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Vascular anaesthesia

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https://www.readbyqxmd.com/read/29219924/combined-laparoscopic-and-perineal-approach-to-omental-interposition-repair-of-complex-rectovaginal-fistula
#1
Hester de Bruijn, Yasuko Maeda, Jamie Murphy, Janindra Warusavitarne, Carolynne J Vaizey
INTRODUCTION: Surgical repair of rectovaginal fistula remains a challenge. Complex and recurrent rectovaginal fistula repairs often fail because of scarring and devascularization of the surrounding tissue. Omental interposition may promote healing by introducing bulky vascularized tissue into the rectovaginal septum. TECHNIQUE: With the patient in the lithotomy position, the rectovaginal septum was dissected transperineally up to the fistula tract and the openings on both vaginal and rectal sides were closed using interrupted, absorbable sutures...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29181841/epidural-therapy-for-the-treatment-of-severe-pre-eclampsia-in-non-labouring-women
#2
REVIEW
Amita Ray, Sujoy Ray
BACKGROUND: Pre-eclampsia is a pregnancy-specific multi-organ disorder, which is characterised by hypertension and multisystem organ involvement and which has significant maternal and fetal morbidity and mortality. Failure of the placental vascular remodelling and reduced uteroplacental flow form the etiopathological basis of pre-eclampsia. There are several established therapies for pre-eclampsia including antihypertensives and anticonvulsants. Most of these therapies aim at controlling the blood pressure or preventing complications of elevated blood pressure, or both...
November 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29161465/neuromuscular-electrical-stimulation-for-the-prevention-of-venous-thromboembolism
#3
REVIEW
Shahab Hajibandeh, Shahin Hajibandeh, George A Antoniou, James Rh Scurr, Francesco Torella
BACKGROUND: Venous thromboembolism (VTE) is a serious but preventable cause of morbidity and mortality. Neuromuscular electrical stimulation systems (NMES) for the prevention of VTE may be beneficial for patients in whom pharmacological or standard mechanical prophylaxis methods are contraindicated or are regarded as unsafe or impractical. Although findings of experimental studies suggest that NMES reduce venous stasis, the clinical utility and effectiveness of NMES in VTE prevention remain controversial...
November 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29161397/abdominal-aortic-aneurysm-repair-in-the-united-kingdom-an-exemplar-for-the-role-of-anaesthetists-in-perioperative-medicine
#4
S J Howell
The past two decades have seen an increasing recognition that the delivery of safe surgery with low complication rates and good long-term outcomes is a team endeavour embracing the whole patient care pathway. The key role of the anaesthetist in managing the patient through the surgical process is widely understood and has driven the emergence of perioperative medicine. In parallel with these developments there has been a sea change in the organisation of the care of patients presenting for elective abdominal aortic aneurysm (AAA) repair...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29135692/ultrasound-with-neurostimulation-compared-with-ultrasound-guidance-alone-for-lumbar-plexus-block-a-randomised-single-blinded-equivalence-trial
#5
Vanlapa Arnuntasupakul, Theerawat Chalachewa, Prangmalee Leurcharusmee, Worakamol Tiyaprasertkul, Roderick J Finlayson, De Q Tran
BACKGROUND: Ultrasound-guided lumbar plexus blocks usually require confirmatory neurostimulation. A simpler alternative is to inject local anaesthetic inside the posteromedial quadrant of the psoas muscle under ultrasound guidance. OBJECTIVE: We hypothesised that both techniques would result in similar total anaesthesia time, defined as the sum of performance and onset time. DESIGN: A randomised, observer-blinded, equivalence trial (equivalence margin = 7...
November 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29125001/hypoxia-due-to-positive-pressure-ventilation-in-edwards-syndrome-a-case-report
#6
Sun Kyung Hoon, Seung-Woo Kang, Sang-Hyun Kwak, Joungmin Kim
Edwards' syndrome also known as trisomy 18 is a congenital disorder associated with cardiovascular issues including ventricular septal defect (VSD), atrial septal defect (ASD) and patent duct arteriosus (PDA). An emergency colostomy was performed on a neonate born with an imperforate anus. Pre-operative transthoracic echocardiography showed presence of VSD, a patent foramen ovale (PFO) or ASD. Even though the baby had a good general condition and optimal peripheral oxygen saturation (SpO2), during positive pressure ventilation, she suffered severe hypoxia (50% SpO2)...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29066647/buttock-wounds-beware-what-lies-beneath
#7
Stephanie Clark, Suzanne Westley, Alexander Coupland, Mohamad Hamady, Alun H Davies
A 25-year-old man presented to a major trauma centre with multiple stab wounds, most significantly to the right buttock. Triple-phase CT revealed no acute bleeding and his wounds were closed. In the month following injury, he re-presented seven times to the emergency department (ED) complaining of bleeding and wound breakdown. After his seventh ED attendance, he was examined under general anaesthesia. Intraoperatively, profuse arterial bleeding was encountered and the local major haemorrhage protocol was activated...
