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Anesthesia emergency care

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https://www.readbyqxmd.com/read/28810649/effect-of-dexmedetomidine-combined-with-sufentanil-on-preventing-emergence-agitation-in-children-receiving-sevoflurane-anesthesia-for-cleft-palate-repair-surgery
#1
Ke Luo, Jun-Mei Xu, Lin Cao, Ju Gao
The aim of the present study was to observe whether dexmedetomidine (DEX) combined with sufentanil decreased emergence agitation (EA) in children receiving sevoflurane anesthesia for cleft palate repair surgery. Children undergoing elective cleft palate repair surgery were randomly allocated into the DEX + sufentanil group (group DS; n=50) and the normal saline + fentanyl group (group SF; n=50). Patients in group DS were treated with 0.5 µg/kg DEX prior to induction of anesthesia, whereas patients in group SF received an equal volume of normal saline...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28802384/retrospective-study-of-intranasal-dexmedetomidine-as-a-prophylactic-against-emergence-delirium-in-pediatric-patients-undergoing-ear-tube-surgery
#2
Lisgelia Santana, Katherine Mills
OBJECTIVES: This study evaluated the effect of intranasal dexmedetomidine on emergence delirium (ED) in pediatric patients who underwent ear tube surgeries. Due to the brief nature of the surgery and low levels of pain experienced, an IV is rarely needed, limiting the medications available to anesthesiologists to manage postoperative delirium that may arise during recovery from inhalational anesthesia. Intravenous dexmedetomidine is an alpha-2 agonist anesthetic that is used in pediatric patients for the management of ED in various surgical procedures...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28801082/-how-to-videos-improve-residents-performance-of-essential-perioperative-electronic-medical-records-and-clinical-tasks
#3
Veronica Zoghbi, Robert C Caskey, Kristoffel R Dumon, Jacqueline M Soegaard Ballester, Ari D Brooks, Jon B Morris, Daniel T Dempsey
OBJECTIVE: The ability to use electronic medical records (EMR) is an essential skill for surgical residents. However, frustration and anxiety surrounding EMR tasks may detract from clinical performance. We created a series of brief, 1-3 minutes "how to" videos demonstrating 7 key perioperative EMR tasks: booking OR cases, placing preprocedure orders, ordering negative-pressure wound dressing supplies, updating day-of-surgery history and physical notes, writing brief operative notes, discharging patients from the postanesthesia care unit, and checking vital signs...
August 8, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28798877/previously-undiagnosed-spinal-and-bulbar-muscular-atrophy-as-a-cause-of-airway-obstruction-after-robot-assisted-laparoscopic-prostatectomy
#4
Miyuki Niki, Taihei Tachikawa, Yuka Sano, Hiroki Miyawaki, Aisa Matoi, Yukari Okano, Nobutaka Kariya, Tsuneo Tatara, Munetaka Hirose
BACKGROUND: Preoperative vocal cord paralysis is a risk factor for postoperative respiratory distress following extubation after general anesthesia. We present an unusual case where a geriatric patient developed airway obstruction after robot-assisted laparoscopic prostatectomy. CASE PRESENTATION: A 67-year-old male, who had suffered from left vocal cord paralysis of unknown etiology, was scheduled for robot-assisted laparoscopic prostatectomy (RALP). General anesthesia was performed without any problems...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28795523/a-limited-evaluation-of-the-association-of-race-and-anesthetic-medication-administration-a-single-center-experience-with-appendectomies
#5
Julia M Rosenbloom, Kumaran Senthil, Alexander S Long, Whitney R Robinson, Kenneth N Peeples, John E Fiadjoe, Ronald S Litman
BACKGROUND: Although it is known that a patient's race may influence their medical care, racial patterns of medication administration in pediatric anesthesia have not been well-studied. The aim of this study was to determine if differences exist between Black and White children with regard to administration of anesthetic and analgesic medications for a single procedure at our institution. METHODS: We conducted a retrospective review of medications administered to patients for emergency appendectomies at a large academic children's hospital from 2010 to 2015...
August 10, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28795214/derivation-validation-and-application-of-a-pragmatic-risk-prediction-index-for-benchmarking-of-surgical-outcomes
#6
Richard T Spence, David C Chang, Haytham M A Kaafarani, Eugenio Panieri, Geoffrey A Anderson, Matthew M Hutter
BACKGROUND: Despite the existence of multiple validated risk assessment and quality benchmarking tools in surgery, their utility outside of high-income countries is limited. We sought to derive, validate and apply a scoring system that is both (1) feasible, and (2) reliably predicts mortality in a middle-income country (MIC) context. METHODS: A 5-step methodology was used: (1) development of a de novo surgical outcomes database modeled around the American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) in South Africa (SA dataset), (2) use of the resultant data to identify all predictors of in-hospital death with more than 90% capture indicating feasibility of collection, (3) use these predictors to derive and validate an integer-based score that reliably predicts in-hospital death in the 2012 ACS-NSQIP, (4) apply the score in the original SA dataset and demonstrate its performance, (5) identify threshold cutoffs of the score to prompt action and drive quality improvement...
