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Arrhythmia and anaesthesia

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https://www.readbyqxmd.com/read/28586614/frequency-indications-and-complications-of-pulmonary-artery-catheter-insertion-in-adult-open-heart-surgery-patients-of-a-tertiary-care-hospital
#1
Syed Shabbir Ahmed, Mohammad Irfan Akhtar, Rehana Kamal
BACKGROUND: Patients presenting for cardiac surgery have unstable cardiovascular disease and haemodynamics with multiple coexisting diseases. Optimal monitoring in the perioperative period is very important for best perioperative outcome. The introduction of the flow-directed pulmonary artery catheter (PAC) into clinical practice is one of the most important and popular advances in the field of cardiac anaesthesia. The objective of the study was to determine the frequency, indications and complications of pulmonary artery catheter insertion in adult open-heart surgery patients...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28579345/efficacy-and-safety-of-midazolam-and-ketamine-in-paediatric-upper-endoscopy
#2
Ahmet Basturk, Reha Artan, Aygen Yılmaz
BACKGROUND AND STUDY AIM: Upper endoscopy can be successfully carried out in children under deep sedation and anaesthesia. However, the best method of upper endoscopy for children who require gastrointestinal intervention has yet to be defined. The aim of this study is to investigate the efficacy and safety of the sedation induced by intravenous midazolam and ketamine during upper endoscopy in children. PATIENTS AND METHODS: This study included patients ages 3-18years who had undergone upper endoscopy...
June 1, 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/28537937/dexmedetomidine-the-new-all-in-one-drug-in-paediatric-anaesthesia
#3
Cedric E Sottas, Brian J Anderson
PURPOSE OF REVIEW: Dexmedetomidine is a drug with sedative, anxiolytic, sympatholytic and analgesic properties, which is finding widespread practice in paediatric anaesthesia and related practices. The present review summarizes its pharmacology and current experience with the drug. RECENT FINDINGS: Dexmedetomidine is proving useful in many diverse areas in paediatric anaesthesia where its sedative properties are useful for premedication, fibreoptic intubation and radiologic procedures...
August 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28501797/predictors-of-procedural-complications-in-adult-fontan-patients-undergoing-non-cardiac-procedures
#4
Alexander C Egbe, Arooj R Khan, Naser M Ammash, David W Barbara, William C Oliver, Sameh M Said, Emmanuel Akintoye, Carole A Warnes, Heidi M Connolly
OBJECTIVE: Limited data exist regarding the outcomes of non-cardiac procedures (NCPs) in adult patients after Fontan operations (Fontan patients). METHODS: To compare procedural outcomes after NCPs in Fontan patients with outcomes for two matched control groups: patients with repaired congenital heart disease and biventricular circulation (CHD-BiV) and patients with no heart disease (NHD). We defined cyanosis as oxygen saturation <90% and procedural hypoxia as saturation <80% or a decrease in saturation >10% from baseline...
May 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28497164/metformin-prevents-ischaemic-ventricular-fibrillation-in-metabolically-normal-pigs
#5
Li Lu, Shuyu Ye, Rebecca L Scalzo, Jane E B Reusch, Clifford R Greyson, Gregory G Schwartz
AIMS/HYPOTHESIS: Metformin is the drug most often used to treat type 2 diabetes. Evidence suggests that metformin may reduce mortality of individuals with type 2 diabetes, but the mechanism of such an effect is unknown and outcomes of metformin treatment in people without diabetes have not been determined. If metformin favourably affected mortality of non-diabetic individuals, it might have even broader therapeutic utility. We evaluated the effect of metformin on myocardial energetics and ischaemic ventricular fibrillation (VF) in metabolically normal pigs...
