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Multimodal anesthesia

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https://www.readbyqxmd.com/read/28094665/fdg-pet-reproducibility-in-tumor-bearing-mice-comparing-a-traditional-suv-approach-with-a-tumor-to-brain-tissue-ratio-approach
#1
Morten Busk, Ole L Munk, Steen Jakobsen, Jørgen Frøkiær, Jens Overgaard, Michael R Horsman
BACKGROUND: Current [F-18]-fluorodeoxyglucose positron emission tomography (FDG-PET) procedures in tumor-bearing mice typically includes fasting, anesthesia, and standardized uptake value (SUV)-based quantification. Such procedures may be inappropriate for prolonged multiscan experiments. We hypothesize that normalization of tumor FDG retention relative to a suitable reference tissue may improve accuracy as this method may be less susceptible to uncontrollable day-to-day changes in blood glucose levels, physical activity, or unnoticed imperfect tail vein injections...
January 17, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28079566/retesting-the-hypothesis-of-a-clinical-randomized-controlled-trial-in-a-simulation-environment-to-validate-anesthesia-simulation-in-error-research-the-vaser-study
#2
Alan F Merry, Jacqueline A Hannam, Craig S Webster, Kylie-Ellen Edwards, Jane Torrie, Chris Frampton, Daniel W Wheeler, Arun K Gupta, Ravi P Mahajan, Rachel Evley, Jennifer M Weller
BACKGROUND: Simulation has been used to investigate clinical questions in anesthesia, surgery, and related disciplines, but there are few data demonstrating that results apply to clinical settings. We asked "would results of a simulation-based study justify the same principal conclusions as those of a larger clinical study?" METHODS: We compared results from a randomized controlled trial in a simulated environment involving 80 cases at three centers with those from a randomized controlled trial in a clinical environment involving 1,075 cases...
January 12, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28012528/the-effect-of-iv-dexamethasone-versus-local-anesthetic-infiltration-technique-in-postoperative-nausea-and-vomiting-after-tonsillectomy-in-children-a-randomized-double-blind-clinical-trial
#3
Zoher Naja, Saleh Kanawati, Rania Al Khatib, Fouad Ziade, Zeina Z Naja, Ahmad Salah Naja, Mariam Rajab
BACKGROUND: Local anesthetic infiltration and corticosteroids had shown effectiveness in reducing post tonsillectomy nausea, vomiting and pain. OBJECTIVES: To compare the effect of intravenous dexamethasone versus pre-incision infiltration of local anesthesia in pediatric tonsillectomy on postoperative nausea and vomiting (PONV). The secondary objective was postoperative pain. METHODS: A randomized double-blind clinical trial was conducted at a tertiary care teaching hospital...
January 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28010998/comparison-of-multimodal-intraoperative-neurophysiological-monitoring-efficacy-in-early-childhood-and-school-aged-children-undergoing-spinal-surgery
#4
Alpaslan Şenköylü, Murat Zinnuroğlu, Alp Börçek, Erdem Aktaş, İrfan Güngör, Mehmet Beyazova
OBJECTIVE: The aim of this study was to compare the performance of multimodal intraoperative neurophysiological monitoring (MIONM) in children below and over 6 years of age. METHODS: 43 children, diagnosed with spinal pathologies were divided into two cohorts according to their age and enrolled in the study. Those under the age of 6 consisted group A, whereas those between the age of 6 and 11 consisted group B. All patients underwent spinal surgical procedures according to their diagnosis...
