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https://www.readbyqxmd.com/read/29145167/contraction-response-to-muscle-percussion-a-reappraisal-of-the-mechanism-of-this-bedside-test
#1
Christoph Czarnetzki, André Truffert, Abdelhafid Mekideche, Antoine Poncet, Christopher Lysakowski, Martin R Tramèr, Michel R Magistris
OBJECTIVE: To study whether the contraction evoked by muscle percussion stems from the excitation of the muscle or of the nerve and to discuss the changes of this response in neuromuscular disorders. METHODS: In 30 neurologically healthy patients undergoing surgery (for ear, nose, or throat problems unrelated to the study) under general anesthesia with propofol and sufentanil we measured with an electrogoniometer the maximal dorsiflexion of the ankle evoked by reflex hammer percussion of the tibialis anterior muscle before and under neuromuscular junction blockade with rocuronium bromide...
October 28, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29143098/cervicofacial-and-mediastinal-emphysema-after-balloon-eustachian-tuboplasty-bet-a-retrospective-multicenter-analysis
#2
Theodoros Skevas, Carsten V Dalchow, Sara Euteneuer, Holger Sudhoff, Götz Lehnerdt
PURPOSE: Balloon Eustachian tuboplasty (BET) is a new treatment modality addressing chronic obstructive dysfunction of the Eustachian tube (ET). So far, BET has been deemed a safe procedure under general anesthesia with only minor adverse effects. However, individual cases of postoperative emphysema have been reported. In the present retrospective multicenter analysis we determined the incidence rate of this potentially life threatening complication after BET. METHODS: In total we collected data from 3,670 BET procedures performed on 2,272 patients in four tertiary care ENT departments...
November 15, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29142855/single-port-thoracoscopic-treatment-of-thoracic-duct-injury-after-thyroidectomy-with-neck-dissection
#3
Serkan Teksoz, Ezel Ersen, Akif Enes Arikan, Sina Ferahman, Kamil Kaynak, Gianlorenzo Dionigi, Yusuf Bukey
Chylous leakage is a complication of thyroidectomy accompanied by bilateral neck dissection with incidence of 0.5-6.2%. A 51-year-old female patient underwent total thyroidectomy, bilateral and central neck dissection for papillary thyroid carcinoma. In post-operative 4(th) day, left sided chylous leakage was observed as 1,500 cc/day through neck drain. Leakage did not cease after 1-month conservative treatment so single port thoracoscopic intervention was performed. Under general anesthesia, patient was placed in left lateral decubitus position...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29141380/-the-analysis-of-anesthetic-management-for-renal-cell-carcinoma-with-associated-inferior-vena-cava-tumor-thrombus
#4
H Zeng, X Y Rong, Y Wang, X Y Guo
Objective: To explore the key points of anesthetic management for renal cell carcinoma combined with inferior vena cava (IVC) tumor thrombus. Methods: Twenty-seven cases of renal cell carcinoma with inferior vena cava (IVC) tumor thrombus underwent radical nephrectomy and inferior caval venous thrombectomy were reviewed retrospectively during January 2014 to January 2017 in our hospital.Analyzed data includs demographics, classification of tumor, perioperative anesthetic management and monitoring approaches, IVC clamping time , vital signs during cardiopulmonary bypass(CPB), estimated blood loss (EBL), usage of blood products, hospitalization time and ICU time , as well as postoperative outcomes...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29140902/endoscopic-carpal-tunnel-release-with-and-without-sedation
#5
Jacob E Tulipan, Nayoung Kim, Asif M Ilyas, Jonas L Matzon
BACKGROUND: This study evaluates outcomes and complications with endoscopic carpal tunnel release (eCTR) performed with local anesthesia (LOCAL) only versus local anesthesia with sedation (SEDATION). We hypothesize that patient outcomes and satisfaction will be equivalent in both groups irrespective of anesthesia type. METHODS: One hundred fifty-four consecutive patients undergoing eCTR with either LOCAL or SEDATION protocols were prospectively enrolled in a study of satisfaction and outcomes...
