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regional anesthesia anesthetized patient

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https://www.readbyqxmd.com/read/29777144/benefits-in-radical-mastectomy-protocol-a-randomized-trial-evaluating-the-use-of-regional-anesthesia
#1
Marcio Matsumoto, Eva M Flores, Pedro P Kimachi, Flavia V Gouveia, Mayra A Kuroki, Alfredo C S D Barros, Marcelo M C Sampaio, Felipe E M Andrade, João Valverde, Eduardo F Abrantes, Claudia M Simões, Rosana L Pagano, Raquel C R Martinez
Surgery is the first-line treatment for early, localized, or operable breast cancer. Regional anesthesia during mastectomy may offer the prevention of postoperative pain. One potential protocol is the combination of serratus anterior plane block (SAM block) with pectoral nerve block I (PECS I), but the results and potential benefits are limited. Our study compared general anesthesia with or without SAM block + PECS I during radical mastectomy with axillary node dissection and breast reconstruction using evaluations of pain, opioid consumption, side effects and serum levels of interleukin (IL)-1beta, IL-6 and IL-10...
May 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29733751/sacrospinous-ligament-fixation-under-local-anesthesia-in-elderly-patients-at-high-risk-of-general-anesthesia
#2
Mehmet Baki Senturk, Ozan Doğan
INTRODUCTION AND HYPOTHESIS: Sacrospinous ligament fixation(SSLF) is a commonly used surgical procedure in pelvic organ prolapse due to high treatment success rates. Many intraoperative and postoperative anesthesia-related obstacles may be encountered by the elderly population. Local anesthesia alone or with intravenous sedation may provide simple, cheap, and safe anesthesia. For elderly patients at high risk for general anesthesia according to the American Society of Anesthesiologists(ASA), it is better to operate through the vaginal route under local anesthesia...
May 7, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29717414/primary-central-sleep-apnea-and-anesthesia-a-retrospective-case-series
#3
Alexandru Alexa, Meghna P Mansukhani, Bhargavi Gali, Atousa Deljou, Juraj Sprung, Toby N Weingarten
PURPOSE: Primary (idiopathic) central sleep apnea (PCSA) is a rare central sleep-related breathing disorder characterized by increased chemoreceptor sensitivity to partial pressure of carbon dioxide, which manifests as hyperventilation followed by apnea during non-rapid eye movement sleep. The purpose of this retrospective study was to describe the postoperative course of patients who had PCSA and underwent procedures requiring anesthetic management. METHODS: Patients who received a diagnosis of PCSA at our institution and required procedural anesthesia between 1 January 2010 and 1 June 2016 underwent a comprehensive review of their health records with a focus on identifying respiratory complications...
May 1, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29708917/epidural-anesthesia-to-facilitate-organ-blood-flow-during-the-first-penile-transplantation-in-the-united-states-a-case-report
#4
Katarina J Ruscic, Grettel J Zamora-Berridi, Francis J McGovern, Curtis Cetrulo, Jonathan M Winograd, Kyle R Eberlin, Branko Bojovic, Dicken S Ko, T Anthony Anderson
Regional anesthesia has been used to help create local sympathectomy and improve blood flow in plastic surgery procedures involving tissue grafts and flaps. However, anesthetic techniques that reduce systemic vascular resistance must be used with caution in patients with aortic stenosis (AS). Combined neuraxial and general anesthesia with careful titration of the local anesthetic dose can be a safe approach for patients with AS undergoing microvascular procedures. We present the anesthetic management of the first North American penile transplant, on an obese patient with moderate AS...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29694305/the-use-of-local-anesthesia-to-perform-lower-limb-revascularization-in-the-fragile-patient-with-critical-limb-ischemia
#5
N Kontopodis, A Papaioannou, E Tavlas, G Papadopoulos, S Lioudaki, K Tzirakis, C V Ioannou
Patients with critical limb ischemia are usually compromised, frequently making administration of general or regional anesthesia problematic. We treated 3 fragile patients presenting contraindications to undertake traditional anesthetic techniques for lower limb revascularization, in whom local anesthesia with conscious sedation was used to complete the operation. An axillo-bifemoral, a unilateral axillo-femoral and a femoro-femoral bypass were performed. Procedure was uneventful in all three cases despite the coexistence of specific surgical challenges (distal anastomosis at the profunda in two cases, redo surgery and scarred groin in the third)...
