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Anesthesia outcome

Glenn Isaacson, Elizabeth T Drum
Objective: To review current evidence and experience with anesthesia and airway management issues in children and young adults with arthrogryposis. Data sources: Review of existing world literature and description of personal experience at a center for children's orthopedic surgery and rehabilitation over 2 decades. Methods: Description of common problems and their solutions in this unusual and diverse group of patients. Results: Arthrogryposis multiplex congenital includes more than 400 conditions that lead to congenital joint contractures affecting more than one body area...
June 2018: World Journal of Otorhinolaryngology—Head and Neck Surgery
Alaa Eldin Adel Elmaddawy, Alaa Eldin Mazy
Background: The thyroid gland surgery is a common and painful procedure demanding analgesia. Many regional techniques are applied for anterior neck surgeries mostly assigned in relation to the involved cervical fascia. Dexmedetomidine (Precedex) is a selective alpha 2 adrenoceptor agonist which prolongs the sensory blockade duration of local anesthetics. Our study hypothesis is that ultrasound (US)-guided bilateral superficial cervical plexus block (BSCPB) may provide longer analgesia when adding dexmedetomidine to bupivacaine-epinephrine...
July 2018: Saudi Journal of Anaesthesia
Yu Liu, Yaoxian Zhang, Zihao Zheng, Xicheng Liu
The aim of this research investigation was to profound analysis the mitigating impact of sevoflurane/arginine post-molding on cerebral ischemia-reperfusion damage in rats. The authors fabricated emulsions fusing sevoflurane, perfluorooctyl bromide as a settling specialist, and mixes of arginine polymer. Cell suitability and gene expression of tubulin and NeuN were assessed. The stability, morphology and functional group were evaluated utilizing dynamic light scattering (DLS), Transmission Electron Microscope (TEM), atomic force microscopy (AFM), and Fourier-transform infrared spectroscopy (FTIR)...
July 18, 2018: Journal of Photochemistry and Photobiology. B, Biology
Zhewei Zhao, Chengran Lu, Tianjia Li, Wenda Wang, Wei Ye, Rong Zeng, Leng Ni, Zhichao Lai, Xuebin Wang, Changwei Liu
Carotid endarterectomy (CEA) is the treatment of choice for carotid stenosis. Some patients develop ischemia and reperfusion (I/R) injury after CEA. This study was designed to investigate the neuroprotective effects of melatonin on I/R injury in both rats and humans. To this end, 36 male rats were evaluated, and a double-blind randomized controlled trial (RCT) including 60 patients was performed. A rat model of middle cerebral artery occlusion (MCAO) was used to mimic cerebral I/R. After 2 hr of occlusion and 24 hr of reperfusion, blood samples and brain tissues were harvested for further assessments...
August 11, 2018: Journal of Pineal Research
Devon Flaherty, Sang Kim, Jeron Zerillo, Chang Park, Thomas Joseph, Bryan Hill, Hung-Mo Lin, Jiawen Li, Carlyle Hamsher, Menachem M Weiner, Samuel DeMaria
OBJECTIVES: The primary objective of this study was to determine whether liver transplantation recipients with preoperative prolonged corrected (QTc) intervals have a higher incidence of intraoperative cardiac events and/or postoperative mortality compared with their peers with normal QTc intervals. DESIGN: This was a retrospective cohort study. SETTING: Single academic hospital in New York, NY. PARTICIPANTS: Patients undergoing liver transplantation between 2007 and 2016...
July 21, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Yin-Fa Zhang, Fei Xiao, Wen-Ping Xu, Lin Liu
BACKGROUND: Phenylephrine infusion to prevent spinal-induced hypotension can attenuate cephalic spread of intrathecal bupivacaine. Therefore, we suspected the intrathecal dose requirement for bupivacaine may differ when using phenylephrine infusion to prevent spinal-induced hypotension in cesarean section. We designed a prospective, randomized study to determine the ED50 of hyperbaric bupivacaine for cesarean section under combined spinal-epidural anesthesia in healthy parturients with and without prophylactic phenylephrine infusion to prevent spinal-induced hypotension...
