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Cardiovascular anesthesia

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https://www.readbyqxmd.com/read/29034255/perioperative-management-of-elderly-patients-with-gastrointestinal-malignancies-the-contribution-of-anesthesia
#1
REVIEW
Rudolf Mörgeli, Kathrin Scholtz, Johannes Kurth, Sascha Treskatsch, Bruno Neuner, Susanne Koch, Lutz Kaufner, Claudia Spies
INTRODUCTION: Elderly patients suffering from gastrointestinal malignancies are particularly prone to perioperative complications. Elderly patients often present with reduced physiological reserves, and comorbidities can limit treatment options and promote complications. Surgeons and anesthesiologists must be aware of strategies required to deal with this vulnerable subgroup. METHODS: We provide a brief review of current and emerging perioperative strategies for the treatment of elderly patients with gastrointestinal malignancies and frequent comorbidities...
August 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29032753/halogenated-agents-and-cardiovascular-surgery-has-mortality-really-decreased
#2
Giovanni Landoni, Juan Carlos Lopez-Delgado, Chiara Sartini, Simona Tamà, Alberto Zangrillo
Halogenated anesthetic agents (desflurane, isoflurane and sevoflurane) may have cardioprotective properties at therapeutic doses against myocardial intraoperative ischemia-reperfusion injury. Cardioprotection mechanisms are related to mitochondrial and anti-apoptotic signaling pathways. Experimental and human studies have proven that their use may reduce morbidity and mortality in the setting of cardiac surgery, including a reduction in myocardial infarct size and mechanical ventilation needs. On the contrary, total intra-venous propofol based anesthesia may be detrimental...
October 10, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29017455/the-ec90-of-remifentanil-for-blunting-cardiovascular-responses-to-head-fixation-for-neurosurgery-under-total-intravenous-anesthesia-with-propofol-and-remifentanil-based-on-bispectral-index-monitoring-estimation-with-the-biased-coin-up-and-down-sequential-method
#3
Jung-Man Lee, Jae-Hyon Bahk, Young-Jin Lim, Jiwon Lee, Leerang Lim
BACKGROUND: Head fixation can induce hemodynamic instability. Remifentanil is commonly used with propofol for total intravenous anesthesia (TIVA) during neurosurgery. This study investigated the 90% effective concentration (EC90) of remifentanil for blunting of cardiovascular responses to head fixation during neurosurgery via bispectral index (BIS) monitoring. METHODS: Fifty patients undergoing neurosurgery requiring head fixation were enrolled. This study was performed using the biased coin up-and-down design sequential method (BCD)...
October 10, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28975032/propofol-2-6-diisopropylphenol-is-an-applicable-immersion-anesthetic-in-the-axolotl-with-potential-uses-in-hemodynamic-and-neurophysiological-experiments
#4
Mathias Møller Thygesen, Mikkel Mylius Rasmussen, Jesper Guldsmed Madsen, Michael Pedersen, Henrik Lauridsen
The Mexican axolotl (Ambystoma mexicanum) is an important model species in regenerative biology. Traditionally, axolotls are anesthetized using benzocaine or MS-222, both of which act to inhibit voltage gated sodium channels thereby preventing action potential propagation. In some neurophysiological experiments this is not desirable; therefore we tested propofol as an alternative anesthetic in the axolotl. We evaluated benzocaine, MS-222, and propofol's cardiovascular effects, effects on action potential propagation in the spinal cord, and gross limb regenerative effects...
June 2017: Regeneration
https://www.readbyqxmd.com/read/28973220/effect-of-individualized-vs-standard-blood-pressure-management-strategies-on-postoperative-organ-dysfunction-among-high-risk-patients-undergoing-major-surgery-a-randomized-clinical-trial
#5
RANDOMIZED CONTROLLED TRIAL
Emmanuel Futier, Jean-Yves Lefrant, Pierre-Gregoire Guinot, Thomas Godet, Emmanuel Lorne, Philippe Cuvillon, Sebastien Bertran, Marc Leone, Bruno Pastene, Vincent Piriou, Serge Molliex, Jacques Albanese, Jean-Michel Julia, Benoit Tavernier, Etienne Imhoff, Jean-Etienne Bazin, Jean-Michel Constantin, Bruno Pereira, Samir Jaber
Importance: Perioperative hypotension is associated with an increase in postoperative morbidity and mortality, but the appropriate management strategy remains uncertain. Objective: To evaluate whether an individualized blood pressure management strategy tailored to individual patient physiology could reduce postoperative organ dysfunction. Design, Setting, and Participants: The Intraoperative Norepinephrine to Control Arterial Pressure (INPRESS) study was a multicenter, randomized, parallel-group clinical trial conducted in 9 French university and nonuniversity hospitals...
