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https://www.readbyqxmd.com/read/29786598/-hypertrophic-cardiomyopathy-an-intraoperative-death-case-analysis-and-substantiation-of-the-standards-of-perioperative-anesthetic-management-in-a-non-cardiosurgery-clinic
#1
Roman N Fedosiuk, Liliia O Shchupachynska
The article is based on the case analysis of a sudden and unexpected intraoperative death of a 51-year-old female patient with hypertrophic cardiomyopathy, who was undergoing a non-cardiac operation in a non-cardiosurgery clinic, from acute precipitation of left ventricular outflow tract obstruction provoked by surgery and anesthesia. It emphasizes the importance of raising non-cardiac anesthesiologists' awareness of the issue and having clear standards of pre-operative evaluation and perioperative management of patients with hypertrophic cardiomyopathy in order to avoid fatal medical errors...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29785552/suppression-of-pupillary-unrest-by-general-anesthesia-and-propofol-sedation
#2
Matthias Behrends, Merlin D Larson, Andrew E Neice, Michael P Bokoch
The pupil undergoes irregular oscillations when exposed to light. These oscillations, known as pupillary unrest in ambient light, originate from oscillatory activity within the Edinger-Westphal nucleus in the midbrain. The midbrain and upper pons also contain nuclei known to be very sensitive to the effects of anesthetics that play a central role in maintaining wakefulness. We hypothesized that anesthetics may display similar effects on wakefulness and pupillary unrest. Repeat measurements of pupillary unrest using infrared pupillometry were performed in 16 patients undergoing general anesthesia and 8 patients undergoing propofol sedation...
May 21, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29784681/use-of-intracardiac-echocardiography-in-interventional-cardiology-working-with-the-anatomy-rather-than-fighting-it
#3
REVIEW
Andres Enriquez, Luis C Saenz, Raphael Rosso, Frank E Silvestry, David Callans, Francis E Marchlinski, Fermin Garcia
The indications for catheter-based structural and electrophysiological procedures have recently expanded to more complex scenarios, in which an accurate definition of the variable individual cardiac anatomy is key to obtain optimal results. Intracardiac echocardiography (ICE) is a unique imaging modality able to provide high-resolution real-time visualization of cardiac structures, continuous monitoring of catheter location within the heart, and early recognition of procedural complications, such as pericardial effusion or thrombus formation...
May 22, 2018: Circulation
https://www.readbyqxmd.com/read/29784549/cost-implications-of-varying-the-surgical-technique-surgical-setting-and-anesthesia-type-for-carpal-tunnel-release-surgery
#4
Nikolas H Kazmers, Angela P Presson, Yizhe Xu, Abby Howenstein, Andrew R Tyser
PURPOSE: Carpal tunnel release (CTR) is a common surgical procedure, representing a financial burden to the health care system. The purpose of this study was to test whether the choice of CTR technique (open carpal tunnel release [OCTR] vs endoscopic carpal tunnel release [ECTR]), surgical setting (operating room vs procedure room [PR]), and anesthetic type (local, monitored anesthesia care [MAC], Bier block, general) affected costs or payments. METHODS: Consecutive adult patients undergoing isolated unilateral CTR between July 2014, and October 2017, at a single academic medical center were identified...
May 18, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29784260/severe-obesity-and-sleep-disordered-breathing-as-risk-factors-for-emergence-agitation-in-pediatric-ambulatory-surgery
#5
Timothy Reynolds, Sumanna Sankaran, Wilson T Chimbira, Thuy Phan, Olubukola O Nafiu
PURPOSE: Sleep-disordered breathing (SDB) may be a critical risk factor for emergence agitation (EA). We hypothesized that SDB diagnosis is a predictor of EA in children after general anesthesia for ambulatory surgery. DESIGN: Prospective, observational, cohort study. METHODS: Children aged 4 to 17 years were assessed for the occurrence of EA. Differences in probability of EA were assessed using multivariable logistic regression analyses...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29784079/analgesic-efficacy-and-safety-of-hydromorphone-in-chinchillas-chinchilla-lanigera
#6
Emily A Evenson, Christoph Mans
Limited information is available regarding the efficacy of opioid analgesics in chinchillas. Here we sought to evaluate the analgesic efficacy and safety of hydromorphone in chinchillas. In a randomized, controlled, blind, complete crossover design, hydromorphone was administered at 0.5, 1, and 2 mg/kg SC to 16 chinchillas. Analgesic efficacy was determined by measuring hindlimb withdrawal latencies after a thermal noxious stimulus (Hargreaves method) at 0, 1, 2, 4, and 8 h after drug administration. Changes in daily food intake and fecal output after hydromorphone administration were recorded...
