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Regional general anesthesia

Bertram Baenziger, Najia Nadi, Ramon Doerig, Peter Proemmel, Brigitta Gahl, Daniel Hodel, Oliver N Hausmann
BACKGROUND: There are only a few prospective clinical trials investigating the effects of different anesthetic techniques on clinical outcomes after lumbar spine surgery. The purpose of this study was to evaluate clinical outcomes in patients receiving general (GA) and regional anesthesia (RA) for lumbar spine surgery. METHODS: This was a single-center, 2-arm, trial in which 100 patients undergoing lumbar spine surgery were randomized to receive either RA or GA (50 per group)...
October 16, 2018: Journal of Neurosurgical Anesthesiology
Gavin M Hamilton, Reva Ramlogan, Anne Lui, Colin J L McCartney, Faraj Abdallah, Daniel I McIsaac
PURPOSE: Regional anesthesia may have immediate postoperative advantages compared with general anesthesia, but its impact on post-discharge outcomes is poorly described. Our objective was to measure the association between regional anesthesia and outcomes after ambulatory shoulder surgery. METHODS: We conducted a historical cohort study at The Ottawa Hospital. Adults ≥ 18 yr old having elective ambulatory shoulder surgery from January 1, 2011 to December 31, 2016 were included...
October 17, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Yugeesh R Lankadeva, Roger G Evans, Junko Kosaka, Lindsea C Booth, Naoya Iguchi, Rinaldo Bellomo, Clive N May
Expansion of extracellular fluid volume with crystalloid solutions is a common medical intervention, but its effects on renal cortical and medullary oxygenation are poorly understood. Therefore, we instrumented sheep under general anesthesia to enable continuous measurement of systemic and renal hemodynamics, global renal oxygen delivery and consumption, and intra-renal tissue perfusion and oxygen tension (pO2 ) in conscious animals (n=7). The effects of three sequential intermittent infusions of 500 mL of compound sodium lactate solution, administered at hourly intervals, were determined...
October 17, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
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
Tian-Xiao Wang, Bo Xiong, Wei Xu, Hao-Hua Wei, Wei-Min Qu, Zong-Yuan Hong, Zhi-Li Huang
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: The parabrachial nucleus (PBN), which is a brainstem region containing glutamatergic neurons, is a key arousal nucleus. Injuries to the area often prevent patient reanimation. Some studies suggest that brain regions that control arousal and reanimation are a key part of the anesthesia recovery. Therefore, we hypothesize that the PBN may be involved in regulating emergence from anesthesia. METHODS: We investigated the effects of specific activation or inhibition of PBN glutamatergic neurons on sevoflurane general anesthesia using the chemogenetic "designer receptors exclusively activated by designer drugs" approach...
October 16, 2018: Anesthesiology
H Vogel, W Schaaf, M Jacob
BACKGROUND: Video-assisted patient education (VaPE) has in the past been a subject of many studies. Compared to conventional methods, most authors reported a better transfer of information, some found increased patient satisfaction and a time-sparing effect. There was no increase in anxiety caused by VaPE. Some authors even found a reduction of anxiety levels before anesthesia. All publications to date have focused on the patient's point of view. There have been no reports on how anesthetists as users assess VaPE...
October 9, 2018: Der Anaesthesist
Ann Monahan, Joanne Guay, John Hajduk, Santhanam Suresh
BACKGROUND: The aim of this systematic review was to compare the effects of regional analgesic (RA) techniques with systemic analgesia on postoperative pain, nausea and vomiting, resources utilization, reoperation, death, and complications of the analgesic techniques in children undergoing cardiac surgery. METHODS: A search was done in May 2018 in PubMed, Embase, and the Cochrane Central Register of Controlled Trials for randomized controlled trials comparing RA techniques with systemic analgesia...
October 8, 2018: Anesthesia and Analgesia
Allan F Simpao, Vladislav Obsekov, Jorge A Gálvez, Rebecca S Isserman, Mohamed A Rehman, Erin S Schwartz
BACKGROUND: General anesthesia and sedation are used routinely for magnetic resonance imaging (MRI) studies in children to optimize image quality. Airway devices such as supraglottic airways (SGAs) can alter the appearance of cervical soft tissue regions on an MRI and increase the risk of misdiagnosis. This phenomenon has not been well described in vivo. AIMS: We conducted this retrospective study to determine how often SGAs affected the appearance of neck masses in children who received multiple anesthetics for MRIs with and without an SGA...
October 9, 2018: Paediatric Anaesthesia
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
Vladimir V Lomivorotov, Vladimir A Shmyrev, Valery A Nepomniashchikh
No abstract text is available yet for this article.
September 13, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Reto Stump, Ivo Dobrev, Niklaus Krayenbühl, Rudolf Probst, Christof Röösli
BACKGROUND: Bone conduction (BC) is an alternative to air conduction (AC) for stimulation of the inner ear. Stimulation for BC can occur directly on the skull bone, on the skin covering the skull bone, or on soft tissue (i.e., eye, dura). All of these stimuli can elicit otoacoustic emissions (OAE). This study aims to compare OAEs generated by different combinations of stimuli in live humans, including direct stimulation of the intracranial contents via the dura, measured intraoperatively...