October 10, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28967722/cardiovascular-risk-assessment-in-the-senior-population-undergoing-anesthesia-for-non-cardiac-surgery
#6
Concezione Tommasino
Older patients are underrepresented in major cardiovascular trials, and only relatively healthy elderly patients, with few comorbidities or functional impairments, have been enrolled. As a result, current guidelines are unable to provide evidence-based recommendations for anesthesia treatment of patients aged ≥75 years, undergoing non-cardiac surgical procedures. Effective strategies, aimed at reducing the risk of perioperative cardiac complications, should involve cardiac evaluation using mostly medical history...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28967579/distribution-of-fos-immunoreactive-cells-in-the-ventral-part-of-rat-medulla-following-voluntary-treadmill-exercise
#7
Nao Kumada, Satoshi Koba, Eri Hanai, Tatsuo Watanabe
The ventral part of the medulla, which contains important cardiovascular regions, is reportedly activated during exercise. Nevertheless, it was uncertain which region(s) in the ventral medulla are specifically activated by exercise. The present study aimed to demonstrate a general pattern of exercise-specific distribution of excited neuronal cells in the rat ventral medulla. Via immunohistochemical experiments, we mapped tyrosine hydroxylase- and Fos-immunoreactive cells (TH-IR and Fos-IR cells, respectively) on rat medullary coronal sections following a bout of voluntary treadmill exercise, a comparative control period, or after pharmacologically induced-hypotension under anesthesia...
September 22, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28956075/-polytrauma-following-a-truck-accident-how-to-save-lives-by-guideline-oriented-emergency-care
#8
M Kippnich, Y Jelting, C Markus, M Kredel, T Wurmb, P Kranke
BACKGROUND: Identification and immediate treatment of life-threatening conditions is fundamental in patients with multiple trauma. In this context, the S3 guidelines on polytrauma and the S1 guidelines on emergency anesthesia provide the scientific background on how to handle these situations. CASE STUDY: This case report deals with a seriously injured driver involved in a truck accident. The inaccessible patient showed a scalping injury of the facial skeleton with massive bleeding and partially blocked airway but with spontaneous breathing as well as centralized cardiovascular circulation conditions and an initial Glasgow coma scale (GCS) of 8...
September 27, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28937421/methylene-blue-to-treat-refractory-latex-induced-anaphylactic-shock-a-case-report
#9
Paulo Sergio Da Silva, Paula Furtado
Anaphylaxis occurs in 1/5000-1/20,000 of anesthesia cases and may evolve with shock and cardiovascular collapse in up to 54% of cases. Mortality varies from 3% to 10%. Latex is the second leading cause of anaphylaxis during the perioperative period. We report a case of latex-induced anaphylactic shock refractory to the usual catecholamine treatment that was reversed with the aid of methylene blue. Exaggerated activation of the nitric oxide-cyclic guanosine monophosphate pathway is observed in refractory shock...
September 20, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28932733/pectoral-nerve-block-pecs-block-with-sedation-for-breast-conserving-surgery-without-general-anesthesia
#10
Eun-Jin Moon, Seung-Beom Kim, Jun-Young Chung, Jeong-Yoon Song, Jae-Woo Yi
Most regional anesthesia in breast surgeries is performed as postoperative pain management under general anesthesia, and not as the primary anesthesia. Regional anesthesia has very few cardiovascular or pulmonary side-effects, as compared with general anesthesia. Pectoral nerve block is a relatively new technique, with fewer complications than other regional anesthesia. We performed Pecs I and Pec II block simultaneously as primary anesthesia under moderate sedation with dexmedetomidine for breast conserving surgery in a 49-year-old female patient with invasive ductal carcinoma...
