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https://www.readbyqxmd.com/read/27913981/the-challenges-of-anaesthesia-and-pain-relief-in-hip-fracture-care
#1
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...
December 3, 2016: 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
#2
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...
November 30, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27892594/chloroprocaine-10-mg-ml-for-low-dose-spinal-anaesthesia-in-perianal-surgery-a-randomised-dose-finding-study
#3
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...
November 28, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27891425/estimation-of-skin-to-subarachnoid-space-depth-an-observational-study
#4
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
https://www.readbyqxmd.com/read/27891405/complete-heart-block-in-pregnancy-a-report-of-emergency-caesarean-section-in-a-parturient-without-pacemaker
#5
Vandana Mohapatra, Aparajita Panda, Satyanarayan Behera, Jagadish Chandra Behera
Management of women with Complete Heart Block (CHB) presenting without pacing, during pregnancy and labour is debatable. Temporary pacemakers have been routinely inserted for labour and birth probably to withstand any haemodynamic variations. However, due to lack of large scale prospective studies, the necessity of this procedure has not been objectively assessed. Also, the most appropriate anaesthetic technique for caesarean section in women with CHB is yet to be clarified. We report herein the case of a pregnant woman with CHB who had uneventful emergency caesarean delivery under spinal anaesthesia without temporary pacing...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27885290/effectiveness-of-spinal-anaesthesia-versus-general-anaesthesia-for-open-cholecystectomy
#6
R B Kuju, Y Dongol, R Verma
BACKGROUND: Cholecystectomy is performed either as an open or a laparascopic route. Despite of a number of peri-operative and post-operative benefits of laparascopic cholecystectomy, the traditional and invasive open cholecystectomy is still in frequent practice for various reasons. Though general anaesthesia is regarded as the gold standard anaesthetic technique, alternatives to it such as spinal anaesthesia, with its advantages, outweighs general anaesthesia. Spinal anaesthesia, therefore, could be a safe and effective anaesthetic procedure over general anaesthesia for open cholecystectomy...
May 2016: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/27860187/autophagy-activated-by-tuberin-mtor-p70s6k-suppression-is-a-protective-mechanism-against-local-anaesthetics-neurotoxicity
#7
Jingwei Xiong, Qiuyue Kong, Leyang Dai, He Ma, Xiaofei Cao, Li Liu, Zhengnian Ding
The local anaesthetics (LAs) are widely used for peripheral nerve blocks, epidural anaesthesia, spinal anaesthesia and pain management. However, exposure to LAs for long duration or at high dosage can provoke potential neuronal damages. Autophagy is an intracellular bulk degradation process for proteins and organelles. However, both the effects of LAs on autophagy in neuronal cells and the effects of autophagy on LAs neurotoxicity are not clear. To answer these questions, both lipid LAs (procaine and tetracaine) and amide LAs (bupivacaine, lidocaine and ropivacaine) were administrated to human neuroblastoma SH-SY5Y cells...
November 15, 2016: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/27858389/clinical-outcomes-of-patients-over-75-years-of-age-with-degenerative-spondylolisthesis-following-bilateral-decompression-via-a-unilateral-approach
#8
Mustafa Ilik, Mustafa Golen, Faik Ilik, Ilker Çöven, Yıldıray Dal
AIM: The purpose of this study was to investigate the clinical outcomes of bilateral decompression via a unilateral approach (BDUA) on degenerative spondylolisthesis with spinal stenosis in patients over 75 years of age. MATERIAL AND METHODS: Elderly patients (n = 41; average age 79.3 ± 2.5 years) who received BDUA under spinal anaesthesia between April 2011 and May 2014 were enrolled. Visual Analogue Scale (VAS) scores and Oswestry Disability Index (ODI) values were evaluated preoperatively and at the last visit postoperatively (median follow-up period, 22 month; mean follow-up period, 27 month)...
