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Cardiovascular anesthesia

Kathryn L Kreicher, Jeremy S Bordeaux
Importance: Cutaneous surgery is performed by otolaryngologists, plastic surgeons, oculoplastic surgeons, dermatologic surgeons, and some primary care physicians. Practice gaps exist among cutaneous surgeons, as do differences in how different physicians approach preoperative, intraoperative, and postoperative decision-making. Objective: To present the newest and best evidence to close common practice gaps in cutaneous surgery. Evidence Review: We performed a detailed search of peer-reviewed publications that were identified through a search of PubMed/MEDLINE (January 1, 2000, through June 30, 2016) using the literature search terms "cutaneous surgery," "Mohs micrographic surgery," "plastic surgery," in combination with "safety," "cost," "anesthesia," "anti-coagulation," "bleeding," "pain," "analgesia," "anxiety," or "infection," among others...
October 20, 2016: JAMA Facial Plastic Surgery
Nicolas Debry, Cédric Delhaye, Alexandre Azmoun, Ramzi Ramadan, Sahbi Fradi, Philippe Brenot, Arnaud Sudre, Mouhamed Djahoum Moussa, Didier Tchetche, Said Ghostine, Darren Mylotte, Thomas Modine
OBJECTIVES: The study sought to assess the safety and efficacy of a minimally invasive strategy (MIS) (local anesthesia and conscious sedation) compared to general anesthesia (GA) among the largest published cohort of patients undergoing transcarotid transcatheter aortic valve replacement (TAVR). BACKGROUND: Transcarotid TAVR has been shown to be feasible and safe. There is, however, no information pertaining to the mode anesthesia in these procedures. METHODS: Between 2009 and 2014, 174 patients underwent transcarotid TAVR at 2 French centers...
October 24, 2016: JACC. Cardiovascular Interventions
Flavia Petrini, Ida Di Giacinto, Rita Cataldo, Clelia Esposito, Vittorio Pavoni, Paolo Donato, Antonella Trolio, Guido Merli, Massimiliano Sorbello, Paolo Pelosi
Proper management of obese patients requires a team vision and appropriate behaviors by all health care providers in hospital. Specialist competencies are fundamental, as are specific clinical pathways and good clinical practices designed to deal with patients whose body mass index is ≥30 kg/m2. Standards of care for bariatric and non-bariatric surgery and for the critical care management of this population exist but are not well defined nor clearly followed in every hospital. Thus every anesthesiologist is likely to deal with this challenging population...
October 19, 2016: Minerva Anestesiologica
Manuel de la Matta
It is universally accepted that deep sedation involves more risks than light-to-moderate sedation. Deep sedation for endoscopic explorations is normally provided by anesthesiologists in Spain and in most countries of the European Unión. The present debate about deep sedation-anesthesia states goes beyond the topic of cardiovascular and respiratory adverse events, and targets the cognitive consequences and global increased mortality of uncontrolled sedation states, especially in specific fragile populations...
October 19, 2016: Revista Española de Enfermedades Digestivas
Kirsten C Odegard, Robert Vincent, Rahul G Baijal, Suanne M Daves, Robert G Gray, Alexander J Javois, Barry A Love, Philip Moore, David Nykanen, Lori Q Riegger, Scott G Walker, Elizabeth C Wilson
Current practice of sedation and anesthesia for patients undergoing pediatric and congenital cardiac catheterization laboratory (PCCCL) procedures is known to vary among institutions, a multi-society expert panel with representatives from the Congenital Heart Disease Council of the Society for Cardiovascular Angiography and Interventions, the Society for Pediatric Anesthesia and the Congenital Cardiac Anesthesia Society was convened to evaluate the types of sedation and personnel necessary for procedures performed in the PCCCL...
October 3, 2016: Anesthesia and Analgesia
H D Rashmi, H K Komala
BACKGROUND: The procedures in anesthesia such as laryngoscopy and endotracheal intubation are the most important skills to be mastered by an anesthesiologist. However, they produce marked cardiovascular responses such as hypertension and tachycardia. Various drugs have been used to suppress this response. One of those is a novel centrally acting α2 agonist - dexmedetomidine. It has numerous uses in anesthesia as it is having sedative, analgesic, hypnotic, and opioid sparing effects. It is also known to suppress the hemodynamic response to laryngoscopy and intubation...
