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Anesthetic Complication

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https://www.readbyqxmd.com/read/28733225/microneurosurgical-clip-ligation-of-acutely-ruptured-cerebral-aneurysm-immediately-preceded-by-intentional-subtotal-endovascular-coil-embolization-under-a-single-anesthesia-observations-using-a-deliberate-combined-sequential-treatment-strategy-in-13-cases
#1
Jeffrey E Thomas, Jack C Rose
BACKGROUND: Endovascular coil embolization and craniotomy with clip ligation are the two most commonly used treatments for ruptured cerebral aneurysm. While coiling maintains the advantages of brevity and complete avoidance of brain retraction and manipulation, clipping offers the benefits of decompression of the injured brain and lower aneurysm recurrence rates. A combined, immediately sequential treatment strategy for acutely ruptured cerebral aneurysm that simultaneously maximizes the advantages of both techniques, while minimizing their respective disadvantages, may be a useful paradigm...
July 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28727314/transperitoneal-rectus-sheath-block-and-transversus-abdominis-plane-block-for-laparoscopic-inguinal-hernia-repair-a-novel-approach
#2
Jun Nagata, Jun Watanabe, Masato Nagata, Yusuke Sawatsubashi, Masaki Akiyama, Takehide Tajima, Koichi Arase, Noritaka Minagawa, Takayuki Torigoe, Yoshifumi Nakayama, Reiko Horishita, Kentaro Kida, Kotaro Hamada, Keiji Hirata
INTRODUCTION: A laparoscopic approach for inguinal hernia repair is now considered the gold standard. Laparoscopic surgery is associated with a significant reduction in postoperative pain. Epidural analgesia cannot be used in patients with perioperative anticoagulant therapy because of complications such as epidural hematoma. As such, regional anesthetic techniques, such as ultrasound-guided rectus sheath block and transversus abdominis plane block, have become increasingly popular. However, even these anesthetic techniques have potential complications, such as rectus sheath hematoma, if vessels are damaged...
August 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28726261/origin-and-prevalence-of-the-accessory-phrenic-nerve-a-meta-analysis-and-clinical-appraisal
#3
REVIEW
Matthew J Graves, Brandon Michael Henry, Wan Chin Hsieh, Beatrice Sanna, Przemysław A Pękala, Joe Iwanaga, Marios Loukas, Krzysztof A Tomaszewski
INTRODUCTION: The Accessory Phrenic Nerve (APN) is a common anatomical variant with differing reports of prevalence in the literature. It can be injured during operative procedures to the neck and thorax or by regional anesthetic techniques in its vicinity. Our aim was to provide a comprehensive evidence-based assessment of the prevalence and origins of the APN. MATERIALS AND METHODS: The databases PubMed, China National Knowledge Infrastructure, ScienceDirect, EMBASE, BIOSIS, SciELO, and Web of Science were searched comprehensively, followed by assessment of eligibility and extraction of data concerning the APN...
July 20, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28725247/novel-anesthetic-technique-for-combined-intracavitary-and-interstitial-brachytherapy-for-cervix-cancer-in-an-outpatient-setting
#4
Yiat Horng Leong, Kenneth Hock Soon Tan, Bok Ai Choo, Vicky Yaling Koh, Johann I-Hsiung Tang
PURPOSE: To determine the feasibility and safety of outpatient combined intracavitary and interstitial brachytherapy for cervix cancer with sedation and local anesthesia. MATERIAL AND METHODS: We included patients diagnosed with non-metastatic cervix cancer and have completed brachytherapy between December 2015 and December 2016. Moderate to deep sedation was achieved using intravenous midazolam, propofol, fentanyl, and oxycodone. Local anesthesia was achieved with 2% lignocaine gel and a paracervical block containing a mixture of 1% ropivacaine, 2% lignocaine, and 1 : 1,000 adrenaline...
