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Pre anaesthetic assessment

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https://www.readbyqxmd.com/read/28442206/change-the-habit-to-change-the-practice-do-audits-really-ever-change-anything
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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...
January 23, 2017: Neuropeptides
https://www.readbyqxmd.com/read/28148256/defining-reasonable-patient-standard-and-preference-for-shared-decision-making-among-patients-undergoing-anaesthesia-in-singapore
#7
J L J Yek, A K Y Lee, J A D Tan, G Y Lin, T Thamotharampillai, H R Abdullah
BACKGROUND: A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. METHODS: A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital...
February 2, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28127716/single-hospital-visit-elective-day-case-laparoscopic-cholecystectomy-without-prior-outpatient-attendance
#8
N J Curtis, P D Robinson, N J Carty
INTRODUCTION: Eighty percent of all UK elective laparoscopic cholecystectomies (LC) are performed as day-case procedures, but the pre-operative patient pathway has received little attention. In response to local patient feedback, we aimed to introduce a single hospital visit pathway for day-case LC. METHODS: A single hospital visit pathway for elective LC was piloted alongside standard services. Following telephone consultation, a pack containing procedure information, knowledge questionnaire and consent form were sent...
January 26, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28124132/tranexamic-acid-versus-fibrin-sealant-in-primary-total-hip-replacement-a-comparative-study
#9
Aatif Mahmood, Seif Sawalha, Aaron Borbora, Gunasekaran Kumar, Viju Peter
BACKGROUND: The effectiveness of intravenous tranexamic acid (TA) in reducing blood loss and transfusion requirements during total hip replacement (THR) is well recognised. The aim of this study was to assess the effectiveness of a fibrin sealant in comparison to intravenous TA and a control group. PATIENTS AND METHODS: We prospectively studied 273 patients with primary hip osteoarthritis who underwent a THR between February 2012 and September 2013. The first 73 patients acted as the control group...
January 25, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28107215/metabolic-cardiac-and-renal-effects-of-the-slow-hydrogen-sulfide-releasing-molecule-gyy4137-during-resuscitated-septic-shock-in-swine-with-pre-existing-coronary-artery-disease
#10
Benedikt L Nubaum, Josef Vogt, Ulrich Wachter, Oscar McCook, Martin Wepler, José Matallo, Enrico Calzia, Michael Gröger, Michael Georgieff, Mark E Wood, Matthew Whiteman, Peter Radermacher, Sebastian Hafner
Decreased levels of endogenous hydrogen sulfide (H2S) contribute to atherosclerosis, whereas equivocal data are available on H2S effects during sepsis. Moreover, H2S improved glucose utilization in anaesthetized, ventilated, hypothermic mice, but normothermia and/or sepsis blunted this effect. The metabolic effects of H2S in large animals are controversial. Therefore, we investigated the effects of the H2S donor GYY4137 during resuscitated, fecal peritonitis-induced septic shock in swine with genetically and diet-induced coronary artery disease (CAD)...
January 19, 2017: Shock
https://www.readbyqxmd.com/read/27942059/role-of-pre-operative-multimedia-video-information-in-allaying-anxiety-related-to-spinal-anaesthesia-a-randomised-controlled-trial
#11
Raylene Dias, Lipika Baliarsing, Neeraj Kumar Barnwal, Shweta Mogal, Pinakin Gujjar
BACKGROUND AND AIMS: A high incidence of anxiety has been reported in patients in the operation theatre set up. We developed a short visual clip of 206 s duration depicting the procedure of spinal anaesthesia (SAB) and aimed to compare the effect of this video on perioperative anxiety in patients undergoing procedures under SAB. METHODS: A prospective randomised study of 200 patients undergoing surgery under SAB was conducted. Patients were allotted to either the nonvideo group (Group NV - those who were not shown the video) or the video group (Group V - those who were shown the video)...
November 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27942058/pre-operative-laboratory-testing-a-prospective-study-on-comparison-and-cost-analysis
#12
Venkatesh H Keshavan, Chidananda Mn Swamy
BACKGROUND AND AIMS: Pre-operative investigations are performed before any surgical intervention under anaesthesia. Many are considered as routine. However, there are no clear guidelines regarding these in India. We aim to look at the relevance of the laboratory investigations ordered routinely and their cost implications compared with the National Institute of Clinical Excellence (NICE) guidelines. METHODS: This prospective study was carried out at a tertiary care hospital...
November 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27933152/ensuring-availability-of-in-date-and-fit-for-purpose-emergency-guidelines-in-all-anaesthetic-areas-throughout-the-south-east-scotland-deanery
#13
Elise Hindle
Our aim was to institute a system whereby emergency anaesthetic guidelines are available in >90% of appropriate clinical areas throughout each of the acute hospital sites in three health board administrative regions, and whereby >90% of available guidelines are deemed to be in date and fit for purpose. Our objective was to achieve these targets within 6 months. Using quality improvement methodology, we inventoried available emergency anaesthetic guidelines in 132 locations throughout seven acute care hospitals...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27866856/free-tissue-transfer-in-patients-with-sickle-cell-disease-considerations-for-multi-disciplinary-peri-operative-management
#14
REVIEW
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*...
January 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27832555/driving-impairment-due-to-propofol-at-effect-site-concentrations-relevant-after-short-propofol-only-sedation
#15
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
https://www.readbyqxmd.com/read/27733872/local-anaesthetic-drug-administration-in-dentistry-using-computer-assisted-anaesthetic-delivery-system-a-systematic-review
#16
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
https://www.readbyqxmd.com/read/27697020/perioperative-considerations-in-rheumatoid-arthritis-patients
#17
REVIEW
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...
2016: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/27648948/effect-of-topically-applied-anaesthetic-formulation-on-the-sensitivity-of-scoop-dehorning-wounds-in-calves
#18
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
https://www.readbyqxmd.com/read/27625236/an-algorithmic-approach-for-clinical-management-of-low-back-pain
#19
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
https://www.readbyqxmd.com/read/27601761/orthopaedic-enhanced-recovery-programme-for-elective-hip-and-knee-arthroplasty-could-a-regional-programme-be-beneficial
#20
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
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