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https://www.readbyqxmd.com/read/28217056/preprocedural-ultrasound-examination-versus-manual-palpation-for-thoracic-epidural-catheter-insertion
#1
Ahmed M Hasanin, Ali M Mokhtar, Shereen M Amin, Ahmed A Sayed
BACKGROUND AND AIMS: Ultrasound imaging before neuraxial blocks was reported to improve the ease of insertion and minimize the traumatic trials. However, the data about the use of ultrasound in thoracic epidural block are scanty. In this study, pre-insertion ultrasound scanning was compared to traditional manual palpation technique for insertion of the thoracic epidural catheter in abdominal operations. SUBJECTS AND METHODS: Forty-eight patients scheduled to midline laparotomy under combined general anesthesia with thoracic epidural analgesia were included in the study...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28203022/-clinical-evaluation-of-in-plane-ultrasound-guided-thoracic-paravertebral-block-using-laterally-intercostal-approach
#2
T Xu, M Li, Y Tian, J T Song, C Ni, X Y Guo
OBJECTIVE: To evaluate the feasibility and success rate of in-plane ultrasound-guided paravertebral block using laterally intercostal approach. METHODS: In the study, 27 patients undergoing elective thoracic surgery were selected to do paravertebral block preoperatively. The fifth intercostal space was scanned by ultrasound probe which was placed along the long axis of the rib and 8 cm lateral to the midline of the spine. The needle was advanced in increments aiming at the space between the internal and innermost intercostal muscles...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28177538/comparison-of-leak-pressures-for-single-layer-simple-continuous-suture-pattern-for-cystotomy-closure-using-barbed-and-monofilament-suture-material-in-an-ex-vivo-canine-model
#3
Nina R Kieves, Alexander I Krebs
OBJECTIVE: To compare leak pressures following simple continuous closure of cystotomy with barbed suture to an analogous monofilament suture, in an ex vivo canine model. STUDY DESIGN: Ex vivo, simple randomized study. ANIMALS OR SAMPLE POPULATION: Urinary bladders harvested from canine cadavers (n = 21). METHODS: Urinary bladders were harvested from cadavers immediately following euthanasia. A 3-cm cystotomy was made on ventral midline of the urinary bladder...
February 8, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28002229/evaluation-of-ultrasound-assisted-thoracic-epidural-placement-in-patients-undergoing-upper-abdominal-and-thoracic-surgery-a-randomized-double-blind-study
#4
David B Auyong, Lucy Hostetter, Stanley C Yuan, April E Slee, Neil A Hanson
BACKGROUND AND OBJECTIVES: The placement of thoracic epidurals can be technically challenging and requires a thorough understanding of neuraxial anatomy. Although ultrasound imaging of the thoracic spine has been described, no outcome studies on the use of this imaging have been performed. We evaluated whether preprocedural ultrasound of the thoracic spine would facilitate the process of epidural catheterization. METHODS: Subjects undergoing thoracic or upper abdominal surgery with planned thoracic epidural placement at T10 or higher were enrolled in this randomized double-blind study...
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27995220/standardized-4-step-technique-of-bladder-neck-dissection-during-robot-assisted-radical-prostatectomy
#5
REVIEW
Mansour Alnazari, Marc Zanaty, Emad Rajih, Assaad El-Hakim, Kevin C Zorn
Bladder neck (BN) dissection is considered one of the most challenging steps during robot-assisted radical prostatectomy. Better understanding of the BN anatomy, coupled with a standardized approach may facilitate dissection while minimizing complications. We describe in this article the 4 anatomic spaces during standardized BN dissection, as well other technical maneuvers of managing difficult scenarios including treatment of a large median lobe or patients with previous transurethral resection of the prostate...
