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Anesthesia simulation

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https://www.readbyqxmd.com/read/28939143/a-physiologically-based-model-to-predict-individual-pharmacokinetics-and-pharmacodynamics-of-remifentanil
#1
Sara Cascone, Gaetano Lamberti, Ornella Piazza, Roberto Andrea Abbiati, Davide Manca
Remifentanil based anesthesia is nowadays spread worldwide. This drug is characterized by a rapid onset of the analgesic effects, but also a rapid onset of the side effects. For this reason, the knowledge of the remifentanil concentration in the human body is a key topic in anesthesiology. The aims of this work are to propose and validate a physiologically based pharmacokinetic model capable to predict both the pharmacokinetics and pharmacodynamics of remifentanil, and to take into account the inter-individual differences among the patients (such as the height and body mass)...
September 19, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28903938/atrial-fibrillation-in-acute-obstructive-sleep-apnea-autonomic-nervous-mechanism-and-modulation
#2
Lilei Yu, Xuefei Li, Bing Huang, Xiaoya Zhou, Menglong Wang, Liping Zhou, Guannan Meng, Yuhong Wang, Zhenya Wang, Jielin Deng, Hong Jiang
BACKGROUND: The mechanisms of atrial fibrillation (AF) induced by obstructive sleep apnea (OSA) are not completely understood. This study investigated the roles of the intrinsic and extrinsic cardiac autonomic nervous system in OSA-induced AF and provided noninvasive autonomic nervous modulation for the suppression of OSA-induced AF by using low-level transcutaneous electrical stimulation (LL-TS) of the auricular branch of the vagus nerve at the tragus. METHODS AND RESULTS: Eighteen dogs received tracheostomy under general anesthesia and were randomly divided into 3 groups: the OSA group (OSA was simulated via clamping of the endotracheal tube at end expiration for 1...
September 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28888420/transition-to-residency-the-successful-development-and-implementation-of-a-nonclinical-elective-in-perioperative-management
#3
Heather McDonald, Nada Gawad, Isabelle Raîche, Fraser D Rubens
OBJECTIVE: Few medical school programs in Canada address challenges related to the significant increase in responsibility for patient care between medical school and residency. This is particularly important in surgery and anesthesia due to the high-acuity care required during the perioperative period. The purpose of this study was to develop and assess a program that would help students transition to surgical and anesthesia residencies, in terms of knowledge acquisition, clinical decision-making skills, and subjective preparedness...
September 6, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28882740/effect-of-sleep-deprivation-after-a-night-shift-duty-on-simulated-crisis-management-by-residents-in-anaesthesia-a-randomised-crossover-study
#4
Ségolène Arzalier-Daret, Clément Buléon, Marie-Laure Bocca, Pierre Denise, Jean-Louis Gérard, Jean-Luc Hanouz
BACKGROUND: Sleep deprivation has been associated with an increased incidence of medical errors and can jeopardise patients' safety during medical crisis management. The aim of the study was to assess the effect of sleep deprivation on the management of simulated anaesthesia crisis by residents in anaesthesiology. METHODS: A randomised, comparative, monocentric crossover study involving 48 residents in anaesthesia was performed on a high fidelity patient simulator...
September 4, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28877273/virtual-reality-simulator-for-dental-anesthesia-training-in-the-inferior-alveolar-nerve-block
#5
Cléber Gimenez Corrêa, Maria Aparecida de Andrade Moreira Machado, Edith Ranzini, Romero Tori, Fátima de Lourdes Santos Nunes
Objectives: This study shows the development and validation of a dental anesthesia-training simulator, specifically for the inferior alveolar nerve block (IANB). The system developed provides the tactile sensation of inserting a real needle in a human patient, using Virtual Reality (VR) techniques and a haptic device that can provide a perceived force feedback in the needle insertion task during the anesthesia procedure. Material and Methods: To simulate a realistic anesthesia procedure, a Carpule syringe was coupled to a haptic device...
