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Pre anaesthetic assessment

Lilli Cooper, Rohit Seth, Elizabeth Rhodes, Mohammed Alousi, Bran Sivakumar
INTRODUCTION AND AIMS: Sickle cell disease (SCD) is an increasingly common condition in the UK. The safety of free tissue transfer in these patients is controversial, and no specific guidelines exist. The aim of this paper is to create recommendations for the plastic surgical multidisciplinary team for use in the assessment and management of SCD patients undergoing free tissue transfer and reconstruction. METHOD: A literature review was performed in PubMed of 'sickle [TiAb] AND plast* adj3 surg*...
October 26, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
J L Telles, S Agarwal, J Monagle, C Stough, R King, L Downey
Australian guidelines state "Following brief surgery or procedures with short acting anaesthetic drugs, the patient may be fit to drive after a normal night's sleep. After long surgery or procedures requiring longer lasting anaesthesia, it may not be safe to drive for 24 hours or more". The increasing use of the short-acting anaesthetic drug propofol as a solitary sedative medication for simple endoscopy procedures suggests a need to review this blanket policy. Thirty patients presenting for elective day surgery were recruited as volunteers for a pre-procedure driving simulation study and randomised to propofol or placebo arms...
November 2016: Anaesthesia and Intensive Care
Gowri Sivaramakrishnan, Kannan Sridharan
BACKGROUND: Local anaesthetics play a key role in reducing pain and anxiety during dental treatment. However the disadvantage of using syringe and needle technique in the maxilla, proximal to the apices of the teeth is that it is painful and also leads to collateral anaesthesia. Hence this systematic review aims to identify whether computer assisted local anaesthetic delivery system could produce predictable results similar to conventional syringe needle technique and also eliminate the disadvantages...
2016: Open Dentistry Journal
Derar Seyoum, Wasim Khan
The pre-operative assessment is used to clarify issues prior to surgery that can change management provided by a multidisciplinary team. A high proportion of rheumatoid arthritis patients are elderly requiring orthopaedic surgery which requires further investigations, assessment of risk through functional capacity and several anaesthetic considerations. Rheumatoid arthritis patients often provide a variety of medical issues that can be found on careful and thorough pre-assessment that can be accommodated for by the surgical and anaesthetic team, however aspects of holistic management is an important considerations for efficient and effective management...
September 27, 2016: Current Rheumatology Reviews
Dominique McCarthy, Peter Andrew Windsor, Charissa Harris, Sabrina Lomax, Peter John White
The post-operative effects of three formulations of topical anaesthetic and a cornual nerve block on the sensitivity of scoop dehorning wounds in calves were compared in two trials. In Trial 1, 21 female Holstein dairy calves aged 8 to 24 weeks were randomly allocated to two groups: (1) scoop dehorning with a post-operative application of a novel topical anaesthetic powder (DTAP, n = 10); and (2) scoop dehorning with a post-operative application of a novel topical anaesthetic ethanol liquid (DTAE, n = 11). In Trial 2, 18 castrated male and 18 female Hereford beef calves aged 16 to 20 weeks were randomly allocated to four groups: (1) scoop dehorning with a pre-operative cornual nerve block of lignocaine (DCB, n = 9); (2) scoop dehorning with a post-operative application of the novel topical anaesthetic ethanol liquid from Trial 1 (DTAE, n = 9); (3) scoop dehorning with a post-operative application of a topical anaesthetic gel (DTAG, n = 9); and (4) sham dehorning (CON, n = 9)...
2016: PloS One
V V Ramesh Chandra, B C M Prasad, C Krishna Mohan, T C Kalawat, V Satyanarayana, A Y Lakshmi
BACKGROUND: Low back pain is caused by a variety of conditions. When conventional imaging failed, single-photon emission computed tomography (SPECT) was superior to scintigraphy in identifying the pathology. Injection therapies are often helpful in treating the pathology. AIM: To determine the cause of chronic low backache in individuals with normal conventional imaging (radiographs, computed tomography and magnetic resonance imaging), to determine the specific pathology using scintigraphic studies and diagnostic blocks; and, to treat the individuals with various spinal injection techniques and determine their efficacy...
September 2016: Neurology India
Adam Tucker, Darren McCusker, Nidhi Gupta, Jonathon Bunn, Mark Murnaghan
INTRODUCTION: Arthroplasty is commonplace in orthopaedic practice, and post operative pain has been shown to substantially hinder recovery and discharge from hospital. OBJECTIVES: The current study assessed a multidisciplinary, multimodal Orthopaedic ERP in terms of its effect on patient perceived post operative pain in hip and knee arthroplasty. Secondary outcome was in the form of a cost analysis. METHODS: A prospective study was performed on consecutive arthroplasty patients across a 6 week period in a district orthopaedic unit...
