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https://www.readbyqxmd.com/read/28079754/ultrasound-guided-needle-technique-accuracy-prospective-comparison-of-passive-magnetic-tracking-versus-unassisted-echogenic-needle-localization
#1
Angela N Johnson, Jeffery S Peiffer, Nahi Halmann, Luke Delaney, Cindy A Owen, Jeff Hersh
BACKGROUND AND OBJECTIVES: Ultrasound-guided regional anesthesia facilitates an approach to sensitive targets such as nerve clusters without contact or inadvertent puncture. We compared accuracy of needle placement with a novel passive magnetic ultrasound needle guidance technology (NGT) versus conventional ultrasound (CU) with echogenic needles. METHODS: Sixteen anesthesiologists and 19 residents performed a series of 16 needle insertion tasks each, 8 using NGT (n = 280) and 8 using CU (n = 280), in high-fidelity porcine phantoms...
January 11, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28079665/anesthetic-management-of-a-patient-with-antimuscle-specific-kinase-antibody-positive-myasthenia-gravis-undergoing-an-open-cholecystectomy-a-case-report
#2
Masahiko Akatsu, Yukihiro Ikegami, Choichiro Tase, Koichi Nishikawa
Myasthenia gravis (MG) is an autoimmune disease characterized by the production of antibodies against the acetylcholine receptor, muscle-specific kinase (MuSK), or other proteins at the neuromuscular junction. MG with antibodies against MuSK (MuSK-MG) has been described recently. Here, we report the first case of anesthetic management of a patient with MuSK-MG undergoing an open cholecystectomy. In our case, propofol and remifentanil-based anesthesia were used for successful management without using muscle relaxants...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28079580/a-predictive-model-for-extended-postanesthesia-care-unit-length-of-stay-in-outpatient-surgeries
#3
Rodney A Gabriel, Ruth S Waterman, Jihoon Kim, Lucila Ohno-Machado
BACKGROUND: A predictive model that can identify patients who are at an increased risk for prolonged postanesthesia care unit (PACU) stay could help optimize resource utilization and case sequencing. Although previous studies identified some predictors, there is not a model that only utilizes various patients demographic and comorbidities, that are already known preoperatively, and that may affect PACU length of stay for outpatient procedures requiring the care of an anesthesiologist...
January 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079566/retesting-the-hypothesis-of-a-clinical-randomized-controlled-trial-in-a-simulation-environment-to-validate-anesthesia-simulation-in-error-research-the-vaser-study
#4
Alan F Merry, Jacqueline A Hannam, Craig S Webster, Kylie-Ellen Edwards, Jane Torrie, Chris Frampton, Daniel W Wheeler, Arun K Gupta, Ravi P Mahajan, Rachel Evley, Jennifer M Weller
BACKGROUND: Simulation has been used to investigate clinical questions in anesthesia, surgery, and related disciplines, but there are few data demonstrating that results apply to clinical settings. We asked "would results of a simulation-based study justify the same principal conclusions as those of a larger clinical study?" METHODS: We compared results from a randomized controlled trial in a simulated environment involving 80 cases at three centers with those from a randomized controlled trial in a clinical environment involving 1,075 cases...
January 12, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28079564/an-anesthesiologist-s-perspective-on-the-history-of-basic-airway-management-the-artisanal-anesthetic-era-1846-to-1904
#5
Adrian A Matioc
This second installment of the history of basic airway management covers the early-artisanal-years of anesthesia from 1846 to 1904. Anesthesia was invented and practiced as a supporting specialty in the context of great surgical and medical advances. The current-day anesthesia provider tends to equate the history of airway management with the history of intubation, but for the first 58 yr after the introduction of ether anesthesia, airway management was provided by basic airway techniques with or without the use of a face mask...
