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hypotensive anesthesia

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https://www.readbyqxmd.com/read/28197279/a-sudden-change-of-heart-a-case-of-rapidly-reversed-stress-cardiomyopathy-in-a-critically-ill-patient
#1
Michael I Brener, Ali R Keramati, Marek A Mirski, Oscar H Cingolani
We report the case of a 79-year-old woman who presented to our hospital for elective removal of an infratentorial meningioma and suffered a periprocedural cardiac arrest. Shortly after uncomplicated induction of anesthesia prior to the surgery, the patient became hypotensive and bradycardic, culminating ultimately in a cardiac arrest with pulseless electrical activity. Return of spontaneous circulation occurred within 90 seconds of arrest, but the patient remained dependent on maximal doses of epinephrine and dopamine for hemodynamic support...
June 2016: Cardiology Research
https://www.readbyqxmd.com/read/28197025/current-perioperative-management-of-pheochromocytomas
#2
REVIEW
Rashmi Ramachandran, Vimi Rewari
Neuroendocrine tumors which have the potential to secrete catecholamines are either associated with sympathetic adrenal (pheochromocytoma) or nonadrenal (paraganglioma) tissue. Surgical removal of these tumors is always indicated to cure and prevent cardiovascular and other organ system complications associated with catecholamine excess. Some of these tumors have malignant potential as well. The diagnosis, localization and anatomical delineation of these tumors involve measurement of catecholamines and their metabolic end products in plasma and urine, (123)I-metaiodobenzylguanidine scintigraphy, computed tomography, and/or magnetic resonance imaging...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28194399/the-role-of-permissive-and-induced-hypotension-in-current-neuroanesthesia-practice
#3
Suren Soghomonyan, Nicoleta Stoicea, Gurneet S Sandhu, Jeffrey J Pasternak, Sergio D Bergese
BACKGROUND: Induced hypotension (IH) had been used for decades in neurosurgery to reduce the risk for intraoperative blood loss and decrease blood replacement. More recently, this method fell out of favor because of concerns for cerebral and other end-organ ischemia and worse treatment outcomes. Other contributing factors to the decline in its popularity include improvements in microsurgical technique, widespread use of endovascular procedures, and advances in blood conservation and transfusion protocols...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28188706/comparison-of-atipamezole-with-yohimbine-for-antagonism-of-xylazine-in-mice-anesthetized-with-ketamine-and-xylazine
#4
Christopher F Janssen Pauline Maiello M Jerry Wright Jr Kara B Kracinovsky And Joseph T Newsome
The α2 adrenergic agonist xylazine produces a sedative effect and is typically combined with ketamine and used for anesthesia or chemical restraint of laboratory mice. Xylazine's sedative effect-and its undesirable side effects of bradycardia, hypotension, and poor tissue perfusion-can be reversed by administration of α2 antagonists, such as atipamezole or yohimbine. Although atipamezole and yohimbine dosing guidelines are available for mice, no controlled comparison has been performed to guide the lab animal community in the selection of one over the other...