October 14, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27852723/regional-versus-general-anesthesia-for-promoting-independence-after-hip-fracture-regain-protocol-for-a-pragmatic-international-multicentre-trial
#9
Mark D Neuman, Susan S Ellenberg, Frederick E Sieber, Jay S Magaziner, Rui Feng, Jeffrey L Carson
INTRODUCTION: Hip fractures occur 1.6 million times each year worldwide, with substantial associated mortality and losses of independence. At present, anaesthesia care for hip fracture surgery varies widely within and between countries, with general anaesthesia and spinal anaesthesia representing the 2 most common approaches. Limited randomised evidence exists regarding potential short-term or long-term differences in outcomes between patients receiving spinal or general anaesthesia for hip fracture surgery...
November 15, 2016: BMJ Open
https://www.readbyqxmd.com/read/27852462/ryszard-rodzinski-a-forgotten-polish-inventor-and-pioneer-of-combined-spinal-epidural-anesthesia
#10
REVIEW
Andrzej R Daszkiewicz, Maja M Copik, Hanna D Misiolek, Wojciech Z Reiss
Dr. Ryszard Rodzinski was a Polish surgeon who, in spite of his short life, had a productive career. His most important discovery was a safer method of performing regional anesthesia for abdominal surgery. The first description of combined spinal epidural anesthesia is generally attributed to Soresi in 1937. In the early 20th century, Rodzinski invented a novel technique, "combined lumbosacral anesthesia," which combined lumbar spinal anesthesia and sacral epidural anesthesia. During the 19th Meeting of Polish Surgeons in July 1922 in Warsaw, Rodzinski presented an article entitled "On Combined Lumbosacral Anaesthesia," in which he described this technique used in surgical clinic in Lwów since October 1921...
October 2016: Journal of Anesthesia History
https://www.readbyqxmd.com/read/27833291/a-case-report-of-acampomelic-campomelic-dysplasia-and-operative-difficulties-in-cleft-palate-reconstruction
#11
M Pasupathy, Vasant Radhakrishnan, Hirji Sorab Adenwalla, Puthucode V Narayanan
Acampomelic campomelic dysplasia (CD) is a type of CD (CD; OMIM #114290), a rare form of congenital short-limbed dwarfism and is due to mutations in SOX9 gene family. Characteristic phenotypes of CD include bowing of the lower limbs, a narrow thoracic cage, 11 pairs of ribs, hypoplastic scapulae, macrocephaly, flattened supraorbital ridges and nasal bridge, cleft palate and micrognathia. The bending of the long bones is not an obligatory feature and is absent in about 10% of cases, referred to as acampomelic CD...
May 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/27818815/leiomyoma-of-the-vulva-a-diagnostic-challenge-case-report
#12
Saad Kurdi, Abdullah S Arafat, Maysan Almegbel, Mayson Aladham
Uterine leiomyomas are common and can affect up to 30% of women older than 35 years. Despite this, leiomyomas of the vulva are rare, masquerading, and usually misdiagnosed as Bartholin cyst preoperatively. These smooth muscle tumors are typically painless, solitary, and well circumscribed and can affect female of any age group. We present a case of a 46-year-old female that presented to the clinic with 2-year history of right labial mass and was diagnosed as Bartholin cyst initially. The patient underwent elective excision under spinal anaesthesia and the mass was removed...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27801748/a-severe-complication-after-ultrasound-guided-thoracic-paravertebral-block-for-breast-cancer-surgery-total-spinal-anaesthesia-a-case-report
#13
Aline Albi-Feldzer, Baptiste Duceau, Williams Nguessom, Christian Jayr
No abstract text is available yet for this article.