March 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29672368/pectoral-i-block-does-not-improve-postoperative-analgesia-after-breast-cancer-surgery-a-randomized-double-blind-dual-centered-controlled-trial
#6
Jérôme Cros, Patrick Sengès, Suzan Kaprelian, Julie Desroches, Caroline Gagnon, Anaïs Labrunie, Benoît Marin, Sabrina Crépin, Nathalie Nathan, Pierre Beaulieu
BACKGROUND AND OBJECTIVES: General anesthesia for breast surgery may be supplemented by using a regional anesthetic technique. We evaluated the efficacy of the first pectoral nerve block (Pecs I) in treating postoperative pain after breast cancer surgery. METHODS: A randomized, double-blind, dual-centered, placebo-controlled trial was performed. One hundred twenty-eight patients scheduled for unilateral breast cancer surgery were recruited. A multimodal analgesic regimen and surgeon-administered local anesthetic infiltration were used for all patients...
April 18, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29643635/regional-anesthesia-is-safe-and-effective-for-lower-limb-orthopedic-surgery-in-patient-with-renal-tubular-acidosis-and-hypokalemia
#7
Indira Gurajala, Sapna Annaji Nikhar, Kavitha Jayaram, Ramachandran Gopinath
Renal tubular acidosis (RTA) with hypokalemia may precipitate acute respiratory failure and potentially fatal arrhythmias like ventricular fibrillation. Though there are random reports of respiratory failure needing mechanical ventilation and sudden death in patients with RTA and hypokalemia, the anesthetic management of these patients has not been clearly elucidated. Acidosis and hypokalemia have significant interactions with both general and local anesthetics and alter their effect substantially. Proper preoperative planning and optimization are required for the safe conduct of anesthesia in this subset of patients...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29643622/effect-of-intravenous-dexmedetomidine-administered-as-bolus-or-as-bolus-plus-infusion-on-subarachnoid-anesthesia-with-hyperbaric-bupivacaine
#8
Upadhya R Kavya, Shenoy Laxmi, Venkateswaran Ramkumar
Background: Subarachnoid anesthesia is a widely practiced regional anesthetic for infraumbilical surgeries. Intravenous dexmedetomidine is known to prolong both sensory and motor blockade when administered along with subarachnoid anesthesia. Material and Methods: Seventy-five patients scheduled to undergo elective infraumbilical surgeries under subarachnoid anesthesia were randomly allocated to one of the three groups. Group B received intravenous saline over 10 min followed by 12...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29628849/pectoralis-blocks-for-insertion-of-an-implantable-cardioverter-defibrillator-in-two-patients-with-duchenne-muscular-dystrophy
#9
Alexander B Froyshteter, Tarun Bhalla, Joseph D Tobias, Gregory S Cambier, Christopher T Mckee
Patients with Duchenne muscular dystrophy (DMD) often have systemic manifestations with comorbid involvement of the cardiac and respiratory systems that increase the risk of anesthetic and perioperative morbidity. These patients frequently develop progressive myocardial involvement with cardiomyopathy, depressed cardiac function, and arrhythmias. The latter may necessitate the placement of an automatic implantable cardioverter defibrillator (AICD) insertion. As a means of avoiding the need for general anesthesia and its inherent potential of morbidity, regional anesthesia may be used in specific cases...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628544/anesthetic-considerations-for-carotid-endarterectomy-a-postgraduate-educational-review
#10
REVIEW
Ahmed Yousef A Al Sultan, Abdulrahman Mawadh A Alsubhi
Carotid endarterectomy (CEA) has shown a significant benefit in preventing ipsilateral stroke when it is compared to conservative management. Surgical morbidity and mortality must be kept to a minimum to achieve this benefit. Neurological status of the CEA patients can be monitored easily during regional anesthesia depending on the awake testing (neurocognitive assessment) method of the CEA patients. In addition, specific parameters can help us to monitor and to predict the neurological status of the CEA patients during the procedures such as regional cerebral oxygen saturation (rSO2 ) and middle cerebral artery velocity (MCAv) changes...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29619786/comparative-study-of-levobupivacaine-and-bupivacaine-for-bilateral-maxillary-nerve-block-during-pediatric-primary-cleft-palate-surgery-a-randomized-double-blind-controlled-study
#11
Mohamed F Mostafa, Ragaa Herdan, Mohamed Elshazly
BACKGROUND: Cleft lip and palate are common major congenital anomalies. Cleft palate (CP) repair causes pain and needs large doses of intravenous opioids. The risk of postoperative airway obstruction or respiratory depression is high, requiring continuous and vigilant monitoring. The primary outcome was to evaluate the efficacy of using different local anesthetics during bilateral maxillary nerve block (MNB) with general anesthesia on quality of recovery after primary CP repair. We hypothesized that levobupivacaine would be better than bupivacaine...
