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https://www.readbyqxmd.com/read/28320312/the-effect-of-an-electronic-cognitive-aid-on-the-management-of-st-elevation-myocardial-infarction-during-caesarean-section-a-prospective-randomised-simulation-study
#1
Michael St Pierre, Bjoern Luetcke, Dieter Strembski, Christopher Schmitt, Georg Breuer
BACKGROUND: Cognitive aids have come to be viewed as promising tools in the management of perioperative critical events. The majority of published simulation studies have focussed on perioperative crises that are characterised by time pressure, rare occurrence, or complex management steps (e.g., cardiac arrest emergencies, management of the difficult airway). At present, there is limited information on the usefulness of cognitive aids in critical situations with moderate time pressure and complexity...
March 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28289667/laparoscopic-cholecystectomy-under-spinal-epidural-anesthesia-vs-general-anaesthesia-a-prospective-randomised-study
#2
Turgut Donmez, Vuslat Muslu Erdem, Sinan Uzman, Dogan Yildirim, Huseyin Avaroglu, Sina Ferahman, Oguzhan Sunamak
PURPOSE: Laparoscopic cholecystectomy (LC) is usually performed under the general anesthesia (GA). Aim of the study is to investigate the availability, safety and side effects of combined spinal/epidural anesthesia (CSEA) and comparison it with GA for LC. METHODS: Forty-nine patients who have a LC plan were included into the study. The patients were randomly divided into GA (n = 25) and CSEA (n = 24) groups. Intraoperative and postoperative adverse events, postoperative pain levels were compared between groups...
March 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28277383/the-use-of-vasopressors-during-spinal-anaesthesia-for-caesarean-section
#3
Warwick D Ngan Kee
PURPOSE OF REVIEW: Hypotension remains one of the most researched subjects in obstetric anaesthesia. The purpose of this study is to review the most recent published articles on the use of vasopressors during spinal anaesthesia for caesarean section. RECENT FINDINGS: Despite continued research indicating advantages of phenylephrine over ephedrine, practitioners in some countries continue to favour ephedrine. Recent research has continued to compare the two drugs with some work emerging on high-risk patients...
March 8, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28277380/update-on-developmental-anesthesia-neurotoxicity
#4
Laszlo Vutskits, Andrew Davidson
PURPOSE OF REVIEW: Adverse long-term impact of general anesthesia on the developing brain is a widely discussed and controversial issue with potential public health relevance. The goal of this article is to give insights into the most recent experimental and clinical observations aimed to advance our understanding in this field. RECENT FINDINGS: Recent investigations demonstrate long-term behavioral consequences of early-life anesthesia exposure in nonhuman primates under experimental conditions that are translationally relevant to human clinical practice...
March 8, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28274000/lateral-anal-sphincterotomy-for-chronic-anal-fissures-a-comparison-of-outcomes-and-complications-under-local-anaesthesia-versus-spinal-anaesthesia
#5
Ravikumar Manoharan, Tarun Jacob, Santosh Benjamin, Sumonth Kirishnan
INTRODUCTION: Fissure-in-Ano is one of the common and most painful anorectal conditions encountered in surgical practice. Inspite of several conservative treatment options, surgical treatment in the form of Lateral Anal Spincterotomy (LAS) remains the gold standard of treatment for Chronic Anal Fissures (CAF). However, LAS is often done under spinal or general anaesthesia incurring huge treatment costs and hospital stay. AIM: To study if LAS can be treated with Local Anaesthesia (LA) thereby, reducing the costs and the anaesthetic risk to patients with no significant change in the surgical ease or clinical outcome...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28258944/caesarean-delivery-in-a-pregnant-woman-with-epidermolysis-bullosa-anaesthetic-challenges
#6
M Araújo, R Brás, R Frada, L Guedes-Martins, P Lemos
Epidermolysis bullosa is a heterogeneous group of hereditary diseases characterised by extreme fragility of skin and mucosa, with blister and lesion formation spontaneously or in response to trauma. Anaesthetic management of these patients is challenging with respect to positioning, monitoring, use of medical devices and airway management. These challenges are increased when managing labour. We report an elective caesarean delivery in a nulliparous woman with autosomal recessive dystrophic epidermolysis bullosa, managed successfully with spinal anaesthesia...
