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anaesthesia analgesia

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https://www.readbyqxmd.com/read/28928567/dexmedetomidine-as-an-adjuvant-for-intravenous-regional-anesthesia-in-upper-limb-surgeries
#1
Vani Subramanya, Shashikala Thuraganur Kapinigowda, Aruna Teggina Math, Vijayalakshmi Beladakere Chennaiah
BACKGROUND: Intravenous regional anaesthesia is a simple, safe and effective technique with good success rate for upper limb surgeries. The duration of postoperative analgesia is an important limitation of this technique. Various adjuvants have been used to overcome this drawback. In this study we evaluate the effect of dexmedetomidine 0.5 μgkg(-1) as an adjuvant for lignocaine intravenous regional anaesthesia. METHODS: Sixty patients scheduled to undergo upper limb surgery were randomised to receive intravenous regional anaesthesia with lignocaine alone (Group L) or lignocaine with dexmedetomidine 0...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928554/study-to-compare-the-effect-of-oral-rectal-and-intravenous-infusion-of-paracetamol-for-postoperative-analgesia-in-women-undergoing-cesarean-section-under-spinal-anesthesia
#2
Lakshmi Mahajan, Vaishali Mittal, Ruchi Gupta, Himani Chhabra, Jyoti Vidhan, Ashreen Kaur
BACKGROUND: Effective pain relief therapy after caesarean section is essential for the parturient's comfort and early ambulation. Paracetamol has an excellent safety profile when compared to opioids. AIM: To assess and evaluate the effect of oral, rectal, and intravenous infusion of paracetamol for post-operative analgesia in women undergoing caesarean section under spinal anaesthesia. SETTINGS AND DESIGN: We conducted a prospective, randomized controlled study (18-35 years of age) of the ASA- I and II parturient scheduled for lower segment caesarean section were included...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928325/transversus-abdominis-plane-block-for-pain-relief-in-patients-undergoing-in-endoscopic-repair-of-abdominal-wall-hernia-a-comparative-randomised-double-blind-prospective-study
#3
Aparna Sinha, Lakshmi Jayaraman, Dinesh Punhani, Pradeep Chowbey
INTRODUCTION: Transversus abdominis plane (TAP) block is now a well-established technique in post-operative analgesia for lower abdominal surgeries. We evaluated the effect of ultrasound-guided TAP block on recovery parameters in patients undergoing endoscopic repair of abdominal wall hernia. METHODS: Thirty adults were randomised to receive either ropivacaine with dexmedetomidine (TR) or saline (TP) in TAP block, before emergence from anaesthesia. The patients were assessed for pain relief, sedation, time to ambulate (TA), discharge readiness (DR), postoperative opioid requirement and any adverse events...
September 20, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28919267/post-carotid-endarterectomy-hypertension-part-2-association-with-peri-operative-clinical-anaesthetic-and-transcranial-doppler-derived-parameters
#4
Jeremy E Newman, Mathew J Bown, Robert D Sayers, Jonathan P Thompson, Thompson G Robinson, Bryan Williams, Ronney Panerai, Peter Lacy, A Ross Naylor
OBJECTIVE/BACKGROUND: The first paper in this series observed that pre-operative baroreceptor dysfunction and poorly controlled hypertension were independently predictive for identifying patients who went on to require treatment for post-endarterectomy hypertension (PEH). The second paper examines the influence of intra-operative patient, transcranial Doppler (TCD) ultrasound, and anaesthetic variables on the incidence of PEH. METHODS: In total, 106 patients underwent carotid endarterectomy (CEA) under general anaesthesia...
September 14, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28894976/implicating-anaesthesia-and-the-perioperative-period-in-cancer-recurrence-and-metastasis
#5
Julia A Dubowitz, Erica K Sloan, Bernhard J Riedel
Cancer, currently the leading cause of death in the population aged less than 85 years, poses a significant global disease burden and is anticipated to continue to increase in incidence in both developed and developing nations. A substantial proportion of cancers are amenable to surgery, with more than 60% of patients undergoing tumour resection. Up to 80% of patients will receive anaesthesia for diagnostic, therapeutic or palliative intervention. Alarmingly, retrospective studies have implicated surgical stress in disease progression that is predominantly characterised by metastatic disease-the primary cause of cancer-associated mortality...
