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https://www.readbyqxmd.com/read/28099321/preoxygenation-physiologic-basis-benefits-and-potential-risks
#1
Usharani Nimmagadda, M Ramez Salem, George J Crystal
Preoxygenation before anesthetic induction and tracheal intubation is a widely accepted maneuver, designed to increase the body oxygen stores and thereby delay the onset of arterial hemoglobin desaturation during apnea. Because difficulties with ventilation and intubation are unpredictable, the need for preoxygenation is desirable in all patients. During emergence from anesthesia, residual effects of anesthetics and inadequate reversal of neuromuscular blockade can lead to hypoventilation, hypoxemia, and loss of airway patency...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099246/paradoxical-emergence-administration-of-subanesthetic-ketamine-during-isoflurane-anesthesia-induces-burst-suppression-but-accelerates-recovery
#2
Viviane S Hambrecht-Wiedbusch, Duan Li, George A Mashour
BACKGROUND: Promoting arousal by manipulating certain brain regions and/or neurotransmitters has been a recent research focus, with the goal of trying to improve recovery from general anesthesia. The current study tested the hypothesis that a single subanesthetic dose of ketamine during isoflurane anesthesia would increase cholinergic tone in the prefrontal cortex and accelerate recovery. METHODS: Adult male rats were implanted with electroencephalography electrodes (frontal, parietal, and occipital cortex) and a microdialysis guide cannula targeted for the prefrontal cortex...
January 18, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28098588/choice-of-anesthesia-for-cesarean-delivery-an-analysis-of-the-national-anesthesia-clinical-outcomes-registry
#3
Jeremy Juang, Rodney A Gabriel, Richard P Dutton, Arvind Palanisamy, Richard D Urman
Neuraxial anesthesia use in cesarean deliveries (CDs) has been rising since the 1980s, whereas general anesthesia (GA) use has been declining. In this brief report we analyzed recent obstetric anesthesia practice patterns using National Anesthesiology Clinical Outcomes Registry data. Approximately 218,285 CD cases were identified between 2010 and 2015. GA was used in 5.8% of all CDs and 14.6% of emergent CDs. Higher rates of GA use were observed in CDs performed in university hospitals, after hours and on weekends, and on patients who were American Society of Anesthesiologists class III or higher and 18 years of age or younger...
January 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28097415/anesthesia-practices-for-interventional-radiology-in-europe
#4
Alessandra Vari, Afshin Gangi
PURPOSE: The Cardiovascular and Interventional Radiological Society of Europe (CIRSE) prompted an initiative to frame the current European status of anesthetic practices for interventional radiology, in consideration of the current variability of IR suite settings, staffing and anesthetic practices reported in the literature and of the growing debate on sedation administered by non-anesthesiologists, in Europe. METHODS: Anonymous online survey available to all European CIRSE members to assess IR setting, demographics, peri-procedural care, anesthetic management, resources and staffing, pain management, data collection, safety, management of emergencies and personal opinions on the role CIRSE should have in promoting anesthetic care for interventional radiology...
January 17, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28096573/prolonged-patient-emergence-time-among-clinical-anesthesia-resident-trainees
#5
L McLean House, Nathan H Calloway, Warren S Sandberg, Jesse M Ehrenfeld
BACKGROUND AND AIMS: Emergence time, or the duration between incision closure and extubation, is costly nonoperative time. Efforts to improve operating room efficiency and identify trainee progress make such time intervals of interest. We sought to calculate the incidence of prolonged emergence (i.e., >15 min) for patients under the care of clinical anesthesia (CA) residents. We also sought to identify factors from resident training, medical history, anesthetic use, and anesthesia staffing, which affect emergence...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28094480/anesthetic-complications-during-general-anesthesia-without-intravenous-access-in-pediatric-ophthalmologic-clinic-assessment-of-5216-cases
#6
Chun W Hung, Lauren Licina, David H Abramson, Vittoria Arslan-Carlon
BACKGROUNDː General anesthesia utilizing inhalational agents without intravenous (IV) access for minor procedures is controversial1. Eliminating IV access increases efficiency and patient satisfaction; however, the ability to introduce rapid acting medications into the circulation during an unanticipated emergency becomes challenging. The objective of this study was to examine complication risk following pediatric ophthalmologic examinations under anesthesia (EUA) without IV placement. METHODSː A retrospective review of consecutive pediatric patients who underwent EUA for retinoblastoma management was performed from 2004 to 2014...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28092095/noradrenergic-transmission-in-the-central-medial-thalamic-nucleus-modulates-the-electroencephalographic-activity-and-emergence-from-propofol-anesthesia-in-rats
#7
Bao Fu, Tian Yu, Jie Yuan, Xingrui Gong, Mazhong Zhang
At present, the mechanisms by which general anesthetics causing loss of consciousness remain unclear. The central medial thalamic nucleus (CMT) is a rarely studied component of the midline thalamic complex, which is deemed to be a part of the nonspecific arousal system. Despite the fact that CMT participates in modulating arousal and receives excitatory noradrenergic projections from locus coeruleus (LC), it remains unknown whether the noradrenergic pathway in the CMT takes part in modulating the arousal system...