May 1, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/29784077/effects-of-ketamine-compared-with-urethane-anesthesia-on-vestibular-sensory-evoked-potentials-and-systemic-physiology-in-mice
#7
Choongheon Lee, Timothy A Jones
The injectable anesthetic mixture ketamine-xylazine is commonly used for electrophysiologic experiments in laboratory animals, especially rodents. General anesthesia can induce significant changes in systemic physiology, including those that compromise neural function, thus introducing research confounds. The extent of such concerns varies by agent. Here in mice, we compared the effects of ketamine-xylazine and urethane-xylazine anesthesia on systemic physiologic parameters and the vestibular sensory evoked potential (VsEP), a tool used commonly to assess peripheral vestibular function...
May 1, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/29783683/estimating-respiratory-rate-in-post-anesthesia-care-unit-patients-using-infrared-thermography-an-observational-study
#8
Nadine Hochhausen, Carina Barbosa Pereira, Steffen Leonhardt, Rolf Rossaint, Michael Czaplik
The post-anesthesia care unit (PACU) is the central hub for recovery after surgery, especially when the surgery is performed under general anesthesia. Aside from clinical aspects, respiratory impairment is one of the major causes of morbidity and affected recovery in the PACU and should therefore be monitored. In previous studies, infrared thermography was applied to assess the breathing rate (BR) of healthy volunteers. Here, the transferability of published methods for postoperative patients in the PACU was examined...
May 18, 2018: Sensors
https://www.readbyqxmd.com/read/29783029/comparison-of-stanford-b-aortic-dissection-patients-who-received-tevar-combined-with-or-without-sleep-apnea-syndrome
#9
Xin Li, Wenwu Cai, Ping Zhang, Kun Fang, Jieting Zhu, Chang Shu
BACKGROUND: Patients with Stanford B aortic dissection usually complicated with sleep apnea syndrome. This condition always threatens the patients' respiration situation. In this study, we collected and analysis data of patients' peri-operative managements of Thoracic Endovascular Aortic Repair (TEVAR) for Stanford B Aortic Dissection (AD) complicated with Sleep Apnea Syndrome (SAS). Comparison has been made between these SAS patients and those who without SAS. METHODS: Between June 2013 and June 2014, the clinical data and outcomes of the Stanford B AD patients in the department of vascular surgery in the Second Xiangya Hospital were retrospectively reviewed and studied...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29781369/contralateral-extensive-cerebral-hemorrhagic-venous-infarction-caused-by-retrograde-venous-reflux-into-the-opposite-basal-vein-of-rosenthal-in-posttraumatic-carotid-cavernous-fistula-a-case-report-and-literature-review
#10
Prasert Iampreechakul, Adisak Tanpun, Punjama Lertbusayanukul, Somkiet Siriwimonmas
We describe a patient with traumatic carotid-cavernous fistula (CCF), subsequently developing contralateral extensive hemorrhagic venous infarction from retrograde venous reflux into the opposite basal vein of Rosenthal. A 54-year-old woman was involved in a motor vehicle accident and sustained severe traumatic brain injury. Two months later, she developed bilateral proptosis and audible bruit. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) of the brain demonstrated the right direct CCF...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29780956/bilateral-corneal-denting-after-surgery-under-general-anesthesia-a-case-report
#11
Satsuki Obata, Akiko Miki, Hisanori Imai, Makoto Nakamura
Purpose: To report a case of temporary bilateral corneal denting in a patient who underwent cardiovascular surgery under general anesthesia. Observations: A 71-year-old male with no history of ophthalmological disease experienced bilateral corneal denting immediately after undergoing surgery for aneurysm of the thoracic aorta under general anesthesia. Anesthesia was induced with propofol and maintained with rocuronium bromide and remifentanil hydrochloride. The initial examination revealed significant denting on the surface of both the corneas and ocular hypotension...
