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Anesthesia management

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https://www.readbyqxmd.com/read/27925241/vertebral-subluxation-repair-in-a-pet-goat
#1
Sara Nannarone, Enrico Bellezza, Yves P Moens, Paula Larenza Menzies
OBJECTIVES: To describe the perioperative management, including surgery, anesthesia, metabolic derangements, and physiotherapy, in a goat referred for paraparesis secondary to a road traffic accident. STUDY DESIGN: Case report. ANIMALS: 2-year-old mixed breed dwarf 44 kg female pet goat. METHODS: Clinical examination showed symptoms of early compensatory stages of shock, paraparesis with hyperextension of the thoracic limbs, pain on palpation of the thoracolumbar spine, increased patellar reflexes of both pelvic limbs without superficial sensitivity, but preserved deep pain sensation...
December 7, 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27924207/combined-spinal-epidural-anesthesia-for-urgent-cesarean-section-in-a-parturient-with-a-single-ventricle-a-case-report
#2
Stefano Catarci, Fabio Sbaraglia, Bruno Antonio Zanfini, Salvatore Vagnoni, Luciano Frassanito, Gaetano Draisci
The number of women with major congenital heart defects reaching reproductive age is likely increasing. We herein describe the anesthetic management of a 33-year-old woman at 37 gestational weeks with a history of Glenn surgery who was undergoing an urgent cesarean section due to pathological cardiotocography. Combined spinal-epidural anesthesia was the most suitable technique for urgent cesarean section in our patient with a single ventricle and phasic flow in the pulmonary artery because it provided rapid-onset anesthesia with negligible hemodynamic effects...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27922569/mode-of-information-delivery-does-not-effect-anesthesia-trainee-performance-during-simulated-perioperative-pediatric-critical-events-a-trial-of-paper-versus-electronic-cognitive-aids
#3
Scott C Watkins, Shilo Anders, Anna Clebone, Elisabeth Hughes, Vikram Patel, Laura Zeigler, Yaping Shi, Matthew S Shotwell, Matthew D McEvoy, Matthew B Weinger
INTRODUCTION: Cognitive aids (CAs), including emergency manuals and checklists, have been recommended as a means to address the failure of healthcare providers to adhere to evidence-based standards of treatment during crisis situations. Unfortunately, users of CAs still commit errors, omit critical steps, fail to achieve perfect adherence to guidelines, and frequently choose to not use CA during both simulated and real crisis events. We sought to evaluate whether the mode in which a CA presents information (ie, paper vs...
December 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/27920858/beware-of-positive-pressure-coronary-artery-air-embolism-following-percutaneous-lung-biopsy
#4
Dmitriy N Kazimirko, William B Beam, Khalid Saleh, Akash M Patel
Patients undergoing percutaneous lung biopsy are at risk of developing a systemic air embolism. Air embolism may manifest as a catastrophic iatrogenic event with ischemic insult to the end organs, with sites of least resistance such as coronary and cerebral circulation the most susceptible. We review the available literature and present a case of iatrogenic air embolism during computed tomography guided percutaenous lung biopsy under general anesthesia. Management, outcome, and periprocedural factors that may have contributed to the complication are discussed...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27919589/preincisional-and-postoperative-epidural-morphine-ropivacaine-ketamine-and-naloxone-treatment-for-postoperative-pain-management-in-upper-abdominal-surgery
#5
Hou-Chuan Lai, Chung-Bao Hsieh, Chih-Shung Wong, Chun-Chang Yeh, Zhi-Fu Wu
OBJECTIVE(S): Previous studies have shown that preincisional epidural morphine, bupivacaine, and ketamine combined with epidural anesthesia (EA) and general anesthesia (GA) provided pre-emptive analgesia for upper abdominal surgery. Recent studies reported that ultralow-dose naloxone enhanced the antinociceptive effect of morphine in rats. This study investigated the benefits of preincisional and postoperative epidural morphine + ropivacaine + ketamine + naloxone (M + R + K + N) treatment for achieving postoperative pain relief in upper abdominal surgery...
