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MAC Anesthesia

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https://www.readbyqxmd.com/read/29091490/prospective-evaluation-of-opioid-consumption-following-hand-surgery-performed-wide-awake-versus-with-sedation
#1
Andrew Miller, Nayoung Kim, Asif M Ilyas
BACKGROUND: We prospectively evaluated opioid consumption postoperatively following trigger finger release (TFR) and open carpal tunnel release (CTR), and hypothesized that cases performed wide awake with local anesthesia and no tourniquet (WALANT) would result in increased opioid consumption compared with cases performed under monitored anesthesia care (MAC). METHODS: Postoperative opioid consumption following CTR and TFR was prospectively collected over 6 months...
November 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29084114/comparison-of-postoperative-outcomes-between-monitored-anesthesia-care-and-general-anesthesia-in-closed-reduction-of-nasal-fracture
#2
Hyunwoo Kyung, Jae-Ik Choi, Seung-Han Song, Sang-Ha Oh, Nakheon Kang
Fracture of nasal bone is among the most common facial bone fractures. Reduction of nasal bone fracture is able to be performed under local or general anesthesia. The aim of this study is to compare monitored anesthetic care (MAC) and general anesthesia (GA) based on intraoperative vital signs, and the adverse effects after closed reduction of nasal bone fractures.The authors performed a retrospective study of 45 patients who underwent a closed reduction of nasal bone fracture between January 1, 2016 and December 31, 2016...
October 27, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29069043/the-effect-of-preoperative-administration-of-morphine-in-alleviating-intraoperative-pain-of-percutaneous-transforaminal-endoscopic-discectomy-under-local-anesthesia-a-strobe-compliant-study
#3
Yunshan Fan, Guangfei Gu, Guoxin Fan, Yanjie Zhu, Yitao Yang, Xin Gu, Hailong Zhang, Shisheng He
Local anesthesia is routinely recommended for percutaneous transforaminal endoscopic discectomy (PTED). However, the intense intraoperative pain remains a serious problem. The purpose of the current study is to find a safe and effective method to alleviate the intense pain during PTED for lumbar disc herniation (LDH) under local anesthesia.This study retrospectively analyzed 63 LDH patients who accepted PTED under local anesthesia. Thirty-one patients received intramuscular injection of morphine before PTED, while the other 32 were not...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29068040/electrophysiological-effects-of-desflurane-in-children-with-wolff-parkinson-white-syndrome-a-randomized-crossover-study
#4
H Hino, Y Oda, Y Yoshida, T Suzuki, M Shimada, K Nishikawa
BACKGROUND: We hypothesized that, compared with propofol, desflurane prolongs the antegrade accessory pathway effective refractory period (APERP) in children undergoing radiofrequency catheter ablation for Wolff-Parkinson-White (WPW) syndrome. METHODS: In this randomized crossover study, children aged 4.1-16.1 years undergoing radiofrequency catheter ablation for WPW syndrome were randomly divided into four groups according to the concentration of desflurane and anesthetics used in the first and the second electrophysiological studies (EPS)...
October 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28976458/evaluation-of-the-c-mac-miller-video-laryngoscope-sizes-0-and-1-during-tracheal-intubation-of-infants-less-than-10-kg
#5
Florian J Raimann, Colleen E Cuca, Detlev Kern, Kai Zacharowski, Udo Rolle, Dirk Meininger, Christian F Weber, Christian Byhahn, Haitham Mutlak
STUDY OBJECTIVE: Video laryngoscopy has primarily been developed to assist in difficult airways. Using video laryngoscopy in pediatric airway management is an up-and-coming topic. The aim of the presented study was to compare the intubation conditions obtained when using the C-MAC video laryngoscope with Miller blades sizes 0 and 1 for standard direct laryngoscopy and indirect laryngoscopy in children weighing less than 10 kg. DESIGN: This was a prospective study...
