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Perioperative Anesthesia

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https://www.readbyqxmd.com/read/28938302/anesthesia-information-management-clinical-decision-support
#1
Robert E Freundlich, Jesse M Ehrenfeld
PURPOSE OF REVIEW: Perioperative informatics tools continue to be developed at a rapid pace and offer clinicians the potential to greatly enhance clinical decision making. The goal of this review is to bring the reader updates on perioperative information management and discuss future research directions in the field. RECENT FINDINGS: Clinical decision support tools become more timely, accurate, and, in some instances, have been shown to improve patient outcomes...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28937421/methylene-blue-to-treat-refractory-latex-induced-anaphylactic-shock-a-case-report
#2
Paulo Sergio Da Silva, Paula Furtado
Anaphylaxis occurs in 1/5000-1/20,000 of anesthesia cases and may evolve with shock and cardiovascular collapse in up to 54% of cases. Mortality varies from 3% to 10%. Latex is the second leading cause of anaphylaxis during the perioperative period. We report a case of latex-induced anaphylactic shock refractory to the usual catecholamine treatment that was reversed with the aid of methylene blue. Exaggerated activation of the nitric oxide-cyclic guanosine monophosphate pathway is observed in refractory shock...
September 20, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28936613/chronic-inflammatory-demyelinating-polyradiculoneuropathy-and-anesthesia-a-case-series
#3
Andrew R Mortenson, Juraj Sprung, James C Watson, P James B Dyck, Toby N Weingarten
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired autoimmune demyelinating polyneuropathy characterized by symmetrical diffuse weakness that also can rarely affect bulbar and respiratory muscles. The study objective was to describe perioperative outcomes of patients with CIDP who received general anesthesia. This retrospective observational study evaluated patients with active (diagnosed or treated within the previous year) CIDP who underwent general anesthesia at our institution between January 1, 2010, and December 31, 2015...
September 21, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28934019/cochlear-implantation-under-conscious-sedation-with-local-anesthesia-safety-efficacy-costs-and-satisfaction
#4
Samion Shabashev, Yasser Fouad, T Kate Huncke, J Thomas Roland
OBJECTIVE: To evaluate the safety, efficiency, cost effectiveness, and satisfaction of patients undergoing cochlear implantation under conscious sedation versus general anesthesia. STUDY DESIGN: Retrospective case review of 20 patients who underwent cochlear implantation under conscious sedation which was compared to 20 age-matched patients where surgery was performed under general anesthesia. METHODS: Perioperative times, length of stay, anesthesia drug costs, postoperative complications, and patient satisfaction were compared between the two groups...
September 21, 2017: Cochlear Implants International
https://www.readbyqxmd.com/read/28930934/anesthesia-and-perioperative-care-for-organ-transplantation
#5
Roman Schumann
No abstract text is available yet for this article.
September 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28928592/the-journey-of-harmless-bullet-the-perioperative-care-of-penetrating-cardiac-injury
#6
Ahmad Abou-Leila, Gennadiy Voronov
Traumatic injuries to the heart contribute significantly to trauma are associated with high mortality. Cardiac gunshot wounds (GSW) are considered more lethal compared to other injuries and present several unique challenges to the anesthesia management and perioperative care. We are reporting a rare case of a trauma victim who survived a GSW to the heart. We will discuss the perioperative care of penetrating cardiac injuries, the role of the anesthesia team in resuscitation, safe anesthesia induction, cardiopulmonary bypass management, and the essential role of intraoperative transesophageal echocardiogram imaging...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928577/a-prospective-observational-study-to-evaluate-the-role-of-gabapentin-as-preventive-analgesic-in-thyroidectomy-under-general-anesthesia
#7
Vadakkoot Raghavan Hema, Konnanath Thekkethil Ramadas, Kannammadathy Poulose Biji, Suseela Indu, Aravind Arun
BACKGROUND: Effective management of postoperative pain is a part of well-organized perioperative care, which helps in reduced morbidity and improved patient satisfaction. Preventive analgesia can reduce acute and chronic pain by blocking the noxious inputs to pain pathways, preventing sensitization. Studies have reported efficacy of gabapentin as a preventive analgesic in perioperative pain. In this study, we aimed to determine whether preoperative gabapentin reduced postoperative pain and tramadol consumption after thyroidectomy under general anesthesia...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928575/referrral-systems-development-and-survey-of-perioperative-and-critical-care-referral-to-anesthetists
#8
P L Narendra, Harihar V Hegde, Maroof Ahmad Khan, Dayanand G Talikoti, Samson Nallamilli