May 2016: Ulster Medical Journal
Habib Md Reazaul Karim, Md Yunus, Prithwis Bhattacharyya
BACKGROUND AND AIMS: Pre-operative investigations are often required to supplement information for risk stratification and assessing reserve for undergoing surgery. Although there are evidence-based recommendations for which investigations should be done, clinical practice varies. The present study aimed to assess the pre-operative investigations and referral practices and compare it with the standard guidelines. METHODS: The present observational study was carried out during 2014-appen2015 in a teaching institute after the approval from Institute Ethical Committee...
August 2016: Indian Journal of Anaesthesia
Fu-Zhou Hua, Jun Ying, Jing Zhang, Xi-Feng Wang, Yan-Hui Hu, Ying-Ping Liang, Qin Liu, Guo-Hai Xu
The volatile anaesthetic isoflurane is one of the most frequently employed general anaesthetics in neonates, children and adults. Accumulating evidence demonstrated that exposure to anaesthetics is associated with widespread neurodegeneration and cognitive impairment. Thus, the identification and development of compounds capable of preventing or reducing these adverse effects is of great clinical importance. For this purpose, the present study aimed to assess the effects of a flavonoid, naringenin, on isoflurane-induced neuroapoptosis and cognitive impairment...
October 2016: International Journal of Molecular Medicine
Michael A Glasby, Athanasios I Tsirikos, Lindsay Henderson, Gillian Horsburgh, Brian Jordan, Ciara Michaelson, Christopher I Adams, Enrique Garrido
PURPOSE: To compare measurements of motor evoked potential latency stimulated either magnetically (mMEP) or electrically (eMEP) and central motor conduction time (CMCT) made pre-operatively in conscious patients using transcranial and intra-operatively using electrical cortical stimulation before and after successful instrumentation for the treatment of adolescent idiopathic scoliosis. METHODS: A group initially of 51 patients with adolescent idiopathic scoliosis aged 12-19 years was evaluated pre-operatively in the outpatients' department with transcranial magnetic stimulation...
August 23, 2016: European Spine Journal
Ketan Gajjar, Pierre P L Martin-Hirsch, Andrew Bryant, Gemma L Owens
BACKGROUND: Pre-cancerous lesions of cervix (cervical intraepithelial neoplasia (CIN)) are usually treated with excisional or ablative procedures. In the UK, the National Health Service (NHS) cervical screening guidelines suggest that over 80% of treatments should be performed in an outpatient setting (colposcopy clinics). Furthermore, these guidelines suggest that analgesia should always be given prior to laser or excisional treatments. Currently various pain relief strategies are employed that may reduce pain during these procedures...
2016: Cochrane Database of Systematic Reviews
F Ghaderi, R Ghaderi, M Davarmanesh, M Bayani, S Arabzade Moghadam
AIM: To date, there is no safe, effective, and rapid method to eliminate the pain associated with needle insertion. It is noticed that using a low-energy laser before intradermal and intramuscular injection would help rapid local anaesthesia with a lidocaine product. However, there is no valuable data on the effect of the concomitant use of laser and benzocaine as a pre-treatment option, compared to local application of benzocaine products alone before needle insertion. MATERIALS AND METHODS: A prospective single-blind clinical trial was designed to assess pain perception during needle insertion into mucosa in 66 healthy volunteer dental students...
June 2016: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
Halide Hande Şahinkaya, Erdem Yaşar, Zeki Tuncel Tekgül, Burcu Özalp Horsanalı, Ertaç Özeroğlu
Brugada Syndrome is a condition with an undetermined aetiology and a tendency for malignant arrhythmias, an electrocardiographic pattern of a right bundle branch block with persistent ST segment elevation in the right precordial leads (V1-V3) and no association with structural heart disease. We aimed to discuss the anaesthetic management of an asymptomatic 35-year-old patient with Brugada syndrome who had been diagnosed during the pre-anaesthetic assessment because of the family history of the early sudden cardiac death of his mother...
April 2016: Turkish Journal of Anaesthesiology and Reanimation
Sergio Barroso Rosa, Dugal James, Brent David Matthews
PURPOSE: To determine that when the patient chooses their intervention, whether there is any difference in duration of surgery, effectiveness, patient satisfaction and recovery time between two methods of anaesthesia, local anaesthetic (LA) and general anaesthesia (GA) in knee arthroscopy (KA). METHODS: Inclusion criteria were medically fit, adults, undergoing unilateral KA, in a native knee as a day case. Exclusion criteria were requirement for ligament reconstruction or meniscal repair, pre-existing regional sensory impairment or active psychiatric condition...