December 20, 2016: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27990189/effects-of-modification-of-pain-protocol-on-incidence-of-post-operative-nausea-and-vomiting
#5
Ran Schwarzkopf, Nimrod Snir, Zachary T Sharfman, Joseph B Rinehart, Michael-David Calderon, Esther Bahn, Brian Harrington, Kyle Ahn
BACKGROUND: A Perioperative Surgical Home (PSH) care model applies a standardized multidisciplinary approach to patient care using evidence-based medicine to modify and improve protocols. Analysis of patient outcome measures, such as postoperative nausea and vomiting (PONV), allows for refinement of existing protocols to improve patient care. We aim to compare the incidence of PONV in patients who underwent primary total joint arthroplasty before and after modification of our PSH pain protocol...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27984226/intraperitoneal-instillation-of-lidocaine-improves-postoperative-analgesia-at-cesarean-delivery-a-randomized-double-blind-placebo-controlled-trial
#6
Ruchira Patel, Jose C A Carvalho, Kristi Downey, Marcelo Kanczuk, Paul Bernstein, Naveed Siddiqui
BACKGROUND: Cesarean delivery is a commonly performed procedure worldwide. Despite improvements in balanced multimodal analgesia, there remains a proportion of women for whom postoperative pain relief and patient satisfaction are still inadequate. Intraperitoneal instillation of local anesthetic has been shown to be effective in reducing postoperative pain after abdominal surgery. We sought to investigate the effect of intraperitoneal instillation of lidocaine on postcesarean delivery pain as part of a multimodal analgesia regimen...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27906937/transversus-abdominis-plane-block-in-the-management-of-acute-postoperative-pain-syndrome-after-caesarean-section-a-randomized-controlled-clinical-trial
#7
Pierfrancesco Fusco, Vincenza Cofini, Emiliano Petrucci, Paolo Scimia, Tullio Pozone, Giuseppe Paladini, Gaspare Carta, Stefano Necozione, Battista Borghi, Franco Marinangeli
BACKGROUND: The international literature is unclear regarding the analgesic efficacy of the transversus abdominis plane block (TAPB) after a Caesarean section (CS). OBJECTIVES: The aim of this study was to determine whether a correctly performed ultrasound-guided TAPB (USG-TAPB) could provide better control of acute postoperative pain during the first 72 hours after CS and if it could provide a faster postoperative recovery. STUDY DESIGN: A double-blind, randomized, controlled clinical trial on pregnant women who underwent CS...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27903339/-effect-of-goal-directed-haemodynamic-management-on-the-postoperative-outcome-in-elderly-patients-with-fragile-cardiac-function-undergoing-abdominal-surgery
#8
L S Zheng, E W Gu, X H Peng, L Zhang, Y Y Cao
Objective: To investigate the effect of goal-directed haemodynamic management based on stroke volume variation (SVV), cardiac index (CI) and mean arterial blood pressure (MAP) on the postoperative outcome in elderly patients with fragile cardiac function undergoing gastrointestinal surgery. Methods: Ninety patients with fragile cardiac function, aged 65-90 years old, ASAⅡ or Ⅲ, NYHA Ⅱor Ⅲ, scheduled for abdominal surgery were enrolled in this study.The patients were randomly assigned to two groups: Experience anesthesia group (group E, n=45) and goal-directed hemodynamic management group (G group, n=45)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27900415/-management-of-anesthesia-in-endovascular-interventions
#9
T Rössel, R Paul, T Richter, S Ludwig, T Hofmockel, A R Heller, T Koch
Cardiovascular diseases are one of the leading causes of morbidity and mortality in Germany. In these patients, the high-risk profile necessitates an interdisciplinary and multimodal approach to treatment. Endovascular interventions and vascular surgery have become established as an important element of this strategy in the past; however, the different anatomical localizations of pathological vascular alterations make it necessary to use a wide spectrum of procedural options and methods; therefore, the requirements for management of anesthesia are variable and necessitate a differentiated approach...
December 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27885426/prospective-cohort-study-assessing-chronic-pain-in-patients-following-minor-surgery-for-breast-cancer
#10
Régis Fuzier, Floriane Puel, Philippe Izard, Agnès Sommet, Sébastien Pierre
PURPOSE: Pain after tumorectomy and sentinel lymph node dissection is poorly reported in the literature. We carried out a prospective survey aimed at assessing pain three months after such minor surgery for breast cancer. METHODS: The study was approved by the local ethics committee. Most surgeries followed a standard protocol involving general anesthesia with no regional analgesia technique, laryngeal mask, sufentanil and propofol for induction, and multimodal analgesia during the postoperative period...
