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Anesthesia management

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https://www.readbyqxmd.com/read/28431427/total-spinal-anesthesia-failure-have-you-assessed-the-sensory-anesthesia-in-sacral-dermatomes
#1
Ronaldo Rodrigo de Sá Oliveira, Marília Pinheiro Módolo, Glênio Bitencourt Mizubuti, Anthony M H Ho, Guilherme Antonio Moreira de Barros, Leopoldo Muniz da Silva, Leandro Gobbo Braz, Norma Sueli Pinheiro Módolo, Andrew G Day, Rachel Phelan, Lais Helena Navarro E Lima, Eliana Marisa Ganem
Intrathecal local anesthetic maldistribution is a well-known cause of spinal anesthesia failure (SAF). This could potentially result in sensory blockade restricted to the sacral dermatomes. We sought to determine the overall incidence of SAF and the role of sacral dermatomes in differentiating between total and partial failures. Of the 3111 spinals prospectively examined, 194 (6.2%) were classified as failures. Of the 72 presumed total failures based on the initial assessment, evaluation of the sacral dermatomes revealed sensory blockade in 32 (44%; 95% confidence interval, 32...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28429926/the-efficacy-of-intraurethral-lidocaine-in-optical-internal-urethrotomy-for-anterior-urethral-stricture-a-multicenter-study
#2
Nedim Y Cem, Yıldız Yildiray, Cem Ö Berat, Melih S Mehmet, Gökhan D Ömer, Metin H Ahmet, Özyuvalı Ekrem, Ayyıldız Ali
BACKGROUND: Male anterior urethral strictures can be treated successfully with the help of optical internal urethrotomy (OIU) and is usually performed under general or regional anaesthesia. In this study, we determined the efficacy of intraurethral lidocaine in OIU for anterior urethral stricture in an outpatient setting. METHODS: 157 patients with anterior urethral strictures underwent OIU under local urethral anaesthesia with lidocaine. Optical urethrotomy was performed with a cold-cutting knife...
April 20, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28428483/a-retrospective-study-of-anesthesia-for-subcutaneous-ureteral-bypass-placement-in-cats-27-cases
#3
Geneviève C Luca, Beatriz P Monteiro, Marilyn Dunn, Paulo Vm Steagall
The goals of this retrospective clinical case series study were to describe the management of anesthesia, and to report perioperative complications in cats undergoing subcutaneous ureteral bypass (SUB) placement due to ureteral obstruction. Medical records of client-owned cats with ureteral obstruction and anesthetized for SUB placement between 2012 and 2015 in a veterinary teaching hospital were reviewed. Twenty-seven cases were identified. Duration of anesthesia and surgery (mean ± standard deviation) were 215 ± 42 min and 148 ± 36 min, respectively...
April 20, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28424537/awake-craniotomy-anesthetic-management-using-dexmedetomidine-propofol-and-remifentanil
#4
Andrea Prontera, Stefano Baroni, Andrea Marudi, Franco Valzania, Alberto Feletti, Francesca Benuzzi, Elisabetta Bertellini, Giacomo Pavesi
INTRODUCTION: Awake craniotomy allows continuous monitoring of patients' neurological functions during open surgery. Anesthesiologists have to sedate patients in a way so that they are compliant throughout the whole surgical procedure, nevertheless maintaining adequate analgesia and anxiolysis. Currently, the use of α2-receptor agonist dexmedetomidine as the primary hypnotic-sedative medication is increasing. METHODS: Nine patients undergoing awake craniotomy were treated with refined monitored anesthesia care (MAC) protocol consisting of a combination of local anesthesia without scalp block, low-dose infusion of dexmedetomidine, propofol, and remifentanil, without the need of airways management...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28420038/retrospective-evaluation-of-coyote-attacks-in-dogs-154-cases-1997-2012
#5
Virginia M Frauenthal, Philip Bergman, Robert J Murtaugh
OBJECTIVE: To describe the clinical presentation and outcome of known attacks in client-owned dogs caused by the common coyote, Canis latrans. DESIGN: Retrospective observational study. SETTING: Private referral hospital. ANIMALS: One hundred fifty-four client-owned dogs known to be attacked by coyotes. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Records from a private referral hospital from May 1997 through December 2012 were reviewed...
April 18, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28419879/challenging-the-myth-of-right-non-dominant-hemisphere-lessons-from-cortico-subcortical-stimulation-mapping-in-awake-surgery-and-surgical-implications
#6
REVIEW
Tatiana Vilasboas, Guillaume Herbet, Hugues Duffau
For a long time, the right hemisphere (RH) was considered as "non-dominant", especially in right-handers. In neurosurgical practice, this dogma resulted in the selection of awake procedure with language mapping only for lesions of the left "dominant" hemisphere. Conversely, surgery under general anesthesia (possibly with motor mapping) was usually proposed for right lesions. However, when objective neuropsychological assessments were performed, they frequently revealed cognitive and behavioral deficits following brain surgery, even in the RH...
