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https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#1
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
March 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28319552/evaluation-of-lung-function-and-clinical-features-of-the-ultrasound-guided-stellate-ganglion-block-with-2-different-concentrations-of-a-local-anesthetic-a-randomized-controlled-trial
#2
Won-Joong Kim, Hahck Soo Park, Myung Sub Yi, Gill-Hoi Koo, Hwa-Yong Shin
BACKGROUND: One possible complication of stellate ganglion block (SGB) is respiratory compromise. No study has yet addressed the comparison of its effect on lung function and clinical features, including Horner's syndrome, changes in temperature, sensory and motor functions, and adverse events of lower versus higher concentrations (LC and HC, respectively) of local anesthetics in an ultrasound-guided SGB. METHODS: Fifty patients were randomized into 1 of 2 groups: the LC group (5 mL of 0...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319550/continuous-transversus-abdominis-plane-nerve-blocks-does-varying-local-anesthetic-delivery-method-automatic-repeated-bolus-versus-continuous-basal-infusion-influence-the-extent-of-sensation-to-cold-a-randomized-triple-masked-crossover-study-in-volunteers
#3
Bahareh Khatibi, Engy T Said, Jacklynn F Sztain, Amanda M Monahan, Rodney A Gabriel, Timothy J Furnish, Johnathan T Tran, Michael C Donohue, Brian M Ilfeld
BACKGROUND: It remains unknown whether continuous or scheduled intermittent bolus local anesthetic administration is preferable for transversus abdominis plane (TAP) catheters. We therefore tested the hypothesis that when using TAP catheters, providing local anesthetic in repeated bolus doses increases the cephalad-caudad cutaneous effects compared with a basal-only infusion. METHODS: Bilateral TAP catheters (posterior approach) were inserted in 24 healthy volunteers followed by ropivacaine 2 mg/mL administration for a total of 6 hours...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28315017/-is-supplemental-ear-acupuncture-for-surgical-tooth-removal-with-local-anesthesia-effective-a%C3%A2-pilot-study
#4
E A Lux, G Wahl, J Erlenwein, C Wiese, S Wirz
BACKGROUND: The application of ear acupuncture can contribute to a reduction of acute pain. Data on the application of ear acupuncture following oral surgery in odontology is insufficient. OBJECTIVE: This study investigated the effectiveness of ear acupuncture as an auxiliary analgesic treatment in addition to local anesthesia for operative tooth removal. METHODS: In this prospective open non-randomized pilot study (in accordance with the CONSORT publication) 2 cohorts of 50 patients each with the indications for an operative tooth removal either with or without the application of ear acupuncture in addition to local anesthesia with articain were observed...
March 17, 2017: Der Schmerz
https://www.readbyqxmd.com/read/28306584/serratus-anterior-plane-block-to-address-post-thoracotomy-and-chest-tube-related-pain-a-report-on-3-cases
#5
George M Chu, G Craig Jarvis
In this case report, the serratus anterior plane block was used in conjunction with multilevel continuous thoracic paravertebral blocks (TPVB) and general anesthesia in 3 thoracotomy cases. All blocks were accompanied by use of catheters that allowed continuous local anesthetic infusions and intermittent local anesthetic bolus injections to address postoperative pain. In all 3 patients, the serratus anterior plane block provided analgesia for chest tube-related pain that was not provided by the TPVB alone.
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28306579/continuous-epidural-analgesia-using-an-ester-linked-local-anesthetic-agent-2-chloroprocaine-during-labor-a-case-report
#6
Simon C Lee, Vanessa Moll
We report the use of the ester-linked local anesthetic, 2-chloroprocaine, for continuous epidural analgesia in a patient in labor with a history of allergic reaction to amide local anesthetics. The patient gave a reliable history of pruritus, hives, erythema, and swelling on her lower extremity after having received a preservative-free amide local anesthetic. This allergy had been confirmed by a dermatologist by her reports. The patient requested an epidural for labor analgesia that was placed successfully...
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28303086/anesthesia-provision-in-disasters-and-armed-conflicts
#7
REVIEW
Miguel Trelles Centurion, Rafael Van Den Bergh, Henry Gray
PURPOSE OF REVIEW: Disasters and armed conflicts are characterized by high numbers of trauma cases, and occur mainly in developing countries where the healthcare response is already impaired, resulting in an inadequate response. Aside of the trauma cases, other surgical health conditions are also still present and require urgent care. Surgical care needs are different from context to context and depend on local means and capabilities. RECENT FINDINGS: Doctors without Borders (MSF) has proven that even in precarious situations, safe administration of anesthesia is possible, and the "do no harm" principle can and must be upheld...
