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Anesthesia simulation

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https://www.readbyqxmd.com/read/28433802/role-of-environmental-stressors-in-determining-the-developmental-outcome-of-neonatal-anesthesia
#1
Ling-Sha Ju, Jiao-Jiao Yang, Nikolaus Gravenstein, Christoph N Seubert, Timothy E Morey, Colin Sumners, Terrie Vasilopoulos, Jian-Jun Yang, Anatoly E Martynyuk
BACKGROUND: The majority of studies evaluating neurocognition in humans who had procedures under anesthesia early in life found long-term deficits even though the typical anesthesia duration normalized to the human life span is much shorter than that shown to induce developmental abnormalities in rodents. Therefore, we studied whether subsequent environmental stressors contribute to deficiencies programmed by a brief neonatal etomidate exposure. METHODS: Postnatal days (P) 4, 5, or 6, Sprague-Dawley rats, pretreated with vehicle or the Na(+)-K(+)-2Cl(-) (NKCC1) inhibitor, bumetanide, received two injections of etomidate resulting in anesthesia for 2h...
April 7, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28395952/a-novel-methodology-for-assessing-laryngeal-and-vagus-nerve-integrity-in-patients-under-general-anesthesia
#2
Catherine F Sinclair, Maria J Téllez, Oscar R Tapia, Sedat Ulkatan, Vedran Deletis
OBJECTIVE: To describe a novel methodology for intraoperative neuro-monitoring of laryngeal and vagus nerves by utilizing the laryngeal adductor reflex (LAR). METHODS: Case series of 15 patients undergoing thyroid and cervical spine surgeries under total intravenous general anesthesia. Vocal fold mucosa was electrically stimulated to elicit a LAR using endotracheal tube based electrodes. Contralateral R1 (cR1) and R2 (cR2) responses were recorded using the endotracheal tube electrode contralateral to the simulating electrode...
March 14, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28386360/neuroprotective-effect-of-mir-665-against-sevoflurane-anesthesia-induced-cognitive-dysfunction-in-rats-through-pi3k-akt-signaling-pathway-by-targeting-insulin-like-growth-factor-2
#3
Xihua Lu, Shuaiguo Lv, Yan Mi, Lei Wang, Gensheng Wang
The aim of this study was to investigate the in vivo and in vitro effects of miR-665 on sevoflurane anesthesia-induced cognitive dysfunction. SH-SY5Y cells and male SD rats were treated with sevoflurane to simulate anesthesia-induced cognitive dysfunction. The cells and rats both were transfected with a miR-665 mimic, inhibitor, scramble, IGF-2 siRNA, or treated with P13K/Akt inhibitor LY294002. The cell apoptosis, autophagy, growth related proteins, and mRNA levels were measured using different methods. The motor performance was assessed using the Morris water maze (MWM) test...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28377943/expert-evaluation-of-a-chicken-tissue-based-model-for-teaching-ultrasound-guided-central-venous-catheter-insertion
#4
Akiva Nachshon, John D Mitchell, Ariel Mueller, Valerie M Banner-Goodspeed, Jakob I McSparron
BACKGROUND: Ultrasound-guided central venous catheterization (CVC) is a commonly performed procedure which carries significant risks for complications. Current models used for simulation-based teaching are expensive and may not replicate tissue feel and ultrasound qualities of human tissues. We aimed to evaluate a tissue model composed of chicken breast and balloons and compare it to a commercially available mannequin. METHODS: Forty attending physicians from four departments with extensive CVC experience were enrolled...
January 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/28377942/an-evaluation-of-ca-1-residents-adherence-to-a-standardized-handoff-checklist
#5
Madeline C Heck, Peter Huges, Mojca Konia
BACKGROUND: Poor-quality handoffs are a significant cause of preventable medical errors and adverse events. Handoff checklists improve handoffs but adherence to these tools is often inconsistent. In our study we aimed to investigate the effects of simulated handoff workshop and clinical instruction on resident handoff quality. METHODS: A three-week pre-education intervention observation period of handoffs was conducted to assess the deficits, variability, and common practice in handoffs at the University of Minnesota Fairview Hospital...
January 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/28333703/higher-fresh-gas-flow-rates-decrease-tidal-volume-during-pressure-control-ventilation
#6
Shazia Mohammad, Nikolaus Gravenstein, Drew Gonsalves, Terrie Vasilopoulos, Samsun Lampotang
BACKGROUND: We observed that increasing fresh gas flow (FGF) decreased exhaled tidal volume (VT) during pressure control ventilation (PCV). A literature search produced no such description whereby unintended VT changes occur with FGF changes during PCV. METHODS: To model an infant's lungs, 1 lung of a mechanical lung model (Dual Adult TTL 1600; Michigan Instruments, Inc, Grand Rapids, MI) was set at a compliance of 0.0068 L/cm H2O. An Rp50 resistor (27.2 cm H2O/L/s at 15 L/min) simulated normal bronchial resistance...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28306682/training-future-anesthesiologists-in-obstetric-care
#7
Mauricio Vasco Ramírez
PURPOSE OF REVIEW: In order for the obstetric anesthesiologist to become a true perioperative / peripartum physician, a change in formative programs and certification process in anesthesia are needed. RECENT FINDINGS: Anesthesia training programs are migrating to competency based medical education (CBME) worldwide. The traditional model of attending lectures, grand rounds, reading textbooks and journal papers should be complemented by virtual modalities such as massive open online courses or online teaching tools...
