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https://www.readbyqxmd.com/read/29339294/ketamine-for-the-treatment-of-addiction-evidence-and-potential-mechanisms
#1
REVIEW
I Ivan Ezquerra-Romano, W Lawn, E Krupitsky, C J A Morgan
Ketamine is a dissociative anaesthetic drug which acts on the central nervous system chiefly through antagonism of the n-methyl-d-aspartate (NMDA) receptor. Recently, ketamine has attracted attention as a rapid-acting anti-depressant but other studies have also reported its efficacy in reducing problematic alcohol and drug use. This review explores the preclinical and clinical research into ketamine's ability to treat addiction. Despite methodological limitations and the relative infancy of the field, results thus far are promising...
January 12, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/29338142/patient-controlled-epidural-analgesia-with-and-without-basal-infusion-using-ropivacaine-0-15-and-fentanyl-2%C3%AE-ml-for-labour-analgesia-a-prospective-comparative-randomised-trial
#2
Paraskevi K Matsota, Kalliopi H Drachtidi, Chrysanthi Z Batistaki, Agathi V Karakosta, Ioanna C Koukopoulou, Eugenia I Koursoumi, Georgia G Kostopanagiotou
BACKGROUND: Patient-Controlled Epidural Analgesia (PCEA) is a common practice for labour pain relief. This study aimed to compare two different settings of a PCEA device using the same solution to obtain labour analgesia. METHODS: Fifty two parturients were randomly allocated to receive ropivacaine 0.15% and fentanyl 2γ/mL via a PCEA device either as a background infusion of 5mL/h plus 5mL demand bolus doses with 10 min lockout (group B/D, n=26) or as only demand bolus doses of 5mL with 10 min lockout (group D, n=26)...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29336785/the-erector-spinae-plane-block-in-4-cases-of-video-assisted-thoracic-surgery
#3
J C Luis-Navarro, M Seda-Guzmán, C Luis-Moreno, J L López-Romero
Multimodal anaesthesia, combining epidural catheter and general anaesthesia, is a common technique in thoracic surgery, however, epidural catheter placement is not always possible. Recently, erector spinae plane block has been described, which provides analgesia like that of the epidural block, although unilateral, and which has been used in various procedures at thoracic level. At present, there are no studies comparing the efficacy or safety of this block with those commonly used in thoracic surgery. However, its safety profile and contraindications seem different from those of the epidural catheter, since its placement is done under ultrasound view, the needle introduction is done in plane and the ultrasound target, the transverse process, is easily identifiable and is relatively remote from major neural or vascular structures and the pleura...
January 11, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29336523/quadratus-lumborum-block-in-management-of-severe-pain-after-uterine-artery-embolization
#4
B Ben-David, Z Kaligozhin, D Viderman
BACKGROUND AND OBJECTIVES: The quadratus lumborum (QL) block has been widely used for acute postoperative pain management after numerous surgical procedures including urological, abdominal, gynaecological and orthopaedic surgical procedures. The local anaesthetic spread in this area can provide unilateral sensory block in T6-L2 dermatomes. We performed bilateral quadratus lumborum block for the management of acute pain after the uterine artery embolization (UAE). METHODS: A 43-year-old woman was admitted to the gynaecology department of Mother and Child Hospital, University Medical Center, for uterine artery embolization...
January 16, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29336195/is-aspiration-and-sclerotherapy-treatment-for-hydroceles-in-the-aging-male-an-evidence-based-treatment
#5
W St J Taylor, J Cobley, W Mahmalji
Symptomatic hydroceles are commonly treated with surgical repair. They are associated with sexual dysfunction in the aging male. Patients who are not fit for surgery often undergo aspiration and sclerotherapy of the hydrocele. There is a range of sclerosing agents used in the literature. I performed a literature search to assess whether one sclerosant was better than the others. STDS is the sclerosing agent with the best cure rate after a single injection and low side effect rates. The cure rates of sodium tetradecyl sulphate (STDS) after a single aspiration and injection were 76%...
January 16, 2018: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
https://www.readbyqxmd.com/read/29335151/-tools-to-overcome-anxiety-in-paediatric-surgery
#6
Nolwenn Febvre
An association of caregivers carried out several actions to combat children's anxiety in paediatric surgery, including anaesthetic masks to cover in stickers, a tactile application on the operating pathway and a cuddly toy in the recovery room. These tools help children at the moment of being separated from their parents and all along their care pathway. They also encourage caregivers to adjust their practices to improve the care provided to the families.
