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Anesthesia And Safety(Regional)

Zheng Gong, Jun Li, Yuling Zhong, Xuehai Guan, Ailan Huang, Li Ma
Effects of dexmedetomidine on postoperative cognitive function in patients undergoing coronary artery bypass grafting were investigated. Eighty patients undergoing systemic anesthesia with extracorporeal coronary artery bypass grafting in The People's Hospital of Guangxi Zhuang Autonomous Region from January 2015 to August 2017 were selected and randomly divided into the observation group (n=40) and control group (n=40). The two groups were treated with dexmedetomidine and equal volume of normal saline, respectively...
December 2018: Experimental and Therapeutic Medicine
Ellen M Soffin, Melinda M Gibbons, Elizabeth C Wick, Stephen L Kates, Maxime Cannesson, Michael J Scott, Michael C Grant, Samantha S Ko, Christopher L Wu
Enhanced recovery after surgery (ERAS) protocols represent patient-centered, evidence-based, multidisciplinary care of the surgical patient. Although these patterns have been validated in numerous surgical specialities, ERAS has not been widely described for patients undergoing hip fracture (HFx) repair. As part of the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery, we have conducted a full evidence review of interventions that form the basis of the anesthesia components of the ERAS HFx pathway...
December 7, 2018: Anesthesia and Analgesia
Y Chung, J W Choi, H C Kim, S H Kim, S I Choi
INTRODUCTION: Laparoscopic total extraperitoneal peritoneal (TEP) repair has become increasingly popular since its introduction. The purpose of this study is to establish the safety and feasibility of TEP in elderly patients compared to that in younger patients. METHODS: The clinical records of patients who received TEP hernia repair from August 2007 to September 2016 were reviewed. The patients were categorized into two groups: younger than 70 and 70 years or older...
December 3, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Stephen Tabiri, Katie W Russell, Frank E Gyamfi, Ali Jalali, Raymond R Price, Micah G Katz
INTRODUCTION: Inguinal hernia repair is a common procedure and a priority for public health efforts in Ghana. It is essential that inguinal hernia repair be performed in a safe, efficient manner to justify its widespread use. Local anesthesia has many favorable properties and has been shown to be superior, compared to regional or general anesthesia, in terms of pain control, safety profile, cost-effectiveness, resources required, and time to discharge. Local anesthesia is recommended for open repair of reducible hernias, provided clinician experience, by multiple international guidelines...
2018: PloS One
Fady Samy Saad, Samia Yehia El Baradie, Maha Abdel Wahab Abdel Aliem, Mohamed Metwally Ali, Tamer Ahmed Mahmoud Kotb
Background: Thoracotomy needs adequate powerful postoperative analgesia. This study aims to compare the safety and efficacy of ultrasound (US)-guided serratus anterior plane block (SAPB) and thoracic paravertebral block (TPVB) for perioperative analgesia in cancer patients having lung lobectomy. Patients and Methods: This clinical trial involved 90 patients with lung cancer scheduled for lung lobectomy randomly divided into three groups according to the type of preemptive regional block...
October 2018: Saudi Journal of Anaesthesia
(no author information available yet)
Systemic toxicity from local anesthetics can occur in any of the wide range of situations in which these agents are used. This practical guide is created to generate a shared awareness of the prevention, diagnosis, and treatment of local anesthetic systemic toxicity among all medical professionals who perform nerve blocks. Systemic toxicity of local anesthetic is induced by an increase of its protein-unbound plasma concentration. Initial symptoms are characterized by central nervous system signs such as excitation, convulsions, followed by loss of consciousness and respiratory arrest...
November 11, 2018: Journal of Anesthesia
Shabana Z Shafy, Mohammed Hakim, Mauricio Arce Villalobos, Gregory D Pearson, Giorgio Veneziano, Joseph D Tobias
Duchenne muscular dystrophy (DMD), first described in 1834, is an X-linked dystrophinopathy, leading to early onset skeletal muscle weakness. Life expectancy is reduced to early adulthood as a result of involvement of voluntary skeletal muscles with respiratory failure, orthopedic deformities, and associated cardiomyopathy. Given its multisystem involvement, surgical intervention may be required to address the sequelae of the disease process. We present a 36-year-old adult with DMD, who required anesthetic care during surgical debridement of an ischial pressure sore...
