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Thoracic anesthesia

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https://www.readbyqxmd.com/read/29325842/use-of-dexmedetomidine-in-cardiothoracic-and-vascular-anesthesia
#1
REVIEW
Lucía Gallego-Ligorit, Marc Vives, Jorge Vallés-Torres, T Alberto Sanjuán-Villarreal, Azucena Pajares, Mario Iglesias
Dexmedetomidine is a highly selective α2-adrenergic agonist with analgesic and sedative properties. In the United States, the Food and Drug Administration approved the use of the drug for short-lasting sedation (24 h) in intensive care units (ICUs) in patients undergoing mechanical ventilation and endotracheal intubation. In October 2008, the Food and Drug Administration extended use of the drug for the sedation of nonintubated patients before and during surgical and nonsurgical procedures. In the European Union, the European Medicine Agency approved the use of dexmedetomidine in September 2011 with a single recognized indication: ICU adult patients requiring mild sedation and awakening in response to verbal stimulus...
December 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29301040/where-and-when-to-cut-fluorescein-guidance-for-brain-stem-and-spinal-cord-tumor-surgery-technical-note
#2
Eric Suero Molina, Walter Stummer
BACKGROUND: Spinal cord and brain stem lesions require a judicious approach with an optimized trajectory due to a clustering of functions on their surfaces. Intraoperative mapping helps locate function. To confidently locate such lesions, neuronavigation alone lacks the desired accuracy and is of limited use in the spinal cord. OBJECTIVE: To evaluate the clinical value of fluoresceins for initial delineation of such critically located lesions. METHODS: We evaluated fluorescein guidance in the surgical resection of lesions with blood-brain barrier disruption demonstrating contrast enhancement in magnet resonance imaging in the spinal cord and in the brain stem in 3 different patients...
December 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29289434/the-history-of-cardiovascular-and-thoracic-anesthesia-in-mexico
#3
REVIEW
Pastor Luna, Martín Martínez
No abstract text is available yet for this article.
November 16, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29286025/-the-outcomes-of-different-surgical-procedures-for-thoracic-injuries
#4
O V Voskresenskiy, M M Abakumov
AIM: To assess the outcomes of video-assisted techniques compared with conventional procedures. MATERIAL AND METHODS: 596 victims with thoracic injuries were enrolled. Video-assisted techniques were applied in 236 cases, conventional procedures - 360 patients. Groups were standardized by the type of surgery. Morbidity, hospital-stay and mortality according to Clavien-Dindo classification have been analyzed. RESULTS: There was similar incidence of complications in both groups...
2017: Khirurgiia
https://www.readbyqxmd.com/read/29284840/effect-of-clonidine-as-adjuvant-in-thoracic-paravertebral-block-for-patients-undergoing-breast-cancer-surgery-a-prospective-randomized-placebo-controlled-double-blind-study
#5
Nairita Mayur, Anjan Das, Hirak Biswas, Subinay Chhaule, Surajit Chattopadhyay, Tapobrata Mitra, Sandip Roybasunia, Subrata Kumar Mandal
Background and Aims: Postoperative pain after breast cancer surgery is unavoidable. Thoracic paravertebral block (TPVB), a locoregional anesthetic technique, has been proven successful for postoperative pain management in different thoracic surgical procedures, such as thoracotomy, breast cancer surgeries. Clonidine, an adjuvant, in TPVB may enhance the quality and prolong the duration of analgesia. This prospective study was to evaluate the effectiveness of clonidine; administered with TPVB; in addition to conventional local anesthetic solution...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29278605/erector-spinae-plane-block-for-surgery-of-the-posterior-thoracic-wall-in-a-pediatric-patient
#6
Maria Alejandra Hernandez, Lucio Palazzi, Julio Lapalma, Mauricio Forero, Ki Jinn Chin
OBJECTIVE: Historically, regional anesthesia for surgery on the posterior thoracic wall has been limited to neuraxial and paravertebral nerve blocks. The erector spinae plane (ESP) block is a novel technique that anesthetizes the dorsal rami of the spinal nerves innervating the posterior thoracic wall. We report the use of the ESP block for this clinical application in a pediatric patient. CASE REPORT: A healthy 3-year-old girl was scheduled for resection of a giant paraspinal lipoma extending over the T4-T7 dermatomes...