October 2, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28944481/efficacy-of-dexmedetomidine-on-perioperative-morbidity-during-nasal-surgery-a-meta-analysis
#6
Se Hwan Hwang, Ho Seok Lee, Young Hoon Joo, Jae Hyun Seo, Jun Myung Kang
OBJECTIVES: The goal of this meta-analysis was to perform a systematic review of the literature on the effect of dexmedetomidine on perioperative morbidity following nasal surgery and on the adverse effects of dexmedetomidine. DATA SOURCES: MEDLINE, Scopus, and Cochrane Database of Systematic Reviews. REVIEW METHODS: Two authors independently searched scientific and medical databases from their inception of article collection to March 2017...
September 25, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28944317/comparison-of-regional-vs-general-anesthesia-for-surgical-repair-of-open-globe-injuries-at-a-university-referral-center
#7
Andrew J McClellan, Jacquelyn J Daubert, Nidhi Relhan, Kimberly D Tran, Harry W Flynn, Steven Gayer
PURPOSE: This study compares the clinical features and physician selection of either Regional Anesthesia (peribulbar or retrobulbar block) with Monitored Anesthesia Care (RA-MAC) or General Anesthesia (GA) for open globe injury repair. DESIGN: A non-randomized, comparative, retrospective case series at a University Referral Center. PARTICIPANTS: All adult repairable open globe injuries receiving primary repair between January 1st, 2004 and December 31st, 2014 (11 years)...
May 2017: Ophthalmology retina
https://www.readbyqxmd.com/read/28930848/nociceptive-stimulation-during-macintosh-direct-laryngoscopy-compared-with-mcgrath-mac-videolaryngoscopy-a-randomized-trial-using-indirect-evaluation-using-an-automated-administration-of-propofol-and-remifentanil
#8
RANDOMIZED CONTROLLED TRIAL
Rathvirak Ing, Ngai Liu, Thierry Chazot, Julien Fessler, Jean François Dreyfus, Marc Fischler, Morgan Le Guen
BACKGROUND: Decrease of the nociceptive stimulation induced by laryngoscopy could be an advantage for patients without risk of difficult intubation. The present study aimed to compare the difference in nociceptive stimulation between the use of a conventional laryngoscope or of a videolaryngoscope. Amount of nociception was assessed indirectly using the peak remifentanil concentration determined by a closed-loop administration of propofol and remifentanil with bispectral index (BIS) as the input signal (target 50)...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28924371/comparison-of-the-analgesic-properties-of-sevoflurane-and-desflurane-using-surgical-pleth-index-at-equi-minimum-alveolar-concentration
#9
Kyoungho Ryu, Keulame Song, Jia Kim, Eugene Kim, Seong-Hyop Kim
Background: Traditionally, minimum alveolar concentration (MAC) has been used as the standard measure to compare the potencies of volatile anesthetics. However, it reflects the spinal mechanism of immobility rather than the subcortical mechanism of analgesia. Recently, the surgical pleth index (SPI) derived from photoplethysmographic waveform was shown to reflect the intraoperative analgesic component. This study was designed to compare the SPI values produced by equi-MAC of two commonly used volatile anesthetics, sevoflurane and desflurane...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28923694/outcomes-of-transcatheter-aortic-valve-replacement-using-a-minimalist-approach
#10
Sergey Gurevich, Brett Oestreich, Rosemary F Kelly, Mackenzie Mbai, Stefan Bertog, Karen Ringsred, Annette Lawton, Brenda Thooft, Julie Wagner, Santiago Garcia
BACKGROUND: Transcatheter Aortic Valve Replacement (TAVR) is increasingly performed using a minimalist approach under monitored anesthesia care (MAC). The safety of this approach remains controversial and adoption has been low in the US. METHODS: The study cohort was comprised of 130 patients (98% male) who underwent TAVR between 4/2015 and 4/2017 at the Minneapolis VA. We compared the outcomes of 81 patients who underwent TAVR using a standard approach (standard TAVR) and 49 who underwent TAVR using a minimalist approach (minimalist TAVR)...