June 2018: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29780914/rescue-technique-for-complete-removal-of-an-accidentally-ruptured-orbital-dumbbell-deep-dermoid-cyst-a-case-report
#12
Pei-Hsuan Lin, Yoshiyuki Kitaguchi, Jacqueline Mupas-Uy, Yasuhiro Takahashi, Hirohiko Kakizaki
Purpose: To report a rescue technique for complete removal of an accidentally ruptured orbital dumbbell deep dermoid cyst. Observations: A 33-year-old female presented with left proptosis with retrobulbar discomfort for 3 months. Computed tomography images showed an orbital dumbbell deep dermoid cyst. A lateral orbitotomy was performed under general anesthesia. The cyst was ruptured during osteotomy of the lateral orbital rim. The cyst was opened vertically from the ruptured site using a Stephen's tenotomy scissors to visually confirm the internal wall of the cyst and to keep the epithelial lining intact while separating the external wall of the cyst from the bone...
June 2018: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29780440/an-algorithmic-approach-to-the-management-of-infantile-digital-fibromatosis-review-of-literature-and-a-case-report
#13
Elizabeth H Eypper, Johnson C Lee, Ashley J Tarasen, Maxene H Weinberg, Oluwaseun A Adetayo
Objective: Infantile digital fibromatosis is a rare benign childhood tumor, infrequently cited in the literature. Hallmarks include nodular growths exclusive to fingers and toes and the presence of eosinophilic cytoplasmic inclusions on histology. This article aims to exemplify diagnoses of infantile digital fibromatosis and possible treatment options. Methods: A computerized English literature search was performed in the PubMed/MEDLINE database using MeSH headings "infantile," "juvenile," "digital," and "fibromatosis...
2018: Eplasty
https://www.readbyqxmd.com/read/29780141/hemorrhagic-stress-induced-gastric-ulcer-in-a-healthy-toddler
#14
Katsunori Matsueda, Tatsuya Toyokawa, Masahiro Sakata, Isao Fujita, Jouichiro Horii, Yoshiko Abe, Toru Araki
A 1-year-old female toddler who was under a great amount of psychological stress presented with acute hematemesis. She had no significant medical history; she displayed lethargy and was anemic. Although blood transfusion and famotidine were administered for upper gastrointestinal bleeding (UGIB), the anemia did not improve. Thus, early endoscopy was performed under general anesthesia, revealing a gastric ulcer with exposed vessels in the supra-angular region. Cauterization via bipolar hemostatic forceps was performed on the exposed vessels, and the bleeding was controlled successfully...
May 18, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29779305/-expert-consensus-on-standardized-processes-of-ambulatory-biliary-surgery-2018-edition
#15
(no author information available yet)
The definition of ambulatory surgery is that the patient is admitted, operated and discharged within a day (24 hours) , but does not include outpatient surgery. It can shorten the average hospital stay, reduce medical expenses, accelerate the recovery of patients, and has been approved to have great social and economic benefits.The main contents of this consensus include: (1)the establishment of ambulatory biliary surgery system, which involves the facilities building, team building, the construction of management systems, operation management, operation state analysis and benefit evaluation; (2)Patient selection criteria, pre-hospital assessment, surgical scheduling, preoperative education, anesthesia and management of adverse reactions after anesthesia, intraoperative application of general surgical principles and postoperative emergency plans, perioperative nursing; (3)Discharge criteria and pre-discharge assessment, post-discharge follow-up and rehabilitation guidance; (4) quality and safety control index system of ambulatory biliary surgery...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29779036/development-of-a-hemodynamic-model-using-routine-monitoring-parameters-for-nociceptive-responses-evaluation-during-surgery-under-general-anesthesia
#16
Munetaka Hirose, Yoshiko Kobayashi, Shiro Nakamoto, Ryusuke Ueki, Nobutaka Kariya, Tsuneo Tatara
BACKGROUND Routine hemodynamic monitoring parameters under general anesthesia, such as heart rate (HR), systolic blood pressure (SBP), and perfusion index (PI), do not solely reflect intraoperative nociceptive levels. We developed a hemodynamic model combining these 3 parameters for nociceptive responses during general anesthesia, and evaluated nociceptive responses to surgical skin incision. MATERIAL AND METHODS We first retrospectively performed discriminant analysis using 3 values - HR, SBP, and PI - to assess response to skin incision during tympanoplasty, laparoscopic cholecystectomy, and open gastrectomy to determine if combined use of these parameters differentiates nociceptive levels among these 3 surgeries...
