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https://www.readbyqxmd.com/read/27906937/transversus-abdominis-plane-block-in-the-management-of-acute-postoperative-pain-syndrome-after-caesarean-section-a-randomized-controlled-clinical-trial
#1
Pierfrancesco Fusco, Vincenza Cofini, Emiliano Petrucci, Paolo Scimia, Tullio Pozone, Giuseppe Paladini, Gaspare Carta, Stefano Necozione, Battista Borghi, Franco Marinangeli
BACKGROUND: The international literature is unclear regarding the analgesic efficacy of the transversus abdominis plane block (TAPB) after a Caesarean section (CS). OBJECTIVES: The aim of this study was to determine whether a correctly performed ultrasound-guided TAPB (USG-TAPB) could provide better control of acute postoperative pain during the first 72 hours after CS and if it could provide a faster postoperative recovery. STUDY DESIGN: A double-blind, randomized, controlled clinical trial on pregnant women who underwent CS...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906718/anesthesia-for-nonintubated-video-assisted-thoracic-surgery
#2
Hiroshi Sunaga, Justin D Blasberg, Paul M Heerdt
PURPOSE OF REVIEW: This review focuses primarily on nonintubated video-assisted thoracic surgery (NIVATS), and discusses advantages, indications, anesthetic techniques, and approaches to intraoperative crisis management. RECENT FINDINGS: Advancements in endoscopic, endovascular, and robotic techniques have expanded the range of surgical procedures that can be performed in a minimally invasive fashion. For thoracic operations in particular, video-assisted thoracic surgery (VATS) has largely replaced traditional thoracotomy, and continued technical development has made surgical access into the pleural space even less disruptive...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27906705/arterial-pressure-variation-in-elective-noncardiac-surgery-identifying-reference-distributions-and-modifying-factors
#3
Michael R Mathis, Samuel A Schechtman, Milo C Engoren, Amy M Shanks, Aleda Thompson, Sachin Kheterpal, Kevin K Tremper
BACKGROUND: Assessment of need for intravascular volume resuscitation remains challenging for anesthesiologists. Dynamic waveform indices, including systolic and pulse pressure variation, are demonstrated as reliable measures of fluid responsiveness for mechanically ventilated patients. Despite widespread use, real-world reference distributions for systolic and pulse pressure variation values have not been established for euvolemic intraoperative patients. The authors sought to establish systolic and pulse pressure variation reference distributions and assess the impact of modifying factors...
December 1, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27904211/post-operative-pain-management-in-shoulder-surgery-suprascapular-and-axillary-nerve-block-by-arthroscope-assisted-catheter-placement
#4
H Çağdaş Basat, D Hakan Uçar, Mehmet Armangil, Berk Güçlü, Mehmet Demirtaş
BACKGROUND: Postoperative pain management is the part of shoulder surgery to improve patient satisfaction, start rehabilitation process rapidly and decrease for hospital stay. Various treatment modalities have been used for pain management, but they have some limitations, side effects and risks. Throughout intraoperative and postoperative period, nerve blocks have been used more popularly than others because of efficacy. For the regional nerve block, local anesthetic should be infiltrated close to the nerve for maximum effect...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27902774/intravenous-treatment-with-a-long-chain-omega-3-lipid-emulsion-provides-neuroprotection-in-a-murine-model-of-ischemic-stroke-a-pilot-study
#5
Dirk Berressem, Konrad Koch, Nicole Franke, Jochen Klein, Gunter P Eckert
Single long-chain omega-3 fatty acids (e.g. docosahexaenoic acid (DHA) or eicosapentaenoic acid (EPA)) are known for their neuroprotective properties associated with ischemic stroke. This pilot study aimed to test the effectiveness of an acute treatment with a long-chain omega-3 lipid emulsion (Omegaven 10%®, OGV) that contains fish oil (DHA 18 mg/ml; EPA 21 mg/ml) and α-tocopherol (0.2 mg/ml) in a transient middle cerebral artery occlusion (MCAO) model of ischemic stroke in mice. For this purpose, female CD-1 mice were anesthetized and subjected to 90 minutes of MCAO...
2016: PloS One
https://www.readbyqxmd.com/read/27896927/a-retrospective-review-of-anesthesia-and-perioperative-care-in-children-with-medium-chain-acyl-coa-dehydrogenase-deficiency
#6
Claire Allen, Russell Perkins, Bernd Schwahn
BACKGROUND: Medium-chain acyl-CoA dehydrogenase deficiency is the most common genetically determined disorder of mitochondrial fatty acid oxidation. Decompensation can result in hypoglycemia, seizures, coma, and death but may be prevented by ensuring glycogen stores do not become depleted. Perioperative care is of interest as surgery, fasting, and infection may all trigger decompensation and the safety of anesthetic agents has been questioned. Current guidelines from the British Inherited Metabolic Disease Group advise on administering fluid containing 10% glucose during the perioperative period...