December 2, 2016: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
https://www.readbyqxmd.com/read/27918405/certified-registered-nurse-anesthetist-perceptions-of-factors-impacting-patient-safety
#6
Susan P McMullan, Charlotte Thomas-Hawkins, Maria R Shirey
Certified registered nurse anesthetists (CRNAs) provide more than 40 million anesthetics each year in the United States. This article describes a study that investigates relationships among CRNA organizational structures (CRNA practice models, work setting, workload, level of education, work experience), CRNA ratings of patient safety culture, and CRNA adverse anesthesia-related event (ARE) reporting. This is a cross-sectional survey study of 336 CRNAs randomly selected from American Association of Nurse Anesthetists database...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27918334/challenges-of-anesthesia-in-low-and-middle-income-countries-a-cross-sectional-survey-of-access-to-safe-obstetric-anesthesia-in-east-africa
#7
Isabella Epiu, Jossy Verel Bahe Tindimwebwa, Cephas Mijumbi, Thomas M Chokwe, Edwin Lugazia, Francois Ndarugirire, Theogene Twagirumugabe, Gerald Dubowitz
BACKGROUND: The United Nations 2015 Millennium Development Goals targeted a 75% reduction in maternal mortality. However, in spite of this goal, the number of maternal deaths per 100,000 live births remains unacceptably high across Sub-Saharan Africa. Because many of these deaths could likely be averted with access to safe surgery, including cesarean delivery, we set out to assess the capacity to provide safe anesthetic care for mothers in the main referral hospitals in East Africa. METHODS: A cross-sectional survey was conducted at 5 main referral hospitals in East Africa: Uganda, Kenya, Tanzania, Rwanda, and Burundi...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27918326/anesthetic-considerations-for-patients-with-congenital-central-hypoventilation-syndrome-a-systematic-review-of-the-literature
#8
Saptashree M Basu, Frances F Chung, Shireen F AbdelHakim, Jean Wong
Congenital central hypoventilation syndrome (CCHS) is a form of sleep-disordered breathing characterized by a diminished drive to breathe during sleep, despite progressive hypercapnia and hypoxia. The condition results from mutations in the paired-like homeobox 2B (PHOX2B) gene. The aim of this review was to conduct a systematic search of the current data on CCHS as it relates to perioperative considerations and to discuss the classification, prevalence, pathophysiology, presentation, genetics, and management of the condition...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27917532/do-women-have-a-choice-care-providers-and-decision-makers-perspectives-on-barriers-to-access-of-health-services-for-birth-after-a-previous-cesarean
#9
Sarah Munro, Jude Kornelsen, Kitty Corbett, Elizabeth Wilcox, Nick Bansback, Patricia Janssen
BACKGROUND: Repeat cesarean delivery is the single largest contributor to the escalating cesarean rate worldwide. Approximately 80 percent of women with a past cesarean are candidates for vaginal birth after a cesarean (VBAC), but in Canada less than one-third plan VBAC. Emerging evidence suggests that these trends may be due in part to nonclinical factors, including care provider practice patterns and delays in access to surgical and anesthesia services. This study sought to explore maternity care providers' and decision makers' attitudes toward and experiences with providing and planning services for women with a previous cesarean...
December 5, 2016: Birth
https://www.readbyqxmd.com/read/27916737/suprascapular-block-associated-with-interscalene-block-an-alternative-to-isolated-interscalene-block-for-analgesia-in-shoulder-instability-surgery
#10
Walid Trabelsi, Abdelkader Ben Gabsia, Anis Lebbi, Walid Sammoud, Iheb Labbène, Mustapha Ferjani
BACKGROUND: Interscalene brachial plexus block (ISB) is the gold standard for postoperative pain management in shoulder surgery. However, this technique has side effects and potentially serious complications. The aim of this study was to compare the combinations of ultrasound-guided suprascapular (SSB) associated with supraclavicular nerve block (SCB) and ultrasound-guided ISB for postoperative analgesia after shoulder instability surgery. METHODS: Sixty ASA physical status I-II patients scheduled to undergo shoulder instability surgery were included...