December 2016: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/27956680/analgesic-efficacy-of-bilateral-continuous-transversus-abdominis-plane-blocks-using-an-oblique-subcostal-approach-in-patients-undergoing-laparotomy-for-gynaecological-cancer-a-prospective-randomized-triple-blind-placebo-controlled-study
#6
T Yoshida, K Furutani, Y Watanabe, N Ohashi, H Baba
BACKGROUND: The analgesic efficacy of continuous transversus abdominis plane (TAP) blocks in comparison with that of single-injection TAP blocks is not clear. This randomized, triple-blind, placebo-controlled trial investigated the benefits of adding continuous TAP blocks to single-injection TAP blocks after a laparotomy. METHODS: Eighty consecutive patients undergoing midline laparotomy for gynaecological cancer were randomized and received bilateral TAP infusions with either ropivacaine 0...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27908432/safety-and-utilization-of-peripherally-inserted-central-catheters-versus-midline-catheters-at-a-large-academic-medical-center
#7
Tianyuan Xu, Lawrence Kingsley, Susan DiNucci, Gwen Messer, Jong-Hyeon Jeong, Brian Morgan, Kathleen Shutt, Mohamed H Yassin
BACKGROUND: Peripherally inserted central catheters (PICCs) are a commonly used central intravenous (IV) access device, which can be associated with significant complications. Midline catheters (MCs) are peripheral IV access devices that may reduce the need for central lines and hence decrease central line-associated bloodstream infections. The objective of this study is to compare the utilization and safety of PICCs and MCs. METHODS: This was a retrospective study comparing the use and outcomes of PICCs and MCs at a large academic medical center between January and May 2015...
December 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27900221/grafted-tubularised-incised-plate-urethroplasty-an-objective-assessment-of-outcome-with-lessons-learnt-from-surgical-experience-with-263-cases
#8
Vipul Gupta, Sunil Kumar Yadav, Talal Alanzi, Islam Amer, Mohmmad Salah, Mamdouh Ahmed
OBJECTIVE: Snodgrass urethroplasty remains the preferred technique in primary distal hypospadias but development of meatal stenosis often limits distal extension of the midline incision of the urethral plate (MIUP), which remains a limiting factor in reconstructing an apical neomeatus (NM). We here-in assess the cosmetic and functional outcome with distal extension of the MIUP in grafted tubularised incised-plate urethroplasty (G-TIP) repair. PATIENTS AND METHODS: This prospective study included the surgical experience of 263 cases of primary hypospadias operated upon between 2012 and 2015...
December 2016: Arab Journal of Urology
https://www.readbyqxmd.com/read/27896665/ultrasound-guided-thoracic-paravertebral-block-by-the-paralaminar-in-plane-approach-using-a-microconvex-array-transducer-methodological-utility-based-on-anatomical-structures
#9
Yasuko Taketa, Taro Fujitani, Yumi Irisawa, Satoko Sudo, Kazushi Takaishi
OBJECTIVE: We evaluated the analgesic feasibility of paralaminar in-plane (PL) approach for ultrasound-guided thoracic paravertebral block (USG-TPVB). As the needle trajectory was expected to be closely affected by the distance from the skin to the lamina-transverse process junction (LTPJ), we examined the correlativity between them on computed tomography (CT) or ultrasonography. METHODS: Thirty-two patients undergoing thoracotomy were recruited. We measured the distances between the skin and LTPJ using preoperative CT (S-L) and procedural ultrasonography (US-L)...
November 28, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27829970/local-intrasinus-thrombolysis-for-cerebral-venous-sinus-thrombosis
#10
Lakshmi Sudha Prasanna Karanam, Sridhar Reddy Baddam, Vijaya Pamidimukkala, Ramatharaknath Vemuri, Sravanthi Byrapaneni, Raghavasarma Polavarapu
BACKGROUND: Cerebral venous strokes due to cerebral venous sinus thrombosis (CVST) have varied presentation and clinical outcome. Despite aggressive medical treatment with optimal anticoagulation, some patients develop progressive neurologic deterioration causing significant morbidity and mortality. The aim of the present series is to analyze the safety and efficacy of in situ thrombolysis in patients with cerebral venous sinus thrombosis in severe clinical grade and refractory to conventional medical management...