July 2017: Journal of Applied Oral Science: Revista FOB
https://www.readbyqxmd.com/read/28852014/anesthetic-alterations-of-collective-terahertz-oscillations-in-tubulin-correlate-with-clinical-potency-implications-for-anesthetic-action-and-post-operative-cognitive-dysfunction
#6
Travis J A Craddock, Philip Kurian, Jordane Preto, Kamlesh Sahu, Stuart R Hameroff, Mariusz Klobukowski, Jack A Tuszynski
Anesthesia blocks consciousness and memory while sparing non-conscious brain activities. While the exact mechanisms of anesthetic action are unknown, the Meyer-Overton correlation provides a link between anesthetic potency and solubility in a lipid-like, non-polar medium. Anesthetic action is also related to an anesthetic's hydrophobicity, permanent dipole, and polarizability, and is accepted to occur in lipid-like, non-polar regions within brain proteins. Generally the protein target for anesthetics is assumed to be neuronal membrane receptors and ion channels, however new evidence points to critical effects on intra-neuronal microtubules, a target of interest due to their potential role in post-operative cognitive dysfunction (POCD)...
August 29, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28815823/ten-years-of-simulation-based-training-in-pediatric-anesthesia-the-inception-evolution-and-dissemination-of-the-managing-emergencies-in-pediatric-anesthesia-mepa-course
#7
Tobias C Everett, Ralph MacKinnon, David de Beer, Matthew Taylor, Matthew Dylan Bould
2016 marked the 10-year anniversary of the inception of the Managing Emergencies in Paediatric Anaesthesia (MEPA) course. This simulation-based program was originally created to allow trainees in pediatric anesthesia to experience operating room emergencies which although infrequent, would be considered key competencies for any practicing anesthetist with responsibility for providing care to children. Since its original manifestation, the course has evolved in content, scope, and worldwide availability, such that it is now available at over 60 locations on five continents...
October 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28802790/vascular-air-embolism-a-silent-hazard-to-patient-safety
#8
REVIEW
Sorin J Brull, Richard C Prielipp
PURPOSE: To narratively review published information on prevention, detection, pathophysiology, and appropriate treatment of vascular air embolism (VAE). MATERIALS AND METHODS: MEDLINE, SCOPUS, Cochrane Central Register and Google Scholar databases were searched for data published through October 2016. The Manufacturer and User Facility Device Experience (MAUDE) database was queried for "air embolism" reports (years 2011-2016). RESULTS: VAE may be introduced through disruption in the integrity of the venous circulation that occurs during insertion, maintenance, or removal of intravenous or central venous catheters...
August 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28801082/-how-to-videos-improve-residents-performance-of-essential-perioperative-electronic-medical-records-and-clinical-tasks
#9
Veronica Zoghbi, Robert C Caskey, Kristoffel R Dumon, Jacqueline M Soegaard Ballester, Ari D Brooks, Jon B Morris, Daniel T Dempsey
OBJECTIVE: The ability to use electronic medical records (EMR) is an essential skill for surgical residents. However, frustration and anxiety surrounding EMR tasks may detract from clinical performance. We created a series of brief, 1-3 minutes "how to" videos demonstrating 7 key perioperative EMR tasks: booking OR cases, placing preprocedure orders, ordering negative-pressure wound dressing supplies, updating day-of-surgery history and physical notes, writing brief operative notes, discharging patients from the postanesthesia care unit, and checking vital signs...
August 8, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28791331/temporal-processing-in-the-visual-cortex-of-the-awake-and-anesthetized-rat
#10
Ida E J Aasebø, Mikkel E Lepperød, Maria Stavrinou, Sandra Nøkkevangen, Gaute Einevoll, Torkel Hafting, Marianne Fyhn
The activity pattern and temporal dynamics within and between neuron ensembles are essential features of information processing and believed to be profoundly affected by anesthesia. Much of our general understanding of sensory information processing, including computational models aimed at mathematically simulating sensory information processing, rely on parameters derived from recordings conducted on animals under anesthesia. Due to the high variety of neuronal subtypes in the brain, population-based estimates of the impact of anesthesia may conceal unit- or ensemble-specific effects of the transition between states...
