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https://www.readbyqxmd.com/read/29773485/pregnancy-after-heterotopic-heart-transplant-removal
#1
S Churchill, L de Lloyd, H C Francis, H Wallis
Heterotopic heart transplants were introduced in 1974. The technique allows the patient's native heart to be preserved in situ, alongside the transplanted heterotopic donor heart (Newcomb et al., 2004). We present the case of a nulliparous woman who underwent heterotopic heart transplant in infancy, and subsequent explantation of the donor heart eleven years later, when her native heart function recovered. In adulthood the patient attended pre-pregnancy counselling and was awaiting cardiac magnetic resonance imaging when she presented pregnant at 6 weeks-of-gestation...
April 24, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29769505/efficacy-of-0-5-hyperbaric-bupivacaine-with-dexamethasone-versus-0-5-hyperbaric-bupivacaine-alone-in-spinal-anaesthesia-for-patient-undergoing-lower-abdominal-urological-and-lower-limb-orthopedic-surgeries
#2
M M Haque, M A Aleem, F H Haque, A B Siddique, R Afrose
Spinal anaesthesia with local anaesthetics has limited duration. Different additives have been used to prolong spinal anaesthesia. The aim of this study was to determine the efficacy of adding dexamethasone to bupivacaine in spinal anaesthesia specially whether it would prolong the duration of sensory block/ surgical analgesia and post-operative analgesia/pain free period or not. This randomized, prospective, double-blind, clinical study was conducted in the Department of Anaesthesia, Analgesia and Critical Care of Combined Military Hospital, Chittagong from October 2016 to August 2017...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29769490/comparison-of-outcome-of-eclamptic-patient-following-vaginal-delivery-versus-caeserian-delivery-by-spinal-anaesthesia
#3
M A Hossain, R K Karmoker, M S Rahman, H O Rashid, S H Khan, M A Rahman
Eclampsia is a common problem in pregnancy in Bangladesh. It is a severe form of preeclampsia which affects 5 to 7% of pregnancies is a significant cause of maternal & neonatal morbidity & mortality. Pre-eclampsia when complicated with generalized tonic-clonic convulsions and/or coma is called eclampsia. The term eclampsia is derived from a Greek word, meaning "like a flash of lightening". It may occur quite abruptly, without any warning manifestations. Eclampsia is a major cause of maternal mortality & morbidity as well as foetal loss worldwide, particularly in the third world...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29761478/pain-relief-for-women-undergoing-oocyte-retrieval-for-assisted-reproduction
#4
REVIEW
Irene Kwan, Rui Wang, Emily Pearce, Siladitya Bhattacharya
BACKGROUND: Various methods of conscious sedation and analgesia (CSA) have been used during oocyte retrieval for assisted reproduction. The choice of agent has been influenced by the quality of sedation and analgesia and by concerns about possible detrimental effects on reproductive outcomes. OBJECTIVES: To assess the effectiveness and safety of different methods of conscious sedation and analgesia for pain relief and pregnancy outcomes in women undergoing transvaginal oocyte retrieval...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29756162/retrospective-analysis-of-mepivacaine-prilocaine-and-chloroprocaine-for-low-dose-spinal-anaesthesia-in-outpatient-perianal-procedures
#5
Volker Gebhardt, Kevin Kiefer, Dieter Bussen, Christel Weiss, Marc D Schmittner
PURPOSE: Perianal procedures are carried out in an outpatient setting regularly. The purpose of this retrospective analysis was to investigate the impact of different local anaesthetics (LA) for spinal anaesthesia (SPA) on operating room (OR) efficiency (perioperative process times, turnaround times) and postoperative recovery. This study aims on the determination of the optimal LA for low-dose SPA in the specific setting of a high-volume day-surgery centre. METHODS: Anaesthesia records of all patients undergoing perianal outpatient surgery under saddle-block SPA at the Mannheim University Medical Centre from 2008 until 2017 were analysed...