January 12, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28078544/epistaxis-during-nasotracheal-intubation-a-randomized-trial-of-the-parker-flex-tip%C3%A2-nasal-endotracheal-tube-with-a-posterior-facing-bevel-versus-a-standard-nasal-rae-endotracheal-tube
#6
Rosie Earle, Enda Shanahan, Himat Vaghadia, Andrew Sawka, Raymond Tang
PURPOSE: Nasotracheal intubation is a widely performed technique to facilitate anesthesia induction during oral, dental, and maxillofacial surgeries. The technique poses several risks not encountered with oropharyngeal intubation, most commonly epistaxis due to nasal mucosal abrasion. The purpose of this study was to test whether the use of the Parker Flex-Tip™ (PFT) nasal endotracheal tube (ETT) with a posterior facing bevel reduces epistaxis when compared with the standard nasal RAE ETT with a leftward facing bevel...
January 11, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28078466/does-stoma-site-specimen-extraction-increase-postoperative-ileostomy-complication-rates
#7
Wanglin Li, Cigdem Benlice, Luca Stocchi, Hermann Kessler, Emre Gorgun, Meagan Costedio
BACKGROUND: Minimizing incisions has the potential to decrease hernia formation and wound complications following laparoscopic surgery. It is currently unknown if using the stoma site for specimen extraction affects outcomes. This study aims to evaluate the impact of stoma site extraction on postoperative complication rates in laparoscopic colorectal surgery. METHODS: After IRB approval, a retrospective comparative review of 738 consecutive patients (405 M) who underwent laparoscopic colorectal surgery with ileostomy between January 2008 and December 2014 was performed...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28078353/comparison-of-nil-by-mouth-versus-early-oral-intake-in-three-different-diet-regimens-following-esophagectomy
#8
Kristine Elisabeth Eberhard, Michael Patrick Achiam, Hans Christian Rolff, Mohamed Belmouhand, Lars Bo Svendsen, Morten Thorsteinsson
BACKGROUND: The literature on oral intake after esophagectomy and its influence on anastomotic leakage and complications is sparse. METHODS: This retrospective study included 359 patients undergoing esophagectomy between January 2011 and August 2015. Three oral intake protocols were evaluated: regimen 1, nil by mouth until postoperative day (POD) 7 followed by a normal diet; regimen 2, oral intake of clear fluids from POD 1 followed by a normal diet; regimen 3, nil by mouth until POD 7 followed by a slow increase to a blended diet...
January 11, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28074825/goldenhar-syndrome-cardiac-anesthesiologist-s-perspective
#9
REVIEW
Minati Choudhury, Poonam Malhotra Kapoor
Goldenhar syndrome or oculo-auriculo-vertebral dysplasia was defined by Goldenhar in 1952 and redefined by Grolin et al. later. As the name denotes, children with this syndrome present with craniofacial and vertebral anomalies which increase the risk of airway compromise. Neonates and infants with this syndrome often have premature internal organs, low birth weight, and airway disorders. For this reason, safe anesthesia in such infants requires a complete knowledge regarding metabolism and side effects of the drugs...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074823/pharmacological-update-new-drugs-in-cardiac-practice-a-critical-appraisal
#10
REVIEW
Rohan Magoon, Arindam Choudhury, Vishwas Malik, Ridhima Sharma, Poonam Malhotra Kapoor
Cardiac practice involves the application of a range of pharmacological therapies. An anesthesiologist needs to keep pace with the rampant drug developments in the field of cardiovascular medicine for appropriate management in both perioperative and intensive care set-up, to strengthen his/her role as a perioperative physician in practice. The article reviews the changing trends and the future perspectives in major classes of cardiovascular medicine.
