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Cardiovascular anesthesia

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https://www.readbyqxmd.com/read/27916737/suprascapular-block-associated-with-interscalene-block-an-alternative-to-isolated-interscalene-block-for-analgesia-in-shoulder-instability-surgery
#1
Walid Trabelsi, Abdelkader Ben Gabsia, Anis Lebbi, Walid Sammoud, Iheb Labbène, Mustapha Ferjani
BACKGROUND: Interscalene brachial plexus block (ISB) is the gold standard for postoperative pain management in shoulder surgery. However, this technique has side effects and potentially serious complications. The aim of this study was to compare the combinations of ultrasound-guided suprascapular (SSB) associated with supraclavicular nerve block (SCB) and ultrasound-guided ISB for postoperative analgesia after shoulder instability surgery. METHODS: Sixty ASA physical status I-II patients scheduled to undergo shoulder instability surgery were included...
December 1, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27909989/orexin-and-central-modulation-of-cardiovascular-and-respiratory-function
#2
Pascal Carrive, Tomoyuki Kuwaki
Orexin makes an important contribution to the regulation of cardiorespiratory function. When injected centrally under anesthesia, orexin increases blood pressure, heart rate, sympathetic nerve activity, and the amplitude and frequency of respiration. This is consistent with the location of orexin neurons in the hypothalamus and the distribution of orexin terminals at all levels of the central autonomic and respiratory network. These cardiorespiratory responses are components of arousal and are necessary to allow the expression of motivated behaviors...
December 2, 2016: Current Topics in Behavioral Neurosciences
https://www.readbyqxmd.com/read/27908788/time-to-wake-up-studying-neurovascular-coupling-and-brain-wide-circuit-function-in-the-un-anesthetized-animal
#3
REVIEW
Yu-Rong Gao, Yuncong Ma, Qingguang Zhang, Aaron T Winder, Zhifeng Liang, Lilith Antinori, Patrick J Drew, Nanyin Zhang
Functional magnetic resonance imaging (fMRI) has allowed the noninvasive study of task-based and resting-state brain dynamics in humans by inferring neural activity from blood-oxygenation-level dependent (BOLD) signal changes. An accurate interpretation of the hemodynamic changes that underlie fMRI signals depends on the understanding of the quantitative relationship between changes in neural activity and changes in cerebral blood flow, oxygenation and volume. While there has been extensive study of neurovascular coupling in anesthetized animal models, anesthesia causes large disruptions of brain metabolism, neural responsiveness and cardiovascular function...
November 28, 2016: NeuroImage
https://www.readbyqxmd.com/read/27901396/effects-of-dobutamine-hydrochloride-on-cardiovascular-function-in-horses-anesthetized-with-isoflurane-with-or-without-acepromazine-maleate-premedication
#4
Mara F Schier, Anthea L Raisis, Cristy J Secombe, Giselle Hosgood, Gabrielle C Musk, Guy D Lester
OBJECTIVE To determine the effects of acepromazine maleate premedication on cardiovascular function before and after infusion of dobutamine hydrochloride for 30 minutes in isoflurane-anesthetized horses. ANIMALS 6 healthy adult horses. PROCEDURES Each horse was anesthetized once following premedication with acepromazine (0.02 mg/kg, IV) administered 30 minutes prior to anesthetic induction (ACP+ treatment) and once without premedication (ACP- treatment). Anesthesia was induced with IV administration of xylazine hydrochloride (0...
December 2016: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/27900415/-management-of-anesthesia-in-endovascular-interventions
#5
T Rössel, R Paul, T Richter, S Ludwig, T Hofmockel, A R Heller, T Koch
Cardiovascular diseases are one of the leading causes of morbidity and mortality in Germany. In these patients, the high-risk profile necessitates an interdisciplinary and multimodal approach to treatment. Endovascular interventions and vascular surgery have become established as an important element of this strategy in the past; however, the different anatomical localizations of pathological vascular alterations make it necessary to use a wide spectrum of procedural options and methods; therefore, the requirements for management of anesthesia are variable and necessitate a differentiated approach...
November 29, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27886904/mastocytosis-and-anaphylaxis
#6
REVIEW
Anna Schuch, Knut Brockow
This article updates current knowledge on epidemiology, risk factors, triggers, and management of anaphylaxis in patients with mastocytosis. Hyperactive mast cells and higher number of effector mast cells are speculated to facilitate anaphylaxis in this condition. In children, increased risk is limited to those with extensive skin involvement and high tryptase. In adults, manifestations of anaphylaxis are severe with high frequency of cardiovascular symptoms. Hymenoptera stings are the most common triggers for these reactions; however, idiopathic anaphylaxis and reactions to food or drugs occur...