June 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28721091/comparison-of-single-injection-ultrasound-guided-approach-versus-multilevel-landmark-based-approach-for-thoracic-paravertebral-blockade-for-breast-tumor-resection-a-retrospective-analysis-at-a-tertiary-care-teaching-institution
#5
Jagroop Singh Saran, Amie L Hoefnagel, Kristin A Skinner, Changyong Feng, Daryl Irving Smith
BACKGROUND: The role of thoracic paravertebral blockade (TPVB) in decreasing opioid requirements in breast cancer surgery is well documented, and there is mounting evidence that this may improve survival and reduce the rate of malignancy recurrence following cancer-related mastectomy. We compared the two techniques currently in use at our institution, the anatomic landmark-guided (ALG) multilevel versus an ultrasound-guided (USG) single injection, to determine an optimal technique. METHODS: We retrospectively reviewed records of patients who received TPVB from January 2013 to December 2014...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28716819/effect-of-type-2-diabetes-surgical-incision-and-volatile-anesthesia-on-hemodynamics-in-the-rat
#6
Carol T Bussey, Regis R Lamberts
Diabetic patients have increased cardiac complications during surgery, possibly due to impaired autonomic regulation. Anesthesia lowers blood pressure and heart rate (HR), whereas surgical intervention has opposing effects. The interaction of anesthesia and surgical intervention on hemodynamics in diabetes is unknown, despite being a potential perioperative risk factor. We aimed to determine the effect of diabetes on the integrative interaction between hemodynamics, anesthesia, and surgical incision. Zucker type 2 diabetic rats (DM) and their nondiabetic littermates (ND) were implanted with an intravenous port for drug delivery, and a radiotelemeter to measure mean arterial blood pressure (MAP) and derive HR (total n = 50)...
July 2017: Physiological Reports
https://www.readbyqxmd.com/read/28711570/anesthetic-management-of-reversible-cerebral-vasoconstriction-syndrome-a-case-report
#7
Hiroshi Hoshijima, Naoki Itoh, Yoshinori Iwase, Hiroshi Nagasaka
Reversible cerebral vasoconstriction syndrome (RCVS) is a group of disorders characterized by prolonged reversible cerebral vasoconstriction, associated with acute-onset, severe, episodic "thunderclap" headaches with or without other neurologic clinical features. We describe the first reported case, to our knowledge, of a patient with RCVS who was managed under general anesthesia in the field of oral and maxillofacial surgery. A 67-year-old woman with a diagnosis of RCVS made 2 months earlier was scheduled to undergo surgical extraction of the mandibular right third molar...
June 14, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28708034/ultrasound-guided-percutaneous-common-carotid-artery-access-in-piglets-for-intracoronary-stem-cell-infusion
#8
Jason H Anderson, Nathaniel W Taggart, Sarah L Edgerton, Susana Cantero Peral, Kimberly A Holst, Frank Cetta
In pigs, the deep location of the common carotid artery and overlying sternomastoideus muscle in the neck has led to the recommendation for a surgical cutdown for common carotid access, as opposed to minimally invasive techniques for vascular access. We sought to determine if direct percutaneous common carotid artery access in piglets is attainable. Seventeen piglets were anesthetized and intubated. Under two-dimensional and color flow Doppler ultrasound guidance, a 21 gauge needle was utilized to access the right common carotid artery...
January 1, 2017: Laboratory Animals
https://www.readbyqxmd.com/read/28707996/effect-of-the-degree-of-head-elevation-on-the-incidence-and-severity-of-venous-air-embolism-in-cranial-neurosurgical-procedures-with-patients-in-the-semisitting-position
#9
Hatice Türe, M Volkan Harput, Nural Bekiroğlu, Özgül Keskin, Özge Köner, Uğur Türe
OBJECTIVE The semisitting position of a patient confers numerous advantages in various neurosurgical procedures, but venous air embolism is one of the associated complications of this position. To date, no prospective studies of the relationship between the degree of head elevation and the rate and severity of venous air embolism for patients undergoing a procedure in this position have been performed. In this study, the authors compared changes in the severity of venous air embolism according to the degree of head elevation (30° or 45°) in patients undergoing an elective cranial neurosurgical procedure in the semisitting position...
July 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28707024/experience-of-immediate-ambulation-and-early-discharge-after-tumescent-anesthesia-and-propofol-infusion-in-cosmetic-breast-augmentation
#10
Weiwu Pang, John M Chois, Diana Lambie, Richard Ming-Hui Lin, Zao-Ming Shih
INTRODUCTION: Current cosmetic breast augmentation relies on general anesthesia that normally requires 40 min to total recovery. With experience, the surgical procedure can be completed expediently in 20 min under tumescent anesthesia and propofol full sedation to achieve immediate postoperative ambulation and home discharge readiness, and thus improve patient satisfaction and reduce cost. We retrospectively examined the outcomes of the protocol. MATERIALS AND METHODS: Per protocol, 1200 female patients underwent simple cosmetic breast augmentation accomplished with tumescent anesthesia, immediate mobilization, and early home discharge readiness after surgery...
