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Regional general anesthesia

Robert A Christian, Daniel B Gibbs, Richard W Nicolay, Ryan S Selley, Matthew D Saltzman
BACKGROUND: Shoulder arthroscopy is a common orthopedic procedure typically performed on an outpatient basis. Occasionally, patients require an unplanned hospital admission. An understanding of the incidence and risk factors for admission after shoulder arthroscopy may assist surgeons in determining which patients may be susceptible to unplanned admission after surgery. METHODS: All consecutive shoulder arthroscopy procedures performed during a 10-year period were reviewed...
December 13, 2018: Journal of Shoulder and Elbow Surgery
Cienwen J Town, James Johnson, André Van Zundert, Haakan Strand
OBJECTIVES: The review article was designed to assess the effectiveness of regional anesthesia, specifically peripheral nerve blocks, in the treatment of burn pain; with noting of clinical indications and contraindications for peripheral nerve block application, along with discussion of evidence-based analgesic strategies for providing improved, comprehensive burn pain management. METHODS: A search of relevant literature was performed using CINAHL, PubMed, EMBASE, Web of Science and SCOPUS with a publication date between January 2005 and December 2017...
December 11, 2018: Clinical Journal of Pain
Ming-Hui Hung, Jin-Shing Chen, Ya-Jung Cheng
PURPOSE OF REVIEW: The current review focuses on precise anesthesia for video-assisted thoracoscopic surgery (VATS) with the goal of enhanced recovery. RECENT FINDINGS: VATS has become an established and widely used minimally invasive approach with broad implementation on a variety of thoracic operations. In the current environment of enhanced recovery protocols and cost containment, minimally invasive VATS operations suggest adoption of individualized tailored, precise anesthesia...
December 11, 2018: Current Opinion in Anaesthesiology
Joana Gomes de Amorim, Manuel Rocha Abecasis, Filipa Maria Nogueira Lança Rodrigues
Thrombocytopenia is the most common hemostatic change in pregnancy, but severe thrombocytopenia is rare. One of the causes, immune thrombocytopenic purpura (ITP), is characterized by increased platelet destruction by immunoglobulin G (IgG) antibodies, presenting a high risk of hemorrhage for the patient, but also for the fetus, since antibodies may cross the placenta. We present the case of a 23-year-old pregnant woman with a history of Langerhans cell histiocytosis of the mandible submitted to surgery and chemotherapy when she was 10 years old, with diagnosis of ITP since then...
December 2018: Revista Brasileira de Ginecologia e Obstetrícia
Jen-Hsiang Shen, Laura Liu, Nan-Kai Wang, Yih-Shiou Hwang, Kuan-Jen Chen, An-Ning Chao, Chi-Chun Lai, Tun-Lu Chen, Wei-Chi Wu
OBJECTIVE: This study aims to examine retinal vascular findings for affected eyes and contralateral eyes as well in typical cases of unilateral persistent fetal vasculature. METHODS: We retrospectively reviewed all patients evaluated at Chang Gung Memorial Hospital, Linkou, for unilateral persistent fetal vasculature between January 2008 and July 2017. All patients underwent fluorescein angiography (FA) examination under general anesthesia. FA was performed using RetCam 3 (Clarity Medical Systems, Inc, Pleasanton, CA)...
November 28, 2018: Retina
Laura Bogusaite, Ilona Razlevice, Laura Lukosiene, Andrius Macas
BACKGROUND Adequate preoperative information for pediatric patients and their families can prevent preoperative anxiety and improve postoperative outcome. The aim of this study was to conduct a survey to determine the preoperative information needs of children and their parents before anesthesia for elective surgery. MATERIAL AND METHODS Two healthcare centers enrolled children from 10 to 17 years of age who had planned elective surgery under general or regional anesthesia, and their parents and anesthesiologists...
