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https://www.readbyqxmd.com/read/28324181/trigeminocardiac-reflex-during-endoscopic-juvenile-nasopharyngeal-angiofibroma-surgery-an-appraisal
#1
Shilpee Bhatia Sharma, Trichy Narayanan Janakiram, Hina Baxi, Balamurugan Chinnasamy
Juvenile nasopharyngeal angiofibroma is a locally aggressive benign tumour which has propensity to erode the skull base. The tumour spreads along the pathways of least resistance and is in close proximity to the extracranial part of trigeminal nerve. Advancements in expanded approaches for endoscopic excision of tumours in infratemporal fossa and pterygopalatine fossa increase the vulnerability for the trigeminocardiac reflex. The manipulation of nerve and its branches during tumour dissection can lead to sensory stimulation and thus inciting the reflex...
March 21, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#2
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28322646/operating-room-personnel-viewpoints-about-certified-registered-nurse-anesthetists
#3
Desiree Hensel, Rachel Cooper, Neil Craney
The purpose of this project was to explore what attitudes physicians, nurses, and operating room technicians had about working with Certified Registered Nurse Anesthetists (CRNAs) to better understand practice barriers and facilitators. This Q methodology study used a purposive sample of operating room personnel from four institutions in the Midwestern United States. Participants completed a -4 to +4 rank-ordering of their level of agreement with 34 attitude statements representing a wide range of beliefs about nurse anesthetists...
December 1, 2016: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28306580/comment-on-growth-in-an-anesthesiologist-and-nurse-anesthetist-supervised-sedation-nurse-program-using-propofol-and-dexmedetomidine
#4
Joseph P Cravero, Randall P Flick, Shobha V Malviya
No abstract text is available yet for this article.
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#5
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28288089/complication-rates-for-fluoroscopic-guided-interlaminar-lumbar-epidural-steroid-injections-performed-by-certified-registered-nurse-anesthetists-in-diverse-practice-settings
#6
Donald E Beissel
STUDY QUESTION: What is the complication rate for Certified Registered Nurse Anesthetists (CRNAs) performing fluoroscopic guided lumbar epidural steroid injections (LESIs)? METHODS: CRNA pain practitioners responded to questionnaires regarding their education level, experience, and practice locations. Participants also collected data on number of fluoroscopic guided LESIs performed and each of 20 complications for a 6-month period, and answered a poll regarding satisfaction with the data collection process...
November 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28269182/development-of-a-real-time-lumbar-ultrasound-image-processing-system-for-epidural-needle-entry-site-localization
#7
Yusong Leng, Shuang Yu, Kok Kiong Tan, Philip Tildsley, Alex Tiong Heng Sia, Ban Leong Sng
A fully-automatic ultrasound image processing system that can determine the needle entry site for epidural anesthesia (EA) in real time is presented in this paper. Neither the knowledge of anesthetists nor additional hardware is required to operate the system, which firstly directs the anesthetists to reach the desired insertion region in the longitudinal view, i.e., lumbar level L3-L4, and then locates the ideal puncture site by instructing the anesthetists to rotate and slightly adjust the position of ultrasound probe...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28257319/contextual-challenges-to-safe-surgery-in-a-resource-limited-setting-a-multicenter-multiprofessional-qualitative-study
#8
John W Scott, Yihan Lin, Georges Ntakiyiruta, Zeta A Mutabazi, William Austin Davis, Megan A Morris, Douglas S Smink, Robert Riviello, Steven Yule
OBJECTIVES: Safe surgery should be available to all patients, no matter the setting. The purpose of this study was to explore the contextual-specific challenges to safe surgical care encountered by surgeons and surgical teams in many in low- and middle-income countries (LMICs), and to understand the ways in which surgical teams overcome them. BACKGROUND: Optimal surgical performance is highly complex and requires providers to integrate and communicate information regarding the patient, task, team, and environment to coordinate team-based care that is timely, effective, and safe...
March 2, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28256332/-anesthesia-management-by-residents-does-not-alter-the-incidence-of-recall-of-tracheal-extubation-a-teaching-hospital-based-propensity-score-analysis
#9
Satoki Inoue, Ryuichi Abe, Yuu Tanaka, Masahiko Kawaguchi
BACKGROUND AND OBJECTIVES: The memory of emergence from anesthesia is recognized as one type of anesthesia awareness. Apart from planed awake extubation, unintentional recall of tracheal extubation is thought to be the results of inadequate anesthesia management; therefore, the incidence can be related with the experience of anesthetists. To assess whether the incidence of recall of tracheal extubation is related to anesthetists' experience, we compared the incidence of recall of tracheal extubation between patients managed by anesthesia residents or by experienced anesthetists...
