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https://www.readbyqxmd.com/read/28922230/optimal-dose-of-perineural-dexamethasone-to-prolong-analgesia-after-brachial-plexus-blockade-a-systematic-review-and-meta-analysis
#1
Kyle Robert Kirkham, Alain Jacot-Guillarmod, Eric Albrecht
BACKGROUND: Perineural dexamethasone has gained popularity in regional anesthesia to prolong analgesia duration. However, uncertainty remains regarding the optimal perineural dose. Clarification of this characteristic is of significant importance as the administration of dexamethasone may lead to dose-dependent complications. The objective of this meta-analysis was to define the optimal perineural dexamethasone dose to prolong analgesia after brachial plexus blockade for adult patients undergoing upper limb surgery...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28919813/a-prospective-double-blinded-randomized-comparison-of-ultrasound-guided-femoral-nerve-block-with-lateral-femoral-cutaneous-nerve-block-versus-standard-anesthetic-management-for-pain-control-during-and-after-traumatic-femur-fracture-repair-in-the-pediatric-population
#2
Nicole M Elsey, Joseph D Tobias, Kevin E Klingele, Ralph J Beltran, Tarun Bhalla, David Martin, Giorgio Veneziano, Julie Rice, Dmitry Tumin
BACKGROUND: Traumatic injury of the femur resulting in femoral fracture may result in significant postoperative pain. As with other causes of acute pain, regional anesthesia may offer a benefit over conventional therapy with intravenous opioids. This study prospectively assesses the effects of femoral nerve blockade with a lateral femoral cutaneous nerve block (FN-LFCN) on intraoperative anesthetic requirements, postoperative pain scores, and opioid requirements. MATERIALS AND METHODS: Seventeen pediatric patients (age 2-18 years) undergoing surgical repair of a traumatic femur fracture fulfilled the study criteria and were randomly assigned to general anesthesia with either an FN-LFCN block (n = 10) or intravenous opioids (n = 7)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28913502/regional-anesthesia-for-a-total-knee-arthroplasty-on-an-adult-patient-with-spastic-diplegia-and-an-intrathecal-baclofen-pump
#3
Elird Bojaxhi, David R Salek, Courtney E Sherman, Roy A Greengrass
We describe the clinical presentation of a patient with spastic diplegia, and its unique perioperative challenges. Opioids and antispasmodic medications are the primary therapy for managing pain and spasticity in the perioperative setting. However, such combination results in several side-effects and their sedative properties are synergistic. A 64-year-old woman with a history of spastic diplegia and an intrathecal baclofen pump for the treatment of her lower extremity spasticity was scheduled for a third elective left knee arthroplasty...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28879339/double-versus-single-cartridge-of-4-articaine-infiltration-into-the-retro-molar-area-for-lower-third-molar-surgery
#4
Kamonpun Sawang, Teeranut Chaiyasamut, Sirichai Kiattavornchareon, Verasak Pairuchvej, Bishwa Prakash Bhattarai, Natthamet Wongsirichat
BACKGROUND: There are no studies regarding 4% articaine infiltration injection into the retro-molar area for an impacted lower third molar (LITM) surgery. This study aimed to evaluate the efficacy of infiltration using 1.7 ml (single cartridge: SC) of 4% articaine versus 3.4 ml (double cartridges: DC) of 4% articaine with 1:100,000 epinephrine in LITM surgery. METHOD: This study involved 30 healthy patients with symmetrical LITM. The patients were assigned to receive either a DC or SC of 4% articaine with 1:100,000 epinephrine as a local anesthetic for each operation...
June 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28878918/development-of-harlequin-syndrome-following-placement-of-thoracic-epidural-anesthesia-in-a-pediatric-patient-undergoing-nuss-procedure
#5
Ashley Lefevre, Gregory Schnepper
We report the development of Harlequin Syndrome following thoracic epidural placement in a pediatric patient. Unilateral facial flushing with contralateral pallor and anhidrosis is the clinical presentation. This syndrome is typically benign. When related to regional anesthesia, treatment involves reducing the local anesthetic infusion or stopping it altogether.