February 3, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28255987/a-randomised-double-blind-trial-of-phenylephrine-and-metaraminol-infusions-for-prevention-of-hypotension-during-spinal-and-combined-spinal-epidural-anaesthesia-for-elective-caesarean-section
#7
N J McDonnell, M J Paech, N A Muchatuta, S Hillyard, E A Nathan
Prophylactic vasopressor administration is commonly recommended to reduce maternal hypotension during spinal anaesthesia for caesarean section. Metaraminol has undergone limited investigation in obstetric anaesthesia for this purpose, particularly in comparison with phenylephrine. In this multicentre, randomised, double-blind, non-inferiority study, we compared prophylactic phenylephrine or metaraminol infusions, started immediately after spinal anaesthesia, in 185 women who underwent elective caesarean section...
March 3, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28255259/the-effect-of-unilateral-spinal-anaesthesia-and-psoas-compartment-with-sciatic-block-on-the-postoperative-pain-management-in-total-knee-artroplastic-surgery
#8
Ebru Canakci, Dogus Unal, Yunus Guzel
Purpose. This study was designed to investigate the effects of peripheral nerve block methods, applied through unilateral spinal anaesthesia on elderly patients to undergo total knee arthroplasty, on perioperative hemodynamic parameters and postoperative analgesia period. Materials and Method. 60 patients were randomly divided into two groups in the study. In group USA spinal anaesthesia was performed. In group PCS it was applied on psoas compartment block and sciatic nerve block. Results. Significantly higher intraoperative 60th and 90th minute mean arterial pressure values were ascertained in the PCS group compared to the USA group...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28250483/intravenous-palonosetron-compared-with-a-combination-of-ramosetron-and-dexamethasone-in-preventing-post-operative-nausea-and-vomiting-in-patients-undergoing-gynaecological-surgeries-under-spinal-anaesthesia-a-randomised-study
#9
Archana B Narayanappa, Shivakumar Gurulingaswamy, Umesh N Prabhakaraiah, Somsundar R Gurushanth, Vinay Sapare, Nagaraj Goud
BACKGROUND AND AIMS: Post-operative nausea and vomiting (PONV) is one of the most common complications in patients undergoing gynaecological surgeries under spinal anaesthesia (SA). Palonosetron has the unique property of controlling 'delayed chemotherapy-induced nausea and vomiting' when compared to older serotonin antagonists. This study compared the effectiveness of palonosetron with a combination of ramosetron and dexamethasone in preventing PONV. METHODS: Sixty patients undergoing gynaecological surgeries under SA were randomly allocated into two groups of thirty each, to receive either a combination of 0...
February 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28222642/prediction-of-intraoperative-nausea-and-vomiting-in-caesarean-delivery-under-regional-anaesthesia
#10
Altuğ Semiz, Yaşam Kemal Akpak, Necip Cihangir Yılanlıoğlu, Ali Babacan, Gökhan Gönen, Canan Çam Gönen, Murat Asıliskender, Selim Karaküçük
Objectives This study aimed to predict patients who have caesarean operations under regional anaesthesia and are at risk for intraoperative nausea and vomiting (IONV), for ultimately prompting anaesthetists and surgeons to take preventive measures. Methods This was a retrospective study on 209 patients who had caesarean section under spinal-epidural combined regional anaesthesia. The relevant medical history, such as severe nausea and vomiting in the first trimester, smoking, a history of motion sickness, and premenstrual syndrome (PMS), were obtained from the patients' records and interviews...
