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https://www.readbyqxmd.com/read/29162522/loss-of-consciousness-is-related-to-hyper-correlated-gamma-band-activity-in-anesthetized-macaques-and-sleeping-humans
#1
Michał Bola, Adam B Barrett, Andrea Pigorini, Lino Nobili, Anil K Seth, Artur Marchewka
Loss of consciousness can result from a wide range of causes, including natural sleep and pharmacologically induced anesthesia. Important insights might thus come from identifying neuronal mechanisms of loss and re-emergence of consciousness independent of a specific manipulation. Therefore, to seek neuronal signatures of loss of consciousness common to sleep and anesthesia we analyzed spontaneous electrophysiological activity recorded in two experiments. First, electrocorticography (ECoG) acquired from 4 macaque monkeys anesthetized with different anesthetic agents (ketamine, medetomidine, propofol) and, second, stereo-electroencephalography (sEEG) from 10 epilepsy patients in different wake-sleep stages (wakefulness, NREM, REM)...
November 18, 2017: NeuroImage
https://www.readbyqxmd.com/read/29160101/postoperative-analgesia-using-peripheral-anesthetic-block-of-the-foot-and-ankle
#2
Kelly Cristina Stéfani, Gabriel Ferraz Ferreira, Miguel Viana Pereira Filho
BACKGROUND: Anesthetic block of the peripheral nerves in the foot and ankle is generally used as anesthesia. The increased use of anesthetic blocks has made this technique an increasingly safe method, and its use has been expanded to postoperative analgesia in foot and ankle surgeries. The objective of this study was to evaluate the analgesia time and pain intensity, using objective scores, after peripheral nerve block in foot and ankle surgeries. METHODS: Patients who underwent surgery by the foot and ankle group of our institution from March 2016 to January 2017 were invited to participate in this prospective, randomized, and blinded study after signing an informed consent form...
November 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29114334/anesthesia-and-analgesia-in-the-patient-with-an-unstable-shoulder
#3
Ismael Acevedo Bambaren, Fernando Dominguez, Maria Elena Elias Martin, Silvia Domínguez
Introduction: The patient with an unstable shoulder represents a challenge for the anesthesiologist. Most patients will be young individuals in good health but both shoulder dislocation reduction, a procedure that is usually performed under specific analgesia in an urgent setting, and instability surgery anesthesia and postoperative management present certain peculiarities. Material and Methods: For the purpose of the article, 78 references including clinical trials and reviews were included...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29099429/the-society-for-obstetric-anesthesia-and-perinatology-consensus-statement-on-the-anesthetic-management-of-pregnant-and-postpartum-women-receiving-thromboprophylaxis-or-higher-dose-anticoagulants
#4
Lisa Leffert, Alexander Butwick, Brendan Carvalho, Katherine Arendt, Shannon M Bates, Alex Friedman, Terese Horlocker, Timothy Houle, Ruth Landau, Heloise Dubois, Roshan Fernando, Tim Houle, Sandra Kopp, Douglas Montgomery, Joseph Pellegrini, Richard Smiley, Paloma Toledo
Venous thromboembolism is recognized as a leading cause of maternal death in the United States. Thromboprophylaxis has been highlighted as a key preventive measure to reduce venous thromboembolism-related maternal deaths. However, the expanded use of thromboprophylaxis in obstetrics will have a major impact on the use and timing of neuraxial analgesia and anesthesia for women undergoing vaginal or cesarean delivery and other obstetric surgeries. Experts from the Society of Obstetric Anesthesia and Perinatology, the American Society of Regional Anesthesia, and hematology have collaborated to develop this comprehensive, pregnancy-specific consensus statement on neuraxial procedures in obstetric patients receiving thromboprophylaxis or higher dose anticoagulants...
November 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29078573/nonintubated-video-assisted-thoracic-surgery-lobectomy-for-lung-cancer
#5
Ming-Hui Hung, Shun-Mao Yang, Jin-Shing Chen
Nonintubated video-assisted thoracic surgery (VATS) is now well established and is performed in different institutions as a safe and versatile procedure in selected patients. To share the surgical and anesthetic techniques for nonintubated VATS, we present a 56-year-old female patient who underwent nonintubated VATS left upper lobectomy for primary non-small cell lung cancer. Our patient was sedated in a spontaneous breathing status using a target-controlled infusion of propofol. Additionally, regional anesthesia using intercostal block and left-sided intrathoracic vagal block enabled us to do left upper lobectomy and mediastinal lymph node dissection without difficulty...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29068830/propofol-induced-changes-in-%C3%AE-%C3%AE-sensorimotor-cortical-connectivity
#6
Mahsa Malekmohammadi, Nicholas AuYong, Collin M Price, Evangelia Tsolaki, Andrew E Hudson, Nader Pouratian
BACKGROUND: Anesthetics are believed to alter functional connectivity across brain regions. However, network-level analyses of anesthesia, particularly in humans, are sparse. The authors hypothesized that propofol-induced loss of consciousness results in functional disconnection of human sensorimotor cortices underlying the loss of volitional motor responses. METHODS: The authors recorded local field potentials from sensorimotor cortices in patients with Parkinson disease (N = 12) and essential tremor (N = 7) undergoing deep brain stimulation surgery, before and after propofol-induced loss of consciousness...
