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awareness in anesthesia

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https://www.readbyqxmd.com/read/28821646/location-of-the-mesopontine-neurons-responsible-for-maintanance-of-anesthetic-loss-of-consciousness
#1
Anne Minert, Shai-Lee Yatziv, Marshall Devor
The transition from wakefulness to general anesthesia is widely attributed to suppressive actions of anesthetic molecules distributed by the systemic circulation to the cerebral cortex (for amnesia and loss-of-consciousness) and to the spinal cord (for atonia and antinociception). An alternative hypothesis proposes that anesthetics act on one or more brainstem or diencephalic nuclei, with suppression of cortex and spinal cord mediated by dedicated axonal pathways. We previously documented induction of an anesthesia-like state in rats by microinjection of small amounts of GABAA-R agonists into an upper brainstem region named the mesopontine tegmental anesthesia area(MPTA)...
August 16, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28808585/spinal-cord-injury-during-the-second-trimester-of-pregnancy
#2
Ahmad Zaheer Qureshi, Sami Ullah, Anas Jehad AlSaleh, Rubina' Ullah
INTRODUCTION: Pregnancies in women with spinal cord injury (SCI) are at greater risk of morbidity and mortality. Although pregnancy after SCI is well elaborated in the literature, SCI occurring during pregnancy is rarely reported. Abrupt changes in the body physiology because of SCI and the resulting disability add a risk to maternal and fetal well-being. Not only is the burden of care increased but there is also a higher risk of developing pressure ulcers, urinary tract infections, autonomic instability, intrauterine growth retardation and venous thromboembolism...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28806208/systemic-hypotension-following-intravenous-administration-of-nonionic-contrast-medium-during-computed-tomography-iopromide-versus-iodixanol
#3
Gerlig Widmann, Reto Bale, Hanno Ulmer, Daniel Putzer, Peter Schullian, Franz-Josef Wiedermann, Wolfgang Lederer
BACKGROUND: In light of the increasing number of radiologic interventions performed under general anesthesia, the effects of contrast media (CM) on circulation and organ perfusion are of paramount importance. The objectives of this study were to systematically quantify effects on blood pressure, heart rate, and kidney function following intravenous administration of nonionic CM with normal and low osmolality. METHODS: In this controlled, double-blinded phase IV clinical trial, 40 consecutive patients were randomly assigned to receive repeated measures of either low-osmolar iopromide or iso-osmolar iodixanol...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28804607/effects-of-buprenorphine-in-the-adrenal-thyroid-and-cytokine-intra-operative-responses-in-a-rat-model-rattus-norvegicus-a-preliminary-study
#4
Nuno M Félix, Rodolfo O Leal, I Goy-Thollot, Ronald S Walton, Solange A Gil, Luísa M Mateus, Ana S Matos, Maria M R E Niza
OBJECTIVES: Buprenorphine is a common analgesic in experimental research, due to effectiveness and having few side-effects, including a limited influence in the immune and endocrine systems. However, how buprenorphine affects cytokine levels and the adrenal and thyroid response during general anesthesia and surgery is incompletely understood. This study aimed to assess whether buprenorphine modulated significantly those responses in rats submitted to general anesthesia, mechanical ventilation, and surgical insertion of intravascular catheters...
April 2017: Iranian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28793825/controlling-acute-pain-to-improve-the-quality-of-postoperative-pain-management-an-update-from-the-european-society-of-regional-anesthesia-meeting-held-in-maastricht-september-2016
#5
Jose De Andrés, Esther Pogatzki-Zahn, Frank Huygen, Edmund Neugebauer, William Fawcett
Improvement in postoperative pain management remains a global concern with a significant unmet need for patients. This was the focus of a 'Change Pain' session at the 35th European Society of Regional Anesthesia meeting (Maastricht, September 2016). Awareness of the size and nature of the problem is important to improve postoperative pain management strategies. Optimal treatment of acute pain should aim to avoid long-term sequelae such as the development of chronic pain disorders (e.g., phantom limb pain)...
August 10, 2017: Pain Management
https://www.readbyqxmd.com/read/28747204/just-fun-or-a-prejudice-physician-stereotypes-in-common-jokes-and-their-attribution-to-medical-specialties-by-undergraduate-medical-students
#6
Sigrid Harendza, Martin Pyra
BACKGROUND: Many jokes exist about stereotypical attributes of physicians in various specialties, which could lead to prejudices against physicians from a specific specialty. It is unknown whether and when medical students are aware of stereotypes about different specialties. The goal of this study was to analyze the degree of stereotypes that exist about medical specialties amongst undergraduate medical students at different stages of their education. METHODS: One hundred fifty-two jokes with different content about attributes of physicians from different specialties were found by an internet search...
