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https://www.readbyqxmd.com/read/28096570/tourniquet-application-during-anesthesia-what-we-need-to-know
#1
REVIEW
Kamal Kumar, Craig Railton, Qutaiba Tawfic
Tourniquets are routinely and safely used in limb surgeries throughout the world. Tourniquet application alters normal physiology. Healthy patients tolerate these physiological changes well, but the physiological changes may not be well-tolerated by patients with poor cardiac function. This review discusses the physiological changes associated with tourniquet use, safe practice and provides the latest updates regarding tourniquet use. A systematic literature search of PubMed, MEDLINE, ScienceDirect, and Google Scholar was done...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28092800/effect-of-venepuncture-process-design-on-efficiency-and-failure-rates-a-simulation-model-study-for-secondary-care
#2
Sean Reed, Rasa Remenyte-Prescott, Ben Rees
BACKGROUND: Healthcare aims to deliver good patient outcomes. For many clinical procedures there are multiple alternative task sequences that can be performed. These deviations can influence procedure reliability, efficiency of usage of hospital resources and risk to staff and patient safety. Venepuncture is one of the most common invasive procedures in healthcare. Literature of clinical practice shows evidence of wide variability in the procedure order and the duration of each step, which can depend on attributes, such as patient health, sampling method and staff skills...
December 29, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28089184/bone-wax-is-effective-in-reducing-blood-loss-after-total-knee-arthroplasty
#3
Ing H Moo, Jerry Y Q Chen, Eric H Pagkaliwaga, See W Tan, Kein B Poon
BACKGROUND: Total knee arthroplasty (TKA) is associated with major blood loss and blood transfusion is often required. This study aimed to evaluate the efficacy of bone wax in reducing blood loss and transfusion rates after TKA. METHODS: A prospective randomized controlled study that included 100 patients undergoing primary unilateral TKA with cement was conducted in a tertiary center between March 2014 and June 2014. The bone wax group received 2.5 g of bone wax, applied onto the uncovered bone around the prostheses and the nail holes before the tourniquet was released, whereas the control group had hemostasis achieved using electrocautery only...
December 24, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28078468/surgery-of-the-hallux-valgus-in-an-ambulatory-setting-a-liability-risk
#4
L Galois, J-M Serwier, A D Arashvand
INTRODUCTION: The primary objective of the study is to make an inventory of malpractice in hallux valgus surgery in an ambulatory setting and to identify the patient characteristics for a higher risk of malpractice. The secondary objective is creating a methodology for analyzing the medicolegal aspects of a surgery in day case comparing with hospitalization. MATERIALS AND METHODS: The database of the Branchet insurance company was used. A total of 11,000 claims for a period of 11 years (2002-2013) have been investigated...
January 11, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28067467/coronal-mode-ultrasound-guided-hemodialysis-cannulation-a-pilot-randomized-comparison-with-standard-cannulation-technique
#5
Lalathaksha Kumbar, Vivek Soi, Elizabeth Adams, Cheryl Brown Deacon, Mohamed Zidan, Jerry Yee
Background Infiltrations from cannulation result in significant morbidity including loss of hemodialysis (HD) vascular access (VA). Cannulation is dependent on personnel skill and VA characteristics. Surface marking of VA lacks real-time information and traditional ultrasound (US) devices are large, expensive, requiring skilled operators. Sonic Window© (Analogic Ultrasound, Peabody, MA, USA) is a coronal mode ultrasound device (CMUD) approved for VA cannulation. Methods Single center randomized, prospective pilot study comparing handheld US-guided cannulation of new arteriovenous fistula (AVF) to standard cannulation practices...
January 9, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28066882/pharmacokinetics-of-400-mg-ropivacaine-after-periarticular-local-infiltration-analgesia-for-total-knee-arthroplasty
#6
M G E Fenten, S M K Bakker, D J Touw, B J F van den Bemt, G J Scheffer, P J C Heesterbeek, R Stienstra
BACKGROUND: Although considered safe, no pharmacokinetic data of high dose, high volume local infiltration analgesia (LIA) with ropivacaine without the use of a surgical drain or intra-articular catheter have been described. The purpose of this study is to describe the maximum total and unbound ropivacaine concentrations (Cmax , Cu max ) and corresponding maximum times (Tmax , Tu max ) of a single-shot ropivacaine (200 ml 0.2%) and 0.75 mg epinephrine (1000 μg/ml) when used for LIA in patients for total knee arthroplasty...
January 9, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28061741/economic-analysis-and-patient-satisfaction-associated-with-outpatient-total-ankle-arthroplasty
#7
Tyler Gonzalez, Erica Fisk, Christopher Chiodo, Jeremy Smith, Eric Bluman
BACKGROUND: Total ankle arthroplasty (TAA) is a rapidly growing treatment for end-stage ankle arthritis that is generally performed as an inpatient procedure. The feasibility of outpatient total ankle arthroplasty (OTAA) has not been reported in the literature. We sought to establish proof of concept for OTAA by comparing outpatient vs inpatient perioperative complications, postoperative emergency department (ED) visits, readmissions, patient satisfaction, and cost analysis. METHODS: From July 2010 to September 2015, a total of 36 patients underwent TAA...
