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Monitored anesthesia care

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https://www.readbyqxmd.com/read/28081306/tracheal-intubation-in-patients-immobilized-by-a-rigid-collar-a-comparison-of-glidescope-and-an-intubating-laryngeal-mask-airway
#1
Semih Özdil, Zehra İpek Arslan Aydın, Zehra Nur Baykara, Kamil Toker, Zeynep Mine Solak
BACKGROUND/AIM: Intubation must be rapidly performed with the utmost care in cervical trauma patients. We present the first comparison of GlideScope and an intubating laryngeal mask airway (ILMA) regarding insertion and intubation times, intubation success rates, mucosal damage, need for optimization maneuvers, effects on hemodynamic changes, and postoperative minor complications in a simulated cervical injury with a Philadelphia cervical collar. MATERIALS AND METHODS: Ethics committee approval and patient consent were obtained and 94 American Society of Anesthesiology physical status I or II patients were enrolled in this study...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28058561/percutaneous-peritoneal-lavage-for-the-rapid-staging-of-gastric-and-pancreatic-cancer
#2
Linda M Pak, Daniel G Coit, Anne A Eaton, Peter J Allen, Michael I D'Angelica, Ronald P DeMatteo, William R Jarnagin, Vivian E Strong, T Peter Kingham
BACKGROUND: Positive peritoneal cytology is classified as M1 disease in gastric and pancreatic cancer. While peritoneal cytology is typically obtained by laparoscopic peritoneal lavage, this study sought to examine the feasibility and safety of performing this percutaneously, with monitored anesthesia care and in combination with other diagnostic procedures to condense and expedite the staging process. METHODS: Patients with gastric or pancreatic cancer scheduled for laparoscopy with peritoneal lavage were prospectively enrolled to undergo intraoperative percutaneous peritoneal lavage prior to laparoscopic peritoneal lavage...
January 5, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28045723/rate-dependent-left-bundle-branch-block-in-an-ambulatory-surgery-patient-a-case-report
#3
Ashraf Farag, Justin Tsai, Sam Deeb, Deidre Putman-Garcia, John D Wasnick, Lydia A Conlay
A 52-year-old woman, ASA II (American Society of Anesthesia classification II) scheduled for cholecystectomy in an ambulatory center, exhibited a wide-complex tachycardia with ectopy on the monitor after induction with propofol and succinylcholine. Blood pressure remained stable; amiodarone was administered for presumed ventricular tachycardia. A 12-lead electrocardiogram (ECG) showed a new left bundle branch block (LBBB) at 98 beats per minute (bpm), which resolved when the heart rate slowed. Surgery was postponed, and both the LBBB and ectopy recurred frequently during the next 24 hours in the intensive care unit, particularly at heart rates >90 bpm...
December 30, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/28024711/-progressive-hematoma-in-anterior-neck-after-endovascular-treatment-of-middle-cerebral-artery-aneurysm
#4
Aysun Ankay Yilbas, Cigdem Kanburoglu, Filiz Uzumcugil, Coskun Cifci, Ozge Ozen Saralp, Heves Karagoz, Seda Banu Akinci, Anil Arat
BACKGROUND: Cervical hematomas can lead to airway compromise, a life threatening condition, regardless of the cause. The following case is the first presentation of cervical hematoma as a complication of endovascular treatment of middle cerebral artery aneurysm. CASE REPORT: A 49 year-old woman was scheduled for stent placement under general anesthesia for middle cerebral artery aneurysm. Few days before intervention, acetyl salicylic acid and clopidogrel treatment was started...
