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Anesthesia basics

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https://www.readbyqxmd.com/read/28625424/scheduling-non-operating-room-anesthesia-cases-in-endoscopy-using-the-sandbox-analogy
#1
Mitchell H Tsai, Leah A Cipri, Stephen E O'Donnell, J Matthew Fisher, Dimitrios A Andritsos
STUDY OBJECTIVE: For many hospitals, the non-operating room anesthesia (NORA) workload continues to expand. We developed a new NORA scheduling process with shared block time - a sandbox - amongst all of the gastroenterology groups and measured the efficacy of the intervention using basic operating room management metrics. DESIGN: Prospective analysis, statistical process control. SETTING: Academic, rural hospital; endoscopy suite; postoperative recovery area...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28619774/protocol-for-a-multicentre-multistage-prospective-study-in-china-using-system-based-approaches-for-consistent-improvement-in-surgical-safety
#2
Xiaochu Yu, Jingmei Jiang, Changwei Liu, Keng Shen, Zixing Wang, Wei Han, Xingrong Liu, Guole Lin, Ye Zhang, Ying Zhang, Yufen Ma, Haixin Bo, Yupei Zhao
INTRODUCTION: Surgical safety has emerged as a crucial global health issue in the past two decades. Although several safety-enhancing tools are available, the pace of large-scale improvement remains slow, especially in developing countries such as China. The present project (Modern Surgery and Anesthesia Safety Management System Construction and Promotion) aims to develop and validate system-based integrated approaches for reducing perioperative deaths and complications using a multicentre, multistage design...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28582277/simulation-based-assessment-identifies-longitudinal-changes-in-cognitive-skills-in-an-anesthesiology-residency-training-program
#3
Avner Sidi, Nikolaus Gravenstein, Terrie Vasilopoulos, Samsun Lampotang
OBJECTIVES: We describe observed improvements in nontechnical or "higher-order" deficiencies and cognitive performance skills in an anesthesia residency cohort for a 1-year time interval. Our main objectives were to evaluate higher-order, cognitive performance and to demonstrate that simulation can effectively serve as an assessment of cognitive skills and can help detect "higher-order" deficiencies, which are not as well identified through more traditional assessment tools. We hypothesized that simulation can identify longitudinal changes in cognitive skills and that cognitive performance deficiencies can then be remediated over time...
June 2, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28579047/surgical-procedures-of-the-distal-limb-for-treatment-of-sepsis-in-cattle
#4
REVIEW
David E Anderson, André Desrochers, Sarel R van Amstel
With a thorough knowledge of the anatomy of the foot, and basic surgical instruments, digit surgery can be performed in field situations. Sepsis of the distal interphalangeal and proximal interphalangeal joints should be treated surgically because conservative treatment is often ineffective. Most of the diseases described in this article are chronic and often the animals have been suffering for some time. Perioperative analgesia is important to alleviate the pain of those animals. All those procedures should be performed under local or regional anesthesia...
July 2017: Veterinary Clinics of North America. Food Animal Practice
https://www.readbyqxmd.com/read/28535026/tetanus-%C3%A2-n%C3%A3-stan-bortgl%C3%A3-md-men-allvarlig-sjukdom-%C3%A3-ldre-kvinnor-%C3%A3-r-en-riskgrupp-diagnosen-kan-vara-en-utmaning
#5
Bernhard Hozgraefe, Akad Koria, Victoria Sem, Joak Johansson
Tetanus, an almost forgotten but serious disease Tetanus is the systemic consequence of a local infection with Clostridium tetani, that produces toxin which spreads in the systemic circulation. In developed countries, it is extremely rare. Women born before 1950 are a group at risk due to lower prevalence of immunisation. This report describes a case of tetanus. The patient is a previously healthy 82-year-old woman. She presented to primary care with a complaint of stiffness in the neck and jaw. A physical exam and basic laboratory tests were normal apart from a slightly increased blood pressure...
