-of-electronic-pre-anesthesia-evaluation-forms
#10
Meshari Almeshari, Mohamed Khalifa, Ashraf El-Metwally, Mowafa Househ, Abdullah Alanazi
BACKGROUND AND OBJECTIVE: Paper-based forms have been widely used to document patient health information for anesthesia; however, hospitals are now switching to electronic patient file documentation for anesthesia. The aim of this study is to compare the quality of paper-based and electronic pre-anesthesia assessment forms. METHODS: The research conducted in this study was quasi-experimental using a pretest-posttest design without a control group. The study was conducted at King Abdulaziz Medical City, Riyadh (KAMC-RD) during November 2015...
July 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29696127/effect-of-oral-clonidine-on-shoulder-tip-pain-and-hemodynamic-response-after-laparoscopic-cholecystectomy-a-randomized-double-blind-study
#11
Hamid Mirhosseini, Mohamad Hossein Avazbakhsh, Meysam Hosseini Amiri, Ahmad Entezari, Reza Bidaki
Background: Shoulder tip pain is a common problem after laparoscopic cholecystectomy. There are a few clinical trial studies on the effect of clonidine on post laparoscopic shoulder pain (PLSP). This study aimed at evaluating the effect of oral clonidine on PLSP in semi-sitting position and post-operative hemodynamic response of patients undergoing LC surgery. Methods: This randomized controlled clinical trial was conducted on 60 patients, who were candidates for elective laparoscopic cholecystectomy surgery under general anesthesia, and were randomly allocated to clonidine and placebo groups...
December 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29692229/corticosteroids-and-other-anti-inflammatory-strategies-in-pediatric-heart-surgery-a-national-survey-of-practice
#12
Daniel P Fudulu, Alvin Schadenberg, Ben Gibbison, Ian Jenkins, Stafford Lightman, Gianni D Angelini, Serban Stoica
BACKGROUND: The role of steroids to mitigate the deleterious effects of pediatric cardiopulmonary bypass (CPB) remains a matter of debate; therefore, we aimed to assess preferences in administering corticosteroids (CSs) and the use of other anti-inflammatory strategies in pediatric cardiac surgery. METHODS: A 19-question survey was distributed to consultants in pediatric cardiac anesthesia from 12 centers across the United Kingdom and Ireland. RESULTS: Of the 37 respondents (37/60, 62%), 24 (65%) use CSs, while 13 (35%) do not use steroids at all...
May 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29691694/-which-medications-are-safe-while-breastfeeding-a-synopsis-for-the-anesthetist-obstetrician-and-pediatrician
#13
REVIEW
Arabella Fischer, Clemens Ortner, Thomas Hartmann, Stefan Jochberger, Klaus Ulrich Klein
Pharmacokinetic data on drug administration during lactation are often inconsistent or missing. For legal reasons medicinal drug product information generally advises to interrupt breastfeeding for 24 h after medication intake. However this is not standard of care in clinical practice as the mother should be instructed to initiate breastfeeding as soon as possible after giving birth. At the same time the medication exposure over the breast milk for the newborn should be minimized. Aim of this article is to summarize pharmacokinetic data and to give important clinical information on medications frequently administered during the lactation period...
April 24, 2018: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29690961/shortened-preoperative-fasting-time-to-allow-oral-rehydration-solution-clear-liquid-up-to-two-hours-before-elective-major-surgery-in-adults
#14
Jay N Shah, Shantabir Maharjan, Rajan Gurung
OBJECTIVE: To generate evidence of feasibility to allow clear liquid 2 hours before elective surgery. STUDY DESIGN: Cross-sectional observational study. PLACE AND DURATION OF STUDY: The Department of Surgery, Patan Hospital, Patan Academy of Health Sciences, Nepal, from October to December 2016. METHODOLOGY: One hundred consecutive adult elective major surgery patients of American Society of Anesthesiologist criteria 1 or 2 were enrolled...
