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Regional AND Anesthesia

Ariel Kiyomi Daoud, Tessa Mandler, Alexia Georgia Gagliardi, Harin Bhavin Parikh, Patrick M Carry, Anusara Carolyn Ice, Jay Albright
Background: Despite advancements in minimally invasive arthroscopic surgical techniques, post-operative pain management following ACL reconstruction remains a concern. This study compares the effectiveness of two common intraoperative pain management strategies - a femoral nerve catheter (FC) versus a combined femoral nerve catheter and single injection sciatic nerve block (FSB) - in pediatric patients undergoing ACL reconstruction. Methods: The medical records of patients age 8 to 18 who underwent ACL reconstruction at our institution were reviewed retrospectively...
2018: Iowa Orthopaedic Journal
Jeetinder Kaur Makkar, Divya Jain, Kajal Jain, Ashish Pareek
No abstract text is available yet for this article.
April 2018: Journal of Anaesthesiology, Clinical Pharmacology
D A Portela, N Verdier, P E Otero
Increasing interest in using peripheral nerve blocks in small animals is evident, given the numerous studies published recently on this topic in important veterinary journals. Initially, research was focused on intraoperative analgesia to the pelvic limb, and several descriptions of lumbosacral plexus, femoral and sciatic nerve blocks have been described in studies. There is recent interest in developing techniques for somatosensory blockade of the abdominal wall. This article is the second part of a two-part review of regional anesthesia (RA) in small animals, and its aim is to discuss the most relevant studies in the veterinary literature, where objective methods of nerve location have been used, and to illustrate in pictures the currently used techniques for providing RA to the abdominal wall and the pelvic limb in small animals...
August 2018: Veterinary Journal
Mark C Kendall, Dominic V Pisano, Alexander D Cohen, Michelle Gorgone, Zachary L McCormick, Christopher J Malgieri
STUDY OBJECTIVE: To review research highlights of manuscripts published in 2017 that pertain to all aspects of the clinical practice of anesthesiology. DESIGN: Narrative review. SETTING: N/A. MATERIALS: The major themes addressed in this review include recent studies examining airway management, obstetrical and gynecological anesthesia, pediatric anesthesia, cardiac anesthesia, regional analgesia and pain management...
August 10, 2018: Journal of Clinical Anesthesia
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
Mohammad Irfan Akhtar, Karima Karam, Fauzia Anis Khan
Context: The South Asian region is comprised of eight countries, i.e., Pakistan, India, Bangladesh, Sri Lanka, Afghanistan, Bhutan, Nepal, and Maldives. There is dearth of literature documenting anesthesia research in this region. Aim: The aim of this audit was to look at research productivity in the region by examining the volume and the type of anesthesia publication in five high-index anesthesia journals. Settings and Design: The study design was a survey of literature in the top five high-impact anesthesiology journals carried out at a tertiary care hospital...
July 2018: Saudi Journal of Anaesthesia
Elisabeth Dewhirst, Hina Walia, Walter P Samora, Allan C Beebe, Jan E Klamar, Joseph D Tobias
Introduction: Cerebral oxygenation can be monitored clinically by cerebral oximetry (regional oxygen saturation, rSO2 ) using near-infrared spectroscopy (NIRS). Changes in rSO2 have been shown to precede changes in pulse oximetry, providing an early detection of clinical deterioration. Cerebral oximetry values may be affected by various factors, including changes in ventilation. The aim of this study was to evaluate the changes in rSO2 during intraoperative changes in mechanical ventilation...
2018: Medical Devices: Evidence and Research
Stephen Tabiri, Edwin M T Yenli, Frank E Gyamfi, Ali Jalali, Richard E Nelson, Raymond R Price, Micah G Katz
BACKGROUND: Despite the recognition that inguinal hernia (IH) repair is cost-effective, repair rates in low- and middle-income countries remain low. Estimated use of mesh in low- and middle-income countries also remains low despite publications about low-cost, noncommercial mesh. The purpose of our study was to assess the current state of IH repair in the northern and transitional zone of Ghana. MATERIALS AND METHODS: A retrospective review of surgical case logs of IH repairs from 2013 to 2017 in 41 hospitals was performed...
October 2018: Journal of Surgical Research
Aysha Hasan, Autumn D Nanassy, Gregory Disilvio, Teerin Meckmongkol, L Grier Arthur, Pravin A Taneja
The sickle cell patient population continues to provide challenges in pain control. Current therapies include narcotic usage with adjuvant therapies such as anti-inflammatories and nonpharmacological interventions. Poor pain management in the sickle cell patient population, especially postoperatively, can lead to hypoventilation, escalating opioid requirements, poor recovery, and longer hospital stays. This case report addresses a novel addition of ultrasound-guided paravertebral and rectus sheath blocks postinduction of general anesthesia and before surgical incision to assist with the intravenous postoperative pain management regimen after laparoscopic cholecystectomy in a 10-year-old boy with sickle cell disease...
