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https://www.readbyqxmd.com/read/28817401/challenges-in-the-anesthetic-management-of-ambulatory-patients-in-the-mri-suites
#1
Jasper Deen, Yzabel Vandevivere, Peter Van de Putte
PURPOSE OF REVIEW: MRI is becoming an indispensable diagnostic tool. The need for prolonged motion-free periods has substantially increased the need for deep sedation or anesthesia in a challenging environment. This review summarises recent literature with respect to pharmacological sedative strategies, nonpharmacological alternative approaches, airway management and safety issues in the ambulatory setting. RECENT FINDINGS: Most literature researches the pediatric patient population...
August 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28809679/automatic-localization-of-the-needle-target-for-ultrasound-guided-epidural-injections
#2
Mehran Pesteie, Victoria Lessoway, Purang Abolmaesumi, Robert N Rohling
Accurate identification of the needle target is crucial for effective epidural anesthesia. Currently, epidural needle placement is administered by a manual technique, relying on the sense of feel, which has a significant failure rate. Moreover, misleading the needle may lead to inadequate anesthesia, post dural puncture headaches and other potential complications. Ultrasound offers guidance to the physician for identification of the needle target, but accurate interpretation and localization remain challenges...
August 11, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28807468/are-revision-hip-arthroplasty-patients-at-higher-risk-for-venous-thromboembolic-events-than-primary-hip-arthroplasty-patients
#3
P Maxwell Courtney, Anthony J Boniello, Brett R Levine, Neil P Sheth, Wayne G Paprosky
BACKGROUND: The purpose of this study is to determine whether revision total hip arthroplasty (THA) is associated with increased rates of deep vein thrombosis (DVT) and pulmonary embolism (PE) when compared to primary THA. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program database for all primary and revision THA cases from 2011 to 2014. Demographic data, medical comorbidities, and venous thromboembolic rates within 30 days of surgery were compared between the primary and revision THA groups...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28802619/sugammadex-efficacy-for-reversal-of-rocuronium-and-vecuronium-induced-neuromuscular-blockade-a-pooled-analysis-of-26-studies
#4
William Joseph Herring, Tiffany Woo, Christopher A Assaid, Robert J Lupinacci, Hendrikus J Lemmens, Manfred Blobner, Karin S Khuenl-Brady
STUDY OBJECTIVE: To summarize and compare efficacy of sugammadex with neostigmine or placebo for reversal of rocuronium- or vecuronium-induced neuromuscular blockade (NMB), and to demonstrate consistency of sugammadex results across various patient populations. DESIGN: Pooled analysis on data from 26 multicenter, randomized, Phase II and III studies. SETTING: Operating room. PATIENTS: 1855 adults undergoing surgery under general anesthesia and receiving rocuronium or vecuronium for NMB...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28796275/immature-platelets-as-a-novel-biomarker-for-adverse-cardiovascular-events-in-patients-after-non-cardiac-surgery
#5
Aida Anetsberger, Manfred Blobner, Bernhard Haller, Sebastian Schmid, Katrin Umgelter, Theresa Hager, Clemens Langgartner, Eberhard F Kochs, Karl-Ludwig Laugwitz, Bettina Jungwirth, Isabell Bernlochner
This study evaluates whether immature platelets (IPF) determined in the post anesthesia care unit (PACU) can predict major adverse cardiovascular events (MACE) or other thromboembolic events after intermediate and high-risk surgery. IPF are increased in patients with acute coronary syndrome and recently gained interest as novel biomarker for risk stratification. In this prospective observational trial 732 patients undergoing intermediate or high-risk non-cardiac surgery were enrolled (NCT02097602). IPF was measured preoperatively and postoperatively in the PACU...
