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"regional anesthesia"

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https://www.readbyqxmd.com/read/29661153/improved-analgesia-and-reduced-post-operative-nausea-and-vomiting-after-implementation-of-an-enhanced-recovery-after-surgery-eras-pathway-for-total-mastectomy
#1
Catherine Chiu, Pedram Aleshi, Laura J Esserman, Christina Inglis-Arkell, Edward Yap, Elizabeth L Whitlock, Monica W Harbell
BACKGROUND: Enhanced Recovery After Surgery (ERAS) pathways have been shown in multiple surgical disciplines to improve outcomes, including reduced opioid consumption, length of stay, and post-operative nausea and vomiting (PONV). However, very few studies describe the application of ERAS to breast surgery and even fewer describe ERAS for outpatient surgery. We describe the implementation and efficacy of an Enhanced Recovery After Surgery (ERAS) pathway for total skin-sparing mastectomy with immediate reconstruction in an outpatient setting...
April 16, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29659439/clotting-factor-concentrations-5-days-after-discontinuation-of-warfarin
#2
Honorio T Benzon, Yogen Asher, Mark C Kendall, Loyda Vida, Robert J McCarthy, David Green
BACKGROUND: The American Society of Regional Anesthesia and Pain Medicine guidelines recommend discontinuation of warfarin and an international normalized ratio (INR) of 1.2 or less before a neuraxial injection. The European and Scandinavian guidelines accept an INR of 1.4 or less. We evaluated INR and levels of clotting factors (CFs) II, VII, IX, and X 5 days after discontinuation of warfarin. METHODS: Patients who discontinued warfarin for 5 days and had an INR of 1...
April 14, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29644106/supraorbital-nerve-exits-positional-variations-and-localization-relative-to-surgical-landmarks
#3
Deepthi Nanayakkara, Ruwanthi Manawaratne, Harshana Sampath, Amal Vadysinghe, Roshan Peiris
Significant variations exist in the occurrence, form, and position of supraorbital nerve exits through the frontal bone. Detailed knowledge of the positional variations of supraorbital exits is important to ensure safe and successful regional anesthesia, and to avoid iatrogenic nerve injuries during surgery of the orbitofacial region. Supraorbital nerve exits from 116 sides of 58 dry intact adult skulls (37 male and 21 female) in a Sri Lankan population were examined to determine the morphological features and the precise position in relation to the facial midline, temporal crest of frontal bone, and frontozygomatic suture...
March 2018: Anatomy & Cell Biology
https://www.readbyqxmd.com/read/29643635/regional-anesthesia-is-safe-and-effective-for-lower-limb-orthopedic-surgery-in-patient-with-renal-tubular-acidosis-and-hypokalemia
#4
Indira Gurajala, Sapna Annaji Nikhar, Kavitha Jayaram, Ramachandran Gopinath
Renal tubular acidosis (RTA) with hypokalemia may precipitate acute respiratory failure and potentially fatal arrhythmias like ventricular fibrillation. Though there are random reports of respiratory failure needing mechanical ventilation and sudden death in patients with RTA and hypokalemia, the anesthetic management of these patients has not been clearly elucidated. Acidosis and hypokalemia have significant interactions with both general and local anesthetics and alter their effect substantially. Proper preoperative planning and optimization are required for the safe conduct of anesthesia in this subset of patients...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29642984/the-effect-of-regional-anesthesia-on-oncologic-outcomes-after-resection-of-colorectal-hepatic-metastases
#5
Mary Garland, Dylan Addis, Greg Russell, Clancy Clark, Edward Levine, Russell Howerton, Konstantinos Votanopoulos, Sean Dobson, Perry Shen
No abstract text is available yet for this article.
