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https://www.readbyqxmd.com/read/28426446/providing-anesthesia-in-resource-limited-settings
#1
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/28425001/brown-s-regional-anesthesia-review-1st-edition-ehab-fharag-loran-mounir-soliman-elsevier-2016-111-00-paperback-192-pages-isbn-9780323400565
#2
Ariane Clairoux
No abstract text is available yet for this article.
April 19, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28417459/does-obesity-complicate-regional-anesthesia-and-result-in-longer-decision-to-delivery-time-for-emergency-cesarean-section
#3
A J Väänänen, J P Kainu, H Eriksson, M Lång, A Tekay, J Sarvela
BACKGROUND: Maternal obesity can cause problems with anesthesia and surgery which may be reflected in emergency cesarean sections (CS) as an increased decision-to-delivery interval (DDI). AIM: To study the association of elevated maternal BMI with DDI and the failure of regional anesthesia. METHODS: Eight hundred and forty-two consecutive emergency CSs during a period of 1 year in a tertiary hospital were studied retrospectively. DDIs were analyzed in Crash and < 30-min urgency categories (n = 528), while the time required to establish regional anesthesia and its success were analyzed for all emergency CS cases...
April 17, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28413272/an-analysis-of-perioperative-adverse-neurological-events-associated-with-anesthetic-management-at-a-tertiary-care-center-of-a-developing-country
#4
Fauzia Anis Khan, Sobia Khan, Gauhar Afshan
BACKGROUND AND AIMS: Existing literature on neurological complications related to anesthesia is reported from affluent countries but the trends may vary in less affluent countries. MATERIAL AND METHODS: The objective was to find the associated factors contributing to neurological adverse events occurring within 48 h of anesthesia and surgery. The existing departmental morbidity and mortality database was reviewed from 1992 to 2012 for major adverse neurological events...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28412052/-the-relationship-between-preoperative-anxiety-levels-and-vasovagal-incidents-during-the-administration-of-spinal-anesthesia
#5
Mürsel Ekinci, Birzat Emre Gölboyu, Onur Dülgeroğlu, Murat Aksun, Pınar Karaca Baysal, Erkan Cem Çelik, Ayşe Nur Yeksan
BACKGROUND: It was aimed to investigate the relationship between preoperative anxiety and vasovagal symptoms observed during the administration of spinal anesthesia in patients undergoing surgery in the perianal and inguinal regions. METHODS: The study included patients with planned surgery for inguinal hernia repair, anal fissure, hemorrhoid and pilonidal sinus excision. The study included a total of 210 patients of ASA I-II, aged 18-65 years. Patients were evaluated in respect of demographic characteristics, smoking and alcohol consumption, ASA grade and educational level...
April 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28410101/medical-instrument-detection-in-3-dimensional-ultrasound-data-volumes
#6
Arash Pourtaherian, Harm Scholten, Lieneke Kusters, Svitlana Zinger, Nenad Mihajlovic, Alexander Kolen, Fei Zou, Gary Ng, Hendrikus Korsten, Peter de With
Ultrasound-guided medical interventions are broadly applied in diagnostics and therapy, e.g. regional anesthesia or ablation. A guided intervention using 2D ultrasound is challenging due to the poor instrument visibility, limited field of view and the multi-fold coordination of the medical instrument and ultrasound plane. Recent 3D ultrasound transducers can improve the quality of the image-guided intervention if an automated detection of the needle is used. In this paper, we present a novel method for detecting medical instruments in 3D ultrasound data that is solely based on image processing techniques and validated on various ex-vivo and in-vivo datasets...