December 22, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29259553/indication-of-cognitive-change-and-associated-risk-factor-after-thoracic-surgery-in-the-elderly-a-pilot-study
#7
Kay Kulason, Rui Nouchi, Yasushi Hoshikawa, Masafumi Noda, Yoshinori Okada, Ryuta Kawashima
Background: This pilot study investigated the effects of partial pulmonary lobectomy lung surgery on cognitive functions of elderly Japanese patients. It is recognized that elderly patients undergoing surgery have increased risk of Postoperative Cognitive Decline (POCD), a condition in which learning, memory, and processing speed is greatly reduced after surgery. Since elderly patients are more likely to exhibit symptoms of POCD, the incidence is increasing as the population receiving surgery is aging. Methods: Cognitive function was measured for all subjects (n = 12) before and after surgery using three different cognitive tests: Mini-Mental Status Exam-Japanese (MMSE-J), Frontal Assessment Battery (FAB), and a computerized Cogstate Brief Battery (CBB)...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/29246712/selection-of-appropriate-endotracheal-tube-size-using-thoracic-radiography-in-beagle-dogs
#8
Chi Won Shin, Won-Gyun Son, Min Jang, Hyunseok Kim, Hyungjoo Han, Jeesoo Cha, Inhyung Lee
OBJECTIVE: To determine the optimal endotracheal tube size in Beagle dogs using thoracic radiography. STUDY DESIGN: Prospective, randomized, crossover experimental study. ANIMALS: A total of eight healthy adult Beagle dogs. METHODS: Lateral thoracic radiographs were used to measure the internal tracheal diameter at the thoracic inlet. This measurement was multiplied by 60, 70 and 80% to determine the outer diameter of the endotracheal tube for each dog...
November 7, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29231542/-clinical-research-of-electroacupuncture-on-the-analgesic-effect-of-thoracic-perioperative-stage
#9
Mintao Zhou, Yu Li, Xuechang Han, Qunzhi Xing, Yiyao Wang, Xu Dong, Junxiao Chang
OBJECTIVE: To discuss the clinical therapeutic effects of electroacupuncture at Neimadian (Extra) and Neiguan (PC 6) on the analgesic effect of thoracic perioperative stage and its effect mechanism. METHODS: Sixty cases of esophageal cancer with elective radical resection under general anesthesia were divided into an observation group and a control group according to the operation sequence, 30 cases in each one. In the control group, the general anesthesia was simply applied and sufentanil was administered for patient controlled intravenous analgesia (PCIA) after operation...
July 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29230283/repair-of-giant-inguinoscrotal-hernia-with-loss-of-domain
#10
Erion Qaja, Carol Le, Ramon Benedicto
A massive inguinoscrotal hernia extending below the midpoint of the inner thigh, in a standing position, constitute a 'giant' inguinoscrotal hernia. A 74-year-old male presented with giant left sided inguinal hernia for the last 30 years. Patient underwent open repair under general anesthesia after perioperative respiratory exercise. Standard hernia repair identified a sliding hernia containing entire omentum, small and large bowel, and the appendix. Giant hernias pose a challenging problem because reduction of the hernia contents inside the abdominal cavity may increase intra-abdominal and thoracic pressures...