August 12, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28911896/patient-selection-and-outcomes-of-transfemoral-transcatheter-aortic-valve-replacement-performed-with-monitored-anesthesia-care-versus-general-anesthesia
#11
Saroj Pani, John Cagino, Paul Feustel, Sridhar Reddy Musuku, Asim Raja, Natalie Bruno, Christopher Ursillo, Nathapong Arunakul, Constantine M Poulos, Michael Welljams-Dorof, Kevin Roberts, Mikhail Torosoff, Augustine Delago
OBJECTIVE: The aim of this study was to compare outcomes of monitored anesthesia care (MAC) versus general anesthesia (GA) for transfemoral transcatheter aortic valve replacement (TF-TAVR) and to describe a selection process for the administration of MAC. DESIGN: Retrospective analysis of patients who underwent TF-TAVR under MAC or GA. SETTING: Department of Cardiac Anesthesia, Albany Medical Center, a tertiary university hospital. PARTICIPANTS: Patients selected for TF-TAVR...
April 5, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28904906/a-step-by-step-guide-to-office-based-sperm-retrieval-for-obstructive-azoospermia
#12
REVIEW
Robert M Coward, Jesse N Mills
A variety of surgical options exists for sperm retrieval in the setting of obstructive azoospermia (OA). With appropriate preparation, the majority of these techniques can safely be performed in the office with local anesthesia and with or without monitored anesthesia care (MAC). The available techniques include percutaneous options such as percutaneous epididymal sperm aspiration (PESA) and testicular sperm aspiration (TESA), as well as open techniques that include testicular sperm extraction (TESE) and microsurgical epididymal sperm aspiration (MESA)...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28867906/open-carpal-tunnel-release-outcomes-performed-wide-awake-versus-with-sedation
#13
Jacob E Tulipan, Nayoung Kim, Jack Abboudi, Christopher Jones, Frederic Liss, William Kirkpatrick, Michael Rivlin, Mark L Wang, Jonas Matzon, Asif M Ilyas
Background  Carpal tunnel release (CTR) is the most common surgery of the hand, and interest is growing in performing it under local anesthesia without tourniquet. To better understand differences, we hypothesized that patients undergoing CTR under wide-awake local anesthesia with no tourniquet (WALANT) versus sedation (monitored anesthesia care [MAC]) would not result in a difference in outcome. Methods  Consecutive cases of electrodiagnostically confirmed open CTR across multiple surgeons at a single center were prospectively enrolled...
August 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28860910/success-rate-of-placement-of-a-bicanalicular-stent-for-partial-nasolacrimal-obstruction-in-adults-under-local-monitored-anesthesia-care-and-general-anesthesia
#14
David I Silbert
PURPOSE: To study The Kaneka Lacriflow Stent, a self-retaining bicanalicular intubation set that can be placed under local anesthetic, providing a new option to treat epiphora and partial NLDO. DESIGN: Retrospective chart review. SUBJECTS: 93 adult patients requiring treatment for a partial NLDO were evaluated. Stents were placed in office setting under local/topical anesthetic or in OR (MAC or GEN). The stent is placed with a stylet, and self-retains due to a widened portion sitting distal to the common canaliculis...
July 2017: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
https://www.readbyqxmd.com/read/28858136/comparison-of-a-curved-forceps-with-a-conventional-straight-forceps-for-nasogastric-tube-insertion-under-videolaryngoscopic-guidance-a-randomized-crossover-manikin-study
#15
RANDOMIZED CONTROLLED TRIAL
Kenta Furutani, Tatsunori Watanabe, Yoshinori Kamiya, Hiroshi Baba
BACKGROUND: Nasogastric tube (NGT) insertion is an easy procedure that can be routinely performed under general anesthesia. However, for difficult cases, there are limited insertion techniques available in routine clinical practice, considering the flexibility of NGTs. The SUZY curved forceps are designed for the removal of pharyngolaryngeal foreign bodies under guidance of the McGRATH MAC (McG) videolaryngoscope. Because McG enables clear visualization of the esophageal inlet, we hypothesized that the SUZY forceps can facilitate easier NGT insertion compared with the conventional Magill forceps under McG guidance and designed a randomized, crossover manikin study to test this hypothesis...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28843955/predictors-of-use-of-monitored-anesthesia-care-for-outpatient-gastrointestinal-endoscopy-in-a-capitated-payment-system
#16
Megan A Adams, Katherine M Prenovost, Jason A Dominitz, Robert G Holleman, Eve A Kerr, Sarah L Krein, Sameer D Saini, Joel H Rubenstein
BACKGROUND & AIMS: Use of monitored anesthesia care (MAC) for gastrointestinal endoscopy has increased in the Veterans Health Administration (VHA) as in fee-for-service environments, despite the absence of financial incentives. We investigated factors associated with use of MAC in an integrated health care delivery system with a capitated payment model. METHODS: We performed a retrospective cohort study using multilevel logistic regression, with MAC use modeled as a function of procedure year, patient- and provider-level factors, and facility effects...