February 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28216705/comparison-of-fractionated-dose-versus-bolus-dose-injection-in-spinal-anaesthesia-for-patients-undergoing-elective-caesarean-section-a-randomised-double-blind-study
#11
Jigisha Prahaladray Badheka, Vrinda Pravinbhai Oza, Ashutosh Vyas, Deepika Baria, Poonam Nehra, Thomas Babu
BACKGROUND AND AIMS: Spinal anaesthesia (SA) with bolus dose has rapid onset but may precipitate hypotension. When we inject local anaesthetic in fractions with a time gap, it provides a dense block with haemodynamic stability and also prolongs the duration of analgesia. We aimed to compare fractionated dose with bolus dose in SA for haemodynamic stability and duration of analgesia in patients undergoing elective lower segment caesarean section (LSCS). METHODS: After clearance from the Institutional Ethics Committee, the study was carried out in sixty patients undergoing elective LSCS...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28184358/vertical-patellar-dislocation-reduction-by-the-push-up-and-rotate-method-a-case-report-and-literature-review
#12
Hayat Ahmad Khan, Adil Bashir Shah, Younis Kamal
INTRODUCTION: Patellar dislocation is an emergency. Vertical patellar dislocation is rare, often seen in adolescents and mostly due to sports injuries or high-velocity trauma. Few cases have been reported in the literature. Closed or open reduction under general anesthesia is often needed. We report a case of vertical locked patellar dislocation in a 26-year-old male, which was reduced by a simple closed method under spinal anaesthesia. A literature review regarding the various methods of treatment is also discussed...
November 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28170398/emergency-obstetric-care-in-a-rural-district-of-burundi-what-are-the-surgical-needs
#13
E De Plecker, R Zachariah, A M V Kumar, M Trelles, S Caluwaerts, W van den Boogaard, J Manirampa, K Tayler-Smith, M Manzi, K Nanan-N'zeth, B Duchenne, B Ndelema, W Etienne, P Alders, R Veerman, R Van den Bergh
OBJECTIVES: In a rural district hospital in Burundi offering Emergency Obstetric care-(EmOC), we assessed the a) characteristics of women at risk of, or with an obstetric complication and their types b) the number and type of obstetric surgical procedures and anaesthesia performed c) human resource cadres who performed surgery and anaesthesia and d) hospital exit outcomes. METHODS: A retrospective analysis of EmOC data (2011 and 2012). RESULTS: A total of 6084 women were referred for EmOC of whom 2534(42%) underwent a major surgical procedure while 1345(22%) required a minor procedure (36% women did not require any surgical procedure)...
2017: PloS One
https://www.readbyqxmd.com/read/28166067/ultrasound-guided-femoral-nerve-block-to-provide-analgesia-for-positioning-patients-with-femur-fracture-before-subarachnoid-block-comparison-with-intravenous-fentanyl
#14
S Ranjit, B B Pradhan
Background Positioning patients with fractured femur for subarachnoid block is painful. Intravenous analgesics or peripheral nerve block like femoral nerve block or fascia iliaca compartment block are some of the available techniques to reduce pain. We compared the efficacy of femoral nerve block and intravenous fentanyl in providing effective analgesia before positioning for subarachnoid block. Objective This study was designed to compare between ultrasound guided femoral nerve block with lignocaine and intravenous fentanyl in providing effective analgesia before positioning patient with femur fracture in sitting position for subarachnoid block...
April 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/28161015/-electrophysiological-testing-in-spinal-cord-tumors
#15
REVIEW
N André-Obadia, F Mauguière
Evoked potentials (EPs) are useful to evaluate the functional impairment of motor and somatosensory pathways in spinal cord tumors. Conduction through pyramidal tracts is evaluated by motor EPs (MEPs) elicited by transcranial stimulation, magnetic for awake patients or electric in the operating room. Somatosensory EPs (SEPs) and laser EPs (LEPs) are complementary procedures to explore conduction in dorsal columns and spinothalamic tracts, respectively. MEPs as well as SEPs show conduction abnormalities in about 60% of cases with a sensitivity that increases up to 70% when both procedures are carried out...
