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Regional anaesthesia

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https://www.readbyqxmd.com/read/28078374/-anaesthesia-procedures-and-invasive-vascular-access-in-severely-injured-patients-at-trauma-room-admission-in-germany-an-online-survey
#1
M F Struck, P Hilbert-Carius, B Hossfeld, J Hinkelbein, M Bernhard, T Wurmb
BACKGROUND: The continuous monitoring of vital parameters and subsequent therapy belong to the core duties of anaesthetists during acute trauma resuscitation in the trauma room. Important procedures may include placement of arterial lines and central venous catheters (CVCs). Knowledge of indication, performance and localization of invasive catheterisation of trauma care in Germany is scarce. METHODS: After approval of the German Society of Anaesthesiology and Intensive Care Medicine we conducted an online survey about arterial and central venous catheterisation of severely injured patients with consideration of common practice used by anaesthetists in German trauma rooms...
January 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28077536/cerebral-oxygen-saturation-and-cardiac-output-during-anaesthesia-in-sitting-position-for-neurosurgical-procedures-a-prospective-observational-study
#2
P Schramm, I Tzanova, F Hagen, M Berres, D Closhen, G Pestel, K Engelhard
BACKGROUND: Neurosurgical operations in the dorsal cranium often require the patient to be positioned in a sitting position. This can be associated with decreased cardiac output and cerebral hypoperfusion, and possibly, inadequate cerebral oxygenation. In the present study, cerebral oxygen saturation was measured during neurosurgery in the sitting position and correlated with cardiac output. METHODS: Perioperative cerebral oxygen saturation was measured continuously with two different monitors, INVOS(®) and FORE-SIGHT(®)...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28070884/a-national-survey-of-neurological-monitoring-practice-after-obstetric-regional-anaesthesia-in-the-uk
#3
E Roderick, J Hoyle, S M Yentis
Neuraxial anaesthesia is widely used in obstetrics and neurological complications are rare. However, when they occur, subsequent investigation and management are time-critical and correlate with the extent of neurological recovery. The Third National Audit Project recommended the implementation of guidelines in obstetric epidural management, including advice on monitoring for early signs of problems and acting upon concerns. However, no national guideline exists for postoperative management in the obstetric population...
January 10, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28044336/monitoring-regional-blockade
#4
REVIEW
K Ode, S Selvaraj, A F Smith
This review attempts to draw on the published literature to address three practical clinical questions. First, what means of testing the degree of regional blockade pre-operatively are available, and can eventual success or failure be determined soon after injection? Second, is it possible to predict if a block inserted after the induction of general anaesthesia will be effective when the patient wakes? Third, what features, and what duration, should cause concern when a block does not resolve as expected after surgery? Although the relevant literature is limited, we recommend testing of multiple sensory modalities before surgery commences; temperature and thermographic changes may offer additional early warning of success or failure...
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28039248/effect-of-anaesthesia-type-on-postoperative-mortality-and-morbidities-a-matched-analysis-of-the-nsqip-database
#5
N N Saied, M A Helwani, L M Weavind, Y Shi, M S Shotwell, P P Pandharipande
BACKGROUND: The anaesthetic technique may influence clinical outcomes, but inherent confounding and small effect sizes makes this challenging to study. We hypothesized that regional anaesthesia (RA) is associated with higher survival and fewer postoperative organ dysfunctions when compared with general anaesthesia (GA). METHODS: We matched surgical procedures and type of anaesthesia using the US National Surgical Quality Improvement database, in which 264,421 received GA and 64,119 received RA...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28017345/axillary-brachial-plexus-block-duration-with-mepivacaine-in-patients-with-chronic-renal-failure-case-control-study
#6
V Mojica, D Nieuwveld, A E Herrera, G Mestres, A M López, X Sala-Blanch
INTRODUCTION: Regional anaesthesia is commonly preferred for arteriovenous fistula (AVF) creation. Previous studies suggest a shorter block duration in patients with chronic renal failure, maybe because of the changes in regional blood flow. The aim of our study was to evaluate the duration of the axillary block with 1.5% mepivacaine in patients with chronic renal failure scheduled for AVF compared with healthy controls. METHODS: Patients scheduled for AVF creation for the first time (GIRC) were included...
December 22, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28012707/effectiveness-of-ureteroscopy-among-the-youngest-patients-one-centre-s-experience-in-an-endemic-region-in-turkey
#7
Mehmet Mazhar Utanğaç, Mansur Dağgülli, Onur Dede, Ahmet Ali Sancaktutar, Yaşar Bozkurt
BACKGROUND: In recent years, the incidence of urinary stone disease reportedly has been increasing. The use of shockwave lithotripsy has seen low success rates, the inefficacy of a single session, and the need for general anaesthesia in children; additionally, children are exposed to radiation. These suboptimal treatment conditions have all led to ureteroscopy (URS) becoming the treatment method of choice for paediatric ureter stones. The aim of this study is to examine the effectiveness of 4...