August 24, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28843008/sevoflurane-neurotoxicity-in-neonatal-rats-is-related-to-an-increase-in-the-gabaa-r-%C3%AE-1-gabaa-r-%C3%AE-2-ratio
#17
Si-Ning Xie, Hong Ye, Jun-Fa Li, Li-Xin An
Exposure of neonatal rat to sevoflurane leads to neurodegeneration and deficits of spatial learning and memory in adulthood. However, the underlying mechanisms remain unclear. The type A γ-aminobutyric acid receptor (GABAA R) is a target receptor for sevoflurane. The present study intends to investigate the changes in GABAA R α1/α2 expression and its relationship with the neurotoxicity effect due to sevoflurane in neonatal rats. After a dose-response curve was constructed to determine minimum alveolar concentration (MAC) and safety was guaranteed in our 7-day-old neonatal rat pup mode, we conducted two studies among the following groups: (A) the control group; (B) the sham anesthesia group; and (C) the sevoflurane anesthesia group and all three groups were treated in the same way as the model...
August 26, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28840160/investigation-of-data-driven-optical-neuromonitoring-approach-during-general-anesthesia-with-sevoflurane
#18
Gabriela Hernandez-Meza, Meltem Izzetoglu, Ahmet Sacan, Michael Green, Kurtulus Izzetoglu
Anesthesia monitoring currently needs a reliable method to evaluate the effects of the anesthetics on its primary target, the brain. This study focuses on investigating the clinical usability of a functional near-infrared spectroscopy (fNIRS)-derived machine learning classifier to perform automated and real-time classification of maintenance and emergence states during sevoflurane anesthesia. For 19 surgical procedures, we examine the entire continuum of the maintenance-transition-emergence phases and evaluate the predictive capability of a support vector machine (SVM) classifier during these phases...
October 2017: Neurophotonics
https://www.readbyqxmd.com/read/28829665/effect-of-local-ropivacaine-on-hemodynamic-responses-in-craniotomy-patients
#19
Sepideh Vahabi, Siavash Beiranvand
BACKGROUND: Increased intracranial pressure (ICP) with hemodynamic is of major concern to anesthesiologists and surgeons in craniotomy surgery. Thus, the management of hemodynamic stability is essential in neuro-anesthesia. This study was performed to investigate the effect of local infiltration of 0.5% ropivacaine on hemodynamic responses in craniotomy patients. MATERIAL AND METHODS: 64 ASA class I -II patients, scheduled for elective craniotomies, were enrolled in this prospective randomized double blind placebo controlled study...
August 22, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28815307/clinical-outcomes-after-local-anesthesia-with-monitored-anesthesia-care-during-thyroidectomy-and-selective-neck-dissection-a-randomized-study
#20
Min-Su Kim, Bo-Hae Kim, Young Eun Han, Dong Woo Nam, J Hun Hah
Although thyroidectomy under local anesthesia with monitored anesthesia care (LA-MAC) has been reported, reports of neck dissections beyond level VI under LA-MAC in patients with thyroid cancer are rare. We aimed to analyze clinical data and patient satisfaction levels during thyroidectomy and selective neck dissection by comparing LA-MAC and general anesthesia (GA) in adult patients undergoing these surgeries for thyroid cancer. The 60 enrolled patients comprised 50 patients that underwent thyroidectomy and 10 that underwent selective neck dissection; 30 underwent thyroidectomy (n = 25) or selective neck dissection (n = 5) under LA-MAC and 30 (matched patients) underwent thyroidectomy (n = 25) or selective neck dissection (n = 5) under GA...
August 16, 2017: European Archives of Oto-rhino-laryngology
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