December 23, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28017174/benefit-of-general-anesthesia-monitored-by-bispectral-index-compared-with-monitoring-guided-only-by-clinical-parameters-systematic-review-and-meta-analysis
#5
Carlos Rogério Degrandi Oliveira, Wanderley Marques Bernardo, Victor Moisés Nunes
BACKGROUND: The bispectral index parameter is used to guide the titration of general anesthesia; however, many studies have shown conflicting results regarding the benefits of bispectral index monitoring. The objective of this systematic review with meta-analysis is to evaluate the clinical impact of monitoring with the bispectral index parameter. METHODS: The search for evidence in scientific information sources was conducted during December 2013 to January 2015, the following primary databases: Medline/PubMed, LILACS, Cochrane, CINAHL, Ovid, SCOPUS and TESES...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28005739/minimally-invasive-strip-craniectomy-simplifies-anesthesia-practice-in-patients-with-isolated-sagittal-synostosis
#6
Daan P F van Nunen, Bart M Stubenitsky, Peter A Woerdeman, Kuo Sen Han, Corstiaan C Breugem, Aebele B Mink van der Molen, Jurgen C de Graaff
BACKGROUND: Traditional open corrective surgery for isolated sagittal synostosis entails significant blood loss, transfusion rates, morbidity, and a lengthy hospitalization. Minimally invasive strip craniectomy (MISC) was introduced to avoid the disadvantages of open techniques. OBJECTIVES: The aim of the study was, first, to compare the anesthesia practice in MISC and open extended strip craniectomy (OESC), and, second, to evaluate the incidence of perioperative complications in both surgical procedures...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28000305/parotidectomy-under-sedation-and-locoregional-anesthesia-with-monitoring-of-brain-activity
#7
Marco Antonio Scirea Tesseroli, Fabricio Battistela Zasso, Humberto Hepp, Antonio Vitor Martins Priante, André Luiz Loureiro de Mattos Filho, Alvaro Sanabria
BACKGROUND: Parotidectomy is usually performed while the patient is under general anesthesia, however, sedation with locoregional anesthesia could be an alternative. METHODS: Fifteen adult patients with parotid tumors of the superficial lobe were included in this study. Anesthetic procedure consisted of sedation associated with cervical plexus and auriculotemporal nerve block. Sedation was managed based on the bispectral index. RESULTS: Superficial parotidectomies were performed in 13 patients, and combined partial resections were performed in 2 patients...
December 21, 2016: Head & Neck
https://www.readbyqxmd.com/read/27990189/effects-of-modification-of-pain-protocol-on-incidence-of-post-operative-nausea-and-vomiting
#8
Ran Schwarzkopf, Nimrod Snir, Zachary T Sharfman, Joseph B Rinehart, Michael-David Calderon, Esther Bahn, Brian Harrington, Kyle Ahn
BACKGROUND: A Perioperative Surgical Home (PSH) care model applies a standardized multidisciplinary approach to patient care using evidence-based medicine to modify and improve protocols. Analysis of patient outcome measures, such as postoperative nausea and vomiting (PONV), allows for refinement of existing protocols to improve patient care. We aim to compare the incidence of PONV in patients who underwent primary total joint arthroplasty before and after modification of our PSH pain protocol...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27942786/-ventilator-associated-pneumonia-vap-a%C3%A2-risk-already-at-the-time-of-anesthetic-induction
#9
L Vetter, C Konrad, G Schüpfer, M Rossi
BACKGROUND: Ventilator-associated pneumonia (VAP) is one of the most common and preventable infections in mechanically ventilated patients. It is associated with a high mortality rate. To prevent VAP, various strategies address this issue using "VAP-bundles", which are implemented in many intensive care units. The risk of acquiring VAP starts with the induction of anesthesia, strictly speaking at the time of intubation. This article considers measures to prevent VAP during general anesthesia in adult patients (>18 years)...