INTRODUCTION: Anesthetists come in contact with more than two-third of hospital patients. Timely referral to anesthetists is vital in perioperative and remote site settings. Delayed referrals, improper referrals, and referrals at inappropriate levels can result in inadequate preparation, perioperative complications, and poor outcome. METHODS: The self administered paper survey to delegates attending anesthesia conferences. Questions were asked on how high-risk, emergency surgical cases remote site and critical care patients were referred to anesthetists and presence of rapid response teams...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928556/a-study-to-compare-the-quality-of-surgical-field-using-total-intravenous-anesthesia-with-propofol-versus-inhalational-anesthesia-with-isoflurane-for-functional-endoscopic-sinus-surgeries
#9
K S Aujla, Manbir Kaur, Ruchi Gupta, Sukhjinder Singh, Bhanupreet, Tavleen
BACKGROUND AND OBJECTIVES: Functional endoscopic sinus surgery (FESS) being a delicate technique, intraoperative bleeding is one of the major challenges. Even a little bleeding can adversely affect the surgeon's ability to visualize the region to be operated. General anesthesia is preferred over topical anesthesia in FESS. This study was conducted to compare the surgical field using total intravenous anesthesia (TIVA) with propofol and inhalational anesthesia with isoflurane for FESS...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28924368/the-effects-of-perioperative-anesthesia-and-analgesia-on-immune-function-in-patients-undergoing-breast-cancer-resection-a-prospective-randomized-study
#10
Jin Sun Cho, Mi-Hyang Lee, Seung Il Kim, Seho Park, Hyung Seok Park, Ein Oh, Jong Ho Lee, Bon-Nyeo Koo
Introduction: Perioperative anesthesia and analgesia exacerbate immunosuppression in immunocompromised cancer patients. The natural killer (NK) cell is a critical part of anti-tumor immunity. We compared the effects of two different anesthesia and analgesia methods on the NK cell cytotoxicity (NKCC) in patients undergoing breast cancer surgery. Methods: Fifty patients undergoing breast cancer resection were randomly assigned to receive propofol-remifentanil anesthesia with postoperative ketorolac analgesia (Propofol-ketorolac groups) or sevoflurane-remifentanil anesthesia with postoperative fentanyl analgesia (Sevoflurane-fentanyl group)...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28922235/perioperative-inflammation-and-its-modulation-by-anesthetics
#11
Jan Rossaint, Alexander Zarbock
Surgery and other invasive procedures, which are routinely performed during general anesthesia, may induce an inflammatory response in the patient. This inflammatory response is an inherent answer of the body to the intervention and can be both beneficial and potentially harmful. The immune system represents a unique evolutionary achievement equipping higher organisms with an effective defense mechanism against exogenous pathogens. However, not only bacteria might evoke an immune response but also other noninfectious stimuli like the surgical trauma or mechanical ventilation may induce an inflammatory response of varying degree...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28922233/endoscopic-versus-open-repair-for-craniosynostosis-in-infants-using-propensity-score-matching-to-compare-outcomes-a-multicenter-study-from-the-pediatric-craniofacial-collaborative-group
#12
Douglas R Thompson, David Zurakowski, Charles M Haberkern, Paul A Stricker, Petra M Meier
BACKGROUND: The North American Pediatric Craniofacial Collaborative Group (PCCG) established the Pediatric Craniofacial Surgery Perioperative Registry to evaluate outcomes in infants and children undergoing craniosynostosis repair. The goal of this multicenter study was to utilize this registry to assess differences in blood utilization, intensive care unit (ICU) utilization, duration of hospitalization, and perioperative complications between endoscopic-assisted (ESC) and open repair in infants with craniosynostosis...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28922231/use-of-regional-anesthesia-for-outpatient-surgery-within-the-united-states-a-prevalence-study-using-a-nationwide-database
#13
Rodney A Gabriel, Brian M Ilfeld
BACKGROUND: Regional anesthesia is of benefit for outpatient surgery given its demonstrated improvement in analgesia and decrease in complications, resulting in shorter average recovery room times and lower hospital readmission rates. Unfortunately, there are few epidemiological studies outlining the overall utilization of peripheral nerve blocks (PNBs) in this setting. Therefore, the primary objective of this study was to report the overall utilization of several types of PNBs among all candidate cases in the outpatient setting within the United States...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28922229/micrornas-as-clinical-biomarkers-and-therapeutic-tools-in-perioperative-medicine
#14
Simone Kreth, Max Hübner, Ludwig Christian Hinske