September 2016: Anesthesia, Essays and Researches
Dong-Hyuk Jeong, Jeong-Jin Yang, Seong-Hoon Seok, Dong-Joo Song, Seong-Chan Yeon
The objective of this study was to determine the dose-dependent effects of isoflurane on various cardiovascular parameters and the stable range of isoflurane concentrations in Asiatic black bears (Ursus thibetanus). Seven Asiatic black bears were intramuscularly injected with medetomidine, zolazepam, and tiletamine (MZT) to induce anesthesia and anesthesia was maintained by administering isoflurane in 100% oxygen (4 l/min) without mechanical ventilation. Several cardiovascular parameters were measured at five end-tidal isoflurane concentrations (0...
September 30, 2016: Journal of Veterinary Medical Science
Andrew Kohut, Nishi Patel, Harpreet Singh
BACKGROUND: Non-invasive high-resolution echocardiography to evaluate cardiovascular function of small animals is increasingly being used due to availability of genetically engineered murine models. Even though guidelines and standard values for humans were revised by the American Society of Echocardiography, evaluations on murine models are not performed according to any standard protocols. These limitations are preventing translation of preclinical evaluations to clinical meaningful conclusions...
September 2016: Journal of Cardiovascular Ultrasound
Jarno Jokelainen, Marianne Udd, Leena Kylänpää, Harri Mustonen, Jorma Halttunen, Outi Lindström, Reino Pöyhiä
OBJECTIVE: Patient controlled sedation (PCS) has been shown to be a valid choice for sedation during endoscopic retrograde cholangiopancreatography (ERCP) in randomized studies. However, large scale studies are lacking. MATERIAL AND METHODS: A single center, prospective observational study to determine how sedation for ERCP is administered in clinical setting. All 956 patients undergoing 1196 ERCPs in the endoscopy unit of Helsinki University Central Hospital 2012-2013, methods of sedation and adverse events associated with different sedations were recorded...
October 5, 2016: Scandinavian Journal of Gastroenterology
Ahmed Kharabish, Naira Mkrtchyan, Christian Meierhofer, Stefan Martinoff, Peter Ewert, Heiko Stern, Sohrab Fratz
OBJECTIVES: Patients younger than 8 years are usually examined by cardiovascular magnetic resonance (CMR) under general anesthesia (GA) or sedation without intubation. Therefore, we sought to study the feasibility of CMR in patients aged 3 to 8years without GA or sedation. PATIENTS: Data sets of 71 consecutive patients aged 3 to 8years were studied retrospectively. DESIGN: The total cohort was divided into 2 groups: a no-GA or sedation without intubation group (no-GA or sedation) and a GA or sedation without intubation group (GA or sedation)...
November 2016: Journal of Clinical Anesthesia
Sergei B Yakushin, Giorgio P Martinelli, Theodore Raphan, Bernard Cohen
The vestibulo-sympathetic reflex (VSR) increases blood pressure (BP) upon arising to maintain blood flow to the brain. The optimal directions of VSR activation and whether there are changes in heart rate (HR) are still not clear. This was studied with manually-driven translations, which had pulses and oscillatory linear accelerations of 0.2-2.5 g along the naso-occipital, interaural, and dorso-ventral axes in Isoflurane-anesthetized male, Long-Evans rats. BP and HR were recorded with intra-aortic sensors and accelerationd with 3-D linear accelerometer...
September 28, 2016: Journal of Neurophysiology
Chantal A Boly, Etto C Eringa, R Arthur Bouwman, Rob F P van den Akker, Frances S de Man, Ingrid Schalij, Stephan A Loer, Christa Boer, Charissa E van den Brom
BACKGROUND: While most studies focus on cardiovascular morbidity following anesthesia and surgery in excessive obesity, it is unknown whether these intraoperative cardiovascular alterations also occur in milder forms of adiposity without type 2 diabetes and if insulin is a possible treatment to improve intraoperative myocardial performance. In this experimental study we investigated whether mild adiposity without metabolic alterations is already associated with cardiometabolic dysfunction during anesthesia, mechanical ventilation and surgery and whether these myocardial alterations can be neutralized by intraoperative insulin treatment...
2016: Cardiovascular Diabetology
Nilay Boztas, Sermin Oztekin, Sevda Ozkardes, Mert Akan, Sule Ozbilgin, Ayse Baytok
OBJECTIVE: We compared the effects of three different doses of remifentanil infusion, which were performed for the induction of anesthesia in elder patients, on cardiovascular response. RESEARCH DESIGN AND METHODS: The present study was designed as a randomized, prospective and double-blind study. A total of 90 ASA I-II patients over the age of 65 years were enrolled. The patients were randomly (by lot) assigned to receive one of the three doses of remifentanil infusion (0...
