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Anesthetic Complication

Frederik Flenner, Nicole Arlt, Mahtab Nasib, Sophie Schobesberger, Thea Koch, Ursula Ravens, Felix Friedrich, Viacheslav Nikolaev, Torsten Christ, Sebastian N Stehr
BACKGROUND: Systemic toxicity of local anesthetics is predominantly complicated by their myocardial toxicity. Especially long-acting local anesthetics exert a negative inotropic effect that has been described at lower concentrations than defined for blockade of myocardial ion channels. We evaluated the negative inotropic effect of bupivacaine at a concentration described for clinical toxicity testing the hypothesis that negative inotropy is a result of reduced Ca sensitivity rather than blockade of ion channels...
March 16, 2018: Anesthesiology
Daniela Filipa Rodrigues Pinho, Cátia Real, Leónia Ferreira, Pedro Pina
BACKGROUND AND OBJECTIVES: Currently there is no agreement regarding which one is the most adequate anesthetic technique for the treatment of retinopathy of prematurity. Peribulbar block may reduce the incidence of oculocardiac reflex and postoperative apnea. The goal of this study was to report the outcomes of peribulbar block, when combined with general anesthesia, for the laser treatment for retinopathy of prematurity, in premature babies. METHODS: A retrospective analysis of anesthetic records of all babies who underwent laser treatment for retinopathy of prematurity from January 2008 through December 2015 in a tertiary hospital was performed...
March 12, 2018: Revista Brasileira de Anestesiologia
Rafael Arboleda Salazar, Jane Heggie, Piotr Wolski, Eric Horlick, Mark Osten, Massimiliano Meineri
BACKGROUND: Twenty percent of patients born with congenital heart disease present with right ventricular outflow tract abnormalities. These patients require multiple surgical procedures in their lifetime. Transcatheter pulmonary valve replacement (TPVR) has become a viable alternative to conventional pulmonary valve and right ventricular outflow tract surgery in pediatric and adult populations. In this retrospective review, we analyze the perioperative management of adult patients who underwent TPVR in our center...
March 14, 2018: Anesthesia and Analgesia
Maha Ahmad
Dental paresthesia is loss of sensation caused by maxillary or mandibular anesthetic administration before dental treatment. This review examines inferior alveolar block paresthesia symptoms, side effect and complications. Understanding the anatomy of the pterygomandibular fossa will help in understanding the nature and causes of the dental paresthesia. In this review, we review the anatomy of the region surrounding inferior alveolar injections, anesthetic agents and also will look also into the histology and injury process of the inferior alveolar nerve...
2018: Open Dentistry Journal
Ryungsa Kim, Ami Kawai, Megumi Wakisaka, Yuri Funaoka, Yui Nishida, Naomi Yasuda, Koji Arihiro
Advances in surgical and anesthetic techniques have allowed for outpatient treatment of breast cancer. We evaluated the feasibility, safety, efficacy, and surgical outcomes of outpatient surgery in 370 patients with breast cancer who underwent breast-conserving surgery (BCS)/axillar lymph node (ALN) management. There were no deaths or severe intraoperative complications, but 41 complications were observed and disease recurrence occurred in 18 patients. The cumulative overall survival rate was 95.2%. Outpatient surgery was well tolerated, feasible, and safe in patients receiving BCS/ALN management...
March 14, 2018: Breast Journal
Carllini Barroso Vicentini, Juliana Cama Ramacciato, Francisco Carlos Groppo, Rubens Gonçalves Teixeira, Rogério Heládio Lopes Motta
PURPOSE: The aim of the present study was to compare two therapeutic protocols of dexamethasone for the prevention of postoperative swelling, pain, and other complications after the extraction of impacted third molars, in a prospective, randomized, crossover, double-blinded clinical trial. METHODS: Fifty patients with symmetrical impaction of third molars were randomly assigned to two different protocols of dexamethasone for each side. Patients underwent two sessions performed at a 21-day interval...
