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Jorrit B A Welling, Jorine E Hartman, Nick H T Ten Hacken, Ina Franz, Jean-Paul Charbonnier, Eva M van Rikxoort, Huib A M Kerstjens, Karin Klooster, Dirk-Jan Slebos
BACKGROUND: Absence of interlobar collateral ventilation using the Chartis measurement is the key predictor for successful endobronchial valve treatment in severe emphysema. Chartis was originally validated in spontaneous breathing patients under conscious sedation (CS); however, this can be challenging due to cough, mucus secretion, mucosal swelling, and bronchoconstriction. Performing Chartis under general anesthesia (GA) avoids these problems and may result in an easier procedure with a higher success rate...
August 16, 2018: Respiration; International Review of Thoracic Diseases
Aalap C Shah, Kevin Ma, David Faraoni, Daniel C S Oh, G Alec Rooke, Gail A Van Norman
BACKGROUND: Pulmonary hypertension (PHTN) is associated with increased post-procedure morbidity and mortality. Pre-procedure echocardiography (ECHO) is a widely used tool for evaluation of these patients, but its accuracy in predicting post-procedure outcomes is unproven. Self-reported exercise tolerance has not been evaluated for operative risk stratification of PHTN patients. OBJECTIVE: We analyzed whether self-reported exercise tolerance predicts outcomes (hospital length-of-stay [LOS], mortality and morbidity) in PHTN patients (WHO Class I-V) undergoing anesthesia and surgery...
2018: PloS One
Allan F Simpao, Mohamed A Rehman
No abstract text is available yet for this article.
September 2018: Anesthesia and Analgesia
Max M Feinstein, Anthony E Pannunzio, Samuel Lobell, Eric Kodish
Informed consent for pediatric anesthesia challenges practitioners to navigate complex ethical, medical, and legal ambiguities. A patient's status as a minor does not negate the importance of his or her participation in the decision-making process but, rather, necessitates a nuanced evaluation of age and development to involve the patient to an appropriate extent. Given the complexities involved with pediatric informed consent in anesthesia practice and research, it is important to understand the experience of key stakeholders involved...
August 14, 2018: Anesthesia and Analgesia
Atousa Deljou, Toby N Weingarten, Michael A Mahr, Juraj Sprung, David P Martin
BACKGROUND: Previous studies of postoperative corneal injury rates relied on provider-initiated incident reports, which may underestimate the true incidence. Postoperative administration of proparacaine eye drops is used almost exclusively to diagnose corneal injury; therefore, identifying instances of administration may provide a better estimate of corneal injuries. We compared proparacaine administration versus provider-initiated reports to determine rates of corneal injury. In addition, potential associations between clinical variables and injury were assessed with a matched case-control study...
August 14, 2018: Anesthesia and Analgesia
Olubukola O Nafiu, Aleda Thompson, S Devi Chiravuri, Benjamin Cloyd, Paul I Reynolds
BACKGROUND: Many children recovering from anesthesia experience pain that is severe enough to warrant intravenous (IV) opioid treatment within moments of admission to the postanesthesia care unit (PACU). Postoperative pain has several negative consequences; therefore, preventing significant PACU pain in children is both a major clinical goal and a moral/ethical imperative. This requires identifying patient-level and perioperative factors that may be used to predict PACU IV opioid requirement...
August 14, 2018: Anesthesia and Analgesia
Aidan M Sharkey, Naveed Siddiqui, Kristi Downey, Xiang Y Ye, Jennifer Guevara, Jose C A Carvalho
BACKGROUND: Phenylephrine (PE) is currently the vasopressor of choice to prevent and treat spinal-induced hypotension at cesarean delivery (CD). However, its use is often associated with reflex bradycardia. Norepinephrine (NE) has been put forward as an alternative vasopressor during CD due to its ability to treat hypotension while maintaining heart rate (HR). Recent studies have focused on the role of NE used as an infusion with favorable results compared to PE. No studies have compared equipotent bolus doses of PE and NE at CD...