2017: Current Anesthesiology Reports
https://www.readbyqxmd.com/read/28299217/management-of-retained-genital-piercings-a-case-report-and-review
#8
Laura J Moulton, Amelia M Jernigan
The prevalence of genital piercing among women is increasing. As the popularity increases, the number of complications from infection, injury, and retained jewelry is likely to rise. Techniques to remove embedded jewelry are not well described in the literature. The purpose of this report was to describe a case of a patient with a retained clitoral glans piercing, discuss a simple technique for outpatient removal, and review current evidence regarding associated risks of clitoral piercings. A 24-year-old female presented to the emergency department with an embedded clitoral glans piercing...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28298791/amyloidosis-and-anesthesia
#9
Zara Wani, Dev Kumar Harkawat, Meenaxi Sharma
AIM: The aim of this article is to provide a view of amyloidosis and discuss implications for the anesthetic management of patients with this condition. MATERIAL AND METHOD: Urine samples from patients with plasma cell dyscrasias were obtained from a urine bank that gathers urine samples from patients who gave research use consent for specimens that would otherwise be considered waste. RESULTS: Patients with amyloidosis may present to the anesthesiologist for procedures relating to diagnosis, surgery relating to the underlying condition (e...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298781/analgesic-efficacy-of-transverse-abdominal-plane-block-after-elective-cesarean-delivery-bupivacaine-with-fentanyl-versus-bupivacaine-alone-a-randomized-double-blind-controlled-clinical-trial
#10
Roshan John, R V Ranjan, T R Ramachandran, Sagiev Koshy George
BACKGROUND: The analgesic benefit of transversus abdominis plane (TAP) blocks for cesarean delivery remains controversial. In our study, we compared the analgesic efficacy of TAP block using local anesthetic bupivacaine and adjunct fentanyl with bupivacaine alone in patients undergoing elective cesarean section. METHODS: Our study was a randomized, double-blind, controlled clinical trial where sixty patients undergoing elective cesarean delivery under subarachanoid block (2 ml of 0...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298773/comparison-of-nerve-stimulation-guided-axillary-brachial-plexus-block-single-injection-versus-four-injections-a-prospective-randomized-double-blind-study
#11
Santoshi V Badiger, Sameer N Desai
BACKGROUND: A variety of techniques have been described for the axillary block using nerve stimulator, either with single injection, two, three, or four separate injections. Identification of all the four nerves is more difficult and time-consuming than other methods. AIMS: Aim of the present study is to compare success rate, onset, and duration of sensory and motor anesthesia of axillary block using nerve stimulator, either with single injection after identification of any one of the four nerves or four separate injections following identification of each of nerve...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298772/effect-of-dexmedetomidine-as-an-adjuvant-to-0-75-ropivacaine-in-interscalene-brachial-plexus-block-using-nerve-stimulator-a-prospective-randomized-double-blind-study
#12
H D Rashmi, H K Komala
BACKGROUND: Ropivacaine, a newer local anesthetic (LA), has been increasingly used nowadays in different concentrations for peripheral nerve blocks. It has lesser cardiac toxicity and higher safety margin when compared to bupivacaine. Dexmedetomidine, a novel α2 agonist, is widely used as adjuvant to LA in peripheral nerve blocks to decrease the time of onset and increase the duration of the block. In this study, we evaluated the effect of dexmedetomidine as an adjuvant with 0.75% ropivacaine for interscalene brachial plexus block using nerve stimulator...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298770/intraperitoneal-levobupivacaine-with-or-without-clonidine-for-pain-relief-after-laparoscopic-cholecystectomy-a-randomized-double-blind-placebo-controlled-trial
#13
Nishith Govil, Parag Kumar
BACKGROUND: Irrigation of local anesthetic intraperitoneally in combination with opioids and non-opioids agents has been used to provide pain relief with varying success in laparoscopic surgeries. This randomized double blind placebo controlled study is designed to study the effect of intraperitoneal instillation of levo-bupivacaine along with clonidine for pain relief after laparascopic cholecystectomy. METHODS: 75 patients were randomized to receive 20 ml of 0...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298756/comparison-of-postoperative-pain-after-epidural-anesthesia-using-0-5-0-75-ropivacaine-and-0-5-bupivacaine-in-patients-undergoing-lower-limb-surgery-a-double-blind-study
#14
Tripat Kaur Bindra, Rajvinder Singh, Ruchi Gupta
BACKGROUND: Ropivacaine (S (-)-1-propyl-2", 6"; pipecoloxylidide hydrochloride) a newer long-acting amide local anesthetic has various clinical and pharmacokinetic advantages over bupivacaine. AIMS: The aim of this study is to compare the onset as well as the duration of sensory block, hemodynamic variables, and postoperative analgesia with 0.5%, 0.75% ropivacaine and 0.5% bupivacaine after epidural anesthesia for lower limb orthopedic surgery. PATIENTS AND METHODS: Sixty American Society of Anesthesiologists I and II patients scheduled for lower limb orthopedic surgery were enrolled into this randomized, double-blind study...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28296541/pharmacological-modulators-of-autophagy-activate-a-parallel-noncanonical-pathway-driving-unconventional-lc3-lipidation
#15
Elise Jacquin, Stéphanie Leclerc-Mercier, Celine Judon, Emmanuelle Blanchard, Sylvie Fraitag, Oliver Florey
The modulation of canonical macroautophagy/autophagy for therapeutic benefit is an emerging strategy of medical and pharmaceutical interest. Many drugs act to inhibit autophagic flux by targeting lysosome function, while others were developed to activate the pathway. Here, we report the surprising finding that many therapeutically relevant autophagy modulators with lysosomotropic and ionophore properties, classified as inhibitors of canonical autophagy, are also capable of activating a parallel noncanonical autophagy pathway that drives MAP1LC3/LC3 lipidation on endolysosomal membranes...
