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https://www.readbyqxmd.com/read/29792218/sudden-cardiac-arrest-under-spinal-anesthesia-in-a-mission-hospital-a-case-report-and-review-of-the-literature
#1
Bamidele Johnson Alegbeleye
BACKGROUND: Sudden cardiac arrest following spinal anesthesia is relatively uncommon and a matter of grave concern for any anesthesiologist as well as clinicians in general. There have been, however, several reports of such cases in the literature. Careful patient selection, appropriate dosing of the local anesthetic, volume loading, close monitoring, and prompt intervention at the first sign of cardiovascular instability should improve outcomes. The rarity of occurrence and clinical curiosity of this entity suggest reporting of this unusual and possibly avoidable clinical event...
May 24, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29787414/perioperative-peripheral-nerve-injury-after-general-anesthesia-a-qualitative-systematic-review
#2
Jason Chui, John M Murkin, Karen L Posner, Karen B Domino
Perioperative peripheral nerve injury (PNI) is a well-recognized complication of general anesthesia that continues to result in patient disability and malpractice claims. However, the multifactorial etiology of PNI is often not appreciated in malpractice claims given that most PNI is alleged to be due to errors in patient positioning. New advances in monitoring may aid anesthesiologists in the early detection of PNI. This article reviews recent studies of perioperative PNI after general anesthesia and discusses the epidemiology and potential mechanisms of injury and preventive measures...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29786598/-hypertrophic-cardiomyopathy-an-intraoperative-death-case-analysis-and-substantiation-of-the-standards-of-perioperative-anesthetic-management-in-a-non-cardiosurgery-clinic
#3
Roman N Fedosiuk, Liliia O Shchupachynska
The article is based on the case analysis of a sudden and unexpected intraoperative death of a 51-year-old female patient with hypertrophic cardiomyopathy, who was undergoing a non-cardiac operation in a non-cardiosurgery clinic, from acute precipitation of left ventricular outflow tract obstruction provoked by surgery and anesthesia. It emphasizes the importance of raising non-cardiac anesthesiologists' awareness of the issue and having clear standards of pre-operative evaluation and perioperative management of patients with hypertrophic cardiomyopathy in order to avoid fatal medical errors...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29785086/the-utilization-of-an-ocular-wound-chamber-on-corneal-epithelial-wounds
#4
Jennifer S McDaniel, Andrew W Holt, Elaine D Por, Elof Eriksson, Anthony J Johnson, Gina L Griffith
Purpose: Currently available ocular moisture chambers are not adequate to manage the treatment of periocular burns, corneal injuries, and infection. The purpose of these studies was to demonstrate that a flexible, semi-transparent ocular wound chamber device adapted from technology currently used on dermal wounds is safe for use on corneal epithelial injuries. Materials and methods: A depilatory cream (Nair™, 30 seconds) was utilized to remove the excess hair surrounding the left eyes of anesthetized Institute Armand Frappier (IAF) hairless, female guinea pigs (Crl:HA-Hrhr)...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29782453/a-robust-approach-to-implementing-fascia-iliaca-compartment-nerve-blocks-in-hip-fracture-patients
#5
Mark G Williams, Zachary Jeffery, Henry W Corner, John Charity, Marina Quantick, Natalie Sartin
BACKGROUND: A clear imperative exists to optimize the preoperative pain management of hip fracture patients. Increasingly, fascia iliaca compartment blocks (FICBs) are being effectively utilized as an adjunct to oral analgesia in the emergency department. PURPOSE: We investigated the feasibility, safety, and delivery rate when junior doctors and specialist nurses are trained in FICBs delivery, alongside the introduction of a step-by-step proforma. METHODS: We conducted a retrospective study of hip fractures patients presenting preinterventions (n = 138) between October and December 2014 and postinterventions (n = 246) between April and August 2015...
May 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29782451/the-efficacy-of-regional-anesthesia-techniques-to-control-postoperative-pain-after-total-knee-arthroplasty
#6
Cecilia Otten, Karen S Dunn
BACKGROUND: Choosing the most effective type of anesthesia for controlling postoperative pain is paramount for improving patient outcomes and patient satisfaction. Most often, the type of anesthesia selected is dependent on the duration and type of surgical procedure and anesthesiologist/surgeon preference. Using a combination of regional anesthesia techniques, however, remains the cornerstone of multimodal analgesia for postoperative pain management after total knee arthroplasty. PURPOSE: The purpose of this study was to determine what regional anesthesia techniques and/or combinations of regional anesthesia techniques provided the best postoperative pain control in patients who had undergone a total knee arthroplasty...
May 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29782331/management-challenges-in-an-infant-with-pentalogy-of-cantrell-giant-anterior-encephalocele-and-craniofacial-anomalies-a-case-report
#7
Richard Hubbard, Seth Hayes, Holly Gillis, Spencer Lindsey, Prashant Malhotra, Tariq Wani, Joseph D Tobias, Ralph Beltran
Pentalogy of Cantrell is a rare syndrome consisting of midline abnormalities involving the heart, sternum, abdominal wall, and the anterior and pericardial diaphragm. This combination of defects places patients at particular perioperative risk and requires individualized management during anesthetic care. The following report documents the management of a patient with pentalogy of Cantrell, whose condition was further complicated by severe midline craniofacial abnormalities, including large anterior encephalocele, deficient mandible, tethered tongue, and cleft palate...
