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https://www.readbyqxmd.com/read/28922985/delayed-development-of-malignant-hyperthermia-following-cardiopulmonary-bypass
#1
Stephen Hall Sams, Stephen Revilla, David Lawrence Stahl
Malignant hyperthermia (MH) is a rare but potentially life-threatening disorder encountered during general anesthesia. The use of cardiopulmonary bypass during cardiac surgery can obscure many of the cardinal signs and symptoms of MH. The development of postoperative MH following cardiac surgery is rare, but anesthesiologists and intensivists must maintain a high index of suspicion in order to make a prompt diagnosis. Initiation and tailored maintenance of MH therapy must also consider the complex physiologic changes of patients in the immediate post-cardiac surgery period...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28920038/comparing-the-effect-of-preoperative-administration-of-melatonin-and-passiflora-incarnata-on-postoperative-cognitive-disorders-in-adult-patients-undergoing-elective-surgery
#2
Faranak Rokhtabnak, Mohammad Reza Ghodraty, Alireza Kholdebarin, Ali Khatibi, Seyedeh Somayeh Seyed Alizadeh, Zahra Sadat Koleini, Mohammad Mahdi Zamani, Alireza Pournajafian
BACKGROUND: Anxiety is a preoperative complication, which most patients encounter. The use of a premedication to reduce preoperative anxiety with minimal cognitive impairment is crucial. OBJECTIVES: This study was conducted to compare the sedative effect of preoperative melatonin and Passiflora incarnata in patients undergoing elective surgery regarding their potential for postoperative cognitive disorders. METHODS: In this clinical trial, 52 patients American society of anesthesiologists grade (ASA) I and II of both genders were selected to receive either Passiflora incarnata (1000 mg nature made) (n = 26) or melatonin (6 mg) (n = 26) as premedication one hour before surgery...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28919813/a-prospective-double-blinded-randomized-comparison-of-ultrasound-guided-femoral-nerve-block-with-lateral-femoral-cutaneous-nerve-block-versus-standard-anesthetic-management-for-pain-control-during-and-after-traumatic-femur-fracture-repair-in-the-pediatric-population
#3
Nicole M Elsey, Joseph D Tobias, Kevin E Klingele, Ralph J Beltran, Tarun Bhalla, David Martin, Giorgio Veneziano, Julie Rice, Dmitry Tumin
BACKGROUND: Traumatic injury of the femur resulting in femoral fracture may result in significant postoperative pain. As with other causes of acute pain, regional anesthesia may offer a benefit over conventional therapy with intravenous opioids. This study prospectively assesses the effects of femoral nerve blockade with a lateral femoral cutaneous nerve block (FN-LFCN) on intraoperative anesthetic requirements, postoperative pain scores, and opioid requirements. MATERIALS AND METHODS: Seventeen pediatric patients (age 2-18 years) undergoing surgical repair of a traumatic femur fracture fulfilled the study criteria and were randomly assigned to general anesthesia with either an FN-LFCN block (n = 10) or intravenous opioids (n = 7)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28915907/effect-of-a-mother-s-recorded-voice-on-emergence-from-general-anesthesia-in-pediatric-patients-study-protocol-for-a-randomized-controlled-trial
#4
Seok Young Song, Sang Gyu Kwak, Eugene Kim
BACKGROUND: Emergence delirium is a behavioral disturbance after general anesthesia in children and may distress both the patients and the primary caregivers, such as parents and medical staff, looking after the patients. Various medical and emotional interventions have been investigated to reduce emergence delirium; however, none are completely effective. This trial intends to assess whether the mother's recorded voice can reduce this adverse post-anesthesia event and facilitate arousal from general anesthesia...
