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https://www.readbyqxmd.com/read/29351097/effect-of-epidural-infusion-bolus-delivery-rate-on-the-duration-of-labor-analgesia-a-randomized-clinical-trial
#1
Elizabeth M S Lange, Cynthia A Wong, Paul C Fitzgerald, Wilmer F Davila, Suman Rao, Robert J McCarthy, Paloma Toledo
BACKGROUND: Programmed intermittent boluses of local anesthetic have been shown to be superior to continuous infusions for maintenance of labor analgesia. High-rate epidural boluses increase delivery pressure at the catheter orifice and may improve drug distribution in the epidural space. We hypothesized that high-rate drug delivery would improve labor analgesia and reduce the requirement for provider-administered supplemental boluses for breakthrough pain. METHODS: Nulliparous women with a singleton pregnancy at a cervical dilation of less than or equal to 5 cm at request for neuraxial analgesia were eligible for this superiority-design, double-blind, randomized controlled trial...
January 19, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29350880/temporal-and-spatial-quantification-of-pain-related-small-fiber-functionality-assessed-using-laser-speckle-contrast-analysis-lasca
#2
Isin Unal-Cevik
BACKGROUND: This study aimed to establish a practical method for assessing pain symptomatology and develop criteria for quantifying small fiber functions, using LASCA. METHODS: Axon flare responses, which reflect small fiber functions, were induced either by histamine or capsaicin applied to the volar surface of the skin of the left forearm. To inhibit small fiber function, local anesthetic cream was applied to the skin of right forearm. The effects on pain symptomatology (severity/timing) and axon flare responses (temporal/spatial characteristics) were measured using LASCA...
January 19, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29350659/thiopental-is-better-than-propofol-for-electroconvulsive-therapy
#3
Massimiliano Nuzzi, Dario Delmonte, Barbara Barbini, Laura Pasin, Ornella Sottocorna, Giuseppina Maria Casiraghi, Cristina Colombo, Giovanni Landoni, Alberto Zangrillo
BACKGROUND AND AIM OF THE WORK: electroconvulsive therapy is a psychiatric procedure requiring general anesthesia. The choice of the hypnotic agent is important because the success of the intervention is associated to the occurrence and duration of motor convulsion. However, all available anesthetic agents have anti-convulsant activity. We compared the effect of thiopental and propofol on seizures. METHODS: We designed a retrospective study at Mood Disorders Unit of a teaching Hospital...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29350189/detection-of-thoracic-vascular-structures-by-electrical-impedance-tomography-a-systematic-assessment-of-prominence-peak-analysis-of-impedance-changes
#4
Karin Henriette Wodack, Sarah Buehler, Sarah A Nishimoto, Michael F Graessler, Christoph R Behem, Andreas Daniel Waldmann, Beat Mueller, Stephan H Böhm, Eugenijus Kaniusas, Florian Thürk, Alexander Maerz, Constantin J C Trepte, Daniel A Reuter
Electrical impedance tomography (EIT) is a noninvasive and radiation free bedside monitoring technology, primarily used to monitor lung function. First experimental data shows that the descending aorta can be detected at different thoracic heights and might allow the assessment of central hemodynamics, i.e. stroke volume and pulse transit time. Approach: First, the feasibility of localizing small non-conductive objects within a saline phantom model was evaluated. Second, this result was utilized for the detection of the aorta by EIT in ten anesthetized pigs in with comparison to thoracic computer tomography (CT)...
January 19, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29349580/perianesthetic-management-of-laparoscopic-kidney-surgery
#5
REVIEW
Georges Nasrallah, Fouad G Souki
PURPOSE OF REVIEW: Laparoscopic kidney surgery is commonly used for living donor, partial, and total tumor nephrectomy. The successful emergence of laparoscopic technique was justified by the many benefits offered such as reduced blood loss, tissue trauma, pain, and hospital stay. However, this comes at the expense of physiologic changes and complications secondary to pneumoperitoneum, surgical technique, and patient positioning with significant challenges in anesthetic management. RECENT FINDINGS: A variety of laparoscopic approaches (transperitoneal, retroperitoneal, hand-assisted, robotic) are used with some having advantages over others...
January 18, 2018: Current Urology Reports
https://www.readbyqxmd.com/read/29349509/complex-issues-in-new-ultrasound-guided-nerve-blocks-how-to-name-where-to-inject-and-how-to-publish
#6
Masanori Yamauchi, Yutaka Sato
The recent development of ultrasound-guide nerve block has led to innovation in anesthesia and pain clinics. However, it has also led to some complex issues, including (1) how to name a new technique, (2) the appropriateness of an intramuscular approach, and (3) how to publicize a new technique. This review addresses naming strategy, feasibility of intramuscular approach block, and methods of publication. First, researchers and authors should pay attention to appropriate nomenclature for the term 'approach', 'compartment block', and 'nerve block' for a new block...