May 17, 2018: A&A practice
https://www.readbyqxmd.com/read/29780726/operative-techniques-for-improving-surgical-exposure-in-basic-cardiac-surgery
#8
Dawn S Hui, Jason M Lizalek, Vikram S Chawa, Richard Lee
Operative exposure is key to ensuring surgical efficiency and patient safety in cardiac surgery. As the population ages and the prevalence of obesity increases, cardiac surgeons will be challenged to consider obese patient physiology and body habitus, surgical exposure and sternotomy closure techniques, and postoperative medical management to ensure optimal outcomes. In this article, we describe techniques to improve operative exposure in both obese and non-obese patients undergoing basic cardiac surgery and highlight the roles of surgical team members to ensure patient safety and provide optimal anesthetic management...
2018: Journal of visualized surgery
https://www.readbyqxmd.com/read/29780637/recent-developments-in-minimally-invasive-surgery-for-biopsy-of-small-pulmonary-nodules
#9
REVIEW
Long Jiang, Jianxing He
Following the development of radiological technology, there has been an increase in the number of pulmonary nodules found. The management of pulmonary nodules represents a specific challenge to thoracic surgeons. Pulmonary nodules are small, focal, rounded radiographic opacities that may be solitary or multiple. The definite histopathologic diagnosis is crucial in determining management ranging from interval imaging to surgical resection. The choice of a particular biopsy technique depends on the risks/benefits of the procedure, the diagnostic yield, and local expertise...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29772271/pain-management-after-bone-reconstruction-surgery-using-an-analgesic-bone-cement-a-functional-non-invasive-in-vivo-study-using-gait-analysis
#10
Manon Dupleichs, Martial Masson, Olivier Gauthier, Maeva Dutilleul, Jean-Michel Bouler, Elise Verron, Pascal Janvier
Postoperative pain following bone reconstruction is a serious complication that could jeopardize the global success of a surgery. This pain must be controlled and minimized during the first 3-4 postoperative days to prevent it from becoming chronic. In this study, a critical-size bone defect was created at the femoral distal end of rats and filled by an injectable calcium phosphate cement (CPC) loaded or not with local anesthetics (bupivacaine or ropivacaine). A functional evaluation of the gait was performed using the CatWalk system to compare the postoperative pain relief enhanced by the different CPCs after such a bone filling surgery...
May 14, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29768321/anesthetic-management-of-cesarean-delivery-for-a-parturient-with-wilson-s-disease-a-case-report
#11
Yantong Wan, Xiaoqin Jiang, Xuemei Lin
RATIONALE: Wilson's disease (WD), or hepatolenticular degeneration, is an autosomal recessive disorder with a prevalence of 1:50,000 to 1:100,000 live births. PATIENT CONCERNS: A 26-year-old primipara with WD was admitted to our hospital, due to awaiting delivery. Her main symptoms were slightly higher total bile acid (TBA) and bilateral depressed edema of lower limbs. DIAGNOSIS: She was at 38 weeks and 4 days of gestation with a 15-year history of WD, controlled with penicillamine in the past and replaced by zinc preparations from three months before pregnancy...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29768160/-selection-of-antiplatelet-therapy-for-patients-with-stable-angina
#12
M V Arkhipov
Acetylsalicylic acid (ASA) has a 120‑years long history. First ASA was used as an antipyretic and anesthetic medicine, nowadays it is widely prescribed to patients with coronary arteries disease as antithrombotic cure for prevention of major adverse clinical events (MACE). Though there are a lot of trials about usage of ASA for first and secondary MACE prevention still there are unmet clinical needs - dosage choice, the therapy length, diagnostic and management of ASA resistance, and also the prophylaxis of gastro-enteric hemorrhages...
2018: Kardiologiia
https://www.readbyqxmd.com/read/29764007/anesthetic-considerations-during-surgical-intervention-in-woake-s-syndrome-a-case-report
#13
So Ron Choi, Jeong Ho Kim, Kyoung Lin Chae, Seung Cheol Lee, Sang Yoong Park
Woake's syndrome (WS) is a recurrent nasal polyposis, accompanied by broadening of the nose, frontal sinus aplasia, dyscrinia, and bronchiectasis. There has been no previous report on anesthetic management in patients with WS. We describe a case involving a 13-year-old male patient with WS who was scheduled for septorhinoplasty for necrotic ethmoiditis. Anesthesia was induced and maintained with propofol and remifentanil using a target-controlled infusion device. The anesthetic considerations of this rare syndrome and the advantages of an intravenous infusion method over local and volatile anesthesia for these patients are discussed...
