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Pre anaesthetic assessment

D Van der Saag, S Lomax, P A Windsor, C Taylor, P Thomson, E Hall, P J White
Although the pain caused by castration of calves is a significant animal welfare issue for the beef industry, analgesia is not always used for this procedure, largely because of practical limitations associated with injectable forms of pain relief. Novel analgesic formulations have now been developed for livestock to allow topical and buccal administration, offering practical options to improve cattle welfare if shown to be effective. To assess the effects of topical anaesthetic (TA) and buccal meloxicam (BM) on average daily gain (ADG), behaviour and inflammation following surgical castration of beef calves, a total of 50 unweaned bull calves were randomly allocated to: (1) sham castration (SHAM, n=10); (2) surgical castration (C, n=10); (3) surgical castration with pre-operative buccal meloxicam (CBM, n=10); (4) surgical castration with post-operative topical anaesthetic (CTA, n=10); and (5) surgical castration with pre-operative buccal meloxicam and post-operative topical anaesthetic (CBMTA, n=10)...
February 26, 2018: Animal: An International Journal of Animal Bioscience
T Reeves, S Bates, T Sharp, K Richardson, S Bali, J Plumb, H Anderson, J Prentis, M Swart, D Z H Levett
Background: Cardiopulmonary exercise testing (CPET) is an exercise stress test with concomitant expired gas analysis that provides an objective, non-invasive measure of functional capacity under stress. CPET-derived variables predict postoperative morbidity and mortality after major abdominal and thoracic surgery. Two previous surveys have reported increasing utilisation of CPET preoperatively in England. We aimed to evaluate current CPET practice in the UK, to identify who performs CPET, how it is performed, how the data generated are used and the funding models...
2018: Perioperative Medicine
Habib Md Reazaul Karim, Avinash Prakash, Sarasa Kumar Sahoo, Anilkumar Narayan, Vidya Vijayan
Background and Aims: One of the reasons for continued routine pre-operative testing practice is the identification of hidden problems which may affect perioperative management. This study was aimed to assess the prevalence of abnormal test results, their impact on perioperative management and cost-effectiveness for detecting such abnormalities. Methods: This observational study was conducted by screening the files of the patients attending pre-anaesthetic check-up during December 2016-January 2017...
January 2018: Indian Journal of Anaesthesia
Sarah Walton, Emily Schaeffer, Kishore Mulpuri, Peter Cundy, Nicole Williams
INTRODUCTION: Developmental dysplasia of the hip (DDH) affects 4-6 per 1000 live births in developed countries. Effective treatment to realign the hip is necessary to avoid long-term morbidities and maximise functional outcome. Treatment options depend on patient age but typically involve hip bracing and/or reduction under general anaesthetic. Some centres also employ prereduction hip traction. Historical papers suggest traction reduces risk of avascular necrosis (AVN) femoral head and reduces requirement for open reduction...
January 29, 2018: BMJ Open
Ronald H F Hunter, Fernando López-Gatius
Bearing in mind specific parallels between cow and human ovarian physiology, as noted in the manuscript, we have measured whether the temperature in a pre-ovulatory follicle is cooler than that in adjacent tissues. Using a novel approach not requiring anaesthetics or surgical procedures, we found that follicular fluid bathing cow oocytes shortly before ovulation is cooler than the neighbouring uterine surface and cooler than deep rectal temperature (the reference body temperature in cattle). By contrast, Graafian follicles of comparable size and ultrasonic image that do not subsequently ovulate do not have a reduced antral temperature...
January 29, 2018: Journal of Assisted Reproduction and Genetics
V D Ward
Parkinson's disease is prevalent worldwide but mainly affects the elderly and is rarely seen in women of child-bearing age. The clinical signs and symptoms, the physiological changes of pregnancy, and drug interactions, pose unique challenges for the anaesthetic management of patients with Parkinson's disease who present for delivery. A 36-year-old primigravid woman at 36 weeks' gestation, with Parkinson's disease, presented for pre-anaesthesia assessment prior to elective caesarean section. Her Parkinson's disease had been diagnosed four years previously and was treated with Sinemet (levodopa/carbidopa) and pramipexole...