August 14, 2018: Anesthesia and Analgesia
Jin-Woo Park, Byung Hun Min, Seong-Joo Park, Bo Young Kim, Sung Il Bae, Sung-Hee Han, Jung-Won Hwang, Jin-Hee Kim
BACKGROUND: During induction of general anesthesia, proper mask ventilation is crucial for supplying sufficient oxygen to unconscious patients. Midazolam has a relaxing effect on airway muscles. We hypothesized that sedative premedication with midazolam would facilitate mask ventilation during anesthetic induction. METHODS: Patients undergoing elective surgery under general anesthesia were randomized into 2 groups. The midazolam group received midazolam premedication at the reception area, 3 minutes before transfer to the operating room...
August 14, 2018: Anesthesia and Analgesia
Furqaan Sadiq, Vanessa L Kronzer, Troy S Wildes, Sherry L McKinnon, Anshuman Sharma, Daniel L Helsten, Lawrence M Scheier, Michael S Avidan, Arbi Ben Abdallah
BACKGROUND: Frailty is an important concept in the care of older adults although controversy remains regarding its defining features and clinical utility. Both the Fried phenotype and the Rockwood deficit accumulation approaches cast frailty as a "burden" without exploring the relative salience of its cardinal markers and their relevance to the patient. New multifactorial perspectives require a reliable assessment of frailty that can validly predict postoperative health outcomes...
August 14, 2018: Anesthesia and Analgesia
Michael C Grant, Melinda M Gibbons, Clifford Y Ko, Elizabeth C Wick, Maxime Cannesson, Michael J Scott, Matthew D McEvoy, Adam B King, Christopher L Wu
Enhanced recovery after surgery protocols for bariatric surgery are increasingly being implemented, and reports suggest that they may be associated with superior outcomes, reduced length of hospital stay, and cost savings. The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery. We have conducted an evidence review to select anesthetic interventions that positively influence outcomes and facilitate recovery after bariatric surgery...
August 14, 2018: Anesthesia and Analgesia
A Ilczyszyn, W Lynn, S Rasheed, J Davids, R Aguilo, S Agrawal
Introduction Laparoscopic Roux-en-Y gastric bypass (LRYGB) is technically demanding and has an associated learning curve. We published previously that bariatric fellowship reduces the learning curve of primary LRYGB and improves patient outcomes after one year of independent practice. However, the long-term effect of fellowship is unknown. We therefore aimed to compare the 30-day outcomes of LRYGB between the first year of a surgeon's independent practice with the subsequent six years. Materials and methods A prospective database of patients undergoing primary LRYGB under a single surgeon from March 2010 until February 2017 was analysed...
August 16, 2018: Annals of the Royal College of Surgeons of England
Xiao-Hui Chen, Dong-Tai Chen, Xiong-Mei Huang, Yong-Hua Chen, Jia-Hao Pan, Xiao-Chun Zheng, Wei-An Zeng
Dexmedetomidine (Dex) is a widely used sedative in anesthesia and critical care units, and it exhibits neuroprotective activity. However, the precise mechanism of Dex-exerted neuroprotection is not clear. Increased neuronal NADPH oxidase 2 (NOX2) contributes to oxidative stress and neuronal damage in various hypoxia-related neurodegenerative disorders. The present study investigated whether Dex regulated neuronal NOX2 to exert its protective effects under hypoxic conditions. Well-differentiated PC12 cells were exposed to cobalt chloride (CoCl2 ) to mimic a neuronal model of chemical hypoxia-mediated neurotoxicity...
August 15, 2018: Neurotoxicity Research
Quan Liu, Li Ma, Shou-Zen Fan, Maysam F Abbod, Qingsong Ai, Kun Chen, Jiann-Shing Shieh
Electroencephalogram (EEG) signal analysis is commonly employed to extract information on the brain dynamics. It mainly targets brain status and communication, thus providing potential to trace differences in the brain's activity under different anesthetics. In this article, two kinds of gamma-amino butyric acid (type A -GABAA) dependent anesthetic agents, propofol and desflurane (28 and 23 patients), were studied and compared with respect to EEG spectrogram dynamics. Hilbert-Huang Transform (HHT) was employed to compute the time varying spectrum for different anesthetic levels in comparison with Fourier based method...
