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https://www.readbyqxmd.com/read/29902699/abuse-of-fentanyl-an-emerging-problem-to-face
#1
REVIEW
Katarzyna Kuczyńska, Piotr Grzonkowski, Łukasz Kacprzak, Jolanta B Zawilska
Fentanyl is a potent synthetic opioid used as a narcotic analgesic supplement in general and regional anesthesia as well as in management of persistent, severe chronic pain. Alarming epidemiological and forensic medicine reports, accumulated mainly during the last two decades, point to a growing increase in illicit use of fentanyl, mainly in North America and Europe. Toxicological data indicates that fentanyl use is inextricably linked with polydrug use. There are two main sources of fentanyl on the "recreational" drug market...
June 2, 2018: Forensic Science International
https://www.readbyqxmd.com/read/29902215/clinical-analgesic-efficacy-of-dexamethasone-as-a-local-anesthetic-adjuvant-for-transversus-abdominis-plane-tap-block-a-meta-analysis
#2
Qi Chen, Ran An, Ju Zhou, Bin Yang
BACKGROUND: Perineural dexamethasone has been shown to prolong the duration of local anesthetic (LA) effect in regional anesthesia; however, the use of perineural dexamethasone as an adjuvant to to the transversus abdominis plane (TAP) block remains controversial. This meta-analysis sought to assess the efficacy of dexamethasone in prolonging the TAP block and enhancing recovery after abdominal surgery. METHODS: We identified and analyzed 9 RCTs published on or before September 30, 2017, regardless of the original language, after searching the following 6 bibliographic databases: PubMed, EMBASE, Medline, Springer, Ovid, and the Cochrane Library...
2018: PloS One
https://www.readbyqxmd.com/read/29894394/improving-clinical-proficiency-using-a-3-dimensionally-printed-and-patient-specific-thoracic-spine-model-as-a-haptic-task-trainer
#3
Jeffrey Bortman, Yanick Baribeau, Jelliffe Jeganathan, Yannis Amador, Faraz Mahmood, Marc Shnider, Muneeb Ahmed, Philip Hess, Robina Matyal
BACKGROUND AND OBJECTIVES: Advanced haptic simulators for neuraxial training are expensive, have a finite life, and are not patient specific. We sought to demonstrate the feasibility of developing a custom-made, low-cost, 3-dimensionally printed thoracic spine simulator model from patient computed tomographic scan data. This study assessed the model's practicality, efficiency as a teaching tool, and the transfer of skill set into patient care. METHODS: A high-fidelity, patient-specific thoracic spine model was used for the study...
June 11, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29894349/anesthetic-considerations-for-a-patient-with-chronic-systemic-capillary-leak-syndrome-a-case-report
#4
Resham Datta, Jason K Panchamia
Systemic capillary leak syndrome (SCLS) is an idiopathic vascular hyperpermeability that leads to profound hypotension, hypoalbuminemia, and hemoconcentration. Sixty years since its inauguration into literature, SCLS is still elusive, underdiagnosed, and profoundly dangerous. Few authors have documented anesthetic implications of classical acute SCLS, a form with complete recovery between exacerbations. However, minimal information is available about chronic SCLS, continuous generalized edema with or without exacerbations...
June 11, 2018: A&A practice
https://www.readbyqxmd.com/read/29894348/eisenmenger-syndrome-in-pregnancy-when-is-it-time-for-ecmo-a-case-report
#5
Marie-Louise Meng, Annie Fu, Carolyn Westhoff, Matthew Bacchetta, Erika B Rosenzweig, Ruth Landau, Richard Smiley
We report the case of a 21-year-old primiparous woman at 22 weeks gestation who presented with a large uncorrected ventricular septal defect, severe pulmonary hypertension, and Eisenmenger syndrome. The patient elected for termination of pregnancy, which was performed under regional anesthesia. Hemodynamic changes apparently associated with uterine contraction immediately after termination resulted in increased right to left shunting across the ventricular septal defect requiring urgent venovenous extracorporeal membrane oxygenation...