May 11, 2017: Diabetologia
https://www.readbyqxmd.com/read/28444228/improved-outcome-and-cost-effectiveness-in-ablation-of-persistent-atrial-fibrillation-under-general-anaesthetic
#6
Claire A Martin, James P Curtain, Parag R Gajendragadkar, David A Begley, Simon P Fynn, Andrew A Grace, Patrick M Heck, Kiran Salaunkey, Munmohan S Virdee, Sharad Agarwal
Aims: Outcome of persistent atrial fibrillation (AF) ablation remains suboptimal. Techniques employed to reduce arrhythmia recurrence rate are more likely to be embraced if cost-effectiveness can be demonstrated. A single-centre observational study assessed whether use of general anaesthesia (GA) in persistent AF ablation improved outcome and was cost-effective. Methods and results: Two hundred and ninety two patients undergoing first ablation procedures for persistent AF under conscious sedation or GA were followed...
April 21, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28384965/anaesthetic-management-in-brugada-syndrome-a-case-report
#7
Sulochana Dash, Shanmugam Pragathee
Brugada Syndrome (BS) is a rare congenital cardiac disorder involving cardiac sodium channels, sometimes presenting with ventricular arrhythmia and sudden cardiac death. Here, we are reporting a case of BS who presented for laparotomy due to obstructed inguinal hernia which was managed satisfactorily with combined epidural and general anaesthesia without any complications.
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28371864/a-multicentre-study-of-patients-with-timothy-syndrome
#8
Mark A Walsh, Christian Turner, Katherine W Timothy, Neil Seller, Dominic L Hares, Andrew F James, Jules C Hancox, Orhan Uzun, Dean Boyce, Alan G Stuart, Paul Brennan, Caroline Sarton, Karen McGuire, Ruth A Newbury-Ecob, Karen Mcleod
Aims: Timothy syndrome (TS) is an extremely rare multisystem disorder characterized by marked QT prolongation, syndactyly, seizures, behavioural abnormalities, immunodeficiency, and hypoglycaemia. The aim of this study was to categorize the phenotypes and examine the outcomes of patients with TS. Methods and results: All patients diagnosed with TS in the United Kingdom over a 24-year period were reviewed. Fifteen centres in the British Congenital Arrhythmia Group network were contacted to partake in the study...
March 24, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28216704/attenuation-of-haemodynamic-responses-to-laryngoscopy-and-endotracheal-intubation-with-intravenous-dexmedetomidine-a-comparison-between-two-doses
#9
Bon Sebastian, Anand T Talikoti, Dinesh Krishnamurthy
BACKGROUND AND AIMS: Laryngoscopic manipulation and endotracheal intubation are noxious stimuli capable of producing tachycardia, arrhythmias and hypertension. The aim of this study was to arrive at an optimal dose of dexmedetomidine by comparing two doses with placebo to attenuate stress response during laryngoscopy and endotracheal intubation. METHODS: It was a randomised, prospective, double-blind placebo-controlled study. After Institutional Ethical Committee clearance, ninety patients of American Society of Anesthesiologists Physical Status 1 were enrolled in the study and divided into three equal groups...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27726918/anaesthetic-management-of-parturients-with-univentricular-congenital-heart-disease-and-the-fontan-operation
#10
R S Monteiro, D P Dob, M R Cauldwell, M A Gatzoulis
Women with a single ventricle circulation palliated with the Fontan operation require specialist multidisciplinary management. We report 14 such cases with successful pregnancies and detail the pathophysiology encountered. A combined obstetric and cardiac service between Chelsea and Westminster Hospital and Royal Brompton Hospital provides care for women with heart disease, and maintains a prospective database of referred women. We searched this database for women with a known Fontan circulation and reviewed the case notes and electronic patient records between January 1994 and December 2015...