May 22, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28534323/-era-of-enhanced-recovery-after-surgery-and-robotic-gastric-cancer-surgery
#6
Yanbing Zhou
Enhanced recovery after surgery (ERAS) has been rapidly developing by combining several techniques with evidence-based adjustments, including preoperative education, preoperative carbohydrate loading, epidural or regional anesthesia, early initiation of enteral nutrition, ambulation and multi-modal pain management. The core part of ERAS is to reduce and reverse surgical stress and therefore greatly improve clinical outcome. Under the guidance of ERAS, perioperative management of robotic gastric cancer operation should follow the basic principles of ERAS and clinical pathway to maximize the advantages of the robotic surgery...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28525513/an-observational-assessment-of-anesthesia-capacity-in-madagascar-as-a-prerequisite-to-the-development-of-a-national-surgical-plan
#7
Linden S Baxter, Vaonandianina A Ravelojaona, Hasiniaina N Rakotoarison, Alison Herbert, Emily Bruno, Kristin L Close, Vanessa Andean, Hery H Andriamanjato, Mark G Shrime, Michelle C White
BACKGROUND: The global lack of anesthesia capacity is well described, but country-specific data are needed to provide country-specific solutions. We aimed to assess anesthesia capacity in Madagascar as part of the development of a Ministry of Health national surgical plan. METHODS: As part of a nationwide surgical safety quality improvement project, we surveyed 19 of 22 regional hospitals, representing surgical facilities caring for 75% of the total population. The assessment was divided into 3 areas: anesthesia workforce density, infrastructure and equipment, and medications...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28504991/tablet-e-logbooks-four-thousand-clinical-cases-and-complications-e-logged-by-14-nondoctor-anesthesia-providers-in-nepal
#8
Shristi Shah, Oliver Ross, Stephen Pickering, Stephen Knoble, Indra Rai
BACKGROUND: To meet the need for essential surgery across rural Nepal, anesthesia at district level is delivered by nondoctor anesthetists. They require support to maintain confidence and competence, and upgraded professional registration to secure their status. To meet these needs, a distance-blended learning course was pioneered and delivered. A core course requirement was to log all clinical cases; these were logged on a new e-logbook. METHODS: Fourteen nondoctor anesthesia providers working in 12 different districts across Nepal were enrolled in the 1-year course...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28474988/premedication-with-fentanyl-midazolam-improves-sevoflurane-anesthesia-for-surgical-intervention-in-laboratory-mice
#9
Miriam Lipiski, Margarete Arras, Paulin Jirkof, Nikola Cesarovic
Balanced anesthesia allows for a reduced dosage of each component, while inducing general anesthesia of sufficient depth with potentially fewer side effects. Here, we compare two anesthetic protocols combining sevoflurane anesthesia with pre-medication (ketamine [K] or fentanyl-midazolam [FM]) to a sevoflurane monoanesthesia (S) concerning their ability to provide reliable anesthesia suitable for moderate surgery in laboratory mice. Twenty-one female C57BL/6J mice assigned randomly to one of three protocols underwent a 50-min anesthesia and a sham embryo transfer...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28451585/where-are-they-now-evolution-of-a-nurse-anesthesia-training-school-in-ghana-and-a-survey-of-graduates
#10
REVIEW
Melissa G Potisek, David M Hatch, Evans Atito-Narh, Jerry Agudogo, Adeyemi J Olufolabi, Michael Rieker, Holly A Muir, Medge D Owen
Ghana, like other countries in sub-Saharan African, has limited access to surgery. One contributing factor is the inadequate number of anesthesia providers. To address this need, Kybele, Inc., a US-based non-governmental organization, partnered with the Ghana Health Service to establish the third nurse anesthesia training school (NATS) in Ghana. The school, based at Ridge Regional Hospital (RRH) in Accra, opened in October 2009. This paper describes the evolution of the training program and presents the curriculum...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28449465/application-of-bronchoscope-for-the-placement-of-nasoenteric-feeding-tube-in-patients-with-esophagectomy-a-novel-technique
#11
Hai-Xia Cao, Wei Zhang, Jun Zhang, Xiong-Huai Hua, Jian-Jun Qin, Yin Li
BACKGROUND: Currently the available techniques for the placement of nasoenteric feeding tube (NET), utilizing transnasal gastroscope are fast and tolerable, which is known as the most popular method. However, lots of hospitals don't have this endoscopic system. Bronchoscope, which is the basic respiratory endoscope, not only has the advantages of transnasal endoscopy, but also is popular in common hospitals. We used oxygen instillation as air supply plant of the bronchoscope, which broke its application limitation in digestive tract...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28439465/single-exponential-decay-waveform-a-synergistic-combination-of-electroporation-and-electrolysis-e2-for-tissue-ablation
#12
Nina Klein, Enric Guenther, Paul Mikus, Michael K Stehling, Boris Rubinsky
BACKGROUND: Electrolytic ablation and electroporation based ablation are minimally invasive, non-thermal surgical technologies that employ electrical currents and electric fields to ablate undesirable cells in a volume of tissue. In this study, we explore the attributes of a new tissue ablation technology that simultaneously delivers a synergistic combination of electroporation and electrolysis (E2). METHOD: A new device that delivers a controlled dose of electroporation field and electrolysis currents in the form of a single exponential decay waveform (EDW) was applied to the pig liver, and the effect of various parameters on the extent of tissue ablation was examined with histology...
2017: PeerJ
https://www.readbyqxmd.com/read/28435095/application-of-advanced-preclinical-models-and-methods-in-anesthetic-neurotoxicity-research
#13
REVIEW
Cheng Wang, Xuan Zhang, Fang Liu
Recently, there has been increasing concern regarding the potential of anesthetics to disturb the long-term function of the central nervous system (CNS). The field of anesthesia-related toxicology, therefore, has engaged multiple scientific disciplines and utilized a variety of pre-clinical research models in an attempt to identify the basic characteristics of the anesthetic agents that may produce acute and/or chronic adverse effects on the CNS. This review discusses how the application of advanced research approaches and models, such as the nonhuman primate, neural stem cell-derived organotypic slice cultures and/or organs-on-chips systems, can serve as translational models of infantile anesthetic exposure...