December 9, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27924208/local-anesthesia-with-monitored-anesthesia-care-for-patients-undergoing-thyroidectomy-a-case-series
#10
Se Eun Kim, Eugene Kim
Because the current trend favors minimally invasive surgery for thyroid disease, increasing interest has developed for thyroidectomy under local anesthesia with monitored anesthesia care (MAC). Here, we retrospectively reviewed 18 cases of thyroidectomy performed under local anesthesia with MAC in a single center. All of the procedures were performed by a single surgeon, using local lidocaine infiltration around the incisional site and propofol plus remifentanil target-controlled infusion. Sore throat (4/18), hypocalcemia (1/18), and transient voice color change (1/18) were observed, but the patients recovered during the follow-up period...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27918334/challenges-of-anesthesia-in-low-and-middle-income-countries-a-cross-sectional-survey-of-access-to-safe-obstetric-anesthesia-in-east-africa
#11
Isabella Epiu, Jossy Verel Bahe Tindimwebwa, Cephas Mijumbi, Thomas M Chokwe, Edwin Lugazia, Francois Ndarugirire, Theogene Twagirumugabe, Gerald Dubowitz
BACKGROUND: The United Nations 2015 Millennium Development Goals targeted a 75% reduction in maternal mortality. However, in spite of this goal, the number of maternal deaths per 100,000 live births remains unacceptably high across Sub-Saharan Africa. Because many of these deaths could likely be averted with access to safe surgery, including cesarean delivery, we set out to assess the capacity to provide safe anesthetic care for mothers in the main referral hospitals in East Africa. METHODS: A cross-sectional survey was conducted at 5 main referral hospitals in East Africa: Uganda, Kenya, Tanzania, Rwanda, and Burundi...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27918326/anesthetic-considerations-for-patients-with-congenital-central-hypoventilation-syndrome-a-systematic-review-of-the-literature
#12
Saptashree M Basu, Frances F Chung, Shireen F AbdelHakim, Jean Wong
Congenital central hypoventilation syndrome (CCHS) is a form of sleep-disordered breathing characterized by a diminished drive to breathe during sleep, despite progressive hypercapnia and hypoxia. The condition results from mutations in the paired-like homeobox 2B (PHOX2B) gene. The aim of this review was to conduct a systematic search of the current data on CCHS as it relates to perioperative considerations and to discuss the classification, prevalence, pathophysiology, presentation, genetics, and management of the condition...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27898164/dexmedetomidine-reduces-catheter-related-bladder-discomfort-a-prospective-randomized-placebo-controlled-double-blind-study
#13
Yang Zhao Yun, Xu Jun Mei, Zhu Rong, Dai Ru Ping, Liu Lei
OBJECTIVE: To evaluate the efficacy of dexmedetomidine in preventing catheterrelated bladder discomfort (CRBD) in a postanesthesia care unit (PACU). METHODS: A total of 138 consecutive adult male patients, classified by the American Society of Anesthesiologists (ASA) as ASA class I and ASA class II, were scheduled for elective open upper-middle abdominal surgery. They were randomized into 2 groups, C and D, comprising 69 patients each. Group C was given a saline solution as placebo, and group D received dexmedetomidine...
December 2016: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/27896927/a-retrospective-review-of-anesthesia-and-perioperative-care-in-children-with-medium-chain-acyl-coa-dehydrogenase-deficiency
#14
Claire Allen, Russell Perkins, Bernd Schwahn
BACKGROUND: Medium-chain acyl-CoA dehydrogenase deficiency is the most common genetically determined disorder of mitochondrial fatty acid oxidation. Decompensation can result in hypoglycemia, seizures, coma, and death but may be prevented by ensuring glycogen stores do not become depleted. Perioperative care is of interest as surgery, fasting, and infection may all trigger decompensation and the safety of anesthetic agents has been questioned. Current guidelines from the British Inherited Metabolic Disease Group advise on administering fluid containing 10% glucose during the perioperative period...
January 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27884349/endotoxemia-accelerates-diaphragm-dysfunction-in-ventilated-rabbits
#15
Yi Yang, Tao Yu, Chun Pan, Federico Longhini, Ling Liu, Yingzi Huang, Fengmei Guo, Haibo Qiu
BACKGROUND: Ventilators may induce diaphragm dysfunction, and most of the septic population who are admitted to the intensive care unit require mechanical ventilation. However, there is no evidence that sepsis accelerates the onset of ventilator-induced diaphragm dysfunction or affects the microcirculation. Our study investigated whether lipopolysaccharide (LPS)-induced endotoxemia accelerated diaphragm dysfunction in ventilated rabbits by evaluating microcirculation, lipid accumulation, and diaphragm contractility...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27876719/-local-anesthesia-selection-algorithm-in-patients-with-concomitant-disease-part-2
#16
E N Anisimova, S T Sokhov, N Yu Letunova, I V Orekhova, M V Gromovik, E A Erilin, N A Ryazantsev
A group of authors presents the rationale for local anesthesia selection in patients with concomitant disease based on case history; interaction analysis of drugs with local anesthetic and sedation agents; estimation of patient functional status; patient anxiety correction; dental care with hemodynamics monitoring. It was found that adhering to this algorithm promotes the prevention of urgent conditions in outpatient settings.