November 19, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28009637/novel-needle-guide-reduces-time-to-perform-ultrasound-guided-femoral-nerve-catheter-placement-a-randomised-controlled-trial
#8
Alparslan Turan, Rovnat Babazade, Hesham Elsharkawy, Wael Ali Sakr Esa, Kamal Maheshwari, Ehab Farag, Nicole M Zimmerman, Loran Mounir Soliman, Daniel I Sessler
BACKGROUND: Ultrasound-guided nerve blocks have become the standard when performing regional nerve blocks in anaesthesia. Infiniti Plus (CIVCO Medical Solutions, Kalona, Iowa, USA) is a needle guide that has been recently developed to help clinicians in performing ultrasound-guided nerve blocks. OBJECTIVES: We tested the hypothesis that femoral nerve catheter placement carried out with the Infiniti Plus needle guide will be quicker to perform than without the Infiniti Plus...
December 22, 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28007520/spinal-anaesthesia-in-outpatient-and-conventional-surgery-a-point-of-view-from-experienced-french-anaesthetists
#9
Régis Fuzier, Christophe Aveline, Paul Zetlaoui, Olivier Choquet, Hervé Bouaziz
INTRODUCTION: The objective of this investigation was to evaluate the practice of spinal anaesthesia among French anaesthetists in inpatient and outpatient settings. METHODS AND MATERIALS: A questionnaire was sent to members of the French Association of Anaesthetists involved in regional anaesthesia during the first 4 months of 2015. The questionnaire included items on the practice of spinal anaesthesia (type of needle, local anaesthetic available, puncture and disinfection techniques, etc...
December 19, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28005766/three-dimensional-handheld-scanning-to-quantify-head-shape-changes-in-spring-assisted-surgery-for-sagittal-craniosynostosis
#10
Maik Tenhagen, Jan L Bruse, Naiara Rodriguez-Florez, Freida Angullia, Alessandro Borghi, Maarten J Koudstaal, Silvia Schievano, Owase Jeelani, David Dunaway
Three-dimensional (3D) imaging is an important tool for diagnostics, surgical planning, and evaluation of surgical outcomes in craniofacial procedures. Gold standard for acquiring 3D imaging is computed tomography that entails ionizing radiations and, in young children, a general anaesthesia. Three-dimensional photographic imaging is an alternative method to assess patients who have undergone calvarial reconstructive surgery. The aim of this study was to assess the utility of 3D handheld scanning photography in a cohort of patients who underwent spring-assisted correction surgery for scaphocephaly...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28003411/dorsal-versus-ventral-differences-in-fast-up-state-associated-oscillations-in-the-medial-prefrontal-cortex-mpfc-of-the-urethane-anaesthetised-rat
#11
Sabine Gretenkord, Adrian Rees, Miles A Whittington, Sarah E Gartside, Fiona E N LeBeau
Cortical slow oscillations (0.1 - 1 Hz), which may play a role in memory consolidation, are a hallmark of non-rapid eye movement (NREM) sleep and also occur under anaesthesia. During slow oscillations the neuronal network generates faster oscillations on the active Up-states and these nested oscillations are particularly prominent in the PFC. In rodents the mPFC consists of several subregions: anterior cingulate cortex (ACC), prelimbic (PrL), infralimbic (IL) and dorsal peduncular cortices (DP). Although each region has a distinct anatomy and function, it is not known whether slow or fast network oscillations differ between subregions in vivo...
December 21, 2016: Journal of Neurophysiology
https://www.readbyqxmd.com/read/27986182/episiotomy-technique-and-management-of-anal-sphincter-tears-a-survey-of-clinical-practice-and-education
#12
Rebecca Menzies, Marian Leung, Nirmala Chandrasekaran, Andrea Lausman, Michael Geary
OBJECTIVE: To ascertain current techniques of episiotomy used by obstetrics and gynaecology faculty members and residents in an academic department and to determine the current management strategies for third and fourth degree tears. METHOD: A 14-question anonymous online survey was circulated to all faculty members and residents in the University of Toronto Department of Obstetrics and Gynaecology between October 2015 and March 2016. Results were analyzed descriptively or with Fisher exact test...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27982554/regional-anaesthesia-and-antithrombotic-agents-instructions-for-use
#13
Gennaro Scibelli, Lucia Maio, Gennaro Savoia
BACKGROUND: The use of anticoagulant agents represents a serious limitation of regional anesthesia, due to the risk of spinal hematoma. Examining all the principles currently available, it has been possible to notice that published guidelines are very often incomplete or also differ significantly on the rules to be followed relating to a specific drug. METHODS: We have carried out a comparison between the guidelines of major scientific societies in order to take a practical and simple user guide which operators can consult...