July 26, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28743752/thalamocortical-synchronization-during-induction-and-emergence-from-propofol-induced-unconsciousness
#7
Francisco J Flores, Katharine E Hartnack, Amanda B Fath, Seong-Eun Kim, Matthew A Wilson, Emery N Brown, Patrick L Purdon
General anesthesia (GA) is a reversible drug-induced state of altered arousal required for more than 60,000 surgical procedures each day in the United States alone. Sedation and unconsciousness under GA are associated with stereotyped electrophysiological oscillations that are thought to reflect profound disruptions of activity in neuronal circuits that mediate awareness and cognition. Computational models make specific predictions about the role of the cortex and thalamus in these oscillations. In this paper, we provide in vivo evidence in rats that alpha oscillations (10-15 Hz) induced by the commonly used anesthetic drug propofol are synchronized between the thalamus and the medial prefrontal cortex...
July 25, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28739063/patients-opinions-of-or-nurses-and-environments-in-the-postoperative-period
#8
Vesile Eskici, Nadiye Özer
PURPOSE: To determine patients' opinions of operating room (OR) nurses and environments in the postoperative period. DESIGN: A descriptive study. METHODS: The data were collected by using researcher developed forms that defined patients' opinions of OR nurses and environments and were given to the patients on the first postoperative day. FINDING: The final sample consisted of a total of 208 patients who underwent surgery with regional anesthesia...
August 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28719524/establishing-obstetric-anesthesiology-practice-guidelines-in-the-republic-of-armenia-a-global-health-collaboration
#9
Gordon Yuill, Ashot Amroyan, Simon Millar, Emil Vardapetyan, Ashraf S Habib, Medge D Owen
BACKGROUND: Disparity exists in anesthesia practices between high- and low-to-middle income countries, and awareness has been raised within the global health community to improve the standards of anesthesia care and patient safety. The establishment of international collaborations and appropriate practice guidelines may help address clinical care deficiencies. This report's aim was to assess the impact of a multiyear collaboration on obstetric anesthesia practices in the Republic of Armenia...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28713495/awareness-of-epidural-analgesia-among-pregnant-women-in-jeddah-saudi-arabia
#10
Abdulrahim Gari, Ala Aziz, Nourah ALSaleh, Yosra Hamour, Hanaa Abdelal, Raed Sayed Ahmed
BACKGROUND AND OBJECTIVE: Labor pain is one of the most severe forms of pain that women experience throughout their lifetime. Many pregnant women decide to have an epidural anesthesia to cope with labor pain. This study has focused on general awareness about epidural anesthesia among pregnant women in Jeddah, Saudi Arabia. METHODS: This was a cross-sectional hospital-based study using a self-administered questionnaire, conducted in King Faisal Specialist Hospital and Research Center and International Medical Centre...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28701156/the-current-level-of-shared-decision-making-in-anesthesiology-an-exploratory-study
#11
F E Stubenrouch, E M K Mus, J W Lut, E M Hesselink, D T Ubbink
BACKGROUND: Shared decision-making (SDM) seeks to involve both patients and clinicians in decision-making about possible health management strategies, using patients' preferences and best available evidence. SDM seems readily applicable in anesthesiology. We aimed to determine the current level of SDM among preoperative patients and anesthesiology clinicians. METHODS: We invited 115 consecutive preoperative patients, visiting the pre-assessment outpatient clinic of the department of Anesthesiology at the Academic Medical Center of Amsterdam...
July 12, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28694167/minimally-invasive-surgery-survey-miss-a-survey-of-surgical-team-members-perceptions-for-successful-minimally-invasive-surgery-mis
#12
Ladin A Yurteri-Kaplan, Leslie Andriani, Anagha Kumar, Pamela A Saunders, Mihriye M Mete, Andrew I Sokol
STUDY OBJECTIVE: To develop a valid and reliable survey to measure surgical team members' perceptions regarding their institution's requirements for successful minimally invasive surgery (MIS). DESIGN: Utilizing the Safety Attitudes questionnaire as a guide, we developed questions assessing study participants' attitudes regarding the requirements for successful MIS. The questions were closed-ended and responses based on a 5-point Likert scale. The large pool of questions was then given to four focus groups made up of 3-6 individuals...
July 7, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28692439/lipid-emulsion-in-local-anesthetic-toxicity
#13
Martyn Harvey, Grant Cave
PURPOSE OF REVIEW: Enthusiasm for regional anesthesia has been driven by multimodal benefits to patient outcomes. Despite widespread awareness and improved techniques (including the increasing use of ultrasound guidance for block placement), intravascular sequestration and the attendant risk of local anesthetic systemic toxicity (LAST) remains. Intravenous lipid emulsion (ILE) for the treatment of LAST has been endorsed by anesthetic regulatory societies on the basis of animal study and human case report data...