October 25, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29064877/evidence-basis-for-regional-anesthesia-in-ambulatory-arthroscopic-knee-surgery-and-anterior-cruciate-ligament-reconstruction-part-ii-adductor-canal-nerve-block-a-systematic-review-and-meta-analysis
#7
Herman Sehmbi, Richard Brull, Ushma Jitendra Shah, Kariem El-Boghdadly, David Nguyen, Girish P Joshi, Faraj W Abdallah
BACKGROUND: Adductor canal block (ACB) has emerged as an effective analgesic regional technique for major knee surgeries in the last decade. Its motor-sparing properties make it particularly attractive for ambulatory knee surgery, but evidence supporting its use in ambulatory arthroscopic knee surgery is conflicting. This systematic review and meta-analysis evaluates the analgesic effects of ACB for ambulatory arthroscopic knee surgeries. METHODS: We conducted a comprehensive search of electronic databases for randomized controlled trials examining the analgesic effects of ACB compared to control or any other analgesic modality...
October 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29058613/effect-of-interscalene-block-on-intraocular-pressure-and-ocular-perfusion-pressure
#8
Betul Basaran, Aysun Ankay Yilbas, Zeki Gultekin
BACKGROUND: Interscalene block (ISB) is commonly associated with Horner's syndrome due to spread of local anesthetic to the cervical sympathetic chain. Postganglionic neurons that originate from superior cervical ganglia form the sympathetic innervation of eye. Decrease in sympathetic tone may change intraocular pressure (IOP) and ocular perfusion pressure (OPP). The aim of the study was to investigate whether ISB affects IOP and/or OPP. METHODS: Thirty patients scheduled for ambulatory shoulder surgery under regional anesthesia with a single-shot ISB (15 mL 0...
October 23, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29053504/anesthesia-and-analgesia-practice-pathway-options-for-total-knee-arthroplasty-an-evidence-based-review-by-the-american-and-european-societies-of-regional-anesthesia-and-pain-medicine
#9
Sandra L Kopp, Jens Børglum, Asokumar Buvanendran, Terese T Horlocker, Brian M Ilfeld, Stavros G Memtsoudis, Joseph M Neal, Narinder Rawal, Jessica T Wegener
In 2014, the American Society of Regional Anesthesia and Pain Medicine in collaboration with the European Society of Regional Anaesthesia and Pain Therapy convened a group of experts to compare pathways for anesthetic and analgesic management for patients undergoing total knee arthroplasty in North America and Europe and to develop a practice pathway. This review is intended to be an analysis of the current literature to assist individuals and institutions in designing a pathway for total knee arthroplasty that is based on existing evidence and expert recommendation and may be customized according to individual settings...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29046933/-regional-anesthesia-are-the-standards-changing
#10
REVIEW
T Volk, C Kubulus
Regional anesthesia has undergone many changes over the years and the increasing use of ultrasound has certainly played an important role in this. Apart from individual case reports in the literature of very different blocking options, some new procedures seem to have become established and can be broadly applied. Among these are blockades, by which ultrasound-guided injection of local anesthetics is carried out in fascial or muscular layers rather than around target nerves (e.g. cervical plexus blocks and truncal blocks)...
October 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29042063/-pharmacokinetic-and-clinical-effects-of-two-bupivacaine-concentrations-on-axillary-brachial-plexus-block
#11
Leonardo H C Ferraro, Alexandre Takeda, Cleber N Barreto, Bernadete Faria, Nilson A Assunção
INTRODUCTION: The risk of systemic bupivacaine toxicity is a persistent problem, which makes its pharmacokinetic study fundamental for regional anesthesia safety. There is little evidence of its influence on plasma peak at different concentrations. The present study compares two bupivacaine concentrations to establish how the concentration affects this drug plasma peak in axillary brachial plexus block. Postoperative latency and analgesia were also compared. METHODS: 30 patients were randomized...
