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Pre anaesthetic assessment

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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
#1
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...
July 25, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28719515/anaesthetic-management-of-patients-with-myopathies
#2
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...
July 15, 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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28663635/an-audit-of-comparison-of-perioperative-outcomes-with-the-introduction-of-standardized-preoperative-evaluation-form-at-a-tertiary-care-hospital-in-rural-india
#6
Shraddha Vidyadhar Naik, Bilal Mohammad, Vitthal K Dhulkhed
INTRODUCTION: Preoperative evaluation of a patient is the fundamental component of anaesthetic practice. Inadequate documentation and record keeping on the preoperative evaluation form (PEF) can be a major obstacle to attaining good practice and improving patient outcomes following operative procedures. AIM: The aim of the study was to conduct an audit to assess the quality of the preoperative anaesthetic information gathered and to observe the quality profile after the introduction of a standardized pre-operative evaluation form...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28658880/ultrasonographic-estimation-of-endotracheal-tube-size-in-paediatric-patients-and-its-comparison-with-physical-indices-based-formulae-a-prospective-study
#7
Jagadish G Sutagatti, Ranjana Raja, Madhuri S Kurdi
INTRODUCTION: Choosing the correct Endotracheal Tube (ETT) size is important in paediatric anaesthesia. The subglottic diameter being the narrowest diameter of the paediatric upper airway plays an important role in appropriate ETT size selection. AIM: This study was planned to determine the accuracy of Ultrasonography (USG) to assess the appropriate ETT size and compare it with physical indices based formulae. The secondary outcome was to assess the number of times the tube was changed based on air leak test for USG estimated tube size...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28657160/ketamine-as-an-adjuvant-to-opioids-for-cancer-pain
#8
REVIEW
Rae F Bell, Christopher Eccleston, Eija A Kalso
BACKGROUND: This is an update of a review first published in 2003 and updated in 2012.Ketamine is a commonly used anaesthetic agent, and in subanaesthetic doses is also given as an adjuvant to opioids for the treatment of refractory cancer pain, when opioids alone or in combination with appropriate adjuvant analgesics prove to be ineffective. Ketamine is known to have psychomimetic (including hallucinogenic), urological, and hepatic adverse effects. OBJECTIVES: To determine the effectiveness and adverse effects of ketamine as an adjuvant to opioids for refractory cancer pain in adults...
June 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28639040/mobile-gastrointestinal-and-endoscopic-surgery-in-rural-ecuador-20%C3%A2-years-experience-of-cinterandes
#9
H T Shalabi, M D Price, S T Shalabi, E B Rodas, A L Vicuña, B Guzhñay, R R Price, E Rodas
INTRODUCTION: Five billion people worldwide do not have timely access to surgical care. Cinterandes is one of the only mobile surgical units in low- and middle-income countries. This paper examines the methodology that Cinterandes uses to deliver mobile surgery. METHODS: Founding and core staff were interviewed, four missions were participated in, and internal documents and records were analysed between 1 May and 1 July 2014. RESULTS: Cinterandes performed 7641 operations over the last 20 years (60% gastrointestinal/laparoscopic), travelling 300,000 km to remote areas of Ecuador...
June 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28623570/enhanced-recovery-protocols-in-total-joint-arthroplasty-a-review-of-the-literature-and-their-implementation
#10
REVIEW
A S Galbraith, E McGloughlin, J Cashman
BACKGROUND: During recent years, there has been an exponential demand for joint arthroplasty, which has coincided with the global economic recession. In response, the management of patients following arthroplasty is continuously evolving, with the average inpatient length of stay decreasing from weeks to days, and more recently, we have witnessed the development of "outpatient arthroplasty" as a novel concept which aims to address the high volume of patients. The reduction in length of stay has been made possible via implementation of "enhanced recovery programmes" encompassing each stage of the patient journey...