April 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29602656/opioid-use-after-upper-extremity-surgery
#12
REVIEW
Erich M Gauger, Erica J Gauger, Mihir J Desai, Donald H Lee
Ever since the institution of pain as the fifth vital sign, there has been a rising opioid epidemic in the United States, with Americans now consuming 80% of the global opioid supply while representing only 5% of the world's population. Surgeons are tasked with the duty of both managing patients' pain in the perioperative period and following responsible prescribing behaviors. Several articles have been published with the goal of evaluating opioid use after upper extremity surgery, risk factors for opioid misuse/abuse, the impact of anesthetic type, and the role of multimodal pain management regimens...
March 27, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29601378/is-anesthesia-technique-associated-with-a-higher-risk-of-mortality-or-complications-within-90-days-of-surgery-for-geriatric-patients-with-hip-fractures
#13
Vimal Desai, Priscilla H Chan, Heather A Prentice, Gary L Zohman, Glenn R Diekmann, Gregory B Maletis, Brian H Fasig, Diana Diaz, Elena Chung, Chunyuan Qiu
BACKGROUND: Postoperative mortality and complications after geriatric hip fracture surgery remain high despite efforts to improve perioperative care for these patients. One factor of particular interest is anesthetic technique, but prior studies on this are limited by sample selection, competing risks, and incomplete followup. QUESTIONS/PURPOSES: (1) Among older patients undergoing surgery for hip fracture, does 90-day mortality differ depending on the type of anesthesia received? (2) Do 90-day emergency department returns and hospital readmissions differ based on anesthetic technique after geriatric hip fracture repairs? (3) Do 90-day Agency for Healthcare Research and Quality (AHRQ) outcomes differ according to anesthetic techniques used during hip fracture surgery? METHODS: We conducted a retrospective study on geriatric patients (65 years or older) with hip fractures between 2009 and 2014 using the Kaiser Permanente Hip Fracture Registry...
March 28, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29601303/the-opioid-epidemic-and-pregnancy-implications-for-anesthetic-care
#14
Britany L Raymond, Bradley T Kook, Michael G Richardson
PURPOSE OF REVIEW: This review summarizes evolving knowledge regarding adverse maternal, fetal, and neonatal effects of opioid exposure during pregnancy, and current treatment options for opioid use disorder (OUD). Maternal and fetal implications of maternal opioid maintenance with methadone and buprenorphine are described. Finally, acute and chronic pain management strategies in opioid-tolerant parturients are reviewed. RECENT FINDINGS: Opioid use among parturients has risen dramatically, with opioid use during pregnancy as high as 20%...
March 29, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29555492/psoas-compartment-block-vs-periarticular-local-anesthetic-infiltration-for-pain-management-after-anterior-total-hip-arthroplasty-a-prospective-randomized-study
#15
Adam M Fahs, Denise M Koueiter, Michael D Kurdziel, Kristine A Huynh, Clayton R Perry, James J Verner
BACKGROUND: The psoas compartment block (PCB) or periarticular soft-tissue local anesthetic injection are forms of regional anesthesia often used as one of the components in multimodal anesthesia applied during total hip arthroplasty (THA). The most efficacious form of regional anesthesia for THA has yet to be determined. METHODS: In a single-surgeon, prospective, clinical trial, patients undergoing THA via direct anterior approach were randomized to receive an intraoperative periarticular local anesthetic infiltration (periarticular injection) or a PCB...