February 10, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28183565/minimum-effective-fluid-volume-of-colloid-to-prevent-hypotension-during-caesarean-section-under-spinal-anesthesia-using-a-prophylactic-phenylephrine-infusion-an-up-down-sequential-allocation-study
#5
Christian Loubert, Pierre-Olivier Gagnon, Roshan Fernando
STUDY OBJECTIVE: The aim of this study was to de termine the minimum effective fluid volume (MEFV) of hydroxyethyl starch 130/0.4 (HES) infused in a preload fashion which would prevent hypotension in 50% of parturients undergoing caesarean section. A secondary objective was to measure the hemodynamic effect of fluid loading on the subjects. DESIGN: This is a prospective, double-blinded, dose-finding study using an up-down sequential allocation design. SETTING: In the operating room...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183555/vasoplegic-syndrome-during-whipple-procedure
#6
Tejesh C Anandaswamy, Geetha C Rajappa, Harish Krishnamachar
Vasoplegic syndrome is an unusual cause of refractory hypotension under general anesthesia. It is commonly described in the setting of cardiac surgery, but rarely seen in noncardiac setting. We describe successful management of vasoplegic syndrome during Whipple procedure with vasopressin infusion. A high index of suspicion and prompt treatment with vasopressin can be lifesaving in patients with risk factors for vasoplegic syndrome who present with severe refractory hypotension and who respond poorly to fluid administration and routine vasopressor infusion...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28182690/impact-of-dexmedetomidine-on-the-incidence-of-delirium-in-elderly-patients-after-cardiac-surgery-a-randomized-controlled-trial
#7
Xue Li, Jing Yang, Xiao-Lu Nie, Yan Zhang, Xue-Ying Li, Li-Huan Li, Dong-Xin Wang, Daqing Ma
BACKGROUND: Delirium is a frequent complication after cardiac surgery and its occurrence is associated with poor outcomes. The purpose of this study was to investigate the impact of perioperative dexmedetomidine administration on the incidence of delirium in elderly patients after cardiac surgery. METHODS: This randomized, double-blinded, and placebo-controlled trial was conducted in two tertiary hospitals in Beijing between December 1, 2014 and July 19, 2015. Eligible patients were randomized into two groups...
2017: PloS One
https://www.readbyqxmd.com/read/28181385/hemodynamic-profile-and-behavioral-characteristics-during-induction-of-anesthesia-in-pediatric-patients-with-attention-deficit-hyperactivity-disorder
#8
Richard S Cartabuke, Joseph D Tobias, Julie Rice, Dmitry Tumin
AIM: There is no consensus regarding the administration of stimulant drugs preoperatively, particularly in pediatric patients diagnosed with ADHD. The primary objective of the current study was to assess differences in blood pressure and heart rate before and after induction of anesthesia between patients on chronic amphetamine or methylphenidate therapy who receive their normal dose preoperatively compared to patients in whom the prescribed medication was withheld. Secondary objectives were to assess the anxiety level during the induction of anesthesia and the effect of premedication with midazolam...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28181351/sedation-methods-for-transthoracic-echocardiography-in-children-with-trisomy-21-a-retrospective-study
#9
Jeff Miller, Lili Ding, James Spaeth, Jennifer Lam, Joanna Paquin, Erica Lin, Allison Divanovic, Bi Lian Li, Shankar Baskar, Andreas W Loepke
BACKGROUND: Many children with Trisomy 21 have neurologic or behavioral problems that make it difficult for them to remain still during noninvasive imaging studies, such as transthoracic echocardiograms (TTEcho). Recently, intranasal dexmedetomidine sedation has been introduced for this purpose. However, dexmedetomidine has been associated with bradycardia. Children with Trisomy 21 have been reported to have a higher risk of bradycardia and airway obstruction with sedation or anesthesia compared to children without Trisomy 21...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28178091/investigating-the-efficacy-of-dexmedetomidine-as-an-adjuvant-to-local-anesthesia-in-brachial-plexus-block-a-systematic-review-and-meta-analysis-of-18-randomized-controlled-trials
#10
Nasir Hussain, Vincent Paul Grzywacz, Charles Andrew Ferreri, Amit Atrey, Laura Banfield, Naum Shaparin, Amaresh Vydyanathan
BACKGROUND AND OBJECTIVES: Dexmedetomidine has been thought to be an effective adjuvant to local anesthetics in brachial plexus blockade. We sought to clarify the uncertainty that still exists as to its true efficacy. METHODS: A meta-analysis of randomized controlled trials was conducted to assess the ability of dexmedetomidine to prolong the duration and hasten the onset of motor and sensory blockade when used as an adjuvant to local anesthesia for brachial plexus blockade versus using local anesthesia alone (control)...