May 20, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29778972/hypnotic-agents-for-induction-of-general-anesthesia-in-cesarean-section-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#17
Kavita Houthoff Khemlani, Stephanie Weibel, Peter Kranke, Jan-Uwe Schreiber
STUDY OBJECTIVE: An ideal induction drug for cesarean section (CS) must have quick action, with minimum side effects such as awareness, hemodynamic compromise, and neonatal depression. Thiopentone is frequently used; however, no reliable evidence is available to support its use as a dedicated hypnotic agent in this setting. DESIGN: A systematic review and meta-analysis, using PRISMA methodology, of randomized controlled trials (RCTs), comparing women undergoing CS using thiopentone with those undergoing CS with propofol, ketamine, or benzodiazepines as hypnotic agents...
May 17, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29778971/infraclavicular-and-supraclavicular-approaches-to-brachial-plexus-for-ambulatory-elbow-surgery-a-randomized-controlled-observer-blinded-trial
#18
Shalini Dhir, Brigid Brown, Peter Mack, Yves Bureau, Janice Yu, Douglas Ross
STUDY OBJECTIVE: To compare the effectiveness of supraclavicular and infraclavicular approaches to brachial plexus block for elbow surgery. DESIGN: Prospective, parallel arm, observer-blinded, randomized controlled trial. SETTING: This study occurred in a designated block room at St. Joseph's hospital, a large academic tertiary hospital in London, Canada. PATIENTS: 150 adult ASA class I-III patients undergoing elective ambulatory elbow surgery...
May 17, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29777144/benefits-in-radical-mastectomy-protocol-a-randomized-trial-evaluating-the-use-of-regional-anesthesia
#19
Marcio Matsumoto, Eva M Flores, Pedro P Kimachi, Flavia V Gouveia, Mayra A Kuroki, Alfredo C S D Barros, Marcelo M C Sampaio, Felipe E M Andrade, João Valverde, Eduardo F Abrantes, Claudia M Simões, Rosana L Pagano, Raquel C R Martinez
Surgery is the first-line treatment for early, localized, or operable breast cancer. Regional anesthesia during mastectomy may offer the prevention of postoperative pain. One potential protocol is the combination of serratus anterior plane block (SAM block) with pectoral nerve block I (PECS I), but the results and potential benefits are limited. Our study compared general anesthesia with or without SAM block + PECS I during radical mastectomy with axillary node dissection and breast reconstruction using evaluations of pain, opioid consumption, side effects and serum levels of interleukin (IL)-1beta, IL-6 and IL-10...
May 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29776668/-fatal-cardiac-tamponade-that-developed-in-the-post-anesthesia-care-unit-a-rare-complication-after-lung-lobectomy
#20
Hyung Mook Lee, Young Jae Jeon, Hye Won Chung, Hyo Min Yun, Mi Hyun Kim
BACKGROUND AND OBJECTIVES: Cardiac tamponade is potentially fatal medical condition, which rarely occurs as a complication of lung lobectomy. We present the first case of cardiac tamponade to develop in a Post-Anesthesia Care Unit following a lung lobectomy. CASE REPORT: A 54-year-old man with pulmonary squamous cell carcinoma underwent an apparently uncomplicated lung lobectomy. His hemodynamics was unremarkable throughout the surgery and initially in the Post-Anesthesia Care Unit...
May 15, 2018: Revista Brasileira de Anestesiologia
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