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Monitored anesthesia care

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https://www.readbyqxmd.com/read/28644939/an-economic-analysis-of-mac-versus-walant-a-trigger-finger-release-surgery-case-study
#1
Jason L Codding, Suneel B Bhat, Asif M Ilyas
BACKGROUND: There has been recent interest in wide awake hand surgery, also referred to as "wide awake local anesthesia with no tourniquet" (WALANT) surgery. Using a model of single trigger finger release (TFR) surgery, a hypothesis was made that WALANT would result in decreased hospital time and cost than patients receiving sedation with monitored anesthetic care (MAC). METHODS: Consecutive cases of single TFR surgery with MAC were compared with WALANT. All surgeries were performed in the same manner, at the same facility, and by the same surgeon...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28621297/endoscopic-ultrasound-with-or-without-fine-needle-aspiration-has-a-meaningful-impact-on-clinical-care-in-the-pediatric-population
#2
Amit Raina, Maire A Conrad, Benjamin Sahn, Alireza Sedarat, Gregory G Ginsberg, Nuzhat A Ahmad, Vinay Chandrasekhara, Petar Mamula, Michael L Kochman
BACKGROUND AND OBJECTIVES: The safety and utility of endoscopic ultrasound (EUS) for the evaluation and management of gastrointestinal (GI) tract disorders among adults has been established. The literature on safety and efficacy in a pediatric referral population (under 21 years of age) is limited. We hypothesized that EUS is safe and useful in the pediatric population. We reviewed the pediatric EUS experience at a single tertiary-care system. We describe the indications, findings, safety, technical success rate, and impact on clinical outcomes...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28617160/rising-need-for-health-education-among-renal-transplant-patients-and-caregiving-competence-in-care-providers
#3
Jianfei Xie, Yingzi Ming, Siqing Ding, Xiaoxia Wu, Jia Liu, Lifang Liu, Jianda Zhou
BACKGROUND: Health education positively affects the efficacy of self-management and should be carried out according to the status of patients' needs, knowledge, and the competence of the primary caregivers. OBJECTIVES: This study was to investigate the needs of health education knowledge in transplant patients and the competence of the primary caregivers. METHODS: This is a cross-sectional study using a convenient sampling approach. Self-report questionnaires were applied to 351 renal transplantation patients and their primary caregivers...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28598918/falls-from-the-o-r-or-procedure-table
#4
Richard C Prielipp, Julia L Weinkauf, Thomas M Esser, Brian J Thomas, Mark A Warner
Patient safety secured by constant vigilance remains a primary responsibility of every anesthesia professional. Although significant attention has been focused on patient falls occurring before and after surgery, a potentially catastrophic complication is when patients fall off an operating room or procedure table during anesthesia care. Because such events are (fortunately) uncommon, and because very little information is published in our literature, we queried 2 independent closed claims databases (the American Society of Anesthesiologists Closed Claims Project and the secure records of a private, anesthesia specialty-specific liability insurer) for information...
June 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28598914/perioperative-temperature-measurement-considerations-relevant-to-reporting-requirements-for-national-quality-programs-using-data-from-anesthesia-information-management-systems
#5
Richard H Epstein, Franklin Dexter, Ira S Hofer, Luis I Rodriguez, Eric S Schwenk, Joni M Maga, Bradley J Hindman
BACKGROUND: Perioperative hypothermia may increase the incidences of wound infection, blood loss, transfusion, and cardiac morbidity. U.S. national quality programs for perioperative normothermia specify the presence of at least 1 "body temperature" ≥35.5°C during the interval from 30 minutes before to 15 minutes after the anesthesia end time. Using data from 4 academic hospitals, we evaluated timing and measurement considerations relevant to the current requirements to guide hospitals wishing to report perioperative temperature measures using electronic data sources...
June 8, 2017: Anesthesia and Analgesia
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
#6
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/28592064/-clinical-analysis-on-monitoring-and-comprehensive-treatment-after-carotid-endarterectomy
#7
X Y Wang, Z H Sun, L Liu, C Wu, Z Ji
Objective: To discuss the therapeutic effect of management of carotid endarterectomy in care unit. Methods: A total of 315 patients with carotid atherosclerotic stenosis were enrolled. All of the patients were taken into care unit under tracheal intubation anesthesia after carotid endarterectomy. Then the patients were managed with a breathing machine, continuous sedation, strict monitoring of hemodynamics and pupil change, strict control of heart rate and blood pressure, atomization inhalation therapy, treatment of anticoagulation and antiplatelet therapy and classification management of airway...