August 10, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28791043/systematic-review-outcomes-by-duration-of-npo-status-prior-to-colonoscopy
#6
REVIEW
Aasma Shaukat, Ashish Malhotra, Nancy Greer, Roderick MacDonald, Joseph Wels, Timothy J Wilt
BACKGROUND/AIMS: Variation exists among anesthesia providers as to acceptable timing of NPO ("nothing by mouth") for elective colonoscopy procedures. There is a need to balance optimal colonic preparation, patient convenience, and scheduling efficiency with anesthesia safety concerns. We reviewed the evidence for the relationship between NPO timing and aspiration incidence and colonoscopy rescheduling. METHODS: We searched MEDLINE (1990-April 2015) for English language studies of any design and included them if at least one bowel preparation regimen was completed within 8 hours of colonoscopy...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28781098/recent-advances-in-surgical-management-of-early-lung-cancer
#7
REVIEW
Shun-Mao Yang, Hsao-Hsun Hsu, Jin-Shing Chen
The broad application of low-dose computed tomography screening has resulted in the detection of many more cases of early lung cancer than ever before in modern history. Recent advances in the management of early-stage non-small cell lung cancer have focused on making therapy less traumatic, enhancing recovery, and preserving lung function. In this review, we discuss several new modalities associated with minimally invasive surgery for lung cancer. Firstly, less lung parenchyma resection via sublobar resection has become an acceptable alternative to lobectomy in patients with tumors less than 2 cm in size or with poor cardiopulmonary reserve...
August 3, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28780666/comparison-of-intubation-and-tracheotomy-in-patients-with-deep-neck-infection
#8
Laura Tapiovaara, Leif Bäck, Katri Aro
Possible airway compromise further complicates treatment of deep neck infections (DNI). Airway management is crucial, but factors affecting the method of choice are unclear. We retrospectively evaluated adult DNIs in a single tertiary center covering 10 years, with special attention on airway management. Patient data were retrieved from electronic data files from 2007 to 2016, and included adult patients with DNI operated through the neck. Of the 202 patients, 127 (63%) were male, with a median age of 47 years...
August 5, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28757826/an-observational-study-effects-of-tenting-of-the-abdominal-wall-on-peak-airway-pressure-in-robotic-radical-prostatectomy-surgery
#9
Avinash Sahebarav Kakde, Harshal D Wagh
BACKGROUND: Robotic radical prostatectomy (RRP) is associated with various anesthetic challenges due to pneumoperitoneum and deep Trendelenburg position. Tenting of the abdominal wall done in RRP surgery causes decrease in peak airway pressure leading to better ventilation. Herein, we aimed to describe the effects of tenting of the abdominal wall on peak airway pressure in RRP surgery performed in deep Trendelenburg position. METHODS: One hundred patients admitted for RRP in Kokilaben Dhirubhai Ambani Hospital of American Society of Anesthesiologists 1 and 2 physical status were included in the study...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28753816/impact-of-high-risk-features-and-effect-of-neoadjuvant-chemotherapy-in-urothelial-cancer-patients-with-invasion-into-the-lamina-propria-on-transurethral-resection-in-the-absence-of-deep-muscle-invasion
#10
Michael J Metcalfe, James E Ferguson, Roger Li, Lianchun Xiao, Charles C Guo, Bogdan A Czerniak, Arlene Siefker-Radtke, Shanna M Pretzsch, Neema Navai, David J McConkey, Ashish M Kamat, Mathew Campbell, Colin Dinney
BACKGROUND: High-risk non-muscle-invasive bladder cancer (NMIBC) that invades into the lamina propria is frequently understaged and is associated with a risk of lymph node metastasis and death. OBJECTIVE: To identify high-risk features (HRFs) for NMIBC that may identify patients with poorer prognosis who may benefit from neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC). DESIGN, SETTING, AND PARTICIPANTS: We performed a single-center retrospective review of patients who underwent RC for NMIBC with invasion into the lamina propria between 1995 and 2013...
July 13, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28743752/thalamocortical-synchronization-during-induction-and-emergence-from-propofol-induced-unconsciousness
#11
Francisco J Flores, Katharine E Hartnack, Amanda B Fath, Seong-Eun Kim, Matthew A Wilson, Emery N Brown, Patrick L Purdon
General anesthesia (GA) is a reversible drug-induced state of altered arousal required for more than 60,000 surgical procedures each day in the United States alone. Sedation and unconsciousness under GA are associated with stereotyped electrophysiological oscillations that are thought to reflect profound disruptions of activity in neuronal circuits that mediate awareness and cognition. Computational models make specific predictions about the role of the cortex and thalamus in these oscillations. In this paper, we provide in vivo evidence in rats that alpha oscillations (10-15 Hz) induced by the commonly used anesthetic drug propofol are synchronized between the thalamus and the medial prefrontal cortex...
