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https://www.readbyqxmd.com/read/28930916/peripheral-muscle-near-infrared-spectroscopy-nirs-variables-are-altered-early-in-septic-shock
#1
Diego Orbegozo, Fuhong Su, Keliang Xie, Lokmane Rahmania, Fabio Silvio Taccone, Daniel De Backer, Jean-Louis Vincent, Jacques Creteur
BACKGROUND: Non-invasive evaluation of muscle perfusion using near infrared spectroscopy (NIRS) coupled with a vascular occlusion test (VOT) may provide an early and simple marker of altered perfusion and microcirculatory function in sepsis. OBJECTIVE: To compare the time-course of NIRS-derived variables with systemic measures of perfusion in an experimental model of peritonitis. METHODS: Peritonitis was induced in eight anesthetized, mechanically ventilated, adult sheep (24-34 Kg), by injecting autologous feces into the peritoneal cavity...
September 19, 2017: Shock
https://www.readbyqxmd.com/read/28928585/postoperative-analgesic-efficacy-of-bilateral-transversus-abdominis-plane-block-in-patients-undergoing-midline-colorectal-surgeries-using-ropivacaine-a-randomized-double-blind-placebo-controlled-trial
#2
Nahida Qazi, Wasim Mohammad Bhat, Malik Zaffar Iqbal, Anisur Rehman Wani, Showkat A Gurcoo, Sahir Rasool
BACKGROUND: Ultrasound-guided transversus abdominis plane (TAP) block is done as a part of multimodal analgesia for pain relief after abdominal surgeries. This prospective randomized, double-blind, placebo-controlled trial was conducted to evaluate the postoperative analgesic efficacy of bilateral TAP block in patients undergoing midline colorectal surgeries using ropivacaine. MATERIALS AND METHODS: Eighty patients scheduled for elective colorectal surgeries involving midline abdominal wall incision under general anesthesia were enrolled in this prospective randomized controlled trial...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928544/role-of-anesthesiologist-in-the-management-of-a-child-with-cerebral-palsy
#3
REVIEW
Safiya Imtiaz Shaikh, Ganapati Hegade
Cerebral palsy (CP) refers to a spectrum of nonprogressive neurological disorders with disturbances in posture and movement, resulting from perinatal intrauterine insult to developing infant brain. Many conditions associated with CP require surgery. Such cases pose important gastrointestinal, respiratory, and other perioperative considerations. Anesthetic management in these cases is delicate. Intraoperative complications including hypovolemia, hypothermia, muscle spasms, seizures, and delayed recovery might complicate the anesthetic management...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28926735/ketamine-metabolites-with-antidepressant-effects-fast-economical-and-eco-friendly-enantioselective-separation-based-on-supercritical-fluid-chromatography-sfc-and-single-quadrupole-ms-detection
#4
Georg M Fassauer, Robert Hofstetter, Mahmoud Hasan, Stefan Oswald, Christina Modeß, Werner Siegmund, Andreas Link
Increasing evidence accumulates that metabolites of the dissociative anesthetic ketamine contribute considerably to the biological effects of this drug and could be developed as next generation antidepressants, especially for acute treatment of patients with therapy-refractory major depression. Analytical methods for the simultaneous determination of the plethora of hydroxylated, dehydrogenated and/or demethylated compounds formed after administration of ketamine hydrochloride are a prerequisite for future clinical investigations and a deeper understanding of the individual role of the isomers of these metabolites...
September 8, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28925861/perioperative-pulmonary-medication-management
#5
Johnathan Ross Renew, Stephen Aniskevich
BACKGROUND: Pulmonary conditions such as asthma and chronic obstructive pulmonary disease (COPD) are common conditions that warrant special consideration in the perioperative period. When these patients undergo surgical interventions, they have risk of complications such as bronchospasm, hypoxia, and even postoperative respiratory failure that warrants unplanned intensive care unit admission. Thus, clinicians must be familiar with pulmonary medication regimens that are critical for maintaining stable homeostasis of these chronic conditions...
September 18, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28916246/pre-clinical-toxicology-considerations-for-vaccine-development
#6
REVIEW
Nabil Al-Humadi
Vaccine development requires pre-clinical toxicology studies, following good laboratory practice (GLP), before first in human (phase I) use. Many factors are critical in the final outcome of any pre-clinical toxicology study. The study design is one of these critical factors and should be carefully planned to avoid any false negative and/or false positive results. Preparation is another most critical factor in a successful study. Major changes in any procedure during the course of study should be avoided by all means...