November 24, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27871558/combipecs-the-single-injection-technique-of-pectoral-nerve-blocks-1-and-2-a-case-series
#11
Arunangshu Chakraborty, Rakhi Khemka, Taniya Datta, Suparna Mitra
Ultrasound-guided Pecs block can provide perioperative analgesia for breast surgery. A single-injection technique (COMBIPECS) combines both Pecs 1 and Pecs 2 blocks in a single needle pass. This technique saves time and is equally effective as the modified Pecs block which uses 2 needle passes. We present a case series of 21 patients who received the COMBIPECS block as a part of multimodal analgesia for breast cancer surgery. The block was administered before the surgery after induction of general anesthesia...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871536/novel-methods-of-local-anesthetic-delivery-in-the-perioperative-and-postoperative-setting-potential-for-fibrin-hydrogel-delivery
#12
REVIEW
Laura Kearney, Derek Whelan, Brian D O'Donnell, Anthony J P Clover
The benefits of high-quality postoperative analgesia are well documented and include earlier mobilization, fewer respiratory and cardiovascular complications, and shorter hospital stay. Local anesthesia-based acute pain regimens are at worst equal to and at best superior to opiate-based regimens from the perspective of analgesia. A multimodal approach limiting opioids by combining with local anesthetics has additional beneficial effect on outcomes such as nausea and vomiting, pruritus, gastrointestinal function, respiratory complications, and neutrophil function...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27836523/-why-and-how-to-perform-an-ultrasound-guided-transversus-abdominis-plane-block-a-step-by-step-approach
#13
E Nohuz, B El Drayi, A Triki, K Grossmannova, B Boudier, K Koffi, M Albaut, C Dualé
Used in clinical practice as part of a multimodal analgesic regimen, the transversus abdominis plane block (TAP block) is a relative novel procedure in which local anaesthetic agents are injected into the anatomic neurofascial space between the internal oblique and the transversus abdominis muscle. It allows a significantly prolonged duration of analgesia during the early postoperative stage in abdominal surgery. This regional anesthesia technique provides analgesia to the skin, muscles of the anterior abdominal wall and parietal peritoneum in order to decrease the incision-related pain...
December 2016: Gynécologie, Obstétrique & Fertilité
https://www.readbyqxmd.com/read/27828796/perioperative-anesthesia-care-and-tumor-progression
#14
Mir W Sekandarzad, André A J van Zundert, Philipp B Lirk, Chris W Doornebal, Markus W Hollmann
This narrative review discusses the most recent up-to-date findings focused on the currently available "best clinical practice" regarding perioperative anesthesia care bundle factors and their effect on tumor progression. The main objective is to critically appraise the current literature on local anesthetics, regional outcome studies, opioids, and nonsteroidal anti-inflammatory drugs (NSAIDs) and their ability to decrease recurrence in patients undergoing cancer surgery. A brief discussion of additional topical perioperative factors relevant to the anesthesiologist including volatile and intravenous anesthetics, perioperative stress and anxiety, nutrition, and immune stimulation is included...
November 8, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27820738/an-update-on-pain-management-for-elderly-patients-undergoing-ambulatory-surgery
#15
Xuezhao Cao, Ofelia L Elvir-Lazo, Paul F White, Roya Yumul, Jun Tang
PURPOSE OF REVIEW: The aim of this review is to provide an overview of the drugs and techniques used for multimodal postoperative pain management in the older population undergoing surgery in the ambulatory setting. RECENT FINDINGS: Interest has grown in the possibility of adding adjuncts to a single shot nerve block in order to prolong the local anesthetic effect. The rapid and short-acting local anesthetics for spinal anesthesia are potentially beneficial for day-case surgery in the older population because of shorter duration of the motor block, faster recovery, and less transient neurologic symptoms...