July 2017: ENeuro
https://www.readbyqxmd.com/read/28776686/contralateral-r1-and-r2-components-of-the-laryngeal-adductor-reflex-in-humans-under-general-anesthesia
#11
Catherine F Sinclair, Maria J Téllez, Oscar R Tapia, Sedat Ulkatan
OBJECTIVES: To demonstrate that under total intravenous general anesthesia (TIVA), the contralateral R1 (cRI) and contralateral R2 (cR2) components of the laryngeal adductor reflex (LAR) can be reliably elicited; to determine effects of topical anesthesia and inhalational anesthesia on the LAR; and to discuss how this technique may be utilized to continuously monitor the vagus nerve reflex arc. STUDY DESIGN: Case series. METHODS: Vocal fold mucosa was electrically stimulated via endotracheal tube surface-based electrodes to elicit a LAR...
August 4, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28759501/ultrasound-guided-regional-anesthesia-simulation-training-a-systematic-review
#12
Xiao Xu Chen, Vatsal Trivedi, AbdulHadi A AlSaflan, Suzanne Clare Todd, Andrea C Tricco, Colin J L McCartney, Sylvain Boet
BACKGROUND AND OBJECTIVES: Ultrasound-guided regional anesthesia (UGRA) has become the criterion standard of regional anesthesia practice. Ultrasound-guided regional anesthesia teaching programs often use simulation, and guidelines have been published to help guide URGA education. This systematic review aimed to examine the effectiveness of simulation-based education for the acquisition and maintenance of competence in UGRA. METHODS: Studies identified in MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were included if they assessed simulation-based UGRA teaching with outcomes measured at Kirkpatrick level 2 (knowledge and skills), 3 (transfer of learning to the workplace), or 4 (patient outcomes)...
July 28, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28742797/a-comparison-of-selective-aortic-arch-perfusion-and-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-the-management-of-hemorrhage-induced-traumatic-cardiac-arrest-a-translational-model-in-large-swine
#13
RANDOMIZED CONTROLLED TRIAL
Ed B G Barnard, James E Manning, Jason E Smith, Jason M Rall, Jennifer M Cox, James D Ross
BACKGROUND: Survival rates remain low after hemorrhage-induced traumatic cardiac arrest (TCA). Noncompressible torso hemorrhage (NCTH) is a major cause of potentially survivable trauma death. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) at the thoracic aorta (Zone 1) can limit subdiaphragmatic blood loss and allow for IV fluid resuscitation when intrinsic cardiac activity is still present. Selective Aortic Arch Perfusion (SAAP) combines thoracic aortic balloon hemorrhage control with intra-aortic oxygenated perfusion to achieve return of spontaneous circulation (ROSC) when cardiac arrest has occurred...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28734531/event-based-control-of-depth-of-hypnosis-in-anesthesia
#14
Luca Merigo, Manuel Beschi, Fabrizio Padula, Nicola Latronico, Massimiliano Paltenghi, Antonio Visioli
BACKGROUND AND OBJECTIVE: In this paper, we propose the use of an event-based control strategy for the closed-loop control of the depth of hypnosis in anesthesia by using propofol administration and the bispectral index as a controlled variable. METHODS: A new event generator with high noise-filtering properties is employed in addition to a PIDPlus controller. The tuning of the parameters is performed off-line by using genetic algorithms by considering a given data set of patients...
August 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28713258/relationship-of-topology-multiscale-phase-synchronization-and-state-transitions-in-human-brain-networks
#15
Minkyung Kim, Seunghwan Kim, George A Mashour, UnCheol Lee
How the brain reconstitutes consciousness and cognition after a major perturbation like general anesthesia is an important question with significant neuroscientific and clinical implications. Recent empirical studies in animals and humans suggest that the recovery of consciousness after anesthesia is not random but ordered. Emergence patterns have been classified as progressive and abrupt transitions from anesthesia to consciousness, with associated differences in duration and electroencephalogram (EEG) properties...