July 13, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28701607/anesthetic-challenges-of-extrinsic-trachea-bronchial-compression-due-to-posterior-mediastinal-mass-our-experience-with-a-large-esophageal-mucocele
#11
Saipriya Tewari, Puneet Goyal, Amit Rastogi, Aarti Agarwal, P K Singh
Large posterior mediastinal masses may lead threatening complications such as critical tracheobronchial compression. Airway management in these individuals is a challenge and being a lower airway obstruction; rescue strategies are limited. We encountered one such case of a large esophageal mucocele causing extrinsic tracheobronchial compression. We have described the anesthetic management of this case using awake fiber-optic assessment followed by intubation. Close communication with the surgical team, meticulous planning of airway management, and early drainage of the mucocele are the cornerstones of management in such patients...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28696947/regional-blocks-carried-out-during-general-anesthesia-or-deep-sedation-myths-and-facts
#12
Peter Marhofer
PURPOSE OF REVIEW: More patients will accept regional blocks if these are performed during sedation or general anesthesia. This review discusses regional anesthesia in sedated or anesthetized patients. RECENT FINDINGS: As complications of regional blocks are rare, regional anesthesia can be considered aswell-tolerated. Awake patients will notice only a minority of needle-to-nerve contacts, that renders the notion of a 'live monitor' obsolete. Using high-resolution ultrasound, the needle can be advanced to an extraepineural position for injection, thus strictly avoiding needle-to-nerve contact or intraepineural injection of local anesthetic...
July 10, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28691540/endoscopic-management-of-foreign-bodies-in-the-upper-gastrointestinal-tract-a-retrospective-study-of-1294-cases
#13
Chong Geng, Xiao Li, Rong Luo, Lin Cai, Xuelian Lei, Chunhui Wang
OBJECTIVE: To report our endoscopic outcomes and explore the effects of duration of impaction and anesthetic methods on the endoscopic removal of foreign bodies in the upper gastrointestinal tract. METHODS: All consecutive patients with suspected foreign body (FB) ingestion between January 2013 and June 2016 were enrolled. Demographic, clinical and endoscopic data were collected and analyzed. RESULTS: A total of 1294 patients aged seven months to 94 years were enrolled...
July 10, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28691385/injectable-loop-recorder-implantation-in-an-ambulatory-setting-by-advanced-practice-providers-analysis-of-outcomes
#14
Ryan Kipp, Natasha Young, Anne Barnett, Douglas Kopp, Miguel A Leal, Lee L Eckhardt, Thomas Teelin, Kurt S Hoffmayer, Jennifer Wright, Michael Field
INTRODUCTION: Implantable loop recorder (ILR) insertion has historically been performed in a surgical environment such as the electrophysiology (EP) lab. The newest generation loop recorder (Medtronic Reveal LINQ™) is injectable with potential for implantation in a non-EP lab setting by advanced practice providers (APPs) facilitating improved workflow and resource utilization. We report the safety and efficacy of injectable ILR placement in the ambulatory care setting by APPs. METHODS: A retrospective review was performed including all patients referred for injectable ILR placement from March 2014 to November 2015...
