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https://www.readbyqxmd.com/read/28184358/vertical-patellar-dislocation-reduction-by-the-push-up-and-rotate-method-a-case-report-and-literature-review
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28007520/spinal-anaesthesia-in-outpatient-and-conventional-surgery-a-point-of-view-from-experienced-french-anaesthetists
#10
Régis Fuzier, Christophe Aveline, Paul Zetlaoui, Olivier Choquet, Hervé Bouaziz
INTRODUCTION: The objective of this investigation was to evaluate the practice of spinal anaesthesia among French anaesthetists in inpatient and outpatient settings. METHODS AND MATERIALS: A questionnaire was sent to members of the French Association of Anaesthetists involved in regional anaesthesia during the first 4 months of 2015. The questionnaire included items on the practice of spinal anaesthesia (type of needle, local anaesthetic available, puncture and disinfection techniques, etc...
December 19, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28003695/anaesthesia-for-foetoscopic-laser-ablation-a-retrospective-study
#11
Vaishali Kumbhar, M Radhika, Parameswara Gundappa, Jayashree Simha, Prathima Radhakrishnan
BACKGROUND AND AIMS: Twin pregnancy with monochorionic placenta may be associated with arteriovenous vascular anastomosis of the placental vessels resulting in twin-to-twin transfusion syndrome (TTTS) and twin reversed arterial perfusion syndrome (TRAP). Foetoscopic LASER ablation (FLA) is the treatment of choice in reducing foetal mortality related to this. METHODS: A retrospective review of medical records of 41 FLA procedures for TTTS and TRAP were analysed for anaesthetic management...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27982554/regional-anaesthesia-and-antithrombotic-agents-instructions-for-use
#12
Gennaro Scibelli, Lucia Maio, Gennaro Savoia
BACKGROUND: The use of anticoagulant agents represents a serious limitation of regional anesthesia, due to the risk of spinal hematoma. Examining all the principles currently available, it has been possible to notice that published guidelines are very often incomplete or also differ significantly on the rules to be followed relating to a specific drug. METHODS: We have carried out a comparison between the guidelines of major scientific societies in order to take a practical and simple user guide which operators can consult...
December 16, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27981932/g6pd-deficiency-with-arnold-chiari-malformation
#13
Shilpi Verma, Pradeep Kumar Bhatia, Vandana Sharma, Priyanka Sethi, Yogendra Raj Singh
A neonate with glucose-6-phosphate dehydrogenase (G6PD) deficiency and Arnold-Chiari Malformation (ACM) type 2 underwent lumbar meningomyelocele (MMC) repair. Patients with G6PD deficiency are prone to develop haemolysis following any kind of oxidative stress and in ACM, there is a disturbed cranio-spinal pressure relationship. The neonate was managed under general anaesthesia with propofol for induction as well as for maintenance along with fentanyl and oxygen-nitrous mixture.
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/27977073/preoperative-sleep-quality-predicts-postoperative-pain-after-planned-caesarean-delivery
#14
S Orbach-Zinger, S Fireman, A Ben-Haroush, T Karoush, Z Klein, N Mazarib, A Artyukh, R Chen, A Ioscovich, L A Eidelman, R Landau
BACKGROUND: Severe post-caesarean pain remains an important issue associated with persistent pain and postpartum depression. Women's sleep quality prior to caesarean delivery and its influence on postoperative pain and analgesic intake have not been evaluated yet. METHODS: Women undergoing caesarean delivery with spinal anaesthesia (bupivacaine 12 mg, fentanyl 20 μg, morphine 100 μg) were evaluated preoperatively for sleep quality using the Pittsburgh Sleep Quality Index (PSQI) questionnaire (PSQI 0-5 indicating good sleep quality, PSQI 6-21 poor sleep quality)...