April 7, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28408712/peritoneal-dialysis-catheter-surgery-using-transversus-abdominis-plane-block
#7
Dean Markić, Božidar Vujičić, Mladen Ivanovski, Kristian Krpina, Antun Gršković, Dražen Rahelić, Nino Rubinić, Željko Župan, Hrvoje Lasić, Mauro Materljan, Sanjin Rački
♦Background: Peritoneal dialysis (PD) catheter surgery can be performed using regional anesthesia. We present our PD catheter placement and extraction experience using ultrasound-guided transversus abdominis plane (TAP) block. ♦ Methods: In the present study, we analyzed 74 patients from our center with end-stage renal disease (ESRD) who underwent PD catheter placement (60 patients) and removal (14 patients) using a TAP block between June 2011 and December 2015. ♦ Results: The TAP block was successful for 55/60 (91...
April 13, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28402089/perioperative-management-of-obstructive-sleep-apnea-a-systematic-review
#8
Ruggero Corso, Vincenzo Russotto, Cesare Gregoretti, Davide Cattano
Obstructive sleep apnea (OSA) is the leading sleep disordered breathing condition, with a prevalence rate of moderate to severe OSA of approximately 10 - 17% in the general population. Its prevalence in the surgical population seems to be higher. However, a proportion of up to 60% of patients may not have a formal diagnosis at the moment of preoperative visit. OSA is associated with a number of comorbidities and increased perioperative risks. However, most interventions for the perioperative management of OSA patients lack high quality evidence...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28396863/real-time-ultrasound-mri-fusion-for-suprasacral-parallel-shift-approach-to-lumbosacral-plexus-blockade-and-analysis-of-injectate-spread-an-exploratory-randomized-controlled-trial
#9
Jennie Maria Christin Strid, Erik Morre Pedersen, Sinan Naseer Hussain Al-Karradi, Mathias Alrø Fichtner Bendtsen, Siska Bjørn, Mette Dam, Morten Daugaard, Martin Sejr Hansen, Katrine Danker Linnet, Jens Børglum, Kjeld Søballe, Thomas Fichtner Bendtsen
Fused real-time ultrasound and magnetic resonance imaging (MRI) may be used to improve the accuracy of advanced image guided procedures. However, its use in regional anesthesia is practically nonexistent. In this randomized controlled crossover trial, we aim to explore effectiveness, procedure-related outcomes, injectate spread analyzed by MRI, and safety of ultrasound/MRI fusion versus ultrasound guided Suprasacral Parallel Shift (SSPS) technique for lumbosacral plexus blockade. Twenty-six healthy subjects aged 21-36 years received two SSPS blocks (20 mL 2% lidocaine-epinephrine [1 : 200,000] added 1 mL diluted contrast) guided by ultrasound/MRI fusion versus ultrasound...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28394849/inhibition-of-voltage-gated-na-channels-by-bupivacaine-is-enhanced-by-the-adjuvants-buprenorphine-ketamine-and-clonidine
#10
Carsten Stoetzer, Christine Martell, Jeanne de la Roche, Andreas Leffler
BACKGROUND AND OBJECTIVES: Regional anesthesia includes application of local anesthetics (LAs) into the vicinity of peripheral nerves. Prolongation or improvement of nerve blocks with LAs can be accomplished by coapplication with adjuvants, including buprenorphine, ketamine, and clonidine. While the mechanisms mediating prolonged or improved LA-induced effects by adjuvants are poorly understood, we hypothesized that they are likely to increase LA-induced block of voltage-gated Na channels...
April 7, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28394848/a-new-step-toward-evidence-of-in-vivo-perineural-dexamethasone-safety-an-animal-study
#11
Philippe Marty, Mehdi Bennis, Benjamin Legaillard, Etienne Cavaignac, Fabrice Ferre, Julie Lebon, Anne Brouchet, Vincent Minville
BACKGROUND AND OBJECTIVES: The aim of this study was to analyze histological nerve toxicity of perineural dexamethasone administration in combination with ropivacaine on mice. Efficacy of perineural dexamethasone in combination with regional anesthesia is clearly demonstrated. However, the safety of this procedure is still a matter of debate. METHODS: A sciatic nerve block was performed on 90 mice. Five groups, each containing 18 mice assigned randomly, were used in these experiments: the sham group (isotonic saline solution), R group (perineural ropivacaine), D group (perineural dexamethasone), RDPN group (perineural ropivacaine and perineural dexamethasone), and the RDS group (perineural ropivacaine and systemic dexamethasone)...
