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Anesthesia awareness

Amy E Vinson, Gail Randel
PURPOSE OF REVIEW: Peer support, a method of providing for the well being of healthcare providers following adverse or stressful events, is garnering increased attention in light of the increased prevalence and awareness of burnout, depression and suicidality in physicians. In this review, we will summarize the evolution of the 'second victim,' explore methods of support and examine how new regulatory requirements are changing the peer support landscape. RECENT FINDINGS: As peer support and the second victim are investigated more, themes are emerging regarding the natural history of recovery...
March 14, 2018: Current Opinion in Anaesthesiology
Maximilian Bielohuby, Martin Bidlingmaier, Uwe Schwahn
The measurement of circulating hormones by immunoassay remains a cornerstone in preclinical endocrine research. For scientists conducting and interpreting immunoassay measurements of rodent samples, the paramount aim usually is to obtain reliable and meaningful measurement data in order to draw conclusions on biological processes. However, the biological variability between samples is not the only variable affecting the readout of an immunoassay measurement and a considerable amount of unwanted or unintended variability can be quickly introduced during the pre-analytical and analytical phase...
March 14, 2018: Endocrine Connections
Richard H Epstein, Joni M Maga, Michael E Mahla, Eric S Schwenk, Marc J Bloom
BACKGROUND: Processed electroencephalogram (EEG) monitors help assess the hypnotic state during general anesthesia or sedation. Maintaining the bispectral index (BIS) or state entropy (SE) between 40 and 60 has been recommended to mitigate anesthesia awareness. Nonetheless, SEs > 70 were frequently observed at end-tidal sevoflurane concentrations unlikely to allow awareness. We sought to determine the prevalence of elevated discordant measurements during BIS and SE monitoring. METHODS: Electronic data collected over 11 months at two academic hospitals were retrospectively reviewed...
March 9, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Benjamin A Willenbring, Callie K Schnitker, Samuel J Stellpflug
BACKGROUND: Esophageal food impaction is a common illness presenting to emergency departments (ED), and is frequently resistant to pharmacologic therapy. Several medications have been promoted for this indication, but so far have not proven effective. Endoscopic removal is frequently required to resolve the impaction, resulting in risks from anesthesia and the physical procedure, and in prolonged hospital stay for recovery. Oral nitroglycerin solution was recently used in two such cases and may represent a new therapeutic option...
March 5, 2018: Journal of Emergency Medicine
Sean Hickey, Jeremy Goverman, Jonathan Friedstat, Robert Sheridan, John Schulz
INTRODUCTION: There are an estimated 2.75 million electronic cigarette (EC) users in the United States. ECs have become the most commonly used nicotine-containing product in young adults ages 18-24 years. Thermal, blast, and missile injuries from EC explosions has grown rapidly in recent years. Burn surgeons must remain up to date regarding management and treatment of burn injuries related to EC device ignition. METHODS: An IRB approved retrospective review of all patients admitted to the Massachusetts General Hospital Burn Center from January 2015 to April 2017 was performed...
March 1, 2018: Burns: Journal of the International Society for Burn Injuries
Hesameddin Modir, Esmail Moshiri, Bijan Yazdi, Abolfazl Mohammadbeigi, Amirreza Modir
Adverse events following surgical operations are common complications due to removal of tracheal tube in contrast to the tracheal intubation. Awareness about the new methods and strategies for tracheal tube extubation is necessary for a safe and successful extubation. Therefore, we aimed to assess the safety and efficacy of laryngeal mask airway (LMA), streamlined liner of the pharyngeal airway (SLIPA) and I-gel in extubation time of tracheal tube. A one-single randomized clinical trial was conducted in 105 eligible patients in three groups including LMA, SLIPA and I-gel...