November 29, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27895942/an-unusual-lacerated-tracheal-tube-during-le-fort-surgery-literature-review-and-case-report
#7
Preeta George, John E Fiadjoe, Allan F Simpao
Maxillofacial surgeries can present unique anesthetic challenges due to potentially complex anatomy and the close proximity of the patient's airway to the surgical field. Damage to the tracheal tube (TT) during maxillofacial surgery may lead to significant airway compromise. We report the management of a patient with a partially severed TT during Le Fort surgery for midfacial hypoplasia and management strategies based on peer-reviewed literature. This case illustrates the clinical clues associated with a damaged TT and explores the challenges of managing this potentially catastrophic issue...
2016: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/27891453/efficacy-of-ketamine-as-an-adjunct-to-local-anesthesia-in-the-surgical-removal-of-impacted-mandibular-third-molars-a-split-mouth-prospective-controlled-clinical-study
#8
Anand Shah, Rajshekhar Halli, Yash Merchant, Rajesh Kshirsagar, Jyotsana Khurana
INTRODUCTION: The removal of impacted teeth is one of the most common procedures performed by oral and maxillofacial surgeons. Reduction of discomfort post-operatively and efficient local anesthesia are imperative for success in surgical practice. At sub-anesthetic doses, ketamine has a noticeable analgesic action, which can be used to supplement local anesthesia with minimal side effects. AIM: To assess the efficacy of low-dose ketamine as an adjunct to local anesthesia in the management of pain, swelling and trismus after surgical removal of impacted mandibular third molars...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27891040/inadvertent-injection-of-potassium-chloride-instead-of-sodium-chloride-during-treatment-of-chronic-low-back-ache-with-epidural-injection-leading-to-paraplegia
#9
Rahul Ranjan, Naiyer Asif, Sohail Ahmad, Syed Ifthekar
Epidural injection of steroid is given for back pain resistant to other conservative management. Normal saline (NS) is used as diluent in 80 mg methylprednisolone and a local anesthetic. Due to a similar looking ampoule of NS and potassium chloride (KCl), there is a probability of accidental use of KCl instead of NS. We present a case of a 50-year-old male patient having low back ache refractory to other conservative treatments. Epidural injection of steroid was given, but accidently KCl was mixed with methylprednisolone instead of NS...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27889503/gamma-knife-radiosurgery-for-uveal-metastases-report-of-three-cases-and-a-review-of-the-literature
#10
William J Ares, Daniel Tonetti, Jenny Y Yu, Edward A Monaco, John C Flickinger, L Dade Lunsford
PURPOSE: Uveal metastases are ophthalmologic tumors that have historically been treated by fractionated external beam radiation therapy or invasive brachytherapy. The need for rapid response and less invasive management options led the authors to explore the use of Gamma knife stereotactic radiosurgery (SRS) for this common problem. DESIGN: Interventional case series. METHODS: Intervention: In order to prevent eye movement during the procedure, all three patients underwent a retrobulbar anesthetic block followed by magnetic resonance imaging to detect the target...
November 23, 2016: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/27884691/aapt-diagnostic-criteria-for-chronic-cancer-pain-conditions
#11
REVIEW
Judith A Paice, Matt Mulvey, Michael Bennett, Patrick M Dougherty, John T Farrar, Patrick W Mantyh, Christine Miaskowski, Brian Schmidt, Thomas J Smith
: Chronic cancer pain is a serious complication of malignancy or its treatment. Currently, no comprehensive, universally accepted cancer pain classification system exists. Clarity in classification of common cancer pain syndromes would improve clinical assessment and management. Moreover, an evidence-based taxonomy would enhance cancer pain research efforts by providing consistent diagnostic criteria, ensuring comparability across clinical trials. As part of a collaborative effort between the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks (ACTTION) and the American Pain Society (APS), the ACTTION-APS Pain Taxonomy (AAPT) initiative worked to develop the characteristics of an optimal diagnostic system...
November 21, 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/27884666/anesthetic-considerations-in-a-parturient-with-congenital-insensitivity-to-pain-with-anhidrosis
#12
Z Pirani, F Qasem, S Katsiris
Congenital insensitivity to pain is a rare autosomal recessive disease characterized by varying degrees of autonomic dysfunction and sensory loss, including nociceptive hyposensitivity. It is this autonomic dysfunction that makes both general and neuraxial anesthesia challenging. Testing the block during neuraxial anesthesia may be difficult and the patient may be prone to hypotension and bradycardia. This case report describes the anesthetic management of a parturient with congenital insensitivity to pain presenting for cesarean delivery...