January 16, 2017: Journal of Neurochemistry
https://www.readbyqxmd.com/read/28079584/the-development-and-implementation-of-cognitive-aids-for-critical-events-in-pediatric-anesthesia-the-society-for-pediatric-anesthesia-critical-events-checklists
#8
Anna Clebone, Barbara K Burian, Scott C Watkins, Jorge A Gálvez, Justin L Lockman, Eugenie S Heitmiller
Cognitive aids such as checklists are commonly used in modern operating rooms for routine processes, and the use of such aids may be even more important during critical events. The Quality and Safety Committee of the Society for Pediatric Anesthesia (SPA) has developed a set of critical-event checklists and cognitive aids designed for 3 purposes: (1) as a repository of the latest evidence-based and expert opinion-based information to guide response and management of critical events, (2) as a source of just-in-time information during critical events, and (3) as a method to facilitate a shared understanding of required actions among team members during a critical event...
January 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079581/assessing-the-impact-of-the-anesthesia-medication-template-on-medication-errors-during-anesthesia-a-prospective-study
#9
Eliot B Grigg, Lizabeth D Martin, Faith J Ross, Axel Roesler, Sally E Rampersad, Charles Haberkern, Daniel K W Low, Kristen Carlin, Lynn D Martin
BACKGROUND: Medication errors continue to be a significant source of patient harm in the operating room with few concrete countermeasures. The organization and identification of medication syringes may have an impact on the commission of medication errors in anesthesia, so a team of physicians and designers at the University of Washington created the Anesthesia Medication Template (AMT) to define a formal way of organizing the anesthesia workspace. The purpose of this study is to assess the ability of the AMT to reduce perioperative medication errors by anesthesia providers...
January 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28079022/lifitegrast-for-the-treatment-of-dry-eye-disease-results-of-a-phase-iii-randomized-double-masked-placebo-controlled-trial-opus-3
#10
Edward J Holland, Jodi Luchs, Paul M Karpecki, Kelly K Nichols, Mitchell A Jackson, Kenneth Sall, Joseph Tauber, Monica Roy, Aparna Raychaudhuri, Amir Shojaei
PURPOSE: Lifitegrast is a lymphocyte function-associated antigen-1 antagonist developed to reduce inflammation in dry eye disease (DED). We report the results of OPUS-3 (NCT02284516), a phase III study evaluating the efficacy and safety of lifitegrast versus placebo in participants with DED. DESIGN: Twelve-week, phase III, randomized, double-masked, multicenter, placebo-controlled study. PARTICIPANTS: Adults aged ≥18 years with Schirmer tear test (without anesthesia) ≥1 and ≤10 mm, corneal fluorescein staining score ≥2...
January 2017: Ophthalmology
https://www.readbyqxmd.com/read/28070654/anesthesia-management-of-cesarean-section-in-parturient-with-anti-n-methyl-d-aspartate-receptor-encephalitis-a-case-report
#11
Zhimin Liao, Xiaoqin Jiang, Juan Ni
A 24-year-old woman at 29 weeks' gestation, and with psychiatric symptoms, was admitted to hospital and diagnosed as having anti-N-methyl-D-aspartate receptor encephalitis. After 4 weeks of immunotherapy with little effect, an emergency cesarean section was performed at 33(+4) weeks gestation under general anesthesia. The parturient was intubated after rapid sequence induction with etomidate, remifentanil and succinylcholine. Anesthesia was maintained with sevoflurane and remifentanil. Except for low weight, the infant was normal at birth...
January 9, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28069540/multi-modal-analysis-of-functional-connectivity-and-cerebral-blood-flow-reveals-shared-and-unique-effects-of-propofol-in-large-scale-brain-networks
#12
Maolin Qiu, Dustin Scheinost, Ramachandran Ramani, R Todd Constable
Anesthesia-induced changes in functional connectivity and cerebral blow flow (CBF) in large-scale brain networks have emerged as key markers of reduced consciousness. However, studies of functional connectivity disagree on which large-scale networks are altered or preserved during anesthesia, making it difficult to find a consensus amount studies. Additionally, pharmacological alterations in CBF could amplify or occlude changes in connectivity due to the shared variance between CBF and connectivity. Here, we used data-driven connectivity methods and multi-modal imaging to investigate shared and unique neural correlates of reduced consciousness for connectivity in large-scale brain networks...
January 6, 2017: NeuroImage
https://www.readbyqxmd.com/read/28063895/improvement-of-table-tennis-dystonia-by-stereotactic-ventro-oral-thalamotomy-a-case-report
#13
Takashi Asahi, Takaomi Taira, Kiyonobu Ikeda, Jiro Yamamoto, Shuji Sato
BACKGROUND: Task-specific focal dystonia, such as writer's cramp and musician's cramp, is a type of dystonia that affects performance of particular tasks. Such movement disorders have been treated with stereotactic ventro-oral (Vo) thalamotomy, with excellent outcomes. However, there has been no previous report of treatment of sport-related/athlete's dystonia by means of stereotactic surgery. We treated a patient with table tennis-related dystonia with Vo thalamotomy, and evaluated the outcome...