January 2018: Soins. Pédiatrie, Puériculture
https://www.readbyqxmd.com/read/29334510/comparing-peri-operative-complications-of-paediatric-and-adult-anaesthesia-a-retrospective-cohort-study-of-81%C3%A2-267-cases
#7
Andrie C Westerkamp, A Fred de Geus, Bouwe Molenbuur, Peter Meyer, J K Götz Wietasch, Michel M R F Struys, Herman G D Hendriks
BACKGROUND: Comparisons of peri-operative complications associated with paediatric (≤16 years) and adult anaesthesia are poorly available, especially in which cardiac surgery, organ transplantation and neurosurgery are involved. OBJECTIVE: The aim of this study was to evaluate the nature and incidence of peri-operative complications that might be due to anaesthesia and to identify independent risk factors for complications in children and adults, including those undergoing cardiac surgery, organ transplantation and neurosurgery...
January 13, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29331007/anaesthetic-management-of-nesidioblastosis-in-two-infants
#8
Muhammad Saad Yousuf, Mohsin Nazir Butt, Fauzia Anis Khan
Nesidioblastosis is the most common cause of non-transient, recurrent and persistent hypoglycaemia in neonates and infants. It is a disorder of diffuse proliferation of beta cells of the pancreas leading to hyperinsulinemia and hypoglycaemia. The main aim is to prevent the severe episodes of hypoglycaemia which can cause damage to the brain and/or mental retardation. In this case report we present two cases of nesidioblastosis and their perioperative anaesthetic course for near-total pancreatectomy. First case was a 7 months old female who had repeated episodes of convulsions since birth...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29328847/an-anaesthesia-perspective-on-carotid-body-tumour-cbt-excision-a-twenty-year-case-series-at-the-singapore-general-hospital
#9
Deanna Wj Ng, Chris I Yam, Loong T Wong, Darren Lk Koh
Carotid body tumours (CBT) are extremely rare neoplasms that arise from chemoreceptor cells at the bifurcation of the carotid artery. This rarity poses a challenge for the anaesthetist when dealing with surgeries for the removal of CBT. Reports of associated perioperative morbidity range from twenty to forty percent. This paper reviews the perioperative anaesthetic management of CBT patients and challenges in our institution's 20 year experience on 13 surgical CBT resections.
October 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29328846/a-review-of-nausea-and-vomiting-in-the-anaesthetic-and-post-anaesthetic-environment
#10
Claire Matthews
Postoperative nausea and vomiting (PONV) has long been known as a complication of anaesthesia and surgery. This paper focuses on the assessment of the risk factors related to PONV along with the strategies and interventions which can be put in place to manage the condition. The pharmacological and multi-modal treatment methods of managing the risk factors that contribute to PONV are discussed.
October 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29328749/thromboembolic-diseases-and-the-use-of-vena-cava-filters
#11
Samanthi De Silva
Mr GW is a 77-year-old gentleman who is hoping to have a total knee replacement of his left knee. He underwent a knee replacement on the right in 2011 under spinal anaesthetic, where his postoperative period was complicated by a saddle pulmonary embolus (PE).
April 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29328747/critical-incident-analysis-equip-to-avoid-failure
#12
Naomi Potts, Daphne Se Martin, Leontia Hoy
This work is set in the context of perioperative practice in difficult airway management. It integrates a root cause analysis and fish bone technique to investigate a critical incident in temporary yet crucial equipment failure. Risk management and incident reporting is analysed alongside human factors in the operating theatre environment. Finally, recommendations for risk reduction, vigilance and checking vital airway equipment are made in anaesthetic practice.
April 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29328742/pragmatic-recycling-of-paper-and-cardboard-in-the-operating-theatre-an-audit
#13
Douglas Ra McKendrick, Lorraine J Snedden, Rozel Bunch, Hazel McGregor
Despite recent legislation introduced in Scotland and motivated recycling at home, very little recycling exists within theatre environments. This study audited the introduction of recycling of paper and cardboard. All waste within a single operating theatre was collected by a dedicated team for 20 surgical cases. The collection of clean paper and cardboard packaging was limited to the theatre preparation room (TPR) and anaesthetic room (AR). No waste segregation was attempted within the operating theatre itself...
March 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29328741/perioperative-teamwork-for-the-patient-with-a-shared-airway-a-case-study
#14
Gareth Jones
Teamwork is an essential element of perioperative care. Shared airway surgery requires additional considerations for the perioperative team. This article analyses a case study of a patient undergoing thyroid surgery. Whilst the anaesthetic team is responsible for maintaining the patient's airway, the theatre and surgical teams have their own individual roles to assist in airway management and surgical care.