October 21, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27884218/the-current-state-of-perioperative-pain-management-challenges-and-potential-opportunities-for-nurses
#13
Melanie H Simpson, Patricia Bruckenthal
Achievement of adequate postoperative pain management is a critical challenge in health care, with an estimated three out of four adult surgical patients reporting moderate to extreme pain after surgery. Overreliance on opioids in acute care settings has persisted, despite well-known adverse side effects frequently associated with this class of drugs. Furthermore, patients with a history of chronic opioid use present additional challenges in terms of postsurgical pain management. Advances in the development of newer analgesic agents and anesthetic techniques may be useful in surgical patients with a history of chronic opioid use and in the overall surgical patient population...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27879606/improving-outcomes-in-tendon-repair-a-critical-look-at-the-evidence-for-flexor-tendon-repair-and-rehabilitation
#14
Wee S Khor, Martin F Langer, Richard Wong, Rui Zhou, Fiona Peck, Jason K F Wong
LEARNING OBJECTIVES: After reading this article, the participant should be able to: 1. Appreciate the variation and evolution of flexor tendon management 2. Know how to assess the patient who presents with a flexor tendon laceration. 3. Understand the biology of repairing flexor tendon lacerations. 4. Appreciate the technical challenges in flexor tendon repair relating to different zones. 5. Understand the rationale of postoperative hand therapy. 6. Have an overview of the types of secondary tendon surgery...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27878890/a-qualitative-exploration-of-anesthesia-trainees-experiences-during-transition-to-a-children-s-hospital
#15
Peter W Howe, Koshila Kumar
BACKGROUND: The stresses of starting a new job can make anyone feel tired and inefficient. In health care, this may impair the ability to learn at a time when there is most to learn, and increase the risk of error in a context where errors may lead to patient harm. AIM: The aim of this study was to understand issues which influence anesthesia trainees' transition to a pediatric setting. METHODS: This qualitative study utilized in-depth semi-structured interviews to gather data from 31 anesthesia trainees who had commenced work at a tertiary children's hospital between 4 and 6 weeks previously...
November 22, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27871599/acute-unanticipated-and-prolonged-superior-vena-cava-occlusion-during-pneumonectomy
#16
Mark S Goh, Vivek Chellappa
Acute, unanticipated superior vena cava (SVC) occlusion during thoracic surgery can have profound hemodynamic consequences and lead to devastating neurologic injury. We describe the successful anesthetic management of a pneumonectomy complicated by prolonged intraoperative SVC occlusion lasting a total of 290 minutes. To our knowledge, this represents the longest reported SVC occlusion time with no subsequent neurologic sequelae. Based on our favorable outcome and a review of the relevant literature, we offer a discussion of strategies for anesthetic management...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871587/peripheral-nerve-blocks-in-the-management-of-postoperative-pain-challenges-and-opportunities
#17
REVIEW
Girish Joshi, Kishor Gandhi, Nishant Shah, Jeff Gadsden, Shelby L Corman
Peripheral nerve blocks (PNBs) are increasingly used as a component of multimodal analgesia and may be administered as a single injection (sPNB) or continuous infusion via a perineural catheter (cPNB). We undertook a qualitative review focusing on sPNB and cPNB with regard to benefits, risks, and opportunities for optimizing patient care. Meta-analyses of randomized controlled trials have shown superior pain control and reductions in opioid consumption in patients receiving PNB compared with those receiving intravenous opioids in a variety of upper and lower extremity surgical procedures...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871578/children-with-heart-disease-risk-stratification-for-non-cardiac-surgery
#18
Angela K Saettele, Jacob L Christensen, Kelly L Chilson, David J Murray
STUDY OBJECTIVE: Children with congenital or acquired heart disease have an increased risk of anesthesia related morbidity and mortality. The child's anesthetic risk is related to the severity of their underlying cardiac disease, associated comorbidities, and surgical procedure. The goal of this project was to determine the ease of use of a preoperative risk stratification tool for assigning pediatric cardiac staff and to determine the relative frequency that children with low, moderate, and high risk cardiac disease present for non-cardiac surgery at a tertiary pediatric hospital...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871568/discrepancy-between-electroencephalography-and-hemodynamics-in-a-patient-with-cockayne-syndrome-during-general-anesthesia
#19
Masanori Tsukamoto, Takashi Hitosugi, Takeshi Yokoyama
Cockayne syndrome is a kind of progeria with autosomal chromosome recessiveness described first by Cockayne in 1936. Patients with this syndrome were characterized by retarded growth, cerebral atrophy, and mental retardation. We experienced an anesthetic management of a patient with Cockayne syndrome, who underwent dental treatment twice. The primary concern was discrepancy between electroencephalography and hemodynamics. The values of bispectral index showed a sharp fall to 1 digit and suppression ratio more than 40, while hemodynamics was stable during induction of anesthesia with sevoflurane 8%...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871566/known-difficult-airway-in-a-patient-with-pheochromocytoma-a-case-report
#20
Laura Alonso Guardo, Carlos Cano Gala, Antonio Rodriguez Calvo, Adriana M Buritica Aguirre, Nadia A Dávila Arango, Elena García Fernández, Carmen Ruiz Chirosa, David Sánchez Poveda, Agustín Díaz Álvarez
: The manipulation of an airway is always a critical moment in the anesthetic management of patients with pheochromocytoma due to the high incidence of undesirable hemodynamic events in relation with the stimulus represented by the laryngoscopy. A known difficult airway in which it is necessary to carry out an orotracheal intubation while preserving spontaneous ventilation subjects the patient to a stressful situation. The objective is to obtain an acceptable level of comfort and sedation avoiding respiratory depression (Anesthesiol Clin 2015;33:233-40)...
December 2016: Journal of Clinical Anesthesia
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