December 15, 2016: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/27942059/role-of-pre-operative-multimedia-video-information-in-allaying-anxiety-related-to-spinal-anaesthesia-a-randomised-controlled-trial
#15
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/27936113/preoperative-csf-melatonin-concentrations-and-the-occurrence-of-delirium-in-older-hip-fracture-patients-a-preliminary-study
#16
Rikie M Scholtens, Sophia E J A de Rooij, Annelies E Vellekoop, Bart C Vrouenraets, Barbara C van Munster
BACKGROUND: Delirium is characterized by disturbances in circadian rhythm. Melatonin regulates our circadian rhythm. Our aim was to compare preoperative cerebrospinal fluid (CSF) melatonin levels in patients with and without postoperative delirium. METHODS: Prospective cohort study with hip fracture patients ≥ 65 years who were acutely admitted to the hospital for surgical treatment and received spinal anaesthesia. CSF was collected after cannulation, before administering anaesthetics...
2016: PloS One
https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#17
Rachel Cowan, Jun Hao Lim, Terence Ong, Ashok Kumar, Opinder Sahota
The care of the older person with hip fracture is complicated by their comorbid condition, limited physiological reserve, cognitive impairment and frailty. Two aspects of hip fracture management that have received considerable attention are how best to manage the pain associated with it and the ideal mode of anaesthesia. Existing literature has reported on the suboptimal treatment of pain in this orthogeriatric cohort. With recent advancements in medical care, a number of options have emerged as alternatives to conservative systemic analgesia...
January 2017: Drugs & Aging
https://www.readbyqxmd.com/read/27900760/choice-of-anaesthesia-for-category-1-caesarean-section-in-women-with-anticipated-difficult-tracheal-intubation-the-use-of-decision-analysis
#18
A J Krom, Y Cohen, J P Miller, T Ezri, S H Halpern, Y Ginosar
A predicted difficult airway is sometimes considered a contra-indication to rapid sequence induction of general anaesthesia, even in an urgent case such as a category-1 caesarean section for fetal distress. However, formally assessing the risk is difficult because of the rarity and urgency of such cases. We have used decision analysis to quantify the time taken to establish anaesthesia, and probability of failure, of three possible anaesthetic methods, based on a systematic review of the literature. We considered rapid sequence induction of general anaesthesia with videolaryngoscopy, awake fibreoptic intubation and rapid spinal anaesthesia...
February 2017: Anaesthesia
https://www.readbyqxmd.com/read/27892594/chloroprocaine-10-mg-ml-for-low-dose-spinal-anaesthesia-in-perianal-surgery-a-randomised-dose-finding-study
#19
V Gebhardt, L Mueller-Hansen, A Schwarz, D Bussen, C Weiss, M D Schmittner
BACKGROUND: Low-dose spinal anaesthesia is a safe and reliable anaesthesia technique in outpatient perianal surgery. Regarding its short duration of action and its trend to hyperbaric characteristics, plain chloroprocaine 10 mg/ml seems to be ideal to perform low-dose spinal anaesthesia. The aim of this trial was to determine the optimal dosage of chloroprocaine for this indication. METHODS: Hundred and twenty patients undergoing perianal surgery were enrolled and randomly allocated to receive 10, 20 or 30 mg of chloroprocaine 10 mg/ml intrathecally...
February 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27891425/estimation-of-skin-to-subarachnoid-space-depth-an-observational-study
#20
Rajib Hazarika, Dipika Choudhury, Sangeeta Nath, Samit Parua
INTRODUCTION: In a patient, the skin to Subarachnoid Space Depth (SSD) varies considerably at different levels of the spinal cord. It also varies from patient to patient at the same vertebral level as per age, sex and Body Mass Index (BMI). Estimation of the skin to SSD reduces complications related to spinal anaesthesia. AIM: To measure the skin to SSD in the Indian population and to find a formula for predicting this depth. MATERIALS AND METHODS: Three hundred adult patients belonging to American Society of Anaesthesiologist class I and II, undergoing surgery using spinal anaesthesia in various surgical specialities of Gauhati Medical College were selected by systemic sampling for this prospective, observational study...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
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