September 15, 2017: Trials
https://www.readbyqxmd.com/read/28810649/effect-of-dexmedetomidine-combined-with-sufentanil-on-preventing-emergence-agitation-in-children-receiving-sevoflurane-anesthesia-for-cleft-palate-repair-surgery
#5
Ke Luo, Jun-Mei Xu, Lin Cao, Ju Gao
The aim of the present study was to observe whether dexmedetomidine (DEX) combined with sufentanil decreased emergence agitation (EA) in children receiving sevoflurane anesthesia for cleft palate repair surgery. Children undergoing elective cleft palate repair surgery were randomly allocated into the DEX + sufentanil group (group DS; n=50) and the normal saline + fentanyl group (group SF; n=50). Patients in group DS were treated with 0.5 µg/kg DEX prior to induction of anesthesia, whereas patients in group SF received an equal volume of normal saline...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28804692/one-case-with-dexmedetomidine-induced-stuporous-state-in-epileptic-patient-undergoing-abdominal-surgery
#6
Dong-Ji Han, Zhi-Gang He, Zhi-Qiang Zhou, Li Feng, Cheng Liu, Yan Xiang, Hong-Bing Xiang
A 56-year-old epileptic patient underwent right hemicolectomy and cholecystectomy surgery under general endotracheal anesthesia. Anesthesia was maintained with sevoflurane, and sufentanil, rocuronium, and dexmedetomidine infusions. After the operation and confirmation of neuromuscular recovery, the patient woke from anesthesia within 15 min and successfully extubated. After the vital signs of patient were stable, the patient was transported to post anesthesia care unit (PACU). 6 h after the surgery, he fell into a stuporous state for lasting 14 h and EEG showed no epileptiform discharges...
2017: American Journal of Neurodegenerative Disease
https://www.readbyqxmd.com/read/28803601/ultrasound-guided-transversus-abdominis-plane-block-improves-postoperative-analgesia-and-early-recovery-in-patients-undergoing-retroperitoneoscopic-urologic-surgeries-a-randomized-controlled-double-blinded-trial
#7
Ge Qu, Xu-Lei Cui, Hong-Ju Liu, Zhi-Gang Ji, Yu-Guang Huang
Objective To evaluate the effects of ultrasound-guided transversus abdominis plane (TAP) block on postoperative analgesia and early recovery in patients undergoing retroperitoneoscopic urologic surgeries. Methods This was a randomized, controlled, double-blinded trial. Eligible patients scheduled for retroperitoneoscopic urologic surgeries were randomly assigned to two groups. Group TAP received ultrasound-guided TAP block with 0.5% ropivacaine 20 ml at 30 minutes before surgery, and Group C received TAP sham block with normal saline...
September 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28802384/retrospective-study-of-intranasal-dexmedetomidine-as-a-prophylactic-against-emergence-delirium-in-pediatric-patients-undergoing-ear-tube-surgery
#8
Lisgelia Santana, Katherine Mills
OBJECTIVES: This study evaluated the effect of intranasal dexmedetomidine on emergence delirium (ED) in pediatric patients who underwent ear tube surgeries. Due to the brief nature of the surgery and low levels of pain experienced, an IV is rarely needed, limiting the medications available to anesthesiologists to manage postoperative delirium that may arise during recovery from inhalational anesthesia. Intravenous dexmedetomidine is an alpha-2 agonist anesthetic that is used in pediatric patients for the management of ED in various surgical procedures...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28800052/pediatric-post-anesthesia-care-unit-discharge-criteria-a-scoping-review-protocol
#9
Mary Ryals, Michelle Palokas
The objectives of this review are to explore existing literature on discharge criteria, tools and strategies utilized in pediatric post-anesthesia care units (PACUs) after outpatient surgery, examine and conceptually map the evidence, and identify gaps in the literature.Specifically, the review question is: what criteria, tools and strategies are being used in pediatric PACUs for discharge?
August 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28796275/immature-platelets-as-a-novel-biomarker-for-adverse-cardiovascular-events-in-patients-after-non-cardiac-surgery
#10
Aida Anetsberger, Manfred Blobner, Bernhard Haller, Sebastian Schmid, Katrin Umgelter, Theresa Hager, Clemens Langgartner, Eberhard F Kochs, Karl-Ludwig Laugwitz, Bettina Jungwirth, Isabell Bernlochner
This study evaluates whether immature platelets (IPF) determined in the post anesthesia care unit (PACU) can predict major adverse cardiovascular events (MACE) or other thromboembolic events after intermediate and high-risk surgery. IPF are increased in patients with acute coronary syndrome and recently gained interest as novel biomarker for risk stratification. In this prospective observational trial 732 patients undergoing intermediate or high-risk non-cardiac surgery were enrolled (NCT02097602). IPF was measured preoperatively and postoperatively in the PACU...