September 12, 2017: Vaccine
https://www.readbyqxmd.com/read/28914647/effect-of-an-intravenous-dexamethasone-added-to-caudal-local-anesthetics-to-improve-postoperative-pain-a-systematic-review-and-meta-analysis-with-trial-sequential-analysis
#7
Hiromasa Kawakami, Takahiro Mihara, Nobuhito Nakamura, Koui Ka, Takahisa Goto
BACKGROUND: Caudal anesthesia has been used for postoperative pain control in pediatric surgical patients, but the duration of the analgesic effect is occasionally unsatisfactory. Intravenous steroids have been shown to be effective for postsurgical pain management after certain surgeries. The aim of this meta-analysis with trial sequential analysis (TSA) was to evaluate the analgesic effect of steroids in patients administered with caudal anesthesia. METHODS: This study was a systematic review and meta-analysis...
September 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28911899/a-rare-iatrogenic-atrial-esophageal-fistula-and-anesthetic-considerations-for-primary-surgical-repair
#8
Gregory A Smith, Amanda M Kleiman
No abstract text is available yet for this article.
April 13, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28904101/methodological-considerations-for-a-chronic-neural-interface-with-the-cuneate-nucleus-of-macaques
#9
Aneesha K Suresh, Jeremy Winberry, Christopher Versteeg, Raeed H Chowdhury, Tucker Tomlinson, Joshua M Rosenow, Lee E Miller, Sliman J Bensmaia
While the response properties of neurons in the somatosensory nerves and anterior parietal cortex have been extensively studied, little is known about the encoding of tactile and proprioceptive information in the cuneate nucleus (CN) or external cuneate nucleus (ECN), the first recipients of upper limb somatosensory afferent signals. The major challenge in characterizing neural coding in CN/ECN has been to record from these tiny, difficult to access brainstem structures. Most previous investigations of CN response properties have been carried out in decerebrate or anesthetized animals, thereby eliminating the well-documented top-down signals from cortex, which likely exert a strong influence on CN responses...
September 13, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28895383/robotic-assisted-thoracoscopic-lung-surgery-anesthetic-impact-and-perioperative-experience
#10
Joshua A Heller, Fraiz Y Bhora, Benjamin J Heller, Edmond Cohen
Anesthesiologists and the perioperative team have a tremendous impact upon clinical outcomes in robotic-assisted thoracoscopic surgery. As anesthesiology is developing its role outside the operating room, the patient population benefits from an expanded focus on perioperative critical care and pain management. This review focuses upon the preoperative optimization, unique intraoperative considerations for surgeons and anesthesiologists, and postoperative management of patients undergoing robotic-assisted thoracoscopic surgery...
September 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28888247/fatal-anaphylaxis-mortality-rate-and-risk-factors
#11
Paul J Turner, Elina Jerschow, Thisanayagam Umasunthar, Robert Lin, Dianne E Campbell, Robert J Boyle
Up to 5% of the US population has suffered anaphylaxis. Fatal outcome is rare, such that even for people with known venom or food allergy, fatal anaphylaxis constitutes less than 1% of total mortality risk. The incidence of fatal anaphylaxis has not increased in line with hospital admissions for anaphylaxis. Fatal drug anaphylaxis may be increasing, but rates of fatal anaphylaxis to venom and food are stable. Risk factors for fatal anaphylaxis vary according to cause. For fatal drug anaphylaxis, previous cardiovascular morbidity and older age are risk factors, with beta-lactam antibiotics, general anesthetic agents, and radiocontrast injections the commonest triggers...
September 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28879335/use-of-local-anesthetics-for-dental-treatment-during-pregnancy-safety-for-parturient
#12
REVIEW
Ji Min Lee, Teo Jeon Shin
Pregnancy induces significant anatomical and physiological changes in the mother. Many pregnant women need dental treatment due to poor oral hygiene related to pregnancy. However, most dentists are reluctant to provide, and most pregnant women are reluctant to receive, dental treatment during pregnancy. Theoretically, maternally administered drugs are transferred to the fetus. Depending on the types of drugs and the stage of pregnancy, the effects of drugs on the mother, as well as the fetus, may vary. Local anesthetics are the most widely used in dental treatment...
June 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28878632/the-influence-of-regional-distribution-and-pharmacologic-specificity-of-gabaar-subtype-expression-on-anesthesia-and-emergence
#13
REVIEW
Iris Speigel, Edyta K Bichler, Paul S García
Anesthetics produce unconsciousness by modulating ion channels that control neuronal excitability. Research has shown that specific GABAA receptor (GABAAR) subtypes in particular regions of the central nervous system contribute to different hyperpolarizing conductances, and behaviorally to distinct components of the anesthetized state. The expression of these receptors on the neuron cell surface, and thus the strength of inhibitory neurotransmission, is dynamically regulated by intracellular trafficking mechanisms...
2017: Frontiers in Systems Neuroscience
https://www.readbyqxmd.com/read/28867907/preemptive-analgesia-in-thumb-basal-joint-arthroplasty-immediate-postoperative-pain-with-preincision-versus-postincision-local-anesthesia
#14
Joseph T Labrum, Asif M Ilyas
Purpose  Currently no guidelines exist for the timing of the injection of anesthetics in surgeries performed under general anesthesia to minimize postoperative pain. To better understand the role of timing of the injection of local anesthesia in hand surgery performed under general anesthesia, we evaluated the effect of pre- versus postincisional local analgesic injection on immediate postoperative pain experience. We hypothesize that the preincisional (preemptive) injection will result in decreased immediate postoperative pain experience and analgesic use when compared with postincisional injection...
