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https://www.readbyqxmd.com/read/28743152/-prevention-of-perioperative-hypothermia-guidelines-for-daily-clinical-practice
#1
Timo Iden, Jan Höcker
Inadvertent perioperative hypothermia (body core temperature < 36 °C) is a serious complication leading to increased rates of wound infection, higher blood loss associated with increased transfusion requirements as well as patient dissatisfaction among others. Body core temperature is a vital parameter and needs constant monitoring just like heart rate, blood pressure and arterial oxygen saturation. Patient-, anesthesia-, surgery- and environment-related risk factors were identified for occurring perioperative hypothermia...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28743122/utility-of-transbronchial-lung-cryobiopsy-in-non-interstitial-diseases
#2
Olivia Sánchez-Cabral, Dina Martínez-Mendoza, Sebastián Fernandez-Bussy, Berenice López-González, Carolina Perea-Talamantes, Rosa María Rivera-Rosales, César Luna-Rivero, José Arturo Martínez-Orozco, Luis Felipe Flores-Suárez, Patricio Santillán-Doherty, Gustavo Reyes-Terán
BACKGROUND: Transbronchial lung cryobiopsy (TLCB), performed with a flexible cryoprobe, is an interventional pulmonology procedure that has proved its diagnostic value for interstitial pulmonary disease. However, it has not been explored extensively as a diagnostic tool for patients with non-interstitial lung pathology, including infectious and malignant diseases. OBJECTIVE: To evaluate the diagnostic yield and safety of an interventional pulmonology approach that integrates TLCB and bronchoalveolar lavage (BAL) for the diagnosis of non-interstitial pulmonary disease...
July 26, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28742774/improving-adherence-to-intraoperative-lung-protective-ventilation-strategies-at-a-university-medical-center
#3
Sean A Josephs, Gretchen A Lemmink, Judith A Strong, Cassandra L Barry, William E Hurford
BACKGROUND: Intraoperative lung-protective ventilation (ILPV) is defined as tidal volumes <8 mL/kg ideal bodyweight and is increasingly a standard of care for major abdominal surgical procedures performed under general anesthesia. In this study, we report the result of a quality improvement initiative targeted at improving adherence to ILPV guidelines in a large academic teaching hospital. METHODS: We performed a time-series study to determine whether anesthesia provider adherence to ILPV was affected by certain improvement interventions and patient ideal body weight (IBW)...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742771/perioperative-amino-acid-infusion-for-preventing-hypothermia-and-improving-clinical-outcomes-during-surgery-under-general-anesthesia-a-systematic-review-and-meta-analysis
#4
Yoshitaka Aoki, Yukie Aoshima, Kazuyuki Atsumi, Ryo Kaminaka, Rintaro Nakau, Kyoko Yanagita, Makiko Kora, Shunsuke Fujii, Junichiro Yokoyama
Amino acid (AA) infusion is sometimes selected to avoid hypothermia during general anesthesia. However, the widespread clinical use of AA infusion therapy has not been established. This study aimed to clarify the evidence that AA infusion can increase patient body temperature and improve clinical outcomes using the Grading of Recommendations Assessment, Development, and Evaluation system. We searched MEDLINE (PubMed), Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi (Japana Centra Revuo Medicina) in November 2015...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742192/significance-of-interleukin-and-matrix-metalloproteinase-in-patients-with-cognitive-dysfunction-after-single-valve-replacement
#5
H-Y Guo
OBJECTIVE: To investigate the changes in serum neurological function parameters, interleukin (IL) and matrix metalloproteinase (MMP) in patients with cognitive dysfunction after single valve replacement. PATIENTS AND METHODS: 51 cases of senile patients with cognitive dysfunction after general anesthesia were selected as the observation group, and 51 senile patients without cognitive dysfunction after general anesthesia were selected as the control group. Serum neurological function parameters and IL and MMP levels were examined and compared between the two groups...
