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Vascular anaesthesia

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https://www.readbyqxmd.com/read/29026686/pain-prediction-from-ecg-in-vascular-surgery
#1
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
#2
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
#3
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...
September 14, 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
#4
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
#5
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
#6
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...
August 23, 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
#7
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-iii-supracondylar-fractures-treated-using-blount-s-method
#8
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 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28751182/unilateral-blindness-after-orthognathic-surgery-hypotensive-anaesthesia-is-not-the-primary-cause
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28431821/near-infrared-spectroscopy-as-a-predictor-for-shunt-requirement-during-carotid-endarterectomy
#14
M Jonsson, D Lindström, A Wanhainen, K Djavani Gidlund, P Gillgren
OBJECTIVE/BACKGROUND: Near infrared spectroscopy (NIRS) continuously monitors regional cerebral oxygenation (rSO2) in the frontal lobes. This method may be used in patients during carotid endarterectomy to indicate the need for shunting. The aim of the study was to evaluate the value of NIRS in determining the need for selective shunting during CEA. A secondary aim was to compare NIRS with stump pressure. METHODS: Between January 2013 and October 2016, 185 patients from two vascular units, undergoing CEA under local anaesthesia were prospectively included...
June 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28413903/digital-revascularization-and-replantation-using-the-wide-awake-hand-surgery-technique
#15
Jkf Wong, C H Lin, N J Chang, H C Chen, Y T Lin, C C Hsu
The use of local anaesthesia and adrenaline for hand surgery is gaining popularity; however, where vascularity is impaired, wide-awake surgery is considered a contraindication. We present our case series of five digital devascularizations and eight amputations that underwent surgery using the 'wide-awake' anaesthetic technique. A temporary digital tourniquet (< 20 min) was used in three cases to identify structures quickly. The anastomoses were performed under local anaesthesia without a tourniquet. All cases had successful re-establishment of blood flow with good perfusion to the digital tips; no cases were re-explored because of vascular crisis...
July 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28389252/the-impact-of-patient-demographics-anatomy-comorbidities-and-peri-operative-planning-on-the-primary-functional-maturation-of-autogenous-radiocephalic-arteriovenous-fistula
#16
A Kordzadeh, A Askari, M Hoff, V Smith, Y Panayiotopoulos
OBJECTIVES: The aim of this study was to evaluate the collective and/or independent impact of patient demographics, comorbidities, anatomical factors, and peri-operative parameters on the primary functional maturation of RCAVFs. This study also aimed to identify the range and best cut off value for each variable and evaluate the likelihood, significance and percentage of primary functional maturation of RCAVFs. METHODS: This was a prospective consecutive single centre cohort study over a 4 year period; it was conducted on patients with the intention-to-treat using a radiocephalic arteriovenous fistula (RCAVF) (Brescia-Cimino)...
May 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28295944/paracentral-acute-middle-maculopathy-as-a-finding-in-patients-with-severe-vision-loss-following-phacoemulsification-cataract-surgery
#17
Katarina Creese, Daini Ong, Sukhpal S Sandhu, David Ware, C Alex Harper, Salmaan H Al-Qureshi, Sanjeewa S Wickremasinghe
IMPORTANCE: Paracentral acute middle maculopathy (PAMM) diagnosed by spectral domain optical coherence tomography (SD-OCT) in patients with poor visual outcome post cataract surgery. BACKGROUND: Case series of severe vision loss due to PAMM after cataract surgery. DESIGN: Retrospective case series. PARTICIPANTS: Cases from five surgical centres in Victoria, Australia. METHODS: Retrospective analysis of cases with unexplained 'patch-off' vision loss post cataract surgery...
March 13, 2017: Clinical & Experimental Ophthalmology
https://www.readbyqxmd.com/read/28285956/regional-versus-local-anaesthesia-for-haemodialysis-arteriovenous-fistula-formation-a-systematic-review-and-meta-analysis
#18
REVIEW
R Cerneviciute, S M Sahebally, K Ahmed, M Murphy, W Mahmood, S R Walsh
BACKGROUND: Arteriovenous fistula (AVF) formation is the most common vascular access procedure for patients requiring haemodialysis. However, it is associated with high failure rates, influenced by vessel diameter and arterial inflow. Mode of anaesthesia may affect these factors, and subsequently AVF maturation rates. OBJECTIVE: To perform a systematic review and meta-analysis to assess the effect of anaesthesia type for autologous primary radiocephalic or brachiocephalic AVF creation on subsequent fistula failure rates...
May 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28268070/post-carotid-endarterectomy-hypertension-part-1-association-with-pre-operative-clinical-imaging-and-physiological-parameters
#19
J E Newman, M J Bown, R D Sayers, J P Thompson, T G Robinson, B Williams, R Panerai, P Lacy, A R Naylor
OBJECTIVE/BACKGROUND: Post-endarterectomy hypertension (PEH) is a well recognised, but poorly understood, phenomenon after carotid endarterectomy (CEA) that is associated with post-operative intracranial haemorrhage, hyperperfusion syndrome, and cardiac complications. The aim of the current study was to identify pre-operative clinical, imaging, and physiological parameters associated with PEH. METHODS: In total, 106 CEA patients undergoing CEA under general anaesthesia underwent pre-operative evaluation of 24 hour ambulatory arterial blood pressure (BP), baroreceptor sensitivity, cerebral autoregulation, and transcranial Doppler measurement of cerebral blood flow velocity (CBFv) and pulsatility index...
March 3, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28258686/ischaemic-preconditioning-for-the-reduction-of-renal-ischaemia-reperfusion-injury
#20
REVIEW
Theo P Menting, Kimberley E Wever, Denise Md Ozdemir-van Brunschot, Daan Ja Van der Vliet, Maroeska M Rovers, Michiel C Warle
BACKGROUND: Ischaemia reperfusion injury can lead to kidney dysfunction or failure. Ischaemic preconditioning is a short period of deprivation of blood supply to particular organs or tissue, followed by a period of reperfusion. It has the potential to protect kidneys from ischaemia reperfusion injury. OBJECTIVES: This review aimed to look at the benefits and harms of local and remote ischaemic preconditioning to reduce ischaemia and reperfusion injury among people with renal ischaemia reperfusion injury...
March 4, 2017: Cochrane Database of Systematic Reviews
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