September 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28878632/the-influence-of-regional-distribution-and-pharmacologic-specificity-of-gabaar-subtype-expression-on-anesthesia-and-emergence
#6
REVIEW
Iris Speigel, Edyta K Bichler, Paul S García
Anesthetics produce unconsciousness by modulating ion channels that control neuronal excitability. Research has shown that specific GABAA receptor (GABAAR) subtypes in particular regions of the central nervous system contribute to different hyperpolarizing conductances, and behaviorally to distinct components of the anesthetized state. The expression of these receptors on the neuron cell surface, and thus the strength of inhibitory neurotransmission, is dynamically regulated by intracellular trafficking mechanisms...
2017: Frontiers in Systems Neuroscience
https://www.readbyqxmd.com/read/28867151/-axillary-local-anesthetic-spread-after-the-thoracic-interfacial-ultrasound-block-a-cadaveric-and-radiological-evaluation
#7
Patricia Alfaro de la Torre, Jerry Wayne Jones, Servando López Álvarez, Paula Diéguez Garcia, Francisco Javier Garcia de Miguel, Eva Maria Monzon Rubio, Federico Carol Boeris, Monir Kabiri Sacramento, Osmany Duany, Mario Fajardo Pérez, Borja de la Quintana Gordon
BACKGROUND: Oral opioid analgesics have been used for management of peri- and postoperative analgesia in patients undergoing axillary dissection. The axillary region is a difficult zone to block and does not have a specific regional anesthesia technique published that offers its adequate blockade. METHODS: After institutional review board approval, anatomic and radiological studies were conducted to determine the deposition and spread of methylene blue and local anesthetic injected respectively into the axilla via the thoracic inter-fascial plane...
August 31, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28860857/preventing-nausea-and-vomiting-in-women-undergoing-regional-anesthesia-for-cesarean-section-challenges-and-solutions
#8
REVIEW
Yvonne Jelting, Christian Klein, Thomas Harlander, Leopold Eberhart, Norbert Roewer, Peter Kranke
BACKGROUND: Intraoperative nausea and vomiting (IONV) or postoperative nausea and vomiting (PONV) affecting women undergoing regional anesthesia for cesarean section is an important clinical problem since these techniques are used widely. There are burdens of literature about IONV/PONV and several in parturient and cesarean. However, it needs more attention. The underlying mechanisms of IONV and PONV in the obstetrical setting mainly include hypotension due to sympathicolysis during neuraxial anesthesia, bradycardia owing to an increased vagal tone, the visceral stimulation via the surgical procedure and intravenously administered opioids...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28852014/anesthetic-alterations-of-collective-terahertz-oscillations-in-tubulin-correlate-with-clinical-potency-implications-for-anesthetic-action-and-post-operative-cognitive-dysfunction
#9
Travis J A Craddock, Philip Kurian, Jordane Preto, Kamlesh Sahu, Stuart R Hameroff, Mariusz Klobukowski, Jack A Tuszynski
Anesthesia blocks consciousness and memory while sparing non-conscious brain activities. While the exact mechanisms of anesthetic action are unknown, the Meyer-Overton correlation provides a link between anesthetic potency and solubility in a lipid-like, non-polar medium. Anesthetic action is also related to an anesthetic's hydrophobicity, permanent dipole, and polarizability, and is accepted to occur in lipid-like, non-polar regions within brain proteins. Generally the protein target for anesthetics is assumed to be neuronal membrane receptors and ion channels, however new evidence points to critical effects on intra-neuronal microtubules, a target of interest due to their potential role in post-operative cognitive dysfunction (POCD)...
August 29, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28837436/are-anesthesia-and-surgery-during-infancy-associated-with-decreased-white-matter-integrity-and-volume-during-childhood
#10
Robert I Block, Vincent A Magnotta, Emine O Bayman, James Y Choi, Joss J Thomas, Karolie K Kimble
BACKGROUND: Anesthetics have neurotoxic effects in neonatal animals. Relevant human evidence is limited. We sought such evidence in a structural neuroimaging study. METHODS: Two groups of children underwent structural magnetic resonance imaging: patients who, during infancy, had one of four operations commonly performed in otherwise healthy children and comparable, nonexposed control subjects. Total and regional brain tissue composition and volume, as well as regional indicators of white matter integrity (fractional anisotropy and mean diffusivity), were analyzed...