May 15, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29759289/comprehensive-acute-pain-management-in-the-perioperative-surgical-home
#14
REVIEW
John-Paul J Pozek, Martin De Ruyter, Talal W Khan
The careful coordination of care throughout the perioperative continuum offered by the perioperative surgical home (PSH) is important in the treatment of postoperative pain. Physician anesthesiologists have expertise in acute pain management, pharmacology, and regional and neuraxial anesthetic techniques, making them ideal leaders for managing perioperative analgesia within the PSH. Severe postoperative pain is one of many patient- and surgery-specific factors in the development of chronic postsurgical pain...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29757793/technique-utilizing-a-modified-oral-ring-adair-elwyn-tube-to-provide-continuous-oxygen-and-sevoflurane-delivery-during-nasotracheal-intubation-in-an-infant-with-a-difficult-airway-a-case-report
#15
Janice Y Man, John E Fiadjoe, Grace Hsu
Managing the airway of an infant with Pierre Robin sequence (PRS) is particularly challenging for anesthesiologists. Patients with PRS have the triad of micrognathia, glossoptosis, and airway obstruction that potentially and frequently leads to difficulty with both ventilation and intubation. Thus continuous oxygenation and spontaneous ventilation during intubation are essential. We describe a new method to deliver continuous oxygen and volatile anesthetic during nasotracheal intubation in an infant with PRS...
May 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29756067/concurrent-intraoperative-uterine-rupture-and-placenta-accreta-do-preoperative-chronic-hypertension-preterm-premature-rupture-of-membranes-chorioamnionitis-and-placental-abruption-provide-warning-to-this-rare-occurrence
#16
M Anthony Cometa, Scott M Wasilko, Adam L Wendling
Uterine and placental pathology can be a major cause of morbidity and mortality in the parturient and infant. When presenting alone, placental abruption, uterine rupture, or placenta accreta can result in significant peripartum hemorrhage, requiring aggressive surgical and anesthetic management; however, the presence of multiple concurrent uterine and placental pathologies can result in significant morbidity and mortality. We present the anesthetic management of a parturient who underwent an urgent cesarean delivery for non-reassuring fetal tracing in the setting of chronic hypertension, preterm premature rupture of membranes, and chorioamnionitis who was subsequently found to have placental abruption, uterine rupture, and placenta accreta...
April 2018: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29753795/non-anesthetic-effects-of-ketamine-a-review-article-authors-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2
#17
REVIEW
Jabril Eldufani, Alireza Nekoui, Gilbert Blaise
Ketamine is considered a dissociative anesthetic medication, and it is a commonly administered by a parenteral route. It works mainly by blocking the N-methyl-D-aspartate (NMDA) receptor. It inhibits the voltage-gated Na_ and K_ channels and serotonin and dopamine re-uptake; also, it affects specific receptors, such as α-amino-3-hydroxy-5-methyl-4- isoxazolepropionic acid (AMPA), kainate and aminobutyric acid A receptors. Ketamine appears to have particular mechanisms that are potentially involved during analgesic induction, including enhancing of descending inhibition and anti-inflammatory effects...
May 10, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29753446/assessment-and-management-of-preoperative-anxiety
#18
Isabel Tulloch, John S Rubin
BACKGROUND: Preoperative anxiety has the potential to alter the dynamics of an elective procedure and has been shown to detrimentally affect patients both cognitively and physiologically. If mismanaged, it can lead to essential procedures being postponed or canceled, delay postoperative recovery, and increase patients' requirements for medical intervention postoperatively. These outcomes have harmful implications both clinically and economically. Our primary objective was to evaluate the levels of anxiety patients experience immediately before elective otorhinolaryngologic procedures...
May 9, 2018: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/29750760/prospective-randomized-controlled-comparison-of-local-anesthetic-infusion-pump-versus-depofoam-bupivacaine-for-pain-management-after-unilateral-delayed-deep-inferior-epigastric-perforator-free-flap-reconstruction
#19
James Gatherwright, Rebecca Knackstedt, Amir Ghaznavi, Steven Bernard, Graham Schwarz, Andrea Moreira, Raffi Gurunluoglu, Risal Djohan
BACKGROUND: Effective postsurgical analgesia is a critical aspect of patient recovery. The goal of this prospective, randomized, controlled, blinded study was to examine the effect that liposomal bupivacaine delivered via a transversus abdominis plane (TAP) block has on pain control in women undergoing unilateral deep inferior epigastic perforator reconstruction. METHODS: IRB approval was granted for this prospective study. Patients were eligible if they were undergoing unilateral, delayed DIEP reconstruction...
March 15, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29748103/gabapentin-as-an-adjunct-to-standard-postoperative-pain-management-protocol-in-lower-extremity-surgery
#20
REVIEW
P Andrew Crisologo, Erik K Monson, Said A Atway
Postoperative pain is a problem that plagues physicians and has since the dawn of the surgical arts. Many interventions are available and used as the standard such as preoperative local anesthetic blocks, opiates, both oral and intravenous, and nonsteroidal antiinflammatory drugs. Although the temptation often exists to increase the postoperative opiate dose, opiate abuse is an increasing problem. This abuse has fueled the search for nonopiate pain adjuncts. Gabapentinoids have been shown to both decrease postoperative pain and, secondarily, decrease opiate dependence...
May 7, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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