October 2016: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/27827796/effect-of-body-position-and-ventilation-on-umbilical-artery-and-venous-blood-flows-during-delayed-umbilical-cord-clamping-in-preterm-lambs
#11
Stuart B Hooper, Kelly J Crossley, Valerie A Zahra, Jeroen van Vonderen, Alison Moxham, Andrew W Gill, Martin Kluckow, Arjan B Te Pas, Euan M Wallace, Graeme R Polglase
OBJECTIVE: While delayed umbilical cord clamping (UCC) is thought to facilitate placental to infant blood transfusion, the physiological factors regulating flow in the umbilical arteries and veins during delayed UCC is unknown. We investigated the effects of gravity, by changing fetal height relative to the placenta, and ventilation on umbilical blood flows and the cardiovascular transition during delayed UCC at birth. METHODS: Catheters and flow probes were implanted into preterm lambs (128 days) prior to delivery to measure pulmonary, carotid, umbilical artery (UaBF) and umbilical venous (UvBF) blood flows...
November 8, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27813457/ventricular-catheter-entry-site-and-not-catheter-tip-location-predicts-shunt-survival-a-secondary-analysis-of-3-large-pediatric-hydrocephalus-studies
#12
MULTICENTER STUDY
William E Whitehead, Jay Riva-Cambrin, Abhaya V Kulkarni, John C Wellons, Curtis J Rozzelle, Mandeep S Tamber, David D Limbrick, Samuel R Browd, Robert P Naftel, Chevis N Shannon, Tamara D Simon, Richard Holubkov, Anna Illner, D Douglas Cochrane, James M Drake, Thomas G Luerssen, W Jerry Oakes, John R W Kestle
OBJECTIVE Accurate placement of ventricular catheters may result in prolonged shunt survival, but the best target for the hole-bearing segment of the catheter has not been rigorously defined. The goal of the study was to define a target within the ventricle with the lowest risk of shunt failure. METHODS Five catheter placement variables (ventricular catheter tip location, ventricular catheter tip environment, relationship to choroid plexus, catheter tip holes within ventricle, and crosses midline) were defined, assessed for interobserver agreement, and evaluated for their effect on shunt survival in univariate and multivariate analyses...
February 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27780607/ultrasound-guided-deep-arm-veins-insertion-of-long-peripheral-catheters-in-patients-with-difficult-venous-access-after-cardiac-surgery
#13
Adam Fabiani, Lorella Dreas, Gianfranco Sanson
OBJECTIVES: To analyze success rate, dwell-time, and complications of long peripheral venous catheters (L-PVCs) inserted under ultrasound guidance. BACKGROUND: In difficult venous access (DVA) patients, L-PVC can represent an alternative to central or midline catheters. METHODS: Prospective observational study. L-PVCs were positioned in DVA patients. The outcome of the cannulation procedure and the times and reasons for catheters removal were analyzed...
January 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/27716699/perioperative-management-of-patients-with-left-ventricular-assist-devices-undergoing-noncardiac-surgery
#14
Meredith Degnan, Jessica Brodt, Yiliam Rodriguez-Blanco
AIM: The aim of this study was to describe our institutional experience, primarily with general anesthesiologists consulting with cardiac anesthesiologists, caring for left ventricular assist device (LVAD) patients undergoing noncardiac surgery. MATERIALS AND METHODS: This is a retrospective review of the population of patients with LVADs at a single institution undergoing noncardiac procedures between 2009 and 2014. Demographic, perioperative, and procedural data collected included the type of procedure performed, anesthetic technique, vasopressor requirements, invasive monitors used, anesthesia provider type, blood product management, need for postoperative intubation, postoperative disposition and length of stay, and perioperative complications including mortality...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27638294/rectus-sheath-block-for-postoperative-analgesia-in-gynecological-oncology-surgery-resons-a-randomized-controlled-trial
#15
Sumitra G Bakshi, Amol Mapari, T S Shylasree
BACKGROUND: Opioid-sparing pain management is important for Enhanced Recovery After Surgery. Rectus sheath (RS) blocks are emerging as a promising modality for pain relief following midline laparotomy; however, there are limited prospective clinical trials testing their efficacy. The purpose of this randomized-controlled trial is to assess the morphine-sparing effect of local anesthetic (LA) boluses through RS catheters following elective gynecological oncology surgery. METHOD: After patients' informed consent, bilateral RS catheters were placed intraoperatively in 74 females (American Society of Anesthesiologists physical status I-II) undergoing elective midline laparotomy under general anesthesia...