December 1, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/28061548/suprafascial-harvest-of-the-radial-forearm-free-flap-decreases-the-risk-of-postoperative-tendon-exposure
#8
David C Shonka, Nikita V Kohli, Benjamin M Milam, Mark J Jameson
OBJECTIVE: To determine if suprafascial harvest of the radial forearm free flap improves postoperative donor site outcomes compared to subfascial harvest. METHODS: Retrospective chart review. RESULTS: Forty-six patients underwent reconstruction of a head and neck defect with a radial forearm free flap (RFFF). Subfascial harvest of the RFFF was performed in 25 (53%) patients and suprafascial harvest performed in 22 (47%) patients. All donor sites were covered with a split thickness skin graft and a bolster that remained in place for 6 days...
January 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28050814/what-orthopaedic-operating-room-surfaces-are-contaminated-with-bioburden-a-study-using-the-atp-bioluminescence-assay
#9
Raveesh Daniel Richard, Thomas R Bowen
BACKGROUND: Contaminated operating room surfaces can increase the risk of orthopaedic infections, particularly after procedures in which hardware implantation and instrumentation are used. The question arises as to how surgeons can measure surface cleanliness to detect increased levels of bioburden. This study aims to highlight the utility of adenosine triphosphate (ATP) bioluminescence technology as a novel technique in detecting the degree of contamination within the sterile operating room environment...
January 3, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28050539/comparative-analysis-of-pain-in-patients-who-underwent-total-knee-replacement-regarding-the-tourniquet-pressure
#10
Marcos George de Souza Leão, Gladys Pedrosa Martins Neta, Lucas Inoue Coutinho, Thiago Montenegro da Silva, Yacov Machado Costa Ferreira, Waryla Raissa Vasconcelos Dias
OBJECTIVES: To evaluate through the visual analog scale (VAS) the pain in patients undergoing total knee replacement (TKR) with different pressures of the pneumatic tourniquet. METHODS: An observational, randomized, descriptive study on an analytical basis, with 60 patients who underwent TKR, divided into two groups, which were matched: a group where TKR was performed with tourniquet pressures of 350 mmHg (standard) and the other with systolic blood pressure plus 100 mmHg (P + 100)...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28040235/-the-effect-of-palonosetron-on-rocuronium-induced-withdrawal-movement
#11
Ki-Bum Park, Younghoon Jeon, Junggu Yi, Ji-Hyun Kim, Seung-Yeon Chung, Kyung-Hwa Kwak
BACKGROUND: Rocuronium causes pain and withdrawal movement during induction of anesthesia. In this study, palonosetron was investigated to have analgesic effect on the reduction of rocuronium-induced withdrawal movement. METHODS: 120 patients were randomly assigned to one of three groups to receive either saline, lidocaine 20mg, or palonosetron 0.075mg with a tourniquet applied two minutes before thiopental sodium (5mg·kg(-1)) was given intravenously. After loss of consciousness, rocuronium (0...
December 29, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28035960/a-survey-of-snakebite-knowledge-among-field-forces-in-china
#12
Chulin Chen, Li Gui, Ting Kan, Shuang Li, Chen Qiu
A snakebite is a neglected extrinsic injury associated with high morbidity and global mortality. Members of Chinese field forces are at high risk of snakebites, and their perception and knowledge of snakebites are unknown. The aim of this study is to assess perception and knowledge of snakebites in field forces in southeast China; Methods: A cross-sectional questionnaire-based survey was conducted in July 2016. A total of 216 field force members participated in this study; Results: A total of 10.3% had experienced snakebites and 86...
December 26, 2016: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28018078/subungual-osteochondroma-nail-sparing-excision
#13
Anurag Tiwari, Nidhi Agrawal, Tarun Verma, Hitesh Lal
Subungual osteochondroma is a relatively uncommon benign bone tumor affecting mostly children and young adults, and is a major source of pain and nail deformity. Treatment consists of marginal excision and meticulous wound closure. In this report, we present three cases of subungual osteochondroma arising from the dorsal aspect of distal phalanx of the great toe, which were managed by marginal excision with preservation of nail apparatus under digital block anesthesia with the use of a ring tourniquet. We emphasize on the use of ring tourniquet made by glove's finger and the technique of preserving the nail apparatus to prevent nail deformity...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28017168/comparisons-of-the-effects-of-the-sevoflurane-and-propofol-on-acute-ischemia-reperfusion-and-dna-damages-in-rabbits
#14
Sema Oncul, Lale Karabiyik, Erdem Coskun, Ela Kadioglu, Ozlem Gulbahar
BACKGROUND AND OBJECTIVES: The aim of this study was to compare the effects of sevoflurane and propofol anesthesia on oxidative DNA damage that occurs in low-extremity ischemia and is caused by tourniquet application. METHODS: Fourteen New Zealand rabbits were randomly allocated into two equal groups. Group S (n=7) received sevoflurane (2.5-4 percent) inhalation and Group P (n=7) received a propofol infusion (1-2mg·kg(-1)·min(-1)), after which a pneumatic tourniquet was placed on the right lower extremity...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28013559/key-factors-influencing-the-incidence-of-hemolysis-a-critical-appraisal-of-current-evidence
#15
Euan James McCaughey, Elia Vecellio, Rebecca Lake, Ling Li, Leslie Burnett, Douglas Chesher, Stephen Braye, Mark Mackay, Stephanie Gay, Tony Badrick, Johanna Westbrook, Andrew Georgiou
Hemolysis is a leading cause of pre-analytical laboratory errors. The identification of contributing factors is an important step towards the development of effective practices to reduce and prevent hemolysis. We performed a review of PUBMED, Embase, Medline and CINAHL to identify articles published between January 2000 and August 2016 that identified factors influencing in vitro hemolysis rates. The 40 studies included in this review provide excellent evidence that hemolysis rates are higher in Emergency Departments (EDs), for non-antecubital draws, for specimens drawn using an intravenous catheter compared to venipuncture and for samples transported by pneumatic tube compared to by hand...