2018: Local and Regional Anesthesia
Pierfrancesco Fusco, Vincenza Cofini, Stefano Di Carlo, Antonio Luciani, Paolo Scimia, Emiliano Petrucci, Astrid U Behr, Stefano Necozione, Laura Brigitta Colantonio, Gilberto Fiore, Alessandro Vergallo, Franco Marinangeli
PURPOSE: In recent years, ultrasound has seen a rapid development with numerous applications in anesthesia, intensive-care medicine, and pain medicine, increasing efficacy and safety of procedures. We investigated the prevalence of ultrasound use among Italian anesthetists. METHODS: A cross-sectional prevalence study was carried out on a sample of 735 anesthetists. The research was conducted during the ultrasound training in anesthesia and intensive care, in the Italian Associazione Anestesisti Rianimatori Ospedalieri - Emergenza Area Critica "SimuLearn® " training centre (Bologna, Italy)...
November 1, 2018: Journal of Ultrasound
Cihun-Siyong Alex Gong, Huang-Chang Lee, Yin Chang, Chien-Kun Ting, Po-Hsun Tu
Purpose: Technology of reflectance spectroscopy incorporated with auto-fluorescence spectroscopy were employed to increase the safety of epidural placement in regional anesthesia which is generally used for surgery, epidural anesthesia, post-operative pain control and painless childbirth. Method: Ex vivo study of auto-fluorescence spectroscopy was performed for the para-vertebral tissues contained fat, interspinous ligament, supraspinous ligament and ligamentumflavum by multimode microplate reader at wavelength 405 nm for the purpose of tissue differentiation...
October 23, 2018: Sensors
Christopher Weldon, Tianjiao Ji, Minh-Thuy Nguyen, Alina Rwei, Weiping Wang, Yi Hao, Chao Zhao, Manisha Mehta, Bruce Y Wang, Robert P Marini, Daniel S Kohane
Intravenous regional anesthesia (IVRA; Bier block) is commonly used to anesthetize an extremity for surgery. Limitations of the procedure include pain from the required tourniquet, the toxicity that can occur from systemic release of local anesthetics, and the lack of postoperative pain relief. We hypothesized that the nanoencapsulation of the local anesthetic would prolong local anesthesia and enhance safety. Here, we developed a ~15 nm micellar bupivacaine formulation (M-Bup) and tested it in a rat tail vein IVRA model, in which active agents were restricted in the tail by a tourniquet for 15 min...
October 23, 2018: ACS Nano
Benjamin J Levy, Brandon M Tauberg, Ari J Holtzman, Konrad I Gruson
INTRODUCTION: To report on the effectiveness of a standardized patient positioning and padding protocol in reducing lateral femoral cutaneous nerve (LFCN) palsy in obese patients who have undergone shoulder surgery in the beach chair position. METHODS: We retrospectively reviewed the medical records of 400 consecutive patients with a body mass index (BMI) of ≥30 kg/m who underwent either open or arthroscopic shoulder surgery in the beach chair position by a single surgeon...
October 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
Jarna Shah, Effrossyni Gina Votta-Velis, Alain Borgeat
Local anesthetics are used for performing various regional anesthesia techniques to provide intraoperative anesthesia and analgesia, as well as for the treatment of acute and chronic pain. Older medications such as lidocaine and bupivacaine as well as newer ones such as mepivacaine and ropivacaine are being used successfully for decades. Routes of administration include neuraxial, perineural, intravenous, various infiltrative approaches, topical, and transdermal. There are new innovations with the use of older local anesthetics in a novel manner, in addition to the development and use of new formulations...
June 2018: Best Practice & Research. Clinical Anaesthesiology
Egils Vjaters, David Nitsan, Michael Mullerad, Dov Engelstein, Ilan Leibovitch, Yair Feld
BACKGROUND: Although effective for benign prostatic hyperplasia (BPH), transurethral resection of the prostate (TURP) can be associated with side effects including prolonged recovery, storage and voiding symptoms, and a risk of acute urinary retention. OBJECTIVE: To test a new minimally invasive device for the treatment of lower urinary tract symptoms (LUTS) due to BPH, involving implantation of a C-shaped nitinol ring (ClearRing) in a circular incision in the prostatic tissue using an electrocuting blade over a dilatation balloon...
