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https://www.readbyqxmd.com/read/29141522/perceived-comfort-during-minor-hand-surgeries-with-wide-awake-local-anaesthesia-no-tourniquet-walant-versus-local-anaesthesia-la-tourniquet
#1
Jayaletchumi Gunasagaran, Ee Soon Sean, Sachin Shivdas, Shams Amir, Tunku Sara Ahmad
PURPOSE: Minor hand surgeries can be done under field sterility in procedure rooms. Surgeons are still sceptical about the usage of wide awake local anaesthesia no tourniquet (WALANT) technique. They perceive that patients can tolerate tourniquet for a brief period while they perform minor surgeries under local anaesthesia (LA). We compared the perceived comfort experienced by patients during minor hand surgeries with WALANT and LA/tourniquet. We investigated the difference in preoperative preparation time, operating time and blood loss between the two groups...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28985692/comprehensive-blood-conservation-program-in-a-new-congenital-cardiac-surgical-program-allows-bloodless-surgery-for-the-jehovah-witness-and-a-reduction-for-all-patients
#2
Vincent Olshove, Nicole Berndsen, Veena Sivarajan, Pooja Nawathe, Alistair Phillips
BACKGROUND: Cardiac surgery on Jehovah's Witnesses (JW) can be challenging, given the desire to avoid blood products. Establishment of a blood conservation program involving the pre-, intra- and post-operative stages for all patients may lead to a minimized need for blood transfusion in all patients. METHODS: Pre-operatively, all JW patients were treated with high dose erythropoietin 500 IU/kg twice a week. JW patients were compared to matching non-JW patients from the congenital cardiac database, two per JW to serve as control...
October 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28979046/bloodless-repair-of-aortic-arch-with-dual-aortic-cannulation-in-a-jehovah-s-witness-patient
#3
Melinda S Valleley, Kimberly R Glogowski, Kim F Duncan, Andrea Dutoit, Corinna Hagedorn
Various methods for surgical repair of the aortic arch are described throughout the literature with many focused on cannulation techniques and degree of systemic cooling in an effort to reduce postoperative morbidities. Despite advancements in techniques, this surgery is still often associated with higher levels of blood loss and subsequent allogenic blood transfusions. Although blood products can be safely transfused to the majority of patients undergoing repair of the aortic arch, the complexity and risk is further multiplied when the patient is of Jehovah's Witness faith and refuses blood transfusions...
September 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28970635/basics-of-cardiopulmonary-bypass
#4
REVIEW
Manjula Sarkar, Vishal Prabhu
Cardiopulmonary bypass (CPB) provides a bloodless field for cardiac surgery. It incorporates an extracorporeal circuit to provide physiological support in which venous blood is drained to a reservoir, oxygenated and sent back to the body using a pump. Team effort between surgeon, perfusionist and anaesthesiologist is paramount for the successful use of CPB. However, it also has its share of complications and strategies to reduce these complications are the area of the current research.
September 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28878585/selective-upper-body-perfusion-technique-for-removal-of-renal-cell-carcinoma-extending-into-the-inferior-vena-cava-and-right-atrium
#5
Selim Aydin, Bora Cengiz, Banu Vural Gokay, Anar Mammadov, Remzi Emiroglu, Saadettin Eskicorapci, Ersin Erek
Invasion of a renal cell carcinoma thrombus into the inferior vena cava and right atrium is infrequent. Reaching and completely excising a tumor from the inferior vena cava is particularly challenging because the liver covers the surgical field. We report the case of a 61-year-old man who underwent surgery for a renal cell carcinoma of the right kidney that extended into the inferior vena cava and right atrium. During dissection of the liver to expose the inferior vena cava, transesophageal echocardiograms revealed right atrial mass migration into the tricuspid valve...
August 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28865632/back-to-basics-pneumatic-tourniquet-use
#6
Lisa Spruce
Pneumatic tourniquets are commonly used in surgeries involving the limbs to achieve a nearly bloodless surgery and an optimal operating field or when administering regional anesthesia during surgery on a limb. Complications can arise from the use of tourniquets, including nerve injuries, pain, compartment syndrome, pressure injuries, chemical burns, and tissue necrosis. More serious injuries-including deep vein thrombosis, thermal damage to tissues, severe ischemic injuries, and rhabdomyolysis-also can occur...
September 2017: AORN Journal
https://www.readbyqxmd.com/read/28815690/treatment-of-individuals-who-cannot-receive-blood-products-for-religious-or-other-reasons
#7
REVIEW
Carlton D Scharman, Debora Burger, Joseph J Shatzel, Edward Kim, Thomas G DeLoughery
By virtue of their religious principles, Jehovah's Witnesses (JWs) generally object to receiving blood products, raising numerous ethical, legal, and medical challenges for providers who care for these patients, especially in the emergent setting. In this review, we discuss several areas relevant to the care of JWs, including the current literature on "bloodless" medical care in the setting of perioperative and intraoperative management, acute blood loss, trauma, pregnancy, and malignancy. We have found that medical and administrative efforts in the form of bloodless medicine and surgery programs can be instrumental in helping to reduce risks of morbidity and mortality in these patients...