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074820/airway-management-of-the-cardiac-surgical-patients-current-perspective
#11
REVIEW
Arindam Choudhury, Nishkarsh Gupta, Rohan Magoon, Poonam Malhotra Kapoor
The difficult airway (DA) is a common problem encountered in patients undergoing cardiac surgery. However, the challenge is not only just establishment of airway but also maintaining a definitive airway for the safe conduct of cardiopulmonary bypass from initiation to weaning after surgical correction or palliation, de-airing of cardiac chambers. This review describes the management of the DA in a cardiac theater environment. The primary aims are recognition of DA both anatomical and physiological, necessary preparations for (and management of) difficult intubation and extubation...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28073903/assessing-patient-safety-culture-in-tunisian-operating-rooms-a-multicenter-study
#12
Manel Mallouli, Mohamed Ayoub Tlili, Wiem Aouicha, Mohamed Ben Rejeb, Chekib Zedini, Amrani Salwa, Ali Mtiraoui, Mohamed Ben Dhiab, Thouraya Ajmi
OBJECTIVE: To assess the patient safety culture (PSC) in operating rooms (ORs) and to determine influencing factors. DESIGN: A cross-sectional descriptive multicenter study which was conducted over a period of 7 months (October 2014-April 2015) using the French validated version of the Hospital Survey On Patient Safety Culture questionnaire. SETTING: Of the note, 15 ORs of public and private healthcare institutions. PARTICIPANTS: In total, there were 368 participants including surgeons, anesthesiologists, surgical and anesthesia technicians, nurses and caregivers, divided into 316 professionals exercising in public sector and 52 working in private one...
January 9, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28073298/extraperitoneal-vs-transperitoneal-robot-assisted-radical-prostatectomy-in-the-setting-of-prior-abdominal-or-pelvic-surgery
#13
David Horovitz, Changyong Feng, Edward M Messing, Jean Volny Joseph
INTRODUCTION: During Robotic-Assisted Radical Prostatectomy (RARP), the prostate may be approached extraperiteoneally (eRARP) or transperitoneally (tRARP). The former avoids the abdominal cavity which might be of benefit in patients who have had prior abdominal or pelvic surgery (PAPS). Our objective was to compare the outcomes of patients with PAPS undergoing either technique. METHODS: A retrospective review of patients treated with RARP from July 1, 2003-Dec. 31, 2014 with a minimum follow-up of 3 months was undertaken...
January 10, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28072932/a-cross-sectional-overview-of-the-first-4-000-incidents-reported-to-webairs-a-de-identified-web-based-anaesthesia-incident-reporting-system-in-australia-and-new-zealand
#14
N M Gibbs, M Culwick, A F Merry
webAIRS is a web-based de-identified anaesthesia incident reporting system, which was introduced in Australia and New Zealand in September 2009. By July 2016, 4,000 incident reports had been received. The incidents covered a wide range of patient age (<28 days to >90 years), American Society of Anesthesiologists physical status, and body mass index (<18.5 to >50 kg/m<sup>2</sup>). They occurred across a wide range of anaesthesia techniques and grade of anaesthesia provider, and over a wide range of anaesthetising locations and times of day...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28070941/the-effect-of-baseline-characteristics-on-the-response-to-proton-pump-inhibitors-in-patients-with-peptic-ulcer-bleeding
#15
James Lau, Tore Lind, Tore Persson, Stefan Eklund
BACKGROUND: The rate of rebleeding from peptic ulcers could differ between Asian and Western populations. AIM: To determine whether the observed twofold difference in rebleeding rates in two similarly designed clinical trials (one in Hong Kong [n=240], the other in a multinational Western population [n=764, http://ClinicalTrials.gov Identifier: NCT00251979]) can be explained by differences in baseline patient characteristics. METHODS: Two-factor and multifactor analyses (adjusted by demographics, established risk factors for peptic ulcer and peptic ulcer bleeding, and disease severity variables) were performed using pooled data from the two studies...