October 4, 2018: European Urology Focus
Amos Neheman, Andrew C Strine, Charles W Concodora, Marion E Schulte, Paul H Noh
PURPOSE: Robotic extravesical ureteral reimplantation has been established as a viable option for surgical management of vesicoureteral reflux. Typically, this procedure is associated with a hospital stay for routine postoperative care. The aim of the study was to assess the short-term safety of robotic unilateral extravesical ureteral reimplantation as a scheduled outpatient procedure in a pediatric population. MATERIAL AND METHODS: A retrospective cohort study was performed for patients who underwent robotic extravesical ureteral reimplantation between June 2012 and January 2018...
September 12, 2018: Journal of Urology
Chrystelle Sola, Cecilia Menacé, Sophie Bringuier, Anne-Charlotte Saour, Olivier Raux, Olivier Mathieu, Xavier Capdevila, Christophe Dadure
BACKGROUND: The transversus abdominis plane (TAP) block has become a common regional anesthesia technique for pain management in a wide variety of abdominal procedures. Evidence to support any particular local anesthetic regimen as well as pharmacokinetic and systemic toxicity risks of TAP block remain insufficiently studied in children. The aim of this study was to compare the analgesic effects and investigate pharmacokinetic profile of levobupivacaine after ultrasound-guided TAP block using a low volume/high concentration (LVHC) or a high volume/low concentration (HVLC) solution in children...
September 5, 2018: Anesthesia and Analgesia
Guan-Nan Wu, Shi-Min Zhang, Yu-Zhang Liu, Ming Ma, Jiao Jin, Zuo-Xu Li, Zhao-Jie Zhang
OBJECTIVE: To evaluate the operative characteristic, safety, clinical effect of percutaneous endoscopic interlaminar discectomy (PEID) in treating displacement-type lumbar intervertebral disc protrusion on L₂-L₅. METHODS: Form November 2015 to October 2016, 15 patients with displacement-type lumbar intervertebral disc protrusion were treated with percutaneous endoscopic interlaminar discectomy. There were 9 males and 6 females, aged from 19 to 63 years old with an average of 42 years...
August 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
David N Bernstein, Hao-Hua Wu, Harry E Jergesen
Background: Although it has been shown that perioperative protocols enhance arthroplasty care and safety, it is not known how prevalent their use is in safety net hospitals, which operate with a mandate to treat the poor and underserved. Understanding the elements currently included in standard perioperative arthroplasty protocols at various institutions may help guide future interventions and policy aimed at improving underserved patients' outcomes. Methods: In this cross-sectional study, safety net hospitals were asked to complete a survey over the phone, via email or in person regarding existence and elements of perioperative management protocols for total hip arthroplasty (THA) and total knee arthroplasty (TKA)...
July 2018: Archives of Bone and Joint Surgery
Meresa Gebremedhin Weldu, Haileselasie Berhane, Negassie Berhe, Kebede Haile, Yosef Sibhatu, Tsehaynesh Gidey, Kahsay Amare, Hiwot Zelalem, Rahel Mezemir, Tsegay Hadgu, Kesete Birhane
BACKGROUND: Surgical site infections (SSIs) are the most common hospital-acquired infection among surgical patients and remains a major clinical issue. In Ethiopia, despite many studies, the magnitude and associated factors of SSIs are not well documented and differ among regions. The aim of this study was to identify the magnitude and associated factors of SSIs in Suhul Hospital, Northern Ethiopia. METHODS: An institution-based cross-sectional study was conducted from February 2-March 31, 2016, in Shire Suhul Hospital...
October 2018: Surgical Infections
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
Ian R Slade, Ron E Samet
Regional anesthesia for the acute trauma patient is increasing due to the growing appreciation of its benefits, development of newer techniques and equipment, and more robust training. Block procedures are expanding beyond perioperative interventions performed exclusively by anesthesiologists to paramedics on scene, emergency medicine physicians, and nurse-led services using these techniques early in trauma pain management. Special considerations and indications apply to trauma victims compared with the elective patient and must be appreciated to optimize safety and clinical outcomes...
September 2018: Anesthesiology Clinics
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