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https://www.readbyqxmd.com/read/29142836/preoperative-intraoperative-and-postoperative-anesthetic-prospective-for-thyroid-surgery-what-s-new
#1
REVIEW
I-Cheng Lu, I-Hua Lin, Che-Wei Wu, Hsiu-Ya Chen, Yi-Chu Lin, Feng-Yu Chiang, Pi-Ying Chang
The aim of this review is to analyze what's new on anesthetic prospective to perioperative management for thyroid surgery. For recent decades intraoperative neuromonitoring (IONM) during thyroid and parathyroid surgery has obtained more and more popularity. New modality of anesthetic technique was also developed to incorporate into surgical teamwork. For example, the precise position of EMG tube and optimal use of neuromuscular blocking agents (NMBAs) play key roles in successful IONM system. Special focus is paid to following issues: (I) preoperative airway evaluation and pre-op preparation; (II) anesthetic managements including advanced intubation tools, NMBAs and sugammadex; and (III) post-op adverse events such as pain and postoperative nausea vomiting...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29126612/desflurane-versus-propofol-in-post-operative-quality-of-recovery-of-patients-undergoing-day-laparoscopic-cholecystectomy-prospective-comparative-non-inferiority-study
#2
M Zaballos, A Reyes, J Etulain, C Monteserín, M Rodríguez, E Velasco
OBJECTIVE: Recently, the evaluation of postoperative results has focused on the opinion of the patient as of great relevance. Our objective was to evaluate the quality of recovery by questionnaire (QoR-15) in patients undergoing laparoscopic cholecystectomy, comparing desflurane versus a total intravenous technique with propofol (TIVA). A non-inferiority hypothesis was proposed between both techniques. MATERIAL AND METHODS: Prospective longitudinal cohort study in patients undergoing laparoscopic cholecystectomy in which multimodal management was applied including low pneumoperitoneum pressures, deep neuromuscular block and pain prevention strategy and PONV...
November 7, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29122523/subcutaneous-immunoglobulin-for-maintenance-treatment-in-chronic-inflammatory-demyelinating-polyneuropathy-path-a-randomised-double-blind-placebo-controlled-phase-3-trial
#3
Ivo N van Schaik, Vera Bril, Nan van Geloven, Hans-Peter Hartung, Richard A Lewis, Gen Sobue, John-Philip Lawo, Michaela Praus, Orell Mielke, Billie L Durn, David R Cornblath, Ingemar S J Merkies
BACKGROUND: Approximately two-thirds of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) need long-term intravenous immunoglobulin. Subcutaneous immunoglobulin (SCIg) is an alternative option for immunoglobulin delivery, but has not previously been investigated in a large trial of CIDP. The PATH study compared relapse rates in patients given SCIg versus placebo. METHODS: Between March 12, 2012, and Sept 20, 2016, we studied patients from 69 neuromuscular centres in North America, Europe, Israel, Australia, and Japan...
November 6, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/29121312/readmission-after-surgery-are-neuromuscular-blocking-drugs-a-cause
#4
M Blobner, K Ulm, J M Hunter
No abstract text is available yet for this article.
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29121289/association-between-intraoperative-non-depolarising-neuromuscular-blocking-agent-dose-and-30-day-readmission-after-abdominal-surgery
#5
T Thevathasan, S L Shih, K C Safavi, D L Berger, S M Burns, S D Grabitz, R S Glidden, R D Zafonte, M Eikermann, J C Schneider
Background: We hypothesised that intraoperative non-depolarising neuromuscular blocking agent (NMBA) dose is associated with 30-day hospital readmission. Methods: Data from 13,122 adult patients who underwent abdominal surgery under general anaesthesia at a tertiary care hospital were analysed by multivariable regression, to examine the effects of intraoperatively administered NMBA dose on 30-day readmission (primary endpoint), hospital length of stay, and hospital costs...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29118959/congenital-myasthenic-syndrome-due-to-dok7-mutations-in-a-family-from-chile
#6
Jorge A Bevilacqua, Marian Lara, Jorge Díaz, Mario Campero, Jessica Vázquez, Ricardo A Maselli
Congenital myasthenic syndromes (CMS) are neuromuscular transmission disorders caused by mutations in genes encoding neuromuscular junction proteins. A 61-year-old female and her older sister showed bilateral ptosis, facial and proximal limb weakness, and scoliosis since childhood. Another female sibling had milder signs, while other family members were asymptomatic. Facial nerve repetitive stimulation in the proband showed decrement of muscle responses. Single fiber EMG revealed increased jitter and blocking...
