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Anesthesia emergency care

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https://www.readbyqxmd.com/read/28721690/pre-or-postoperative-interscalene-block-and-or-general-anesthesia-for-arthroscopic-shoulder-surgery-a-retrospective-observational-study
#1
Laura Bosco, Cheng Zhou, John A C Murdoch, Ryan Bicknell, Wilma M Hopman, Rachel Phelan, Vidur Shyam
PURPOSE: Arthroscopic shoulder surgery can be performed with an interscalene brachial plexus block (ISBPB) alone, ISBPB combined with general anesthesia (GA), or GA alone. Postoperative pain is typically managed with opioids; however, both GA and opioids have adverse effects which can delay discharge. This retrospective study compares the efficacy of four methods of anesthesia management for arthroscopic shoulder surgery. METHODS: Charts of all patients who underwent shoulder surgery by a single surgeon from 2012-2015 were categorized by analgesic regimen: GA only (n = 177), single-shot ISBPB only (n = 124), or pre- vs postoperative ISBPB combined with GA (ISBPB + GA [n = 72] vs GA + ISBPB [n = 52], respectively)...
July 18, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28713660/a-cross-sectional-pharmacoepidemiological-study-of-the-utilization-pattern-of-pre-anesthetic-medications-in-major-surgical-procedures-in-a-tertiary-care-hospital
#2
Madhuri Kulkarni, Anant Patil
OBJECTIVE : A study of the utilization pattern of pre-anesthetic medications in major surgical procedures. MATERIAL AND METHODS : A cross-sectional, pharmacoepidemiological study was conducted among patients undergoing surgical procedures in routine or emergency conditions under general anesthesia. The utilization of pre-anesthetic medicines in all patients was reported. RESULTS: A total of 110 patients (mean age - 42.36 years; 57.27% males) were enrolled...
June 13, 2017: Curēus
https://www.readbyqxmd.com/read/28708753/effectiveness-of-preoperative-intranasal-dexmedetomidine-compared-with-oral-midazolam-for-the-prevention-of-emergence-delirium-in-the-pediatric-patient-undergoing-general-anesthesia-a-systematic-review
#3
James FitzSimons, Laura S Bonanno, Stephanie Pierce, Jennifer Badeaux
BACKGROUND: Emergence delirium is defined as a cognitive disturbance during emergence from general anesthesia resulting in hallucinations, delusions and confusion manifested by agitation, restlessness, involuntary physical movement and extreme flailing in bed. Postoperative emergence delirium develops in 12% to 18% of all children undergoing general anesthesia for surgery. This post-anesthetic phenomenon changes cognitive and psychomotor behavior, and puts pediatric patients and health care personnel at risk of injury...
July 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#4
Alain Cariou, Jean-Francois Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
July 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28685304/perioperative-and-icu-healthcare-analytics-within-a-veterans-integrated-system-network-a-qualitative-gap-analysis
#5
Seshadri Mudumbai, Ferenc Ayer, Jerry Stefanko
Health care facilities are implementing analytics platforms as a way to document quality of care. However, few gap analyses exist on platforms specifically designed for patients treated in the Operating Room, Post-Anesthesia Care Unit, and Intensive Care Unit (ICU). As part of a quality improvement effort, we undertook a gap analysis of an existing analytics platform within the Veterans Healthcare Administration. The objectives were to identify themes associated with 1) current clinical use cases and stakeholder needs; 2) information flow and pain points; and 3) recommendations for future analytics development...
August 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28675609/effects-of-intravenous-fentanyl-around-the-end-of-surgery-on-emergence-agitation-in-children-systematic-review-and-meta-analysis
#6
REVIEW
Namo Kim, Jin Ha Park, Jong Seok Lee, Taeyang Choi, Min-Soo Kim
BACKGROUND: Emergence agitation is a serious postoperative problem in children undergoing general anesthesia. The use of fentanyl around the end of surgery has been proposed to prevent emergence agitation. However, the efficacy and disadvantages of this method remain uncertain because previous results have not been consistent, depending on the variable assessed. METHODS: In July 2016, the PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Embase, and KoreaMed were searched for randomized controlled trials that compared fentanyl (1 μg/kg) and placebo administered around the end of surgery to prevent emergence agitation after general anesthesia in children between birth and 14 years of age...
July 4, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28668199/chronic-respiratory-failure-utilization-of-a-pediatric-specialty-integrated-care-program
#7
Robert J Graham, Michael L McManus, Angie Mae Rodday, Ruth Ann Weidner, Susan K Parsons
OBJECTIVE: Describe utilization and satisfaction in a specialty integrated care program for children with severe, chronic respiratory insufficiency (CRI). SUBJECTS: Enrollees of the Critical Care, Anesthesia, Perioperative Extension (CAPE) and Home Ventilation Program. METHODS: Children with CRI received home visits, care coordination, and "on-demand" 24/7 access to physicians. Program activity and outcomes were recorded for 3 years using an adapted Care Coordination Measurement Tool© version...