January 18, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29349390/durability-of-the-viabahn-stent-graft-after-axillary-artery-pseudoaneurysm-exclusion
#7
Aaron Y Chen, Isaac Laniado, Peter H Lin
Pseudoaneurysm formation caused by iatrogenic arterial injury during a regional anesthetic block is a rare complication. We report a case of a 56-year-old male patient who developed an axillary artery pseudoaneurysm caused by brachial plexus block performed for an upper extremity dialysis access operation. Successful repair of this pseudoaneurysm was achieved with endovascular stent graft exclusion. The repaired axillary artery with the stent graft remained patent after 10 years of follow-up. The successful long-term patency of this treatment and a strategy to potentially avoid this complication are discussed...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349355/facial-blanching-after-inferior-alveolar-nerve-block-anesthesia-an-unusual-complication
#8
Sang-Hoon Kang, Yu-Jin Won
The present case report describes a complication involving facial blanching symptoms occurring during inferior alveolar nerve block anesthesia (IANBA). Facial blanching after IANBA can be caused by the injection of an anesthetic into the maxillary artery area, affecting the infraorbital artery.
December 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29349352/learning-fiberoptic-intubation-for-awake-nasotracheal-intubation
#9
Hyuk Kim, Eunsun So, Myong-Hwan Karm, Hyun Jeong Kim, Kwang-Suk Seo
Background: Fiberoptic nasotracheal intubation (FNI) is performed if it is difficult to open the mouth or if intubation using laryngoscope is expected to be difficult. However, training is necessary because intubation performed by inexperienced operators leads to complications. Methods: Every resident performed intubation in 40 patients. Success of FNI was evaluated as the time of FNI. First intubation time was restricted to 2 min 30 s. If the second attempt was unsuccessful, it was considered a failed case, and a specialist performed nasotracheal intubation...
December 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29349349/a-retrospective-analysis-of-outpatient-anesthesia-management-for-dental-treatment-of-patients-with-severe-alzheimer-s-disease
#10
Eunsun So, Hyun Jeong Kim, Myong-Hwan Karm, Kwang-Suk Seo, Juhea Chang, Joo Hyung Lee
Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017...
December 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29349346/characteristics-of-electroencephalogram-signatures-in-sedated-patients-induced-by-various-anesthetic-agents
#11
REVIEW
Byung-Moon Choi
Devices that monitor the depth of hypnosis based on the electroencephalogram (EEG) have long been commercialized, and clinicians use these to titrate the dosage of hypnotic agents. However, these have not yet been accepted as standard monitoring devices for anesthesiology. The primary reason is that the use of these monitoring devices does not completely prevent awareness during surgery, and the development of these devices has not taken into account the neurophysiological mechanisms of hypnotic agents, thus making it possible to show different levels of unconsciousness in the same brain status...
December 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29349045/advantages-disadvantages-indications-contraindications-and-surgical-technique-of-laryngeal-airway-mask
#12
REVIEW
Anubhav Jannu, Ashim Shekar, Ramdas Balakrishna, H Sudarshan, G C Veena, S Bhuvaneshwari
The beauty of the laryngeal mask is that it forms an air tight seal enclosing the larynx rather than plugging the pharynx, and avoid airway obstruction in the oropharynx. The goal of its development was to create an intermediate form of airway management face mask and endotracheal tube. Indication for its use includes any procedure that would normally involve the use of a face mask. The laryngeal mask airway was designed as a new concept in airway management and has been gaining a firm position in anesthetic practice...
December 2017: Archives of Craniofacial Surgery
https://www.readbyqxmd.com/read/29349036/alternative-topical-anesthesia-for-bronchoscopy-in-a-case-of-severe-lidocaine-allergy
#13
Matthew Hensley, Benjamin H Singer
Lidocaine allergy presents a unique difficulty for both patients and providers who undergo/perform bronchoscopy. We present a case of a 73 yo male with severe lidocaine allergy who successfully underwent bronchoscopy with chloroprocaine topical anesthesia and discuss alternative topical anesthetic agents that may be used in this special situation.
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29347949/effects-of-surgery-and-anesthetic-choice-on-immunosuppression-and-cancer-recurrence
#14
REVIEW
Ryungsa Kim
BACKGROUND: The relationship between surgery and anesthetic-induced immunosuppression and cancer recurrence remains unresolved. Surgery and anesthesia stimulate the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS) to cause immunosuppression through several tumor-derived soluble factors. The potential impact of surgery and anesthesia on cancer recurrence was reviewed to provide guidance for cancer surgical treatment. METHODS: PubMed was searched up to December 31, 2016 using search terms such as, "anesthetic technique and cancer recurrence," "regional anesthesia and cancer recurrence," "local anesthesia and cancer recurrence," "anesthetic technique and immunosuppression," and "anesthetic technique and oncologic surgery...