August 7, 2018: A&A practice
Promil Kukreja, Joel Feinstein, Hari K Kalagara, Samuel R Huntley, Sung R Lee, Sameer Naranje, Ashish Shah
The planning and implementation of an effective postoperative pain management program depend on the surgical technique for total knee arthroplasty (TKA), the type of regional anesthesia, and the multimodal analgesia regimen. It is imperative to understand the surgical anatomy of TKA and the relevant nerve supply of the knee for optimum perioperative patient satisfaction with respect to pain management in the patient undergoing TKA. The commonly used regional techniques have their own specific benefits and limitations...
June 7, 2018: Curēus
Lee A Fleisher
No abstract text is available yet for this article.
September 2018: Anesthesiology Clinics
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
Rodney A Gabriel, Brian M Ilfeld
Maximizing analgesia is critical following joint arthroplasty because postoperative pain is a major barrier to adequate physical therapy. Continuous peripheral nerve blocks have been the mainstay for acute pain management in this population; however, this and similar techniques are limited by their duration of action. Cryoneurolysis and peripheral nerve stimulation are two methodologies used for decades to treat chronic pain. With the advent of portable ultrasound devices and percutaneous administration equipment, both procedures may now be suitable for treatment of acute pain...
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
James R Riehl, Ben J Palanca, ShiNung Ching
Characterizing anesthesia-induced alterations to brain network dynamics provides a powerful framework to understand the neural mechanisms of unconsciousness. To this end, increased attention has been directed at how anesthetic drugs alter the functional connectivity between brain regions as defined through neuroimaging. However, the effects of anesthesia on temporal dynamics at functional network scales is less well understood. Here, we examine such dynamics in view of the free-energy principle, which postulates that brain dynamics tend to promote lower energy (more organized) states...
2018: Network neuroscience
Chunxiao Wei, Fengchun Wan, Haiwei Zhao, Jiajia Ma, Zhenli Gao, Chunhua Lin
Objective This study was performed to evaluate the application of enhanced recovery after surgery (ERAS) in patients undergoing radical cystectomy (RC). Methods The clinical data of 192 patients who underwent RC were collected in this retrospective cohort study. Among them, 91 patients who underwent ERAS were allocated to the ERAS group, and the remaining 101 patients who underwent traditional postoperative care procedures were allocated to the non-ERAS group. Perioperative indexes in the two groups were compared...
August 8, 2018: Journal of International Medical Research
Landon T Burns, Drew A Beasley, Mark A Stevens, Donald E Crabtree, Gregory R Mehaffey
Providing analgesia for patients with anterior rib and sternum fracture has been addressed from various types of modalities. Regional anesthesia via epidurals or peripheral nerve blocks, opiates, and other forms of multimodal pain regimens have been used. However, in the polytraumatic injury patient, positioning for an epidural may be problematic, and a predominantly opiate-based treatment plan may compromise respiratory status. In this case series, we describe the pectointercostal fascial block as another tool to treat patients with anterior rib and sternal fracture with polytraumatic injuries...
August 6, 2018: A&A practice
Benjamin J Walker, Justin B Long, Madhankumar Sathyamoorthy, Jennifer Birstler, Christine Wolf, Adrian T Bosenberg, Sean H Flack, Elliot J Krane, Navil F Sethna, Santhanam Suresh, Andreas H Taenzer, David M Polaner, Lynn Martin, Corrie Anderson, Rani Sunder, Trevor Adams, Lizabeth Martin, Martha Pankovich, Amod Sawardekar, Patrick Birmingham, Ryan Marcelino, R J Ramarmurthi, Peter Szmuk, Galit Kastner Ungar, Sara Lozano, Karen Boretsky, Ranu Jain, Maria Matuszczak, Timothy R Petersen, Jennifer Dillow, Robert Power, Kim Nguyen, Benjamin H Lee, Lisa Chan, Jorge Pineda, Jacob Hutchins, Kimberly Mendoza, Kristen Spisak, Aali Shah, Kathryn DelPizzo, Naomi Dong, Vidya Yalamanchili, Claudia Venable, Cassandra Armstead Williams, Reena Chaudahari, Susumu Ohkawa, Helga Usljebrka, Tarun Bhalla, Pedro Paulo Vanzillotta, Seza Apiliogullari, Andrew D Franklin, Akiko Ando, Sophie R Pestieau, Caroline Wright, Julia Rosenbloom, Tony Anderson
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Complications in pediatric regional anesthesia are rare, so a large sample size is necessary to quantify risk. The Pediatric Regional Anesthesia Network contains data on more than 100,000 blocks administered at more than 20 children's hospitals. This study analyzed the risk of major complications associated with regional anesthesia in children. METHODS: This is a prospective, observational study of routine clinical practice...
July 30, 2018: Anesthesiology
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