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Simulation anesthesia

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https://www.readbyqxmd.com/read/27884665/airway-management-for-cesarean-delivery-performed-under-general-anesthesia
#1
S Rajagopalan, M Suresh, S L Clark, B Serratos, S Chandrasekhar
BACKGROUND: With the increasing popularity of neuraxial anesthesia, there has been a decline in the use of general anesthesia for cesarean delivery. We sought to examine the incidence, outcome and characteristics associated with a failed airway in patients undergoing cesarean delivery under general anesthesia. METHODS: A retrospective review of airway management in women undergoing cesarean delivery under general anesthesia over an eight-year period from 2006-2013 at an academic medical center was conducted...
October 27, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27863464/low-wall-shear-stress-is-associated-with-the-rupture-of-intracranial-aneurysm-with-known-rupture-point-case-report-and-literature-review
#2
Yisen Zhang, Linkai Jing, Ying Zhang, Jian Liu, Xinjian Yang
BACKGROUND: Few previous hemodynamic studies demonstrated the detailed features of rupture point of intracranial aneurysms. The hemodynamic simulation for the case that ruptured during angiography was even rare. In the present study, we studied the hemodynamic characteristics of a posterior communicating artery segment aneurysm that ruptured during angiography and detailed the hemodynamic features at the rupture point. CASE PRESENTATION: One 64-years-patient was 60-69 years old and suffered a subarachnoid hemorrhage within 24 h...
November 18, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27828797/intranasal-medication-administration-using-a-squeeze-bottle-atomizer-results-in-overdosing-if-deployed-in-supine-patients
#3
Jordan E Goldhammer, Mark A Dobish, Joshua T McAnulty, Todd J Smaka, Richard H Epstein
BACKGROUND: Vasoconstrictors and local anesthetics are commonly administered using a squeeze bottle atomizer to the nasal mucosa to reduce edema, limit bleeding, and provide analgesia. Despite widespread use, there are few clinical guidelines that address technical details related to safe administration. The purpose of this study was to quantify, via simulation, the amount of liquid delivered to the nasal mucosa when patients are in the supine and upright positions and administration parameters that would reliably provide the desired amount of medication per spray...
November 8, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27819255/an-adaptive-and-generalizable-closed-loop-system-for-control-of-medically-induced-coma-and-other-states-of-anesthesia
#4
Yuxiao Yang, Maryam M Shanechi
OBJECTIVE: Design of closed-loop anesthetic delivery (CLAD) systems is an important topic, particularly for medically induced coma, which needs to be maintained for long periods. Current CLADs for medically induced coma require a separate offline experiment for model parameter estimation, which causes interruption in treatment and is difficult to perform. Also, CLADs may exhibit bias due to inherent time-variation and non-stationarity, and may have large infusion rate variations at steady state...
December 2016: Journal of Neural Engineering
https://www.readbyqxmd.com/read/27796007/anesthetic-effect-and-physiological-response-in-olive-flounder-paralichthys-olivaceus-to-clove-oil-in-a-simulated-transport-experiment
#5
Hyun Woo Gil, Min Gyun Ko, Tae Ho Lee, In-Seok Park, Dong Soo Kim
The optimum concentrations of clove oil as an anesthetic for olive flounder (Paralichthys olivaceus) and the stress response of the fish to clove oil anesthesia were determined over a range of water temperatures, and investigated in a simulated transport experiment using analysis of various water and physiological parameters. While the time for induction of anesthesia decreased significantly as both the concentration of clove oil and water temperature increased, the recovery time increased significantly (P<0...
September 2016: Balsaeng'gwa Saengsig
https://www.readbyqxmd.com/read/27787571/-anesthesia-for-medical-students-a-brief-guide-to-practical-anesthesia-in-adults-with-a-web-based-video-illustration
#6
S Mathis, O Schlafer, J Abram, J Kreutziger, P Paal, V Wenzel
In Germany, Austria and Switzerland, anesthesiologists are the second largest group of physicians in hospitals, but this does not correspond to the amount of anesthesiology teaching that medical students receive in medical schools. Accordingly, the chances of medical students recognizing anesthesiology as a promising personal professional career are smaller than in other disciplines with large teaching components. Subsequent difficulties to recruit anesthesiology residents are likely, although many reasons support anesthesiology as a professional career...
October 27, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27782729/an-iterative-projection-based-motion-estimation-and-compensation-scheme-for-head-x-ray-ct
#7
Tao Sun, Jung-Ha Kim, Roger Fulton, Johan Nuyts
PURPOSE: Although current computed tomography (CT) systems can scan the head in a very short time, patient motion sometimes still induces artifacts. If motion occurs, one has to repeat the scan; to avoid motion, sedation or anesthesia is sometimes applied. METHODS: The authors propose a method to iteratively estimate and compensate this motion during the reconstruction. In every iteration, the rigid motion was estimated view-by-view and then used to update the system matrix...