April 10, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28298747/benefits-and-pitfalls-of-cadavers-as-learning-tool-for-ultrasound-guided-regional-anesthesia
#8
REVIEW
Chhavi Sawhney, Sanjeev Lalwani, Bikash Ranjan Ray, Sumit Sinha, Abhyuday Kumar
Ultrasound-guided regional anesthesia (UGRA), like other basic skills, should be learnt in a simulation laboratory before performing on the patient. Cadavers provide an ideal tool for learning sonoanatomy and skills required for performing UGRA. On the basis of preservation technique used, the cadavers can be formalin embalmed cadavers, Thiel cadavers (soft cadavers), and fresh frozen cadavers. We compared three types of cadavers for performing ultrasound-guided upper and lower limb blocks. We observed that fresh frozen and Thiel cadavers were less smelling and had more realistic appearance as compared to formalin embalmed cadavers...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28294695/operating-room-team-training-with-simulation-a-systematic-review
#9
Jamie M Robertson, Roger D Dias, Steven Yule, Douglas S Smink
INTRODUCTION: Nontechnical skills (NTS) such as teamwork and communication play an important role in preventing adverse outcomes in the operating room (OR). Simulation-based OR team training focused on these skills provides an environment where team members can learn with and from one another. We sought to conduct a systematic review to identify simulation-based approaches to NTS training for surgical teams. MATERIALS AND METHODS: We conducted a systematic search of PubMed, ERIC, and the Cochrane Database using keywords and MeSH terms for studies describing simulation-based training for OR teams, including members from surgery, anesthesia, and nursing in September 2016...
March 15, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#10
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286528/evaluation-of-a-pilot-project-to-introduce-simulation-based-team-training-to-pediatric-surgery-trauma-room-care
#11
Markus Lehner, Ellen Heimberg, Florian Hoffmann, Oliver Heinzel, Hans-Joachim Kirschner, Martina Heinrich
Introduction. Several studies in pediatric trauma care have demonstrated substantial deficits in both prehospital and emergency department management. Methods. In February 2015 the PAEDSIM collaborative conducted a one and a half day interdisciplinary, simulation based team-training course in a simulated pediatric emergency department. 14 physicians from the medical fields of pediatric surgery, pediatric intensive care and emergency medicine, and anesthesia participated, as well as four pediatric nurses. After a theoretical introduction and familiarization with the simulator, course attendees alternately participated in six simulation scenarios and debriefings...
2017: International Journal of Pediatrics
https://www.readbyqxmd.com/read/28282987/lateral-pressure-profile-and-free-volume-properties-in-phospholipid-membranes-containing-anesthetics
#12
Balázs Fábián, Marcello Sega, Vladimir P Voloshin, Nikolai N Medvedev, Pál Jedlovszky
The effect of four general anesthetics, namely chloroform, halothane, diethyl ether, and enflurane on the free volume fraction and lateral pressure profiles in a fully hydrated dipalmitoylphosphatidylcholime (DPPC) membrane is investigated by means of computer simulation. In order to find changes that can be related to the molecular mechanism of anesthesia as well as its pressure reversal, the simulations are performed both at atmospheric and high (1000 bar) pressures. The obtained results show that the additional free volume occurring in the membrane is localized around the anesthetic molecules themselves...
March 27, 2017: Journal of Physical Chemistry. B
https://www.readbyqxmd.com/read/28279584/simulation-training-for-the-office-based-anesthesia-team
#13
REVIEW
Richard M Ritt, Jeffrey Bennett, David Todd
An OMS office is a complex environment. Within such an environment, a diverse scope of complex surgical procedures is performed with different levels of anesthesia, ranging from local anesthesia to general anesthesia, on patients with varying comorbidities. Optimal patient outcomes require a functional surgical and anesthetic team, who are familiar with both standard operational principles and emergency recognition and management. Offices with high volume and time pressure add further stress and potential risk to the office environment...
March 6, 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28275282/additive-manufacturing-for-surgical-planning-of-mandibular-fracture
#14
Nadja Maria da Silva Oliveira Brito, Renata de Souza Coelho Soares, Erik Lafitt Tavares Monteiro, Sergio Charifker Ribeiro Martins, Josuel Raimundo Cavalcante, Rafael Grotta Grempel, José Augusto de Oliveira Neto
Currently, imaging techniques such as Computed Tomography with three-dimensional reconstruction (3D) and Magnetic Resonances are being routinely used in pre-surgical planning in all fields of medicine. Nowadays, virtual three-dimensional images, commonly displayed on two-dimensional surfaces, such as the computer screen, can be used to produce rapidly prototyped models, with excellent dimensional accuracy and fine reproduction of anatomical structures, providing professionals with the ability to use the biomodel in planning and simulating medical and dental procedures (oral and maxillofacial surgery, making individualized facial implants and prostheses, measurements and previous adaptations of prefabricated fixation plates), thus contributing to considerable reductions in surgical time and consequently the duration of anesthesia, minimizing infection risks and reducing hospital costs...