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29628849/pectoralis-blocks-for-insertion-of-an-implantable-cardioverter-defibrillator-in-two-patients-with-duchenne-muscular-dystrophy
#6
Alexander B Froyshteter, Tarun Bhalla, Joseph D Tobias, Gregory S Cambier, Christopher T Mckee
Patients with Duchenne muscular dystrophy (DMD) often have systemic manifestations with comorbid involvement of the cardiac and respiratory systems that increase the risk of anesthetic and perioperative morbidity. These patients frequently develop progressive myocardial involvement with cardiomyopathy, depressed cardiac function, and arrhythmias. The latter may necessitate the placement of an automatic implantable cardioverter defibrillator (AICD) insertion. As a means of avoiding the need for general anesthesia and its inherent potential of morbidity, regional anesthesia may be used in specific cases...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628602/anosmia-after-caudal-epidural-steroid-injection
#7
Ayhan Kaydu, Ebru Tarikçi Kiliç, Erhan Gökçek, Cem Kivilcim Kaçar
There are no reports for anosmia after caudal epidural steroid injections (CESIs). General anesthesia is among the reasons, but the reports up to date are extremely limited. There are no identifiable factors contributing to anosmia after epidural injection, so it is worth discussing. We present the case of a 50-year-old woman with no previous history of any sensory deficits. She experienced anosmia after CESI that had been performed due to her chronic low back pain and lasted for 4 months. Clinical and imaging studies did not reveal any pathology...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628580/comparison-of-intravenous-bolus-and-infusion-of-dexmedetomidine-on-characteristics-of-subarachnoid-block
#8
Tripti Vatsalya, Chandrakant Waikar, Madhurima Singh
Aims: Dexmedetomidine is very dynamic drug, used for analgesia, sedation, blunting the laryngoscopic responses and as adjuvants in regional anesthesia. Studies have shown that intravenous (iv) dexmedetomidine given during spinal anesthesia increases the quality of subarachnoid block (SAB). In this study, we compare the two iv regimen of dexmedetomidine on analgesic effect of spinal anesthesia. One is bolus dose of dexmedetomidine and other is infusion during the surgery, both given after induction of spinal anesthesia...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628564/comparison-of-magnesium-sulfate-and-dexmedetomidine-as-an-adjuvant-to-0-5-ropivacaine-in-infraclavicular-brachial-plexus-block
#9
Mohamed M Abu Elyazed, Mona M Mogahed
Background: Magnesium sulfate and dexmedetomidine were used as adjuvants to local anesthesia to improve the quality of regional anesthesia. Aims: The aim of this study is to evaluate and compare the effects of magnesium sulfate and dexmedetomidine when added to ropivacaine on the quality of infraclavicular brachial plexus block (BPB). Settings and Design: This was a prospective randomized double-blinded controlled study. Patients and Methods: A total of 105 adult patients undergoing surgery in hands, wrist, and forearm using infraclavicular BPB were randomly assigned into three groups...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628544/anesthetic-considerations-for-carotid-endarterectomy-a-postgraduate-educational-review
#10
REVIEW
Ahmed Yousef A Al Sultan, Abdulrahman Mawadh A Alsubhi
Carotid endarterectomy (CEA) has shown a significant benefit in preventing ipsilateral stroke when it is compared to conservative management. Surgical morbidity and mortality must be kept to a minimum to achieve this benefit. Neurological status of the CEA patients can be monitored easily during regional anesthesia depending on the awake testing (neurocognitive assessment) method of the CEA patients. In addition, specific parameters can help us to monitor and to predict the neurological status of the CEA patients during the procedures such as regional cerebral oxygen saturation (rSO2 ) and middle cerebral artery velocity (MCAv) changes...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29615378/intraoperative-psoas-compartment-block-vs-preoperative-fascia-iliaca-block-for-pain-control-after-direct-anterior-total-hip-arthroplasty-a-randomized-controlled-trial
#11
Clayton R Perry, Adam M Fahs, Michael D Kurdziel, Denise M Koueiter, Randy J Fayne, James J Verner
BACKGROUND: Modern joint arthroplasty protocols place an emphasis on minimizing patient-reported postoperative pain while minimizing opioid consumption. The use of multimodal pain management protocols has been reported to improve patient outcomes and satisfaction after total hip arthroplasty. METHODS: In a prospective, single-surgeon trial, 50 patients undergoing primary direct anterior approach total hip arthroplasty were randomized to receive a preoperative fascia iliaca compartment block (FICB) or an intraoperative surgeon-delivered psoas compartment block (PCB)...