August 24, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28832894/ultrasound-guided-regional-blockade-for-lipoma-excision-a-new-approach-to-an-old-technique
#11
T F Tammam, G A Kamhawy
BACKGROUND: Local anesthesia for lipoma excision can be feasible with anesthetic injection in the fascial plane between the lipoma and the surrounding soft tissues under real-time ultrasonography [ultrasound- guided lipoma plane (ULP) block]. The advantage of targeting a single anesthetic injection plane under ultrasound guidance may allow for technically easier block placement and long-term analgesic effects. METHODS: Forty-eight patients were randomly assigned to receive ULP block, group A (n = 24) or traditional block, group B (n = 24)...
August 22, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28829665/effect-of-local-ropivacaine-on-hemodynamic-responses-in-craniotomy-patients
#12
Sepideh Vahabi, Siavash Beiranvand
BACKGROUND: Increased intracranial pressure (ICP) with hemodynamic is of major concern to anesthesiologists and surgeons in craniotomy surgery. Thus, the management of hemodynamic stability is essential in neuro-anesthesia. This study was performed to investigate the effect of local infiltration of 0.5% ropivacaine on hemodynamic responses in craniotomy patients. MATERIAL AND METHODS: 64 ASA class I -II patients, scheduled for elective craniotomies, were enrolled in this prospective randomized double blind placebo controlled study...
August 22, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28814096/ankle-block-vs-single-shot-popliteal-fossa-block-as-primary-anesthesia-for-forefoot-operative-procedures-prospective-randomized-comparison
#13
Oliver N Schipper, Kenneth J Hunt, Robert B Anderson, W Hodges Davis, Carroll P Jones, Bruce E Cohen
BACKGROUND: Postoperative pain is often difficult to control with oral medications, requiring large doses of opioid analgesia. Regional anesthesia may be used for primary anesthesia, reducing the need for general anesthetic and postoperative pain medication requirements in the immediate postoperative period. The purpose of this study was to compare the analgesic effects of an ankle block (AB) to a single-shot popliteal fossa block (PFB) for patients undergoing orthopedic forefoot procedures...
August 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28800992/new-approaches-to-airway-management-in-tracheal-resections-a-systematic-review-and-meta-analysis
#14
Mark Schieren, Andreas Böhmer, Fabian Dusse, Aris Koryllos, Frank Wappler, Jerome Defosse
OBJECTIVES: Although endotracheal intubation, surgical crossfield intubation, and jet ventilation are standard techniques for airway management in tracheal resections, there are also reports of new approaches, ranging from regional anesthesia to extracorporeal support. The objective was to outline the entire spectrum of new airway techniques. DESIGN: The literature databases PubMed/Medline and the Cochrane Library were searched systematically for prospective and retrospective trials as well as case reports on tracheal resections...
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28794581/comparison-of-general-versus-isolated-regional-anesthesia-in-total-shoulder-arthroplasty-a-retrospective-propensity-matched-cohort-analysis
#15
David Y Ding, Siddharth A Mahure, Brent Mollon, Steven D Shamah, Joseph D Zuckerman, Young W Kwon
BACKGROUND: Intraoperative anesthetic typically consists of either general anesthesia (GA) or isolated regional anesthesia (RA). METHODS: A retrospective propensity-matched cohort analysis on patients undergoing TSA was performed to determine differences between GA and RA in regard to patient population, complications, LOS and hospital readmission. RESULTS: 4158 patients underwent TSA with GA or isolated RA. Propensity-matching resulted in 912 patients in each cohort...