December 2016: Acta Stomatologica Croatica
https://www.readbyqxmd.com/read/28268745/development-of-artificial-tissue-like-structures-for-a-hybrid-epidural-anesthesia-simulator
#15
Benjamin Esterer, Johannes Razenbock, Marianne Hollensteiner, David Fuerst, Andreas Schrempf
Puncturing the epidural space and lumbar puncture are common procedures in anesthesia. They are carried out blind, where a needle is advanced from posterior between two adjacent vertebrae. Two different approaches are common practice for this technique, the midline and the paramedian one. The learning curve characteristics of both approaches significantly depends on the number of punctures carried out by a medical novice. For the training of these blind procedures a hybrid simulator requires artificial structures imitating the tissues which are penetrated by the needle...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28263243/use-of-3-dimensional-printing-to-create-patient-specific-thoracic-spine-models-as-task-trainers
#16
Jelliffe Jeganathan, Yanick Baribeau, Jeffrey Bortman, Feroze Mahmood, Marc Shnider, Muneeb Ahmed, Azad Mashari, Rabia Amir, Yannis Amador, Robina Matyal
BACKGROUND AND OBJECTIVES: Thoracic epidural anesthesia is a technically challenging procedure with a high failure rate of 24% to 32% nationwide. Residents in anesthesiology have limited opportunities to practice this technique adequately, and there are no training tools available for this purpose. Our objective was to build a low-cost patient-specific thoracic epidural training model. METHODS: We obtained thoracic computed tomography scan data from patients with normal and kyphotic spine...
March 3, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28230465/hypnotic-tactile-anesthesia-psychophysical-and-signal-detection-analyses
#17
Douglas J Tataryn, John F Kihlstrom
Two experiments that studied the effects of hypnotic suggestions on tactile sensitivity are reported. Experiment 1 found that suggestions for anesthesia, as measured by both traditional psychophysical methods and signal-detection procedures, were linearly related to hypnotizability. Experiment 2 employed the same methodologies in an application of the real-simulator paradigm to examine the effects of suggestions for both anesthesia and hyperesthesia. Significant effects of hypnotic suggestion on both sensitivity and bias were found in the anesthesia condition but not for the hyperesthesia condition...
April 2017: International Journal of Clinical and Experimental Hypnosis
https://www.readbyqxmd.com/read/28226933/development-of-artificial-tissue-like-structures-for-a-hybrid-epidural-anesthesia-simulator
#18
Benjamin Esterer, Johannes Razenbock, Marianne Hollensteiner, David Fuerst, Andreas Schrempf, Benjamin Esterer, Johannes Razenbock, Marianne Hollensteiner, David Fuerst, Andreas Schrempf, David Fuerst, Benjamin Esterer, Johannes Razenbock, Andreas Schrempf, Marianne Hollensteiner
Puncturing the epidural space and lumbar puncture are common procedures in anesthesia. They are carried out blind, where a needle is advanced from posterior between two adjacent vertebrae. Two different approaches are common practice for this technique, the midline and the paramedian one. The learning curve characteristics of both approaches significantly depends on the number of punctures carried out by a medical novice. For the training of these blind procedures a hybrid simulator requires artificial structures imitating the tissues which are penetrated by the needle...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28213945/optimization-of-initial-propofol-bolus-dose-for-eeg-narcotrend-index-guided-transition-from-sevoflurane-induction-to-intravenous-anesthesia-in-children
#19
Nils Dennhardt, Dietmar Boethig, Christiane Beck, Sebastian Heiderich, Martin Boehne, Andreas Leffler, Barbara Schultz, Robert Sümpelmann
BACKGROUND: Sevoflurane induction followed by intravenous anesthesia is a widely used technique to combine the benefits of an easier and less traumatic venipuncture after sevoflurane inhalation with a recovery with less agitation, nausea, and vomiting after total intravenous anesthesia (TIVA). Combination of two different anesthetics may lead to unwanted burst suppression in the electroencephalogram (EEG) during the transition phase. OBJECTIVE: The objective of this prospective clinical observational study was to identify the optimal initial propofol bolus dose for a smooth transition from sevoflurane induction to TIVA using the EEG Narcotrend Index (NI)...
February 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28211193/sequential-allocation-trial-design-in-anesthesia-an-introduction-to-methods-modeling-and-clinical-applications
#20
REVIEW
Matthias Görges, Guohai Zhou, Rollin Brant, J Mark Ansermino
Estimation of the dose-response curve for new anesthetic protocols typically focuses on identifying minimum effective doses. The application of a sequential experimental method is appropriate, as it minimizes sample size requirements by updating dose assignments based on information accrued from successive subjects. One approach is the up-and-down method for estimating the median effective dose in a patient population (ED50 ). Designs better suited for achieving greater than 50% effectiveness, include the biased coin approach, and continual reassessment method...
March 2017: Paediatric Anaesthesia
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