November 11, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29138544/early-postoperative-delirium-after-hemiarthroplasty-in-elderly-patients-aged-over-70-years-with-displaced-femoral-neck-fracture
#6
Yi-Hwa Choi, Dae-Hwan Kim, Tae-Young Kim, Tae-Wan Lim, Seok-Woo Kim, Je-Hyun Yoo
Purpose: Postoperative delirium is a risk factor for worse outcome after hip fracture surgery in elderly patients. Postoperative delirium is associated with anesthesia, postoperative pain, and patient factors. We investigated the incidence, predictors, and prognostic implications of post-operative delirium after hemiarthroplasty (HA) in elderly patients with femoral neck fracture. Patients and methods: A total of 356 consecutive patients aged >70 years who underwent HA for femoral neck fracture were enrolled...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29138380/-three-patients-with-gastric-cancer-who-underwent-surgery-during-ramucirumab-treatment
#7
Hayato Omori, Sadayuki Kawai, Rie Makuuchi, Tomoyuki Irino, Masanori Tokunaga, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura, Hirofumi Yasui, Masanori Terashima
According to the REGARD and RAINBOW trials, ramucirumab(RAM)was introduced as second-line therapy for advanced or metastatic gastric cancer. RAM may impair wound healing due to the inhibition of angiogenesis; details on the postoperative course of patients who underwent surgery during RAM treatment remain unclear. Between 2011 and 2016, 93 patients with incurable gastric cancer were treated with RAM in our institute. Among them, 3 patients underwent surgery after RAM treatment. Case 1: A 74-year-old man with liver metastasis from gastric cancer was treated with a paclitaxel(PTX)plus RAM regimen...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29138109/mesopontine-neurons-implicated-in-anesthetic-loss-of-consciousness-have-either-ascending-or-descending-axonal-projections-but-not-both
#8
Adi Miriam Goldenberg, Anne Minert, Yelena Fishman, Gilly Wolf, Marshall Devor
The MPTA (mesopontine tegmental anesthesia area) is a key node in a network of axonal pathways that collectively engage the key components of general anesthesia: immobility and atonia, analgesia, amnesia and loss-of-consciousness. In this study we have applied double retrograde tracing to analyze MPTA connectivity, with a focus on axon collateralization. Prior tracer studies have shown that collectively, MPTA neurons send descending projections to spinal and medullary brain targets associated with atonia and analgesia as well as ascending projections to forebrain structures associated with amnesia and arousal...
November 11, 2017: Neuroscience
https://www.readbyqxmd.com/read/29137628/hypertonic-saline-for-prevention-of-delirium-in-geriatric-patients-who-underwent-hip-surgery
#9
Xi Xin, Fei Xin, Xuguang Chen, Qi Zhang, Yanan Li, Shuping Huo, Chongfu Chang, Qiujun Wang
BACKGROUND: Postoperative delirium (POD) is a common disorder in the elderly patients, and neuroinflammation is the possible underlying mechanism. This study is designed to determine whether or not hypertonic saline (HS) pre-injection can alleviate POD in aged patients. METHODS: This prospective study recruited 120 geriatric patients who underwent hip surgery. The patients were randomly divided into two groups: control group (NS group) and HS group. Patients in the NS group were pre-injected with 4 mL/kg isotonic saline, and those in the HS group were pre-injected with 4 mL/kg 7...