May 30, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28551058/-anesthesia-recovery-comparison-between-remifentanil-propofol-and-remifentanil-desflurane-guided-by-bispectral-index-%C3%A2-monitoring
#8
Raphael Grossi Rocha, Eduardo Giarola Almeida, Lara Moreira Mendes Carneiro, Natália Farias de Almeida, Walkíria Wingester Vilas Boas, Renato Santiago Gomez
BACKGROUND AND OBJECTIVES: There is a strong demand for fast and predictable anesthesia recovery with few side effects. Choice of the hypnotic agent could impact on that. This study investigated the differences between recoveries after remifentanil-propofol and remifentanil-desflurane anesthesias guided by bispectral index (BIS(®)). METHODS: Forty patients were randomly assigned into 2 groups according to the anesthesia technique applied: remifentanil-propofol (REM-PRO) and remifentanil-desflurane (REM-DES)...
May 25, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28537981/development-of-education-and-research-in-anesthesia-and-intensive-care-medicine-at-the-university-teaching-hospital-in-lusaka-zambia-a-descriptive-observational-study
#9
Anna Janowicz, Tuma Kasole, Emily Measures, Meg Langley, Fastone M Goma, Feruza Ismailova, John A Kinnear, M Dylan Bould
BACKGROUND: Data from 2006 show that the practice of anesthesia at the University Teaching Hospital in Lusaka, Zambia was underdeveloped by international standards. Not only was there inadequate provision of resources related to environment, equipment, and drugs, but also a severe shortage of staff, with no local capability to train future physician anesthetic providers. There was also no research base on which to develop the specialty. This study aimed to evaluate patient care, education and research to determine whether conditions had changed a decade later...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28535137/the-effect-of-heart-disease-on-anesthetic-complications-during-routine-dental-procedures-in-dogs
#10
Jennifer E Carter, Alison A Motsinger-Reif, William V Krug, Bruce W Keene
Dental procedures are a common reason for general anesthesia, and there is widespread concern among veterinarians that heart disease increases the occurrence of anesthetic complications. Anxiety about anesthetizing dogs with heart disease is a common cause of referral to specialty centers. To begin to address the potential effect of heart disease on anesthetic complications in dogs undergoing anesthesia for routine dental procedures, we compared anesthetic complications in 100 dogs with heart disease severe enough to trigger referral to a specialty center (cases) to those found in 100 dogs without cardiac disease (controls) that underwent similar procedures at the same teaching hospital...
May 23, 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28532922/awake-craniotomy-anesthesia-a-comparison-between-the-monitored-anesthesia-care-versus-the-asleep-awake-asleep-technique
#11
Chikezie I Eseonu, Karim ReFaey, Oscar Garcia, Amballur John, Alfredo Quinones-Hinojosa, Punita Tripathi
BACKGROUND: The commonly used sedation techniques for an awake craniotomy includes monitored anesthesia care(MAC), using an unprotected airway, or the asleep-awake-asleep(AAA) technique, using a partially or totally protected airway. We present a comparative analysis between the MAC and AAA technique evaluating anesthetic management, perioperative outcomes, and complications in a consecutive series of patients undergoing the removal of an eloquent brain lesion. METHODS: Eighty-one patients underwent an awake craniotomy for an intracranial lesion over a nine-year period by a single-surgeon and a team of anesthesiologists...
May 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28528356/operating-room-fires-in-periocular-surgery
#12
Michael A Connor, Anne M Menke, Ivan Vrcek, John W Shore
AIM: A survey of ophthalmic plastic and reconstructive surgeons as well as seven-year data regarding claims made to the Ophthalmic Mutual Insurance Company (OMIC) is used to discuss operating room fires in periocular surgery. METHODS: A retrospective review of all closed claim operating room fires submitted to OMIC was performed. A survey soliciting personal experiences with operating room fires was distributed to all American Society of Oculoplastic and Reconstructive Surgeons...