July 25, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28740765/lipoabdominoplasty-with-progressive-traction-sutures
#12
Javier Vera Cucchiaro, Horacio Lostia, Patricia Velazquez, Elizabeth Liska
BACKGROUND: Proactively preserving Scarpa's fascia and thus its intrinsic lymphatic drainage and tensile strength for suture placement can eliminate the need for drains after lipoabdominoplasty and therefore reduce the rate of seroma development. In this article, we describe the effectiveness of a modified progressive traction suture (PTS) technique, which enables us to lessen the most common complications and avoid hospital readmission; these sutures take 3-5 minutes of additional surgery time...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28735132/asleep-robot-assisted-surgery-for-the-implantation-of-subthalamic-electrodes-provides-the-same-clinical-improvement-and-therapeutic-window-as-awake-surgery
#13
Michel Lefranc, Yassine Zouitina, Mélissa Tir, Philippe Merle, Martial Ouendo, Jean-Marc Constans, Olivier Godefroy, Johann Peltier, Pierre Krystkowiak
OBJECTIVE: To study the impact of not performing an awake clinical evaluation during the robot-assisted implantation subthalamic nucleus deep brain stimulation (STN-DBS) electrodes on the stimulation parameters and clinical outcome in patients with Parkinson's disease (PD). METHODS: A total of 23 PD patients underwent robot-assisted surgery for the bilateral implantation of STN-DBS electrodes. Thirteen patients received general anesthesia (GA) and a limited intraoperative evaluation (side effects only), whereas 10 received local anesthesia and a full evaluation...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28729926/coherence-of-bold-signal-and-electrical-activity-in-the-human-brain-during-deep-sevoflurane-anesthesia
#14
Daniel Golkowski, Andreas Ranft, Tobias Kiel, Valentin Riedl, Philipp Kohl, Guido Rohrer, Joachim Pientka, Sebastian Berger, Christine Preibisch, Claus Zimmer, George A Mashour, Gerhard Schneider, Eberhard F Kochs, Rüdiger Ilg, Denis Jordan
INTRODUCTION: Changes in neural activity induce changes in functional magnetic resonance (fMRI) blood oxygenation level dependent (BOLD) signal. Commonly, increases in BOLD signal are ascribed to cellular excitation. OBJECTIVE: The relationship between electrical activity and BOLD signal in the human brain was probed on the basis of burst suppression EEG. This condition includes two distinct states of high and low electrical activity. METHODS: Resting-state simultaneous EEG and BOLD measurements were acquired during deep sevoflurane anesthesia with burst suppression EEG in nineteen healthy volunteers...
July 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28728911/effects-of-riluzole-on-spinal-seizure-like-activity-in-the-brainstem-spinal-cord-preparation-of-newborn-rat
#15
Shih Tien Lin, Masayuki Ohbayashi, Toshinori Yamamoto, Hiroshi Onimaru, Mari Kogo
Riluzole blocks persistent Na(+) current, inhibits generation of neuronal bursts and decreases glutamate-induced excitotoxicity. In previous studies of respiratory activity, riluzole suppressed inspiratory-related burst generation activity in rat slice or en bloc preparations. We examined riluzole's effects on inspiratory burst generation and drug-induced seizure-like activity in newborn rat en bloc preparations. Medulla-spinal cord preparations from postnatal day 0-3 Wistar rats were isolated under deep isoflurane anesthesia and were superfused with artificial cerebrospinal fluid equilibrated with 95% O2 and 5% CO2, pH 7...
