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https://www.readbyqxmd.com/read/29785552/suppression-of-pupillary-unrest-by-general-anesthesia-and-propofol-sedation
#1
Matthias Behrends, Merlin D Larson, Andrew E Neice, Michael P Bokoch
The pupil undergoes irregular oscillations when exposed to light. These oscillations, known as pupillary unrest in ambient light, originate from oscillatory activity within the Edinger-Westphal nucleus in the midbrain. The midbrain and upper pons also contain nuclei known to be very sensitive to the effects of anesthetics that play a central role in maintaining wakefulness. We hypothesized that anesthetics may display similar effects on wakefulness and pupillary unrest. Repeat measurements of pupillary unrest using infrared pupillometry were performed in 16 patients undergoing general anesthesia and 8 patients undergoing propofol sedation...
May 21, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29780914/rescue-technique-for-complete-removal-of-an-accidentally-ruptured-orbital-dumbbell-deep-dermoid-cyst-a-case-report
#2
Pei-Hsuan Lin, Yoshiyuki Kitaguchi, Jacqueline Mupas-Uy, Yasuhiro Takahashi, Hirohiko Kakizaki
Purpose: To report a rescue technique for complete removal of an accidentally ruptured orbital dumbbell deep dermoid cyst. Observations: A 33-year-old female presented with left proptosis with retrobulbar discomfort for 3 months. Computed tomography images showed an orbital dumbbell deep dermoid cyst. A lateral orbitotomy was performed under general anesthesia. The cyst was ruptured during osteotomy of the lateral orbital rim. The cyst was opened vertically from the ruptured site using a Stephen's tenotomy scissors to visually confirm the internal wall of the cyst and to keep the epithelial lining intact while separating the external wall of the cyst from the bone...
June 2018: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29775401/electroencephalographic-signals-during-anesthesia-recorded-from-surface-and-depth-electrodes
#3
Ville Jäntti, Tuomo Ylinen, Narayan Puthanmadam Subramaniyam, Kotoe Kamata, Arvi Yli-Hankala, Pasi Kauppinen, Eila Sonkajärvi
Purpose - Anesthesiologists have increasingly started to use EEG based indexes to estimate the level and type of unconsciousness. However, the physiology and biophysics are poorly understood in anesthesiological literature. Methods - EEG was recorded from electrodes on the surface of head, including scalp, as well as DBS (deep brain stimulation) electrodes implanted deep in the brain. Mathematical modeling with a realistic head model was performed to create illustrative images of the sensitivity of electrode montages...
May 18, 2018: International Journal of Radiation Biology
https://www.readbyqxmd.com/read/29772269/a-new-method-for-determining-levels-of-sedation-in-dogs-a-pilot-study-with-propofol-and-a-novel-neuroactive-steroid-anesthetic
#4
B L Youngblood, Y Ueyama, W W Muir, G M Belfort, R H Hammond, J Dai, F G Salituro, A J Robichaud, J J Doherty
BACKGROUND: Different levels of consciousness are required in order to perform different medical procedures. Sedation scales established to objectively define various levels of sedation in humans have not been thoroughly characterized in non-human species. Postural changes in rats or dogs are useful as gross measures of sedation but are inadequate for quantitative assessment since graded levels of sedation are difficult to delineate and obscured by movement abnormalities. NEW METHOD: A new canine sedation scoring (CSS) method was developed based on the modified observer's assessment of alertness and sedation score (MOAA/S) used in humans...
May 14, 2018: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/29768988/single-cell-recordings-to-target-the-anterior-nucleus-of-the-thalamus-in-deep-brain-stimulation-for-patients-with-refractory-epilepsy
#5
Frédéric L W V J Schaper, Yan Zhao, Marcus L F Janssen, G Louis Wagner, Albert J Colon, Danny M W Hilkman, Erik Gommer, Mariëlle C G Vlooswijk, Govert Hoogland, Linda Ackermans, Lo J Bour, Richard J A Van Wezel, Paul Boon, Yasin Temel, Tjitske Heida, Vivianne H J M Van Kranen-Mastenbroek, Rob P W Rouhl
Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is a promising treatment for patients with refractory epilepsy. However, therapy response varies and precise positioning of the DBS lead is potentially essential for maximizing therapeutic efficacy. We investigate if single-cell recordings acquired by microelectrode recordings can aid targeting of the ANT during surgery and hypothesize that the neuronal firing properties of the target region relate to clinical outcome. We prospectively included 10 refractory epilepsy patients and performed microelectrode recordings under general anesthesia to identify the change in neuronal signals when approaching and transecting the ANT...