December 1, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27916062/-perioperational-management-of-gynecological-cancer-patients-with-severe-internal-medical-complications-a-serial-of-37-clinical-cases
#11
J Hu, W Q Lyu, Y L Guo, H W Wen, H Qiao, Y Qu
Objective: To evaluate the effectiveness and safety of perioperational management of gynecological cancer patients with severe internal medical complications. Methods: We collected 37 cases of gynecological cancer patients with severe internal medical complications who were hospitalized in Peking University First Hospital from Jan. 2010 to Nov. 2014. All of the cases were planned to move to ICU right after operation based on the preoperational assessment of anesthetist and physician. The median age was 69.4 years, and 25 cases (68%,25/37) of them were over 70 years old...
November 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/27912973/micro-ureteroscopy-for-the-treatment-of-distal-ureteral-calculi-in-children
#12
Mehmet Mazhar Utanğaç, Ahmet Ali Sancaktutar, Abdulkadir Tepeler
OBJECTIVE: The objective of this study was to demonstrate the efficacy and safety of micro-ureteroscopy (micro-URS) in the management of distal ureteral stones in the pediatric population. MATERIALS AND METHODS: A total of 11 children, who had undergone micro-URS between September 2015 and April 2016 with the indication of distal ureteral calculi in two referral centers, were retrospectively evaluated. The procedures were performed with the patient in the lithotomy position under general anesthesia using the standard URS technique with a micro-ureteroscope that has a caliber of 4...
November 17, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27911238/managing-overlapping-surgery-an-analysis-of-1018-neurosurgical-and-spine-cases
#13
Jian Guan, Andrea A Brock, Michael Karsy, William T Couldwell, Meic H Schmidt, John R W Kestle, Randy L Jensen, Andrew T Dailey, Richard H Schmidt
OBJECTIVE Overlapping surgery-the performance of parts of 2 or more surgical procedures at the same time by a single lead surgeon-has recently come under intense scrutiny, although data on the effects of overlapping procedures on patient outcomes are lacking. The authors examined the impact of overlapping surgery on complication rates in neurosurgical patients. METHODS The authors conducted a retrospective review of consecutive nonemergent neurosurgical procedures performed during the period from May 12, 2014, to May 12, 2015, by any of 5 senior neurosurgeons at a single institution who were authorized to schedule overlapping cases...
December 2, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27910175/postanesthesia-evaluation-of-emotional-and-psychological-satisfaction-in-a-hispanic-population
#14
Angela Zauner, Alvaro Pinilla, Daniel Benitez, Alejandra Tellez, David Romero, Ana Suarez, Vanessa López, Eduardo Hermida
BACKGROUND: Patient satisfaction has a positive impact on clinical care. Different strategies, such as questionnaires, have been developed to evaluate and improve patient satisfaction. A validated pediatric anesthesia questionnaire previously showed the importance of perioperative care built upon a relationship of trust between healthcare providers and children and parents, and a comfortable environment in which satisfactory answers are provided. However, the questionnaire was validated in English, and no research exists on the use of satisfaction questionnaires in Spanish...
December 2, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27909672/arthroscopic-360%C3%A2-capsular-release-for-adhesive-capsulitis-in-the-lateral-decubitus-position
#15
Gregory L Cvetanovich, Timothy Leroux, Jason T Hamamoto, John D Higgins, Anthony A Romeo, Nikhil N Verma
Idiopathic adhesive capsulitis of the shoulder is a relatively common condition that results in pain and loss of motion due to capsular thickening and fibrosis. Most cases are successfully treated with conservative management including physical therapy and intra-articular steroid injections. If conservative management fails, arthroscopic capsular release allows precise release of thickened capsular tissue with a lower risk of complications and less soft-tissue trauma than manipulation under anesthesia alone...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27908568/squamous-cell-carcinoma-presenting-with-trigeminal-anesthesia-an-uncommon-presentation-of-head-neck-cancer-with-unknown-primary
#16
Ameer T Shah, Walid I Dagher, Miriam A O'Leary, Richard O Wein
BACKGROUND: The differential diagnosis of facial anesthesia is vast. This may be secondary to trauma, neoplasm, both intracranial and extracranial, infection, and neurologic disease. When evaluating a patient with isolated facial anesthesia, the head and neck surgeon often thinks of adenoid cystic carcinoma, which has a propensity for perineural invasion and spread. When one thinks of head and neck squamous cell carcinoma with or without unknown primary, the typical presentation involves dysphagia, odynophagia, weight loss, hoarseness, or more commonly, a neck mass...