December 16, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27979834/ciclosporin-to-protect-renal-function-in-cardiac-surgery-ciprics-a-study-protocol-for-a-double-blind-randomised-placebo-controlled-proof-of-concept-study
#14
Per Ederoth, Edgars Grins, Alain Dardashti, Björn Brondén, Carsten Metzsch, André Erdling, Shahab Nozohoor, Arash Mokhtari, Magnus J Hansson, Eskil Elmér, Lars Algotsson, Stefan Jovinge, Henrik Bjursten
INTRODUCTION: Acute kidney injury (AKI) after cardiac surgery is common and results in increased morbidity and mortality. One possible mechanism for AKI is ischaemia-reperfusion injury caused by the extracorporeal circulation (ECC), resulting in an opening of the mitochondrial permeability transition pore (mPTP) in the kidneys, which can lead to cell injury or cell death. Ciclosporin may block the opening of mPTP if administered before the ischaemia-reperfusion injury. We hypothesised that ciclosporin given before the start of ECC in cardiac surgery can decrease the degree of AKI...
December 15, 2016: BMJ Open
https://www.readbyqxmd.com/read/27974889/regional-anaesthesia-is-associated-with-shorter-postanaesthetic-care-and-less-pain-than-general-anaesthesia-after-upper-extremity-surgery
#15
Sven Grauman, Jakob Boethius, Joakim Johansson
Introduction. For surgery on the upper extremity, the anaesthetist often has a choice between regional anaesthesia (RA) and general anaesthesia (GA). We sought to investigate the possible differences between RA and GA after upper extremity surgery with regard to postoperative patient comfort. Methods. This is a retrospective observational study that was performed at an acute care secondary referral centre. One hundred and eighty-seven procedures involving orthopaedic surgery on the upper extremity were included...
2016: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/27956674/patient-reported-outcome-of-adult-perioperative-anaesthesia-in-the-united-kingdom-a-cross-sectional-observational-study
#16
E M K Walker, M Bell, T M Cook, M P W Grocott, S R Moonesinghe
BACKGROUND: Understanding the patient perspective on healthcare is central to the evaluation of quality. This study measured selected patient-reported outcomes after anaesthesia in order to identify targets for research and quality improvement. METHODS: This cross-sectional observational study in UK National Health Service hospitals, recruited adults undergoing non-obstetric surgery requiring anaesthesia care over a 48 h period. Within 24 h of surgery, patients completed the Bauer questionnaire (measuring postoperative discomfort and satisfaction with anaesthesia care), and a modified Brice questionnaire to elicit symptoms suggestive of accidental awareness during general anaesthesia (AAGA)...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27956666/glycaemic-control-during-cataract-surgery-under-loco-regional-anaesthesia-a-growing-problem-and-we-are-none-the-wiser
#17
EDITORIAL
C M Kumar, E Seet, T Eke, K Dhatariya, G P Joshi
No abstract text is available yet for this article.
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27939487/cerebrospinal-fluid-levels-of-tau-and-phospho-tau-181-proteins-during-pregnancy
#18
Wolfgang Lederer, Cristina Alomar Dominguez, Marina Popovscaia, Günther Putz, Christian Humpel
OBJECTIVES: During pregnancy various interactions occur between structural alterations of the maternal brain and placental metabolism. The aim of the present study was to investigate whether cerebrospinal fluid concentrations of tau and phospho-tau-181 protein vary during normal pregnancy and in women with preeclampsia and HELLP syndrome. STUDY DESIGN: We measured cerebrospinal fluid biomarkers, tau and phospho-tau-181 protein levels in 90 pregnant women electively assigned for regional anaesthesia during pregnancy or for cesarean section using enzyme-linked immunosorbent assays...
October 2016: Pregnancy Hypertension
https://www.readbyqxmd.com/read/27939017/regional-analgesia-in-postsurgical-critically-ill-patients
#19
S Moliner Velázquez, R Rubio Haro, C De Andrés Serrano, J De Andrés Ibáñez
Regional analgesia intrinsically, based on its physiological effects, is routinely used for the perioperative treatment of pain associated with surgical procedures. However, in other areas such as the non-surgical treatment of acute pain for patients in a critical condition, it has not been subjected to specific prospective studies. If we confine ourselves to the physiological effects of the nerve block, in a situation of stress, the indications for regional anaesthesia in this group of patients extend to the management of a wide variety of medical as well as postsurgical conditions, of trauma patients and of other painful procedures performed in the patient's bed...
December 7, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27935552/prefabrication-and-free-transfer-of-a-tissue-engineered-composite-flap-an-experimental-model-in-the-rat
#20
V Mandlik, A Kehrer, L Jiga, B Hoinoiu, M Ionac, F Jung, R Staudenmaier, L Prantl
BACKGROUND: The technique of flap-prefabrication has been successfully established in tissue engineering: missing intrinsic vascularisation of engineered tissue can be generated in vivo by microsurgical vesselloop construction. It is possible to move engineered tissue into a defect with microsurgery. In the literature, the combination of engineered tissue covered with skin is not widely reported. OBJECTIVE: Aim of this study was to establish a model to investigate scaffold prefabrication with full thickness skin graft coverage with subsequent free tissue transfer...
December 8, 2016: Clinical Hemorheology and Microcirculation
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