December 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28742435/the-role-of-transversus-abdominis-plane-blocks-in-enhanced-recovery-after-surgery-pathways-for-open-and-laparoscopic-colorectal-surgery
#16
Alexander J Kim, Robert Jason Yong, Richard D Urman
INTRODUCTION: The concepts of Enhanced Recovery After Surgery (ERAS(®)) have steadily increased in usage, with benefits in patient outcomes and hospital length of stay. One important component of successful implementation of ERAS protocol is optimized pain control, via the multimodal approach, which includes neuraxial or regional anesthesia techniques and reduction of opioid use as the primary analgesic. Transversus abdominis plane (TAP) block is one such regional anesthesia technique, and it has been widely studied in abdominal surgery...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28740419/perineural-versus-intravenous-dexamethasone-as-an-adjuvant-in-regional-anesthesia-a-systematic-review-and-meta-analysis
#17
REVIEW
Wen-Ling Zhao, Xiao-Feng Ou, Jin Liu, Wen-Sheng Zhang
BACKGROUND: Dexamethasone is a common adjuvant for local anesthetics in regional anesthesia, but the optimal route of administration is controversial. Therefore, we did a systematic review and meta-analysis of randomized controlled trials to assess the effect of perineural versus intravenous dexamethasone on local anesthetic regional nerve-blockade outcomes. MATERIALS AND METHODS: Medline (through PubMed), Embase, Cochrane, Web of Science, and Biosis Previews databases were systematically searched (published from inception of each database to January 1, 2017) to identify randomized controlled trials...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28739038/anesthetic-and-perioperative-management-of-patients-with-brugada-syndrome
#18
REVIEW
Gregory Dendramis, Claudia Paleologo, Giuseppe Sgarito, Umberto Giordano, Roberto Verlato, Adrian Baranchuk, Pedro Brugada
Brugada syndrome (BrS) is an arrhythmogenic disease reported to be one among the leading causes of cardiac death in subjects under the age of 40 years. In these patients, episodes of lethal arrhythmias may be induced by several factors or situations, and for this reason, management during anesthesia and surgery must provide some precautions and drugs restrictions. To date, it is difficult to formulate guidelines for anesthetic management of patients with BrS because of the absence of prospective studies, and there is not a definite recommendation for neither general nor regional anesthesia, and there are no large studies in merit...
September 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28727704/evaluating-the-adjuvant-effect-of-dexamethasone-to-ropivacaine-in-transversus-abdominis-plane-block-for-inguinal-hernia-repair-and-spermatocelectomy-a-randomized-controlled-trial
#19
Robert Wegner, Duane Akwar, Sarah Guzman-Reyes, Greesha Pednekar, Rabail Chaudhry, Navneet Grewal, Naveen Kukreja, Omar L Mancillas, George W Williams, Omonele Nwokolo
BACKGROUND: The transversus abdominis plane (TAP) block is a relatively straightforward regional technique used for postoperative analgesia in patients undergoing abdominal surgeries. Various adjuvants have been used in past to prolong the duration of action of analgesia in peripheral nerve blocks. Several studies investigating the analgesic efficacy of dexamethasone added to local anesthetic agents, such as bupivacaine, have shown promising results. However, there are few studies comparing the efficacy of dexamethasone with ropivacaine...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727314/transperitoneal-rectus-sheath-block-and-transversus-abdominis-plane-block-for-laparoscopic-inguinal-hernia-repair-a-novel-approach
#20
Jun Nagata, Jun Watanabe, Masato Nagata, Yusuke Sawatsubashi, Masaki Akiyama, Takehide Tajima, Koichi Arase, Noritaka Minagawa, Takayuki Torigoe, Yoshifumi Nakayama, Reiko Horishita, Kentaro Kida, Kotaro Hamada, Keiji Hirata
INTRODUCTION: A laparoscopic approach for inguinal hernia repair is now considered the gold standard. Laparoscopic surgery is associated with a significant reduction in postoperative pain. Epidural analgesia cannot be used in patients with perioperative anticoagulant therapy because of complications such as epidural hematoma. As such, regional anesthetic techniques, such as ultrasound-guided rectus sheath block and transversus abdominis plane block, have become increasingly popular. However, even these anesthetic techniques have potential complications, such as rectus sheath hematoma, if vessels are damaged...
August 2017: Asian Journal of Endoscopic Surgery
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