July 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28678068/anesthesia-adverse-events-voluntarily-reported-in-the-veterans-health-administration-and-lessons-learned
#14
Julia Neily, Elda S Silla, Sam John T Sum-Ping, Roberta Reedy, Douglas E Paull, Lisa Mazzia, Peter D Mills, Robin R Hemphill
BACKGROUND: Anesthesia providers have long been pioneers in patient safety. Despite remarkable efforts, anesthesia errors still occur, resulting in complications, injuries, and even death. The Veterans Health Administration (VHA) National Center of Patient Safety uses root cause analysis (RCA) to examine why system-related adverse events occur and how to prevent future similar events. This study describes the types of anesthesia adverse events reported in VHA hospitals and their root causes and preventative actions...
July 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28665830/undiagnosed-pheochromocytoma-simulating-malignant-hyperthermia
#15
Nisha S Ramani, Robert Stoppacher, Ajaykumar C Morani, Charles Catanese
INTRODUCTION: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. They are surgically curable but can be lethal if remain undiagnosed. We report a patient earlier diagnosed with malignant hyperthermia but later found to have pheochromocytoma on autopsy. CASE REPORT: After a preprocedural pain block for elective right shoulder arthroscopy, a 53-year-old hypertensive white man developed chest pain. In the operating room, he had increased blood pressure...
September 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28663647/incidence-of-awareness-with-recall-under-general-anesthesia-in-rural-india-an-observational-study
#16
Deepak Singla, Mishu Mangla
CONTEXT: Awareness under anesthesia is a rare but extremely unpleasant phenomenon. There are very few studies in the developing world and none from rural areas where incidence of intraoperative awareness may be higher due to increased patient load, limited patient knowledge and lack of trained hospital staff, reliance on older, cheaper but less effective drugs, and lack of proper equipment both for providing anesthesia, as well as monitoring the patient. AIMS: To assess the incidence of intraoperative awareness during general anesthesia among patients in rural India and any factors associated with the same...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28651954/case-report-ultrasound-guided-infraclavicular-brachial-plexus-block-for-a-case-with-posterior-elbow-dislocation
#17
Sinan Akay, Sami Eksert, Murtaza Kaya, Kenan Keklikci, Ali Kantemir
BACKGROUND: The interest in regional anesthesia procedures for the management of upper-extremity emergencies has increased. Toward that end, supraclavicular, interscalene, or infraclavicular approaches, with or without ultrasound guidance, are used for brachial plexus nerve blocks. Although many studies have reported on the use of ultrasound-guided supraclavicular and interscalene brachial plexus blocks for upper-extremity dislocations, very few studies have reported on the use of ultrasound-guided infraclavicular brachial plexus blocks...
June 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28601422/exposure-to-surgery-and-anesthesia-after-concussion-due-to-mild-traumatic-brain-injury
#18
Arnoley S Abcejo, Rodolfo Savica, William L Lanier, Jeffrey J Pasternak
OBJECTIVE: To describe the epidemiology of surgical and anesthetic procedures in patients recently diagnosed as having a concussion due to mild traumatic brain injury. PATIENTS AND METHODS: Study patients presented to a tertiary care center after a concussion due to mild traumatic brain injury from July 1, 2005, through June 30, 2015, and underwent a surgical procedure and anesthesia support under the direct or indirect care of a physician anesthesiologist. RESULTS: During the study period, 1038 patients met all the study inclusion criteria and subsequently received 1820 anesthetics...
July 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28587738/important-non-technical-skills-in-video-assisted-thoracoscopic-surgery-lobectomy-team-perspectives
#19
Kirsten Gjeraa, Anna S Mundt, Lene Spanager, Henrik J Hansen, Lars Konge, René H Petersen, Doris Østergaard
BACKGROUND: Safety in the operating room is dependent on the team's non-technical skills. The importance of non-technical skills appears to be different for minimally invasive surgery as compared with open surgery. The aim of this study was to identify which non-technical skills are perceived by team members to be most important for patient safety, in the setting of video-assisted thoracoscopic surgery (VATS) lobectomy. METHODS: This was an explorative, semistructured interview-based study with 21 participants from all four thoracic surgery centers in Denmark that perform VATS lobectomy...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28579714/neumann-s-tumor-a-case-report
#20
Kashi Nataraj Vinay, Lidetu Afework Anjulo, Prabhakar Nitin, Kashi Vinay Neha, Dwivedi Dhara
BACKGROUND: The congenital granular cell tumour of the newborn, also known as congenital epulis or Neumann's tumor, is rare. It occurs on the gingiva of the anterior alveolar ridge of the jaws. This lesion behaves in a benign manner and no recurrent or metastatic lesions have been reported. CASE REPORT: We are reporting a 2-day-old female neonate, who came to our unit with a well defined, solitary, firm mass arising from the maxillary anterior region measuring about 3...
March 2017: Ethiopian Journal of Health Sciences
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