March 13, 2018: Oral and Maxillofacial Surgery
Kazuchika Suzuki, Hiroaki Sakai, Kenji Takahashi
We herein report anesthetic management during aortic valve replacement for aortic valve regurgitation in a patient with adult mucopolysaccharidosis type II (MPS type 2) (Hunter syndrome). This disorder is rare and related to the accumulation of a mucopolysaccharide in lysosomes. It affects various organs, including the airways, heart, and central nerves. In children with MPS type 2, the risk of airway obstruction during anesthesia/sedation is high, and the degree of difficulty increases with aging. The patient described herein was a 33-year-old male without mental retardation...
2018: JA Clin Rep
Solina Tith, Garinder Bining, Laurent Bollag
Background : Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by "The American College of Obstetrics and Gynecology" as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists' unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia...
2018: F1000Research
Michael Gottlieb, Brit Long, Alex Koyfman
BACKGROUND: Pharyngitis is a common disease in the emergency department (ED). Despite a relatively low incidence of complications, there are many dangerous conditions that can mimic this disease and are essential for the emergency physician to consider. OBJECTIVE: This article provides a review of the evaluation and management of group A β-hemolytic Streptococcal (GABHS) pharyngitis, as well as important medical conditions that can mimic this disease. DISCUSSION: GABHS pharyngitis often presents with fever, sore throat, tonsillar exudates, and anterior cervical lymphadenopathy...
March 6, 2018: Journal of Emergency Medicine
Asad A Khawaja, Dmitry Tumin, Ralph J Beltran, Joseph D Tobias, Joshua C Uffman
OBJECTIVES: General anesthesia or sedation can facilitate the completion of diagnostic radiological studies in children. We evaluated the incidence, predictors, and causes of adverse events (AEs) when general anesthesia is provided for diagnostic radiological imaging. METHODS: Deidentified data from 24 pediatric tertiary care hospitals participating in the Wake-Up Safe registry during 2010-2015 were obtained for analysis. Children 18 years or younger receiving general anesthesia for radiological procedures were identified using Current Procedural Terminology codes, and reported AEs were analyzed if they were associated with anesthetic care at magnetic resonance imaging or computed tomography locations...
March 8, 2018: Journal of Patient Safety
Jessica E McDonald, Amy M Knollinger
PURPOSE: To evaluate the use of hyaluronic acid (HA) subdermal filler in canines and felines for entropion. METHODS: Complete ophthalmologic examination was performed by a board-certified veterinary ophthalmologist or ABVO-approved resident. Each case was characterized as primary, secondary, spastic or cicatricial entropion. HA subdermal filler, specifically Restylane® and Restylane Silk® , were utilized in dogs and cats, respectively. Subdermal injection was performed 1-2 mm from the eyelid margin in the affected area until normal eyelid conformation was achieved...
March 9, 2018: Veterinary Ophthalmology
Arun Kelay, Nigel J Hall
Pyloromyotomy is the tried and tested surgical procedure for successful operative treatment of pyloric stenosis. Over time, the operative approach has evolved to take advantage of cosmetically superior incisions and more recently minimally invasive surgery. During and following surgery, complications are uncommon. The specific complications of an inadequate pyloromyotomy requiring repeated procedure and mucosal perforation during an overzealous pyloromyotomy represent the ends of a spectrum within which sits the perfect procedure...
March 6, 2018: European Journal of Pediatric Surgery
N Levy, O Goren, A Cattan, C F Weiniger, I Matot
BACKGROUND: Laboring women with low platelet counts may be denied neuraxial block due to concerns about causing a spinal-epidural hematoma. AIMS: To assess the anesthetic management, complications and outcome variables of women with low platelet counts, and to expand the existing data regarding the safety of neuraxial blocks in this patient population. METHODS: This is a retrospective analysis of anesthetic and obstetric data from women with platelet counts <100 000/μL, who were admitted to a single referral center during 2011-2014...