December 4, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Simona Portaro, Antonino Naro, Claudio Guarneri, Giuseppe Di Toro, Alfredo Manuli, Rocco Salvatore Calabrò
RATIONALE: Myotonic dystrophy type 1 (DM1) is an autosomal dominant disease caused by a cytosine, guanine, thymine (CTG) trinucleotide repeat expansion in the non-coding region of dystrophia myotonica protein kinase gene, causing a multisystem involvement. To date, few studies have been performed to evaluate skin features in DM1 patients, but none reported on the possible association between the disease and tongue hemangiomas. PATIENTS CONCERNS: We report a case of a 63-year-old woman affected by DM1 and presenting, at the intraoral examination, several swelling and buish lesions occurring on buccal and palatal mucosa, and in the anterior two-thirds and margins of the tongue...
November 2018: Medicine (Baltimore)
David Astapenko, Jiri Pouska, Jan Benes, Roman Skulec, Christian Lehmann, Hans Vink, Vladimir Cerny
BACKGROUND: Damage of the endothelial glycocalyx (EG) has been described during surgery, but the effect of different anesthesia techniques remains unknown. Perfused boundary region (PBR) evaluated by side-stream dark field (SDF) imaging of the sublingual microcirculation enables in vivo EG assessment. PBR values are inversely related to the EG thickness. OBJECTIVE: The aim of the observational study was to evaluate the changes of PBR in patients undergoing elective joint surgery under general (GA) vs...
November 29, 2018: Clinical Hemorheology and Microcirculation
Muhammad Sohaib, Ali Sarfaraz Siddiqui
We herein describe the successful anesthetic management of a patient with stiff person syndrome undergoing right total hip replacement under spinal anesthesia. We also describe the problems associated with general anesthesia. The advantage of using regional anesthesia in these patients is the avoidance of muscle relaxants. The use of general anesthesia carries the risk of hypotonia in stiff person syndrome postoperatively due to enhancement of γ aminobutyric acid (GABA) action on synaptic transmission by drugs that have a γ GABA agonistic action...
December 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Alessandro De Cassai, Daniele Bonvicini, Michele Ruol, Christelle Correale, Maurizio Furnari
Breast innervation consists of intercostal nerves and brachial plexus. Here we propose a technique to execute breast surgery without general anesthesia using erector spinae plane (ESP) block and selective block of four nerves arising from brachial plexus and innervating breast and axilla (from now on SBP block. A 77-year-old male presented for breast cancer with indication to radical mastectomy and axillary clearance. He had a history of myocardial infarction resulting in postinfarction dilated cardiomyopathy with a severe reduction in ejection fraction...
November 27, 2018: Korean Journal of Anesthesiology
Katheleen Miranda Dos Santos, Jennifer Tsi Gerber, Pedro Teruo Mendes Okazaki, Cibele Cândida de Almeida Kintopp, Leandro Eduardo Klüppel, Allan Fernando Giovanini, Rafaela Scariot
Introduction: Plasmacytoma describes a neoplastic proliferation of plasma cells affecting different groups of patients according to location, and may demonstrate heterogeneous tumor progression and survival rate. The present article describes a case of solitary plasmacytoma in the mandible . Presentation of case: A 57-year-old male smoker was referred to the oral and maxillofacial service with extensive injury, approximately 4-5 cm in size, involving the anterior inferior region of mandible...
December 2018: Annals of Medicine and Surgery
Chia-Hung Yu, Shih-Feng Weng, Chung-Han Ho, Yi-Chen Chen, Jen-Yin Chen, Ying-Jen Chang, Jhi-Joung Wang, Ming-Ping Wu, Chin-Chen Chu
BACKGROUND: Whether nonobstetric surgery during gestation is associated with a higher risk of spontaneous abortion or adverse delivery outcomes is still unclear. METHODS: We performed a retrospective case-control study using a Longitudinal Health Insurance Database (LHID 2000) containing claim-data of 1 million randomly selected beneficiaries. We compared the incidences and estimated the adjusted odds ratios (aOR) with 95% confidence interval (95% CI) for spontaneous abortion, adverse delivery outcomes, cesarean delivery, and prolonged hospital stay to determine the risk of adverse outcomes in women who had nonobstetric surgery during gestation as compared to those who did not have any surgery during gestation...