July 17, 2017: Neuroscience Research
https://www.readbyqxmd.com/read/28728144/retinal-penetration-of-intravitreally-injected-tissue-plasminogen-activator-a-rat-model-study
#16
Kfir Tal, Assaf Dotan, Yael Nisgav, Mor Dachbash, Orly Gal-Or, Rita Ehrlich, Dan D Gaton, Dov Weinberger, Tami Livnat
PURPOSE: To determine whether intravitreal unconjugated tissue plasminogen activator (tPA) (alteplase) can penetrate the intact neural retina and reach the subretinal space in an experimental model. METHODS: This study was performed in 24 Sprague-Dawley rats aged 12 weeks. Under general anesthesia, the right eye was injected with either 0.75 μg of 3 μL tPA (14 rats; study group) or saline (10 rats, control group) into the vitreous. Animals were euthanized at 3, 24, and 48 h...
July 20, 2017: Ophthalmic Research
https://www.readbyqxmd.com/read/28725247/novel-anesthetic-technique-for-combined-intracavitary-and-interstitial-brachytherapy-for-cervix-cancer-in-an-outpatient-setting
#17
Yiat Horng Leong, Kenneth Hock Soon Tan, Bok Ai Choo, Vicky Yaling Koh, Johann I-Hsiung Tang
PURPOSE: To determine the feasibility and safety of outpatient combined intracavitary and interstitial brachytherapy for cervix cancer with sedation and local anesthesia. MATERIAL AND METHODS: We included patients diagnosed with non-metastatic cervix cancer and have completed brachytherapy between December 2015 and December 2016. Moderate to deep sedation was achieved using intravenous midazolam, propofol, fentanyl, and oxycodone. Local anesthesia was achieved with 2% lignocaine gel and a paracervical block containing a mixture of 1% ropivacaine, 2% lignocaine, and 1 : 1,000 adrenaline...
June 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28723765/perioperative-management-of-intracardiac-leiomyomatosis-an-observational-cohort-study
#18
Jiaying Xu, Min Wei, Qi Miao, Bin Zhu, Chunhua Yu, Yuguang Huang
Intracardiac leiomyomatosis (ICLM) is a rare condition in which the benign tumor extends into the right heart chambers through inferior vena cava. The best surgical approach still remains unclear.We present a retrospective cohort of 36 patients diagnosed with ICLM in Peking Union Medical College Hospital between 2002 and 2016.The mean patient age was 44.5 (range 25-55) years. The clinical manifestations were various, including shortness of breath, chest tightness, edema of the lower extremities, palpitations, syncope, etc...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28714298/effect-of-sugammadex-on-coagulation-as-detected-by-rotational-thromboelastometry-in-morbidly-obese-patients
#19
Michele Carron, Diana Bertini, Tancredi Prandini, Francesca Fanton, Mirto Foletto, Carlo Ori, Egle Perissinotto, Paolo Simioni
BACKGROUND: Sugammadex, which is used to reverse rocuronium-induced neuromuscular blockade, has a limited and transient effect on activated partial thromboplastin time and prothrombin time. However, no data are available on the effects of sugammadex on coagulation in morbidly obese patients, as assessed by rotational thromboelastometry (ROTEM®). METHODS: Sixty patients received sugammadex 2 mg/kg or 4 mg/kg to reverse moderate or deep rocuronium-induced neuromuscular blockade (n = 30/group) at the end of surgery under desflurane anesthesia...
July 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28709756/postoperative-outcomes-associated-with-neuraxial-vs-general-anesthesia-following-bilateral-total-knee-arthroplasty
#20
Jeffrey B Walker, Patrick L Nguyen, Ulrich H Schmidt, Rodney A Gabriel
BACKGROUND: There is sparse evidence on the benefit of neuraxial (NA) vs general anesthesia (GA) as the primary anesthetic in postoperative outcomes following bilateral total knee arthroplasty. We sought to elucidate differences in outcomes in this surgical population using a national database. METHODS: We used data from the National Surgical Quality Improvement Program from 2007 to 2013 and compared rates of various postoperative outcomes in propensity-matched cohorts (NA vs GA)...
June 23, 2017: Journal of Arthroplasty
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