September 11, 2017: Clinical & Experimental Metastasis
https://www.readbyqxmd.com/read/28893018/changes-in-gas-composition-during-low-flow-anaesthesia-without-nitrous-oxide
#6
Ranjana Venkatachalapathy, Anusha Cherian, Sakthirajan Panneerselvam
INTRODUCTION: Low flow anaesthesia utilising Oxygen (O2) and Nitrous Oxide (N2O) mixture carries a risk of hypoxia, but avoiding N2O results in increased analgesic and volatile anaesthetic agent requirement. AIM: This study attempted to find the lowest Fraction of inspired Oxygen (FiO2) levels achieved with a mixture of 300 mL/min each of O2 and medical air over two hours and to compare the overall analgesic requirement and cost while using similar flows of N2O and O2, respectively...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28893017/a-comparative-study-of-analgesic-effect-of-intrathecal-nalbuphine-and-fentanyl-as-adjuvant-in-lower-limb-orthopaedic-surgery
#7
Shagufta Naaz, Usha Shukla, Swati Srivastava, Erum Ozair, Adil Asghar
INTRODUCTION: Intrathecal opioids when added to local anaesthetics decrease their dosage and provide haemodynamic stability. Nalbuphine is an agonist-antagonist and acts on kappa receptors providing analgesia. AIM: The study aims to compare the analgesic efficacy of fentanyl with that of two doses of nalbuphine when used with injection bupivacaine heavy in spinal anaesthesia. MATERIALS AND METHODS: A randomised, double blinded, prospective study on 90 patients of ASA I and II undergoing lower limb orthopaedic surgery under subarachnoid block was done...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28893013/effects-of-intraperitoneal-local-anaesthetics-bupivacaine-and-ropivacaine-versus-placebo-on-postoperative-pain-after-laparoscopic-cholecystectomy-a-randomised-double-blind-study
#8
Neha T Das, Charulata Deshpande
INTRODUCTION: Laparoscopic Cholecystectomy (LC) is the most frequently performed elective daycare surgery and provision of postoperative pain relief is of importance. After laparoscopic cholecystectomy shoulder and abdominal pain causes considerable distress. Visceral pain during coughing, respiration and mobilization increases morbidity, hospital stay and costs. AIM: To compare the analgesic efficacy of intraperitoneally instilled equipotent concentrations of bupivacaine and ropivacaine versus placebo in relieving postoperative pain after laparoscopic cholecystectomy when used as a part of multimodal analgesia...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28890563/comparison-of-intrathecal-clonidine-and-magnesium-sulphate-used-as-an-adjuvant-with-hyperbaric-bupivacaine-in-lower-abdominal-surgery
#9
Mamta Khandelwal, Debojyoti Dutta, Usha Bafna, Sunil Chauhan, Pranav Jetley, Saikat Mitra
BACKGROUND AND AIMS: Use of various adjuvants to spinal anaesthesia is a well-known modality to provide intra- and post-operative analgesia. This study was designed to evaluate and compare the analgesic efficacy of clonidine and magnesium when used as an additive to intrathecal 0.5% hyperbaric bupivacaine. METHODS: Ninety patients of the American Society of Anesthesiologists' physical status grade I or II, scheduled for lower abdominal surgery under spinal anaesthesia, were randomly allocated into three groups...
August 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28890435/pain-control-in-thoracic-oncology
#10
Christine Peeters-Asdourian, Gilbert Massard, Paragi H Rana, Paul Van Houtte, Andrew P White, Bogdan Grigoriu, Dominique Lossignol, Mohammed Almalki, Jean Alexiou, Jean-Luc Engelholm, Jean-Paul Sculier
This review of pain management in lung cancer is based on the presentation of four cases of thoracic oncology patients with pain at various stages of their disease. The approach will be multidisciplinary, involving a thoracic oncologist, radiologist, thoracic and orthopaedic spine surgeon, radiation therapist, pain medicine specialist, and palliative care specialist. This multispecialty approach to the management of different painful presentations in thoracic oncology will demonstrate the complexity of each case and the improved patient outcomes which result from the involvement of different disciplines working in concert...