October 14, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29033731/ultrasound-guided-continuous-spinal-anesthesia-for-cesarean-section-in-a-parturient-with-scoliosis-corrected-with-harrington-s-rod-surgery
#12
Amer Majeed, Iftikhar Ahmed, Ghadah Jamaan Alkahtani, Nasser Abdullah Altahtam
With rapid improvement in healthcare in Saudi Arabia, increasing number of women with surgically corrected kyphoscoliosis are likely to present for cesarean section (CS) or vaginal delivery requiring anesthesia or analgesia. Despite the surgical correction, these patients have poor cardiopulmonary reserves which increase the risks associated with general anesthesia. Whereas altered vertebral anatomy from previous surgery and the presence of metal work in spine make performing of regional anesthesia (RA) difficult and unpredictable, we report anesthetic management of such a patient who underwent CS using continuous spinal anesthesia technique...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033726/ultrasound-guided-multilevel-paravertebral-block-versus-local-anesthesia-for-medical-thoracoscopy
#13
Maha A Abo-Zeid, Mohammad M Elgamal, Asem A Hewidy, Amro A Moawad, Alaa Eldin Adel Elmaddawy
BACKGROUND: Local anesthetic infiltration for medical thoracoscopy has an analgesic properties for short duration. Single injection thoracic paravertebral block (PVB) provides limited analgesia. PURPOSE: Comparison between thoracic PVB performed at two or three levels with local infiltration for anesthetic adequacy in adult medical thoracoscopy as a primary outcome and postthoracoscopic analgesia and pulmonary function as secondary outcomes for adult medical thoracoscopy...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29030933/technical-success-of-the-ultrasound-guided-supra-inguinal-fascia-iliaca-compartment-block-in-older-children-and-adolescents-for-hip-arthroscopy
#14
Elizabeth Eastburn, Maria A Hernandez, Karen Boretsky
BACKGROUND: Hip arthroscopic surgery is performed on older pediatric patients. Fascia iliaca compartment block has proven efficacy in providing analgesia following hip surgery and can be performed with target location of local anesthetic below or above the inguinal ligament. The reported success of ultrasound-guided infra-inguinal fascia iliaca compartment block is lower when compared to traditional landmark technique, while the reliability of supra-inguinal fascia iliaca compartment block is unreported...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28965442/the-impact-of-curve-severity-on-obstetric-complications-and-regional-anesthesia-utilization-in-pregnant-patients-with-adolescent-idiopathic-scoliosis-a-preliminary-analysis
#15
Emily W Chan, Stephen R Gannon, Chevis N Shannon, Jeffrey E Martus, Gregory A Mencio, Christopher M Bonfield
OBJECTIVE Adolescent idiopathic scoliosis (AIS), the most common type of scoliosis, often presents immediately prior to a woman's childbearing years; however, research investigating the impact of AIS on women's health, particularly pregnancy delivery outcomes, is sparse, with existing literature reporting mixed findings. Similarly limited are studies examining the change in scoliotic curve during or after pregnancy. Therefore, this study aims to determine 1) the impact of scoliotic curvature on obstetric complications (preterm births, induction of labor, and urgent/emergency caesarean section delivery), 2) regional anesthetic decision making and success during delivery for these patients, and 3) the effect of pregnancy on curve progression...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28953508/impact-of-regional-anesthesia-on-recurrence-metastasis-and-immune-response-in-breast-cancer-surgery-a-systematic-review-of-the-literature
#16
Oscar Pérez-González, Luis F Cuéllar-Guzmán, José Soliz, Juan P Cata
BACKGROUND AND OBJECTIVES: The perioperative period is critical in the long-term prognosis of breast cancer patients. The use of regional anesthesia, such as paravertebral block (PVB), could be associated with improvements in long-term survival after breast cancer surgery by modulating the inflammatory and immune response associated with the surgical trauma, reducing opioid and general anesthetic consumption, and promoting cancer cells death by a direct effect of local anesthetics. METHODS: A systematic literature search was conducted for studies of patients who received PVB for breast cancer surgery...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28928589/laparoscopic-cholecystectomy-under-segmental-thoracic-spinal-anesthesia-a-feasible-economical-alternative
#17
Aditya Kumar Kejriwal, Shaheen Begum, Gopal Krishan, Richa Agrawal
Laparoscopic surgery is normally performed under general anesthesia, but regional techniques like thoracic epidural and lumbar spinal have been emerging and found beneficial. We performed a clinical case study of segmental thoracic spinal anaesthesia in a healthy patient. We selected an ASA grade I patient undergoing elective laparoscopic cholecystectomy and gave spinal anesthetic in T10-11 interspace using 1 ml of bupivacaine 5 mg ml(-1) mixed with 0.5 ml of fentanyl 50 μg ml(-1). Other drugs were only given (systemically) to manage patient anxiety, pain, nausea, hypotension, or pruritus during or after surgery...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28922230/optimal-dose-of-perineural-dexamethasone-to-prolong-analgesia-after-brachial-plexus-blockade-a-systematic-review-and-meta-analysis
#18
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
#19
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
#20
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
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