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Pre anaesthetic assessment

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https://www.readbyqxmd.com/read/29121915/clinical-monitoring-of-cardiac-output-assessed-by-transoesophageal-echocardiography-in-anaesthetised-dogs-a-comparison-with-the-thermodilution-technique
#1
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
https://www.readbyqxmd.com/read/29118838/a-complex-obstetric-case
#2
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: J Intensive Care Soc
https://www.readbyqxmd.com/read/29110797/pre-anaesthetic-evaluation-of-the-patient-with-end-stage-lung-disease
#3
REVIEW
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
https://www.readbyqxmd.com/read/29075034/dental-treatment-under-general-anaesthetic-and-children-s-oral-health-related-quality-of-life
#4
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
https://www.readbyqxmd.com/read/29071124/management-of-anticoagulation-in-hip-fractures-a-pragmatic-approach
#5
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
https://www.readbyqxmd.com/read/29061193/subtotal-parathyroidectomy-and-relocation-of-the-parathyroid-remnant-for-renal-hyperparathyroidism-modification-of-a-traditional-operation
#6
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
https://www.readbyqxmd.com/read/29017289/comparative-evaluation-of-the-efficacy-of-lignocaine-containing-topical-anesthetic-agents-during-extraction-of-deciduous-anterior-teeth
#7
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
https://www.readbyqxmd.com/read/28992285/remote-ischaemic-preconditioning-for-renal-and-cardiac-protection-in-adult-patients-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#8
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
https://www.readbyqxmd.com/read/28970631/cardiomyopathies-and-anaesthesia
#9
REVIEW
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
https://www.readbyqxmd.com/read/28969247/amelioration-of-pain-on-injection-of-propofol-a-comparison-of-pretreatment-with-granisetron-vs-lignocaine
#10
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
https://www.readbyqxmd.com/read/28969245/effect-of-different-dosages-of-intravenous-midazolam-premedication-on-patients-undergoing-head-and-neck-surgeries-a-double-blinded-randomized-controlled-study
#11
Roshni Gupta, Neeta Santha, Madhusudan Upadya, Jesni Joseph Manissery
INTRODUCTION: Benzodiazepines primarily acts on the central nervous system. Most patients are extremely anxious in the pre-operative period. Excessive anxiety adversely influences anaesthetic induction and often leads to functional impairment and poor recovery after surgery. AIM: To determine whether amnesia, anxiety, sedation and cardio respiratory symptoms are affected while administering two different doses of intravenous midazolam (0.02 mg/kg & 0.06 mg/kg). MATERIALS AND METHODS: Two forty patients posted for head and neck surgeries were involved in this double blinded prospective randomised controlled trial...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28890557/are-cardiac-surgical-patients-at-increased-risk-of-difficult-intubation
#12
Deepak Prakash Borde, Savani Sameer Futane, Vijay Daunde, Sujata Zine, Nayana Joshi, Sumit Jaiswal, Sadhana Chinchole, Prasannakumar Kulkarni, Amit Hiwarkar, Priti Bhagyawant, Dilip Deshmukh, Manisha Takalkar
BACKGROUND AND AIMS: Safe airway management is the cornerstone of contemporary anaesthesia practice, and difficult intubation (DI) remains a major cause of anaesthetic morbidity and mortality. The surgical category, particularly cardiac surgery as a risk factor for DI has not been studied extensively. The aim of this study was to test the hypothesis whether cardiac surgical patients are at increased risk of DI. METHODS: During the study, 627 patients (329 cardiac and 298 non-cardiac surgical) were enrolled...
August 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28869718/prevalence-and-causes-of-preoperative-anaemia-in-elective-major-surgery-patients
#13
Frank S Hong, Nicole Sieradzki, Claire Pollock, Faye Nasra, Allison Mo, Abbey Willcox, Leonid Churilov, Wai Khoon Ho, Carole Smith
BACKGROUND: Preoperative anaemia is associated with increased morbidity and mortality in surgical patients. Recent national patient blood management guideline recommended screening surgical patients for anaemia and in particular iron deficiency anaemia, without reference to the prevalence of anaemia or iron deficiency anaemia in this patient population. AIMS: To establish the prevalence and cause of preoperative anaemia in elective major surgery patients. METHODS: Patients attending the anaesthetic pre-admission clinics from 1 July 2013 to 30 June 2014 prior to their major elective surgery in our institution were screened for anaemia and iron deficiency by measuring full blood count, iron studies and C-reactive protein...