July 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28741408/appropriateness-of-tympanostomy-tubes-in-the-boston-metropolitan-area-are-the-aao-hnsf-guidelines-being-met
#6
Amy L Hughes, David Roberson, Cassandra Bannos, Emily K Trudell, Louis Vernacchio
Introduction Otitis media (OM) is the most common reason children receive general anesthesia, with bilateral tympanostomy tube (TT) insertion the second most common surgery in children. Prior research suggests overuse of TT. As part of a project designed to improve appropriateness of OM referrals, we evaluated appropriateness of TT insertion in a patient cohort. Methods Patients younger than 9 years with initial otolaryngology (ORL) visits in academic and private office settings for OM from January 1, 2012, to August 31, 2013, were identified through claims database...
July 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28740418/comparison-of-patient-controlled-intravenous-analgesia-with-sufentanil-versus-tramadol-in-post-cesarean-section-pain-management-and-lactation-after-general-anesthesia-a-prospective-randomized-double-blind-controlled-study
#7
Xiaohui Chi, Man Li, Wei Mei, Mingfeng Liao
INTRODUCTION: Acute pain is a common complication following cesarean section under general anesthesia. Post-cesarean section pain management is important for both the mother and the newborn. This study compared the effects of patient-controlled intravenous analgesia (PCIA) using sufentanil or tramadol on postoperative pain control and initiation time of lactation in patients who underwent cesarean section under general anesthesia. METHODS: Primiparas (n=146) scheduled for cesarean section under general anesthesia were randomized to receive PCIA with sufentanil or tramadol...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28740417/efficacy-and-safety-of-0-75-ropivacaine-instillation-into-subinguinal-wound-in-patients-after-bilateral-microsurgical-varicocelectomy-a-bi-center-randomized-double-blind-placebo-controlled-trial
#8
Wan Shou Cui, Yu Seob Shin, Jae Hyung You, A Ram Doo, Kiran Kumar Soni, Jong Kwan Park
OBJECTIVE: To evaluate the efficacy and safety of 0.75% ropivacaine instillation into inguinal wound in patients who have undergone bilateral microsurgical varicocelectomy. PATIENTS AND METHODS: Eighty-five men who were screened for bilateral varicoceles from March 2015 to July 2016 were randomized for the treatment. All patients underwent inguinal varicocelectomy by general anesthesia. After ligation of the internal spermatic veins from the spermatic cord, additional delivery of testis through inguinal incision site was done to ligate external spermatic veins and gubernacular veins...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28739730/comparison-of-different-muscle-relaxant-anesthetics-on-growth-migration-and-invasion-of-gastric-cancer-cells
#9
Aihua Jiang, Huishan Zhao, Xiaofei Liu, Mingwei Yu, Jian Chen, Wen G Jiang
BACKGROUND/AIM: Muscle relaxants, also known as neuromuscular blocking agents, can block nerve impulses to the muscles and are always used in surgery for general anesthesia. However, the effect of muscle-relaxant anesthetics on cell activity in gastric cancer is currently unknown. The present study aimed to examine and compare the role of three different muscle-relaxant anesthetics in gastric cancer cells. MATERIALS AND METHODS: Gastric cancer cells (SGC7901 and BGC 823) were treated with a different dose of muscle-relaxant anesthetics, Rocuronium bromide (Rb), Vecuronium bromide (Vb) and Cisatracurium Besilate (CB)...
August 2017: Anticancer Research
https://www.readbyqxmd.com/read/28739189/endoscopic-transcanal-myringoplasty-for-tympanic-perforations-an-outpatient-minimally-invasive-procedure
#10
Chih-Chieh Tseng, Ming-Tang Lai, Chia-Che Wu, Sheng-Po Yuan, Yi-Fang Ding
OBJECTIVE: Since the 1950s, microscopic myringoplasty has been the standard surgery for repairing a perforated tympanic membrane. In addition to conventional microscopic myringoplasty, endoscopic myringoplasty has been an emerging technique since the late 1990s. This study evaluated the efficacy of endoscopic transcanal myringoplasty for repairing tympanic perforations and examined the minimally invasive feature of this technique (no postauricular incision, no canalplasty). METHODS: We retrospectively reviewed the medical records of patients who underwent endoscopic transcanal myringoplasty for perforations of the tympanic membrane...