June 11, 2018: A&A practice
https://www.readbyqxmd.com/read/29890516/-correction-peripheral-regional-anesthesia-without-any-complications-a-dream-comes-true
#6
Thomas Wiesmann, Jens Döffert, Thorsten Steinfeldt
No abstract text is available yet for this article.
June 11, 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29881525/effect-of-adding-dexamethasone-to-lidocaine-on-the-quality-of-intravenous-regional-anesthesia-for-upper-extremity-orthopedic-operations-a-randomized-clinical-trial
#7
Abbas Moallemy, Hashem Jarineshin, Fereydoon Fekrat, Alireza Abdullahzadeh Baghaaei, Manuchehr Kamali, Bibi Mona Razavi, Zobeir Shaerzadeh
Background: Intravenous regional anesthesia (IVRA) is an ideal technique for short surgery on the distal extremities. Different additives have been used to improve lidocaine's block quality. Objective: The aim of this study was to determine the effect of adding dexamethasone to lidocaine on improving the quality of IVRA. Methods: This study is a prospective, double-blind randomized study which was done on patients with upper extremity injuries of the distal elbow in Shahid Mohammadi Hospital, Bandar Abbas from October 2014 to December 2015...
April 2018: Electronic Physician
https://www.readbyqxmd.com/read/29870458/consensus-guidelines-on-the-use-of-intravenous-ketamine-infusions-for-chronic-pain-from-the-american-society-of-regional-anesthesia-and-pain-medicine-the-american-academy-of-pain-medicine-and-the-american-society-of-anesthesiologists
#8
Steven P Cohen, Anuj Bhatia, Asokumar Buvanendran, Eric S Schwenk, Ajay D Wasan, Robert W Hurley, Eugene R Viscusi, Samer Narouze, Fred N Davis, Elspeth C Ritchie, Timothy R Lubenow, William M Hooten
BACKGROUND: Over the past 2 decades, the use of intravenous ketamine infusions as a treatment for chronic pain has increased dramatically, with wide variation in patient selection, dosing, and monitoring. This has led to a chorus of calls from various sources for the development of consensus guidelines. METHODS: In November 2016, the charge for developing consensus guidelines was approved by the boards of directors of the American Society of Regional Anesthesia and Pain Medicine and, shortly thereafter, the American Academy of Pain Medicine...
June 7, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29870457/consensus-guidelines-on-the-use-of-intravenous-ketamine-infusions-for-acute-pain-management-from-the-american-society-of-regional-anesthesia-and-pain-medicine-the-american-academy-of-pain-medicine-and-the-american-society-of-anesthesiologists
#9
Eric S Schwenk, Eugene R Viscusi, Asokumar Buvanendran, Robert W Hurley, Ajay D Wasan, Samer Narouze, Anuj Bhatia, Fred N Davis, William M Hooten, Steven P Cohen
BACKGROUND: Ketamine infusions have been used for decades to treat acute pain, but a recent surge in usage has made the infusions a mainstay of treatment in emergency departments, in the perioperative period in individuals with refractory pain, and in opioid-tolerant patients. The widespread variability in patient selection, treatment parameters, and monitoring indicates a need for the creation of consensus guidelines. METHODS: The development of acute pain ketamine guidelines grew as a corollary from the genesis of chronic pain ketamine guidelines...
June 7, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29866390/plating-of-distal-radius-fracture-using-the-wide-awake-anesthesia-technique
#10
REVIEW
Amir Adham Ahmad, Liew Mei Yi, Abdul Rauf Ahmad
Fractures of the distal radius are one of the most common types of injuries encountered in hand surgery. Plate osteosynthesis is recommended for unstable fractures. Because distal radius fracture fixation is usually performed under general or regional anesthesia with the use of a tourniquet, this exposes patients, especially elderly people with extensive comorbidities, to adverse effects commonly associated with these forms of anesthesia. As such, many of these patients are unable to undergo surgery in a timely manner until they are deemed medically fit for surgery or anesthesia, and some may still be treated nonsurgically...