September 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28928588/patient-with-persistent-low-oxygen-saturation-for-emergency-cesarean-section
#11
Shivali Panwar, Kirti Nath Saxena, Prachi Gaba
A 24-year-old woman with previous undiagnosed congenital methemoglobinemia presented for the emergency cesarean section in view of fetal distress. The patient had a persistent low oxygen saturation on pulse oximetry with normal heart rate and blood pressure. Arterial blood gas values were normal. The patient was asymptomatic and respiratory and cardiovascular system examination was normal. The patient underwent cesarean section under general anesthesia and was shifted to the Intensive Care Unit postoperatively...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928558/oral-clonidine-premedication-attenuates-hemodynamic-responses-of-ketamine-during-total-intravenous-anesthesia
#12
Pulak Tosh, Sunil Rajan, Nitu Puthenveettil, Lakshmi Kumar
BACKGROUND: The most commonly used drug for total intravenous anesthesia (TIVA) is ketamine which results in cardiovascular stimulation. AIMS: The primary aim of this study was to assess the effect of oral clonidine premedication on attenuating the hemodynamic responses following ketamine administration. SETTINGS AND DESIGNS: This was a prospective, observational, comparative study conducted in a tertiary care institution. SUBJECTS AND METHODS: A total of 40 female patients aged 18-55 years who were posted for elective short gynecological procedures under TIVA were recruited for this study...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28905718/physiologic-behavioral-and-histologic-responses-to-various-euthanasia-methods-in-c57bl-6ntac-male-mice
#13
Gregory P Boivin, Michael A Bottomley, Patricia A Schiml, Lori Goss, Nadja Grobe
Rodent euthanasia using exposure to increasing concentrations of CO2 has come under scrutiny due to concerns of potential pain during the euthanasia process. Alternatives to CO2, such as isoflurane and barbiturates, have been proposed as more humane methods of euthanasia. In this study, we examined 3 commonly used euthanasia methods in mice: intraperitoneal injection of pentobarbital-phenytoin solution, CO2 inhalation, and isoflurane anesthesia followed by CO2 inhalation. We hypothesized that pentobarbital-phenytoin euthanasia would cause fewer alterations in cardiovascular response, result in less behavioral evidence of pain or stress, and produce lower elevations in ACTH than would the isoflurane and CO2 methods, which we hypothesized would not differ in regard to these parameters...
January 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28889004/quantitative-vascular-neuroimaging-of-the-rat-brain-using-superparamagnetic-nanoparticles-new-insights-on-vascular-organization-and-brain-function
#14
Codi A Gharagouzloo, Liam Timms, Ju Qiao, Zihang Fang, Joseph Nneji, Aniket Pandya, Praveen Kulkarni, Anne L van de Ven, Craig Ferris, Srinivas Sridhar
A method called Quantitative Ultra-Short Time-to-Echo Contrast Enhanced (QUTE-CE) Magnetic Resonance Imaging (MRI) which utilizes superparamagnetic iron oxide nanoparticles (SPIONs) as a contrast agent to yield positive contrast angiograms with high clarity and definition is applied to the whole live rat brain. QUTE-CE MRI intensity data are particularly well suited for measuring quantitative cerebral blood volume (qCBV). A global map of qCBV in the awake resting-state with unprecedented detail was created via application of a 3D MRI rat brain atlas with 173 segmented and annotated brain areas...
September 6, 2017: NeuroImage
https://www.readbyqxmd.com/read/28879316/survey-of-the-sevoflurane-sedation-status-in-one-provincial-dental-clinic-center-for-the-disabled
#15
Chang-Hyun Park, Seungoh Kim
BACKGROUND: Sevoflurane sedation in pediatric and disabled patients has the advantage of faster induction and recovery compared to general anesthesia, as well as minimum influence on the respiratory and cardiovascular functions, and airway protective reflexes. This study aimed to evaluate the clinical efficacy of sevoflurane sedation used in dental treatment at one provincial dental clinic center for the disabled. METHODS: We investigated patients' gender, age, reasons for undergoing sedation, medication history prior to treatment, duration of anesthesia, treatment length, type of treatment, and yearly patterns, for 387 cases of dental treatment performed using sevoflurane sedation from January 2013 to October 2016...