July 21, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28739068/management-of-emergence-delirium-in-adult-ptsd-patients-recommendations-for-practice
#11
Donnamarie Lovestrand, Steven Lovestrand, Denise M Beaumont, Jonathan G Yost
Emergence delirium is a known phenomenon which occurs after general anesthesia in approximately 5% of the general population. However, individuals who have been diagnosed with post-traumatic stress disorder may present with symptoms refractory to conventional methods of reorientation. In the past several years, literature has begun to address the problem, but no standardized guidelines exist at present. The authors synthesize the available literature, combining data with evidence-driven principles from multiple disciplines, to submit an initial set of guidelines until research either supports or disproves these recommendations...
August 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28739038/anesthetic-and-perioperative-management-of-patients-with-brugada-syndrome
#12
REVIEW
Gregory Dendramis, Claudia Paleologo, Giuseppe Sgarito, Umberto Giordano, Roberto Verlato, Adrian Baranchuk, Pedro Brugada
Brugada syndrome (BrS) is an arrhythmogenic disease reported to be one among the leading causes of cardiac death in subjects under the age of 40 years. In these patients, episodes of lethal arrhythmias may be induced by several factors or situations, and for this reason, management during anesthesia and surgery must provide some precautions and drugs restrictions. To date, it is difficult to formulate guidelines for anesthetic management of patients with BrS because of the absence of prospective studies, and there is not a definite recommendation for neither general nor regional anesthesia, and there are no large studies in merit...
June 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28738985/intraoperative-handoffs-among-anesthesia-providers-increase-the-incidence-of-documentation-errors-for-controlled-drugs
#13
Richard H Epstein, Franklin Dexter, David M Gratch, David A Lubarsky
BACKGROUND: When electronic anesthesia records are compared to pharmacy transactions, discrepancies in total doses of controlled drugs are commonly found (≈16% of cases), potentially affecting patient safety and placing hospitals at risk for regulatory action. Errors (≈5%) persisted even with near real-time drug reconciliation feedback to providers. A study was conducted to test the hypothesis of greater risks of discrepancy for longer-duration cases and for intraoperative handoff involving a permanent handoff of care...
August 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28738893/anaphylaxis-with-delayed-appearance-of-skin-manifestations-during-general-anesthesia-two-case-reports
#14
Hiroshi Hanamoto, Fumi Kozu, Aiko Oyamaguchi, Mika Inoue, Chizuko Yokoe, Hitoshi Niwa
BACKGROUND: Anaphylaxis is difficult to diagnose in the absence of skin or mucosal signs and symptoms. We report two cases of anaphylaxis under general anesthesia, in which the initial presentation was in the form of respiratory signs, followed by skin manifestations 10-15 min later. Diagnosis of anaphylaxis was delayed because skin symptoms were absent early on in the presentation. CASE PRESENTATION: In the first case, a 23-year-old male patient with jaw deformity was scheduled to undergo maxillary alveolar osteotomy...
July 24, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28738447/comparison-of-local-versus-general-anesthesia-in-patients-undergoing-transcatheter-aortic-valve-replacement-a-meta-analysis
#15
Pedro A Villablanca, Divyanshu Mohananey, Katarina Nikolic, Sripal Bangalore, David P Slovut, Verghese Mathew, Vinod H Thourani, Josep Rode's-Cabau, Iván J Núñez-Gil, Tina Shah, Tanush Gupta, David F Briceno, Mario J Garcia, Jacob T Gutsche, John G Augoustides, Harish Ramakrishna
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is typically performed under general anesthesia (GA). However, there is increasing data supporting the safety of performing TAVR under local anesthesia/conscious sedation (LA). We performed a meta-analysis to gain better understanding of the safety and efficacy of LA versus GA in patients with severe aortic stenosis undergoing TAVR. METHODS AND RESULTS: We comprehensively searched EMBASE, PubMed, and Web of Science...