February 27, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28251323/bilateral-position-related-ulnar-neuropathy-at-elbow-in-pediatric-population-and-review-of-the-literature
#10
REVIEW
Mariana Balikova, Marta Neklanova, Igor Sulla, Martin Hönig, Jan Halek, Vladimir Mihal, Vladimir Balik
Perioperative ulnar neuropathies attributed to inappropriate arm positioning and padding during surgical procedures are commonly found in adults. However, their extremely rare incidence in the pediatric population may cause absent awareness of the risk of nerve injury in anesthetized pediatric patients. Furthermore, young patients respond to conservative treatment of neuropathy less favorably than adults and their response also depends on the pathomechanism of the ulnar nerve injury. A surgeon's or anesthetist's failure to recognize all of these specifics in children may result in substantial morbidity of young patients leading to lawsuits...
March 1, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28243888/assessing-the-impact-of-state-opt-out-policy-on-access-to-and-costs-of-surgeries-and-other-procedures-requiring-anesthesia-services
#11
John E Schneider, Robert Ohsfeldt, Pengxiang Li, Thomas R Miller, Cara Scheibling
In 2001, the U.S. government released a rule that allowed states to "opt-out" of the federal requirement that a physician supervise the administration of anesthesia by a nurse anesthetist. To date, 17 states have opted out. The majority of the opt-out states cited increased access to anesthesia care as the primary rationale for their decision. In this study, we assess the impact of state opt-out policy on access to and costs of surgeries and other procedures requiring anesthesia services. Our null hypothesis is that opt-out rule adoption had little or no effect on surgery access or costs...
December 2017: Health Economics Review
https://www.readbyqxmd.com/read/28236859/regulation-of-hypnosis-in-propofol-anesthesia-administration-based-on-non-linear-control-strategy
#12
Muhammad Ilyas, Ali Khaqan, Jamshed Iqbal, Raja Ali Riaz
Continuous adjustment of Propofol in manual delivery of anesthesia for conducting a surgical procedure overburdens the workload of an anesthetist who is working in a multi-tasking scenario. Going beyond manual administration and Target Controlled Infusion, closed-loop control of Propofol infusion has the potential to offer several benefits in terms of handling perturbations and reducing the effect of inter-patient variability. This paper proposes a closed-loop automated drug administration approach to control Depth Of Hypnosis in anesthesia...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28235524/awake-tracheal-intubation-in-anticipated-difficult-airways-lma-fastrach-vs-flexible-bronchoscope-a-pilot-study
#13
Sherine F Hanna, Marianne Mikat-Stevens, James Loo, Raj Uppal, W Scott Jellish, Matthew Adams
STUDY OBJECTIVE: To compare the use of LMA Fastrach intubating laryngeal mask airway (ILMA) to flexible bronchoscopy (FB) for awake intubation in patients with difficult airways. DESIGN: Randomized prospective study. SETTING: Large academic medical center. PATIENTS: Forty adult patients, American Society of Anesthesiologists I-IV, meeting the criteria for awake intubation based on history and physical examination. INTERVENTIONS: After sedation and airway topicalization, patients were randomized to either FB group, n=19, or ILMA group, n=21...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235507/hypnopraxia-a-new-hypnotic-technique-for-hypnoanesthesia
#14
Nicolas Drouet, Guy Chedeau
Various hypnotic techniques are used in anesthesia, either on their own or as adjuncts. A new hypnotic technique, hypnopraxia, was tested in 5 patients undergoing various procedures (4 colonoscopies, 1 inguinal hernia repair, and 1 transobturator tape procedure). The patients were accompanied throughout the procedure by an anesthetist trained in hypnoanesthesia and hypnopraxia. Initially developed for use in hypnotherapy, the accompaniment with hypnopraxia relied on the closeness of the link between the anesthetist and the patient...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235177/aana-journal-course-update-for-nurse-anesthetists-part-5-use-of-tranexamic-acid-in-preventing-postpartum-hemorrhage
#15
Derrick C Glymph, Tito D Tubog, Mariya Vedenikina
Postpartum hemorrhage (PPH) continues to be a serious complication in both developed and underdeveloped countries. It remains the leading cause of maternal mortality in underdeveloped countries. Implementation of the World Health Organization guidelines of PPH treatment has reduced mortality. In addition, the prophylactic administration of tranexamic acid with uterotonic agents may contribute to the reduction of PPH. This evidence-based literature review of tranexamic acid will examine its mechanism of action as well as its effectiveness in prevention of PPH and blood loss reduction in elective surgery, obstetrics, and trauma...