December 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27666330/potentially-modifiable-risk-factors-for-atrial-fibrillation-following-lung-resection-surgery-a-retrospective-cohort-study
#11
S H Lee, H J Ahn, S M Yeon, M Yang, J A Kim, D M Jung, J H Park
Atrial fibrillation is the most frequent arrhythmia after thoracic surgery and is associated with increased hospital costs, morbidity and mortality. In this study, we aimed to identify potentially modifiable risk factors for postoperative atrial fibrillation following lung resection surgery and to suggest possible measures to reduce risk. We retrospectively reviewed the medical records of 4731 patients who underwent lobectomy or more major lung resection over a 6-year period. Patients who developed atrial fibrillation postoperatively and required treatment were included in the postoperative atrial fibrillation group, while the remaining patients were assigned to the non-postoperative atrial fibrillation group...
December 2016: Anaesthesia
https://www.readbyqxmd.com/read/27541848/the-management-of-the-second-stage-of-labour-in-women-with-cardiac-a-mixed-methods-study
#12
Matthew Cauldwell, Kate Von Klemperer, Anselm Uebing, Lorna Swan, Philip J Steer, Michael Gatzoulis, Mark R Johnson
OBJECTIVE: To examine the duration of the passive and active parts of the second stage (SS) of labour in women with cardiac disease (CD) and to assess the adherence to antenatal care plans regarding timing of assisted delivery. Cardiac parameters were measured in a subset of women to investigate any differences between the passive and active SS of labour. STUDY DESIGN: Cohort study of 73 women with CD, classified into mWHO Class Groups I-IV. Women were matched with an equal number of women controlling for gestational age, maternal age (+/- five years), parity, use of regional anaesthesia, and spontaneous versus assisted delivery...
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27498449/efficacy-of-external-warming-in-attenuation-of-hypothermia-in-surgical-patients
#13
RANDOMIZED CONTROLLED TRIAL
Snjezana Zeba, Maja Surbatović, Milan Marjanović, Jasna Jevdjić, Zoran Hajduković, Radovan Karkalić, Dalibor Jovanović, Sonja Radaković
BACKGROUND/AIM: Hypothermia in surgical patients can be the consequence of long duration of surgical intervention, general anaesthesia and low temperature in operating room. Postoperative hypothermia contributes to a number of postoperative complications such as arrhythmia, myocardial ischemia, hypertension, bleeding, wound infection, coagulopathy, and prolonged effect of muscle relaxants. External heating procedures are used to prevent this condition. The aim of this study was to evaluate the efficiency of external warming system in alleviation of cold stress and hypothermia in patients who underwent major surgical procedures...
June 2016: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
https://www.readbyqxmd.com/read/27488764/nitrates-for-the-prevention-of-cardiac-morbidity-and-mortality-in-patients-undergoing-non-cardiac-surgery
#14
REVIEW
Na Zhao, Jin Xu, Balwinder Singh, Xuerong Yu, Taixiang Wu, Yuguang Huang
BACKGROUND: Cardiac complications are not uncommon in patients undergoing non-cardiac surgery, especially in patients with coronary artery disease (CAD) or at high risk of CAD. Perioperative cardiac complications can lead to mortality and morbidity, as well as higher costs for patient care. Nitrates, which are among the most commonly used cardiovascular drugs, perform the function of decreasing cardiac preload while improving cardiac blood perfusion. Sometimes, nitrates are administered to patients undergoing non-cardiac surgery to reduce the incidence of cardiac complications, especially for patients with CAD...
August 4, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27366568/safe-anaesthesia-management-in-a-child-with-congenital-long-qt-syndrome
#15
Mustafa Özgür, Ayhan Köseoğlu
Long QT syndrome is a cardiac repolarisation disorder that can occur with clinical symptoms such as dizziness, fainting, life-threatening arrhythmias and sudden cardiac death, and its incidence is increasing in the general population. A careful anaesthetic management is required for patients with this syndrome because of the risk of torsades de pointes and malignant arrhythmias. In this case report, we discuss the anaesthetic management of a seven-year-old patient with congenital long QT syndrome that was diagnosed during the preoperative evaluation...