2016: Stomatologii︠a︡
https://www.readbyqxmd.com/read/27876446/gastrostomy-tube-placement-is-safe-in-advanced-amyotrophic-lateral-sclerosis
#17
Manisha Kak, Naoum P Issa, Raymond P Roos, Bobbie Jean Sweitzer, Ori Gottlieb, Amy Guralnick, Steven R White, Carol E Semrad, Betty Soliven, Joumana Baroody, Kourosh Rezania
OBJECTIVES: To evaluate the safety and effect on survival of insertion of a gastrostomy tube (G-tube) in patients with amyotrophic lateral sclerosis (ALS) who have upright forced vital capacity (uFVC) ≤ 50% predicted. Current guidelines, which are based on higher rates of post-procedure complications in ALS patients with advanced respiratory dysfunction, have led to a recommendation to perform G-tube insertion before the FVC drops to <50% predicted, even when the patient has no significant dysphagia...
January 2017: Neurological Research
https://www.readbyqxmd.com/read/27871631/-benefit-of-general-anesthesia-monitored-by-bispectral-index-compared-with-monitoring-guided-only-by-clinical-parameters-systematic-review-and-meta-analysis
#18
Carlos Rogério Degrandi Oliveira, Wanderley Marques Bernardo, Victor Moisés Nunes
BACKGROUND: The bispectral index parameter is used to guide the titration of general anesthesia; however, many studies have shown conflicting results regarding the benefits of bispectral index monitoring. The objective of this systematic review with meta-analysis is to evaluate the clinical impact of monitoring with the bispectral index parameter. METHODS: The search for evidence in scientific information sources was conducted during December 2013 to January 2015, the following primary databases: Medline/PubMed, LILACS, Cochrane, CINAHL, Ovid, SCOPUS and TESES...
January 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27871520/cisatracurium-and-rocuronium-associated-residual-neuromuscular-dysfunction-under-intraoperative-neuromuscular-monitoring-and-postoperative-neostigmine-reversal-a-single-blind-randomized-trial
#19
Paolo Feltracco, Tommaso Tonetti, Stefania Barbieri, Anna Chiara Frigo, Carlo Ori
BACKGROUND: Postoperative residual neuromuscular blockade (RNMB) is a common complication in the postanesthesia care unit (PACU), but also one of the most controversial issues. Many studies and trials demonstrated that some methods and techniques can reduce the incidence and the extent of the phenomenon. STUDY OBJECTIVE: To determine the incidence of RNMB in the PACU at standardized times after extubation with the implementation of a protocol of careful neuromuscular blockade management...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27857689/the-safety-and-efficacy-of-dexmedetomidine-vs-sufentanil-in-monitored-anesthesia-care-during-burr-hole-surgery-for-chronic-subdural-hematoma-a-retrospective-clinical-trial
#20
Wenming Wang, Lei Feng, Fenfen Bai, Zongwang Zhang, Yong Zhao, Chunguang Ren
Background: Chronic subdural hematoma (CSDH) is a very common clinical emergency encountered in neurosurgery. While both general anesthesia (GA) and monitored anesthesia care (MAC) can be used during CSDH surgery, MAC is the preferred choice among surgeons. Further, while dexmedetomidine (DEX) is reportedly a safe and effective agent for many diagnostic and therapeutic procedures, there have been no trials to evaluate the safety and efficacy of DEX vs. sufentanil in CSDH surgery. Objective: To evaluate the safety and efficacy of DEX vs...
2016: Frontiers in Pharmacology
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