November 21, 2017: International Journal of Obstetric Anesthesia
Destiny F Chau, Arundathi Reddy, Patrick Breheny, Anna Rebecca Young, Eric Ashford, Megan Song, Christina Zhang, Tammy Taylor, Abbas Younes, Turaj Vazifedan
Background and Aims: Post-operative vomiting (POV) in children remains a significant clinical problem. This prospective study aims to investigate the applicability of well-established adult early post-operative nausea and vomiting (PONV) risk factors on paediatric POV after adenotonsillectomies under regulated anaesthetic conditions. Methods: After Institutional Review Board approval, 213 children aged 3-10-year-old were enrolled. The participants had pre-operative questionnaires completed, followed protocolised anaesthetic plans and had saliva analysed for cotinine...
December 2017: Indian Journal of Anaesthesia
Maryann Street, Nicole M Phillips, Mohammadreza Mohebbi, Bridie Kent
OBJECTIVES: This study aimed to evaluate whether use of a discharge criteria tool for nursing assessment of patients in Post Anaesthesia Care Unit (PACU) would enhance nurses' recognition and response to patients at-risk of deterioration and improve patient outcomes. METHODS: A prospective non-randomised pre-post intervention study was conducted in three hospitals in Australia. Participants were adults undergoing elective surgery before (n=723) and after (n=694) implementation of the Post-Anaesthetic Care Tool (PACT)...
December 3, 2017: BMJ Open
Aoife B Monk, Jayne E Harrison, Helen V Worthington, Annabel Teague
BACKGROUND: Pain is a common side effect of orthodontic treatment. It increases in proportion to the amount of force applied to the teeth, and the type of orthodontic appliance used can affect the intensity of the pain. Pain during orthodontic treatment has been shown to be the most common reason for people wanting to discontinue treatment, and has been ranked as the worst aspect of treatment. Although pharmacological methods of pain relief have been investigated, there remains some uncertainty among orthodontists about which painkillers are most suitable and whether pre-emptive analgesia is beneficial...
November 28, 2017: Cochrane Database of Systematic Reviews
Raymond B King, Sarah Os Osman, Ciaran Fairmichael, Denise M Irvine, Ciara A Lyons, Ananth Ravi, Joe M O'Sullivan, Alan R Hounsell, Darren M Mitchell, Conor K McGarry, Suneil Jain
OBJECTIVE: This study assessed the use of implanted hydrogel rectal spacers for stereotactic ablative radiotherapy-volumetric modulated arc therapy (SABR-VMAT) patients, investigating practicality, dosimetric impact, normal tissue complication probability (NTCP) and early toxicity. METHODS: Data from the first 6 patients treated within a prostate SABR and rectal spacer trial were examined to determine spacer insertion tolerability, resultant changes in treatment planning and dosimetry and early toxicity effects...
February 2018: British Journal of Radiology
Matheus M Mantovani, Denise T Fantoni, André M Gimenes, Jacqueline R de Castro, Patrícia B Flor, Keila K Ida, Denise S Schwartz
BACKGROUND: Cardiac output (CO) is an important haemodynamic parameter to monitor in patients during surgery. However, the majority of the techniques for measuring CO have a limited application in veterinary practice due to their invasive approach and associated complexity and risks. Transoesophageal echocardiography (TEE) is a technique used to monitor cardiac function in human patients during surgical procedures and allows CO to be measured non-invasively. This prospective clinical study aimed to compare the transoesophageal echocardiography using a transgastric view of the left ventricular outflow tract (LVOT) and the thermodilution (TD) technique for the assessment of CO during mean arterial pressure of 65-80 mmHg (normotension) and <65 mmHg (hypotension) in dogs undergoing elective surgery...
November 9, 2017: BMC Veterinary Research
Michael Hoy, Kate Flavin, Venkat Prasad
A 33-year-old primigravida presented with severe sepsis, severe pre-eclampsia, peripartum cardiomyopathy and the haemolysis, elevated liver enzymes and low platelets syndrome manifesting over the course of 24 h causing a diagnostic conundrum and a difficult sequence of physiological problems to overcome. We describe a previously unreported sequence of events involving a pre-eclamptic, septic parturient to improve anaesthetic and intensive care physician awareness of confounding factors that complicate assessment and management of these patients...
August 2017: Journal of the Intensive Care Society
Mahesh Prabhu, Kamen Valchanov
Lung transplantation is a viable alternative for end-stage lung diseases, which offers good quality of life and survival outcomes for recipients. The aims of pre-assessment for potential lung transplant recipients are to assess fitness for surgery, optimise co-morbidities, commence interventions or investigations, weigh risk-benefit ratio, plan appropriate analgesia and obtain informed consent. The assessment information is gathered from the medical record, patient interview, physical examination and pre-operative tests...