November 23, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27907923/association-between-the-surgical-apgar-score-and-perioperative-complications-after-radical-prostatectomy
#17
Matthias Orberger, Jüri Palisaar, Florian Roghmann, Ludger Mittelstädt, Petra Bischoff, Joachim Noldus, Björn Löppenberg
OBJECTIVE: To evaluate whether the Surgical Apgar Score (SAS) can identify patients who are at risk for perioperative adverse events (PAE) following radical prostatectomy for prostate cancer. PATIENTS AND METHODS: At a single academic institution, 994 patients undergoing radical prostatectomy between 2010 and 2013 were analyzed retrospectively. The SAS was calculated from anesthesia records, evaluated to predict PAE within a 30-day time period postoperatively; these events were classified according to standardized classification systems...
December 2, 2016: Urologia Internationalis
https://www.readbyqxmd.com/read/27906941/epidural-blood-patch-for-the-treatment-of-spontaneous-and-iatrogenic-orthostatic-headache
#18
Yun So, Jung Min Park, Pil-Moo Lee, Cho Long Kim, Cheolhan Lee, Jae Hun Kim
BACKGROUND: The cerebrospinal fluid (CSF) leakage could be happened spontaneously or related to the procedures such as spinal anesthesia, epidural anesthesia, CSF tapping, intrathecal chemotherapy or other spinal procedures. The leakage of CSF leads to intracranial hypotension of which distinguishing clinical feature is orthostatic headache. The epidural blood patch is a gold-standard treatment for intracranial hypotension-related orthostatic headaches. OBJECTIVE: We conducted this study to compare the efficacy and number of epidural blood patches for spontaneous and iatrogenic orthostatic headaches...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906937/transversus-abdominis-plane-block-in-the-management-of-acute-postoperative-pain-syndrome-after-caesarean-section-a-randomized-controlled-clinical-trial
#19
Pierfrancesco Fusco, Vincenza Cofini, Emiliano Petrucci, Paolo Scimia, Tullio Pozone, Giuseppe Paladini, Gaspare Carta, Stefano Necozione, Battista Borghi, Franco Marinangeli
BACKGROUND: The international literature is unclear regarding the analgesic efficacy of the transversus abdominis plane block (TAPB) after a Caesarean section (CS). OBJECTIVES: The aim of this study was to determine whether a correctly performed ultrasound-guided TAPB (USG-TAPB) could provide better control of acute postoperative pain during the first 72 hours after CS and if it could provide a faster postoperative recovery. STUDY DESIGN: A double-blind, randomized, controlled clinical trial on pregnant women who underwent CS...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906718/anesthesia-for-nonintubated-video-assisted-thoracic-surgery
#20
Hiroshi Sunaga, Justin D Blasberg, Paul M Heerdt
PURPOSE OF REVIEW: This review focuses primarily on nonintubated video-assisted thoracic surgery (NIVATS), and discusses advantages, indications, anesthetic techniques, and approaches to intraoperative crisis management. RECENT FINDINGS: Advancements in endoscopic, endovascular, and robotic techniques have expanded the range of surgical procedures that can be performed in a minimally invasive fashion. For thoracic operations in particular, video-assisted thoracic surgery (VATS) has largely replaced traditional thoracotomy, and continued technical development has made surgical access into the pleural space even less disruptive...
November 30, 2016: Current Opinion in Anaesthesiology
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