February 21, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29554361/last-double-check-a-comprehensive-pre-regional-checklist-for-the-busy-institution
#16
Angelica G Mancone, Alyssa R Dickey, Brian M Fitzgerald, Gregory P Kraus, Sandeep T Dhanjal
Introduction: Wrong site peripheral nerve blocks are included in the National Quality Forum and Joint Commission's category of "never event." Multiple attempts have been made by various groups in an effort to eliminate these events. Prior attempts to eliminate these never events include the Regional Block Preprocedural Checklist provided by the American Society of Regional Anesthesia (ASRA) taskforce. Following a series of errors involving anticoagulation prior to regional anesthesia, our department saw a need for a more comprehensive checklist...
March 15, 2018: Military Medicine
https://www.readbyqxmd.com/read/29496300/a-retrospective-analysis-of-factors-associated-with-anesthetic-case-duration-for-cesarean-deliveries
#17
M J Harris, R A Gabriel, R P Dutton, R D Urman
INTRODUCTION: Accurately predicting cesarean delivery case duration is an integral component of designing appropriate workflow protocols and ensuring adequate provider availability. Our primary objective was to describe the variability of case duration, based on factors that we hypothesized would be influential, such as hospital facility type, United States region, time of day, case volume, and patient and provider characteristics. METHODS: We analyzed hospital-, patient-, and provider-level variables from the National Anesthesia Clinical Outcomes Registry, a voluntary registry created to share anesthesia-related data and outcomes...
May 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29487361/multicenter-cohort-study-of-15326-cases-analyzing-patient-satisfaction-and-perioperative-pain-management-general-regional-and-combination-anesthesia-in-knee-arthroplasty
#18
Felix Greimel, Guenther Maderbacher, Clemens Baier, Armin Keshmiri, Timo Schwarz, Florian Zeman, Winfried Meissner, Joachim Grifka, Achim Benditz
Numbers of knee replacement surgeries have been rising over the past years. After having ameliorated operation techniques and material, pain management and anesthetic methods have come into focus. All 15326 patients included had undergone primary knee arthroplasty within this multicenter cohort-study, conducted in 46 orthopedic departments. Parameters were evaluated on first postoperative day. Primary outcome values were pain levels (activity, minimum and maximum pain, and pain management satisfaction). Pain medication necessity was analyzed...
February 27, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29485340/incentive-spirometry-and-positive-expiratory-pressure-improve-ventilation-and-recruitment-in-postoperative-recovery-a-randomized-crossover-study
#19
Gregory Reychler, Valeska Uribe Rodriguez, Cheryl Elizabeth Hickmann, Bertrand Tombal, Pierre-François Laterre, Axel Feyaerts, Jean Roeseler
INTRODUCTION: Impairment of global and regional pulmonary ventilations is a well-known consequence of general anesthesia. Positive expiratory pressure (PEP) or incentive spirometry (IS) is commonly prescribed, albeit their efficacy is poorly demonstrated. The aim of this study was to assess the effects of PEP and IS on lung ventilation and recruitment in patients after surgery involving anesthesia using electrical impedance tomography (EIT). METHOD: Ten male subjects (age = 61...
February 27, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29476939/effectiveness-of-regional-anaesthesia-for-treatment-of-facial-and-hand-wounds-by-emergency-physicians-a-9-month-prospective-study
#20
R Siaffa, J Bordes, L Vatin, B Prunet, D Vinciguerra, E Meaudre, G Lacroix
OBJECTIVE: We compared the effectiveness of nerve blocks (regional anaesthesia, [RA]) versus local anaesthesia (LA) to treat face and hand wounds. Emergency physicians who had not previously used nerve blocks administered the anaesthesia based on anatomic landmarks. METHODS: This prospective observational open study was conducted at a military teaching hospital emergency department (ED) between May 1, 2013 and January 31, 2014. All patients requiring treatment of facial or hand wounds were included...
February 21, 2018: Anaesthesia, Critical Care & Pain Medicine
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