October 2017: Medical Gas Research
Tulika Singh, Sanju Sharma, Bratati Banerjee, Suneela Garg
INTRODUCTION: Anesthesia has become one of the most advanced specialties in modern medicine with tremendous growth in knowledge and substances available for use. However, public awareness toward anesthesiologist and anesthesiology is limited. It is important for us to make people aware about the role played by an anesthesiologist in medical setup. The present study was conducted among patients and attendants to assess the knowledge regarding the anesthesiologist and anesthesiology. MATERIALS AND METHODS: The study was carried out at a rural hospital of New Delhi, on 250 adult patients and attendants visiting outpatient departments to assess their knowledge regarding anesthesiologists and anesthesiology...
2018: Journal of Education and Health Promotion
Rebecca H Allen, Rameet Singh
Satisfactory pain control for women undergoing surgical abortion is important for patient comfort and satisfaction. Clinicians ought to be aware of the safety and efficacy of different pain control regimens. This document will focus on nonpharmacologic modalities to reduce pain and pharmacologic interventions up to the level of minimal sedation. For surgical abortion without intravenous medications, a multimodal approach to pain control may combine a dedicated emotional-support person, visual or auditory distraction, administration of local anesthesia to the cervix with buffered lidocaine, and a preoperative nonsteroidal anti-inflammatory drug...
January 30, 2018: Contraception
Kevin K Tremper, Jenny J Mace, Jan M Gombert, Theodore T Tremper, Justin F Adams, James P Bagian
BACKGROUND: This paper describes the design of a multifunction alerting display for intraoperative anesthetic care. The design was inspired by the multifunction primary flight display used in modern aviation. RESULTS: The display retrieves live data from multiple sources; the physiologic monitors, the anesthesia information management system, the laboratory values and comorbidities from patient's problem summary list, medical history or history & physical. This information is integrated into a display composed of readily identifiable icons of organ systems, which are color coded to signify normal range, marginal range, abnormal range (by green, yellow, red respectively) and orange outlines for comorbidities/risk factors...
February 5, 2018: BMC Anesthesiology
Yoon Hee Choi, Dong Hoon Lee
BACKGROUND: Endotracheal tube (ETT) obstruction or narrowing in patients undergoing general anesthesia due to dissection of reinforced ETT is unusual. CASE REPORT: A 26-year-old woman was transferred to the emergency department due to drowsy mental status after surgery. She was intubated by reinforced ETT with grossly normal external appearance, but the inner layer of ETT was dissected, the inner diameter was narrowed, and the extent of protrusion of inner layer of ETT was more severe at the distal end...
January 29, 2018: Journal of Emergency Medicine
Dong Wang, Xiao-Mei Sun, Jin Wu
RATIONALE: Cavernous sinus-carotid fistula (CCF) is a rare complication of craniofacial injuries in patients receiving oral and maxillofacial surgical care. PATIENT CONCERNS: A retrospective review of 15 patients with CCF records was conducted. In addition, we present a rare case of a 32-year-old Chinese woman with CCF receiving oral and maxillofacial surgical care. DIAGNOSES: Digital subtraction angiography (DSA) confirmed a diagnosis of CCF...
December 2017: Medicine (Baltimore)
Krista N Eberle, Michael P Martin, Sanjay Shah, Ramon D Malheiros, Kimberly A Livingston, Kenneth E Anderson
The use of electroencephalograms (EEG) to study the avian brain relative to behavior was conducted as early as the 1960's. EEG readings, combined with visual cues, provide the ability to elucidate and correlate behaviors to neurological and physiological changes in a chicken. The use of EEG recordings in animal models require access to the brain to implant electrodes. Having the ability to observe EEG activity on sensible birds without surgical implantation could broaden the research in this area and give further insight related to the hen's state of awareness...