August 17, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28789655/efficacy-and-safety-of-a-new-elastic-tourniquet-cuff-in-total-knee-arthroplasty-a-prospective-randomized-controlled-study
#8
O-Sung Lee, Myung Chul Lee, Hyuk-Soo Han
BACKGROUND: The effects of cuff shape, timing of tourniquet application, and automated systems using limb occlusion pressure (LOP) have been reported to minimize the appropriate tourniquet pressure. However, studies on the raw material of the cuff itself to reduce the complications related to the tourniquet have been very rarely reported. The purpose of this study is to report the efficacy and safety of a tourniquet system with a new elastic cuff in which pressure is set with LOP in total knee arthroplasty (TKA)...
August 8, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28580218/cryotherapy-as-a-conservative-treatment-modality-for-gingival-enlargement-in-a-patient-with-sturge-weber-syndrome
#9
Vikender Singh Yadav, Souvik Chakraborty, Shikha Tewari, Nitesh Tewari, Tuhina Ghosh
This case report describes a case of Sturge-Weber syndrome reported for unilateral gingival enlargement and bleeding from gingiva in maxillary left region. Initial treatment in the form of scaling and root planing was done but recurrence was observed after one year of follow up. Instead of performing conventional surgery, an alternative conservative treatment was planned in the form of cryotherapy with the help of closed nitrous oxide probe. Seeing the satisfactory results obtained, cryotherapy can be suggested as an atraumatic, bloodless and effective chair side procedure for treating vascular gingival enlargement...
May 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/28560111/clonidine-or-remifentanil-for-adequate-surgical-conditions-in-patients-undergoing-endoscopic-sinus-surgery-a-randomized-study
#10
Laurent Bairy, Marie Vanderstichelen, Jacques Jamart, Edith Collard
BACKGROUND: Deliberate hypotension is one way to achieve a bloodless surgical field in endoscopic sinus surgery (ESS). We compared two anaesthesia regimens to induce deliberate hypotension and attempted to determine the most efficient one. METHODS: Fifty-nine patients undergoing ESS were minimized into two groups. In the CLO group, patients received I.V. sufentanil 0.15 µg/kg together with I.V. clonidine 2-3 µg/kg. In the REMI group, patients received remifentanil at a rate of up to 1 µg/kg/min...
2017: PeerJ
https://www.readbyqxmd.com/read/28544979/preoperative-left-hepatic-lobe-devascularisation-to-minimize-perioperative-bleeding-in-a-jehovah-s-witness-undergoing-left-hepatectomy
#11
Laurence Weinberg, Georgina Hanus, Jonathan Banting, Diana Abu-Ssaydeh, Manfred Spanger, Su Kah Goh, Vijayaragavan Muralidharan
INTRODUCTION: Major liver resection in a Jehovah's Witness presents unique clinical challenges requiring multimodal blood minimization strategies to reduce perioperative complications. We report a case where complete left hepatic lobe devascularisation was undertaken to minimize bleeding in a Jehovah's Witness undergoing left hepatectomy. PRESENTATION OF CASE: A 65-year-old male Jehovah's Witness presented for open left hepatectomy for a large left-sided hepatocellular carcinoma involving segment IV of the liver...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28435130/intramyometrial-injection-of-vasopressin-a-novel-method-for-hemostasis-at-laparoscopic-management-of-cornual-ectopic
#12
Ramesh Bettaiah, Shwetha Sudhakar Kamath
STUDY OBJECTIVE: Although all ectopic pregnancies are associated with risk of hemorrhage, cornual pregnancies are feared for catastrophic hemorrhage and uncontrollable bleeding. The maternal mortality rate can be as high as 2.5%, which is 7 times higher than the mortality rate for ectopic pregnancies in general. Different techniques have been used to control hemostasis, including purse string suture, square suture, endo-loop, electrocoagulation, and devascularization. Injection of vasopressin into the uterus is a simple method that greatly reduces the blood loss at cornuostomy...
November 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28280667/intradermal-infiltration-of-local-anesthetic-rapid-and-bloodless-deepithelialization-of-the-breast-pedicle
#13
Katelyn G Bennett, Robert H Gilman
Breast reduction is one of the most commonly performed plastic surgery procedures, and pedicle deepithelialization remains a time-consuming step of the operation. This is especially true when using an inferior pedicle. We present a novel technique of intradermal infiltration of the breast pedicle with local anesthetic to facilitate efficient, bloodless deepithelialization. The senior author uses a 20-ml syringe to inject 0.25% lidocaine and 1:400,000 epinephrine just beneath the epidermis of the breast pedicle to create a series of wheals...