April 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28419616/the-provision-of-pediatric-cardiac-anesthesia-services-in-germany-current-status-of-structural-and-personnel-organization
#7
Torsten Baehner, Oliver Dewald, Ingo Heinze, Matthias Mueller, Ehrenfried Schindler, Uwe Schirmer, Georg Baumgarten, Andreas Hoeft, Richard K Ellerkmann
BACKGROUND: Anesthesia for pediatric cardiac surgery requires a high level of expert knowledge. There are currently no recommendations and standards for anesthetic management for congenital cardiac surgery in Germany. AIM: The aim of the present study was to assess the current status of structural and personnel anesthetic standards at pediatric cardiac surgery centers in Germany. METHOD: All cardiac surgical centers in Germany were reviewed for an active program for congenital heart surgery...
April 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28419035/clinical-practice-guidelines-decrease-unnecessary-echocardiograms-before-hip-fracture-surgery
#8
Chris Adair, Eric Swart, Rachel Seymour, Joshua Patt, Madhav A Karunakar
BACKGROUND: Preoperative assessment of geriatric patients with a hip fracture may include transthoracic echocardiography (TTE), which increases resource utilization and cost and may delay surgery. The purpose of this study was to evaluate preoperative TTE utilization at a single institution in order to determine (1) how often TTE is ordered in accordance with clinical practice guidelines (CPGs), (2) how frequently TTE reveals cardiac disease that may alter medical or anesthesia management, and (3) whether following CPGs reduces unnecessary TTE utilization without potentially missing important disease...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28417889/monitoring-for-the-oral-and-maxillofacial-surgeon
#9
REVIEW
Robert C Bosack
Parenteral medications are titrated in the oral and maxillofacial surgery office to achieve moderate sedation, deep sedation, or general anesthesia while continuously maintaining spontaneous ventilation with an open airway. After initial drug administration, the provider assesses and interprets both the level of anesthesia and the presence/severity of adverse side effects, both of which guide further drug titration, cessation, reversal, or medical management. This assessment is called monitoring, which guides the conduct of anesthesia delivery and becomes the essence of this art...
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28413552/trigeminocardiac-reflex-preceding-development-of-postoperative-superior-orbital-fissure-syndrome
#10
Rudrashish Haldar, Prakhar Gyanesh, Arun Srivastava, Guru Prasad Bettaswamy
The superior orbital fissure syndrome (SOFS) is a rare condition presenting as painful unilateral opthalmoplegia, ptosis, pupillary dilatation and anesthesia of the upper eyelid and forehead. It has been described after facial trauma. Other etiologies include infections, tumors or spontaneous hemorrhages in the retro-orbital space. Occurrence of SOFS after surgery in the skull base has not been described before. We recently encountered a case where a young female developed SOFS following surgery for cerebrospinal fluid (CSF) rhinorrhea...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28413524/perioperative-complications-in-endovascular-neurosurgery-anesthesiologist-s-perspective
#11
Megha U Sharma, Pragati Ganjoo, Daljit Singh, Monica S Tandon, Jyotsna Agarwal, Durga P Sharma, Anita Jagetia
BACKGROUND: Endovascular neurosurgery is known to be associated with potentially serious perioperative complications that can impact the course and outcome of anesthesia. We present here our institutional experience in the anesthetic management of various endovascular neurosurgical procedures and their related complications over a 10-year period. METHODS: Data was obtained in 240 patients pertaining to their preoperative status, details of anesthesia and surgery, perioperative course and surgery-related complications...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28413300/anorectal-agenesis-with-rectovaginal-fistula-a-rare-regional-variant
#12
Subhasis Roy Choudhury, Niyaz Ahmed Khan, Pinaki Ranjan Debnath, Partap Singh Yadav, Shalu Shah, Rajiv Chadha
AIMS AND OBJECTIVES: The anatomical types of female anorectal malformation (ARM) are complex and include several rare and regional variants. The aim of this report is to highlight the diagnosis and management of cases of anorectal agenesis with rectovaginal fistula (RVF). MATERIALS AND METHODS: This is a retrospective chart review of cases of RVF who underwent definitive surgery between November 2000 and September 2016 in a single institution. RESULTS: Of the 244 female patients with anorectal anomalies treated in our institution over a 16-year period, there were 15 cases of RVF with anorectal agenesis giving it an incidence of 6%...