May 13, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29756060/factors-associated-with-acute-and-chronic-pain-after-inguinal-herniorraphy
#6
Elif Erdogan, Ecder Ozenc
Objectives: The aim of this study was to analyse the relationship between types of anaesthesia, patients' demographic variables, preoperative emotional states and the prevalence of postoperative pain. Method: In this randomized prospective study, postoperative pain was assessed in 100 patients, who were ASA (American Society of Anaesthesiologist) I-II and between 18-65 years old, undergoing inguinal herniorrhaphy with either general or spinal anaesthesia. In addition, postoperative pain compared with patients' demographic properties and psychological conditions in each group was also considered...
April 2018: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29744249/the-effect-of-anaesthetic-techniques-on-maternal-and-cord-blood-brain-derived-neurotrophic-factor-levels
#7
Mehmet Aksoy, Ayşe Nur Aksoy, Ali Ahıskalıoğlu, İlker İnce, Esra Laloğlu, Ayşenur Dostbil, Mine Gürsaç Çelik
Objective: Brain-derived neurotrophic factor (BDNF), a member of neurotrophins, plays a critical role in neuronal tissue. In this study, the effects of spinal or general anaesthesia on cord and maternal peripheral blood BDNF and malondialdehyde (MDA) levels were investigated in patients undergoing elective caesarean section. Methods: Eighty patients with term pregnancy were included. General anaesthesia was induced with intravenous (IV) propofol 2 mg kg-1 in the general anaesthesia group (n=36)...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29744247/hypobaric-unilateral-spinal-anaesthesia-versus-general-anaesthesia-in-elderly-patients-undergoing-hip-fracture-surgical-repair-a-prospective-randomised-open-trial
#8
Pascal Meuret, Lionel Bouvet, Benoit Villet, Mohamed Hafez, Bernard Allaouchiche, Emmanuel Boselli
Objective: Intraoperative hypotension during hip fracture surgery is frequent in the elderly. No study has compared the haemodynamic effect of hypobaric unilateral spinal anaesthesia (HUSA) and standardised general anaesthesia (GA) in elderly patients undergoing hip fracture surgical repair. Methods: We performed a prospective, randomised open study, including 40 patients aged over 75 years, comparing the haemodynamic effects of HUSA (5 mg isobaric bupivacaine with 5 μg sufentanil and 1 mL sterile water) and GA (induction with etomidate/remifentanil and maintenance with desflurane/remifentanil)...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29728741/residual-medial-tightness-in-extension-is-corrected-spontaneously-after-total-knee-arthroplasty-in-varus-knees
#9
Tadashi Tsukeoka, Yoshikazu Tsuneizumi
PURPOSE: Although soft tissue balancing is considered important for successful total knee arthroplasty (TKA), it is unclear whether the laxity and balance achieved intraoperatively change postoperatively. A recent study demonstrated anaesthesia significantly influenced knee joint laxity after TKA; however, there has been no comparison of the varus-valgus laxity immediately after TKA and in the postoperative period under the same anesthetic conditions. Therefore, quantitative stress arthrometric studies were conducted under identical conditions to identify changes in coronal ligament laxity after TKA spontaneously...
May 4, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29725506/comparison-of-adductor-canal-block-versus-local-infiltration-analgesia-on-postoperative-pain-and-functional-outcome-after-total-knee-arthroplasty-a-randomized-controlled-trial
#10
W Kampitak, A Tanavalee, S Ngarmukos, C Amarase, B Songthamwat, A Boonshua
Introduction: Total knee arthroplasty (TKA) is associated with intense postoperative pain for which effective analgesia is essential to facilitate early postoperative recovery. Adductor canal block (ACB) and local infiltration analgesia (LIA) have become increasingly involved in postoperative pain management after TKA. We aimed to compare their efficacy and outcomes in patients undergoing TKA. Materials and Methods: Sixty patients undergoing unilateral TKA were randomized to receive either postoperative single-injection ACB (Group A) or LIA (Group L) during the operation...