December 2016: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28874164/radiation-free-cmr-diagnostic-heart-catheterization-in-children
#16
Kanishka Ratnayaka, Joshua P Kanter, Anthony Z Faranesh, Elena K Grant, Laura J Olivieri, Russell R Cross, Ileen F Cronin, Karin S Hamann, Adrienne E Campbell-Washburn, Kendall J O'Brien, Toby Rogers, Michael S Hansen, Robert J Lederman
BACKGROUND: Children with heart disease may require repeated X-Ray cardiac catheterization procedures, are more radiosensitive, and more likely to survive to experience oncologic risks of medical radiation. Cardiovascular magnetic resonance (CMR) is radiation-free and offers information about structure, function, and perfusion but not hemodynamics. We intend to perform complete radiation-free diagnostic right heart catheterization entirely using CMR fluoroscopy guidance in an unselected cohort of pediatric patients; we report the feasibility and safety...
September 6, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28858554/office-based-anesthesia-safety-and-outcomes-in-pediatric-dental-patients
#17
Allison L Spera, Mark A Saxen, Juan F Yepes, James E Jones, Brian J Sanders
The number of children with caries requiring general anesthesia to achieve comprehensive dental care and the demand for dentist anesthesiologists to provide ambulatory anesthesia for these patients is increasing. No current published studies examine the safety and outcomes of ambulatory anesthesia performed by dentist anesthesiologists for dental procedures in pediatric patients, and there is no national requirement for reporting outcomes of these procedures. In 2010, the Society for Ambulatory Anesthesia Clinical Outcomes Registry was developed...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28858551/the-anesthetic-management-for-a-patient-with-trisomy-13
#18
Masanori Tsukamoto, Takashi Hitosugi, Kanako Esaki, Takeshi Yokoyama
Trisomy 13 is a chromosomal disorder that occurs in complete or partial mosaic forms. It is characterized by central apnea, mental retardation, seizure and congenital heart disease. The survival of the patients with trisomy 13 is the majority dying before one month. Trisomy 13 is the worst life prognosis among all trisomy syndromes. It is reported the cause of death is central apnea. Special needs patients with mental retardation are recognized to have poorer oral health condition. Oral health related quality of life reflects daily activity and well-being...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28852442/cardiovascular-effects-of-nitrergic-system-of-the-pedunculopontine-tegmental-nucleus-in-anesthetized-rats
#19
Mohammad Naser Shafei, Tahereh Nikyar, Mahmoud Hosseini, Saeed Niazmand, Maryam Paseban
OBJECTIVES: Nitric oxide (NO) is an important neurotransmitter in central nervous system involved in central cardiovascular regulation. The presence of NO in the pedunculopontine tegmental (PPT) nucleus has been shown, but its cardiovascular effect has not been determined. In the present study, the cardiovascular effect of NO in the PPT nucleus was evaluated. MATERIALS AND METHODS: After induction of anesthesia, a polyethylene catheter (PE-50) filled with heparinized saline inserted into the femoral artery, and the blood pressure (BP) and heart rate (HR) were continuously recorded...
July 2017: Iranian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28836342/single-trans-septal-access-technique-for-left-atrial-intracardiac-echocardiography-to-guide-left-atrial-appendage-closure
#20
Daniel Aguirre, Christian Pincetti, Luis Perez, Carlos Deck, Mario Alfaro, Maria Jesus Vergara, Gabriel Maluenda
OBJECTIVE: This registry aimed to describe the safety and feasibility of a single trans-septal (TS) access technique for left intracardiac echocardiography (ICE) guidance of left-atrial appendage (LAA) closure procedure. BACKGROUND: LAA closure is currently accepted as an alternative to oral anticoagulation (OAC) in patients with non-valvular atrial fibrillation (NVAF) who are at high-risk for bleeding. Currently, LAA closure procedure is typically performed under trans-esophageal echocardiogram (TEE) guidance...
August 24, 2017: Catheterization and Cardiovascular Interventions
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