August 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28861722/preoperative-assessment-for-ambulatory-surgery
#15
REVIEW
Amit Prabhakar, Erik Helander, Nikki Chopra, Aaron J Kaye, Richard D Urman, Alan David Kaye
PURPOSE OF REVIEW: Ambulatory surgery has grown in recent decades in volume and represents a significant number of anesthetics delivered throughout the USA. Preoperative anesthetic assessment in the ambulatory setting has become important because patients with numerous complex comorbidities are now commonplace in this arena. Disease states involving the lungs, the heart, the kidneys, and subpopulations including those who are obese and the elderly commonly receive anesthetics in an ambulatory setting...
August 31, 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28858897/anesthetic-considerations-for-patients-undergoing-bronchial-thermoplasty
#16
Jagroop S Saran, Melissa Kreso, Sandhya Khurana, Michael Nead, Michael Larj, Suzanne Karan
Bronchial thermoplasty (BT) is a novel, Food and Drug Administration-approved nondrug treatment for patients whose asthma remains uncontrolled despite traditional pharmacotherapy. BT involves application of controlled radiofrequency energy to reduce airway smooth muscle in large- and medium-sized airways. Although BT is often performed under general anesthesia, anesthetic management strategies for BT are poorly described. We describe the anesthetic management of 7 patients who underwent 19 BT treatments in a tertiary academic medical center...
August 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28857329/anesthetic-considerations-for-a-novel-anterior-surgical-approach-to-pediatric-scoliosis-correction
#17
Jonathan S Gal, Christopher J Curatolo, Jeron Zerillo, Bryan Hill, Baron Lonner, Laury A Cuddihy, M D Antonacci, Randal R Betz, Samuel DeMaria, Yury Khelemsky
BACKGROUND: Idiopathic scoliosis is a condition that may require surgical correction. Limitations of previous surgical modalities, however, created the need for novel methods of repair. One such technique, a newer form of anterolateral scoliosis correction, has shown considerable promise, which our center has had substantial experience performing. AIM: In this article, we present the case details of our first 105 patients for the purposes of describing the evolution and details of the anesthetic management and considerations for this procedure...
August 31, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28853117/a-randomized-comparison-between-neurostimulation-and-ultrasound-guided-lateral-femoral-cutaneous-nerve-block
#18
Gaurav Gupta, Mohan Radhakrishna, Isaac Tamblyn, D Q Tran, Markus Besemann, Atikun Thonnagith, Maria Francisca Elgueta, Marie Eve Robitaille, Roderick J Finlayson
BACKGROUND: This prospective, randomized trial compared neurostimulation (NS) and ultrasound (US) guided lateral femoral cutaneous nerve (LFCN) block. We hypothesized that US would result in a shorter total anesthesia-related time (sum of performance and onset times). METHODS: Twenty-one volunteers were enrolled. The right lower limb was randomized to an NS- or US-guided LFCN block. The alternate technique was employed for the left lower limb. With NS, paresthesias were sought in the lateral thigh at a stimulatory threshold of 0...
July 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/28831913/pharmacology-and-perioperative-considerations-for-psychiatric-medications
#19
Neeti Sadana, Girish P Joshi
BACKGROUND: Psychotropic medications are being used increasingly as analgesics and for other off-label indications for patients with and without psychiatric conditions. While the pharmacology of most of these drugs is now known, their interaction with anesthetic drugs and implications of regular use are still relatively unclear. OBJECTIVE: We discuss the pharmacology, side effects, and potential medication interactions with anesthetic agents of various commonly prescribed psychotropic medications and the current recommendations regarding the continuation of these medications during the patients' perioperative care...
August 23, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28816893/periarticular-liposomal-bupivacaine-injection-versus-intra-articular-bupivacaine-infusion-catheter-for-analgesia-after-total-knee-arthroplasty-a-double-blinded-randomized-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Eric B Smith, Gregory S Kazarian, Mitchell G Maltenfort, Jess H Lonner, Peter F Sharkey, Robert P Good
BACKGROUND: Intra-articular bupivacaine hydrochloride (HCl) infusion catheters and periarticular injections of liposomal bupivacaine are often used as postoperative local anesthetics. The purpose of this study was to compare the efficacies of these local anesthetics following total knee arthroplasty. METHODS: This study was a superiority trial with a randomized, controlled, double-blinded design. Patients were randomly assigned to either delivery of bupivacaine HCl by the ON-Q* Pain Relief System pump (n = 96) or by an injection of Exparel (liposomal bupivacaine) (n = 104)...
August 16, 2017: Journal of Bone and Joint Surgery. American Volume
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