February 15, 2017: Autophagy
https://www.readbyqxmd.com/read/28295822/anterior-rectus-sheath-blocks-in-children-with-abdominal-wall-pain-due-to-anterior-cutaneous-nerve-entrapment-syndrome-a-prospective-case-series-of-85-children
#16
Murid Siawash, Frederique Mol, Walther Tjon-A-Ten, Christel Perquin, Percy van Eerten, Ernst van Heurn, Rudi Roumen, Marc Scheltinga
BACKGROUND: Chronic abdominal pain in children may be caused by the anterior cutaneous nerve entrapment syndrome. Local nerve blocks are recommended as an initial treatment in adults. Evidence on effectiveness and safety of such a treatment in children is lacking. AIM: Our aim was to study outcome and adverse events of anterior rectus sheath blocks in childhood anterior cutaneous nerve entrapment syndrome. METHODS: Patients <18 years of age receiving anterior rectus sheath blocks were prospectively followed...
March 10, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28294508/transversus-abdominis-plane-block-for-the-diagnosis-and-treatment-of-chronic-abdominal-wall-pain-following-surgery-a-case-series
#17
Marco Baciarello, Greta Migliavacca, Maurizio Marchesini, Adriana Valente, Massimo Allegri, Guido Fanelli
OBJECTIVE: The transversus abdominis plane (TAP) block is a relatively simple regional anesthesia technique which entails the injection of local anesthetics (LA) into the interfascial plane between the internal oblique and transversus abdominis muscles, where nerves supplying the anterolateral abdominal wall course. It is widely used for acute pain management following abdominal surgical procedures. We describe a series of cases in which TAP blocks were used to aid in the diagnosis and treatment of chronic abdominal wall pain (CAWP)...
March 14, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28293525/surgical-site-infiltration-for-abdominal-surgery-a-novel-neuroanatomical-based-approach
#18
Girish P Joshi, Jeffrey E Janis, Eric M Haas, Bruce J Ramshaw, Mikio A Nihira, Brian J Dunkin
BACKGROUND: Provision of optimal postoperative analgesia should facilitate postoperative ambulation and rehabilitation. An optimal multimodal analgesia technique would include the use of nonopioid analgesics, including local/regional analgesic techniques such as surgical site local anesthetic infiltration. This article presents a novel approach to surgical site infiltration techniques for abdominal surgery based upon neuroanatomy. METHODS: Literature searches were conducted for studies reporting the neuroanatomical sources of pain after abdominal surgery...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28293165/-pyr-1-apelin-13-1-12-is-a-biologically-active-ace2-metabolite-of-the-endogenous-cardiovascular-peptide-pyr-1-apelin-13
#19
Peiran Yang, Rhoda E Kuc, Aimée L Brame, Alex Dyson, Mervyn Singer, Robert C Glen, Joseph Cheriyan, Ian B Wilkinson, Anthony P Davenport, Janet J Maguire
Aims: Apelin is a predicted substrate for ACE2, a novel therapeutic target. Our aim was to demonstrate the endogenous presence of the putative ACE2 product [Pyr(1)]apelin-13(1-12) in human cardiovascular tissues and to confirm it retains significant biological activity for the apelin receptor in vitro and in vivo. The minimum active apelin fragment was also investigated. Methods and Results: [Pyr(1)]apelin-13 incubated with recombinant human ACE2 resulted in de novo generation of [Pyr(1)]apelin-13(1-12) identified by mass spectrometry...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28291541/evidence-for-a-novel-neurohumoral-antinociceptive-mechanism-mediated-by-peripheral-capsaicin-sensitive-nociceptors-in-conscious-rats
#20
Gábor Pethő, Kata Bölcskei, Réka Füredi, Bálint Botz, Teréz Bagoly, Erika Pintér, János Szolcsányi
Stimulation of capsaicin-sensitive peripheral sensory nerve terminals induces remote anti-inflammatory effects throughout the body of anesthetized rats and guinea-pigs mediated by somatostatin. As somatostatin has also antinociceptive effects, the study aimed at investigating whether similar remote antinociceptive effects can be demonstrated in awake animals. In conscious rats, nociceptive nerve endings of the right hind paw decentralized by cutting the sciatic and saphenous nerves 18h before were chemically stimulated, and drop of the noxious heat threshold (heat hyperalgesia) induced by prior (18h before) plantar incision was measured on the contralateral, left hind paw using an increasing-temperature water bath...
February 10, 2017: Neuropeptides
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