January 17, 2018: Poultry Science
Kong Eric You-Ten, Naveed Siddiqui, Wendy H Teoh, Michael S Kristensen
Airway management is a critical skill in the practice of several medical specialities including anesthesia, emergency medicine, and critical care. Over the years mounting evidence has showed an increasing role of ultrasound (US) in airway management. The objective of this narrative review is to provide an overview of the indications for point-of-care ultrasound (POCUS) of the upper airway. The use of US to guide and assist clinical airway management has potential benefits for both provider and patient. Ultrasound can be utilized to determine airway size and predict the appropriate diameter of single-lumen endotracheal tubes (ETTs), double-lumen ETTs, and tracheostomy tubes...
January 18, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Balaji Kuppuswamy, Kirubakaran Davis, Raj Sahajanandan, Manickam Ponniah
OBJECTIVE: The objective of the study is to compare the myocardial protective effects of isoflurane with propofol in patients undergoing elective coronary artery bypass surgery on cardiopulmonary bypass (CPB), the cardio protection been assessed by changes in N-terminal brain natriuretic peptide (NT proBNP). Methodology and Design: This study is designed as a participant blinded, prospective randomized clinical trial. SETTING: Christian Medical College Hospital, Vellore, India...
January 2018: Annals of Cardiac Anaesthesia
D Bolkenius, C Dumps, E Halbeck
In a series of articles dealing with hypnotics for induction of anesthesia, this article describes the development and current value of propofol. Its significance far exceeds that of a pure induction hypnotic (sedation in diagnostic and therapeutic procedures and on the intensive care unit). Propofol is also used for sedation in diagnostic and therapeutic procedures and on the intensive care unit. In the field of induction of anesthesia, the alternatives are barely used. Some contraindications are still controversial whereas others are no longer sufficiently anchored in the users' awareness (widespread off-label use)...
February 2018: Der Anaesthesist
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
February 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Aykut Urfalıoğlu, Selma Urfalıoğlu, Gözen Öksüz
Objectives: To evaluate the knowledge of ophthalmologists regarding local anesthesia toxicity syndrome (LATS) and intravenous lipid emulsion used in treatment, and to raise awareness of this issue. Materials and Methods: A questionnaire comprising 14 questions about demographics, local anesthesia (LA) use, toxicity, and treatment methods was administered to ophthalmologists at different hospitals. Results: The study included 104 ophthalmologists (25% residents, 67...
December 2017: Turkish Journal of Ophthalmology
Mathew Nelson, Alexandra Reens, Lara Reda, David Lee
BACKGROUND: Interscalene brachial plexus blocks have been a routinely performed method of anesthesia for shoulder surgery that decreases the need for general anesthesia, length of stay, and recovery time. We describe a case of bupivacaine toxicity after an interscalene block. CASE REPORT: The patient was a 66-year-old man who presented to our Emergency Department by emergency medical services from an ambulatory surgery center where he had undergone rotator cuff surgery, with bradycardia and hypotension...
December 30, 2017: Journal of Emergency Medicine
Jerel Chacko, Kelly Levis, Barry Hahn
BACKGROUND: Pneumocephalus, or air in the intracranial space, is most commonly encountered after trauma or surgery. Epidural injections are commonly performed in obstetrics and pain management. Complications are uncommon and include hemorrhage, cerebrospinal fluid leak, and infection. A rare complication is pneumocephalus, described in only a few case reports of epidural anesthesia. CASE REPORT: We describe a 34-year-old woman complaining of a generalized headache 6 days after an unremarkable vaginal delivery that was assisted by an epidural injection...
December 30, 2017: Journal of Emergency Medicine
Sherry Johnson, Jessica McCracken, Fadi Baidoun
INTRODUCTION: Abdominal visceral injuries after cardiopulmonary resuscitation (CPR) are infrequent though can be significant complications of CPR requiring invasive interventions. We present a case of a gastric perforation as a result of bystander CPR. This resulted in tension pneumoperitoneum necessitating abdominal decompression prior to laparotomy and repair. PRESENTATION OF CASE: 37-year-old female complained of abdominal pain and distension after return of spontaneous circulation from successful CPR following a drug overdose and cardiopulmonary arrest...
December 12, 2017: International Journal of Surgery Case Reports
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