May 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29682028/management-of-chronic-subdural-hematoma-burr-hole-versus-twist-drill-a-prospective-study
#15
Ram Kumar Goyal, Biswaranjan Nayak, Rajiv Maharshi, Debadulal Das Bidhar, Sunil Panchal, Harish Chandra Pathak
Introduction: Incidence of chronic subdural hematoma (CSDH) is about 5/100,000/year in the general population and still rising. Two surgical techniques, namely, burr-hole evacuation (BHE) versus twist-drill evacuation (TDE) are commonly used to manage such patients but the preferred surgical method continues to attract debate, and the time for an evidence-based approach is now overdue. In vogue with recent trends, a minimally invasive surgical approach is considered as best; therefore, we tried to establish the hypothesis that TDE is as safe and as effective as BHE for CSDH treatment...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29666844/burnout-among-anesthetists-and-intensive-care-physicians
#16
Audrius Mikalauskas, Rimantas Benetis, Edmundas Širvinskas, Judita Andrejaitienė, Šarūnas Kinduris, Andrius Macas, Žilvinas Padaiga
Burnout is a syndrome of depersonalization, emotional exhaustion, and low personal accomplishment. Little is known about burnout in physicians. Our objective was to determine the prevalence of burnout among anesthetists and intensive care physicians, and associations between burnout and personal, as well as professional, characteristics. Methods: In total, 220 anesthetists and intensive care physicians were contacted by email, asking them to participate in the study. For depression screening the PHQ-2 questionnaire, for problem drinking, CAGE items were used...
2018: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/29644445/-perioperative-onset-of-sarcoidosis-rare-differential-diagnosis-of-a-difficult-airway
#17
G Jansen, A Nowak
Sarcoidosis is a rare multisystemic chronic inflammatory condition. Typically, there is a big discrepancy between the patient's subjectively perceived symptoms and the presence of clinical signs. Due to the high number of potential sites of onset (e. g. larynx, lungs, heart, liver, kidneys) the affected organs may show functional restrictions that are relevant for decisions related to anesthesia. Therefore, an anesthetists working in a clinical setting should be familiar with the special needs of this patient collective...
April 11, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29643730/transient-femoral-nerve-palsy-following-ilioinguinal-nerve-block-for-inguinal-hernioplasty
#18
Isaac Assam Udo, Kingsley U Umeh, Catherine S Eyo
Background: Elective inguinal hernia repair in young fit patients is preferably done under ilioinguinal nerve block anesthesia in the ambulatory setting to improve throughput, save cost, and increase patient satisfaction. A rare complication of ilioinguinal nerve block is transient femoral nerve palsy (TFNP). Objectives: The aim of this study is to examine the incidence of TFNP among adults undergoing ambulatory inguinal hernia repair under ilioinguinal nerve block...
January 2018: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/29628594/an-unusual-case-of-a-parturient-with-uncorrected-pentalogy-of-fallot-presenting-for-elective-cesarean-section-delivery-of-twins
#19
Ying Ci Ho, Sek Koon Boey, Abey Matthew Varughese Mathews, Hooi Geok See, Nian Chih Hwang
We present a 31-year-old primigravida with uncorrected pentalogy of Fallot, pregnant with monochorionic-diamniotic twins, undergoing elective lower segment cesarean section at 36 weeks gestation. Preoperative workup included a transthoracic echocardiogram which revealed a large ventricular septal defect of 1.8 cm with bidirectional shunting, a moderate size atrial septal defect of 1.8 cm with predominant left-to-right shunting, an overriding aorta, moderate right ventricular hypertrophy, and severe pulmonary valve stenosis...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628333/multidisciplinary-difficult-airway-course-an-essential-educational-component-of-a-hospital-wide-difficult-airway-response-program
#20
W Robert Leeper, Elliott R Haut, Vinciya Pandian, Sajan Nakka, Jeffrey Dodd-O, Nasir Bhatti, Elizabeth A Hunt, Mustapha Saheed, Nicholas Dalesio, Adam Schiavi, Christina Miller, Thomas D Kirsch, Lauren Berkow
OBJECTIVE: A hospital-wide difficult airway response team was developed in 2008 at The Johns Hopkins Hospital with three central pillars: operations, safety monitoring, and education. The objective of this study was to assess the outcomes of the educational pillar of the difficult airway response team program, known as the multidisciplinary difficult airway course (MDAC). DESIGN: The comprehensive, full-day MDAC involves trainees and staff from all provider groups who participate in airway management...
April 5, 2018: Journal of Surgical Education
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