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28874243/central-regional-anaesthesia-in-patients-with-aortic-stenosis-a-systematic-review
#11
Sofia Johansson, Morten Nikolaj Lind
INTRODUCTION: Aortic stenosis is a valvular lesion that poses several haemodynamic challenges for the anaesthesiologist. The use of central regional anaesthesia is traditionally regarded as contraindicated in patients with severe aortic stenosis due to its sympatholytic effect, potentially causing loss of vascular tone and ultimately diminished cardiac output. The aim of this paper was to review current literature to find evidence for or against the use of neuroaxial blockade in patients with aortic stenosis...
September 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28868167/comparing-the-effects-of-combined-general-epidural-anaesthesia-and-general-anaesthesia-on-serum-cytokine-levels-in-radical-cystectomy
#12
Meltem Savran Karadeniz, Orkhan Mammadov, Hayriye Şentürk Çiftci, Sebahat Akgül Usta, Kamil Pembeci
OBJECTIVE: Surgical stress combined with general anaesthesia (GA) suppresses the immune system and leads to cancer cell growth and premature metastasis in major oncological interventions. Epidural analgesia decreases the need for inhalation agents and opioids during surgery by suppressing sympathetic and neuroendocrine responses in the postoperative period. This study aimed to compare the effects of combined general/epidural anaesthesia (GEA)+patient-controlled epidural analgesia (PCEA) and GA+IV patient-controlled analgesia (PCA) on serum tumour necrosis factor-alpha TNF-α), interleukin-1 beta (IL-1β) and interferon-gamma (IFN-γ) levels in patients undergoing radical cystectomy...
August 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28856631/implications-of-entropy-and-surgical-pleth-index-guided-general-anaesthesia-on-clinical-outcomes-in-critically-ill-polytrauma-patients-a-prospective-observational-non-randomized-single-centre-study
#13
Alexandru Florin Rogobete, Dorel Sandesc, Carmen Alina Cradigati, Mirela Sarandan, Marius Papurica, Sonia Elena Popovici, Corina Vernic, Ovidiu Horea Bedreag
Being highly unstable, the critically ill polytrauma patient represents a challenge for the anaesthesia team. The aim of this study was to compare the Entropy and Surgical Pleth Index (SPI)-guided general anaesthesia with standard haemodynamic monitoring methods used in the critically ill polytrauma patients and to evaluate the incidence of hemodynamic events, as well as the opioid and vasopressor demand. 72 patients were included in this prospective observational study, divided in two groups, the ESPI Group (N = 37, patients that benefited from Entropy and SPI monitoring) and the STDR Group (N = 35 patients that benefited from standard hemodynamic monitoring)...
August 30, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28855219/dural-ectasia-associated-with-mounier-kuhn-syndrome-a-novel-association-in-the-context-of-spinal-stenosis
#14
Gerard Anthony Sheridan, Owen Godkin, Aiden Devitt
We present the case of a patient undergoing lumbar spine decompression for stenosis with a history of Mounier-Kuhn syndrome. The patient presented with axial lumbar spine pain over 6 months with progressive radicular pain to the left L3 dermatome. MRI confirmed spinal stenosis at L3/4 level with associated dural ectasia. The patient had an uneventful spinal decompression with resolution of radicular symptoms and axial spine pain. Dural ectasia poses a significant risk when operating on the lumbosacral spine...
August 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28854551/efficacy-of-perineural-vs-systemic-dexamethasone-to-prolong-analgesia-after-peripheral-nerve-block-a-systematic-review-and-meta-analysis
#15
M Baeriswyl, K R Kirkham, A Jacot-Guillarmod, E Albrecht
Perineural dexamethasone has gained popularity in regional anaesthesia to prolong the duration of analgesia, but its advantage over systemic administration is disputed. The objective of this meta-analysis was to compare the analgesic efficacy of both routes of administration during peripheral nerve block. The methodology followed the PRISMA statement guidelines. The primary outcome was the duration of analgesia analysed according to the type of local anaesthetic administered (bupivacaine or ropivacaine). Secondary outcomes included cumulative opioid consumption in morphine i...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28833337/maternal-body-mass-index-and-regional-anaesthesia-use-at-term-prevalence-and-complications
#16
Frances M Biel, Nicole E Marshall, Jonathan M Snowden
BACKGROUND: There is an evidence gap regarding the use of regional anaesthesia (epidural, spinal, or combined epidural/spinal anaesthesia) and associated complications by maternal body mass index (BMI). We examine associations between regional anaesthesia, mode of delivery, and regional anaesthesia complications by pre-pregnancy BMI categories among term deliveries. METHODS: Retrospective cohort study of births in California, 2007-2010, utilizing linked birth certificate data and patient discharge data...