July 10, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28688643/topical-anesthesia-for-staple-removal-from-surgical-wounds-on-the-knee-a-prospective-double-blind-randomized-trial
#15
Tzu-Hao Tseng, Ching-Chuan Jiang, Shau-Huai Fu, Tsung-Lin Lee, Ya-Hui Chuang, Hongsen Chiang
BACKGROUND: Staple removal from surgical wounds is painful. Only a few articles have provided expert opinions using anesthetic cream for such a problem; however, direct application of the anesthetic cream to a wound may cause infection. A safe alternative can be an anesthetic patch without wound contact. MATERIALS AND METHODS: This was a prospective, double-blind, randomized clinical trial. Sixty patients who underwent primary total knee replacement were assigned to an experimental group or control group...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28684346/antibiotic-loaded-bone-graft-for-reduction-of-surgical-site-infection-in-spinal-fusion
#16
Stefanie M Shiels, Vivek P Raut, Patrick B Patterson, Brian R Barnes, Joseph C Wenke
BACKGROUND CONTEXT: Infections remain a leading complication associated with spinal arthrodesis, regardless of the use of prophylactic antibiotics and improved surgical techniques, with incidence of infection as high as 8.2%. Infection prolongs antibiotic usage, increases hospital time, and inevitably inflates overall treatment costs. Local antibiotics, such as vancomycin, have been used in combination with fusion materials over the past decade to decrease infection risk. An ideal graft material would serve a dual role: encourage vertebral fusion while reducing incidence of infection...
July 3, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28684143/what-s-new-in-clinical-obstetric-anesthesia-in-2015
#17
REVIEW
P E Hess
Each calendar year the Society for Obstetric Anesthesia and Perinatology invites an individual to conduct a review of the medical literature, identifying clinically relevant publications of interest to the obstetric anesthesia provider. This report of that effort covers the publications from 2015 and includes the categories of anesthesia and analgesia, complications of neuraxial procedures, and the effects of anesthesia on the fetus. Neuraxial procedures represent the foundation of obstetric anesthesia; advances in anesthesia and analgesia include novel modes of administration, and refinements in care of the medically complex patient...
March 18, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28682889/femoral-nerve-block-versus-fascia-iliaca-block-for-pain-control-in-total-knee-and-hip-arthroplasty-a-meta-analysis-from-randomized-controlled-trials
#18
REVIEW
Xin Wang, Yuan Sun, Li Wang, Xuelian Hao
BACKGROUND: This meta-analysis aimed to perform a meta-analysis to compare the efficiency and safety between femoral nerve block (FNB) and fascia iliaca block (FIB) for postoperative pain control in patients undergoing total knee and hip arthroplasties. METHODS: A systematic search was performed in Medline (1966-2017.05), PubMed (1966-2017.05), Embase (1980-2017.05), ScienceDirect (1985-2017.05) and the Cochrane Library. Inclusion criteria (1) Participants: Only published articles enrolling adult participants that with a diagnosis of end-stage of osteoarthritis and prepared for unilateral TKA or THA; (2) Interventions: The intervention group received FIB for postoperative pain management; (3) Comparisons: The control group was received FNB for postoperative pain control; (4) Outcomes: Visual analogue scale (VAS) scores in different periods, opioids consumption, length of stay and postoperative complications; (5) Study design: clinical randomized control trials (RCTs) were regarded as eligible in our study...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28675094/effect-of-increased-body-mass-index-on-complication-rates-during-laryngotracheal-surgery-utilizing-jet-ventilation
#19
Rachel A Barry, Daniel S Fink, Dusty Cole Pourciau, Kasey Hayley, Rachael Lanius, Schuylor Hayley, Eddy Sims, Andrew J McWhorter
Objective Jet ventilation has been used for >30 years as an anesthetic modality for laryngotracheal surgery. Concerns exist over increased risk with elevated body mass index (BMI). We reviewed our experience using jet ventilation for laryngotracheal stenosis to assess for complication rates with substratification by BMI. Study Design Case series with chart review. Setting Tertiary care center. Subjects and Methods A total of 126 procedures with jet ventilation were identified from October 2006 to December 2014...
June 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28671499/focal-intramural-pericardial-effusion-and-cardiac-tamponade-associated-with-necrotic-adipose-tissue-in-a-dog
#20
Terence A Krentz, Robert J Schutrumpf, Julie C Zitz
CASE DESCRIPTION A 1-year-old castrated male German Shepherd Dog was examined because of an acute onset of lethargy, tachypnea, and inappetence. CLINICAL FINDINGS On initial physical examination, the dog was tachypneic with muffled heart sounds on thoracic auscultation and a palpable abdominal fluid wave. Transthoracic echocardiography revealed focal intramural pericardial effusion and cardiac tamponade. TREATMENT AND OUTCOME The patient underwent emergency therapeutic pericardiocentesis, followed by right lateral intercostal thoracotomy and subtotal pericardiectomy...
July 15, 2017: Journal of the American Veterinary Medical Association
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