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Trauma And Anesthesia

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https://www.readbyqxmd.com/read/28720187/experiences-with-regional-anesthesia-for-analgesia-during-prolonged-aeromedical-evacuation
#1
Jeffrey M Carness, Melissa A Wilson, Mark J Lenart, Danny E Smith, Susan F Dukes
INTRODUCTION: There is much debate regarding the appropriate analgesic management of patients undergoing medical evacuation following combat trauma. Our primary objective was to review the utility of regional anesthetic techniques in patients undergoing aeromedical evacuation following surgical limb amputation as treatment for combat trauma. METHODS: This study was conducted as an observational retrospective cohort whereby acutely injured amputee patients were identified via the U...
August 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28719457/regional-anesthesia-in-diabetic-peripheral-neuropathy
#2
Werner Ten Hoope, Marjolein Looije, Philipp Lirk
PURPOSE OF REVIEW: The aim of this review is to summarize recent relevant literature regarding regional anesthesia in the diabetic neuropathic patient and formulate recommendations for clinical practice. RECENT FINDINGS: Diabetic neuropathic nerves, but not nerves of diabetic patients per se, exhibit complex functional changes. As a result, they seem more sensitive to local anesthetics, and are more difficult to stimulate. When catheters are used postoperatively, diabetes is an independent risk factor for infection...
July 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28715950/efficacy-of-the-novel-medical-adhesive-mar-vivo-107-in-an-acute-porcine-liver-resection-model
#3
Hirokazu Tanaka, Kenji Fukushima, Pramod Kadaba Srinivasan, Kerstin Pawlowsky, Babette Koegel, Koichiro Hata, Yonson Ku, Shinji Uemoto, René H Tolba
BACKGROUND: Despite modern surgical techniques, insufficient hemostasis after liver trauma is still a major cause of morbidity and mortality after injury. Therefore, efficient hemostatic agents are indicated. In this study, we evaluated the hemostatic efficacy of a novel synthetic wound adhesive (MAR-VIVO-107) based on polyurethane/polyurea, compared with a widely used fibrin adhesive (Tisseel). MATERIALS AND METHODS: Twelve German Landrace pigs were randomly assigned to 2 groups...
July 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28712105/evaluation-of-a-low-cost-3d-printed-model-for-bronchoscopy-training
#4
Matteo Parotto, Joshua Qua Jiansen, Ahmed AboTaiban, Svetlana Ioukhova, Alisher Agzamov, Richard Cooper, Gerald O'Leary, Massimiliano Meineri
BACKGROUND: Flexible bronchoscopy is a fundamental procedure in anesthesia and critical care medicine. Learning this procedure is a complex task, but the use of simulation-based training provides significant advantages like enhanced patient safety. Access to bronchoscopy simulators may be limited in low resources settings. We developed a low-cost 3D printed bronchoscopy training model. METHODS: A parametric airway model was obtained from an online medical model repository and fabricated using a low-cost 3D printer...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28704652/environmental-stress-causes-lethal-neuro-trauma-during-asymptomatic-viral-infections
#5
Jonathan Chow, Zsuzsa Márka, Imre Bartos, Szabolcs Márka, Jonathan C Kagan
Asymptomatic infections often proceed undetected, yet can still prime the host to be sensitive to secondary environmental stress. While the mechanisms underlying disease caused by asymptomatic infections are unknown, it is believed that productive pathogen replication is required. We report that the environmental stress of carbon dioxide (CO2) anesthesia converts an asymptomatic rhabdovirus infection in Drosophila to one that is lethal. This lethality results from a pool of infectious virus in glial cells and is regulated by the antiviral RNAi pathway of the host...
July 12, 2017: Cell Host & Microbe
https://www.readbyqxmd.com/read/28704248/low-end-tidal-carbon-dioxide-at-the-onset-of-emergent-trauma-surgery-is-associated-with-nonsurvival-a-case-series
#6
Roman Dudaryk, Danielle K Bodzin, Juliet J Ray, Craig S Jabaley, Richard R McNeer, Richard H Epstein
BACKGROUND: End-tidal carbon dioxide (EtCO2) is a valuable marker of the return of adequate circulation following cardiac arrest due to medical causes. Previously, the prognostic value of capnography in trauma has been studied among limited populations in prehospital and emergency department settings. We aimed to investigate the relationship between early intraoperative EtCO2 and nonsurvival of patients undergoing emergency surgery at a level 1 academic trauma center as a case series...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28692684/comparative-cyto-histological-study-of-needle-tip-aspirates-and-entry-sites-after-intravitreal-injection-using-different-needle-types
#7
Lyubomyr Lytvynchuk, Andrij Sergienko, Iryna Savytska, Réka Albert, Carl Glittenberg, Susanne Binder, Goran Petrovski
A comparison of the cellular content of needle tip aspirates and entry sites after transconjunctival intravitreal injection (IVI) using different needle types was performed. White outbred rats and human cadaver eyes were used for IVI by hypodermic 27 gauge (G) and 30G needles, and spinal anesthesia Pencan 27G needles. Aspiration of vitreous for quantitative morphological and cell cultivation analysis, as well as cyto-histological analysis of aspirates and entry sites were carried out. The most common cells in the aspirates from all needle types were conjunctival epithelial-, ciliary body non-pigmented epithelial- and sclerocyte-like cells and granular proteins...