January 31, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29607863/total-hip-replacement-in-sickle-cell-disorder-a-preliminary-report-of-challenges-and-early-outcome-of-21-consecutive-patients
#12
A U Katchy, U E Anyaehie, C U Nwadinigwe, G O Eyichukwu
Objective: The aim of this study is to describe the pattern of presentation osteoarthritic patients with sickle cell disorder (SCD) in our environment, determine the implant sizes taking the peculiar nature of the pathology and our operating environment into consideration, highlight the challenges and technical difficulties encountered during the procedure, measure the functional outcome and observe complications of treatment, recommend ways of improving outcome. Patients and Methods: Between November 2008 and November 2012, 29 consecutive primary total hip replacements (THRs) were performed on 21 patients with avascular necrosis of the head of femur secondary to SCD...
April 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29602555/surgical-practice-and-outcome-in-711-neonates-and-infants-undergoing-hernia-repair-in-a-large-multicenter-rct-secondary-results-from-the-gas-study
#13
Nicola Disma, Davinia Withington, Mary Ellen McCann, Rodney Wayne Hunt, Sarah Jane Arnup, Francesca Izzo, Girolamo Mattioli, Neil Morton, Geoff Frawley, Andrew Davidson, Anne Lynn, Peter Szmuk, Joss John Thomas, Philip Ragg, Alessio Pini Prato
BACKGROUND: The GAS study is an international RCT to evaluate neurodevelopmental outcome comparing general plus regional anesthesia versus regional anesthesia alone in 722 neonates and infants who had inguinal hernia repair up to 60 weeks of postmenstrual age. This paper comprises a secondary descriptive analysis of hernias, aspects of surgery and outcomes. METHODS: The incidence of unilateral and bilateral hernias, side preponderance, predictive factors for bilateral hernias and surgical approaches were collated...
January 31, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29601378/is-anesthesia-technique-associated-with-a-higher-risk-of-mortality-or-complications-within-90-days-of-surgery-for-geriatric-patients-with-hip-fractures
#14
Vimal Desai, Priscilla H Chan, Heather A Prentice, Gary L Zohman, Glenn R Diekmann, Gregory B Maletis, Brian H Fasig, Diana Diaz, Elena Chung, Chunyuan Qiu
BACKGROUND: Postoperative mortality and complications after geriatric hip fracture surgery remain high despite efforts to improve perioperative care for these patients. One factor of particular interest is anesthetic technique, but prior studies on this are limited by sample selection, competing risks, and incomplete followup. QUESTIONS/PURPOSES: (1) Among older patients undergoing surgery for hip fracture, does 90-day mortality differ depending on the type of anesthesia received? (2) Do 90-day emergency department returns and hospital readmissions differ based on anesthetic technique after geriatric hip fracture repairs? (3) Do 90-day Agency for Healthcare Research and Quality (AHRQ) outcomes differ according to anesthetic techniques used during hip fracture surgery? METHODS: We conducted a retrospective study on geriatric patients (65 years or older) with hip fractures between 2009 and 2014 using the Kaiser Permanente Hip Fracture Registry...
March 28, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29601303/the-opioid-epidemic-and-pregnancy-implications-for-anesthetic-care
#15
Britany L Raymond, Bradley T Kook, Michael G Richardson
PURPOSE OF REVIEW: This review summarizes evolving knowledge regarding adverse maternal, fetal, and neonatal effects of opioid exposure during pregnancy, and current treatment options for opioid use disorder (OUD). Maternal and fetal implications of maternal opioid maintenance with methadone and buprenorphine are described. Finally, acute and chronic pain management strategies in opioid-tolerant parturients are reviewed. RECENT FINDINGS: Opioid use among parturients has risen dramatically, with opioid use during pregnancy as high as 20%...