August 2018: Medicine (Baltimore)
Minsu Noh, Byung-Moon Choi, Hyunwook Kwon, Youngjin Han, Gi-Young Ko, Tae-Won Kwon, Gyu-Jeong Noh, Yong-Pil Cho
The aim of this study was to compare general and local anesthesia techniques in patients treated with elective endovascular aortic aneurysm repair (EVAR) for infrarenal aortic aneurysms.In this single-center, observational cohort study, in all, 259 consecutive patients who underwent elective EVAR was included; 144 patients (55.6%, 126 men, mean age 72.8 years) operated on under general anesthesia (GA group) and 115 (44.4%, 100 men, mean age 72.3 years) operated on under local anesthesia (LA group). A retrospective analysis regarding technical feasibility, endoleaks, length of hospital stay, and 30-day clinical outcomes was performed...
August 2018: Medicine (Baltimore)
David J Mathew, Rana A Greene, Yousaf Jamal Mahsood, Numan Hallaji, Ana Maria B Vargas, Ya-Ping Jin, Antonio Finelli, Matteo Parotto, Avner Belkin, Graham E Trope, Yvonne M Buys
PURPOSE: This study evaluated the effect of preoperative brimonidine tartrate 0.2% on intraocular pressure (IOP) during robotic-assisted laparoscopic radical prostatectomy (RALP) in steep Trendelenburg position (sTBURG). METHODS: In this prospective randomized controlled masked interventional trial, eligible patients scheduled for RALP in sTBURG at the Toronto General Hospital had one eye randomized to placebo (artificial tears) or drug (brimonidine tartrate 0.2%) preoperatively...
August 7, 2018: Journal of Glaucoma
Ilse Molendijk, Andrea E van der Meulen-de Jong, Hein W Verspaget, Roeland A Veenendaal, Daniel W Hommes, Bert A Bonsing, Koen C M J Peeters
BACKGROUND: Local administration of mesenchymal stromal cells (MSCs) into the fistula tract seems to improve patient outcome in perianal fistulas due to Crohn's disease (CD). In this paper we propose a standardized and validated protocol for the local administration of MSCs for CD perianal fistulas to be able to reliably assess efficacy. MATERIALS AND METHODS: A working group consisting of gastroenterologists and surgeons with expertise in the treatment of perianal CD developed a consensus perianal fistula treatment protocol for local MSC treatment of perianal fistulizing CD...
August 7, 2018: European Journal of Gastroenterology & Hepatology
Andreea Seicean, Prateek Kumar, Sinziana Seicean, Duncan Neuhauser, Robert J Weil
OBJECTIVE The goal of this study was to compare outcomes of carotid endarterectomy performed by neurological, general, and vascular surgeons. METHODS The authors identified 80,475 patients who underwent carotid endarterectomy between 2006 and 2015 in the National Surgical Quality Improvement Program, a prospectively collected, national clinical database with established reproducibility and validity. Nine hundred forty-three patients were operated on by a neurosurgeon; 75,649 by a vascular surgeon; and 3734 by a general surgeon...
August 10, 2018: Journal of Neurosurgery
Henry A Reinhart, Samuel K Snyder, Susan V Stafford, Victoria E Wagner, Camille W Graham, Michael D Bortz, Xiaohui Wang
Historically, thyroidectomies have been performed as inpatient operations due to concerns of postoperative bleeding and symptomatic hypocalcemia. We aim to demonstrate that outpatient thyroidectomy can be performed safely. METHODS: This report outlines a 7-year retrospective analysis (2009-2016) of outpatient vs inpatient thyroidectomies, with outcomes including hematoma, blood loss, recurrent laryngeal nerve injury, symptomatic hypocalcemia, and postoperative emergency room (ER) visits...
August 7, 2018: Surgery
Jost von Hardenberg, Niklas Westhoff, Daniel Baumunk, Daniel Hausmann, Thomas Martini, Alexander Marx, Stefan Porubsky, Martin Schostak, Maurice Stephan Michel, Manuel Ritter
OBJECTIVES: Magnetic resonance imaging/transrectal ultrasound (MRI/TRUS) fusion-guided focal high intensity focused ultrasound (HIFU) therapy of the prostate has recently been developed as a selective HIFU-therapy technique to enable targeted ablation of prostate cancer. Here we report a series of patients treated with focal HIFU therapy, discuss its potential pitfalls, and address controversies concerning the indications. MATERIALS AND METHODS: This single-center prospective study reports outcomes of patients treated from September 2014 to March 2016...