September 4, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28794872/thd-and-mucopexy-efficacy-and-controversy
#14
Haytham Abudeeb, Ajogwu Ugwu, Jamshid Darabnia, Ahmed Hammad, Khurram Khan, Min Maung, Elizabeth McNulty, Abdul Latif Khan, Arijit Mukherjee
AIMS: Transanal haemorrhoidal dearterialisation and mucopexy has evolved in recent years as a popular minimally invasive non-excisional surgery for symptomatic prolapsing haemorrhoids. The long-term outcome of this procedure however, remains to be established. We aim to analyse the long-term outcome of THD-mucopexy in the management of prolapsing haemorrhoids based on the evidence of a prospective data from a single institution. METHODS: A prospective data was collected on 100 consecutive cases of grade 3 and 4 symptomatic haemorrhoids between the period 03/2010 and 06/2015 who underwent the procedure as a day case under general anaesthetic...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28751375/automated-full-range-pressure-volume-curves-in-mice-and-rats
#15
Annette Robichaud, Liah Fereydoonzad, Nathachit Limjunyawong, Richard Rabold, Benoit Allard, Andrea Benedetti, James G Martin, Wayne Mitzner
Pressure-volume (PV) curves constructed over the entire lung volume range can reliably detect functional changes in mouse models of lung diseases. In the present study, we constructed full-range PV curves in healthy and elastase-treated mice using either a classic manually operated technique or an automated approach using a computer-controlled piston ventilator [flexiVent FX; Scientific Respiratory Equipment (SCIREQ), Montreal, Quebec, Canada]. On the day of the experiment, subjects were anesthetized, tracheotomized, and mechanically ventilated...
October 1, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28741649/the-effect-of-metrics-based-feedback-on-acquisition-of-sonographic-skills-relevant-to-performance-of-ultrasound-guided-axillary-brachial-plexus-block
#16
O M A Ahmed, T Niessen, B D O'Donnell, A G Gallagher, D S Breslin, A DunnGalvin, G D Shorten
The objective of this study was to examine the effect of metrics-based vs. non-metrics-based feedback on novices learning predefined competencies for acquisition and interpretation of sonographic images relevant to performance of ultrasound-guided axillary brachial plexus block. Twelve anaesthetic trainees were randomly assigned to either metrics-based-feedback or non-metrics-based feedback groups. After a common learning phase, all participants attempted to perform a predefined task that involved scanning the left axilla of a single volunteer...
September 2017: Anaesthesia
https://www.readbyqxmd.com/read/28719515/anaesthetic-management-of-patients-with-myopathies
#17
Mark Schieren, Jerome Defosse, Andreas Böhmer, Frank Wappler, Mark U Gerbershagen
: The anaesthetic management of patients with myopathies is challenging. Considering the low incidence and heterogeneity of these disorders, most anaesthetists are unfamiliar with key symptoms, associated co-morbidities and implications for anaesthesia. The pre-anaesthetic assessment aims at the detection of potentially undiagnosed myopathic patients and, in case of known or suspected muscular disease, on the quantification of disease progression. Ancillary testing (e.g. echocardiography, ECG, lung function testing etc...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28702828/evaluating-the-perioperative-safety-of-laparoscopic-radical-nephrectomy-for-large-non-metastatic-renal-tumours-a-comparative-analysis-of-t1-t2-with-t3a-tumours
#18
E M Bolton, D Hennessy, P E Lonergan, F T Darcy, R P Manecksha, T H Lynch
OBJECTIVE: With increasing surgeon experience, the use of laparoscopic radical nephrectomy (LRN) in large and locally advanced renal tumours (T3a) is gaining favour in urological practice. There are limited studies reporting surgical outcomes in such groups. The aim of this study was to review our experience with LRN in these patients. METHODS: Data was retrospectively collected on 201 consecutive patients who underwent LRN for renal cancer by a single surgeon. Perioperative parameters assessed were age, gender, American Society of Anaesthesiologists score (ASA), waist circumference, tumour size, specimen size, histological subtypes, anaesthetic duration, operative approach and technique, surgery duration, blood loss, pre and postoperative renal function, complication rate and duration of hospital stay...
July 13, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28691744/dentists-attitudes-towards-acute-pharmacological-pain-management-in-children-and-adolescents
#19
Henrik Berlin, Thomas List, Karin Ridell, Gunilla Klingberg
AIM: This study aimed to investigate Swedish dentists' attitudes regarding pain management strategies for treating children and adolescents. It assessed recommendations for pre- and postoperative analgesics, and use of local anaesthesia, and whether application of these strategies differs between general dental practitioners (GDPs) and specialists in paediatric dentistry (SPDs). DESIGN: We invited all GDPs (n = 807) in southern Sweden (Region Skåne), and all registered SPDs (n = 122) working in Sweden (929 actively practising dentists under age 65 years) to participate in a postal survey on pain management in paediatric dental care...
July 10, 2017: International Journal of Paediatric Dentistry
https://www.readbyqxmd.com/read/28677829/intravenous-lignocaine-in-colorectal-surgery-a-systematic-review
#20
REVIEW
Wiremu S MacFater, Jamie-Lee Rahiri, Melanie Lauti, Bruce Su'a, Andrew G Hill
BACKGROUND: Colorectal surgery leads to morbidity during recovery including pain and fatigue. Intravenous (IV) lignocaine (IVL) has both analgesic and anti-inflammatory effects that may improve post-operative pain and recovery. The aim of this review is to compare the effectiveness of IVL to other perioperative analgesia regimens for reducing pain and opioid consumption following colorectal surgery. METHODS: Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, a literature search was conducted to identify randomized clinical trials that compared IVL with IV placebo or epidural anaesthesia in open or laparoscopic colorectal surgery...
July 5, 2017: ANZ Journal of Surgery
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