August 9, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28794834/anesthesia-for-ambulatory-surgery
#7
REVIEW
Jeong Han Lee
Ambulatory anesthesia allows quick recovery from anesthesia, leading to an early discharge and rapid resumption of daily activities, which can be of great benefit to patients, healthcare providers, third-party payers, and hospitals. Recently, with the development of minimally invasive surgical techniques and short-acting anesthetics, the use of ambulatory surgery has grown rapidly. Additionally, as the indications for ambulatory surgery have widened, the surgical methods have become more complex and the number of comorbidities has increased...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28763432/endovascular-treatment-of-acute-ischemic-stroke-under-general-anesthesia-predictors-of-good-outcome
#8
Umeshkumar Athiraman, Ali Sultan-Qurraie, Bala Nair, David L Tirschwell, Basavaraj Ghodke, Adam D Havenon, Danial K Hallam, Louis J Kim, Kyra J Becker, Deepak Sharma
BACKGROUND: The choice of anesthetic technique, general anesthesia (GA) versus Monitored Anesthesia Care, may impact the outcome of patients undergoing endovascular treatment of acute ischemic stroke (AIS). The aim of this study was to identify the factors associated with good discharge outcome in patients receiving GA for AIS. MATERIALS AND METHODS: Electronic medical records of patients above 18 years old who underwent endovascular treatment of AIS under GA at a Comprehensive Stroke Center from 2010 to 2014 were reviewed...
July 31, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28749265/emergency-anesthesia-and-exploratory-laparotomy-in-a-compromised-pacific-white-sided-dolphin-lagenorhynchus-obliquidens
#9
Justin F Rosenberg, Martin Haulena, James E Bailey, Dean A Hendrickson, Marina Ivančić, Stephen A Raverty
Anesthesia and surgery in cetaceans have inherent risks and have rarely been utilized as viable treatment options. This report represents the first known multidisciplinary team approach to emergency laparotomy in a compromised, 22-yr-old, female Pacific white-sided dolphin ( Lagenorhynchus obliquidens ). The inciting clinical signs and ancillary diagnostics were consistent with a mechanical ileus. Although no torsion or obstruction was apparent during surgery, severe enteritis and peritonitis were noted. Postoperatively, the animal was maintained on aggressive medical management with continuous supportive care until succumbing 3 days later with clinical pathology indicative of terminal sepsis and profound inflammation...
June 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28744243/the-odyssey-of-dental-anxiety-from-prehistory-to-the-present-a-narrative-review
#10
REVIEW
Enrico Facco, Gastone Zanette
Dental anxiety (DA) can be considered as a universal phenomenon with a high prevalence worldwide; DA and pain are also the main causes for medical emergencies in the dental office, so their prevention is an essential part of patient safety and overall quality of care. Being DA and its consequences closely related to the fight-or-flight reaction, it seems reasonable to argue that the odyssey of DA began way back in the distant past, and has since probably evolved in parallel with the development of fight-or-flight reactions, implicit memory and knowledge, and ultimately consciousness...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28743149/-the-influence-of-anesthesia-on-perioperative-outcome-in-children-institutional-and-individual-factors
#11
Frank Fideler, Christian Grasshoff
The perioperative care of children is challenging for health care providers. Since anesthetists cannot affect the nature of the disease and have hardly an impact on the decision for surgery we summarized in this review individual and institutional factors for improving perioperative outcome by anesthetists. Individual factors include the level of education and the professional experience of the anesthetist as well as an anesthetic management that is focused on the maintenance of an adequate cerebral perfusion...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28735860/are-oral-and-maxillofacial-surgery-residents-being-adequately-trained-to-care-for-pediatric-patients
#12
Shelly Abramowicz, Leonard B Kaban, Andrew S Wurtzel, Steven M Roser
OBJECTIVE: To evaluate whether current oral and maxillofacial surgery (OMS) residents are receiving adequate training and experience to perform specific surgical procedures and anesthesia for pediatric patients. STUDY DESIGN: A 17-question survey was sent electronically to fellows of the American Academy of Craniomaxillofacial Surgeons. Descriptive data for individual surgeons, their associated residency programs, and the quantity of specific pediatric procedures they performed were collected...
May 4, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28721690/pre-or-postoperative-interscalene-block-and-or-general-anesthesia-for-arthroscopic-shoulder-surgery-a-retrospective-observational-study
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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...
September 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28668199/chronic-respiratory-failure-utilization-of-a-pediatric-specialty-integrated-care-program
#19
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
#20
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
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