December 2016: AANA Journal
https://www.readbyqxmd.com/read/28235172/exploring-strategies-to-increase-and-sustain-membership-in-the-american-association-of-nurse-anesthetists
#16
Cynthia Ann Farina, Wanda Wilson, Kim FitzSimmons
The total numbers of Certified Registered Nurse Anesthetists (CRNAs) in the United States and members of the American Association of Nurse Anesthetists (AANA) have risen to an all-time high. However, the percentage of CRNAs who are AANA members has been slowly declining since 2006, particularly among newly certified nurse anesthetists. To develop new strategies to increase and sustain CRNA membership, the AANA conducted a translational research project that explored evidence-based determinants of individuals' decisions to join professional associations, current membership practices and patterns, results of a recent member needs survey, and socialization of student registered nurse anesthetists (SRNAs) into the AANA...
December 2016: AANA Journal
https://www.readbyqxmd.com/read/28230673/va-grants-most-aprns-full-practice-authority
#17
Dalia Sofer
But certified registered nurse anesthetists are excluded.
March 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28227412/development-of-a-real-time-lumbar-ultrasound-image-processing-system-for-epidural-needle-entry-site-localization
#18
Yusong Leng, Shuang Yu, Kok Kiong Tan, Philip Tildsley, Alex Tiong Heng Sia, Ban Leong Sng, Yusong Leng, Shuang Yu, Kok Kiong Tan, Philip Tildsley, Alex Tiong Heng Sia, Ban Leong Sng, Yusong Leng, Shuang Yu, Philip Tildsley, Ban Leong Sng, Kok Kiong Tan
A fully-automatic ultrasound image processing system that can determine the needle entry site for epidural anesthesia (EA) in real time is presented in this paper. Neither the knowledge of anesthetists nor additional hardware is required to operate the system, which firstly directs the anesthetists to reach the desired insertion region in the longitudinal view, i.e., lumbar level L3-L4, and then locates the ideal puncture site by instructing the anesthetists to rotate and slightly adjust the position of ultrasound probe...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28213945/optimization-of-initial-propofol-bolus-dose-for-eeg-narcotrend-index-guided-transition-from-sevoflurane-induction-to-intravenous-anesthesia-in-children
#19
Nils Dennhardt, Dietmar Boethig, Christiane Beck, Sebastian Heiderich, Martin Boehne, Andreas Leffler, Barbara Schultz, Robert Sümpelmann
BACKGROUND: Sevoflurane induction followed by intravenous anesthesia is a widely used technique to combine the benefits of an easier and less traumatic venipuncture after sevoflurane inhalation with a recovery with less agitation, nausea, and vomiting after total intravenous anesthesia (TIVA). Combination of two different anesthetics may lead to unwanted burst suppression in the electroencephalogram (EEG) during the transition phase. OBJECTIVE: The objective of this prospective clinical observational study was to identify the optimal initial propofol bolus dose for a smooth transition from sevoflurane induction to TIVA using the EEG Narcotrend Index (NI)...
February 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28211128/staged-intraperitoneal-brachytherapy-and-hyperthermic-intraperitoneal-chemotherapy-in-an-adolescent-novel-anesthetic-challenges-for-pediatric-anesthetists
#20
Andrew D Weatherall, Tristan R Bennett, Mark Lovell, Winnie Fung, Jonathan de Lima
Newer techniques that have found a place in cancer management in adults are offered far less commonly in pediatric patients. We present a case of a patient with recurrent Wilms' tumor managed with a novel combination of cytoreductive surgery, intraperitoneal brachytherapy, and subsequent hyperthermic intraperitoneal chemotherapy. Each stage presents challenges that the pediatric anesthetist is unlikely to have faced before. Such cases require flexibility and thorough planning to manage the combination of major surgery, remote anesthesia with brachytherapy and hyperthermic chemotherapy with its potential for metabolic derangement, significant fluid shifts, analgesic care, and potential exposure of staff to cytotoxic agents...
February 17, 2017: Paediatric Anaesthesia
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