March 2018: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29723241/intra-operative-cerebrospinal-fluid-sampling-versus-post-operative-lumbar-puncture-for-detection-of-leptomeningeal-disease-in-malignant-paediatric-brain-tumours
#11
Sharon Y Y Low, Chen Min Wei, Kenneth T E Chang, Chan Yiong Huak, Ng Lee Ping, Seow Wan Tew, David C Y Low
INTRODUCTION: Leptomeningeal disease is a feared sequelae of malignant paediatric brain tumours. Current methods for its detection is the combined use of cranio-spinal MRI, and CSF cytology from a post-operative lumbar puncture. In this study, the authors hypothesize that CSF taken at the start of surgery, either from an external ventricular drain or neuroendoscope will have equal sensitivity for positive tumour cells, in comparison to lumbar puncture. Secondary hypotheses include positive correlation between CSF cytology and MRI findings of LMD...
2018: PloS One
https://www.readbyqxmd.com/read/29720753/comparison-of-landmark-versus-pre-procedural-ultrasonography-assisted-midline-approach-for-identification-of-subarachnoid-space-in-elective-caesarean-section-a-randomised-controlled-trial
#12
Sangeeta Dhanger, Stalin Vinayagam, Bhavani Vaidhyanathan, Idhuyya Joseph Rajesh, Debendra Kumar Tripathy
Background and Aims: Identification of subarachnoid space in pregnant patients can pose a great challenge to anaesthesiologists. This study was designed to compare conventional landmark technique with pre-procedural ultrasonography-assisted midline approach for identification of the subarachnoid space in elective caesarean section. Methods: After institute ethics committee approval and written informed consent, 100 parturients scheduled for elective caesarean section under spinal anaesthesia were included in this prospective randomised control trial and divided into Group L ( n = 50) (landmark technique) and Group U ( n = 50) (ultrasound-guided technique)...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29709077/use-of-platelet-transfusions-prior-to-lumbar-punctures-or-epidural-anaesthesia-for-the-prevention-of-complications-in-people-with-thrombocytopenia
#13
REVIEW
Lise J Estcourt, Reem Malouf, Sally Hopewell, Carolyn Doree, Joost Van Veen
BACKGROUND: People with a low platelet count (thrombocytopenia) often require lumbar punctures or an epidural anaesthetic. Lumbar punctures can be diagnostic (haematological malignancies, subarachnoid haematoma, meningitis) or therapeutic (spinal anaesthetic, administration of chemotherapy). Epidural catheters are placed for administration of epidural anaesthetic. Current practice in many countries is to correct thrombocytopenia with platelet transfusions prior to lumbar punctures and epidural anaesthesia, in order to mitigate the risk of serious procedure-related bleeding...
April 30, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29662278/comparison-of-efficacy-of-bupivacaine-with-dexmedetomidine-versus-bupivacaine-alone-for-transversus-abdominis-plane-block-for-post-operative-analgesia-in-patients-undergoing-elective-caesarean-section
#14
A Ramya Parameswari, Prabha Udayakumar
Background: Increasing rate of Caesarean sections and inadequate pain relief following Caesarean section is seen in almost all parts of the world. Transversus abdominis plane block is gaining popularity as a part of multimodal analgesia for post-operative pain relief following abdominal surgeries. Aim: To compare bupivacaine and bupivacaine with dexmedetomidine in transversus abdominis plane block for pain relief after Caesarean section. Method: American Society of Anaesthesiologists I and II parturients with no comorbidities admitted for elective Caesarean section were included in the study...