October 2016: Medical Physics
https://www.readbyqxmd.com/read/27779341/study-of-neurometabolic-and-behavioral-alterations-in-rodent-model-of-mild-traumatic-brain-injury-a-pilot-study
#8
Kavita Singh, Richa Trivedi, Seenu Haridas, Kailash Manda, Subash Khushu
Mild traumatic brain injury (mTBI) is the most common form of TBI (70-90%) with consequences of anxiety-like behavioral alterations in approximately 23% of mTBI cases. This study aimed to assess whether mTBI-induced anxiety-like behavior is a consequence of neurometabolic alterations. mTBI was induced using a weight drop model to simulate mild human brain injury in rodents. Based on injury induction and dosage of anesthesia, four animal groups were included in this study: (i) injury with anesthesia (IA); (ii) sham1 (injury only, IO); (iii) sham2 (only anesthesia, OA); and (iv) control rats...
October 25, 2016: NMR in Biomedicine
https://www.readbyqxmd.com/read/27761448/non-intubated-simultaneous-en-bloc-resection-of-pulmonary-nodule-and-rib-chondrosarcoma
#9
Miao Zhang, Heng Wang, Wenbin Wu, Dong Liu, Min Li, Zhengqun Hu, Hui Zhang
Adequate surgical resection was required for patients with rib chondrosarcoma. A 61-year-old woman was presented with a palpable chest wall mass. Computed tomography (CT) of the chest revealed an isolated pulmonary nodule about 0.9 cm, and a giant rib tumor about 12 cm × 9 cm which penetrated through the 7(th) rib into thorax. CT reconstruction and simulated surgery was utilized for disease-free surgical margin (R0 resection), then a simultaneous en bloc resection of pulmonary nodule and rib tumor was performed along with chest wall reconstruction under local anesthesia and intravenous sedation without endotracheal intubation...
September 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27730035/granular-cell-tumor-in-a-child-an-uncommon-cutaneous-presentation
#10
Deepashree Daulatabad, Chander Grover, Nadeem Tanveer, Divya Bansal
Granular cell tumors (GCTs) are uncommon soft tissue tumors which present as papulonodular lesions and are often diagnosed histopathologically. These usually develop in adulthood and are considered to be of Schwann cell origin. Most of the lesions are benign, but malignant lesions with poor prognosis are known to occur. We report a case of GCT in a 9-year-old girl presenting as an isolated lesion simulating an acrochordon. The histopathological and immunohistochemical evaluation showing polygonal granular cells positive for S-100 and neuron-specific enolase, and negative for cytokeratin and desmin helped clinch the diagnosis...
September 2016: Indian Dermatology Online Journal
https://www.readbyqxmd.com/read/27723803/a-comparison-of-multiscale-permutation-entropy-measures-in-on-line-depth-of-anesthesia-monitoring
#11
Cui Su, Zhenhu Liang, Xiaoli Li, Duan Li, Yongwang Li, Mauro Ursino
OBJECTIVE: Multiscale permutation entropy (MSPE) is becoming an interesting tool to explore neurophysiological mechanisms in recent years. In this study, six MSPE measures were proposed for on-line depth of anesthesia (DoA) monitoring to quantify the anesthetic effect on the real-time EEG recordings. The performance of these measures in describing the transient characters of simulated neural populations and clinical anesthesia EEG were evaluated and compared. METHODS: Six MSPE algorithms-derived from Shannon permutation entropy (SPE), Renyi permutation entropy (RPE) and Tsallis permutation entropy (TPE) combined with the decomposition procedures of coarse-graining (CG) method and moving average (MA) analysis-were studied...
2016: PloS One
https://www.readbyqxmd.com/read/27703622/a-first-step-toward-understanding-patient-safety
#12
Kyoung Ok Kim
Patient safety has become an important policy agenda in healthcare systems since publication of the 1999 report entitled "To Err Is Human." The paradigm has changed from blaming the individual for the error to identifying the weakness in the system that led to the adverse events. Anesthesia is one of the first healthcare specialties to adopt techniques and lessons from the aviation industry. The widespread use of simulation programs and the application of human factors engineering to clinical practice are the influences of the aviation industry...
October 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27695352/cost-analysis-of-magnetically-controlled-growing-rods-compared-with-traditional-growing-rods-for-early-onset-scoliosis-in-the-us-an-integrated-health-care-delivery-system-perspective
#13
David W Polly, Stacey J Ackerman, Karen Schneider, Jeff B Pawelek, Behrooz A Akbarnia
PURPOSE: Traditional growing rod (TGR) for early-onset scoliosis (EOS) is effective but requires repeated invasive surgical lengthenings under general anesthesia. Magnetically controlled growing rod (MCGR) is lengthened noninvasively using a hand-held magnetic external remote controller in a physician office; however, the MCGR implant is expensive, and the cumulative cost savings have not been well studied. We compared direct medical costs of MCGR and TGR for EOS from the US integrated health care delivery system perspective...
2016: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/27678137/-simulation-based-training-and-or-apprenticeship-for-medical-students-a%C3%A2-prospective-randomized-single-blind-study-of-clinical-skills
#14
T Ott, I Schmidtmann, T Limbach, P F Gottschling, H Buggenhagen, S Kurz, G Pestel
BACKGROUND: Simulation-based training (SBT) has developed into an established method of medical training. Studies focusing on the education of medical students have used simulation as an evaluation tool for defined skills. A small number of studies provide evidence that SBT improves medical students' skills in the clinical setting. Moreover, they were strictly limited to a few areas, such as the diagnosis of heart murmurs or the correct application of cricoid pressure. Other studies could not prove adequate transferability from the skills gained in SBT to the patient site...