June 16, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28620694/results-of-day-case-ureterorenoscopy-dc-urs-for-stone-disease-prospective-outcomes-over-4-5%C3%A2-years
#11
Anngona Ghosh, Rachel Oliver, Carolyn Way, Lucy White, Bhaskar K Somani
PURPOSE: To investigate the prospective outcomes of day-case ureterorenoscopy (DC-URS) for stone disease. With the rising prevalence of stone disease in the face of finite resources, there is increasing pressure to undertake procedures as a day case avoiding in-patient stay. There are a limited number of studies reporting on the feasibility of ureteroscopy as a day-case procedure. This study aimed to investigate the prospective outcomes and predictors precluding to DC-URS for stone disease in patients treated in our university teaching hospital...
June 15, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28603610/does-additional-reconstruction-of-the-anterolateral-ligament-during-a-primary-anterior-cruciate-ligament-reconstruction-affect-tibial-rotational-laxity-a-case-series
#12
Rohi Shah, Runveer Singh, Clodagh Dugdale, Guido Geutjens
BACKGROUND: The current evidence suggests that rotational stability in not restored in patients with anterior cruciate ligament (ACL) ruptures, despite reconstructive surgery. The graded pivot-shift is a useful clinical test to delineate extent of ligamentous laxity within the knee. Given its lateralised position, we hypothesized that reconstruction of the anterolateral ligament (ALL) would provide restraint to excessive internal rotation, restoring rotational stability. METHODS: 10 patients with MRI confirmed diagnosis of an isolated ACL rupture were included...
July 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28498903/efficacy-and-safety-of-inhaled-anaesthetic-for-postoperative-sedation-during-mechanical-ventilation-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#13
J Spence, E Belley-Côté, H K Ma, S Donald, J Centofanti, S Hussain, S Gupta, P J Devereaux, R Whitlock
The aim was to evaluate the efficacy and safety of volatile anaesthetic for postoperative sedation in adult cardiac surgery patients through a systematic review and meta-analysis. We retrieved randomized controlled trials from MEDLINE, EMBASE, CENTRAL, Web of Science, clinical trials registries, conference proceedings, and reference lists of included articles. Independent reviewers extracted data, including patient characteristics, type of intraoperative anaesthesia, inhaled anaesthetic used, comparator sedation, and outcomes of interest, using pre-piloted forms...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28468607/does-local-infiltration-analgesia-reduce-peri-operative-inflammation-following-total-hip-arthroplasty-a-randomized-double-blind-study
#14
J Kuchálik, A Magnuson, E Tina, A Gupta
BACKGROUND: Postoperative inflammation following total hip arthroplasty (THA) can lead to delayed mobilization and return of hip function. Our primary aim was to assess whether local infiltration analgesia (LIA) during surgery can prevent postoperative inflammation. METHODS: This is a sub-analysis of data from a broader double-blind study where 56 patients received spinal anaesthesia for THA. Additionally, Group FNB (Femoral Nerve Block) received an ultrasound-guided femoral nerve block using 30 mL of ropivacaine 7...
May 3, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28442206/change-the-habit-to-change-the-practice-do-audits-really-ever-change-anything
#15
D Bodansky, Y Oskrochi, G Judah, M Lewis, B Fischer, B Narayan
INTRODUCTION: Methicillin resistant staphylococcus aureus (MRSA) eradication by nurses and pre-op induction antibiotics are mandated for emergency surgery, where true status is unknown. We assessed adherence to local MRSA guidelines for patients undergoing emergency hip fracture surgery and employed point of decision prompts to influence clinicians' behaviour. METHODS: We undertook a retrospective record review for all patients undergoing emergency hip fracture surgery at a UK major trauma centre over 3-months...