January 10, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28070632/-prevention-of-perioperative-hypothermia-implementation-of-the-s3-guideline
#16
E-P Horn, E Klar, J Höcker, A Bräuer, B Bein, H Wulf, A Torossian
To improve perioperative quality and patient safety, the German S3 guideline should be consistently implemented to avoid perioperative hypothermia. Perioperative normothermia is a quality indicator and should be achieved by anesthesiologists and surgeons. To detect hypothermia early during the perioperative process, measuring body temperature should be started 1-2 h preoperatively. Patients should be actively warmed for 20-30 min before starting anesthesia. Prewarming is most effective and should be included in the preoperative process...
January 9, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28070328/safety-and-feasibility-of-single-incision-laparoscopic-cholecystectomy-in-obese-patients
#17
Masaki Wakasugi, Masahiro Tanemura, Mitsuyoshi Tei, Kenta Furukawa, Yozo Suzuki, Toru Masuzawa, Kentaro Kishi, Hiroki Akamatsu
BACKGROUND: Current literature frequently indicates that experienced laparoscopic surgeons can safely perform single-incision laparoscopic cholecystectomy, but there have been few reports evaluating the feasibility and safety of performing single-incision laparoscopic cholecystectomy for obese patients. Therefore, a large single-center database was retrospectively reviewed to evaluate the feasibility and safety of single-incision laparoscopic cholecystectomy for obese patients by comparing the outcomes of normal-weight and obese patients undergoing single-incision laparoscopic cholecystectomy...
January 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28069329/chronic-kidney-disease-is-an-independent-risk-factor-for-transfusion-cardiovascular-complication-and-thirty-day-readmission-in-minimally-invasive-total-knee-arthroplasty
#18
Feng-Chih Kuo, Po-Chun Lin, Yu-Der Lu, Mel S Lee, Jun-Wen Wang
BACKGROUND: Little is known about the relationship between chronic kidney disease (CKD) and minimally invasive total knee arthroplasty (MIS-TKA). We hypothesized that CKD was an independent risk factor for postoperative complications and increased blood transfusion in patients following MIS-TKA. METHODS: A retrospective review of a prospective database was conducted on patients who underwent MIS-TKAs at an academic medical center between 2009 and 2012. Glomerular filtration rates (GFRs) were calculated for each patient at the time of surgery and a CKD group of 205 patients (GFR < 60 mL/min) were matched at a ratio of 1:2 with 410 patients showing a GFR ≥ 60 mL/min (control group)...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28068972/an-underlying-diagnosis-of-osteonecrosis-of-bone-is-associated-with-worse-outcomes-than-osteoarthritis-after-total-hip-arthroplasty
#19
Jasvinder A Singh, Jason Chen, Maria C S Inacio, Robert S Namba, Elizabeth W Paxton
BACKGROUND: Well-designed studies of complications and readmission rates in patients undergoing total hip arthroplasty (THA) with osteonecrosis are lacking. Our objective was to examine if a diagnosis of osteonecrosis was associated with complications, mortality and readmission rates after THA. METHODS: We analyzed prospectively collected data from an integrated healthcare system's Total Joint Replacement Registry of adults with osteonecrosis vs. osteoarthritis (OA) undergoing unilateral primary THA during 2001-2012, in an observational cohort study...
January 9, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28068834/design-considerations-of-a-randomized-controlled-trial-of-sedation-level-during-hip-fracture-repair-surgery-a-strategy-to-reduce-the-incidence-of-postoperative-delirium-in-elderly-patients
#20
Tianjing Li, L Susan Wieland, Esther Oh, Karin J Neufeld, Nae-Yuh Wang, Kay Dickersin, Frederick E Sieber
Background Delirium is an acute change in mental status characterized by sudden onset, fluctuating course, inattention, disorganized thinking, and abnormal level of consciousness. The objective of the randomized controlled trial "A STrategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients" (STRIDE) is to assess the effectiveness of light versus heavy sedation on delirium and other outcomes in elderly patients undergoing hip fracture repair surgery. Our goal is to describe the design considerations and lessons learned in planning and implementing the STRIDE trial...
January 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
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