October 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29026686/pain-prediction-from-ecg-in-vascular-surgery
#8
Tricia Adjei, Wilhelm Von Rosenberg, Valentin Goverdovsky, Katarzyna Powezka, Usman Jaffer, Danilo P Mandic
Varicose vein surgeries are routine outpatient procedures, which are often performed under local anaesthesia. The use of local anaesthesia both minimises the risk to patients and is cost effective, however, a number of patients still experience pain during surgery. Surgical teams must therefore decide to administer either a general or local anaesthetic based on their subjective qualitative assessment of patient anxiety and sensitivity to pain, without any means to objectively validate their decision. To this end, we develop a 3-D polynomial surface fit, of physiological metrics and numerical pain ratings from patients, in order to model the link between the modulation of cardiovascular responses and pain in varicose vein surgeries...
2017: IEEE Journal of Translational Engineering in Health and Medicine
https://www.readbyqxmd.com/read/28983903/dynamic-ultrasound-guided-short-axis-needle-tip-navigation-technique-vs-landmark-technique-for-difficult-saphenous-vein-access-in-children-a-randomised-study
#9
S Hanada, M T Van Winkle, S Subramani, K Ueda
Dynamic ultrasound-guided short-axis needle tip navigation is a novel technique for vascular access. After venipuncture, the needle and catheter are further advanced within the vessel lumen under real-time ultrasound guidance with constant visualisation of the needle tip in the short-axis view. This can minimise the risk of transfixing the cannulated vessel. We compared two techniques for non-visible saphenous vein cannulation under general anaesthesia in children weighing ≥ 3 kg and less than four years of age: dynamic ultrasound-guided short-axis needle tip navigation technique (ultrasound group) vs...
October 6, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28919267/post-carotid-endarterectomy-hypertension-part-2-association-with-peri-operative-clinical-anaesthetic-and-transcranial-doppler-derived-parameters
#10
Jeremy E Newman, Mathew J Bown, Robert D Sayers, Jonathan P Thompson, Thompson G Robinson, Bryan Williams, Ronney Panerai, Peter Lacy, A Ross Naylor
OBJECTIVE/BACKGROUND: The first paper in this series observed that pre-operative baroreceptor dysfunction and poorly controlled hypertension were independently predictive for identifying patients who went on to require treatment for post-endarterectomy hypertension (PEH). The second paper examines the influence of intra-operative patient, transcranial Doppler (TCD) ultrasound, and anaesthetic variables on the incidence of PEH. METHODS: In total, 106 patients underwent carotid endarterectomy (CEA) under general anaesthesia...
November 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28889963/quantitative-analysis-of-retinal-perfusion-in-mice-using-optical-coherence-tomography-angiography
#11
Maged Alnawaiseh, Cristin Brand, Eike Bormann, Joachim Wistuba, Nicole Eter, Peter Heiduschka
PURPOSE: To evaluate repeatability of the quantitative analysis of vessel density in the retinas of healthy mice using optical coherence tomography angiography (OCT-A). METHODS: Seventeen eyes of seventeen healthy mice aged 10-15 weeks (young) and 75-95 weeks (old) were included in this study. OCT-A was performed using RTVue XR Avanti (Optovue Inc., Fremont, California, USA) under general anaesthesia. The retina was imaged twice using a 3 × 3 mm(2) scan. Retinal thickness and flow density data in the superficial and deep retinal OCT angiograms were extracted and analysed...
November 2017: Experimental Eye Research
https://www.readbyqxmd.com/read/28874243/central-regional-anaesthesia-in-patients-with-aortic-stenosis-a-systematic-review
#12
Sofia Johansson, Morten Nikolaj Lind
INTRODUCTION: Aortic stenosis is a valvular lesion that poses several haemodynamic challenges for the anaesthesiologist. The use of central regional anaesthesia is traditionally regarded as contraindicated in patients with severe aortic stenosis due to its sympatholytic effect, potentially causing loss of vascular tone and ultimately diminished cardiac output. The aim of this paper was to review current literature to find evidence for or against the use of neuroaxial blockade in patients with aortic stenosis...
September 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28834795/microvascular-reactivity-monitored-with-near-infrared-spectroscopy-is-impaired-after-induction-of-anaesthesia-in-cardiac-surgery-patients-an-observational-study
#13
Lien Vandenbulcke, Koen G Lapage, Katrien V Vanderstraeten, Filip M De Somer, Stefan G De Hert, Annelies T Moerman
BACKGROUND: Induction of anaesthesia causes significant macrohaemodynamic changes, but little is known about its effects on the microcirculation. However, alterations in microvascular perfusion are known to be associated with impaired tissue oxygenation and organ dysfunction. Microvascular reactivity can be assessed with vascular occlusion testing, which evaluates the response of tissue oxygen saturation to transient ischaemia and reperfusion. OBJECTIVE: The aim of the current study was to evaluate the effects of an opioid-based anaesthesia induction on microvascular reactivity...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28814306/blood-acid-base-status-in-impala-aepyceros-melampus-immobilised-and-maintained-under-total-intravenous-anaesthesia-using-two-different-drug-protocols
#14
Gareth E Zeiler, Leith C R Meyer
BACKGROUND: In mammals, homeostasis and survival are dependent on effective trans-membrane movement of ions and enzyme function, which are labile to extreme acid-base changes, but operate efficiently within a narrow regulated pH range. Research in patients demonstrating a pH shifts outside the narrow regulated range decreased the cardiac output and systemic vascular resistance and altered the oxygen binding to haemoglobin. These cardiopulmonary observations may be applicable to the risks associated with anaesthesia and performance of wildlife ungulates on game farms...