April 7, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28389285/outcome-analysis-of-carotid-cross-clamp-intolerance-during-carotid-endarterectomy-under-loco-regional-anesthesia
#12
Gabriele Piffaretti, Antonino Tarallo, Marco Franchin, Alessandro Bacuzzi, Nicola Rivolta, Massimo Ferrario, Stefania Ferraro, Matteo Bossi, Patrizio Castelli, Matteo Tozzi
OBJECTIVES: To analyze the predictors and describe the outcomes of cross-clamp intolerance (CCI), and the results of the use of carotid endarterectomy (CEA) with shunting or a shift strategy to immediate carotid artery stenting (CAS) in this setting. MATERIALS AND METHODS: Between January 2008 and December 2015, 385 patients were elected for single sided, isolated CEA under loco-regional anesthesia. In case of CCI, CEA with shunt was used selectively, whereas indication to immediate conversion to CAS was the immediate onset and severe persistent deterioration of the neurologic status, and/or local technical difficulties to perform endarterectomy...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28387892/anesthesia-and-analgesia-in-breast-surgery-the-benefits-of-peripheral-nerve-block
#13
L Calì Cassi, F Biffoli, D Francesconi, G Petrella, O Buonomo
Breast surgery is frequently associated with postoperative pain, nausea and vomiting, that result in increased patient's suffering, prolongation of hospital stays and related costs. Thoracic paravertebral nerve block (TPVB) is a viable option to the classic multimodal analgesia in breast surgery as it enhances surgical anesthesia and postoperative analgesia. In this review, we report the results of a number of studies on the role of TPVB in breast surgery. This technique is associated with a superior control of the pain, a reduction in opioids consumption after surgery, a decrease in postoperative nausea and vomiting, and an overall decrease in length of hospital stay...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28386070/efficacy-and-safety-of-multimodal-analgesic-techniques-for-preventing-chronic-postsurgery-pain-under-different-surgical-categories-a-meta-analysis
#14
Jun Zhou, Youling Fan, Jiying Zhong, Xianjie Wen, Hongtao Chen
The purpose of this meta-analysis was to compare the efficacy and safety of regional anesthesia to manage chronic postsurgery pain. A systematic search of PubMed, EmBase, and the Cochrane Central Register of Controlled Trials was performed to identify randomized controlled trials that focused on chronic pain frequency, analgesic consumption, and adverse effects under different surgical categories. We collected 21 trials assessing 1,980 patients for our meta-analysis. The summary of relative risks (RRs) and standard mean differences (SMDs) were calculated to measure the treatment effect of regional anesthesia...
April 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28382293/combined-spinal-epidural-anesthesia-in-laparoscopic-appendectomy-a-prospective-feasibility-study
#15
Sinan Uzman, Turgut Donmez, Vuslat Muslu Erdem, Adnan Hut, Dogan Yildirim, Muzaffer Akinci
PURPOSE: Laparoscopic appendectomy (LA) is routinely performed under general, not regional anesthesia. This study assessed the feasibility, efficacy, and side effects of combined spinal-epidural anesthesia (CSEA) in LA. METHODS: Thirty-three American Society of Anesthesiologist (ASA) physical status classification grade I patients underwent LA under CSEA. CSEA was performed using the needle-through-needle technique at the L3-L4 interspace. Preoperative and postoperative adverse events related to CSEA, patient satisfaction, and postoperative pain levels were recorded...