February 1, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28133720/heart-rate-variability-as-a-predictor-of-hypotension-following-spinal-for-elective-caesarean-section-a-prospective-observational-study
#16
D G Bishop, C Cairns, M Grobbelaar, R N Rodseth
Post-spinal hypotension remains a common and clinically-important problem during caesarean section, and accurate pre-operative prediction of this complication might enhance clinical management. We conducted a prospective, single-centre, observational study of heart rate variability in 102 patients undergoing elective caesarean section in a South African regional hospital. We performed Holter recording for ≥ 5 min in the hour preceding spinal anaesthesia. The low-frequency/high-frequency ratio component of heart rate variability was compared, using a logistic regression model, with baseline heart rate and body mass index (BMI) as a predictor of hypotension (defined as systolic arterial pressure < 90 mmHg) occurring from the time of spinal insertion until 15 min after delivery of the baby...
January 30, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28120104/adjuncts-to-local-anaesthetics-in-tonsillectomy-a-systematic-review-and-meta-analysis
#17
REVIEW
R Vlok, T M Melhuish, C Chong, T Ryan, Leigh D White
The infiltration of local anaesthetic agents has been shown to reduce post-tonsillectomy pain. A number of recent studies have shown that the addition of agents such as clonidine and dexamethasone improve the efficacy of nerve blocks and spinal anaesthesia. The aim of this review was to determine whether additives to local anaesthetic agents improve post-tonsillectomy outcomes. Four major databases were systematically searched for all relevant studies published up to August 2016. All study designs with a control group receiving local anaesthetic infiltration and an intervention receiving the same infiltration with an added agent were included in this review...
January 24, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28088218/spinal-versus-general-anaesthesia-in-surgery-for-inguinodynia-spinasia-trial-study-protocol-for-a-randomised-controlled-trial
#18
Willem A R Zwaans, Léon H P M le Mair, Marc R M Scheltinga, Rudi M H Roumen
BACKGROUND: Chronic inguinodynia (groin pain) is a common complication following open inguinal hernia repair or a Pfannenstiel incision but may also be experienced after other types of (groin) surgery. If conservative treatments are to no avail, tailored remedial surgery, including a neurectomy and/or a (partial) meshectomy, may be considered. Retrospective studies in patients with chronic inguinodynia suggested that spinal anaesthesia is superior compared to general anaesthesia in terms of pain relief following remedial operations...
January 14, 2017: Trials
https://www.readbyqxmd.com/read/28029669/safety-and-efficacy-of-spinal-anaesthesia-in-percutaneous-nephrolithotomy
#19
R Shah, A S Thapa, N Lamichhane, S R Kc
INTRODUCTION: Renal stone is one of the common entities occurring in our population. There are different treatment modalities of stones; out of those percutaneous nephrolithotomy is one of the most popular and effective for the renal and upper tract stones. This study is based to compare the safety and efficacy of spinal anaesthesia and general anaesthesia in PCNL. METHODS: In a randomized prospective study 60 patients were divided in two groups; group 1 (n=30) underwent PCNL in general anaesthesia and group 2 (n=30) underwent PCNL in spinal anaesthesia in prone position with the conventional technique...
October 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28007522/the-pupillary-light-reflex-for-predicting-the-risk-of-hypotension-after-spinal-anaesthesia-for-elective-caesarean-section
#20
Céline Riffard, Truong Quoc Viêt, François-Pierrick Desgranges, Lionel Bouvet, Bernard Allaouchiche, Adrienne Stewart, Dominique Chassard
INTRODUCTION: The balance between the sympathetic and parasympathetic systems could be used to predict the onset of hypotension following spinal anaesthesia. The autonomic innervation of the pupil may reflect this balance. The aim of this study was to evaluate the ability of pupillometry to predict the risk of hypotension after spinal anaesthesia for caesarean section. METHODS: Two hundred patients receiving spinal anaesthesia for caesarean section were recruited...
December 19, 2016: Anaesthesia, Critical Care & Pain Medicine
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