May 20, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28525513/an-observational-assessment-of-anesthesia-capacity-in-madagascar-as-a-prerequisite-to-the-development-of-a-national-surgical-plan
#13
Linden S Baxter, Vaonandianina A Ravelojaona, Hasiniaina N Rakotoarison, Alison Herbert, Emily Bruno, Kristin L Close, Vanessa Andean, Hery H Andriamanjato, Mark G Shrime, Michelle C White
BACKGROUND: The global lack of anesthesia capacity is well described, but country-specific data are needed to provide country-specific solutions. We aimed to assess anesthesia capacity in Madagascar as part of the development of a Ministry of Health national surgical plan. METHODS: As part of a nationwide surgical safety quality improvement project, we surveyed 19 of 22 regional hospitals, representing surgical facilities caring for 75% of the total population. The assessment was divided into 3 areas: anesthesia workforce density, infrastructure and equipment, and medications...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28525510/zika-virus-obstetric-and-pediatric-anesthesia-considerations
#14
Jacqueline L Tutiven, Benjamin T Pruden, James S Banks, Mario Stevenson, David J Birnbach
As of November 2016, the Florida Department of Health (FDH) and the Centers for Disease Control and Prevention have confirmed more than 4000 travel-related Zika virus (ZIKV) infections in the United States with >700 of those in Florida. There have been 139 cases of locally acquired infection, all occurring in Miami, Florida. Within the US territories (eg, Puerto Rico, US Virgin Islands), >30,000 cases of ZIKV infection have been reported. The projected number of individuals at risk for ZIKV infection in the Caribbean and Latin America approximates 5 million...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28520832/evaluation-of-monitored-anesthesia-care-in-sialendoscopy
#15
Oscar Trujillo, Madeleine A Drusin, Parwane P Pagano, Gulce Askin, Rahmatullah Rahmati
Importance: In the United States, sialendoscopy is most often performed under general anesthesia with endotracheal intubation (GETA); however, monitored anesthesia care (MAC) may be a viable alternative. Objective: To investigate patient characteristics and outcomes following sialendoscopy performed under MAC or GETA to assess the potential of MAC as an alternative anesthetic option. Design, Setting, and Participants: A retrospective review of medical records on patients who underwent sialendoscopy between October 1, 2011, and August 31, 2014, was performed...
May 18, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28520718/retrospective-observational-evaluation-of-postoperative-oxygen-saturation-levels-and-associated-postoperative-respiratory-complications-and-hospital-resource-utilization
#16
Satya Krishna Ramachandran, Aleda Thompson, Jaideep J Pandit, Scott Devine, Amy M Shanks
INTRODUCTION: The clinical importance of postoperative episodic hypoxemia is still unclear, and therefore largely under-studied. As a result, there is limited understanding of its relationship with early postoperative respiratory complications (PRC, defined as intubation within three days of surgery) and hospital resource utilization. MATERIALS AND METHODS: This single center study was performed using a retrospective observational design. We described population based definitions of desaturation from continuous SpO2 monitoring data captured in the post anesthesia care unit (PACU), namely median SpO2 in PACU, duration of desaturation below median, nadir desaturation, and length of oxygen therapy relative to PACU duration...
2017: PloS One
https://www.readbyqxmd.com/read/28510664/trends-in-use-of-sedation-for-low-risk-endoscopy-looking-beyond-monitored-anesthesia-care
#17
COMMENT
Felix W Leung
No abstract text is available yet for this article.
May 16, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28504992/trends-in-perioperative-practice-and-resource-utilization-in-patients-with-obstructive-sleep-apnea-undergoing-joint-arthroplasty
#18
Crispiana Cozowicz, Jashvant Poeran, Ashley Olson, Madhu Mazumdar, Eva E Mörwald, Stavros G Memtsoudis
BACKGROUND: Emerging evidence associating obstructive sleep apnea (OSA) with adverse perioperative outcomes has recently heightened the level of awareness among perioperative physicians. In particular, estimates projecting the high prevalence of this condition in the surgical population highlight the necessity of the development and adherence to "best clinical practices." In this context, a number of expert panels have generated recommendations in an effort to provide guidance for perioperative decision-making...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28501533/promising-modalities-to-identify-and-monitor-eosinophilic-esophagitis
#19
Girish Hiremath, Sandeep K Gupta
Eosinophilic esophagitis (EoE) is an allergen-mediated condition characterized by symptoms of esophageal dysfunction and histologic evidence of intense eosinophilic inflammation involving the esophagus in the absence of overlapping conditions such as gastroesophageal reflux disease. Since the initial description as a distinct entity approximately 2 decades ago, there has been a remarkable increase in the recognition of this clinicopathologic entity. The current approach to diagnose and monitor EoE requires repeated esophagogastroduodenoscopies, with associated sedation/anesthesia, to visualize mucosal abnormalities, and to obtain multiple biopsy specimens for histologic assessment and to evaluate treatment response...
May 10, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28489765/anesthetic-management-of-cesarean-delivery-in-parturients-with-ruptured-sinus-of-valsalva-aneurysm-care-compliant-2-case-reports-and-literature-review
#20
Gang Fang, Man Li, Jian Li, Li Lin, Wei Mei
RATIONALE: Ruptured sinus of Valsalva aneurysm is rare and dangerous in parturients. Few cases of ruptured SVA in pregnancy are reported, and the anesthetic management for cesarean delivery has scarcely been described. PATIENT CONCERNS: A parturient at 37-week gestation complained of a sore throat and cough that started 3 days before admission, followed 1 day later by fever, dizziness, breathlessness, and palpitation on exertion. Case two at 36-week gestation complained of a 1-day history of bloating in the lower abdomen...
May 2017: Medicine (Baltimore)
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