April 2, 2018: International Journal of Neural Systems
https://www.readbyqxmd.com/read/29764750/patient-oriented-optimal-depth-of-conscious-sedation-using-midazolam-during-flexible-bronchoscopy-a-prospective-open-labeled-single-arm-trial
#6
Yuichiro Takeda, Hibiki Udagawa, Shinji Nakamichi, Yasuto Yoneshima, Motoyasu Iikura, Satoshi Hirano, Go Naka, Haruhito Sugiyama
BACKGROUND: The British Thoracic Society guidelines for diagnostic flexible bronchoscopy (FB) in adults recommend that intravenous sedation should be offered to patients undergoing bronchoscopy. However, it is difficult to determine the adequate depth of sedation for each patient because of inter-individual variability. METHODS: This prospective, open-label, single-arm study was conducted in patients undergoing routine bronchus examination with FB. All patients underwent FB under local anesthesia and conscious sedation, with initial administration of 0...
May 6, 2018: Respiratory Investigation
https://www.readbyqxmd.com/read/29752664/patient-related-factors-predicting-workspace-conditions-during-laparoscopic-bariatric-surgery
#7
Paola Aceto, Cristina Modesti, Teresa Sacco, Roberto De Cicco, Valter Perilli, Marco Raffaelli, Carlo Lai, Liliana Sollazzi
BACKGROUND: Previous studies have focused on the role of deep neuromuscular blockade (NMB) in improving surgical conditions during laparoscopic bariatric surgery. However, a wide inter-individual variability has been noted. The aim of this study was to identify patient-related factors affecting surgeon satisfaction with the surgical space and surgery duration in laparoscopic bariatric surgery under deep NMB. METHODS: One hundred eighty-five patients scheduled for laparoscopic gastric bypass were enrolled...
May 12, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29750662/supplemental-carbon-dioxide-stabilizes-the-upper-airway-in-volunteers-anesthetized-with-propofol
#8
Katarina Jennifer Ruscic, Janne Bøgh Stokholm, Johann Patlak, Hao Deng, Jeroen Cedric Peter Simons, Timothy Houle, Jürgen Peters, Matthias Eikermann
BACKGROUND: Propofol impairs upper airway dilator muscle tone and increases upper airway collapsibility. Preclinical studies show that carbon dioxide decreases propofol-mediated respiratory depression. We studied whether elevation of end-tidal carbon dioxide (PETCO2) via carbon dioxide insufflation reverses the airway collapsibility (primary hypothesis) and impaired genioglossus muscle electromyogram that accompany propofol anesthesia. METHODS: We present a prespecified, secondary analysis of previously published experiments in 12 volunteers breathing via a high-flow respiratory circuit used to control upper airway pressure under propofol anesthesia at two levels, with the deep level titrated to suppression of motor response...
May 10, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29747378/treating-mucocele-in-pediatric-patients-using-a-diode-laser-three-case-reports
#9
Sara M Bagher, Ayman M Sulimany, Martin Kaplan, Cheen Y Loo
A mucocele is the most common minor salivary gland disease and among the most common biopsied oral lesions in pediatric patients. Clinically, a mucocele appears as a round well-circumscribed painless swelling ranging from deep blue to mucosa alike in color. Mucoceles rarely resolve on their own and surgical removal under local anesthesia is required in most cases. Different treatment options are described in the literature, including cryosurgery, intra-lesion injection of corticosteroid, micro-marsupialization and conventional surgical removal using a scalpel, and laser ablation...