June 27, 2017: European Journal of Translational Myology
https://www.readbyqxmd.com/read/29118957/morphological-peculiarities-of-neuromuscular-junctions-among-different-fiber-types-effect-of-exercise
#7
Teet Seene, Maria Umnova, Priit Kaasik
The aim of our research was to examine whether there are differences in the morphology of neuromuscular junctions of different types of muscle fibers in rodents, and after their adaptation to six weeks endurance exercise training. After 5-day acclimation, Wistar rats were subjected to run with the speed 35 m/min during 6 week, 5 days per week and the training volume reached 60 min per day. Muscle samples for ultrastructural studies were fixed, dehydrated and embedded in Epon-812. Ultra-thin sections were cut from longitudinally and transversely oriented blocs, using 4 blocks from each animal...
June 27, 2017: European Journal of Translational Myology
https://www.readbyqxmd.com/read/29116572/admission-of-tetanus-patients-to-the-icu-a-retrospective-multicentre-study
#8
Rafael Mahieu, Thomas Reydel, Adel Maamar, Jean-Marc Tadié, Angeline Jamet, Arnaud W Thille, Nicolas Chudeau, Julien Huntzinger, Steven Grangé, Gaetan Beduneau, Anne Courte, Stephane Ehrmann, Jérémie Lemarié, Sébastien Gibot, Michael Darmon, Christophe Guitton, Julia Champey, Carole Schwebel, Jean Dellamonica, Thibaut Wipf, Ferhat Meziani, Damien Du Cheyron, Achille Kouatchet, Nicolas Lerolle
BACKGROUND: An extended course of tetanus (up to 6 weeks) requiring ICU admission and protracted mechanical ventilation (MV) may have a significant impact on short- and long-term survival. The subject is noteworthy and deserves to be discussed. METHODS: Twenty-two ICUs in France performed tetanus screenings on patients admitted between January 2000 and December 2014. Retrospective data were collected from hospital databases and through the registers of the town hall of the patients...
November 7, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29095176/sugammadex-for-neuromuscular-blockade-reversal
#9
Michelle R Papathanas, Alley Killian
Postoperative residual neuromuscular blockade is associated with an increased risk of respiratory insufficiency, aspiration, and potential pulmonary complications. The standard of care for reversal of residual block centers on anticholinesterases such as neostigmine. However, these medications provide inconsistent or inadequate effect while being associated with potentially severe adverse effects. Sugammadex, a modified γ-cyclodextrine compound, is a recently approved agent for the reversal of blockade with aminosterodial neuromuscular blockers...
October 2017: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29081850/obstacles-to-reduction-in-infantile-developmental-dysplasia-of-the-hip
#10
K Studer, N Williams, P Studer, M Baker, A Glynn, B K Foster, P J Cundy
PURPOSE: Identification of anatomical structures that block -reduction in developmental dysplasia of the hip (DDH) is -important for the management of this challenging condition. Obstacles to reduction seen on arthrogram are well-known. However, despite the increasing use of MRI in the assessment of adequacy of reduction in DDH, the interpretation of MRI patho-anatomy is ill-defined with a lack of relevant literature to guide clinicians. METHOD: This is a retrospective analysis of the MRI of patients with DDH treated by closed reduction over a five-year period (between 2009 and 2014)...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29077832/does-deep-neuromuscular-block-optimize-surgical-space-better-than-moderate-block
#11
W H Kim, J-H Bahk
No abstract text is available yet for this article.
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29077827/postoperative-conditions-after-antagonism-of-neuromuscular-blocking-agent-and-extubation-without-use-of-a-neuromuscular-monitor
#12
A Dahan, M Boon, C Martini
No abstract text is available yet for this article.
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29077826/reply-to-does-deep-neuromuscular-block-optimise-surgical-space-better-than-moderate-block
#13
M H Bruintjes, G J Scheffer, A Dahan, M C Warlé
No abstract text is available yet for this article.
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29066245/effects-of-neostigmine-or-edrophonium-on-force-of-contraction-when-administered-at-a-train-of-four-ratio-of-0-9-in-anesthetized-dogs
#14
Marta Romano, Manuel Martin-Flores, Daniel M Sakai, Chia T Tseng, Luis Campoy, Robin D Gleed
OBJECTIVE: Anticholinesterase drugs may produce paradoxical neuromuscular block when administered at shallow levels of neuromuscular block. The objective of this study was to evaluate the effects of neostigmine and edrophonium when administered at near-complete reversal from nondepolarizing block in anesthetized dogs. STUDY DESIGN: Incomplete crossover, randomized, blinded experimental study. ANIMALS: A total of 12 Beagle dogs. METHODS: Each dog was anesthetized twice with propofol and maintained with isoflurane and dexmedetomidine...