February 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27871536/novel-methods-of-local-anesthetic-delivery-in-the-perioperative-and-postoperative-setting-potential-for-fibrin-hydrogel-delivery
#7
REVIEW
Laura Kearney, Derek Whelan, Brian D O'Donnell, Anthony J P Clover
The benefits of high-quality postoperative analgesia are well documented and include earlier mobilization, fewer respiratory and cardiovascular complications, and shorter hospital stay. Local anesthesia-based acute pain regimens are at worst equal to and at best superior to opiate-based regimens from the perspective of analgesia. A multimodal approach limiting opioids by combining with local anesthetics has additional beneficial effect on outcomes such as nausea and vomiting, pruritus, gastrointestinal function, respiratory complications, and neutrophil function...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871512/case-report-management-of-differential-diagnosis-and-treatment-of-severe-anaphylaxis-in-the-setting-of-spinal-anesthesia
#8
Brian M Osman, Joni M Maga, Sebastian M Baquero
The purpose of this case report is to educate fellow anesthesiologists of a complicated differential diagnosis for sudden cardiovascular collapse after spinal anesthesia. We report a case where anaphylaxis occurred while under spinal anesthesia and resulted in difficult resuscitation. A 58-year-old woman undergoing bilateral knee replacements under spinal anesthesia experienced sudden seizure and cardiovascular collapse from acute anaphylactic shock while administering a cephalosporin. Local anesthetic toxicity, high spinal, and anaphylaxis were considered due to overlapping of symptoms...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871236/the-timing-of-administration-of-intravenous-dexmedetomidine-during-lower-limb-surgery-a-randomized-controlled-trial
#9
Eunsu Kang, Ki Hwa Lee, Sang Yoon Jeon, Kyu Won Lee, Myoung Jin Ko, Hyojoong Kim, Yong Han Kim, Jae-Wook Jung
BACKGROUND: Dexmedetomidine, a selective alpha-2 agonist, has sedative, analgesic, and anxiolytic effects without respiratory depression. Dexmedetomidine can cause a biphasic cardiovascular response, and induce transient hypertension. Hypotension is a common complication of spinal anesthesia. Decreasing anxiety of patients before procedure is important for high quality of procedure. This study aimed to compare the incidence of hypotension and patients' anxiety and comfort levels when dexmedetomidine was intravenously administered before and after spinal anesthesia...
November 21, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27861433/understanding-phenotypes-of-obstructive-sleep-apnea-applications-in-anesthesia-surgery-and-perioperative-medicine
#10
Yamini Subramani, Mandeep Singh, Jean Wong, Clete A Kushida, Atul Malhotra, Frances Chung
Obstructive sleep apnea (OSA) is a prevalent sleep-disordered breathing with potential long-term major neurocognitive and cardiovascular sequelae. The pathophysiology of OSA varies between individuals and is composed of different underlying mechanisms. Several components including the upper airway anatomy, effectiveness of the upper airway dilator muscles such as the genioglossus, arousal threshold of the individual, and inherent stability of the respiratory control system determine the pathogenesis of OSA...
November 17, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27854111/the-risk-of-hypotension-and-seizures-in-patients-receiving-prophylactic-anti-epileptic-drugs-for-supratentorial-craniotomy
#11
Julius Höhne, Karl M Schebesch, Christian Ott, Alexander Brawanski, Max Lange
BACKGROUND: Perioperative seizure prophylaxis with antiepileptic drugs (AED) has been advocated in patients undergoing supratentorial craniotomy. The practice remains controversial. The reasoning presupposes that the possibility of an adverse drug reaction from the AED is lower than the probability of harm from a seizure. Even short periods of hypotension during the operation can lead to acute kidney and myocardial injury. We retrospectively evaluated cardiovascular effects and tolerability of Levetiracetam (LEV) alone, LEV and Lacosamid (LCM) as compared to Phenytoin (PHT)...
November 17, 2016: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27843042/low-risk-of-thromboembolic-events-after-routine-administration-of-tranexamic-acid-in-hip-and-knee-arthroplasty
#12
Rune V Madsen, Christian S Nielsen, Thomas Kallemose, Henrik Husted, Anders Troelsen
BACKGROUND: The blood-conserving effect of intravenous (IV) tranexamic acid (TXA) is well-documented for total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, the risk of thromboembolic (TE) events after routine use of TXA is unclear and the safety profile is debated. This retrospective study investigates patient characteristics, occurrences, and predictors of TE events after routine administration of IV TXA in THA and TKA. METHODS: Three thousand one hundred fifty-nine THA or TKA procedures performed from 2007-2013 at our institution were included...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27816133/anesthesia-for-patients-with-concomitant-sepsis-and-cardiac-dysfunction
#13
REVIEW
Abed Abubaih, Charles Weissman
Anesthesiologists faced with a patient with sepsis and concurrent cardiac dysfunction must be cognizant of the patient's cardiac status and cause of the cardiac problem to appropriately adapt physiologic and metabolic monitoring and anesthetic management. Anesthesia in such patients is challenging because the interaction of sepsis and cardiac dysfunction greatly complicates management. Intraoperative anesthesia management requires careful induction and maintenance of anesthesia; optimizing intravascular volume status; avoiding lung injury during mechanical ventilation; and close monitoring of arterial blood gases, serum lactate concentrations, and hematology renal and electrolyte parameters...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27816131/anesthesia-patients-with-concomitant-cardiac-and-hepatic-dysfunction
#14
REVIEW
Julianne Ahdout, Michael Nurok
Anesthesia and surgery in patients with hepatic and cardiac dysfunction poses a challenge for anesthesiologists. It is imperative to optimize these patients perioperatively. Cirrhosis is associated with a wide range of cardiovascular abnormalities. Cirrhotic cardiomyopathy is characterized by blunted contractile responsiveness or systolic incompetence, and/or diastolic dysfunction. In liver disease, anesthetic drug distribution, metabolism, and elimination may be altered. Among patients with liver disease, propofol is a reasonable anesthetic choice and cisatracurium is the preferred neuromuscular blocker...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27816129/anesthesia-for-patients-with-concomitant-cardiac-and-renal-dysfunction
#15
REVIEW
Radwan Safa, Nicholas Sadovnikoff
Renal disease and cardiovascular disease are commonly encountered in the same patient. The dynamic interactions between renal disease and cardiovascular disease have an impact on perioperative management. Renal failure is an independent risk factor for cardiovascular disease and the link between the two disease states remains to be fully elucidated.