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28165305/effect-of-anesthesia-associated-hypotension-on-neurologic-outcome-in-dogs-undergoing-hemilaminectomy-because-of-acute-severe-thoracolumbar-intervertebral-disk-herniation-56-cases-2007-2013
#11
Alexandra Dixon, Amy E Fauber
OBJECTIVE To evaluate the effect of anesthesia-associated hypotension on final motor and urinary function in paraplegic dogs without nociception that underwent hemilaminectomy because of acute, severe thoracolumbar intervertebral disk herniation (IVDH). DESIGN Retrospective case series. ANIMALS 56 paraplegic dogs with acute thoracolumbar IVDH and absent nociception. PROCEDURES Medical records were reviewed, and signalment, history, anesthetic details, and results of serial neurologic assessments performed for at least 4 weeks after surgery were recorded...
February 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28165304/effects-of-acepromazine-and-trazodone-on-anesthetic-induction-dose-of-propofol-and-cardiovascular-variables-in-dogs-undergoing-general-anesthesia-for-orthopedic-surgery
#12
Lindsey A Murphy, Michele Barletta, Lynelle F Graham, Lorna J Reichl, Margaret M Duxbury, Jane E Quandt
OBJECTIVE To compare the doses of propofol required to induce general anesthesia in dogs premedicated with acepromazine maleate or trazodone hydrochloride and compare the effects of these premedicants on cardiovascular variables in dogs anesthetized for orthopedic surgery. DESIGN Prospective, randomized study. ANIMALS 30 systemically healthy client-owned dogs. PROCEDURES 15 dogs received acepromazine (0.01 to 0.03 mg/kg [0.005 to 0.014 mg/lb], IM) 30 minutes before anesthetic induction and 15 received trazodone (5 mg/kg [2...
February 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28164084/comparison-of-phenylephrine-and-ephedrine-in-treatment-of-spinal-induced-hypotension-in-high-risk-pregnancies-a-narrative-review
#13
REVIEW
Sasima Dusitkasem, Blair H Herndon, Monsicha Somjit, David L Stahl, Emily Bitticker, John C Coffman
PURPOSE: To compare maternal and fetal effects of intravenous phenylephrine and ephedrine administration during spinal anesthesia for cesarean delivery in high-risk pregnancies. SOURCE: An extensive literature search was conducted using the US National Library of Medicine, MEDLINE search engine, Cochrane review, and Google Scholar using search terms "ephedrine and phenylephrine," "preterm and term and spinal hypotension," "preeclampsia and healthy parturients," or "multiple and singleton gestation and vasopressor...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28141603/prevention-and-management-of-postoperative-delirium-in-elderly-patients-following-elective-spinal-surgery
#14
Alireza K Nazemi, Anirudh K Gowd, Jonathan J Carmouche, Stephen L Kates, Todd J Albert, Caleb J Behrend
STUDY DESIGN: This study is a systematic review. OBJECTIVE: Propose an evidence-based algorithm for prevention, diagnosis, and management of postoperative delirium in geriatric patients undergoing elective spine surgery. SUMMARY OF BACKGROUND DATA: Delirium is associated with longer stays after elective surgery, increased risk of readmission, and $6.9 billion annually in medical costs. Early diagnosis and treatment of delirium can reduce length of stay (LOS), in-hospital morbidity, and health care costs...
January 30, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28128660/cardiac-failure-in-a-trisomy-9-patient-undergoing-anesthesia-a-case-report
#15
Cara J Riley, Timothy Moore, Lauren Eagelston, Dale Burkett, Scott Auerbach, Richard J Ing
A 27-year-old female with Trisomy 9 mosaicism presented to Children's Hospital Colorado for outpatient dental surgery under general anesthesia. The patient's past medical history was also significant for premature birth, gastroesophageal reflux, scoliosis and kyphosis, obesity, and developmental delay. Per her mother's report, the patient had no cardiac issues. She had undergone multiple previous general anesthetics, some of which documented respiratory complications such as laryngospasm, bronchospasm, and possible aspiration...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28125532/the-modern-male-rhytidectomy-lessons-learned
#16
Rod J Rohrich, James M Stuzin, Smita Ramanadham, Christopher Costa, Phillip B Dauwe
BACKGROUND: Cosmetic surgery among male patients has become increasingly popular. The face-lift technique is different in male patients, specifically regarding preservation of hair follicles, restoration of a youthful and well appearance, and reduction of the risk of hematoma. METHODS: A retrospective review of a single surgeon's past 20 years of consecutive male rhytidectomies revealed a cohort of 83 patients. A control group was created by random selection of 83 age-matched female rhytidectomy patients during the same period...