August 22, 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/28826745/does-continuous-infusion-of-local-anaesthesia-improve-pain-control-and-walking-distance-after-coronary-artery-bypass-graft-surgery-a-randomised-controlled-trial
#17
Serena S Hong, Jennifer A Alison, Maree A Milross, Kristy Robledo, Rebecca Dignan
OBJECTIVES: To evaluate the effects of continuous infusion of ropivacaine compared to sham infusion or usual care on pain scores before and after physiotherapy treatment, distance walked and time to discharge from physiotherapy, after coronary artery bypass graft (CABG) surgery. DESIGN: Prospective, randomised, double blind controlled trial. SETTING AND PARTICIPANTS: Seventy-five participants who underwent CABG surgery with left internal mammary artery grafts were allocated, to the ropivacaine group (n=26), the sham group (n=25), or usual care group (n=24)...
February 21, 2017: Physiotherapy
https://www.readbyqxmd.com/read/28767456/effects-of-anaesthesia-and-analgesia-on-long-term-outcome-after-total-knee-replacement-a-prospective-observational-multicentre-study
#18
Dario Bugada, Massimo Allegri, Marco Gemma, Andrea L Ambrosoli, Giuseppe Gazzerro, Fernando Chiumiento, Doriana Dongu, Fiorella Nobili, Andrea Fanelli, Paolo Ferrua, Massimo Berruto, Gianluca Cappelleri
BACKGROUND: Perioperative regional anaesthesia may protect from persistent postsurgical pain (PPSP) and improve outcome after total knee arthroplasty (TKA). OBJECTIVES: Aim of this study was to evaluate the impact of regional anaesthesia on PPSP and long-term functional outcome after TKA. DESIGN: A web-based prospective observational registry. SETTING: Five Italian Private and University Hospitals from 2012 to 2015. PATIENTS: Undergoing primary unilateral TKA, aged more than 18 years, informed consent, American Society of Anesthesiologists (ASA) physical status classes 1 to 3, no previous knee surgery...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28766691/risk-factors-for-peripheral-nerve-injuries-following-neuraxial-labour-analgesia-a-nested-case-control-study
#19
G Haller, I Pichon, F-O Gay, G Savoldelli
BACKGROUND: Post-partum lower extremity motor and sensory dysfunctions occur in 0.1-9.2‰ of deliveries. While macrosomia, lithotomy position and forceps use are well-identified causes of peripheral nerve injuries, additional contributors such as patient condition and anaesthesia care may also have to be considered. METHODS: We performed a case-control study nested in a cohort of 19,840 patients having neuraxial anaesthesia for childbirth. Cases were all patients who developed motor or sensory dysfunction of lower extremities in the post-partum period...
August 2, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28766304/benefits-of-ultrasound-guided-transversus-abdominis-plane-block-for-open-appendectomy-in-children
#20
Ilona Batko, Barbara K Kościelniak, Ilona Al-Mutari, Krzysztof Kobylarz
BACKGROUND: One of the most frequently performed emergency surgical procedures in children is an appendectomy. The aim of this study was to determine the benefits of supplementing standard, general anaesthesia with the ultrasound-guided right TAP block. METHODS: We analyzed the medical records of 90 children of both sexes, aged 4-16 years with a body mass of 16-78 kg who underwent general anaesthesia for open appendectomy. Sixty-two individuals were anaesthetized using the standard method, while 28 patients had an additional right-sided TAP block under ultrasound guidance...
2017: Anaesthesiology Intensive Therapy
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