April 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27320051/the-stop-bang-questionnaire-and-the-risk-of-perioperative-respiratory-complications-in-urgent-surgery-patients-a-prospective-observational-study
#16
Nicolas Chudeau, Tommy Raveau, Laurence Carlier, Damien Leblanc, Guillaume Bouhours, Frédéric Gagnadoux, Emmanuel Rineau, Sigismond Lasocki
INTRODUCTION: The STOP-BANG (SB) questionnaire, a tool originally proposed for identifying patients at risk of obstructive sleep apnoea, may also identify patients at increased risk of perioperative complications (when>3). Perioperative complications, including respiratory ones, are more frequent in emergency surgery. This study aimed at evaluating whether the SB is predictive of perioperative respiratory complications in urgent surgery. METHODS: Consecutive adult patients admitted for an urgent surgery under general anaesthesia were included...
October 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27083873/anaesthesia-with-sevoflurane-in-pigeons-minimal-anaesthetic-concentration-mac-determination-and-investigation-of-cardiorespiratory-variables-at-1-mac
#17
J Botman, F Gabriel, A H A Dugdale, J-M Vandeweerd
The objective of the study was to determine the minimal anaesthetic concentration (MAC) of sevoflurane (SEVO) in pigeons and investigate the effects of 1 MAC SEVO anaesthesia on cardiovascular and respiratory variables compared with the awake state. This is a prospective, experimental study. Animals were seven healthy adult pigeons. After acclimatisation to handling, heart rate (HR), heart rhythm, respiratory rate (fR), end-expired carbon dioxide tension (PE'CO2), inspired CO2 tension, indirect systolic arterial blood pressure (SAP) and cloacal temperature were measured to determine baseline, 'awake' values...
May 28, 2016: Veterinary Record
https://www.readbyqxmd.com/read/26986038/the-influence-of-regional-anaesthesia-and-local-anaesthetics-on-cardiac-repolarization
#18
REVIEW
Jowita Biernawska, Jarosław Kaźmierczak, Katarzyna Kotfis, Maciej Żukowski
The normal function of the heart muscle is the result of electro-mechanic and hemodynamic coupling. Modification of the structure and activity of ion channels within the cardiomyocytes may induce cardiac arrhythmias. Electrophysiological mechanisms of arrhythmia, generated by a prolonged period of repolarization, result either from conduction disturbances (reentry mechanism) and/or the induction of beats (early after-depolarizations). Local anaesthetic drug deposition does not affect the repolarization period, as long as the concentration of the free drug in the plasma does not reach the critical value to cause toxic effects in the cardiomyocytes...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/26979468/electroanatomic-mapping-and-transoesophageal-echocardiography-for-near-zero-fluoroscopy-during-complex-left-atrial-ablation
#19
Hariharan Raju, John Whitaker, Carly Taylor, Matthew Wright
BACKGROUND: We evaluated Carto 3, transoesophageal echocardiography (TOE) and contact force (CF) sensing catheter in atrial fibrillation (AF) ablation. METHODS: Unselected consecutive ablations performed under general anaesthesia (GA) were studied with modified protocol (cases, n=11) and compared to retrospective consecutive controls (n=10). Patent foramen ovale (PFO) or single transseptal puncture enabled left atrial (LA) access; ablation strategy was stepwise approach...
July 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/26897642/paravertebral-block-versus-thoracic-epidural-for-patients-undergoing-thoracotomy
#20
REVIEW
Joyce H Y Yeung, Simon Gates, Babu V Naidu, Matthew J A Wilson, Fang Gao Smith
BACKGROUND: Operations on structures in the chest (usually the lungs) involve cutting between the ribs (thoracotomy). Severe post-thoracotomy pain can result from pleural (lung lining) and muscular damage, costovertebral joint (ribcage) disruption and intercostal nerve (nerves that run along the ribs) damage during surgery. Poor pain relief after surgery can impede recovery and increase the risks of developing complications such as lung collapse, chest infections and blood clots due to ineffective breathing and clearing of secretions...
February 21, 2016: Cochrane Database of Systematic Reviews
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