January 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28059945/airway-management-with-a-stereotactic-headframe-in-situ-a-mannequin-study
#14
Melissa Brockerville, Zoe Unger, Nathan C Rowland, Francesco Sammartino, Pirjo H Manninen, Lashmi Venkatraghavan
BACKGROUND: Stereotactic headframe-based imaging is often needed for target localization during surgery for insertion of deep brain stimulators. A major concern during this surgery is the need for emergency airway management while an awake or sedated patient is in the stereotactic headframe. The aim of our study was to determine the ease of emergency airway management with a stereotactic headframe in situ. MATERIALS AND METHODS: We conducted an observational study using a mannequin...
January 4, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28045726/postoperative-hemiplegic-migraine-after-a-laparoscopic-cholecystectomy-a-case-report
#15
Joseph Happel, Albin S Quiko, Huy Phun, Martin Collier, Amy Mortensen
We report the case of a 35-year-old woman who developed severe right-sided hemiplegia and hemisensory loss shortly after emergence from general anesthesia for a laparoscopic cholecystectomy. Her medical history was significant for migraine with aura and a family history of transient hemiparesis thought to be a result of a transient ischemic attack. The patient's deficits slowly resolved, and she was ultimately diagnosed with familial hemiplegic migraine after a negative workup for cerebrovascular accidents.
December 30, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/28045725/utilization-of-stand-by-extracorporeal-membrane-oxygenation-in-a-high-risk-parturient-with-methamphetamine-associated-cardiomyopathy-undergoing-dilation-and-evacuation-a-case-report
#16
Cesar Padilla, Antonio Hernandez Conte, Danny Ramzy, Lorraine Lubin, Troy LaBounty, Judith H Chung, Ying Zeng
Parturients may present with evidence of acute heart failure or respiratory distress during the peripartum period. This case report documents utilization of "stand-by" extracorporeal membrane oxygenation (ECMO) for a 40-year-old woman with a history of severe left ventricular dysfunction who presented for elective dilation and evacuation of triplets at 20 weeks' gestation. The patient's medical history was significant for hypertension, diabetes mellitus, methamphetamine use (acute/chronic), and cardiac-respiratory arrest before her previous emergent cesarean delivery...
December 30, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/28045721/case-report-red-urine-after-day-care-strabismus-surgery
#17
Pregardien Caroline, Nassogne Marie-Cécile, Yuksel Demet, Veyckemans Francis
In the absence of surgery on the urinary tract, the emission of red urine after anesthesia should be considered as a diagnostic emergency because it can be a sign of hematuria, hemoglobinuria, blood transfusion reaction, significant myoglobinuria, or porphyria.This case describes the management of a 12-year-old boy who presented red urine at the day care unit after strabismus surgery.
December 30, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/28045036/speed-hysteresis-and-noise-shaping-of-traveling-fronts-in-neural-fields-role-of-local-circuitry-and-nonlocal-connectivity
#18
Cristiano Capone, Maurizio Mattia
Neural field models are powerful tools to investigate the richness of spatiotemporal activity patterns like waves and bumps, emerging from the cerebral cortex. Understanding how spontaneous and evoked activity is related to the structure of underlying networks is of central interest to unfold how information is processed by these systems. Here we focus on the interplay between local properties like input-output gain function and recurrent synaptic self-excitation of cortical modules, and nonlocal intermodular synaptic couplings yielding to define a multiscale neural field...
January 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28042430/experimental-protocol-of-dental-procedures-in-patients-with-hereditary-angioedema-the-role-of-anxiety-and-the-use-of-nitrogen-oxide
#19
A Rosa, M Miranda, R Franco, M G Guarino, A Barlattani, P Bollero
Hereditary angioedema (HAE) is a rare disease, little known to the medical and dental community, but with a growing rate of hospitalization over the years. HAE is due to a deficit/dysfunction of C1 esterase inhibitor which leads to an increase in vascular permeability and the appearance of edemas widespread in all body areas. The airways are the most affected and laryngeal swelling, which can occur, it is dangerous for the patient's life, is also a sensitive spot in our daily practice, therefore, it is also important to be aware of all the signs of this disease...
April 2016: Oral & Implantology
https://www.readbyqxmd.com/read/28039649/or-fire-virtual-training-simulator-design-and-face-validity
#20
Denis Dorozhkin, Jaisa Olasky, Daniel B Jones, Steven D Schwaitzberg, Stephanie B Jones, Caroline G L Cao, Marcos Molina, Steven Henriques, Jinling Wang, Jeff Flinn, Suvranu De
BACKGROUND: The Virtual Electrosurgical Skill Trainer is a tool for training surgeons the safe operation of electrosurgery tools in both open and minimally invasive surgery. This training includes a dedicated team-training module that focuses on operating room (OR) fire prevention and response. The module was developed to allow trainees, practicing surgeons, anesthesiologist, and nurses to interact with a virtual OR environment, which includes anesthesia apparatus, electrosurgical equipment, a virtual patient, and a fire extinguisher...
December 30, 2016: Surgical Endoscopy
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