March 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29328383/oxymatrine-protects-against-the-effects-of-cardiopulmonary-resuscitation-via-modulation-of-the-tgf-%C3%AE-1-smad3-signaling-pathway
#15
Dawei Wang, Xiao Qian Lou, Xiao-Ming Jiang, Chenxi Yang, Xiao-Liang Liu, Nan Zhang
Previous studies have demonstrated that oxymatrine may inhibit ventricular remodeling and serves an important role in the treatment of cardiovascular disease. The present study investigated whether oxymatrine treatment protects against the effects of cardiopulmonary resuscitation (CPR) via regulation of the transforming growth factor‑β1 (TGF‑β1)/mothers against decapentaplegic (Smad) signaling pathway. A CPR model was established in Sprague‑Dawley (SD) rats by asphyxiation, and rats were subsequently anaesthetized by intraperitoneal injection of chloral hydrate...
January 4, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29327607/up-regulation-of-cav3-1-expression-in-sh-sy5y-cells-induced-by-lidocaine-hydrochloride
#16
Qin Gong, Xianjie Wen, Heng Li, Jian He, Yunhua Wang, Huiping Wu, Hanbing Wang, Xiaoping Wang
BACKGROUND: Neurotoxicity induced by the local anaesthetics has aroused concern. A previous study has shown that an overload of intracellular calcium was involved in the neurotoxic effect. Cav3.1 is one of the low-voltage-activated (LVA) calcium channels which play a key point to regulate the intracellular calcium ion level. This study aimed to investigate the changes of the Cav3.1 expression in the SH-SY5Y cells treated with lidocaine hydrochloride. METHODS: The SH-SY5Y cells were treated with different concentrations of lidocaine hydrochloride(1 mM, 5 mM and 10 mM, namely L1 group, L5 group and L10 group) and different exposure times (1 h,12 h and 24 h), respectively...
January 12, 2018: Artificial Cells, Nanomedicine, and Biotechnology
https://www.readbyqxmd.com/read/29327341/combined-thoracic-paravertebral-and-pectoral-nerve-blocks-for-breast-surgery-under-sedation-a-prospective-observational-case-series
#17
A Pawa, J Wight, D N Onwochei, R Vargulescu, I Reed, L Chrisman, E Pushpanathan, A Kothari, K El-Boghdadly
Avoidance of general anaesthesia for breast surgery may be because of clinical reasons or patient choice. There is emerging evidence that the use of regional anaesthesia and the avoidance of volatile anaesthetics and opioid analgesia may have beneficial effects on oncological outcomes. We conducted a prospective observational case series of 16 breast cancer surgeries performed under thoracic paravertebral plus pectoral nerve block with propofol sedation to demonstrate feasibility of technique, patient acceptability and surgeon satisfaction...
January 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29318640/major-influence-of-a-smoke-and-mirrors-effect-caused-by-wave-reflection-on-early-diastolic-coronary-arterial-wave-intensity
#18
Jonathan P Mynard, Daniel J Penny, Joseph J Smolich
Coronary arterial wave intensity analysis (WIA) is thought to provide clear insight into upstream and downstream forces on coronary flow, with a large early-diastolic surge in coronary flow accompanied by a prominent backward decompression wave (BDWdia ), as well as a forward decompression wave (FDWdia ) and forward compression wave (FCWdia ). The BDWdia is believed to arise from distal suction due to release of extravascular compression by relaxing myocardium, while FDWdia and FCWdia are thought to be transmitted from the aorta into the coronary arteries...
January 9, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29317914/a-high-impact-intervention-for-a-high-impact-intervention-improving-documentation-of-peripheral-venous-access-insertion-in-theatre
#19
Kavita Upadhyaya, Heidy Hendra, Nick Wilson
The Department of Health's 'High Impact Intervention (HII) - Peripheral intravenous cannula care bundle' lists six actions to be performed at the time of peripheral intravenous cannulation. Audit of compliance to these requires documentation. We assessed documentation on the anaesthetic charts of 50 surgical patients. Purpose-made stickers were then placed on all anaesthetic charts. Re-assessment of a further 50 patients' charts demonstrated a significant improvement in documentation of the bundle post intervention (Fisher's exact test P < 0...
January 2018: Journal of Infection Prevention
https://www.readbyqxmd.com/read/29315046/supraglottic-airway-devices-current-and-future-uses
#20
Lloyd E Kwanten, Pradeep Madhivathanan
Supraglottic airway devices have increasingly been used in anaesthesia since their invention in 1982. Now over half of general anaesthetic cases in the UK use them, and they have vital roles in difficult airway algorithms, pre-hospital use and emergency medicine. This article presents the current evidence regarding the complications of these devices, and compares these devices and endotracheal intubation. The technology of the newer generation devices has improved the safety profile, and they may be considered a better choice than endotracheal tubes in some cases...
January 2, 2018: British Journal of Hospital Medicine
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