August 6, 2018: Urologic Oncology
Nishtha Yadav, Hima Pendharkar, Girish Baburao Kulkarni
INTRODUCTION: Spinal cord infarction is an uncommon disease varying in its clinical presentation. This study describes the clinical and radiological presentation of spinal cord infarcts in 17 consecutive patients. MATERIAL AND METHODS: Clinical and MR imaging data of 17 patients were reviewed. Inclusion criteria were acute or subacute presentation (peak within 72 hours) and MRI showing typical signal changes on T2WI compatible with spinal cord infarct. Exclusion criteria were clinical or MRI findings suggesting other etiologies...
August 6, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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
Taras Grosh, Nabil M Elkassabany
Enhanced recovery after surgery (ERAS) protocols depend on multidisciplinary care and should be peer-reviewed and data-driven. ERAS has reduced hospital length of stay and complications, simultaneously improving patient outcomes. ERAS protocol after shoulder arthroplasty features multidisciplinary collaboration among different perioperative services and multimodal analgesia with a focus on regional anesthesia. Despite success, adoption is not universal because ERAS protocols are resource intensive. They require clinicians invested in the success of these programs and patients who can take charge of their own health...
September 2018: Anesthesiology Clinics
Dario Bugada, Valentina Bellini, Luca F Lorini, Edward R Mariano
In hip surgery, regional anesthesia offers benefits in pain management and recovery. There are a wide range of regional analgesic options; none have shown to be superior. Lumbar plexus block, femoral nerve block, and fascia iliaca block are the most supported by published literature. Other techniques, such as selective obturator and/or lateral femoral cutaneous nerve blocks, represent alternatives. Newer approaches, such as quadratus lumborum block and local infiltration analgesia, require rigorous studies...
September 2018: Anesthesiology Clinics
Christopher A J Webb, T Edward Kim
Acute pain management is an expanding perioperative specialty and there is a renewed focus on implementing and developing an acute pain service (APS) in nonacademic hospitals (ie, "private practice"). An anesthesiologist-led APS can improve patient care by decreasing perioperative morbidity and potentially reducing the risk of chronic postsurgical pain syndromes. Elements of a successful APS include multidisciplinary collaboration to develop perioperative pain protocols, education of health care providers and patients, and regular evaluation of patient safety and quality of care metrics...
September 2018: Anesthesiology Clinics
Zhixuan Bai, Jun Gu, Yingkang Shi, Wei Meng
OBJECTIVE: Type A aortic dissection (AD) and ascending thoracic aortic aneurysm (AA) are thoracic vascular diseases with similar initial pathology but inequable clinical features and outcomes, where local and systemic inflammation play an important part. We aimed to observe and analyze the differences and correlation between inflammation and pathological changes in the aorta and biomechanical strength between AD and AA. METHODS: From August 2011 to February 2013, 20 patients with AD (AD group) and 13 patients with AA (AA group) who underwent aorta surgery were included...
August 2018: Anatolian Journal of Cardiology
Yoshitaka Kinoshita, Toru Sugihara, Hideo Yasunaga, Hiroki Matsui, Akira Ishikawa, Tetsuya Fujimura, Hiroshi Fukuhara, Yoshitaka Ishibashi, Kiyohide Fushimi, Yukio Homma
BACKGROUND: Evidence regarding volume-outcome effects on peritoneal dialysis (PD) catheter implantation is limited. This study aimed to investigate associations between hospital volume (annual caseload of catheter implantation) and perioperative outcomes. METHODS: Clinical data for patients who underwent PD catheter implantation from 2007 to 2012 were extracted from the Japanese nationwide Diagnosis Procedure Combination database. Hospital volume was divided into tertiles: low-volume (1 - 6 cases/year), medium-volume (7 - 13 cases/year), and high-volume (≥ 14 cases/year)...
August 7, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Satoshi Kodama, Noritoshi Arai, Akiyoshi Hagiwara, Akio Kimura, Sousuke Takeuchi
Background: New-onset refractory status epilepticus (NORSE) is a newly defined critical disease entity characterized by prolonged periods of refractory epileptic seizure with no readily identifiable cause in otherwise healthy individuals. Its etiology is uncertain, but autoimmune encephalitis is a possible candidate for the underlying cause of this condition. Immunotherapies could be considered for this condition, but its efficacy is not established. Case presentation: A 31-year-old man with no prior history presented with refractory status epilepticus...
2018: Journal of Intensive Care
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