April 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28413284/combined-mitral-and-aortic-stenosis-in-parturient-anesthesia-management-for-labor-and-delivery
#13
Manish Kela, Madhvi Buddhi
Maternal heart disease complicates 0.2-3% of pregnancies. The optimal management of the pregnant patient with cardiac disease depends on the co-operative efforts of the obstetrician, the cardiologist and the anesthesiologist involved in peripartum care. A comprehensive understanding of physiology of pregnancy and pathophysiology of underlying cardiac disease is of primary importance in provision of obstetric analgesia or anesthesia for these high-risk groups of patients. We report a successful and uncomplicated use of epidural anesthesia for labor and delivery in patient with combined aortic and mitral stenosis...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28413276/comparison-between-ketamine-and-hyoscine-for-the-management-of-postoperative-catheter-related-bladder-discomfort-a-randomized-controlled-double-blind-study
#14
Atef Kamel Salama
BACKGROUND AND AIM: Postoperative catheter-related bladder discomfort (CRBD) can be a distressing complication for patients in whom a urinary catheter was inserted intraoperatively and is accompanied with patients' dissatisfaction. This trial investigated the efficacy of hyoscine and ketamine on treatment of postoperative CRBD in patients undergoing various surgeries. MATERIAL AND METHODS: This was a prospective randomized, double-blind study, which included 60 American Society of Anesthesiologists Class I-II male patients undergoing elective nonurological operations requiring intraoperative urinary catheterization under general anesthesia after ethical approval and written informed consent...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28413272/an-analysis-of-perioperative-adverse-neurological-events-associated-with-anesthetic-management-at-a-tertiary-care-center-of-a-developing-country
#15
Fauzia Anis Khan, Sobia Khan, Gauhar Afshan
BACKGROUND AND AIMS: Existing literature on neurological complications related to anesthesia is reported from affluent countries but the trends may vary in less affluent countries. MATERIAL AND METHODS: The objective was to find the associated factors contributing to neurological adverse events occurring within 48 h of anesthesia and surgery. The existing departmental morbidity and mortality database was reviewed from 1992 to 2012 for major adverse neurological events...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28412850/assessment-of-hysteroscopic-role-in-management-of-women-with-recurrent-pregnancy-loss
#16
M Elsokkary, M Elshourbagy, K Labib, M Ali
OBJECTIVES: To assess the hysteroscopic value in the management of intrauterine lesion in women with recurrent pregnancy loss. METHODS: This study done in Ain Shams Maternity Hospital after the approval of the research Ethics Committee, during the period between August 2014 to December 2015 where 200 non-pregnant women with a history of three or more consecutive unexplained first and second trimester miscarriages before 20 weeks were recruited from recurrent miscarriage clinic...
April 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28410092/tidal-volume-delivery-during-the-anesthetic-management-of-neonates-is-variable
#17
Thanaa Abouzeid, Elizabeth J Perkins, Prue M Pereira-Fantini, Anushi Rajapaksa, Asha Suka, David G Tingay
OBJECTIVES: To describe expiratory tidal volume (VT) during routine anesthetic management of neonates at a single tertiary neonatal surgical center, as well as the proportion of VT values within the range of 4.0-8.0?mL/kg. STUDY DESIGN: A total of 26 neonates needing surgery under general anesthesia were studied, of whom 18 were intubated postoperatively. VT was measured continuously during normal clinical care using a dedicated neonatal respiratory function monitor (RFM), with clinicians blinded to values...
March 3, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28409733/endovascular-management-of-acute-epidural-hematomas-clinical-experience-with-80-cases
#18
Carlos Michel A Peres, Jose Guilherme M P Caldas, Paulo Puglia, Almir F de Andrade, Igor A F da Silva, Manoel J Teixeira, Eberval G Figueiredo
OBJECTIVE Small acute epidural hematomas (EDHs) treated conservatively carry a nonmeasurable risk of late enlargement due to middle meningeal artery (MMA) lesions. Patients with EDHs need to stay hospitalized for several days, with neurological supervision and repeated CT scans. In this study, the authors analyzed the safety and efficacy of the embolization of the involved MMA and associated lesions. METHODS The study group consisted of 80 consecutive patients harboring small- to medium-sized EDHs treated by MMA embolization between January 2010 and December 2014...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28408986/pain-management-using-acetaminophen-throughout-postoperative-course-of-laparoscopic-colorectal-surgery-a-case-matched-control-study
#19
Masanori Naito, Takeo Sato, Takatoshi Nakamura, Takahiro Yamanashi, Hirohisa Miura, Atsuko Tsutsui, Masahiko Watanabe
BACKGROUD: The main advantage of laparoscopic surgery is that it is minimally invasive because of the use of small incisions. An approach using small incisions offers many benefits including attenuation of surgical wound pain. However, the presence of postoperative pain may undermine the advantages of laparoscopic surgery as a minimally invasive technique. In addition, perioperative pain management is an important factor affecting recovery after surgery. This study investigated the usefulness of a multimodal approach to postoperative pain management with acetaminophen as a baseline analgesic after minimally invasive laparoscopic colorectal surgery...
May 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28406772/crigler-massage-for-congenital-blockade-of-nasolacrimal-duct
#20
Jahanzeb Durrani
OBJECTIVE: To determine the success rate of non-surgical management of congenital nasolacrimal duct obstruction (CNLDO) with Crigler massage in infants below the age of one year. STUDY DESIGN: A cross-sectional observational study. PLACE AND DURATION OF STUDY: Department of Ophthalmology at HBS General Hospital, Hazrat Bari Sarkar Medical and Dental College, Islamabad from November 2015 to May 2016. METHODOLOGY: One hundred children with watering of eyes, due to congenital blockage of the distal part of the nasolacrimal duct (at the valve of Hasner), unilateral or bilateral were included in the study...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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