April 20, 2017: Neurotoxicology and Teratology
https://www.readbyqxmd.com/read/28431420/generative-retrieval-improves-learning-and-retention-of-cardiac-anatomy-using-transesophageal-echocardiography
#14
Amanda M Kleiman, Katherine T Forkin, Allison J Bechtel, Stephen R Collins, Jennie Z Ma, Edward C Nemergut, Julie L Huffmyer
BACKGROUND: Transesophageal echocardiography (TEE) is a valuable monitor for patients undergoing cardiac and noncardiac surgery as it allows for evaluation of cardiovascular compromise in the perioperative period. It is challenging for anesthesiology residents and medical students to learn to use and interpret TEE in the clinical environment. A critical component of learning to use and interpret TEE is a strong grasp of normal cardiovascular ultrasound anatomy. METHODS: Fifteen fourth-year medical students and 15 post-graduate year (PGY) 1 and 2 anesthesiology residents without prior training in cardiac anesthesia or TEE viewed normal cardiovascular anatomy TEE video clips; participants were randomized to learning cardiac anatomy in generative retrieval (GR) and standard practice (SP) groups...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28426446/providing-anesthesia-in-resource-limited-settings
#15
Lena E Dohlman
PURPOSE OF REVIEW: The article reviews the reality of anesthetic resource constraints in low and middle-income countries (LMICs). Understanding these limitations is important to volunteers from high-income countries who desire to teach or safely provide anesthesia services in these countries. RECENT FINDINGS: Recently published information on the state of anesthetic resources in LMICs is helping to guide humanitarian outreach efforts from high-income countries. The importance of using context-appropriate anesthesia standards and equipment is now emphasized...
April 19, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28409254/pediatric-brain-mri-part-1-basic-techniques
#16
REVIEW
Mai-Lan Ho, Norbert G Campeau, Thang D Ngo, Unni K Udayasankar, Kirk M Welker
Pediatric neuroimaging is a complex and specialized field that uses magnetic resonance (MR) imaging as the workhorse for diagnosis. Standard MR techniques used in adult neuroimaging are suboptimal for imaging in pediatrics because there are significant differences in the child's developing brain. These differences include size, myelination and sulcation. MR protocols need to be tailored to the specific indication and reviewed by the supervising radiologist in real time, and the specialized needs of this population require careful consideration of issues such as scan timing, sequence order, sedation, anesthesia and gadolinium administration...
May 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28381794/effect-of-nerve-growth-factor-on-innervation-of-perivascular-nerves-in-neovasculatures-of-mouse-cornea
#17
Akiko Matsuyama, Shingo Takatori, Yoko Sone, Eiko Ochi, Mitsuhiro Goda, Yoshito Zamami, Narumi Hashikawa-Hobara, Yoshihisa Kitamura, Hiromu Kawasaki
Angiogenesis, which is the generation of new vascular networks from existing blood vessels, occurs under normal and pathophysiological conditions. Perivascular nerves, which innervate mature vasculatures, maintain vascular tone and regulate tissue blood flow. However, little is known whether perivascular nerves innervate newborn blood vessels. Therefore, the aim of this study was to investigate the distribution and characterization of perivascular nerves in neovasculatures, which were generated by the mouse corneal micropocket method...
2017: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/28328640/we-are-going-to-name-names-and-call-you-out-improving-the-team-in-the-academic-operating-room-environment
#18
Richard Bodor, Brian J Nguyen, Kevin Broder
INTRODUCTION: Communication failures between multidisciplinary teams can impact efficiency, performance, and morale. Academic operating rooms (ORs) often have surgical, anesthesia, and nursing teams, each teaching multiple trainees. Incorrectly identifying name and "rank" (postgraduate year [PGY]) of resident trainees can disrupt performance evaluations and team morale and even potentially impair delivery of quality care when miscommunication errors proliferate. METHODS: Our OR-based survey asked 50 participants (18 surgeons, 14 anesthesiologists, and 18 nursing members), to recall basic identification data including provider names and PGY levels from their recent collaborating OR teams...
May 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28298760/the-effectiveness-of-intravenous-dexmedetomidine-on-perioperative-hemodynamics-analgesic-requirement-and-side-effects-profile-in-patients-undergoing-laparoscopic-surgery-under-general-anesthesia
#19
Vinayak Panchgar, Akshaya N Shetti, H B Sunitha, Vithal K Dhulkhed, A V Nadkarni
BACKGROUND: There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298747/benefits-and-pitfalls-of-cadavers-as-learning-tool-for-ultrasound-guided-regional-anesthesia
#20
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
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