May 9, 2018: Dentistry journal
https://www.readbyqxmd.com/read/29737490/regional-entropy-of-functional-imaging-signals-varies-differently-in-sensory-and-cognitive-systems-during-propofol-modulated-loss-and-return-of-behavioral-responsiveness
#10
Xiaolin Liu, Kathryn K Lauer, B Douglas Ward, Christopher J Roberts, Suyan Liu, Suneeta Gollapudy, Robert Rohloff, William Gross, Zhan Xu, Shanshan Chen, Lubin Wang, Zheng Yang, Shi-Jiang Li, Jeffrey R Binder, Anthony G Hudetz
The level and richness of consciousness depend on information integration in the brain. Altered interregional functional interactions may indicate disrupted information integration during anesthetic-induced unconsciousness. How anesthetics modulate the amount of information in various brain regions has received less attention. Here, we propose a novel approach to quantify regional information content in the brain by the entropy of the principal components of regional blood oxygen-dependent imaging signals during graded propofol sedation...
May 8, 2018: Brain Imaging and Behavior
https://www.readbyqxmd.com/read/29727761/systematic-review-and-meta-analyses-of-tranexamic-acid-use-for-bleeding-reduction-in-prostate-surgery
#11
REVIEW
Marcelo A Longo, Bárbara T Cavalheiro, Getúlio R de Oliveira Filho
BACKGROUND: Prostate cancer and benign prostatic hyperplasia have an increased incidence with aging. The most effective treatments are radical prostatectomy and transurethral resection of the prostate. To reduce perioperative bleeding in these surgeries, an approach is the use of tranexamic acid (TXA). Studies show that TXA is effective in reducing the blood loss and the need for transfusion in cardiac, orthopedic, and gynecological surgeries. In prostate surgeries, its efficacy and safety have not been established yet...
May 1, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29727475/subthalamic-nucleus-deep-brain-stimulation-evokes-resonant-neural-activity
#12
Nicholas C Sinclair, Hugh J McDermott, Kristian J Bulluss, James B Fallon, Thushara Perera, San San Xu, Peter Brown, Wesley Thevathasan
Deep brain stimulation (DBS) is a rapidly expanding treatment for neurological and psychiatric conditions; however, a target-specific biomarker is required to optimize therapy. Here, we show that DBS evokes a large-amplitude resonant neural response focally in the subthalamic nucleus. This response is greatest in the dorsal region (the clinically optimal stimulation target for Parkinson disease), coincides with improved clinical performance, is chronically recordable, and is present under general anesthesia...
May 4, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29719833/a-survey-of-enhanced-recovery-after-surgery-protocols-for-cesarean-delivery-in-serbia
#13
Borislava Pujic, Mirjana Kendrisic, Matthew Shotwell, Yaping Shi, Curtis L Baysinger
Enhanced recovery after surgery (ERAS) protocols have been described for patients undergoing colon surgery. Similar protocols for cesarean delivery (CD) have been developed recently. CD is one of the most commonly performed surgical procedures, and adoption of ERAS protocols following CD might benefit patients and the health-care system. We aimed to determine which Serbian hospitals reported ERAS protocols, which elements of ERAS protocols were used in CD patients, and whether ERAS and non-ERAS hospitals differed...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29709469/effect-of-resident-involvement-on-morbidity-and-mortality-following-thoracic-endovascular-aortic-repair
#14
Derrick O Acheampong, Philip Paul, Shanice Guerrier, Percy Boateng, I Michael Leitman
OBJECTIVE: To evaluate the effect of resident involvement in thoracic endovascular aortic repair (TEVAR). SUMMARY OF BACKGROUND DATA: Although the influence of resident intraoperative involvement in several types of surgical procedures has been reported, the effect of resident participation in TEVAR is unknown. We evaluated patient outcomes in resident-involved TEVAR procedures. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was analyzed for TEVAR performed from 2010 to 2012...