August 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Anna Rosati, Lucrezia Ilvento, Manuela L'Erario, Salvatore De Masi, Annibale Biggeri, Giancarlo Fabbro, Roberto Bianchi, Francesca Stoppa, Lucia Fusco, Silvia Pulitanò, Domenica Battaglia, Andrea Pettenazzo, Stefano Sartori, Paolo Biban, Elena Fontana, Elisabetta Cesaroni, Donatella Mora, Paola Costa, Rosanna Meleleo, Roberta Vittorini, Alessandra Conio, Andrea Wolfler, Massimo Mastrangelo, Maria Cristina Mondardini, Emilio Franzoni, Kathleen S McGreevy, Lorena Di Simone, Alessandra Pugi, Lorenzo Mirabile, Federico Vigevano, Renzo Guerrini
INTRODUCTION: Status epilepticus (SE) is a life-threatening neurological emergency. SE lasting longer than 120 min and not responding to first-line and second-line antiepileptic drugs is defined as 'refractory' (RCSE) and requires intensive care unit treatment. There is currently neither evidence nor consensus to guide either the optimal choice of therapy or treatment goals for RCSE, which is generally treated with coma induction using conventional anaesthetics (high dose midazolam, thiopental and/or propofol)...
2016: BMJ Open
T S Wildes, A C Winter, H R Maybrier, A M Mickle, E J Lenze, S Stark, N Lin, S K Inouye, E M Schmitt, S L McKinnon, M R Muench, M R Murphy, R T Upadhyayula, B A Fritz, K E Escallier, G P Apakama, D A Emmert, T J Graetz, T W Stevens, B J Palanca, R L Hueneke, S Melby, B Torres, J Leung, E Jacobsohn, M S Avidan
INTRODUCTION: Postoperative delirium, arbitrarily defined as occurring within 5 days of surgery, affects up to 50% of patients older than 60 after a major operation. This geriatric syndrome is associated with longer intensive care unit and hospital stay, readmission, persistent cognitive deterioration and mortality. No effective preventive methods have been identified, but preliminary evidence suggests that EEG monitoring during general anaesthesia, by facilitating reduced anaesthetic exposure and EEG suppression, might decrease incident postoperative delirium...
2016: BMJ Open
Maria I Castillo, Marie Cooke, Bonnie Macfarlane, Leanne M Aitken
BACKGROUND: Anxiety is an unpleasant emotion that most intensive care patients experience. This emotion is an important issue in intensive care settings because of its prevalence, adverse effects and severity. Little is known about the factors associated with state and trait anxiety during critical illness. OBJECTIVES: To describe the patterns of state anxiety reported by intensive care patients, and identify factors associated with state and trait anxiety. DESIGN: Prospective observational cohort study...
August 2016: International Journal of Nursing Studies
Jeong Jin Min, Gahyun Kim, Eunhee Kim, Jong-Hwan Lee
OBJECTIVES: The diagnostic validity of clinical airway assessment tests for predicting difficult laryngoscopy in patients requiring endotracheal intubation were evaluated using receiver operating characteristic (ROC) curve analysis and a grey zone approach. METHODS: In this prospective observational study, patients were evaluated during a pre-anaesthetic visit. Predictive airway assessment tests (i.e. Modified Mallampati [MMT] classification; upper lip bite test [ULBT]; mouth opening; sternomental distance; thyromental distance [TMD]; neck circumference; neck mobility; height to thyromental distance [HT/TMD]; neck circumference-to-thyromental distance [NC/TMD]) were performed on each patient and LEMON, Naguib, and MACOCHA scores were also calculated...
August 2016: Journal of International Medical Research
T H Pham, I Mendez-David, C Defaix, B P Guiard, L Tritschler, D J David, A M Gardier
Unlike classic serotonergic antidepressant drugs, ketamine, an NMDA receptor antagonist, exhibits a rapid and persistent antidepressant (AD) activity, at sub-anaesthetic doses in treatment-resistant depressed patients and in preclinical studies in rodents. The mechanisms mediating this activity are unclear. Here, we assessed the role of the brain serotonergic system in the AD-like activity of an acute sub-anaesthetic ketamine dose. We compared ketamine and fluoxetine responses in several behavioural tests currently used to predict anxiolytic/antidepressant-like potential in rodents...
May 17, 2016: Neuropharmacology
Adam Mikstacki, Marzena Skrzypczak-Zielinska, Oliwia Zakerska-Banaszak, Barbara Tamowicz, Maria Skibinska, Marta Molinska-Glura, Marlena Szalata, Ryszard Slomski
BACKGROUND: The serum glutathione S-transferase alpha (α-GST) concentration has been used as a marker of hepatic condition. After sevoflurane anaesthesia a mild impairment of hepatocellular integrity was observed. Genetic polymorphisms in CYP2E1, GSTA1 and GSTP1 genes, affecting enzymes activity, may possibly influence the hepatotoxic effect of sevoflurane. The aim of this study was to assess the influence of genetic polymorphism of CYP2E1, GSTA1 and GSTP1 genes on serum α-GST level in 86 unrelated patients representing ASA physical status I-II, undergoing laryngological surgery under general anaesthesia with sevoflurane...
2016: BMC Medical Genetics
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