April 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28377023/percutaneous-ultrasound-guided-vs-intraoperative-rectus-sheath-block-for-pediatric-umbilical-hernia-repair-a-randomized-clinical-trial
#16
Cristen N Litz, Sandra M Farach, Allison M Fernandez, Richard Elliott, Jenny Dolan, Nikhil Patel, Lillian Zamora, Paul M Colombani, Nebbie E Walford, Ernest K Amankwah, Christopher W Snyder, Paul D Danielson, Nicole M Chandler
BACKGROUND: Regional anesthesia is commonly used in children. Our hypothesis was that percutaneous ultrasound-guided (PERC) rectus sheath blocks would result in lower postoperative pain scores compared to intraoperative (IO) rectus sheath blocks following umbilical hernia repair. METHODS: A single-institution randomized blinded trial was conducted in pediatric patients undergoing elective umbilical hernia repair. The primary outcome was mean postoperative Wong-Baker pain score...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28374183/effect-of-adding-dexmedetomidine-to-ropivacaine-on-ultrasound-guided-dual-transversus-abdominis-plane-block-after-gastrectomy
#17
Wengang Ding, Wanying Li, Xianzhang Zeng, Jinying Li, Jingjing Jiang, Changchun Guo, Wenzhi Li
OBJECTIVES: Transversus abdominis plane (TAP) block is an analgesic technique. Adding dexmedetomidine can enhance regional anesthesia. This study's aim was to evaluate whether dexmedetomidine prolonged analgesic time of TAP block after gastrectomy. METHODS: Patients scheduled for gastrectomy were randomly assigned to receive a TAP block with saline (group S), ropivacaine (group R), or ropivacaine and dexmedetomidine (group RD). Visual analogue scale (VAS) scores, postoperative nausea and vomiting (PONV) scores, sedation scores, tramadol consumption, ropivacaine concentration, and Quality of Recovery Questionnaire 40 (QoR-40) were recorded...
April 3, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28371877/comprehensive-analysis-of-13-897-consecutive-regional-anesthetics-at-an-ambulatory-surgery-center
#18
Randall J Malchow, Rajnish K Gupta, Yaping Shi, Matthew S Shotwell, Lisa M Jaeger, Clifford Bowens
Objective.:  The authors investigated a wide range of perioperative outcome measures in the context of a robust regional anesthesia practice. Design.:  Comprehensive review of a prospectively collected six-year database. Setting.:  Freestanding, academic ambulatory surgery center. Subjects.:  There were 13,897 consecutive regional anesthetics in 10,338 patients. Methods.:  We investigated patient satisfaction, postoperative nausea and vomiting (PONV), postoperative pain, catheter analgesia, and complications...
March 24, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28368901/fortuitous-diagnosis-of-preexisting-neuropathy-during-ultrasound-guided-regional-anesthesia-performance-a-case-report
#19
Philippe Marty, Bertrand Basset, Constance Marquis, Medhi Merouani, Olivier Rontes, Alain Delbos
Ultrasound-guided regional anesthesia requires the anesthesia provider to interpret new information. This article reports on the case of a 38-year-old man scheduled for a fifth metacarpal fracture repair. Ultrasound nerve examination revealed abnormal pathology of the axillary brachial plexus consisting of an increased volume of the terminal nerves of the brachial plexus. Ultrasound scanning initiated the subsequent diagnosis of multifocal motor neuropathy. Regional anesthesia was abandoned in favor of general anesthesia...
March 31, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28367293/thoracic-interfascial-nerve-block-for-breast-surgery-in-a-pregnant-woman-a-case-report
#20
Boohwi Hong, Seok-Hwa Yoon, Ann Misun Youn, Bum June Kim, Seunghyun Song, Yeomyung Yoon
Regional anesthesia for non-obstetric surgery in parturients is a method to decrease patient and fetal risk during general anesthesia. Thoracic interfascial nerve block can be used as an analgesic technique for surgical procedures of the thorax. The Pecs II block is an interfascial block that targets not only the medial and lateral pectoral nerves, but also the lateral cutaneous branch of the intercostal nerve. Pecto-intercostal fascial block (PIFB) targets the anterior cutaneous branch of the intercostal nerve...
April 2017: Korean Journal of Anesthesiology
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