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Regional AND Anesthesia

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
Brendon M Hart, Stephane M Ferrell, Mark W Motejunas, Lauren A Bonneval, Elyse M Cornett, Richard D Urman, Alan D Kaye
There are several new anticoagulants on the market that will impact perioperative care, including the use of these anticoagulant drugs in the setting of regional anesthesia. The ideal pharmacological agent would prevent pathological thrombosis and allow for a normal response to vascular injury to limit bleeding. At present, all antithrombotic agents have increased bleeding risk as their main side effect. We describe the different categories of drugs, e.g., antiplatelet, anticoagulant, and thrombolytic, with particular emphasis on the new drugs that have been introduced into the market...
June 2018: Best Practice & Research. Clinical Anaesthesiology
Ajay P Singh, S Lakshminrusimha, M E Thompson
OBJECTIVE: The primary aim of this pilot study was to assess feasibility and to evaluate if peri-operative pain management with regional analgesia resulted in decreased use of narcotic medication and earlier return to preoperative respiratory/nutritional status. STUDY DESIGN: Cases were defined as infants who received regional analgesia as part of their perioperative anesthetic management. Controls were matched for surgical procedures without regional analgesia...
October 10, 2018: Journal of Neonatal-perinatal Medicine
Huan Wang, Yingjie Geng, Weijian Zheng, Weiping Fang, Erwei Gu, Xuesheng Liu, Wenzhi Li
BACKGROUND: During regional anesthesia, including combined spinal and epidural anesthesia (CSEA), patients may develop a perceptual alteration of limb position known as phantom limb syndrome (PLS). We aimed to identify factors that influence the PLS onset, to explore whether PLS predisposes to other postoperative symptoms, and to document the relationship between PLS and sensorimotor impairment during recovery. METHODS: Psychological questionnaires for anxiety and depression were completed beforehand, then multimodal tests of sensory and motor function, especially tests of proprioception, were performed regularly afterward...
October 2018: Medicine (Baltimore)
Norihiko Shiiya
Near infra-red spectroscopy (NIRS) and motor evoked potentials (MEP) have been used to monitor brain and spinal cord ischemia. NIRS calculates oxygen saturation of hemoglobin, based on the modified Beer-Lambert law. It correlates with the change in regional tissue blood flow. However, the technology is not matured enough for the measured value to be used as an index of tissue oxygenation, so that relative change should be carefully followed. Myogenic MEP has widely been used to monitor spinal cord ischemia, since the introduction of pulse train transcranial electrical stimulation...
September 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Carolina C Rennó, Juliana Z B Papini, Cintia Maria Saia Cereda, Elizabeth Martinez, Victor Angelo Montalli, Eneida de Paula, José Pedrazzoli Júnior, Silvana Aparecida Calafatti, Giovana Radomille Tofoli
BACKGROUND: Our research group has recently developed liposomes with ionic gradient and in a combined manner as donor and acceptor vesicles containing ropivacaine (RVC; at 2% or 0.75%). Looking for applications of such novel formulations for postoperative pain control, we evaluated the duration of anesthesia, pharmacokinetics, and tissue reaction evoked by these new RVC formulations. METHODS: The formulations used in this study were large multivesicular vesicle (LMVV) containing sodium acetate buffer at pH 5...
October 9, 2018: Anesthesia and Analgesia
Atakan Tanacan, Canan Unal, Halise Meltem Yucesoy, Sinem Ayse Duru, Mehmet Sinan Beksac
PURPOSE: To evaluate the clinical characteristics, obstetric/neonatal outcomes, and pregnancy complications of pregnant women with Takayasu arteritis (TA). METHODS: We retrospectively evaluated the data of 22 pregnancies of 11 patients with TA between January 1 2000, and December 31 2017. Patient characteristics, severity of disease, obstetric outcomes, pregnancy complications, mode of delivery, and neonatal outcomes were evaluated. RESULTS: Based on the angiographic classification, four, two, one, three, and one patient were classified into groups I, IIa, III, IV, and V, respectively...
October 9, 2018: Archives of Gynecology and Obstetrics
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
Leonardo Diniz Correa Pinto, Cláudia Helena Ribeiro da Silva, Pedro Marcos Silva E Gonçalves, Roberto José Valadares
BACKGROUND AND OBJECTIVES: Ultrasound-guided upper limb blocks may provide great benefits to patients with serious diseases. Patients with Steinert's disease have muscle weakness and risk of triggering myotomy or malignant hyperthermia due to the use of anesthetic agents and surgical stress. The objective of this report was to demonstrate a viable alternative for clavicle fracture surgery with upper trunk and supraclavicular nerve block, thus reducing the spread of local anesthetic to the phrenic nerve in a patient with muscular dystrophy...
October 6, 2018: Revista Brasileira de Anestesiologia
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
Antoine G M Aya, Pierre-Henri Pouchain, Hubert Thomas, Jacques Ripart, Philippe Cuvillon
BACKGROUND: While the incidence of postoperative delirium is high in aged hospitalized patients undergoing major surgery, little is known concerning patients undergoing ambulatory surgery. OBJECTIVE: To determine the incidence of postoperative delirium in aged patients after hospital discharge from an ambulatory surgery unit. DESIGN: Prospective observational study. PATIENTS: Elderly patients (≥75 years) scheduled for a surgical procedure on an ambulatory basis...
October 3, 2018: Journal of Clinical Anesthesia
Hironobu Ueshima, Hiroshi Otake
RATIONALE: The relief of selective hip pain may be difficult to attain. Therefore, a deep nerve block such as epidural anesthesia or lumbar plexus nerve block is required. However, deep nerve blocks may not be possible in patients with complications, including severe cardiovascular disease. PATIENTS CONCERNS: The patient in our report had coronary stents inserted previously and required continuous anticoagulant therapy owing to severe heart failure. DIAGNOSIS: Bipolar hip arthroplasty was required in our patient because of a fracture of the neck of femur on the left side...
October 2018: Medicine (Baltimore)
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
Wei-Zen Sun, James L Reynolds
No abstract text is available yet for this article.
June 2018: Asian Journal of Anesthesiology
Debbie Chi, Edward R Mariano, Stavros G Memtsoudis, Laurence C Baker, Eric C Sun
BACKGROUND: Total knee arthroplasty is a commonly performed procedure and an important contributor to national health care spending. Reducing the incidence of readmission could have important consequences for patient well-being and relevant financial implications. Whether regional anesthesia techniques are associated with decreased readmission rates and costs among privately insured patients remains unknown. METHODS: Using administrative claims data, we identified 138,362 privately insured patients 18-64 years of age who underwent total knee arthroplasty between 2002 and 2013...
October 3, 2018: Anesthesia and Analgesia
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