June 1, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29863606/starving-patients-before-cataract-surgery-under-regional-anesthesia-needed-or-not
#11
Edwin Seet, Chandra M Kumar, Tom Eke, Girish P Joshi
No abstract text is available yet for this article.
May 31, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29863605/risks-and-benefits-of-ultrasound-nerve-stimulation-and-their-combination-for-guiding-peripheral-nerve-blocks-a-retrospective-registry-analysis
#12
Hagen Bomberg, Laura Wetjen, Stefan Wagenpfeil, Jakob Schöpe, Paul Kessler, Hinnerk Wulf, Thomas Wiesmann, Thomas Standl, André Gottschalk, Jens Döffert, Werner Hering, Jürgen Birnbaum, Bernd Kutter, Jörg Winckelmann, Simone Liebl-Biereige, Winfried Meissner, Oliver Vicent, Thea Koch, Hartmut Bürkle, Daniel I Sessler, Thomas Volk
BACKGROUND: Ultrasound, nerve stimulation, and their combination are all considered acceptable ways to guide peripheral nerve blocks. Which approach is most effective and associated with the fewest complications is unknown. We therefore used a large registry to analyze whether there are differences in vascular punctures, multiple skin punctures, and unintended paresthesia. METHODS: Twenty-six thousand seven hundred and thirty-three cases were extracted from the 25-center German Network for Regional Anesthesia registry between 2007 and 2016 and grouped into ultrasound-guided puncture (n = 10,380), ultrasound combined with nerve stimulation (n=8173), and nerve stimulation alone (n = 8180)...
May 31, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29849332/ultrasound-guided-femoral-nerve-block-to-facilitate-the-closed-reduction-of-a-dislocated-hip-prosthesis
#13
Edward Carlin, Brendon Stankard, Ashley Voroba, Mathew Nelson
Prosthetic hip dislocation is a common but unfortunate complication in patients who have undergone total hip arthroplasty. Successful closed reduction in the emergency department leads to a reduced length of stay and rate of hospitalization.1,2 The use of regional anesthesia by femoral nerve block represents a novel approach for controlling pain in patients with hip pathologies.3 Ultrasound-guided approaches have been used with great success for controlling pain in patients with hip fractures.4,5 Here we report the case of a 90-year-old male who presented with a dislocated hip prosthesis, which was subsequently corrected with closed reduction following delivery of regional anesthesia to the femoral nerve under ultrasound guidance...
November 2017: Clinical practice and cases in emergency medicine
https://www.readbyqxmd.com/read/29846754/-pain-therapy-in-intensive-care-patients
#14
REVIEW
Katharina Rose, Winfried Meißner
After intensive care unit (ICU) treatment, the recollection of experienced pain is one of the most burdensome aftermaths. In addition, pain has several negative physiological consequences. The majority of patients report moderate to severe pain while being treated on an ICU, often caused by diagnostic or therapeutic procedures. Pain and its functional consequences during ICU treatment should therefore be systematically recorded and treated. Due to their high analgesic potency, pharmacological pain therapy focuses on opioids; however, gastrointestinal motility disturbance and development of tolerance are disadvantages...
May 30, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29805106/the-efficacy-of-tranexamic-acid-in-total-knee-arthroplasty-a-network-meta-analysis
#15
Yale A Fillingham, Dipak B Ramkumar, David S Jevsevar, Adolph J Yates, Peter Shores, Kyle Mullen, Stefano A Bini, Henry D Clarke, Emil Schemitsch, Rebecca L Johnson, Stavros G Memtsoudis, Siraj A Sayeed, Alexander P Sah, Craig J Della Valle
BACKGROUND: A growing body of published research on tranexamic acid (TXA) suggests that it is effective in reducing blood loss and the risk for transfusion in total knee arthroplasty (TKA). The purpose of this network meta-analysis was to evaluate TXA in primary TKA as the basis for the efficacy recommendations of the combined clinical practice guidelines of the American Association of Hip and Knee Surgeons, American Academy of Orthopaedic Surgeons, Hip Society, Knee Society, and American Society of Regional Anesthesia and Pain Medicine on the use of TXA in primary total joint arthroplasty...