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27801973/scai-ccas-spa-expert-consensus-statement-for-anesthesia-and-sedation-practice-recommendations-for-patients-undergoing-diagnostic-and-therapeutic-procedures-in-the-pediatric-and-congenital-cardiac-catheterization-laboratory
#16
Kirsten C Odegard, Robert Vincent, Rahul Baijal, SuAnne Daves, Robert Gray, Alex Javois, Barry Love, Phil Moore, David Nykanen, Lori Riegger, Scott G Walker, Elizabeth C Wilson
Current practice of sedation and anesthesia for patients undergoing pediatric 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 (SCAI), the Society for Pediatric Anesthesia (SPA) and the Congenital Cardiac Anesthesia Society (CCAS) was convened to evaluate the types of sedation and personnel necessary for procedures performed in the PCCCL...
November 1, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27795775/-prioperative-adverse-events-critical-reading-of-the-data-registry-used-in-the-surgery-department-of-military-hospital-moulay-ismail-meknes
#17
Hicham Kechna, Omar Ouzzad, Khalid Chkoura, Jaouad Loutid, Moulay Ahmed Hachimi, Sidi Mohamed Hanafi
INTRODUCTION: Despite significant progress made in the field of safety in anesthesia, morbidity (serious or not, completely or partially related to anesthesia) remains common and no health practitioner is immune from accidents. In the current context where priority is given to training programmes, to quality and safety improvement in health care, the occurrence of an anesthesia-related accident in the surgery department is an extremely traumatic event. The fear of prosecution, the emotional context make it difficult to manage...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27793852/acute-exposure-to-progesterone-attenuates-cardiac-contraction-by-modifying-myofilament-calcium-sensitivity-in-the-female-mouse-heart
#18
Hirad A Feridooni, Jennifer K MacDonald, Anjali Ghimire, W Glen Pyle, Susan E Howlett
Acute application of progesterone attenuates cardiac contraction, although the underlying mechanisms are unclear. We investigated whether progesterone modified contraction in isolated ventricular myocytes and identified the Ca(2+) handling mechanisms involved in female C57BL/6 mice (6-9 mos; sodium pentobarbital anesthesia). Cells were field-stimulated (4 Hz; 37°C) and exposed to progesterone (0.001-10.0 μM) or vehicle (35 mins). Ca(2+) transients (fura-2) and cell shortening were recorded simultaneously...
October 28, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27790142/physical-properties-and-effect-in-a-battery-of-safety-pharmacology-models-for-three-structurally-distinct-enteric-polymers-employed-as-spray-dried-dispersion-carriers
#19
Ryan M Fryer, Mita Patel, Xiaomei Zhang, Katja S Baum-Kroker, Akalushi Muthukumarana, Brian Linehan, Yin-Chao Tseng
Establishing a wide therapeutic index (TI) for pre-clinical safety is important during lead optimization (LO) in research, prior to clinical development, although is often limited by a molecules physiochemical characteristics. Recent advances in the application of the innovative vibrating mesh spray-drying technology to prepare amorphous solid dispersions may offer an opportunity to achieve high plasma concentrations of poorly soluble NCEs to enable testing and establishment of a wide TI in safety pharmacology studies...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27787391/cardiac-arrest-in-a-patient-with-anterior-fascicular-block-after-administration-of-dexmedetomidine-with-spinal-anesthesia-a-case-report
#20
Baek Jin Kim, Bong Il Kim, Sung Hye Byun, Eugene Kim, Shin Yeung Sung, Jin Yong Jung
BACKGROUND: Dexmedetomidine is a sedative and analgesic agent that is administered intravenously as an adjunct to spinal anesthesia. It does not suppress the respiratory system significantly, but has adverse effects on the cardiovascular system, for example, bradycardia and hypotension. We here report a patient who underwent cardiac arrest during spinal anesthesia after intravenous infusion of dexmedetomidine. METHODS: A 57-year-old woman with no significant medical history underwent spinal anesthesia for arthroscopic meniscus resection after rupturing the right knee meniscus...
October 2016: Medicine (Baltimore)
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