Over the past decade, evolutionarily conserved, noncoding small RNAs-so-called microRNAs (miRNAs)-have emerged as important regulators of virtually all cellular processes. miRNAs influence gene expression by binding to the 3'-untranslated region of protein-coding RNA, leading to its degradation and translational repression. In medicine, miRNAs have been revealed as novel, highly promising biomarkers and as attractive tools and targets for novel therapeutic approaches. miRNAs are currently entering the field of perioperative medicine, and they may open up new perspectives in anesthesia, critical care, and pain medicine...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28922228/anesthesia-capacity-in-ghana-a-teaching-hospital-s-resources-and-the-national-workforce-and-education
#15
Mark A Brouillette, Alfred J Aidoo, Maria A Hondras, Nana A Boateng, Akwasi Antwi-Kusi, William Addison, Alec R Hermanson
BACKGROUND: Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital's resources and the national workforce and education in this LMIC capacity report. METHODS: A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28920035/anesthesia-management-of-a-patient-with-papillon-lefevre-syndrome-a-case-report
#16
Afshin Iranpour, Ata Mahmoodpoor
INTRODUCTION: Papillon-Lefèvre syndrome (PLS) is a rare autosomal recessive trait; it often requires some interventions with general anesthesia because of the accompanied complications. CASE PRESENTATION: We report a 19-year-old girl with palmoplantar hyperkeratosis who presented total loss of her teeth. She was candidate to mandibular bone graft and lower jaw dental implants under general anesthesia. CONCLUSIONS: There are only a few studies about perioperative management of these patients; however, the anesthesiologists should consider a few important issues during pre-operative and intra-operative management...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28919125/multi-institution-analysis-of-infection-control-practices-identifies-the-subset-associated-with-best-surgical-site-infection-performance-a-texas-alliance-for-surgical-quality-collaborative-project
#17
Catherine H Davis, Lillian S Kao, Jason B Fleming, Thomas A Aloia
BACKGROUND: In an effort to reduce surgical site infection (SSI) rates, a large number of infection control practices (ICPs), including operating room attire policies, have been recommended. However, few have proven benefits and many are costly, time-consuming, and detrimental to provider morale. The goal of this multi-institution study was to determine which ICPs are associated with lower postoperative SSI rates. STUDY DESIGN: Twenty American College of Surgeons NSQIP and Texas Alliance for Surgical Quality-affiliated hospitals completed this Quality Improvement Assessment Board-approved study...
August 16, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28916989/comparison-of-the-recovery-profile-between-desflurane-and-sevoflurane-in-patients-undergoing-bariatric-surgery-a-meta-analysis-of-randomized-controlled-trials
#18
REVIEW
Preet Mohinder Singh, Anuradha Borle, Jason McGavin, Anjan Trikha, Ashish Sinha
Early and clear recovery from anesthesia is the crux for preventing perioperative complications in the obese undergoing bariatric surgery. Volatile inhalation agents by virtue of high lipid solubility are expected to produce residual anesthetic effects. Prospective randomized trials comparing desflurane and sevoflurane used for anesthesia maintenance (electroencephalograph guided) during bariatric surgery published till 1st of July 2017 were searched in the medical database. Comparisons were made for surrogate markers of recovery from anesthesia that included time to eye-opening (TEo), time to tracheal-extubation (TEx), and Aldrete scores on immediately shifting to recovery (Ald-I)...
September 16, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28913502/regional-anesthesia-for-a-total-knee-arthroplasty-on-an-adult-patient-with-spastic-diplegia-and-an-intrathecal-baclofen-pump
#19
Elird Bojaxhi, David R Salek, Courtney E Sherman, Roy A Greengrass
We describe the clinical presentation of a patient with spastic diplegia, and its unique perioperative challenges. Opioids and antispasmodic medications are the primary therapy for managing pain and spasticity in the perioperative setting. However, such combination results in several side-effects and their sedative properties are synergistic. A 64-year-old woman with a history of spastic diplegia and an intrathecal baclofen pump for the treatment of her lower extremity spasticity was scheduled for a third elective left knee arthroplasty...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28913499/perioperative-hyperoxia-perhaps-a-malady-in-disguise
#20
REVIEW
Yalim Dikmen, Aybike Onur
Oxygen is an element, which is used liberally during several medical procedures. The use of oxygen during perioperative care is a controversial issue. Anesthesiologists use oxygen to prevent hypoxemia during surgical procedures, but the effects of its liberal use can be harmful. Another argument for using high oxygen concentrations is to prevent surgical site infections by increasing oxygen levels at the incision site. Although inconclusive, literature concerning the use of high oxygen concentrations during anesthesia show that this approach may cause hemodynamic changes, altered microcirculation and increased oxidative stress...
April 2017: Rom J Anaesth Intensive Care
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