March 2017: Healthcare
https://www.readbyqxmd.com/read/28664348/paravertebral-blocks-for-same-day-breast-surgery
#8
REVIEW
Mark R Jones, Graham R Hadley, Alan D Kaye, Philipp Lirk, Richard D Urman
PURPOSE OF REVIEW: Breast surgery, performed for medical or cosmetic reasons, remains one of the most frequently performed procedures, with over 500,000 cases performed annually in the USA alone. Historically, general anesthesia (GA) has been widely accepted as the gold-standard technique, while epidural anesthesia was largely considered too invasive and thus unnecessary for breast surgery. Over the past years, paravertebral block (PVB) has emerged as an alternative analgesic or even anesthetic technique...
August 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28660414/-stocks-of-dantrolene-in-anesthesia-and-intensive-care-units-in-germany-nationwide-online-survey-with-1673-participants
#9
E Pfenninger, S Heiderich, W Klingler
BACKGROUND: A malignant hyperthermia (MH) crisis is a potentially fatal complication in anesthesia and intensive care units (ICU). Rapid administration and adequate dosage of dantrolene is the only known effective pharmacological and causal treatment of an MH crisis. International anesthesiology societies recommend an initial dose of 2.0-2.5 mg/kg body weight (BW). The necessary total dosage should be titrated up to 10 mg/kg BW depending on the effectiveness. OBJECTIVE: The goal of this study was an analysis of the stocking situation of dantrolene in Germany...
June 28, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28657959/monitoring-anesthesia-care-delivery-and-perioperative-mortality-in-kenya-utilizing-a-provider-driven-novel-data-collection-tool
#10
Bantayehu Sileshi, Mark W Newton, Joash Kiptanui, Matthew S Shotwell, Jonathan P Wanderer, Mary Mungai, Jon Scherdin, Paul A Harris, Sten H Vermund, Warren S Sandberg, Matthew D McEvoy
BACKGROUND: Perioperative mortality rate is regarded as a credible quality and safety indicator of perioperative care, but its documentation in low- and middle-income countries is poor. We developed and tested an electronic, provider report-driven method in an East African country. METHODS: We deployed a data collection tool in a Kenyan tertiary referral hospital that collects case-specific perioperative data, with asynchronous automatic transmission to central servers...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28648141/anesthetic-management-of-spontaneous-cervical-epidural-hematoma-during-pregnancy-a-case-report
#11
Mehdi Samali, Abdelghafour Elkoundi, Achraf Tahri, Mustapha Bensghir, Charki Haimeur
BACKGROUND: Spontaneous spinal epidural hematoma during pregnancy is a quite rare event requiring emergent decompressive surgery in the majority of cases to prevent permanent neurological damage. Therefore, there is little data in the literature regarding anesthetic management of cervical localization during pregnancy. The potential for difficult airway management with the patient under general anesthesia is one of the major concerns that needs to be addressed to prevent further cord compression...
June 26, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28639117/tubeless-outpatient-robotic-upper-urinary-tract-reconstruction-in-the-pediatric-population-short-term-assessment-of-safety
#12
Eric J Fichtenbaum, Andrew C Strine, Charles W Concodora, Marion Schulte, Paul H Noh
Robotic upper urinary tract reconstruction (UUTR) has been widely utilized for surgical management of congenital obstruction. To further reduce morbidity and simplify postoperative care, outpatient robotic pyeloplasty (RP) and robotic ureteroureterostomy (RUU) were performed without ureteral stents, drains, or urethral catheters. The aim of the study was to assess the safety of performing tubeless robotic UUTR as an outpatient procedure. A retrospective review was performed for patients who underwent outpatient tubeless RP and RUU between July 2015 and January 2017...
June 21, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28634094/regional-anesthesia-in-total-joint-arthroplasty-what-is-the-evidence
#13
Dalia H Elmofty, Asokumar Buvanendran
Total joint arthroplasty is one of the most common surgical procedures performed for end-stage osteoarthritis. The increasing demand for knee and hip arthroplasties along with the improvement in life expectancy has created a substantial medical and economic impact on the society. Effective planning of health care for these individuals is vital. The best method for providing anesthesia and analgesia for total joint arthroplasty has not been defined. Yet, emerging evidence suggests that the type of anesthesia can affect morbidity and mortality of patients undergoing these procedures...