April 2018: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/29661417/postoperative-delirium-in-total-knee-and-hip-arthroplasty-patients-a-study-of-perioperative-modifiable-risk-factors
#15
S M Weinstein, L Poultsides, L R Baaklini, E E Mörwald, C Cozowicz, J N Saleh, M B Arrington, J Poeran, N Zubizarreta, S G Memtsoudis
BACKGROUND: Postoperative delirium continues to pose major clinical difficulties. While unmodifiable factors (e.g. age and comorbidity burden) are commonly studied risk factors for delirium, the role of modifiable factors, such as anaesthesia type and commonly used perioperative medications, remains understudied. This study aims to evaluate the role of modifiable factors for delirium after hip and knee arthroplasties. METHODS: We performed a retrospective study of 41 766 patients who underwent hip or knee arthroplasties between 2005 and 2014 at a single institution...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29644037/obstructive-hydrocephalus-secondary-to-odontoid-pannus-case-report-and-review-of-literature
#16
Wai Cheong Soon, Gopiga Thanabalasundaram, Kyaw Zayar Thant, Ebere Sunny Ogbonnaya, Stuart Edward Harrisson
Odontoid pannus or periodontoid pseudotumour is associated with a variety of rheumatological conditions. We report a case of an 80-year old man who presented with acute hydrocephalus following an emergency operation to amputate his infected left big toe. Imaging revealed a large tissue mass causing severe compression at the cervico-medullary junction and obstruction of CSF flow. The acute hydrocephalus was presumed to be related to neck manoeuvring during general anaesthesia. Following an initial emergency CSF diversion through external ventricular drainage catheter insertion, the patient subsequently underwent ventriculo-peritoneal insertion and posterior spinal decompression and fixation...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29627630/awake-intradural-spinal-tumour-resection
#17
Anan Shtaya, Chan Bao Luong, Erlick Pereira
BACKGROUND: Meningioma is a common slow growing spinal tumour with a predilection for intradural occurrence. Patients usually present with pain followed by ataxia and sensory and sphincter problems. The gold standard treatment in these cases is gross total microsurgical resection under general anaesthesia. However, there exist high anaesthetic risk patients unsuitable for general anaesthesia. Performing spinal surgeries under local anaesthesia and sedation has been reported albeit rarely for mostly minimally invasive procedures but not for open intradural pathologies...
April 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29623224/spinal-anaesthesia-for-cesarean-section-in-a-patient-with-vascular-type-ehlers-danlos-syndrome
#18
Jeffrey M Carness, Mark J Lenart
We report the administration of spinal anaesthesia for cesarean delivery in a parturient with vascular Ehlers-Danlos syndrome. Parturients who genetically inherit this disorder are at risk for significant morbidity and mortality. Risks during pregnancy include premature labor, uterine prolapse, and uterine rupture. Additionally, such laboring parturients are at increased risk of hemodynamic volatility, vascular stress, and severe postpartum hemorrhage. Instrumented delivery and cesarean delivery bring additional risks...
2018: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/29620988/a-simple-guide-to-regional-anaesthesia
#19
E M Valsamis, S Wade, C Thornhill, C Carey, D Ricketts
Regional anaesthesia is widely used in modern anaesthetic practice for perioperative and postoperative analgesia. In the operating theatre, regional anaesthesia is used both on its own and in combination with other techniques (general anaesthesia and sedation). Regional anaesthesia is now a core skill set in anaesthetic training. This article provides a basic outline of regional anaesthesia for surgeons and other non-anaesthetic staff working with anaesthetists, reviewing preparation, consent, basic and specialist equipment, central neuraxial blocks (spinal, epidural and caudal), trunk blocks, upper limb blocks (interscalene, supraclavicular, infraclavicular and axillary) and lower limb blocks (femoral, fascia iliaca, sciatic, popliteal and ankle)...
April 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29578248/incidence-and-related-factors-for-intraoperative-failed-spinal-anaesthesia-for-lower-limb-arthroplasty
#20
E K Aasvang, M B Laursen, J Madsen, M Krøigaard, S Solgaard, P Kjaersgaard-Andersen, H Mandøe, T B Hansen, J U Nielsen, N Krarup, A E Skøtt, H Kehlet
BACKGROUND: Spinal anaesthesia is the preferred choice for total hip- and knee arthroplasty (THA/TKA), due to the claimed superior outcome profile, relative simple technique and without the need for advanced airway support. However, choosing and informing about spinal anaesthesia should also include the risk for intraoperative failed spinal anaesthesia with associated pain, discomfort and suboptimal settings for airway management. Small-scale studies suggest incidences from 1 to 17%; however, no multi-institutional large data exists on failed spinal incidence and related factors during THA/TKA, hindering evidence-based information and potential anaesthesia stratification...
March 26, 2018: Acta Anaesthesiologica Scandinavica
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