August 3, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29064259/the-cardiovascular-implications-of-sedatives-in-the-cardiac-intensive-care-unit
#15
Sammy Zakaria, Helaine J Kwong, Jonathan E Sevransky, Marlene S Williams, Nisha Chandra-Strobos
Patients admitted to the cardiac intensive care unit frequently develop multi-organ system dysfunction associated with their cardiac disease. In many cases, invasive mechanical ventilation is required, which often necessitates sedation for patient-ventilator synchrony, reduction of work of breathing, and patient comfort. In this paper, we describe the use of common sedatives available in the endotracheally intubated critically ill patient and emphasize the clinical and cardiovascular effects. We review γ-aminobutyric acid agonists such as etomidate, benzodiazepines, and propofol, the centrally acting α2-agonist dexmedetomidine, and the N-methyl-D-aspartate receptor antagonist ketamine...
February 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29054436/in-vitro-and-ex-vivo-screening-of-candidate-therapeutics-to-restore-neurotransmission-in-nerve-terminals-intoxicated-by-botulinum-neurotoxin-serotype-a1
#16
Phillip H Beske, Aaron B Bradford, Katie M Hoffman, Sydney Mason, Patrick M McNutt
Botulinum neurotoxins (BoNTs) are exceedingly potent neurological poisons that block cholinergic release in the peripheral nervous system and cause death by asphyxiation. While post-exposure prophylaxis can effectively eliminate toxin in the bloodstream, there are no clinically effective treatments to prevent or reverse disease once BoNT has entered the neuron. To address the need for post-symptomatic countermeasures, we designed and developed an in vitro assay based on whole-cell, patch-clamp electrophysiological monitoring of miniature excitatory post-synaptic currents in synaptically active murine embryonic stem cell-derived neurons...
October 17, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/29051828/intubation-following-high-dose-rocuronium-in-a-cat-with-protracted-laryngospasm
#17
Graeme M Doodnaught, Daniel Sj Pang
CASE SUMMARY: An 11-year-old spayed female domestic shorthair cat with a history of laryngospasm at induction of general anesthesia presented for dental evaluation and treatment. The cat was premedicated with hydromorphone (0.05 mg/kg) and alfaxalone (0.5 mg/kg) intravenously, pre-oxygenated for 5 mins (3 l/min, face mask) and anesthesia was induced with alfaxalone (to effect) intravenously. Lidocaine (0.1 ml, 2%) was applied topically to the arytenoid cartilages following loss of jaw tone...
July 2017: JFMS open reports
https://www.readbyqxmd.com/read/29050397/the-antimyotonic-effect-of-lamotrigine-in-non-dystrophic-myotonias-a-double-blind-randomized-study
#18
RANDOMIZED CONTROLLED TRIAL
Grete Andersen, Gitte Hedermann, Nanna Witting, Morten Duno, Henning Andersen, John Vissing
Mexiletine is the only drug with proven effect for treatment of non-dystrophic myotonia, but mexiletine is expensive, has limited availability and several side effects. There is therefore a need to identify other pharmacological compounds that can alleviate myotonia in non-dystrophic myotonias. Like mexiletine, lamotrigine is a sodium channel blocker, but unlike mexiletine, lamotrigine is available, inexpensive, and well tolerated. We investigated the potential of using lamotrigine for treatment of myotonia in patients with non-dystrophic myotonias...
September 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29047136/apnoeic-oxygenation-with-high-flow-nasal-oxygen-for-laryngeal-surgery-a-case-series
#19
C Lyons, M Callaghan
Surgery under apnoeic conditions with the use of high-flow nasal oxygen is novel. Between November 2016 and May 2017, 28 patients underwent tubeless laryngeal or tracheal surgery under apnoeic conditions with high-flow nasal oxygen as the sole method of gas exchange. Patients received total intravenous anaesthesia and neuromuscular blocking agents for the duration of their surgery. The median (IQR [range]) apnoea time was 19 (15-24 [9-37]) min. Four patients experienced an episode of oxygen desaturation to a value between 85% and 90%, lasting less than 2 min in each case...
November 2017: Anaesthesia
https://www.readbyqxmd.com/read/29046769/factors-that-affect-the-onset-of-action-of-non-depolarizing-neuromuscular-blocking-agents
#20
REVIEW
Yong Byum Kim, Tae-Yun Sung, Hong Seuk Yang
Neuromuscular blockade plays an important role in the safe management of patient airways, surgical field improvement, and respiratory care. Rapid-sequence induction of anesthesia is indispensable to emergency surgery and obstetric anesthesia, and its purpose is to obtain a stable airway, adequate depth of anesthesia, and appropriate respiration within a short period of time without causing irritation or damage to the patient. There has been a continued search for new neuromuscular blocking drugs (NMBDs) with a rapid onset of action...
October 2017: Korean Journal of Anesthesiology
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