June 2017: Best Practice & Research. Clinical Anaesthesiology
Paulo A Martins-Junior
Data sourcesMedline, Scopus and the Web of Science.Study selectionStudies conducted in children under 16 undergoing general anaesthesia having change in oral health-related quality of life were considered. Selection was undertaken by two reviewers independently.Data extraction and synthesisData abstraction was undertaken independently by three groups of two reviewers - discrepancies were resolved by discussion. Study quality was assessed using the Quality Assessment Tool for Studies of Diverse Design (QATSDD)...
October 27, 2017: Evidence-based Dentistry
Rafik Yassa, Mahdi Yacine Khalfaoui, Ihab Hujazi, Hannah Sevenoaks, Paul Dunkow
Hip fractures are common and increasing with an ageing population. In the United Kingdom, the national guidelines recommend operative intervention within 36 hours of diagnosis. However, long-term anticoagulant treatment is frequently encountered in these patients which can delay surgical intervention. Despite this, there are no set national standards for management of drug-induced coagulopathy pre-operatively in the context of hip fractures.The aim of this study was to evaluate the management protocols available in the current literature for the commonly encountered coagulopathy-inducing agents...
September 2017: EFORT Open Reviews
Tsu-Hui Hubert Low, John Yoo
BACKGROUND: We describe a modification of the conventional subtotal parathyroidectomy operation where the parathyroid gland(s) remnant is repositioned with intact vascular supply to a plane superficial to the infrahyoid strap muscles and immediately under the skin incision. This technique called Subtotal Parathyroidectomy and Remnant Relocation (SPARE) retains all the metabolic advantages of the conventional operation with the added advantage of easier identification of a recurrent hyperplastic remnant if re-exploration becomes necessary...
October 23, 2017: Journal of Otolaryngology—Head & Neck Surgery
Mythri Sarpangala, Ashwin Devasya, Ashford L George
To evaluate the efficacy of 2%, 4% Lignocaine, EMLA mixture and Precaine topical anaesthetic agents (with 1:1, 00,000 epinephrine) during the extraction of deciduous anterior tooth. Eighty patients with pre-shedding mobility of deciduous anterior tooth were divided randomly into four groups. Lignocaine, in amount of 2% and 4%, Precaine and EMLA topical anaesthetic agents were applied and the tooth was extracted. VAS has been used to assess the subjective pain while Wong-Baker faces scale and SEM pain scale have been used to record the objective pain to check the efficacy of these topical anaesthetic agents...
October 9, 2017: Minerva Stomatologica
Giacomo Deferrari, Alice Bonanni, Maurizio Bruschi, Cristiano Alicino, Alessio Signori
Background: The main aim of this systematic review was to assess whether remote ischaemic preconditioning (RIPC) protects kidneys and the heart in cardiac surgery with cardiopulmonary bypass (CPB) and to investigate a possible role of anaesthetic agents. Methods: Randomized clinical trials (RCTs) on the effects of RIPC through limb ischaemia in adult patients undergoing cardiac surgery with CPB were searched (1965-October 2016) in PubMed, Cochrane Library and article reference lists...
July 19, 2017: Nephrology, Dialysis, Transplantation
Rajiv Juneja, Prajeesh M Nambiar
Cardiomyopathy is considered as a heart muscle disease of multiple aetiologies, unlike other cardiac diseases related to a definitive pathophysiology. With more and more research and with the advent of genetic analysis pin pointing the disease causing mutations, causative factors have been defined and classifications and definitions have changed over time. Patients with these conditions present to anaesthesiologists in elective and emergency situations, placement of automated internal cardioverter defibrillator (AICD) devices or biventricular pacing but may also be diagnosed at anaesthetic pre-assessment...
September 2017: Indian Journal of Anaesthesia
Parvin Banu, Arunava Biswas, Syed Mohammed Naser, Sujata Ghosh, Kakoli Ghosh, Sangita Mandal
INTRODUCTION: Pain during propofol injection is a very commonly and frequently encountered event during induction of anaesthesia. A 5HT3 antagonists like granisetron are commonly used just prior to intravenous propofol as pre anaesthetic medication to prevent emesis in patients. AIM: Comparison of pre treatment with granisetron versus lignocaine with respect to amelioration of pain induced by injection of propofol, in patient admitted for elective surgery with general anaesthesia...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
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