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28263419/transoral-ultrasonic-surgery-of-pharyngolaryngeal-giant-hemangioma-after-ethylene-vinyl-alcohol-copolymer-onyx-embolization
#14
Meritxell Valls-Mateus, Luis San Román, Juan Macho, Alfons Nadal, Manuel Bernal-Sprekelsen, Isabel Vilaseca
BACKGROUND: Cervico-mediastinal hemangiomas in adulthood are rare and slow-growing vascular tumors. The optimal treatment for giant hemangiomas is controversial. In asymptomatic cases, clinical observation is generally recommended. METHODS: We report the transoral resection of a pharyngolaryngeal hemangioma (diameters of 44 × 56 × 39 mm) with tracheal involvement and mediastinal extension. Clinically, the patient had throat foreign body sensation, severe dyspnea and stridor...
June 2017: Head & Neck
https://www.readbyqxmd.com/read/28214461/wide-awake-hand-surgery
#15
REVIEW
Matthew Cantlon, Steven Yang
Wide awake hand surgery employs local-only anesthesia with low-dose epinephrine to create a bloodless field without the use of an arm tourniquet. Despite traditional teaching, evidence-based medicine suggests epinephrine is safe for use in hand and digital anesthesia. Eliminating an arm tourniquet reduces the requirement for sedation and general anesthetic. This confers particular advantage in surgeries such as tendon repairs, tendon transfers, and soft tissue releases in which intraoperative active motion can used to optimize outcomes...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28197644/routine-application-of-bloodless-priming-in-neonatal-cardiopulmonary-bypass-a-3-year-experience
#16
Wolfgang Boettcher, Nicodème Sinzobahamvya, Oliver Miera, Matthias Redlin, Frank Dehmel, Mi-Young Cho, Peter Murin, Felix Berger, Joachim Photiadis
A restrictive transfusion strategy led us to routinely try to conduct donor-blood free open-heart surgery even in neonates. The cardio-pulmonary bypass (CPB) circuit was minimized by priming volumina at 73 ml for the smallest patients with body weight up to 2.5 kg and 85-95 ml for those with body weight of more than 2.5 kg, and by positioning the console as close as possible to operation table. Measures were applied to save blood during the procedure. Transfusion threshold of 8 g/dl hemoglobin was retained...
April 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28163429/modified-closed-chamber-sutureless-technique-for-anomalous-pulmonary-venous-connection
#17
Sabarinath Menon, Thomas Mathew, Jayakumar Karunakaran, Baiju Sashidhar Dharan
Visibility continues to be a major problem during repair of obstructed total anomalous pulmonary venous connection (TAPVC) resulting in frequent use of deep hypothermia and low flow bypass. Sutureless technique for primary repair of anomalous pulmonary venous connection is fast becoming popular. In this described modification of sutureless technique through the lateral approach, the left atrium is marsupialized around the common pulmonary venous chamber, except on the right lateral aspect, providing a bloodless field with minimal retraction of heart facilitating the surgery at mild hypothermia...
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28097242/anterior-to-psoas-atp-fusion-of-the-lumbar-spine-evolution-of-a-technique-facilitated-by-changes-in-equipment
#18
Cristian Gragnaniello, Kevin Seex
BACKGROUND: Lateral interbody cages have been proven useful in spinal fusions. Spanning both lateral cortical rims while sparing the Anterior Longitudinal Ligament, the lateral interbody cages restore and maintain disc height while adding stability prior to supplemental fixation. The standard approach for their insertion is by a 90-degree lateral transpsoas method. This is relatively bloodless compared to other techniques although has its limitations, requiring neuro-monitoring and being, at times, very difficult at L4/5 due to iliac crest obstruction or an anterior plexus position...
December 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28060689/-schwannoma-of-the-upper-extremity-retrospective-analysis-of-17-cases
#19
Ângelo Sá, Leandro Nobre Azevedo, Luísa Cunha
INTRODUCTION: Schwannoma or neurilemmoma is a benign peripheric nerve tumor that usually presents as a slow growing single lesion; it has origin in Schwann cells proliferation. Although it represents a small percentage of the benign tumors of the upper arm, it is the most frequent of neural origin. We present a retrospective study of upper limb schwannomas; our aim is establish the appropriate preoperative approach, to recognise the efficiency of the treatment and the pos-operative follow-up...
September 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28007749/intermuscular-technique-for-implantation-of-the-subcutaneous-implantable-cardioverter-defibrillator-long-term-performance-and-complications
#20
Joachim Winter, Markus Siekiera, Dong-In Shin, Christian Meyer, Patric Kröpil, Harald Clahsen, Stephen O'Connor
AIMS: The subcutaneous cardioverter defibrillator was designed to overcome electrode complications of transvenous defibrillation systems. While largely achieved, pocket complications have increased. Subcutaneous implantation of the pulse generator leaves it prone to erosion, extrusion, discomfort, and poor cosmesis. METHODS AND RESULTS: We use a demonstration electrode and pulse generator with fluoroscopy, prior to prepping and draping, to maximize the left ventricular mass between them...
December 22, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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