August 16, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28780003/outcomes-of-gartland-type%C3%A2-iii-supracondylar-fractures-treated-using-blount-s-method
#15
C Muccioli, S ElBatti, I Oborocianu, O Rosello, F Solla, E Chau, J-L Clement, V Rampal
BACKGROUND: Supracondylar fractures of the elbow with major displacement are usually treated by surgical pinning and less often non-operatively as described by Blount. The objective of this study was to assess the clinical and radiological outcomes of Gartland type III supracondylar fractures treated at least 3 years earlier using Blount's method. HYPOTHESIS: Blount's method produces good outcomes after more than 3 years when used to treat Gartland type III supracondylar fractures of the humerus...
August 3, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28751182/unilateral-blindness-after-orthognathic-surgery-hypotensive-anaesthesia-is-not-the-primary-cause
#16
Á Rodríguez-Navarro, F M Gonzalez-Valverde
Perioperative vision loss in non-ocular surgery represents a rare but devastating complication and multiple causes have been proposed. Any portion of the visual system may be involved and several authors have tried to relate that complication with deliberate hypotension anaesthetic technique, used to control intraoperative bleeding. We report a patient operated for orthognathism who suffered unilateral blindness. After review of similar cases, we can state that the transmission of forces generated during Le fort I osteotomy is related to the complication...
July 24, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28744857/the-effect-of-pre-operative-methylprednisolone-on-early-endothelial-damage-after-total-knee-arthroplasty-a-randomised-double-blind-placebo-controlled-trial
#17
V Lindberg-Larsen, S R Ostrowski, M Lindberg-Larsen, M L Rovsing, P I Johansson, H Kehlet
We wished to evaluate whether inhibition of the systemic inflammatory response by a single pre-operative dose of methylprednisolone reduced markers of early endothelial damage after fast-track total knee arthroplasty. We randomly allocated 70 patients undergoing elective unilateral total knee arthroplasty (1:1) to receive either pre-operative intravenous methylprednisolone 125 mg (methylprednisolone group) or isotonic saline (control group). All procedures were performed under spinal anaesthesia without a tourniquet, using a standardised multimodal analgesic regime...
July 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28710899/effects-of-dobutamine-dopamine-phenylephrine-and-noradrenaline-on-systemic-haemodynamics-and-intestinal-perfusion-in-isoflurane-anaesthetised-horses
#18
C Dancker, K Hopster, K Rohn, S B Kästner
BACKGROUND: In the horse, effects of cardiovascular-active drugs on local perfusion of the gastrointestinal tract are poorly understood. OBJECTIVES: To determine the effect of drugs commonly used to support blood pressure, on local intestinal blood flow and tissue oxygenation under isoflurane anaesthesia. STUDY DESIGN: In vivo randomised crossover experiment. METHODS: Ten horses were anaesthetised with isoflurane. After 90 min of equilibration three doses (μg/kg bwt/min) of dobutamine (DOB 0...
July 15, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28495814/automated-control-of-mechanical-ventilation-during-general-anaesthesia-study-protocol-of-a-bicentric-observational-study-avas
#19
Dirk Schädler, Georg Miestinger, Tobias Becher, Inéz Frerichs, Norbert Weiler, Christoph Hörmann
INTRODUCTION: Automated control of mechanical ventilation during general anaesthesia is not common. A novel system for automated control of most of the ventilator settings was designed and is available on an anaesthesia machine. METHODS AND ANALYSIS: The 'Automated control of mechanical ventilation during general anesthesia study' (AVAS) is an international investigator-initiated bicentric observational study designed to examine safety and efficacy of the system during general anaesthesia...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28479769/analysis-of-outcome-of-end-to-end-and-end-to-side-internal-iliac-artery-anastomosis-in-renal-transplantation-our-initial-experience-with-a-case-series
#20
Dilip Kumar Pal, Prakash Kumar Sanki, Sayak Roy
INTRODUCTION: In renal transplantation, there is end-to-side anastomosis of renal artery to external iliac artery and end-to-end anastomosis of renal artery to internal iliac artery. The end-to-end internal iliac artery anastomosis can be associated with complications due to compromised distal vascular supply to limbs and penile erectile tissue. A method of end-to-side anastomosis can overcome them. Till date, there is no case series or trial that has studied the effect of end-to-side anastomosis...
April 2017: Urology Annals
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