August 10, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28757921/the-impact-of-magnesium-sulfate-as-adjuvant-to-intrathecal-bupivacaine-on-intra-operative-surgeon-satisfaction-and-postoperative-analgesia-during-laparoscopic-gynecological-surgery-randomized-clinical-study
#11
Khaled Salah Mohamed, Sayed Kaoud Abd-Elshafy, Ali Mahmoud El Saman
BACKGROUND: Surgeon satisfaction and patient analgesia during the procedure of laparoscopic surgery are important issues. The aim of this work was to study if an intrathecal (IT) Bupivacaine combined with Magnesium sulfate may or may not provide good surgeon satisfaction in addition to improvement of intraoperative and postoperative analgesia. METHODS: Sixty female patients were enrolled in this prospective, randomized, double-blind controlled clinical trial study...
July 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/28746515/analysis-of-intensity-sensory-and-affective-aspects-of-pain-of-patients-in-immediate-postoperative-care
#12
Alcione Carla Meier, Fernanda Duarte Siqueira, Carolina Renz Pretto, Christiane de Fátima Colet, Joseila Sonego Gomes, Cátia Cristiane Matte Dezordi, Eniva Miladi Fernandes Stumm
Objective: To evaluate the pain of patients in the immediate postoperative period during admission, an hour after admission, and at discharge of the post-anesthesia care unit in terms of intensity, and sensory and affective aspects. Methods: Analytical, cross-sectional study with 336 patients. Data were collected using a sociodemographic and clinical form, the Numeric Pain Rating Scale, and the short-form McGill Pain Questionnaire. Data collection occurred from September to October 2015 at the post-anesthesia care unit of a general hospital in the north-west of Rio Grande do Sul, Brazil...
July 20, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28735131/mini-craniotomy-under-local-anesthesia-for-chronic-subdural-hematoma-an-effective-choice-for-elderly-and-for-patients-in-a-resource-strained-environment
#13
Shaikh Danish Mahmood, Muhammad Waqas, Mirza Z Baig, Aneela Darbar
BACKGROUND: Mini craniotomy for chronic subdural hematoma (CSDH) is associated with lower recurrence rates. However, the procedure is mostly performed under general anesthesia (GA) and therefore frequently requires intensive care unit (ICU) facility, especially in the elderly population. Due to unavailability of ICU beds, and to avoid GA, we started to perform this procedure under local anesthesia (LA). MATERIALS AND METHODS: This was a retrospective medical chart review conducted in the section of Neurosurgery at the Aga Khan Hospital in Karachi, Pakistan...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28727703/intrathecal-morphine-improves-hemodynamic-parameters-and-analgesia-in-patients-undergoing-aortic-valve-replacement-surgery-a-prospective-double-blind-randomized-trial
#14
Hamed Elgendy, Hatem A R Helmy
BACKGROUND: Intrathecal morphine (ITM) has been used in hopes of providing good postoperative analgesia in cardiac surgery. Little is known about its use in isolated aortic valve replacement surgery. OBJECTIVES: To evaluate the effects of 7 µ/kg ITM administration in aortic valve replacement in regards to hemodynamics, pain score, and postoperative complications when compared to general anesthesia alone. STUDY DESIGN: A randomized, double-blind trial...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28721091/comparison-of-single-injection-ultrasound-guided-approach-versus-multilevel-landmark-based-approach-for-thoracic-paravertebral-blockade-for-breast-tumor-resection-a-retrospective-analysis-at-a-tertiary-care-teaching-institution
#15
Jagroop Singh Saran, Amie L Hoefnagel, Kristin A Skinner, Changyong Feng, Daryl Irving Smith
BACKGROUND: The role of thoracic paravertebral blockade (TPVB) in decreasing opioid requirements in breast cancer surgery is well documented, and there is mounting evidence that this may improve survival and reduce the rate of malignancy recurrence following cancer-related mastectomy. We compared the two techniques currently in use at our institution, the anatomic landmark-guided (ALG) multilevel versus an ultrasound-guided (USG) single injection, to determine an optimal technique. METHODS: We retrospectively reviewed records of patients who received TPVB from January 2013 to December 2014...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28698343/protocol-for-an-observational-study-of-delirium-in-the-post-anaesthesia-care-unit-pacu-as-a-potential-predictor-of-subsequent-postoperative-delirium