May 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28632541/hospital-based-acute-care-within-7-days-of-discharge-after-outpatient-arthroscopic-shoulder-surgery
#14
Jiabin Liu, David N Flynn, Wai-Man Liu, Lee A Fleisher, Nabil M Elkassabany
BACKGROUND: The rate of hospital-based acute care (defined as hospital transfer at discharge, emergency department [ED] visit, or subsequent inpatient hospital [IP] admission) after outpatient procedure is gaining momentum as a quality metric for ambulatory surgery. However, the incidence and reasons for hospital-based acute care after arthroscopic shoulder surgery are poorly understood. METHODS: We studied adult patients who underwent outpatient arthroscopic shoulder procedures in New York State between 2011 and 2013 using the Healthcare Cost and Utilization Project database...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#15
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28616619/a-case-of-late-diagnosis-of-chronic-subdural-hematoma-following-spinal-anesthesia
#16
Ali Aygun, Hava Semra Vuran, Nurhak Aksut, Yunus Karaca, Ozgur Tatli
Intracranial subdural hematoma developing following spinal anesthesia is a rare but serious complication. We describe a case of subdural hematoma developing following spinal anesthesia and diagnosed late. A female patient receiving spinal anesthesia for cesarean delivery 45 days prior to arrival at the emergency department presented to our hospital with non-severe headache persisting for 45 days after discharge. Computerized tomography (CT) of the brain performed due to long-term persisting headache resistant to medical treatment and a history of spinal intervention revealed a hypodense chronic subdural hematoma in the left frontoparietal area and a shift from left to right in midline structures...
June 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28594070/labor-delivery-and-anesthesia-experiences-of-women-with-physical-disability
#17
Suzanne C Smeltzer, Amy J Wint, Jeffrey L Ecker, Lisa I Iezzoni
BACKGROUND: Although many women with physical disabilities report poor quality reproductive health care, little research has addressed labor, delivery, and anesthesia experiences of these women. This study was conducted to explore these experiences in women with significant mobility disabilities. METHODS: A qualitative descriptive study was conducted with 22 women from the United States who had delivered newborns within the prior 10 years. All had significant mobility disabilities...
June 8, 2017: Birth
https://www.readbyqxmd.com/read/28593682/interactive-pediatric-emergency-checklists-to-the-palm-of-your-hand-how-the-pedi-crisis-app-traveled-around-the-world
#18
Jorge A Gálvez, Justin L Lockman, Laura E Schleelein, Allan F Simpao, Luis M Ahumada, Bryan A Wolf, Maully J Shah, Eugenie Heitmiller, Mohamed Rehman
BACKGROUND: Cognitive aids help clinicians manage critical events and have been shown to improve outcomes by providing critical information at the point of care. Critical event guidelines, such as the Society of Pediatric Anesthesia's Critical Events Checklists described in this article, can be distributed globally via interactive smartphone apps. From October 1, 2013 to January 1, 2014, we performed an observational study to determine the global distribution and utilization patterns of the Pedi Crisis cognitive aid app that the Society for Pediatric Anesthesia developed...
June 7, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28537570/safe-and-uncomplicated-inguinal-hernia-surgery-in-the-elderly-message-from-anesthesiologists-to-general-surgeons
#19
Tomasz Chlebny, Piotr Zelga, Mateusz Pryt, Marta Zelga, Adam Dziki
Introduction Elderly patients are often discouraged from surgery due to the risk of complications that increases with age. Aim We wanted to assess mortality, morbidity, and complications in patients older than 75 years who underwent elective or emergency inguinal hernia repair in a single center. Methods All patients older than 75 years who were operated on because of inguinal hernia in the Department of General and Colorectal Surgery, Medical University of Lodz between 2003 and 2015 were analyzed. Detailed information was collected with regard to patient demographics, mode of admission, comorbidities, type of intervention, applied anesthesia, and 30-day outcomes...
April 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28535940/-postpartum-hemorrhage-and-pregnancy-induced-hypertension-during-emergency-lower-segment-cesarean-section-dexmedetomidine-to-our-rescue
#20
Uma Hariharan
Dexmedetomidine is a highly selective α-2 agonist which has recently revolutionized our anesthesia and intensive care practice. An obstetric patient presented for emergency cesarean delivery under general anesthesia, with pre-eclampsia and postpartum hemorrhage. In carefully selected cases with refractory hypertension and postpartum hemorrhage, dexmedetomidine can be used for improving overall patient outcome. It was beneficial in controlling both the blood pressure and uterine bleeding during cesarean section in our patient...
May 20, 2017: Revista Brasileira de Anestesiologia
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