2017: PloS One
https://www.readbyqxmd.com/read/28690745/closed-reduction-of-a-traumatic-hip-dislocation-in-children-case-report
#8
Achraf El Bakkaly, Fouad Ettayebi, Houda Oubeja, Mounir Erraji, Hicham Zerhouni
Traumatic dislocation of the hip in children is a rare disease. It only represents 5% of hip dislocations in all age groups. Before 10 years, the mechanism is often a minimal domestic accident; after 10 years, the dislocation occurs with the waning of an accident of the public highway. It is different from that of the adult by its rarity, its ease of reduction and better prognosis. This is an emergency trauma: risk necrosis of the femoral head (If delayed reduction). We report a rare case of a 3 year old boy, who suffered from bipolar trauma after a fall near his height of his house causing him a detachment of the right humerus and post-traumatic dislocation of the left hip...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28682827/anesthesia-for-minimally-invasive-neurosurgery
#9
Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor
PURPOSE OF REVIEW: With an ultimate aim of improving patients overall outcome and satisfaction, minimally invasive surgical approach is becoming more of a norm. The related anesthetic evidence has not expanded at the same rate as surgical and technological advancement. This article reviews the recent evidence on anesthesia and perioperative concerns for patients undergoing minimally invasive neurosurgery. RECENT FINDINGS: Minimally invasive cranial and spinal surgeries have been made possible only by vast technological development...
July 5, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28660196/endovascular-repair-of-traumatic-isthmic-ruptures-special-concerns
#10
REVIEW
Nikolaos Patelis, Athanasios Katsargyris, Chris Klonaris
Injury of the aortic isthmus is the second most frequent cause of death in cases of blunt traumatic injury. Conventional open repair is related to significant morbidity and mortality. Thoracic endovascular aortic repair (TEVAR) has increasing role in traumatic isthmic rupture, as it avoids the thoracotomy-related morbidity, aortic cross clamping, and cardiopulmonary bypass. Additionally to the technical difficulties of open repair, multi-trauma patients may not tolerate the manipulations necessary to undergo open surgery, due to concomitant injuries...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28657430/tumescent-anesthesia-for-reducing-pain-swelling-and-ecchymosis-during-polycaprolactone-filler-injections-in-the-face
#11
JongSeo Kim
PCL filler can be injected in two major ways to control pain. One is such method involves mixing 0.3cc of PCL filler with lidocaine, and the other is the method introduced in this report, which involves pre-injection with a tumescent solution . It is hard to reduce pain effectively with pre-mixing PCL filler with lidocaine because there may be not enough time to act lidocaine solution effect immediately for pain control. Pre-mixing method change properties of original filler especially the property of CMC portion...
June 28, 2017: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
https://www.readbyqxmd.com/read/28625441/the-protective-effects-of-dexmedetomidine-on-ischemic-brain-injury-a-meta-analysis
#12
REVIEW
Lianxiang Jiang, Meizhu Hu, Yan Lu, Ya Cao, Yan Chang, Zeping Dai
BACKGROUND: Intracranial lesions, trauma or surgery-related damage activate immune inflammation and neuroendocrine responses, causing ischemic brain injury. Studies have shown that inflammatory cascade mediated by neuroendocrine hormones and proinflammatory mediators is implicated in the pathophysiology of ischemic brain injury. Alpha2-adrenoceptor agonists, dexmedetomidine, is widely used as neuroprotectants in anesthesia practice. However, it is still lack of a comprehensive meta-analysis to evaluate the neuroprotection of dexmedetomidine against ischemic brain injury via suppressing these two physiological responses...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28619401/assessment-of-surgical-and-trauma-capacity-in-potos%C3%A3-bolivia
#13
Kevin J Blair, Marissa A Boeck, José Luis Gallardo Barrientos, José Luis Hidalgo López, Irene B Helenowski, Benedict C Nwomeh, Michael B Shapiro, Mamta Swaroop
BACKGROUND: Scaling up surgical and trauma care in low- and middle-income countries could prevent nearly 2 million annual deaths. Various survey instruments exist to measure surgical and trauma capacity, including Personnel, Infrastructure, Procedures, Equipment, and Supplies (PIPES) and International Assessment of Capacity for Trauma (INTACT). OBJECTIVE: We sought to evaluate surgical and trauma capacity in the Bolivian department of Potosí using a combined PIPES and INTACT tool, with additional questions to further inform intervention targets...