December 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27816130/anesthesia-for-patients-with-anemia
#16
REVIEW
Aryeh Shander, Gregg P Lobel, Mazyar Javidroozi
Anemia is a common and often ignored condition in surgical patients. Anemia is usually multifactorial and iron deficiency and inflammation are commonly involved. An exacerbating factor in surgical patients is iatrogenic blood loss. Anemia has been repeatedly shown to be an independent predictor of worse outcomes. Patient blood management (PBM) provides a multimodality framework for prevention and management of anemia and related risk factors. The key strategies in PBM include support of hematopoiesis and improving hemoglobin level, optimizing coagulation and hemostasis, use of interdisciplinary blood conservation modalities, and patient-centered decision making throughout the course of care...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27774967/trans-subclavian-aortic-valve-replacement-with-various-bioprosthetic-valves-single-center-experience
#17
Hacı Ahmet Kasapkara, Abdullah Nabi Aslan, Hüseyin Ayhan, Serdal Baştuğ, Hakan Süygün, Telat Keleş, Tahir Durmaz, Engin Bozkurt
OBJECTIVE: Transcatheter aortic valve replacement (TAVR) has been accepted as an alternative to surgery in high risk or inoperable patients with severe aortic stenosis (AS). Although transfemoral approach is the most often preferred means of access, in patients with severe ilio-femoral arteriopathy, other vascular access sites may be required. The aim of the present study was to report our experience with trans-subclavian approach for TAVR using different valve systems. METHODS: Among 273 patients undergoing TAVR between June 2011 and May 2016, 10 patients (mean age: 68...
October 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/27774493/two-photon-microscopy-measurement-of-cerebral-metabolic-rate-of-oxygen-using-periarteriolar-oxygen-concentration-gradients
#18
Sava Sakadžić, Mohammad A Yaseen, Rajeshwer Jaswal, Emmanuel Roussakis, Anders M Dale, Richard B Buxton, Sergei A Vinogradov, David A Boas, Anna Devor
The cerebral metabolic rate of oxygen ([Formula: see text]) is an essential parameter for evaluating brain function and pathophysiology. However, the currently available approaches for quantifying [Formula: see text] rely on complex multimodal imaging and mathematical modeling. Here, we introduce a method that allows estimation of [Formula: see text] based on a single measurement modality-two-photon imaging of the partial pressure of oxygen ([Formula: see text]) in cortical tissue. We employed two-photon phosphorescence lifetime microscopy (2PLM) and the oxygen-sensitive nanoprobe PtP-C343 to map the tissue [Formula: see text] distribution around cortical penetrating arterioles...
October 2016: Neurophotonics
https://www.readbyqxmd.com/read/27766594/prospective-survey-to-study-factors-which-could-influence-same-day-discharge-after-elective-laparoscopic-cholecystectomy-in-a-tertiary-care-hospital-of-a-developing-country
#19
Samina Ismail, Aliya Ahmed, Muhammad Qamarul Hoda, Muhammad Sohaib, Zia-Ur-Rehman
All laparoscopic cholecystectomy (LC) patients in our hospital setting are admitted overnight. This article assesses the contribution of factors like postoperative nausea and vomiting (PONV), postoperative pain and surgical complications to overnight stay after elective LC. This 1-year observational study included patients having normal liver functions undergoing elective LC before 1400 h. The collected data included patient demographics, co-morbidities, PONV, pain scores, complications, surgical time, anesthesia technique, use of prophylactic antiemetics, analgesics, patient satisfaction and desire to have this surgery as day case or in-patient procedure...
December 2016: Updates in Surgery
https://www.readbyqxmd.com/read/27758147/same-day-discharge-for-patients-undergoing-robot-assisted-laparoscopic-radical-prostatectomy-is-safe-and-feasible-results-of-a-pilot-study
#20
Melinda Wolboldt, Barbara Saltzman, Patrick Tenbrink, Khaled Shahrour, Samay Jain
INTRODUCTION: With healthcare reform, cost and patient satisfaction will directly affect hospital reimbursement. We present data on same-day discharge (SDD) for patients who underwent robot-assisted laparoscopic radical prostatectomy (RALP). METHODS: Patient data were gathered in an IRB-approved database. In April 2015, the surgeon (S.J.) began SDD. The SDD protocol for RALP includes multimodal anesthesia/analgesia and extended recovery. Interim analysis revealed that government insurance (CMS) refused hospital reimbursement for SDD...
December 2016: Journal of Endourology
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