2017: Frontiers in Computational Neuroscience
https://www.readbyqxmd.com/read/28712105/evaluation-of-a-low-cost-3d-printed-model-for-bronchoscopy-training
#16
Matteo Parotto, Joshua Qua Jiansen, Ahmed AboTaiban, Svetlana Ioukhova, Alisher Agzamov, Richard Cooper, Gerald O'Leary, Massimiliano Meineri
BACKGROUND: Flexible bronchoscopy is a fundamental procedure in anaesthesia and critical care medicine. Although learning this procedure is a complex task, the use of simulation-based training provides significant advantages, such as enhanced patient safety. Access to bronchoscopy simulators may be limited in low-resource settings. We have developed a low-cost 3D-printed bronchoscopy training model. METHODS: A parametric airway model was obtained from an online medical model repository and fabricated using a low-cost 3D printer...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28704284/evaluation-of-a-simpler-tool-to-assess-nontechnical-skills-during-simulated-critical-events
#17
Scott C Watkins, David A Roberts, John R Boulet, Matthew D McEvoy, Matthew B Weinger
INTRODUCTION: Management of critical events requires teams to employ nontechnical skills (NTS), such as teamwork, communication, decision making, and vigilance. We sought to estimate the reliability and provide evidence for the validity of the ratings gathered using a new tool for assessing the NTS of anesthesia providers, the behaviorally anchored rating scale (BARS), and compare its scores with those of an established NTS tool, the Anaesthetists' Nontechnical Skills (ANTS) scale. METHODS: Six previously trained raters (4 novices and 2 experts) reviewed and scored 18 recorded simulated pediatric crisis management scenarios using a modified ANTS and a BARS tool...
April 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28695248/divergent-effects-of-anesthetics-on-lipid-bilayer-properties-and-sodium-channel-function
#18
REVIEW
Karl F Herold, Olaf S Andersen, Hugh C Hemmings
General anesthetics revolutionized medicine by allowing surgeons to perform more complex and much longer procedures. This widely used class of drugs is essential to patient care, yet their exact molecular mechanism(s) are incompletely understood. One early hypothesis over a century ago proposed that nonspecific interactions of anesthetics with the lipid bilayer lead to changes in neuronal function via effects on membrane properties. This model was supported by the Meyer-Overton correlation between anesthetic potency and lipid solubility and despite more recent evidence for specific protein targets, in particular ion-channels, lipid bilayer-mediated effects of anesthetics is still under debate...
July 10, 2017: European Biophysics Journal: EBJ
https://www.readbyqxmd.com/read/28678068/anesthesia-adverse-events-voluntarily-reported-in-the-veterans-health-administration-and-lessons-learned
#19
Julia Neily, Elda S Silla, Sam John T Sum-Ping, Roberta Reedy, Douglas E Paull, Lisa Mazzia, Peter D Mills, Robin R Hemphill
BACKGROUND: Anesthesia providers have long been pioneers in patient safety. Despite remarkable efforts, anesthesia errors still occur, resulting in complications, injuries, and even death. The Veterans Health Administration (VHA) National Center of Patient Safety uses root cause analysis (RCA) to examine why system-related adverse events occur and how to prevent future similar events. This study describes the types of anesthesia adverse events reported in VHA hospitals and their root causes and preventative actions...
July 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28665830/undiagnosed-pheochromocytoma-simulating-malignant-hyperthermia
#20
Nisha S Ramani, Robert Stoppacher, Ajaykumar C Morani, Charles Catanese
INTRODUCTION: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. They are surgically curable but can be lethal if remain undiagnosed. We report a patient earlier diagnosed with malignant hyperthermia but later found to have pheochromocytoma on autopsy. CASE REPORT: After a preprocedural pain block for elective right shoulder arthroscopy, a 53-year-old hypertensive white man developed chest pain. In the operating room, he had increased blood pressure...
September 2017: American Journal of Forensic Medicine and Pathology
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