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https://www.readbyqxmd.com/read/27884666/anesthetic-considerations-in-a-parturient-with-congenital-insensitivity-to-pain-with-anhidrosis
#1
Z Pirani, F Qasem, S Katsiris
Congenital insensitivity to pain is a rare autosomal recessive disease characterized by varying degrees of autonomic dysfunction and sensory loss, including nociceptive hyposensitivity. It is this autonomic dysfunction that makes both general and neuraxial anesthesia challenging. Testing the block during neuraxial anesthesia may be difficult and the patient may be prone to hypotension and bradycardia. This case report describes the anesthetic management of a parturient with congenital insensitivity to pain presenting for cesarean delivery...
October 21, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27879606/improving-outcomes-in-tendon-repair-a-critical-look-at-the-evidence-for-flexor-tendon-repair-and-rehabilitation
#2
Wee S Khor, Martin F Langer, Richard Wong, Rui Zhou, Fiona Peck, Jason K F Wong
LEARNING OBJECTIVES: After reading this article, the participant should be able to: 1. Appreciate the variation and evolution of flexor tendon management 2. Know how to assess the patient who presents with a flexor tendon laceration. 3. Understand the biology of repairing flexor tendon lacerations. 4. Appreciate the technical challenges in flexor tendon repair relating to different zones. 5. Understand the rationale of postoperative hand therapy. 6. Have an overview of the types of secondary tendon surgery...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27873001/1-2-dimethylimidazole-4-sulfonyl-chloride-dmisc-a-novel-derivatization-strategy-for-the-analysis-of-propofol-by-lc-esi-ms-ms
#3
Alexandra Maas, Christoph Maier, Beate Michel-Lauter, Burkhard Madea, Cornelius Hess
Analysis of the anesthetic agent propofol in biological samples by LC-MS/MS is a great challenge due to weak fragmentation and poor ionization efficacy of propofol resulting in weak signal intensities. Improvements of the ionization and fragmentation efficacy can be achieved by conversion of propofol to its dimethylimidazolesulfonyl (DMIS) derivative by a derivatization reaction using 1,2-dimethylimidazole-4-sulfonyl chloride (DMISC). This DMIS derivative produced intense [M + H](+) ions in positive-ion LC-ESI-MS/MS with the dimethylimidazole moieties representing the most abundant product ions...
November 21, 2016: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/27871591/continuous-intra-articular-local-anesthetic-drug-instillation-versus-discontinuous-sciatic-nerve-block-after-total-knee-arthroplasty
#4
Johannes Cip, Hedwig Erb-Linzmeier, Peter Stadlbauer, Christian Bach, Arno Martin, Reinhard Germann
STUDY OBJECTIVE: Sciatic nerve block (SNB) is commonly used as adjunct to femoralis nerve block (FNB) to achieve high-quality pain relief after total knee arthroplasty (TKA). However, this combination is associated with considerable muscle weakness, foot drop and surgically related nerve injuries may be masked. The purpose of this study was to assess whether low risk continuous intra-articular anesthetic drug instillation is an adequate alternative to SNB when adding to FNB after TKA...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871587/peripheral-nerve-blocks-in-the-management-of-postoperative-pain-challenges-and-opportunities
#5
REVIEW
Girish Joshi, Kishor Gandhi, Nishant Shah, Jeff Gadsden, Shelby L Corman
Peripheral nerve blocks (PNBs) are increasingly used as a component of multimodal analgesia and may be administered as a single injection (sPNB) or continuous infusion via a perineural catheter (cPNB). We undertook a qualitative review focusing on sPNB and cPNB with regard to benefits, risks, and opportunities for optimizing patient care. Meta-analyses of randomized controlled trials have shown superior pain control and reductions in opioid consumption in patients receiving PNB compared with those receiving intravenous opioids in a variety of upper and lower extremity surgical procedures...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871511/zika-virus-review-and-obstetric-anesthetic-clinical-considerations
#6
REVIEW
Cesar Padilla, Aileen Pan, Andrew Geller, Mark I Zakowski
STUDY OBJECTIVES: To review the clinical and basic science literature regarding Zika viral illness and highlight relevant findings for obstetric anesthesiologists. This review provides a global review of Zika viral illness, transmission patterns, pathophysiology of disease, and anesthetic management of the parturient with Zika viral illness and associated comorbidities. DESIGN: Systematic review. SETTING: Large academic hospital. SUBJECTS: None...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870668/cost-savings-opportunities-in-perioperative-management-of-the-patients-with-orthopaedic-trauma
#7
Alastair E Moody, Catriona E Moody, Peter L Althausen
Considerable opportunities for cost savings exist surrounding the perioperative management of patients with orthopaedic fracture and trauma. Scientific evidence is available to support each potential cost savings measure. Much of these data had been documented for years but has never been adhered to, resulting in millions of dollars in unnecessary testing and treatment. Careful attention to preoperative laboratory testing can save huge amounts of money and expedite medical clearance for injured patients. The use of a dedicated orthopaedic trauma operating room has been shown to improve resource utilization, decrease costs, and surgical complications...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27861438/cardiotoxic-antiemetics-metoclopramide-and-domperidone-block-cardiac-voltage-gated-na-channels
#8
Carsten Stoetzer, Marc Voelker, Thorben Doll, Joerg Heineke, Florian Wegner, Andreas Leffler
BACKGROUND: Metoclopramide and domperidone are prokinetic and antiemetic substances often used in clinical practice. Although domperidone has a more favorable side effect profile and is considered the first-line agent, severe cardiac side effects were reported during the administration of both substances. Cardiac Na channels are common targets of therapeutics inducing cardiotoxicity. Therefore, the aim of this study was to investigate whether the differential cardiotoxicities of metoclopramide and domperidone correlate with the block of Na channels...