November 26, 2018: BMC Pregnancy and Childbirth
Ulrica Nilsson, Maria Jaensson, Karuna Dahlberg, Karin Hugelius
PURPOSE: To investigate differences and describe experiences of postoperative recovery after day surgery between patients undergoing general anesthesia (GA) versus regional anesthesia (RA). DESIGN: A mixed methods design. METHODS: Day surgery patients (N = 401) were included. Postoperative recovery was assessed daily for 14 days using the Swedish Web Version of the Quality of Recovery questionnaire included in a mobile application. In addition, qualitative interviews were completed with 20 day surgery patients...
November 20, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Tatsuki Kono, Atsuomi Saiga, Keiichi Tamagawa, Kensuke Katsuki, Misako Nomura, Toshinori Hokazono, Yuuki Uchida
Harvesting grafts from the anterior iliac bone has been associated with various complications. A 50-year-old woman presented to our department with a chief complaint of right inguinal swelling and pain. Autologous bone grafts had been harvested on two previous occasions from the right anterior iliac crest for use in the reconstruction of multiple facial fractures. Computed tomography and magnetic resonance imaging revealed a full-thickness bone defect in the right anterior iliac crest. A mass was noted in the right gluteus minimus, while a multilocular cystic mass extended from the right iliac crest defect to the right inguinal region...
November 2018: Archives of Plastic 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
Natalie Vaughn, Niraja Rajan, Michael Darowish
BACKGROUND: Bier block provides anesthesia of an entire extremity distal to the tourniquet without necessitating direct injection at the surgical site. This avoids obscuring anatomy with local anesthetic and anesthetizes a wide area, allowing for multiple procedures and incisions. We hypothesize that a low-volume Bier block with forearm tourniquet, rather than a traditional brachial tourniquet, is a safe, well-tolerated, and effective anesthesia technique. METHODS: All cases in which adult patients underwent hand procedures using Bier block anesthesia by a single surgeon over a 4-year period were reviewed...
November 21, 2018: Hand: Official Journal of the American Association for Hand Surgery
Takumi Nishi, Toshiki Maeda, Takuya Imatoh, Akira Babazono
Objective: The aim of this study was to examine whether anesthetic technique is associated with 30- or 90-day mortality and perioperative length of stay (LOS). Design: We used a retrospective cohort design using a healthcare insurance claims database. Setting: The Fukuoka Prefecture's claims database of older patients who underwent hip fracture surgery under general or regional (spinal or epidural) anesthesia from April 2012 to March 2016 was used for analyses...
November 17, 2018: International Journal for Quality in Health Care
M Májovský, D Netuka
INTRODUCTION: Chronic subdural hematoma (ChSDH) is, by definition, a subdural collection of blood older than 21 days. It is not exceptional that ChSDH is diagnosed in regional hospitals and thus we believe that basic knowledge on this topic is relevant for every general surgeon. Below, we summarize information on ChSDH and present simple clinical management guidelines. TREATMENT: In asymptomatic patients with ChSDH, monitoring alone may be sufficient. Subdural collections of only a few millimeters are a relatively common incidental finding on graphical examination of the brain, especially in the elderly with brain atrophy...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Nikolaos Patelis, Maria Diakomi, Anastasios Maskanakis, Konstantinos Maltezos, Dimitrios Schizas, Marianna Papaioannou
Anesthesia for carotid endarterectomy (CEA), general or locoregional, has been an issue of debate in literature ever since the first Cochrane review in 1991. The largest available study on the subject, the GALA trial, has not shown any difference in patient's outcome - incidence of stroke and 30-day-mortality postsurgery. However, increasing evidence favors regional anesthesia as an independent factor of reduced morbidity after CEA. The advantages and disadvantages of general versus regional anesthesia for CEA have been well established...
October 2018: Saudi Journal of Anaesthesia
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
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