September 27, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27666638/development-of-a-rapid-response-plan-for-intraoperative-emergencies-the-circulate-scrub-and-technical-assistance-team
#15
David Earle, Diane Betti, Emilia Scala
BACKGROUND: Unplanned intraoperative events are inevitable and cause stress and inefficiency among staff. We believe that developing a technical rapid response team with explicitly defined, narrow roles would reduce the amount of chaos during such emergencies. This article provides a detailed description of the development and implementation of such a program. METHODS: In-situ simulation of an intraoperative emergency was used for a formal assessment of the current practice...
June 29, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27666546/-localizating-and-extracting-small-peripheral-nodules-of-lung-with-simulating-%C3%A2-radiaotherapy-combining-methylene-blue-staining
#16
Feng Mao, Liang Zhang, Hengle Gu, Hui Zhang, Changxing Lv, Yang Shen-Tu
BACKGROUND: With the extensively application of HRCT (high resolution CT) and the popularization of early lung cancer screening, the proportion of small nodullar lung cancer to be operated increases rapidly. Identifying the focus lesions quickly and accurately in operation has shown to be a challenge. We carried out this research trying to make use of and evaluate a new method that localizaes and extracts small peripheral pulmonary nodules by way of simulating radiaotherapy combining methylene blue staining...
September 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/27664487/budesonide-attenuates-ventilator-induced-lung-injury-in-a-rat-model-of-inflammatory-acute-respiratory-distress-syndrome
#17
Wei Gao, Ying-Nan Ju
BACKGROUND AND AIMS: Patients with acute respiratory distress syndrome (ARDS) are particularly susceptible to ventilator-induced lung injury (VILI). This study investigated the effect of budesonide on VILI in a rat model of inflammatory ARDS. METHODS: Forty eight rats were randomized into three groups (n = 16 each): sham group (S), endotoxin/ventilation group (LV), endotoxin/ventilation/budesonide group (LVB). Rats in the S group received anesthesia only. Rats in the LV and LVB groups received endotoxin to simulate ARDS and were mechanically ventilated for 4 h (tidal volume 30 mL/kg)...
May 2016: Archives of Medical Research
https://www.readbyqxmd.com/read/27662532/complication-rates-lengths-of-stay-and-readmission-rates-in-awake-and-asleep-deep-brain-simulation
#18
Tsinsue Chen, Zaman Mirzadeh, Kristina Chapple, Margaret Lambert, Francisco A Ponce
OBJECTIVE As the number of deep brain stimulation (DBS) procedures performed under general anesthesia ("asleep" DBS) increases, it is more important to assess the rates of adverse events, inpatient lengths of stay (LOS), and 30-day readmission rates in patients undergoing these procedures compared with those in patients undergoing traditional "awake" DBS without general anesthesia. METHODS All patients in an institutional database who had undergone awake or asleep DBS procedures performed by a single surgeon between August 2011 and August 2014 were reviewed...
September 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27647647/positive-state-observer-for-the-automatic-control-of-the-depth-of-anesthesia-clinical-results
#19
Filipa N Nogueira, T Mendonça, P Rocha
The depth of anesthesia (DoA) is a crucial feature in general anesthesia. Nowadays the DoA is usually evaluated by the bispectral index (BIS). According to the surgical procedure, different reference levels for the BIS may be clinically required. This can be achieved by the simultaneous administration of an analgesic (e.g. remifentanil) and an hypnotic (eg propofol). As a contribution to the effort of automating the processes of drug delivery in general anesthesia, in this paper, a positive state observer is designed for the implementation of a control scheme proposed for the automatic administration of propofol and of remifentanil, in order to track a desired level for the BIS...
September 13, 2016: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/27638297/simulation-based-assessment-of-anesthesiology-residents-competence-development-and-implementation-of-the-canadian-national-anesthesiology-simulation-curriculum-cannasc
#20
Michelle Chiu, Jordan Tarshis, Andreas Antoniou, T Laine Bosma, Jessica E Burjorjee, Neil Cowie, Simone Crooks, Kate Doyle, David Dubois, Tobias Everett, Rachel Fisher, Megan Hayter, Genevieve McKinnon, Diana Noseworthy, Noel O'Regan, Greg Peachey, Arnaud Robitaille, Michael Sullivan, Marshall Tenenbein, Marie-Helene Tremblay
The specialty of anesthesiology will soon adopt the Competence By Design (CBD) approach to residency education developed by the Royal College of Physicians and Surgeons of Canada (RCPSC). A foundational component of CBD is frequent and contextualized assessment of trainees. In 2013, the RCPSC Anesthesiology Specialty Committee assembled a group of simulation educators, representing each of the 17 Canadian anesthesiology residency programs, to form the Canadian National Anesthesiology Simulation Curriculum (CanNASC) Task Force...
September 16, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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