December 26, 2016: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28012598/mechanisms-underpinning-protection-against-eccentric-exercise-induced-muscle-damage-by-ischemic-preconditioning
#16
Alexander Franz, Michael Behringer, Kazunori Nosaka, Bettina Alexandra Buhren, Holger Schrumpf, Constantin Mayer, Christoph Zilkens, Moritz Schumann
Eccentric exercise training is effective for increasing muscle mass and strength, and improving insulin sensitivity and blood lipid profiles. However, potential muscle damage symptoms such as prolonged loss of muscle function and delayed onset of muscle soreness may restrict the use of eccentric exercise, especially in clinical populations. Therefore, strategies to reduce eccentric exercise-induced muscle damage (EIMD) are necessary, and an extensive number of scientific studies have tried to identify potential intervention modalities to perform eccentric exercises without adverse effects...
January 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28011033/cost-savings-and-patient-experiences-of-a-clinic-based-wide-awake-hand-surgery-program-at-a-military-medical-center-a-critical-analysis-of-the-first-100-procedures
#17
Peter C Rhee, Michelle M Fischer, Laura S Rhee, Ha McMillan, Anthony E Johnson
PURPOSE: Wide-awake, local anesthesia, no tourniquet (WALANT) hand surgery was developed to improve access to hand surgery care while optimizing medical resources. Hand surgery in the clinic setting may result in substantial cost savings for the United States Military Health Care System (MHS) and provide a safe alternative to performing similar procedures in the operating room. METHODS: A prospective cohort study was performed on the first 100 consecutive clinic-based WALANT hand surgery procedures performed at a military medical center from January 2014 to September 2015 by a single hand surgeon...
December 20, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28009677/effectiveness-of-temporary-deafferentation-of-the-arm-on-somatosensory-and-motor-functions-following-stroke-a-systematic-review
#18
Emmanuelle Opsommer, Camille Zwissig, Natalya Korogod, Thomas Weiss
BACKGROUND: After stroke, regaining functional use of the upper limb can be challenging. Temporary deafferentation (TD) is a novel approach used in neurorehabilitation to voluntarily reduce the somatosensory input in a body part by temporary anesthesia; which has been shown to improve sensorimotor functions in the affected limb. OBJECTIVES: The primary objective of this systematic review was to present the best available evidence related to the effects of TD of the affected arm on the recovery of motor function and activity of the upper limb (arm and hand) following stroke...
December 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28005104/potential-operating-room-fire-hazard-of-bone-cement
#19
Udai S Sibia, Kevin Connors, Sarah Dyckman, Hamid R Zahiri, Ivan George, Adrian E Park, James H MacDonald
Approximately 600 cases of operating room (OR) fires are reported annually. Despite extensive fire safety education and training, complete elimination of OR fires still has not been achieved. Each fire requires an ignition source, a fuel source, and an oxidizer. In this case report, we describe the potential fire hazard of bone cement in the OR. A total knee arthroplasty was performed with a standard medial parapatellar arthrotomy. Tourniquet control was used. After bone cement was applied to the prepared tibial surface, the surgeon used an electrocautery device to resect residual lateral meniscus tissue-and started a fire in the operative field...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27999958/use-of-patient-specific-cutting-blocks-reduces-blood-loss-after-total-knee-arthroplasty
#20
Vicente J León, María A Lengua, Víctor Calvo, Alonso J Lisón
Total knee arthroplasty (TKA) is associated with substantial blood loss. Sources of bleeding are the femoral and tibial intramedullary canals, which are violated during implantation using standard instrumentation. Patient-specific instrumentation (PSI) and computer-assisted surgery (CAS) do not require violation of the intramedullary canals. Therefore, we sought to assess the impact of these methods on blood loss and transfusion requirement. A retrospective cohort study was conducted in a series of 107 consecutive primary TKAs...
December 20, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
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