January 18, 2018: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29346698/procedural-knowledge-and-skills-of-residents-entering-canadian-family-medicine-programs-in-alberta
#15
Juan Antonio Garcia-Rodriguez, James A Dickinson, Grace Perez, David Ross, Lilian Au, Shelley Ross, Oksana Babenko, Ian Johnston
BACKGROUND AND OBJECTIVES: Incoming family medicine (FM) residents start residency with different levels of procedural training. Understanding their baseline skill level is necessary to plan the educational experiences and teaching methods that will provide the desired knowledge, skills, and attitudes related to performing medical procedures. METHODS: A survey of 69 procedures based on the core list issued by the College of Family Physicians of Canada was administered to incoming residents in Alberta (Calgary and Edmonton FM programs)...
January 2018: Family Medicine
https://www.readbyqxmd.com/read/29346133/dexmedetomidine-impairs-diaphragm-function-and-increases-oxidative-stress-but-does-not-aggravate-diaphragmatic-atrophy-in-mechanically-ventilated-rats
#16
Thomas Breuer, Christian Bleilevens, Rolf Rossaint, Gernot Marx, Julian Gehrenkemper, Henning Dierksen, Antoine Delpierre, Joachim Weis, Ghislaine Gayan-Ramirez, Christian S Bruells
BACKGROUND: Anesthetics in ventilated patients are critical as any cofactor hampering diaphragmatic function may have a negative impact on the weaning progress and therefore on patients' mortality. Dexmedetomidine may display antioxidant and antiproteolytic properties, but it also reduced glucose uptake by the muscle, which may impair diaphragm force production. This study tested the hypothesis that dexmedetomidine could inhibit ventilator-induced diaphragmatic dysfunction. METHODS: Twenty-four rats were separated into three groups (n = 8/group)...
January 18, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29346046/ultrasonographic-characteristics-of-the-reproductive-tract-and-serum-progesterone-and-estradiol-concentrations-in-captive-female-red-wolves-canis-rufus-with-and-without-reproductive-tract-disease
#17
Kadie M Anderson, Mandi W Schook, Karen L Goodrowe, William T Waddell, Karen N Wolf
OBJECTIVE To describe ultrasonographic characteristics of the reproductive tract and serum progesterone and estradiol concentrations in captive female red wolves (Canis rufus) with and without reproductive tract disease. DESIGN Prospective study. ANIMALS 13 adult female red wolves. PROCEDURES Wolves with varying parity and history of contraceptive treatment were anesthetized to facilitate ultrasonographic examination and measurement of the reproductive tract and blood collection for determination of serum progesterone and estradiol concentrations in December 2011 and June 2012...
February 1, 2018: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29345326/live-animal-imaging-of-renal-function-by-multiphoton-microscopy
#18
Kenneth W Dunn, Timothy A Sutton, Ruben M Sandoval
Intravital microscopy, microscopy of living animals, is a powerful research technique that combines the resolution and sensitivity found in microscopic studies of cultured cells with the relevance and systemic influences of cells in the context of the intact animal. The power of intravital microscopy has recently been extended with the development of multiphoton fluorescence microscopy systems capable of collecting optical sections from deep within the kidney at subcellular resolution, supporting high-resolution characterizations of the structure and function of glomeruli, tubules, and vasculature in the living kidney...
January 18, 2018: Current Protocols in Cytometry
https://www.readbyqxmd.com/read/29344658/microrna-188-3p-is-involved-in-sevoflurane-anesthesia-induced-neuroapoptosis-by-targeting-mdm2
#19
Lei Wang, Mengliang Zheng, Shuishui Wu, Zhiqiang Niu
Sevoflurane is a commonly used inhalation anesthetic. Sevoflurane-induced neuroapoptosis and cognitive impairments in animals are widely reported, however, the underlying molecular mechanisms remain largely unknown. The results of the present study demonstrated that sevoflurane anesthesia induced spatial memory impairments in rats, as determined by the Morris water maze test. Mechanistically, the current study demonstrated that sevoflurane administration significantly enhanced the expression of microRNA (miR)‑188‑3p...
January 16, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29344649/effects-of-intrathecal-bupivacaine-on-the-nr2b-camkii%C3%AE-creb-signaling-pathway-in-the-rat-lumbar-spinal-cord
#20
Liyan Zhao, Yonghai Zhang, Fan Yang, Di Zhu, Ningkang Li, Li Zhao, Na Li, Jianqiang Yu, Hanxiang Ma
Neuraxial anesthesia produces an anesthetic-sparing, sedative effect. The mechanism underlying this effect potentially involves decreased spinal afferent input. However, the neurochemical mechanisms at the spinal level remain unknown. The N‑methyl‑D‑aspartate receptor 2B subunit/calcium‑calmodulin‑dependent protein kinase II α/cAMP response element‑binding protein (NR2B/CaMKIIα/CREB) signaling pathway serves an important role in regulating the transmittance of peripheral noxious stimulation to supraspinal regions in the process of nociception...
January 17, 2018: Molecular Medicine Reports
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