October 17, 2016: Current Medical Research and Opinion
Elliot V Hersh, Mana Saraghi, Paul A Moore
BACKGROUND: An intranasal formulation of 3% tetracaine and 0.05% oxymetazoline (Kovanaze) received FDA approval on 29 June 2016. This formulation appears to provide sufficient local anesthesia to perform routine dental restorative (filling) procedures in maxillary teeth from second premolar forward. OBJECTIVES: The aim of this paper is to provide an overview of the efficacy, pharmacokinetics and tolerability of 3% tetracaine plus 0.05% oxymetazoline when administered intranasally...
October 3, 2016: Current Medical Research and Opinion
Mark J McVey, Chris M Farlinger, Glen Van Arsdell, Derek Armstrong, Helen Holtby
No abstract text is available yet for this article.
July 11, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Mahtab Poorzamany Nejat Kermany, Mastaneh Dahi, Reyhaneh Yamini Sharif, Badiozaman Radpay
BACKGROUND: Dexmedetomidine is a potent and highly specific α2-adrenoreceptor agonist that induces sedative and analgesic effects over a short-term period. As a result of these benefits, dexmedetomidine may be a better alternative than other available drugs for keeping the patient's cognition state in an acceptable condition after outpatient ophthalmic surgeries. OBJECTIVES: This randomized study was conducted to compare the sedative effects of dexmedetomidine and remifentanil on the cognitive state of patients who have undergone cataract surgery...
June 2016: Anesthesiology and Pain Medicine
Jonatan Myrup Staalsø, Kim Zillo Rokamp, Niels D Olesen, Lars Lonn, Niels H Secher, Niels V Olsen, Teit Mantoni, Ulf Helgstrand, Henning B Nielsen
BACKGROUND: Gly16arg polymorphism of the adrenergic β2-receptor is associated with the elevated cardiac output (Q) in healthy gly16-homozygotic subjects. We questioned whether this polymorphism also affects Q and regional cerebral oxygen saturation (SCO2) during anesthesia in vascular surgical patients. METHODS: One hundred sixty-eight patients (age 71 ± 6 years) admitted for elective surgery were included. Cardiovascular variables were determined before and during anesthesia by intravascular pulse contour analysis (Nexfin) and SCO2 by cerebral oximetry (INVOS 5100C)...
September 13, 2016: Anesthesia and Analgesia
Tomasz Gaszynski
INTRODUCTION: We report on the anesthetic management using opioid-free method of a patient with Steinert syndrome (myotonic dystrophy, MD), autosomal dominant dystrophy which is characterized by consistent contracture of muscle following stimulation. A myotonic crisis can be induced by numerous factors including hypothermia, shivering, and mechanical or electrical stimulation. In patients with MD, hypersensitivity to anesthetic drugs, especially muscle relaxants and opioids, may complicate postoperative management...
September 2016: Medicine (Baltimore)
Agnieszka Noszczyk-Nowak, Urszula Pasławska, Jacek Gajek, Adrian Janiszewski, Robert Pasławski, Dorota Zyśko, Józef Nicpoń
BACKGROUND: Swine are recognized animal models of human cardiovascular diseases. However, little is known on the CHF-associated changes in the electrophysiological ventricular parameters of humans and animals. OBJECTIVES: The aim of this study was to analyze changes in the durations of ventricular effective refraction period (VERP), QT and QTc intervals of pigs with chronic tachycardia-induced tachycardiomyopathy (TIC). MATERIAL AND METHODS: The study was comprised of 28 adult pigs (8 females and 20 males) of the Polish Large White breed...
May 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
David Ae Imber, Massimiliano Pirrone, Changsheng Zhang, Daniel F Fisher, Robert M Kacmarek, Lorenzo Berra
With a rising incidence of obesity in the United States, anesthesiologists are faced with a larger volume of obese patients coming to the operating room as well as obese patients with ever-larger body mass indices (BMIs). While there are many cardiovascular and endocrine issues that clinicians must take into account when caring for the obese patient, one of the most prominent concerns of the anesthesiologist in the perioperative setting should be the status of the lung. Because the pathophysiology of reduced lung volumes in the obese patient differs from that of the ARDS patient, the best approach to keeping the obese patient's lung open and adequately ventilated during mechanical ventilation is unique...
September 13, 2016: Respiratory Care
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