November 14, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29137091/the-effects-of-hypervolemic-infusion-on-microcirculation-perfusion-of-patients-during-laparoscopic-colorectal-surgery
#10
Yunxin Deng, Qianlin Zhu, Buwei Yu, Minhua Zheng, Jue Jin
The aim of this study is to assess the effects of hypervolemic infusion with different solutions on microcirculation perfusion during laparoscopic colorectal surgery.Thirty-six patients were randomly divided into Ringer lactate solution [RL] group, succinylated gelatin injection [Gel] group, and hypertonic saline hydroxyethyl starch 40 injection [HS] group. Hypervolemic infusion was performed during the induction period of general anesthesia. Arterial blood-gas parameters, noninvasive hemodynamics, gastric tonometry values, and central venous pressure (CVP) were compared at baseline (T1); the end of hypervolemic infusion (T2); 5 min (T3), 15 min (T4), 30 min (T5), and 60 min (T6) during pneumoperitoneum; 5 min (T7), 15 min (T8), and 25 min (T9) after pneumoperitoneum...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137067/harlequin-syndrome-and-horner-syndrome-after-neck-schwannoma-excision-in-a-pediatric-patient-a-case-report
#11
Dong Hoon Lee, Jong Yuap Seong, Tae Mi Yoon, Joon Kyoo Lee, Sang Chul Lim
RATIONALE: Harlequin syndrome is an extremely rare benign condition characterized by unilateral facial flushing and sweating. PATIENT CONCERN: An 11-year-old boy presented with complaint of a right neck mass of 1-month duration. DIAGNOSIS: The preoperative diagnosis was neurogenic tumor of vagus nerve or sympathetic nerve. INTERVENTIONS: We performed right neck mass removal under general anesthesia. OUTCOMES: We report a case of harlequin syndrome associated with Horner syndrome in an 11-year boy who underwent excision of right neck schwannoma...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137052/arytenoid-cartilage-dislocation-mimicking-bilateral-vocal-cord-paralysis-a-case-report
#12
Eun H Chun, Hee J Baik, Rack K Chung, Hun J Lee, Kwangseob Shin, Jae H Woo
RATIONALE: Arytenoid dislocation is very rare and may be misdiagnosed as vocal cord paralysis or a self-limiting sore throat. PATIENT CONCERNS: A 70-year-old male (70 kg, 156 cm) was scheduled for transurethral resection of bladder tumors. A McGrath videolaryngoscope, with a basic cuffed Mallinckrodt oral tracheal tube of 7.5 mm internal diameter, was used to successfully intubate his trachea. The duration of surgery was 25 minutes. In the recovery room, he complained of sore throat and dyspnea with inspiratory stridor, which were not resolved after intravenous injection of 10 mg of dexamethasone...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137028/role-of-positioning-posterior-cord-on-coracoid-approach-brachial-plexus-block-guided-by-nerve-stimulator-compared-with-guided-by-ultrasound
#13
Wensheng He, Zhuo Liu, Zhenyu Wu, Wenchao Liu, Haijun Sun, Xiaochun Yang
BACKGROUND: Coracoid approach is efficient and safe for brachial plexus block, and is guided by nerve stimulator or ultrasound in general. Many trials have proved that ultrasonic guidance was more efficacious than nerve stimulator guidance. We hypothesized that positioning posterior cord could enhance the anesthesia effect of coracoid approach brachial plexus block (CABPB) guided by nerve stimulator. METHODS: Eighty patients were randomized into 2 groups to receive CABPB with positioning posterior cord guided by nerve stimulator (group A) or CABPB guided by ultrasound (group B)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136523/the-advantages-of-hypnosis-intervention-on-breast-cancer-surgery-and-adjuvant-therapy
#14
M Berlière, F Roelants, C Watremez, M A Docquier, N Piette, S Lamerant, V Megevand, A Van Maanen, P Piette, A Gerday, F P Duhoux
BACKGROUND: In oncology, hypnosis has been used for pain relief in metastatic patients but rarely for induction of anesthesia. MATERIAL AND METHOD: Between January 2010 and October 2015, 300 patients from our Breast Clinic (Cliniques universitaires Saint-Luc, Université catholique de Louvain) were included in an observational, non-randomized study approved by our local ethics committee (ClinicalTrials.gov - NCT03003611). The hypothesis of our study was that hypnosis intervention could decrease side effects of breast surgery...
November 11, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/29135596/general-anesthetics-to-treat-major-depressive-disorder-clinical-relevance-and-underlying-mechanisms
#15
Laszlo Vutskits
Major depressive disorder is a frequent and devastating psychological condition with tremendous public health impact. The underlying pathophysiological mechanisms involve abnormal neurotransmission and a relatedly impaired synaptic plasticity. Since general anesthetics are potent modulators of neuronal activity and, thereby, can exert long-term context-dependent impact on neural networks, an intriguing hypothesis is that these drugs could enhance impaired neural plasticity associated with certain psychiatric diseases...