April 17, 2017: Injury
https://www.readbyqxmd.com/read/28390712/safe-intrathecal-fluorescein-use-for-identification-of-cerebrospinal-fluid-leaks-case-report-and-perioperative-algorithm-description
#16
M Á Rodríguez-Navarro, C Díaz-Alejo, M L Padilla-Del Rey, A B Alcaraz, P González-Pérez, M Benítez
Intrathecal injection of fluorescein is a method for repairing cerebrospinal fluid fistulas. The most frequent surgical procedure is endonasal endoscopy and the purpose of injecting this dye is to locate the fistula. The anaesthesiologists usually perform the puncture, therefore it is necessary to review this method and to specify some anaesthetic considerations such as correct dosing, safe management protocols and medical-legal aspects. In this case-report we describe the pre, intra and postoperative protocol of action implemented in our department that basically consists of: obtaining a specific consent, prior neurological/ophthalmologic assessment to rule out hypertension and brain damage, use of corticosteroids and previous antihistamines, choosing the correct dose and concentration of intrathecal sodium fluorescein (maximum 1ml at a concentration of 5% diluted in 9ml of cerebrospinal fluid) and close intra and postoperative monitoring...
April 5, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28384146/effect-of-house-officer-clerking-on-short-term-outcomes-in-paediatric-orthopaedic-patients
#17
Yassar Alamri
AIM: Children who are admitted with acute orthopaedic problems are often fit and healthy. The house officer (ie, intern) is required to carry out the formal clerking/admission of inpatients. However, they are often also busy with sick ward patients, which leads to delays in formal clerking of these children until after they have been to the operating theatre (OT). The aim of this study was to assess what information, if any, is missed in children who were seen by a house officer prior to going to OT, compared to those who were not...
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28214370/the-effect-of-preoperative-submucosal-administration-of-tramadol-on-the-success-rate-of-inferior-alveolar-nerve-block-on-mandibular-molars-with-symptomatic-irreversible-pulpitis-a-randomized-double-blind-placebo-controlled-clinical-trial
#18
A De Pedro-Muñoz, J Mena-Álvarez
AIM: This randomized, double-blind, placebo-controlled, clinical trial was designed to improve the success of inferior alveolar nerve blocks (IANB) in mandibular molars with symptomatic irreversible pulpitis (SIP) by means of preoperative submucosal administration of 50 mg tramadol. METHODOLOGY: Forty-two patients with a mandibular molar diagnosed with SIP took part in the trial. Patients were assigned randomly to one of two groups: tramadol group (n = 21), who received 50 mg tramadol in 1 mL by mandibular infiltration, and a placebo group (n = 21), who received 1 mL of normal saline administered to the affected tooth by the same means...
February 18, 2017: International Endodontic Journal
https://www.readbyqxmd.com/read/28188621/the-analgesic-efficacy-of-pre-operative-bilateral-erector-spinae-plane-esp-blocks-in-patients-having-ventral-hernia-repair
#19
K J Chin, S Adhikary, N Sarwani, M Forero
Laparoscopic ventral hernia repair is an operation associated with significant postoperative pain, and regional anaesthetic techniques are of potential benefit. The erector spinae plane (ESP) block performed at the level of the T5 transverse process has recently been described for thoracic surgery, and we hypothesised that performing the ESP block at a lower vertebral level would provide effective abdominal analgesia. We performed pre-operative bilateral ESP blocks with 20-30 ml ropivacaine 0.5% at the level of the T7 transverse process in four patients undergoing laparoscopic ventral hernia repair...
April 2017: Anaesthesia
https://www.readbyqxmd.com/read/28162846/ketamine-xylazine-anaesthesia-and-orofacial-administration-of-substance-p-a-lethal-combination-in-rats
#20
Janetti N Francischi, Taíssa Iolanda C Frade, Marcella P A de Almeida, Bárbara F G de Queiroz, Y S Bakhle
BACKGROUND AND AIMS: Ketamine+xylazine mixture is a widely used anaesthetic in animal experiments. In rats anaesthetized with this mixture, we have shown that injection of carrageenan, a standard proinflammatory stimulus, into the cheek (intra-oral injection) induced oedema. A likely mediator of this oedema is substance P (SP), a major transmitter of sensory nerves in orofacial tissue. We have assessed the effects of intra-oral injection of SP in rats. EXPERIMENTAL APPROACH: SP (50-1μg per rat) was injected intra-orally in male adult Holtzman or Wistar rats, anaesthetized with ketamine+xylazine...
April 2017: Neuropeptides
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