December 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27623810/a-novel-technique-for-repair-of-mid-penile-hypospadias-using-a-preputial-skin-flap-results-of-110-patients
#16
Hazem Elmoghazy, Mohamed M Hussein, Elnisr Mohamed, Abdelbasset Badawy, Gamal Alsagheer, Ahmed Mamdouh Abd Elhamed
BACKGROUND: Several techniques have been used to repair mid-penile hypospadias; however, high failure rates and major complications have been reported. In this study, we describe a novel technique using a well-vascularized flap of the inner and outer preputial skin. METHODS: A total of 110 male children with hypospadias underwent repair by our technique between 2008 and 2015. The inclusion criteria were children with mid-penile or slightly more proximal hypospadias, with or without ventral chordae, and an intact prepuce of the cobra eyes variety...
December 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27568348/transcutaneous-near-infrared-spectroscopy-for-monitoring-spinal-cord-ischemia-an-experimental-study-in-swine
#17
Koichi Suehiro, Tomoharu Funao, Yohei Fujimoto, Akira Mukai, Mitsuyo Nakamura, Kiyonobu Nishikawa
We aimed to assess the ability of near-infrared spectroscopy (NIRS) to detect spinal cord ischemia, and to evaluate changes in regional oxygen saturation (rSO2) following recovery of spinal cord circulation and cerebrospinal fluid drainage. Four 12-month-old female swine weighing 28.7-29.5 kg were acquired for this study. NIRS probes were placed along the midline of the upper (T6/7) and lower (T9/T10) thoracic vertebrae. The thoracic aorta was clamped distal of the left subclavian artery to induce spinal ischemia...
August 27, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27538165/-ultrasound-assisted-neuraxial-anesthesia-in-a-patient-with-previous-lumbar-laminectomy-and-fusion-a-case-report
#18
J Geng, M Li
A patient with previous L3-4 posterior lumbar interbody fusion, pedicle screws instrumentation and L3-4 decompression, was scheduled for left total hip arthroplasty. Two years ago, due to poor landmarks palpation, the patient experienced a failed lumbar puncture after multiple attempts before herniorrhaphy. His plain radiography showed bilateral partial laminectomy at L3-4 level, and between L3 and L4, two posterior pedicle screws connected by metal rods on both sides. This time, we used ultrasound to locate L4-5 interlaminar space in paramedian sagittal oblique view and identified the spine midline by transverse interlaminar view before puncture...
February 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/27495883/prophylactic-bilateral-internal-iliac-artery-balloon-occlusion-in-the-management-of-placenta-accreta-a-36-month-review
#19
Y L Tan, H Suharjono, N L J Lau, H Y Voon
BACKGROUND: The contemporary obstetrician is increasingly put to the test by rising numbers of pregnancies with morbidly adherent placenta. This study illustrates our experience with prophylactic bilateral internal iliac artery occlusion as part of its management. METHODS: Between January 2011 to January 2014, 13 consecutive patients received the intervention prior to scheduled caesarean delivery for placenta accreta. All cases were diagnosed by ultrasonography, color Doppler imaging and supplemented with MRI where necessary...
June 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/27467651/clinical-evaluation-of-a-securement-device-used-on-midline-catheters
#20
Roy Ventura, Chris O'Loughlin, Boris Vavrik
Since the introduction of sutureless securement products for vascular access devices (VADs), there has been a great deal of discussion of their advantages and disadvantages in comparison with sutures. This includes questions related to VAD securement, patients' comfort, infection control, user-friendliness and potential complications of using the device. The literature review of the available evidence indicates the superiority of the novel sutureless devices in the aforementioned aspects. The authors collected data to further contribute in the analysis of the attributes of these products, namely Statlock™ and Grip-Lok™ (current devices)...
July 28, 2016: British Journal of Nursing: BJN
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