December 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27797093/a-comparison-of-selective-and-conventional-spinal-anaesthesia-for-ambulatory-surgery
#14
Andrzej Daszkiewicz, Andrzej Janik, Magdalena Śliwczyńska, Jacek Karpe, Hanna Misiołek
BACKGROUND: Selective spinal anaesthesia is the practice of employing minimal doses of intrathecal agents so that only the nerve roots supplying a specific area and only the modalities that require to be anaesthetised are affected. The study is based on the hypothesis that small dose lidocaine spinal anaesthesia may be adequate for elective surgical procedures, providing limited motor and sensory block, and thus enabling earlier patient's discharge. The aim of this study was the comparison of the low and the conventional dose of lidocaine spinal anaesthesia discharge time...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27791240/feasibility-of-day-case-total-hip-arthroplasty-a-single-centre-observational-study
#15
Jens Rolighed Larsen, Birgitte Skovgaard, Thomas Prynø, Laimonas Bendikas, Lone R Mikkelsen, Malene Laursen, Mette T Høybye, Søren Mikkelsen, Lene Bastrup Jørgensen
INTRODUCTION: Recent reports indicate that total hip arthroplasty (THA) can be further accelerated and might be managed as day-case. This could provide benefits to health care expenditure, lower patient risks and change patient satisfaction. We evaluated the feasibility, efficacy, safety and patient satisfaction of same-day (<12 hours) THA operation and discharge. METHODS: Consecutive patients were screened for eligibility (primary THA, ASA 1 or 2 physical status) and the presence of a support person to follow the patient for 48 hours postoperatively in an observational study...
October 24, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27790556/efficacy-of-sciatic-nerve-block-for-pain-management-in-below-knee-orthopaedic-surgery
#16
Subhadra Arun Sinha, Sandeep Champalal Mutha, Deepak Sadashiv Phalgune
INTRODUCTION: Perioperative pain management is an integral part of anaesthesia and patients are most satisfied if there is minimal or no pain after surgery. Sciatic nerve block provides postoperative pain relief after below knee surgery and knee surgery. Many studies with different approaches for sciatic nerve block have been conducted to demonstrate the efficacy of sciatic nerve block with different local anaesthetic drugs over the past decade. AIM: To study the efficacy of single-shot sciatic nerve block for postoperative pain management in below knee orthopaedic surgery...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27785357/perioperative-regional-anaesthesia-and-postoperative-longer-term-outcomes
#17
REVIEW
Jan Jakobsson, Mark Z Johnson
Regional anaesthesia provides effective anaesthesia and analgesia in the perioperative setting. Central neuraxial blocks-that is, spinal and epidural blocks-are well established as an alternative or adjunct to general anaesthesia. Peripheral blocks may be used as part of multimodal anaesthesia/analgesia in perioperative practice, reducing the need for opioid analgesics and enhancing early recovery. Furthermore, regional anaesthesia has increased in popularity and may be done with improved ease and safety with the introduction of ultrasound-guided techniques...
2016: F1000Research
https://www.readbyqxmd.com/read/27770448/impact-of-spinal-anaesthesia-vs-general-anaesthesia-on-peri-operative-outcome-in-lumbar-spine-surgery-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#18
T Meng, Z Zhong, L Meng
Lumbar spinal surgery is most commonly performed under general anaesthesia. However, spinal anaesthesia has also been used. We aimed to systematically review the comparative evidence. We only included randomised, controlled trials in this meta-analysis and calculated the risk ratio or standardised mean difference for haemodynamics, blood loss, surgical time, analgesic requirement, nausea and/or vomiting, and length of hospital stay. Eight studies with a total of 625 patients were included. These were considered to be at high risk of bias...
October 22, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27766904/intraspinal-hypotension-syndrome-presents-as-transient-quadriplegia
#19
Miki Katzir, Svetlana Tov, Ayelet Eran, Gill E Sviri
Intracranial hypotension can be a complication of epidural anaesthesia. Pure clinical spinal hypotension manifesting as acute transient quadriplegia following epidural anaesthesia is a severe, life-threatening complication that have not been described before. This complication can be solved with an epidural blood patch; thus, it should be familiar to doctors across all specialities.
October 21, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27762521/conus-medullaris-injury-following-spinal-anaesthesia
#20
K Mugundhan, Rajesh Shankar Iyer
No abstract text is available yet for this article.
September 2016: Journal of the Association of Physicians of India
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