November 17, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27859797/in-vitro-and-in-vivo-effects-of-a-novel-dimeric-inhibitor-of-psd-95-on-excitotoxicity-and-functional-recovery-after-experimental-traumatic-brain-injury
#9
Jens Bak Sommer, Anders Bach, Hana Malá, Kristian Strømgaard, Jesper Mogensen, Darryl Scott Pickering
PSD-95 inhibitors have been shown to be neuroprotective in stroke, but have only to a very limited extent been evaluated in the treatment of traumatic brain injury (TBI) that has pathophysiological mechanisms in common with stroke. The aims of the current study were to assess the effects of a novel dimeric inhibitor of PSD-95, UCCB01-147, on histopathology and long-term cognitive outcome after controlled cortical impact (CCI) in rats. As excitotoxic cell death is thought to be a prominent part of the pathophysiology of TBI, we also investigated the neuroprotective effects of UCCB01-147 and related compounds on NMDA-induced cell death in cultured cortical neurons...
November 17, 2016: European Journal of Neuroscience
https://www.readbyqxmd.com/read/27847211/phyto-anesthetics-a-mini-review-on-herb-anesthesia-drug-interactions
#10
REVIEW
Sepideh Vahabi, Ali Eatemadi
Over the years studies have shown the high prevalence rate in the use of herbal drugs among patients, doctors and health workers as such there is a need to take care of any health consequences associated with herbal drugs administrations. Herbal drugs are made of pharmacologically effective constituents, that can interact with anesthesia drugs that risk the life of the patients in question. In addition, pharmacokinetics and pharmacodynamics of herbal drugs are yet to be fully understood thus still needs more study...
November 12, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/27833477/transversus-abdominis-plane-block-in-renal-allotransplant-recipients-a-retrospective-chart-review
#11
S R Gopwani, M A Rosenblatt
CONTEXT: The efficacy of the transversus abdominis plane (TAP) block appears to vary considerably, depending on the surgical procedure and block technique. AIMS: This study aims to add to the existing literature and provide a more clear understanding of the TAP blocks role as a postoperative analgesic technique, specifically in renal allotransplant recipients. SETTINGS AND DESIGN: A retrospective chart review was conducted by querying the intraoperative electronic medical record system of a 1200-bed tertiary academic hospital over a 5 months period, and reviewing anesthetic techniques, as well as postoperative morphine equivalent consumption...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27826950/effects-of-common-anesthetic-agents-on-18-f-flumazenil-binding-to-the-gabaa-receptor
#12
Mikael Palner, Corinne Beinat, Sam Banister, Francesca Zanderigo, Jun Hyung Park, Bin Shen, Trine Hjoernevik, Jae Ho Jung, Byung Chul Lee, Sang Eun Kim, Lawrence Fung, Frederick T Chin
BACKGROUND: The availability of GABAA receptor binding sites in the brain can be assessed by positron emission tomography (PET) using the radioligand, [(18)F]flumazenil. However, the brain uptake and binding of this PET radioligand are influenced by anesthetic drugs, which are typically needed in preclinical imaging studies and clinical imaging studies involving patient populations that do not tolerate relatively longer scan times. The objective of this study was to examine the effects of anesthesia on the binding of [(18)F]flumazenil to GABAA receptors in mice...
December 2016: EJNMMI Research
https://www.readbyqxmd.com/read/27821785/anesthetic-considerations-for-surgery-on-the-aortic-arch
#13
REVIEW
Barbara J Wilkey, Nathaen S Weitzel
Aortic arch surgery requires meticulous teamwork in the true perioperative sense. Planning and communication at all phases from preoperative evaluation, through intraoperative management, to postoperative care should be well coordinated between surgical, anesthesia, perfusion, and intensive care unit teams. This review discusses intraoperative management from the anesthesiologist's perspective, with particular emphasis on transesophageal echo evaluation and coagulation management.
December 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27796549/-endovascular-embolic-hemispherectomy-a-strategy-for-the-initial-management-of-catastrophic-holohemispheric-epilepsy-in-the-neonate
#14
Chima Oluigbo, Monica S Pearl, Tammy N Tsuchida, Taeun Chang, Cheng-Ying Ho, William D Gaillard
PURPOSE: Conflicting challenges abound in the management of the newborn with intractable epilepsy related to hemimegalencephaly. Early hemispherectomy to stop seizures and prevent deleterious consequences to future neurocognitive development must be weighed against the technical and anesthetic challenges of performing major hemispheric surgery in the neonate. METHODS: We hereby present our experience with two neonates with hemimegalencephaly and intractable seizures who were managed using a strategy of initial minimally invasive embolization of the cerebral blood supply to the involved hemisphere...