March 29, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29601275/effects-of-conversational-hypnosis-on-relative-parasympathetic-tone-and-patient-comfort-during-axillary-brachial-plexus-blocks-for-ambulatory-upper-limb-surgery-a-quasiexperimental-pilot-study
#16
Emmanuel Boselli, Hervé Musellec, Franck Bernard, Nicolas Guillou, Pierre Hugot, Caroline Augris-Mathieu, Nathalie Diot-Junique, Lionel Bouvet, Bernard Allaouchiche
This two-center quasiexperimental pilot study was to determine the effect of conversational hypnosis on patient comfort and parasympathetic tone, which may represent a quantitative measure of hypnotic depth, during regional anesthesia. The patients received conversational hypnosis in one center and oral premedication in the other. The patients' subjective comfort (0-10 rating scale) and objective parasympathetic tone, as assessed by the Analgesia/Nociception Index (ANI), were measured before and after regional anesthesia...
April 2018: International Journal of Clinical and Experimental Hypnosis
https://www.readbyqxmd.com/read/29600256/fellowships-represent-a-logical-target-for-cultivating-research-in-academic-anesthesiology
#17
Jean Daniel Eloy, Molly D Amin, Anna A Pashkova, Peter F Svider, Kevin M Mauro, Jean Anderson Eloy
Background: The need for greater emphasis on research contributions in academic anesthesiology has been widely recognized in recent years. Some propose increasing integration of research, including dedicated research time, into ACGME requirements for residency and fellowship training experiences. The h-index , an effective measure of research productivity that takes into account relevance and impact of an author's contributions on discourse within a field, was used to examine whether there are differences in research productivity between non-fellowship and fellowship-trained faculty in academic anesthesiology departments...
July 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/29596099/evidence-basis-for-regional-anesthesia-in-ambulatory-anterior-cruciate-ligament-reconstruction-part-i-femoral-nerve-block
#18
Leon Vorobeichik, Richard Brull, Girish P Joshi, Faraj W Abdallah
The optimal management of pain after ambulatory anterior cruciate ligament reconstruction (ACLR) is unclear. Femoral nerve block (FNB) is purported to enhance postoperative analgesia, but its effectiveness in the setting of modern multimodal analgesia is unclear. This systematic review examines the effect of adding FNB to multimodal analgesia on analgesic outcomes after ACLR, whether or not the analgesic regimen used included local instillation analgesia (LIA). We retrieved randomized controlled trials evaluating the effects of adding FNB to multimodal analgesia on analgesic outcomes after ACLR, compared to multimodal analgesia alone (control)...
March 27, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29582361/complications-of-regional-anesthesia-principles-of-safe-practice-in-local-and-regional-anesthesia-third-edition-brendan-t-finucane-ban-c-h-tsui-editors-springer-international-publishing-2017-501-pages-doi-10-1007-978-3-319-49386-2-hardcover-209-00-isbn-978
#19
https://www.readbyqxmd.com/read/29570501/local-anesthetic-injection-speed-and-common-peroneal-nerve-block-duration-a-randomized-controlled-trial-in-healthy-volunteers
#20
Mikkel Herold Madsen, Claus B Christiansen, Christian Rothe, Asger M Andreasen, Lars H Lundstrøm, Kai H W Lange
BACKGROUND AND OBJECTIVES: The speed of local anesthetic (LA) injections in peripheral regional anesthesia ranges from slow continuous infusions (3-12 mL/h) to rapid manual injections (>7500 mL/h). Optimizing injection speed could augment the spread of LA toward the targeted nerves and influence nerve block characteristics. The objective of this study was to investigate whether injection speed of a single dose of LA affects peripheral nerve block duration. METHODS: After approval from the Danish Regional Scientific Ethics Committee, we enrolled 60 healthy adult volunteers...
March 22, 2018: Regional Anesthesia and Pain Medicine
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