September 28, 2018: Hearing Research
Volker Arnd Coenen, Michel Rijntjes, Bastian Sajonz, Tobias Piroth, Thomas Prokop, Wolfgang Jost, Michael Trippel, Horst Urbach, Peter Christoph Reinacher
INTRODUCTION:  A 28-year-old man presented with a history of sensorineural deafness since early childhood treated with bilateral cochlear implants (CIs). He showed signs of debilitating dystonia that had been present since puberty. Dystonic symptoms, especially a protrusion of the tongue and bilateral hand tremor, had not responded to botulinum toxin therapy. We diagnosed Mohr-Tranebjaerg syndrome (MTS). METHODS AND MATERIAL:  Deep brain stimulation (DBS) of the bilateral globus pallidus internus was performed predominantly with stereotaxic computed tomography angiography guidance under general anesthesia...
October 5, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Dimosthenis Petsas, Valentini Pogiatzi, Thanasis Galatidis, Maria Drogouti, Iliana Sofianou, Alexis Michail, Iosif Chatzis, Georgios Donas
The Erector Spinae Plane Block (ESP) is a novel regional technique for anesthesia or analgesia. Originally the ESP block was described in 2016 in a case report regarding analgesia intervention for a case of thoracic neuropathic pain. Since then, there has been growing interest and research adding experience about the ESP block as regional anesthetic and analgesic technique. Reviewing the literature about this novel technique in databases like PubMed using the key words "erector spinae plane block" returns approximately 56 publications...
2018: Journal of Pain Research
Thomas M Hemmerling
BACKGROUND: Abdominal surgery has undergone major changes during the last two decades with a general shift from open, invasive surgery to closed minimally invasive surgery. Accordingly, pain management strategies have also changed, especially with the introduction of ultrasound-guided abdominal wall blocks. Despite laparoscopic abdominal surgery classified as minimal, pain can be quite significant and needs to be addressed appropriately. PURPOSE: This narrative review focuses on adequate pain strategies for various types of surgery...
October 3, 2018: Langenbeck's Archives of Surgery
Aastha Srivastava, Ankit Arora, Divya Gupta, Veena Asthana
Ankylosing spondylitis (AS) is a chronic inflammatory disease of the spine which leads to ossification and formation of a classical bamboo spine. This poses a challenge to the anesthetist both in terms of administering general and regional anesthesia due to the limited mobility of the spine. With the advent of ultrasound as an aid in regional anesthesia, it has been relatively easy to perform a central neuraxial blockade in such patients though the skill requires some degree of expertise. Here, we have described the use of ultrasound as a guide for administering regional anesthesia to a patient with AS after initially attempting a blind approach which had failed due to difficult anatomy...
July 2018: Anesthesia, Essays and Researches
Naglaa Khalil Yousef
Background: Abdominal hysterectomy is associated with sever postoperative pain. Quadratus lumborum (QL) block is a regional analgesic technique which has an evolving role in postoperative analgesia. Aims: we aimed to compare ultrasound guided bilateral transverse abdominis plane (TAP) block versus bilateral QL block in patients undergoing total abdominal hysterectomy. Settings and Design: This is a prospective randomized controlled double blinded study...
July 2018: Anesthesia, Essays and Researches
Tamami Maeda, Naoki Morimoto, Natsuko Kakudo, Kenji Kusumoto
Cultured epithelial autograft (CEA) is an epithelial sheet prepared from a patient's own skin using cell culture. In Japan, CEA (JACE; Japan Tissue Engineering Co., Ltd., Gamagori, Japan) was approved and covered by public health care insurance for use in the treatment of giant congenital melanocytic nevus (GCMN) in 2016. There are several treatment options for GCMN; however, the complete removal of a GCMN is usually difficult due to the lack of skin. In this report, we describe a case of GCMN in the occipital region that was treated using CEA after curettage...
June 2018: Plastic and Reconstructive Surgery. Global Open
Sharnie Wu, Kong Chan Tang
PURPOSE: Ocular regional blocks generally require blind instrumentation to the posterior orbit, leading to rare but serious complications. However, topical anesthesia does not suppress eye or lid movements and may lead to more surgical complications. Advanced subconjunctival anesthesia (ASCAN) is a technique developed to provide reliable akinesia and anesthesia without anterior dissection or blind intrusion into the posterior orbit, while allowing visualization of the needle-tip position...
September 2018: Asia-Pacific Journal of Ophthalmology
Kazuto Kurohara, Yasuyuki Michi, Akane Yukimori, Satoshi Yamaguchi
BACKGROUND: A glomus tumor is a rare neoplasm usually found in the dermis or subcutaneous tissue of the extremities. It is rare for the glomus tumor to occur on the head and face. Only 26 glomus tumors of the oral region and affected bone have been reported in the English-language literature (Table 1). We report a case of a glomus tumor at the mandible. As a new point, the glomus tumor resorbed a bone and teeth roots when the tumor progressed into the mandible. CASE PRESENTATION: The patient was a 44-year-old Japanese man who complained swelling of the right mandible...
September 25, 2018: Head & Face Medicine
Philippe Van Camp, Bert Gemels, Guido Heijsters, Serge Schepers
INTRODUCTION: Inspired by the presented case, this paper investigates treatment options for patients under active bisphosphonate therapy, suffering from a traumatic fracture in the absence of MRONJ (patients classified as 'at risk'). We review literature in search of standardized protocols and in combination. PRESENTATION OF CASE: A 75-year-old woman, suffering from osteoporosis for over a decade and being treated with alendronate for about 10 years, stumbled and fell and ended up with a displaced fracture on the right side of her extremely atrophied mandible...
September 10, 2018: International Journal of Surgery Case Reports
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