April 27, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29708568/preoperative-vitamin-d-deficiency-is-associated-with-higher-postoperative-complication-rates-in-total-knee-arthroplasty
#15
Vishal Hegde, Armin Arshi, Christopher Wang, Zorica Buser, Jeffrey C Wang, Andrew R Jensen, John S Adams, Erik N Zeegen, Nicholas M Bernthal
The purpose of this study was to determine the relative incidence of postoperative complications in 25-hydroxyvitamin D (25D)-deficient and -sufficient patients undergoing total knee arthroplasty (TKA). Patients who were either serum 25D deficient (25D <20 ng/mL) or 25D sufficient (25D ≥20 ng/mL) 90 days prior to primary TKA from 2007 to 2016 were identified using the Humana administrative claims registry. The incidence of postoperative medical and surgical complications was determined by querying for relevant International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29693941/pre-anesthetic-whole-body-point-of-care-ultrasonography
#16
Takeshi Nomura, Itaru Watanabe
Point-of-care ultrasonography has become widely used in diagnosis and managements of patients. In the field of anesthesiology, ultrasound guided nerve blocks and central venous catheterization (CVC), and transesophageal echocardiography (TEE) have become popular. Now, ultrasound devices are familiar to anesthesiologists. In pre-anesthetic patient risk evaluation, the sonographic results of transthoracic echocardiography (TTE) or the examination of deep venous thrombus are often helpful for anesthesia planning...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29679783/radiofrequency-lesioning-through-deep-brain-stimulation-electrodes-in-patients-with-generalized-dystonia
#17
Nobuhiko Takeda, Shiro Hoeisawa, Takaomi Taira, Takakazu Kawamata
BACKGROUND: Deep brain stimulation (DBS) is an established treatment for generalized dystonia. However, the DBS device is sometimes removed owing to hardware complications. Here, we present four cases of generalized dystonia treated with radiofrequency lesioning through the DBS electrodes. CASE DESCRIPTION: The patients were three men and one woman (34 to 44 years old). They had undergone DBS for generalized dystonia. However, they subsequently developed complications, such as infection, and removal of the devices became necessary...
April 18, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29678713/posterior-fossa-epidural-hematomas-a-rare-but-serious-complication-of-occipito-cervical-fusion-surgery
#18
Chang Rong Zhu, Jianhua Wang, Dai Jianqiang, Kun Chen, Xia Hong
BACKGROUND: Posterior occipito-cervical fusion surgery is a commonly used surgical method to treat various craniovertebral junction pathologies. Though it is an effective method, there also have been some reports about complications of occipito-cervical fusion. However, there have been no reports about posterior fossa epidural hematomas after occipito-cervical fusion. CASE DESCRIPTION: A 44-year-old female was referred to our Hospital with a 6-month history of neck pain and numbness limbs for 2 months...
April 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29670012/percutaneous-imaging-guided-biopsy-of-bone-metastases
#19
REVIEW
Dimitrios Filippiadis, Argyro Mazioti, Alexios Kelekis
Approximately 70% of cancer patients will eventually develop bone metastases. Spine, due to the abundance of red marrow in the vertebral bodies and the communication of deep thoracic-pelvic veins with valve-less vertebral venous plexuses, is the most common site of osseous metastatic disease. Open biopsies run the risk of destabilizing an already diseased spinal or peripheral skeleton segment. Percutaneous biopsies obviate such issues and provide immediate confirmation of correct needle location in the area of interest...
April 18, 2018: Diagnostics
https://www.readbyqxmd.com/read/29669351/bronchial-thermoplasty-in-severe-asthma-best-practice-recommendations-from-an-expert-panel
#20
Peter I Bonta, Pascal Chanez, Jouke T Annema, Pallav L Shah, Robert Niven
Bronchial thermoplasty (BT) is a bronchoscopic treatment for patients with severe asthma who remain symptomatic despite optimal medical therapy. In this "expert best practice" paper, the background and practical aspects of BT are highlighted. Randomized, controlled clinical trials have shown BT to be safe and effective in reducing severe exacerbations, improving quality of life, and decreasing emergency department visits. Five-year follow-up studies have provided evidence of the functional stability of BT-treated patients with persistence of a clinical benefit...
2018: Respiration; International Review of Thoracic Diseases
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