October 29, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27794607/melibiose-a-non-digestible-disaccharide-promotes-absorption-of-quercetin-glycosides-in-rat-small-intestine
#15
Seiya Tanaka, Aki Shinoki, Hiroshi Hara
We demonstrated that melibiose, a non-digestible disaccharide composed of galactose and glucose with α-1,6 glycoside linkage, promotes the absorption of water soluble quercetin glycosides in ligated small intestinal loop of anesthetized rats. Water soluble quercetin glycoside, a quercetin-3-Ο-glucoside mixture (Q3GM), includes quercetin-3-Ο-glucoside (Q3G, 31.9%), mono (21.2%) and di (17.1%), glucose adducts with α-1,4 linkages. After instillation of Q3GM into the intestinal loop with or without melibiose, the plasma concentration of quercetin derivatives in the portal blood, was considerably higher in the melibiose group at 60 min...
October 31, 2016: Journal of Agricultural and Food Chemistry
https://www.readbyqxmd.com/read/27787270/prevention-and-management-of-injection-related-adverse-effects-in-facial-aesthetics-considerations-for-atx-101-deoxycholic-acid-injection-treatment
#16
Steven Fagien, Patricia McChesney, Meenakshi Subramanian, Derek H Jones
ATX-101 (deoxycholic acid injection; Kythera Biopharmaceuticals, Inc. [an affiliate of Allergan plc, Dublin, Ireland]) was approved in 2015 in the United States (Kybella) and Canada (Belkyra) for submental fat reduction. As expected, injection-site reactions such as pain, swelling, and bruising, which were mostly mild or moderate and transient, were common adverse events (AEs) reported in clinical trials. An exploratory Phase 3b study investigating interventions for management of injection-site AEs associated with ATX-101 treatment was recently completed...
November 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/27783022/new-trends-in-interventional-pulmonology
#17
Angela Roberts Selzer, Matthew Murrell, Eugene Shostak
PURPOSE OF REVIEW: As the field of interventional pulmonology continues to expand and develop at a rapid pace, anesthesiologists are increasingly called upon to provide well tolerated anesthetic care during these procedures. These patients may not be candidates for surgical treatment and often have multiple comorbidities. It is important for anesthesiologists to familiarize themselves with these procedures and their associated risks and complications. RECENT FINDINGS: The scope of the interventional pulmonologist's practice is varied and includes both diagnostic and therapeutic procedures...
October 25, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27773843/using-tiletamine-zolazepam-xylazine-anesthesia-compared-to-co2-inhalation-for-terminal-clinical-chemistry-hematology-and-coagulation-analysis-in-mice
#18
Oksana N Khokhlova, Elena A Tukhovskaya, Irina N Kravchenko, Elena S Sadovnikova, Irina A Pakhomova, Elena A Kalabina, Alexander V Lobanov, Elvira R Shaykhutdinova, Alina M Ismailova, Arkady N Murashev
INTRODUCTION: It is important that the method of anesthesia of mice does not considerably alter the animal's physiological and metabolic status before terminal blood sampling taken in order to analyze clinical pathology parameters. METHODS: Hematology, hemostasis, and clinical chemistry parameters were compared in male and female BALB/c mice exposed to either tiletamine-zolazepam-xylazine (TZX) anesthesia or euthanasia in carbon dioxide (CO2) chamber to reveal an alternative method of anesthesia vs...
October 20, 2016: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/27766261/extrapedicular-infiltration-anesthesia-as-an-improved-method-of-local-anesthesia-for-unipedicular-percutaneous-vertebroplasty-or-percutaneous-kyphoplasty
#19
Liehua Liu, Shiming Cheng, Rui Lu, Qiang Zhou
Aim. This report introduces extrapedicular infiltration anesthesia as an improved method of local anesthesia for unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty. Method. From March 2015 to March 2016, 44 patients (11 males and 33 females) with osteoporotic vertebral compression fractures with a mean age of 71.4 ± 8.8 years (range: 60 to 89) received percutaneous vertebroplasty or percutaneous kyphoplasty. 24 patients were managed with conventional local infiltration anesthesia (CLIA) and 20 patients with both CLIA and extrapedicular infiltration anesthesia (EPIA)...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27755141/current-thinking-regarding-potential-neurotoxicity-of-general-anesthesia-in-infants
#20
Mary Ellen McCann, Jurgen de Graaff
PURPOSE OF REVIEW: Numerous preclinical studies have shown that general anesthetics adversely influence the development of young brains. These adverse effects are dose-dependent occurring in specific stages of brain development. Histologic examinations show increased apoptosis, pathological neurogenesis and dendritic formation after exposure in infant animals to virtually all general anesthetics at a clinically effective dose which are associated with memory and behavioral changes at adulthood...
January 2017: Current Opinion in Urology
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