February 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28121930/dexmedetomidine-as-an-adjuvant-to-local-anesthetics-in-brachial-plexus-blocks-a-meta-analysis-of-randomized-controlled-trials
#17
Yongmei Ping, Qigang Ye, Wenwei Wang, Pingke Ye, Zhibin You
BACKGROUND: Brachial plexus block (BPB) for upper extremity surgery provides superior analgesia, but this advantage is limited by the pharmacological duration of local anesthetics. Dexmedetomidine (DEX) as a local anesthetics adjuvant for BPB has been utilized to prolong the duration of the nerve block in some randomized controlled trials (RCTs) but is far from unanimous in the efficacy and safety of the perineural route. Hence, an updated meta-analysis was conducted to assess the efficacy and safety of DEX as local anesthetic adjuvants on BPB...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28118795/the-perforation-of-the-superior-vena-cava-secondary-to-the-left-subclavian-dialysis-catheter
#18
Atila Turkyilmaz, Sami Karapolat, Mehmet Kilic, Celal Tekinbas
INTRODUCTION: The perforation of the superior vena cava during the placement of dialysis catheter and consequent hemothorax is a rare serious complication. CASE REPORT: Dialysis catheter was placed in the left subclavian vein in a 69-year-old male patient with chronic renal insufficiency who was hospitalized for intracerebral hematoma. During hemodialysis a day after the procedure, the patient was noted having right-sided hemothorax, causing lethargy, dyspnea, hypotension, and bradycardia...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28107274/the-sluscore-a-novel-method-for-detecting-hazardous-hypotension-in-adult-patients-undergoing-noncardiac-surgical-procedures
#19
Wolf H Stapelfeldt, Hui Yuan, Jefferson K Dryden, Kristen E Strehl, Jacek B Cywinski, Jesse M Ehrenfeld, Pamela Bromley
BACKGROUND: It has been suggested that longer-term postsurgical outcome may be adversely affected by less than severe hypotension under anesthesia. However, evidence-based guidelines are unavailable. The present study was designed to develop a method for identifying patients at increased risk of death within 30 days in association with the severity and duration of intraoperative hypotension. METHODS: Intraoperative mean arterial blood pressure recordings of 152,445 adult patients undergoing noncardiac surgery were analyzed for periods of time accumulated below each one of the 31 thresholds between 75 and 45 mm Hg (hypotensive exposure times)...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28101342/pharmacodynamic-analysis-of-target-controlled-infusion-of-propofol-in-patients-with-hepatic-insufficiency
#20
Jing-Ru Pan, Jun Cai, Shao-Li Zhou, Qian-Qian Zhu, Fei Huang, Yi-Han Zhang, Xin-Jin Chi, Zi-Qing Hei
The effect of liver dysfunction on target-controlled infusion (TCI) of propofol remains poorly documented. The pharmacodynamic performance of propofol TCI was evaluated in a cohort of Chinese patients with hepatic insufficiency. Fifty-three patients with hepatic insufficiency were enrolled in the current prospective, observational study. Anesthesia was induced with propofol via TCI to a plasma concentration of 3 µg/ml. Following loss of consciousness (LOC), fentanyl and cisatracurium were administered. Pharmacodynamic parameters were recorded during TCI, including time to LOC, bispectral index (BIS), heart rate (HR) and blood pressure...
December 2016: Biomedical Reports
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