July 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28735683/pain-management-in-penile-prosthetic-surgery-a-review-of-the-literature
#16
REVIEW
Lael Reinstatler, Kevin Shee, Martin S Gross
INTRODUCTION: The literature on perioperative pain control and management in inflatable penile prosthesis placement is not firmly established. Because inflatable penile prosthesis placement is an elective procedure, pain can be one of the many issues that influence patient decision making. Pain control also presents a unique challenge to providers in an era of widespread opiate abuse. AIM: To review published data on pain management before, during, and after penile prosthetic surgery...
July 20, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28735132/asleep-robot-assisted-surgery-for-the-implantation-of-subthalamic-electrodes-provides-the-same-clinical-improvement-and-therapeutic-window-as-awake-surgery
#17
Michel Lefranc, Yassine Zouitina, Mélissa Tir, Philippe Merle, Martial Ouendo, Jean-Marc Constans, Olivier Godefroy, Johann Peltier, Pierre Krystkowiak
OBJECTIVE: To study the impact of not performing an awake clinical evaluation during the robot-assisted implantation subthalamic nucleus deep brain stimulation (STN-DBS) electrodes on the stimulation parameters and clinical outcome in patients with Parkinson's disease (PD). METHODS: A total of 23 PD patients underwent robot-assisted surgery for the bilateral implantation of STN-DBS electrodes. Thirteen patients received general anesthesia (GA) and a limited intraoperative evaluation (side effects only), whereas 10 received local anesthesia and a full evaluation...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28735131/mini-craniotomy-under-local-anesthesia-for-chronic-subdural-hematoma-an-effective-choice-for-elderly-and-for-patients-in-a-resource-strained-environment
#18
Shaikh Danish Mahmood, Muhammad Waqas, Mirza Z Baig, Aneela Darbar
BACKGROUND: Mini craniotomy for chronic subdural hematoma (CSDH) is associated with lower recurrence rates. However, the procedure is mostly performed under general anesthesia (GA) and therefore frequently requires intensive care unit (ICU) facility, especially in the elderly population. Due to unavailability of ICU beds, and to avoid GA, we started to perform this procedure under local anesthesia (LA). MATERIALS AND METHODS: This was a retrospective medical chart review conducted in the section of Neurosurgery at the Aga Khan Hospital in Karachi, Pakistan...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28734732/perinatal-and-neonatal-use-of-sedation-and-analgesia
#19
REVIEW
Christopher McPherson, Terrie Inder
Optimal obstetric and neonatal care requires the provision of adequate analgesia for painful procedures. However, anesthetic and analgesic agents have the potential to adversely impact the developing fetal/neonatal brain. In this setting, clinicians must assess the risks and benefits of pharmacologic anesthesia and analgesia for specific indications in this population. General anesthesia is required for non-obstetric surgery and cesarean section in the absence of neuraxial anesthesia for the health of the mother and fetus...
July 19, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28733939/comparison-of-endotracheal-tube-cuff-pressure-values-before-and-after-training-seminar
#20
Ayça Tuba Dumanlı Özcan, Cihan Döğer, Abdülkadir But, Işık Kutlu, Şemsi Mustafa Aksoy
It is recommended that endotracheal cuff (ETTc) pressure be between 20 and 30 cm H2O. In this present study, we intend to observe average cuff pressure values in our clinic and the change in these values after the training seminar. The cuff pressure values of 200 patients intubated following general anesthesia induction in the operating theatre were measured following intubation. One hundred patients whose values were measured before the training seminar held for all physician assistants, and 100 patients whose values were measured after the training seminar were regarded as Group 1 and Group 2, respectively...
July 22, 2017: Journal of Clinical Monitoring and Computing
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