#16
Victoria Cui, Catherine M Tedeschi, Vanessa L Kronzer, Sherry L McKinnon, Michael S Avidan
INTRODUCTION: Postoperative delirium can be a serious consequence of major surgery, associated with longer hospital stays, readmission, cognitive and functional deterioration and mortality. Delirium is an acute, reversible disorder characterised by fluctuating course, inattention, disorganised thinking and altered level of consciousness. Delirium occurring in the hours immediately following anaesthesia and delirium occurring in the postoperative period of 1-5 days have been described as distinct clinical entities...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28685304/perioperative-and-icu-healthcare-analytics-within-a-veterans-integrated-system-network-a-qualitative-gap-analysis
#17
Seshadri Mudumbai, Ferenc Ayer, Jerry Stefanko
Health care facilities are implementing analytics platforms as a way to document quality of care. However, few gap analyses exist on platforms specifically designed for patients treated in the Operating Room, Post-Anesthesia Care Unit, and Intensive Care Unit (ICU). As part of a quality improvement effort, we undertook a gap analysis of an existing analytics platform within the Veterans Healthcare Administration. The objectives were to identify themes associated with 1) current clinical use cases and stakeholder needs; 2) information flow and pain points; and 3) recommendations for future analytics development...
August 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28679460/serratia-marcescens-bacteremia-nosocomial-cluster-following-narcotic-diversion
#18
Leah M Schuppener, Aurora E Pop-Vicas, Erin G Brooks, Megan N Duster, Christopher J Crnich, Alana K Sterkel, Aaron P Webb, Nasia Safdar
OBJECTIVE To describe the investigation and control of a cluster of Serratia marcescens bacteremia in a 505-bed tertiary-care center. METHODS Cluster cases were defined as all patients with S. marcescens bacteremia between March 2 and April 7, 2014, who were found to have identical or related blood isolates determined by molecular typing with pulsed-field gel electrophoresis. Cases were compared using bivariate analysis with controls admitted at the same time and to the same service as the cases, in a 4:1 ratio...
July 6, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28679359/bilateral-thoracic-paravertebral-block-for-immediate-postoperative-pain-relief-in-the-pacu-a-prospective-observational-study
#19
Fei Liu, HuanKai Zhang, Yunxia Zuo
BACKGROUND: To investigate the feasibility, effectiveness and safety of bilateral thoracic paravertebral block (TPVB) in the post anesthesia care unit (PACU) for pain relief in participants after laparotomy. METHODS: A single shot of bilateral TPVB with 25 ml of 0.2% ropivacaine and 5 mg dexamethasone in combination for both sides at the 8th thoracic transverse level (T8) was performed on 201 participants who complained moderate to severe pain on arrival to PACU after laparotomy...
July 5, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28676443/a-modified-tongue-depressor-facilitates-the-insertion-of-proseal-laryngeal-mask-airway-comparison-with-digital-and-introducer-techniques
#20
Yao-Chia Liu, Chen-Hwan Cherng
BACKGROUND: The larger and softer cuff of the ProSeal laryngeal mask airway (LMA) may cause difficulty in insertion. We introduced a novel technique using a modified tongue depressor to aid the ProSeal LMA insertion. METHODS: A total of 150 patients were randomly allocated into three groups of 50 each, digital (D), introducer (I), and tongue depressor (TD). The ProSeal LMA was inserted by the aid of digit, introducer and a modified tongue depressor, respectively...
July 1, 2017: Journal of the Chinese Medical Association: JCMA
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