November 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29135589/safety-and-effectiveness-of-a-novel-facemask-for-positive-pressure-ventilation
#16
Tod A Brown, Tamas A Szabo, Kathryn H Bridges, Michel J Sabbagh, William R Hand, Bethany J Wolf, Robert D Warters
BACKGROUND: Manual positive pressure ventilation is an essential skill in a variety of clinical situations. The C&E technique is commonly used with standard facemasks to provide effective ventilation. The Tao mask is a novel design that allows a more ergonomic grip. A seal between the mask and face is made with downward pressure of the palm, centered on the mask, and jaw lift is achieved with 4 fingers centered under the mandible. The purpose of this study was to evaluate the safety and effectiveness of the Tao mask compared to a standard mask before and after the administration of neuromuscular blockade (NMB) using 2 previously established ventilation scales...
November 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29135526/case-report-of-an-awake-craniotomy-in-a-patient-with-eisenmenger-syndrome
#17
Boris D Heifets, Erin Crawford, Ethan Jackson, Jessica Brodt, Richard A Jaffe, Mark A Burbridge
We present a detailed report of an awake craniotomy for recurrent third ventricular colloid cyst in a patient with severe pulmonary arterial hypertension in the setting of Eisenmenger syndrome, performed 6 weeks after we managed the same patient for a more conservative procedure. This patient has a high risk of perioperative mortality and may be particularly susceptible to perioperative hemodynamic changes or fluid shifts. The risks of general anesthesia induction and emergence must be balanced against the risks inherent in an awake craniotomy on a per case basis...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29134423/perioperative-respiratory-complications-current-evidence-and-strategy-discussed-in-2017-ja-symposium
#18
K Hirota, M Yamakage, S Hashimoto, T Asai, S Isono
Respiratory management during general anesthesia aims to safely secure the airway and maintain adequate ventilation to deliver oxygen to the vital organs, maintaining homeostasis even during surgery. Despite its clinical importance, anesthesiologists often encounter difficulties in properly managing respiration during the perioperative period, leading to severe respiratory complications. In this year's JA symposium, 5 editorial board members of Journal of Anesthesia (JA) who are experts in the field of respiratory management in anesthesia discussed the following topics: quitting smoking before surgery: exposure to passive smoke is damaging to children, ventilator-associated pneumonia, high inspiratory oxygen concentration and lung injury, aspiration pneumonia, and postoperative respiratory management strategy in patients with obstructive sleep apnea...
November 13, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29133966/effect-of-low-level-laser-therapy-on-fracture-healing-in-rabbits
#19
Fahimeh Kamali Sarvestani, Nasrin Salehi Dehno, Seifollah Dehghani Nazhvani, Mohammad Hadi Bagheri, Soheila Abbasi, Yasaman Khademolhosseini, Elham Gorji
Background and aims: The purpose of this study was to investigate the effect of low-level laser therapy (LLLT) on radial bone fracture gap healing in a rabbit model. Materials Subjects and Methods: Thirty male white New Zealand rabbits under general anesthesia had a 3mm slice of radial bone surgically removed. Fifteen rabbits were treated by 830 nm laser at 4 J/cm(2) and 15 were used as non-treated controls. Callus development was assessed by X-ray and radiographs every 7 days for 3 weeks...
September 30, 2017: Laser Therapy
https://www.readbyqxmd.com/read/29133659/congenital-capillary-hemangioma-arising-from-palpebral-conjunctiva-of-a-neonate
#20
S Padmanaban, P Sumathi, Prayagi Kandoth, R P Dharmendra
Capillary hemangioma is the most common benign vascular eyelid tumor in childhood. The periocular lesion appears within the first few weeks after birth and usually has superficial or deep components. Primary conjunctival capillary hemangiomas are rarely reported. We present the case of a 2-day-old child with a pedunculated capillary hemangioma arising from superior palpebral conjunctiva. A complete surgical excision was performed under general anesthesia, and the child was asymptomatic at follow-up of two months...
November 2017: Indian Journal of Ophthalmology
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