January 31, 2018: International Journal of Obstetric Anesthesia
Adam J Kundishora, Dario J Englot, Philip A Starr, Alastair J Martin, Paul S Larson
BACKGROUND/AIMS: Interventional MRI (iMRI) allows real-time confirmation of electrode and microcatheter location in anesthetized patients; however, MRI-compatible pneumatic compression devices (PCD) to reduce the periprocedural venous thromboembolism (VTE) risk are not commercially available. Given the paucity of literature on VTE following iMRI surgery, better characterizing patients suffering this complication and the incidence of this event following iMRI procedures is pivotal for defining best surgical practices...
March 1, 2018: Stereotactic and Functional Neurosurgery
Ramsis F Ghaly, Armen Haroutunian, Kenneth D Candido, Nebojsa Nick Knezevic
Background: Altered mental status describes impaired mental functioning ranging from confusion to coma and indicates an illness, either metabolic or structural in nature. Metabolic causes include hypothyroidism, hyperuremia, hypo/hyperglycemia, hypo/hypernatremia, and encephalopathy. The structural causes include tumors, brain hemorrhage, infection, and stroke. To our knowledge, this is the first case in which a patient presented with altered mental status from both metabolic (myxedema coma) and structural diseases (frontal meningioma) with vasogenic edema and midline shift...
2018: Surgical Neurology International
Marcelo Carlos Bortoluzzi, Luciana Dorochenko, Giovana Massuqueto, Rodrigo César da Silva, Rafael Manfro, Fábio André Santos
AIMS: To identify relevant variables that may predict pain after routine extraction of erupted teeth, to construct a Pain Prediction Index (PPI) based on these variables, and to verify how these variables are related by using valid structural equation modeling (ie, path analysis). METHODS: This study was designed as an observational prospective study for postoperative memory of pain after dental extraction of erupted teeth. Data from a total of 781 surgical procedures related to dental extractions were included...
February 28, 2018: Journal of Oral & Facial Pain and Headache
Jean Liew, James Lundblad, Adam Obley
The overdiagnosis of thyroid malignancies may be contributing to the increased incidence of these cancers with a relatively stable mortality rate. We present the case of a man with known malignancies, who underwent biopsy of a suspicious thyroid nodule. This procedure was complicated by local anesthetic systemic toxicity (LAST). It is important to address goals of diagnostic testing and treatment with patients, particularly if further evaluation is unlikely to change management or outcomes.
December 16, 2017: Curēus
Doron D Sommer, Sadaf Arbab-Tafti, Forough Farrokhyar, Marc Tewfik, Allan Vescan, Ian J Witterick, Brian Rotenberg, Rakesh Chandra, Erik K Weitzel, Erin Wright, Jayant Ramakrishna
BACKGROUND: The goal of this study was to develop and evaluate the impact of an aviation-style challenge and response sinus surgery-specific checklist on potential safety and equipment issues during sinus surgery at a tertiary academic health center. The secondary goal was to assess the potential impact of use of the checklist on surgical times during, before, and after surgery. This initiative is designed to be utilized in conjunction with the "standard" World Health Organization (WHO) surgical checklist...
February 27, 2018: International Forum of Allergy & Rhinology
Siaffa Romain, Bordes Julien, Vatin Loraine, Prunet Bertrand, Vinciguerra Daniel Md, Meaudre Eric Professor, Lacroix Guillaume
OBJECTIVE: We compared the effectiveness of nerve blocks (regional anesthesia, RA) versus local anesthesia (LA) to treat face and hand wounds. Emergency physicians who had not previously used nerve blocks administered the anesthesia based on anatomic landmarks. METHODS: This prospective observational open study was conducted at a military teaching hospital emergency department (ED) between May 1, 2013 and January 31, 2014. All patients requiring treatment of facial or hand wounds were included...
February 21, 2018: Anaesthesia, Critical Care & Pain Medicine
Weijia Du, Zhendong Xu, Wenjing Wang, Zhiqiang Liu
Anesthetics represent an uncommon cause of taste and smell disorders. We describe a case of anosmia and hypogeusia for 6 weeks after recovery from a uterine curettage operation in a 32-year-old woman. The case is unusual because propofol was the only anesthetic used during surgery and anesthesia. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed no abnormality. This case may highly suggest that propofol could induce smell and taste disorders.
February 23, 2018: Journal of Anesthesia
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