2018: BioMed Research International
Rati Chadha
Background: Klippel-Trenaunay-Weber syndrome is a rare neurocutaneous syndrome with vascular involvement. Given the rarity of the syndrome, its management in pregnancy is based on the outcome of a few case reports and expert opinion. Case Summary: The management of a complicated case with its antepartum, intrapartum, and postpartum concerns has been addressed in this review. Conclusions: Prenatal consults with anesthesia, general surgery, intervention radiology, and internal medicine should be arranged, prior to delivery in anticipation of all the possible complications...
2018: Case Reports in Obstetrics and Gynecology
Kiyoko Fukui, Masaki Fujioka, Kazumi Yamasaki, Sho Yamakawa, Haruka Matsuo, Miho Noguchi
Background: The frequency of surgery involving elderly patients has been increasing. The use of free tissue transfers in the elderly has been examined previously (Howard et al., 2005, Hwang et al., 2016, Grammatica et al., 2015, Serletti et al., 2000, and Sierakowski et al., 2017), whereas there have not been any such studies of plastic surgery procedures. We evaluated the risk factors for complications after plastic surgery procedures performed under general anesthesia in patients aged ≥75 years...
2018: Plastic Surgery International
Thomas Mitterlechner, Peter Paal, Daniel C Schroeder, Volker Wenzel, Holger Herff
Several incidents of anesthesia-attributed mortality in the past were caused by misconnection of gas pipelines resulting in ventilation with pure nitrous oxide. A simple safety feature may be to "mark" nitrous oxide with a lower pressure than oxygen and room air within the hospital's gas pipeline system. Then, any misconnection of gas pipelines could be detected by pressure differences with a manometer in the anesthesia machine. To check technical suitability, we tested maximum achievable nitrous oxide flows of an anesthesia machine at different pressures in the nitrous oxide supply line...
April 2018: Medical Gas Research
Shirin Pazoki, Hesameddin Modir, Alireza Kamali, Ashraf Zamani, Marzieh Shahidani
The study aims to evaluate the efficacy of ondansetron in preventing post-spinal headache, considering the high prevalence of the headache in pregnant women and the common use of the adjuvants for prophylaxis against post-operative nausea and vomiting (PONV). This double-blind clinical trial included the 195 patients who were referred to Taleghani Hospital (in Arak, Iran) for cesarean section (C/S) under spinal anesthesia, and then the subjects were assigned to three equally sized groups using block randomization...
April 2018: Medical Gas Research
I S Komang-Agung, O Sindrawati, P S William
Introduction: The only treatment for grade IV knee osteoarthritis is total knee arthroplasty (TKA) irrespective of the age of the patient. Most of the grade IV OA patient are elderly and most likely to have some comorbidities. Age and comorbidities are the major reasons for patient's reluctance to undergo TKA. A clinical pathway with standard length of stay (LOS) could justify the patient's hesitation for TKA. The aim of this study was to determine the factors, including age and comorbidity, that affect the LOS of patients treated with TKA...
July 2018: Malaysian Orthopaedic Journal
Min Fu, Dongdong Li
Effects of general anesthesia combined with epidural anesthesia on the postoperative cognitive functions in pregnant women with dystocia were investigated. Postoperative cognitive functions of 84 dystocia pregnant women treated with cesarean section were retrospectively analyzed. Patients who received general anesthesia were included in group A (n=42), and those who received general anesthesia combined with epidural anesthesia were included in group B (n=42). Mean arterial pressure (MAP), heart rate (HR) and bispectral index (BIS) at different time-points after anesthesia in the two groups of patients were observed and compared...
August 2018: Experimental and Therapeutic Medicine
Chunfang Yi, Zhiyun Fu, Xiaofeng Luo
Dexmedetomidine is a highly-selective α adrenergic receptor agonist, widely used as an anesthesia adjuvant drug in clinic. Effects of dexmedetomidine on autophagy of hippocampal neurons and cognitive dysfunction in aged rats under sevoflurane anesthesia were investigated. Sixty healthy Sprague-Dawley (SD) rats aged 4-6 months of either sex, weighing 150-200 g were selected and randomly divided into control group (n=10), sevoflurane group (n=25) and dexmedetomidine + sevoflurane group (compound group, n=25)...
August 2018: Experimental and Therapeutic Medicine
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