March 2017: Annals of Global Health
https://www.readbyqxmd.com/read/28614863/-anesthetic-management-in-thoracic-trauma-patients
#14
Alf Kozian, Astrid Bergmann, Thomas Hachenberg, Thomas Schilling
In daily practice, management of patients with blunt thoracic trauma is challenging for the anesthetist. Injuries of airways, lungs, diaphragm, heart and large vessels are the main difficulties.Respiratory and circulatory physiology in general is affected by general anesthesia, which may result in an increased number of perioperative complications. Therefore, anesthetic management of patients with thoracic trauma needs to address different clinical topics: management of difficult airways, intrinsic effects of anesthetics and mechanical ventilation on respiratory and cardiac function, the adequate replacement of blood loss as well as type and extent of the surgical intervention...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28606639/isolated-serratus-palsy-etiology-influences-its-long-term-outcome
#15
Martti Vastamäki, Leena Ristolainen, Heidi Vastamäki, Veera Pikkarainen
HYPOTHESIS AND BACKGROUND: The cause of isolated serratus palsy is multifactorial, but evaluation of the mechanism of the injury indicates that the lesion to the long thoracic nerve is mechanical in origin in most cases. What is unknown, however, is how etiology influences its long-term outcome. We believed that overuse injuries may recover sooner and better than acute traumatic, infectious, or inflammatory injuries. METHODS: We determined the presumed etiology of isolated serratus palsy in 92 patients treated by brace or observation only and compared it with its long-term outcome after a mean follow-up of 18...
June 9, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28602382/value-in-oral-and-maxillofacial-surgery-a-systematic-review-of-economic-analyses
#16
Benjamin P Geisler, Yisi D Ji, Zachary S Peacock
PURPOSE: The purpose of this study is to describe the state of economic analyses in the field of oral and maxillofacial surgery (OMS). MATERIALS AND METHODS: A systematic search of published literature up to 2016 was performed. The inclusion criteria were as follows: English-language articles on economic analyses pertaining to OMS including anesthesia and pain management; dentoalveolar surgery; orthognathic, cleft, and/or obstructive sleep apnea treatment; pathology; reconstruction; temporomandibular disorders; trauma; and other...
May 18, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28601422/exposure-to-surgery-and-anesthesia-after-concussion-due-to-mild-traumatic-brain-injury
#17
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/28590065/safety-and-efficacy-of-laryngeal-mask-airway-ventilation-in-obese-patients-with-airway-stenosis
#18
D Cole Pourciau, D Peter Hotard, Schuylor Hayley, Kasey Hayley, Collin Sutton, Andrew J McWhorter, Daniel S Fink
OBJECTIVE: To assess the efficacy of laryngeal mask airway (LMA) ventilation in obese patients with airway stenosis. STUDY DESIGN: A retrospective chart review was conducted in an academic practice in a tertiary care center. METHODS: We retrospectively reviewed our experience using LMA ventilation in obese patients with airway stenosis. Lowest intraoperative O2 saturation and maximum-end tidal carbon dioxide (CO2 ) levels were recorded. Complications including intubation, unplanned admission, re-admission, postoperative pain, dysphonia, oral trauma, pneumothorax, pneumomediastinum, and tracheostomy were recorded...
June 7, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28589067/intraoperative-dexmedetomidine-induced-polyuric-syndrome
#19
Shannon Granger, David Ninan
A 23-year-old male trauma patient with a cervical spine fracture underwent an anterior and posterior discectomy and spinal fusion surgery. The patient presented to the operating room with a stabilizing halo fixation device in place, and a fiberoptic intubation was performed with dexmedetomidine for sedation. During the surgical procedure, general anesthesia was maintained with a propofol and remifentanil infusion as the patient was monitored using somatosensory and motor evoked potentials. The patient's urine output increased gradually during the nine-hour surgical procedure from 150 mL/hour to over 700 mL/hour in the eighth hour of the procedure, where it remained until the end of the procedure...
May 3, 2017: Curēus
https://www.readbyqxmd.com/read/28588328/internal-fixation-of-fractured-ribs-in-neonatal-foals-with-nylon-cable-tie-using-a-modified-technique
#20
T Boullhesen Williams, Jarred M Williams, Dwayne H Rodgerson
Nylon cable tie has been shown to be an effective and economical method for fixing fractured ribs in the neonatal foal. This article describes a modification of the previously described technique. Under general anesthesia, the fractured ribs were exposed and a hole was drilled in the dorsal and ventral fragments. The fracture was not reduced, leaving the fragments overriding each other. The nylon cable tie was passed through the hole in the dorsal fragment from the external surface of the rib. The free end of the cable tie was then passed through the hole in the ventral fragment from the external surface of the rib and the tie was tightened...
June 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
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