May 5, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29801659/process-measures-facilitate-maturation-of-pediatric-enhanced-recovery-protocols
#16
Ira L Leeds, Mitchell R Ladd, Margaret H Sundel, Melissa L Fannon, Jessica A George, Emily F Boss, Eric B Jelin
BACKGROUND/PURPOSE: The role of process measures used to predict quality in pediatric colorectal surgery enhanced recovery protocols has not been described. The purpose of this study was to demonstrate the feasibility of abstracting and monitoring process measures over protocol improvement iteration. METHODS: Patients enrolled in the Pediatric Colorectal Enhanced Recovery After Surgery pathway at our institution were grouped by stage of implementation. We used a quality improvement database to compare multistage enhanced recovery process measures and 30-day patient outcomes...
May 4, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29794944/use-of-serratus-plane-block-for-repair-of-coarctation-of-aorta-a-report-of-3-cases
#17
Abhijit Biswas, Igor Luginbuehl, Elod Szabo, Monica Caldeira-Kulbakas, Mark W Crawford, Tobias Everett
OBJECTIVES: The practice of regional anesthesia techniques (thoracic, epidural, paravertebral) in pediatric cardiac surgery enhances perioperative outcomes such as improved perioperative analgesia, decreased stress response, early extubation, and shortened hospital stay. However, these blocks can be technically challenging and can be associated with unacceptable failure rate and complications in infants. For these reasons, regional anesthesia is sometimes avoided in pediatric cardiac surgery...
May 23, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29794942/major-laparoscopic-intraperitoneal-surgery-performed-with-combined-bilateral-subcostal-transversus-abdominal-plane-block-and-celiac-plexus-block-intravenous-sedation-without-tracheal-intubation-a-feasibility-study-of-3-cases
#18
Azeddine Taleb, MʼHamed Boumadani, Paul J Zetlaoui, Dan Benhamou
OBJECTIVES: Major abdominal surgery usually requires general anesthesia with tracheal intubation and may be supplemented with neuraxial anesthesia to provide intraoperative and postoperative pain relief. Attempts at using only neuraxial anesthesia for major abdominal surgery have often been shown to be poorly effective. This report demonstrates that laparoscopic colonic surgical procedures can be performed with ultrasound-guided blocks (bilateral transversus abdominal plane block and celiac plexus block) and intravenous sedation, while avoiding general or neuraxial anesthesia...
May 23, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29790369/an-innovative-perioperative-pain-program-for-chronic-opioid-users-an-academic-medical-center-s-response-to-the-opioid-crisis
#19
Marie N Hanna, Traci J Speed, Ronen Shechter, Michael C Grant, Rosanne Sheinberg, Elizabeth Goldberg, Claudia M Campbell, Nicholas Theodore, Colleen G Koch, Kayode Williams
Increased utilization of prescription opioids for pain management has led to a nationwide public health crisis with alarming rates of addiction and opioid-related deaths. In the surgical setting, opioid prescriptions have been implicated as a contributing factor to the opioid epidemic. The authors developed an innovative model to address aspects of pain management and opioid utilization during preoperative evaluation, acute surgical hospitalization, and postoperative follow-up for chronic opioid users. This program involves multidisciplinary teams that include acute and chronic pain specialists, psychiatrists, integrative medicine specialists, and physical medicine and rehabilitation services...
May 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29782452/the-efficacy-of-regional-anesthesia-techniques-to-control-postoperative-pain-after-total-knee-arthroplasty
#20
(no author information available yet)
No abstract text is available yet for this article.
May 2018: Orthopaedic Nursing
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