November 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29221974/criteria-for-postoperative-mechanical-ventilation-after-thymectomy-in-patients-with-myasthenia-gravis-a-retrospective-analysis
#11
Keerthi Chigurupati, Shrinivas Gadhinglajkar, Rupa Sreedhar, Muraleedharan Nair, Madathipat Unnikrishnan, Manjusha Pillai
OBJECTIVE: To determine the criteria for postoperative mechanical ventilation after thymectomy in patients with Myasthenia Gravis. DESIGN: Retrospective study. SETTING: Teritiary care centre. PARTICIPANTS: 77 Myasthenia gravis patients operated for thymectomy were studied. INTERVENTIONS: After obtaining clearance from Institutional ethics committee, medical records of 77 patients with MG, who were operated for thymectomy between January 2005 and December 2015 were reviewed in a retrospective manner...
June 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29215365/physiologic-evaluation-of-ventilation-perfusion-mismatch-and-respiratory-mechanics-at-different-positive-end-expiratory-pressure-in-patients-undergoing-protective-one-lung-ventilation
#12
Savino Spadaro, Salvatore Grasso, Dan Stieper Karbing, Alberto Fogagnolo, Marco Contoli, Giacomo Bollini, Riccardo Ragazzi, Gilda Cinnella, Marco Verri, Narciso Giorgio Cavallesco, Stephen Edward Rees, Carlo Alberto Volta
BACKGROUND: Arterial oxygenation is often impaired during one-lung ventilation, due to both pulmonary shunt and atelectasis. The use of low tidal volume (VT) (5 ml/kg predicted body weight) in the context of a lung-protective approach exacerbates atelectasis. This study sought to determine the combined physiologic effects of positive end-expiratory pressure and low VT during one-lung ventilation. METHODS: Data from 41 patients studied during general anesthesia for thoracic surgery were collected and analyzed...
December 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29211841/perioperative-benefit-and-outcome-of-thoracic-epidural-in-esophageal-surgery-a-clinical-review
#13
P Feltracco, A Bortolato, S Barbieri, E Michieletto, E Serra, A Ruol, S Merigliano, C Ori
Surgery for esophageal cancer is a highly stressful and painful procedure, and a significant amount of analgesics may be required to eliminate perioperative pain and blunt the stress response to surgery. Proper management of postoperative pain has invariably been shown to reduce the incidence of postoperative complications and accelerate recovery. Neuraxial analgesic techniques after major thoracic and upper abdominal surgery have long been established to reduce respiratory, cardiovascular, metabolic, inflammatory, and neurohormonal complications...
December 2, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29211198/respiratory-status-of-adult-patients-in-the-postoperative-period-of-thoracic-or-upper-abdominal-surgeries
#14
Alana Gomes de Araujo Almeida, Lívia Maia Pascoal, Francisco Dimitre Rodrigo Pereira Santos, Pedro Martins Lima, Simony Fabíola Lopes Nunes, Vanessa Emille Carvalho de Sousa
OBJECTIVE: to evaluate the respiratory status of postoperative adult patients by assessing the nursing outcome Respiratory Status. METHOD: descriptive, cross-sectional study developed with 312 patients. Eighteen NOC indicators were assessed and rated using a Likert-scale questionnaire and definitions. Descriptive and correlative analysis were conducted. RESULTS: the most compromised clinical indicators were coughing (65.5%), auscultated breath sounds (55%), and respiratory rate (51...
December 4, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/29206300/effects-of-mtor-nf-%C3%AE%C2%BAb-signaling-pathway-and-high-thoracic-epidural-anesthesia-on-myocardial-ischemia-reperfusion-injury-via-autophagy-in-rats
#15
Wei-Qiang Huang, Jian-Lin Wen, Ri-Qi Lin, Peng Wei, Feng Huang
We investigated the role of mammalian target of rapamycin/nuclear factor-kappa B (mTOR/NF-κB) signaling pathway in high thoracic epidural anesthesia (HTEA) against myocardial ischemia-reperfusion (I/R) injury in rats. The rat model of myocardial I/R injury was established. Ninety rats were divided into the normal, sham, I/R, eHTEA, the PDTC and HTEA + PDTC groups. ELISA was applied to detect cardiac function indexes. HE staining was conducted to observe histopathological changes of myocardial tissues, and TTC staining was performed to detect the myocardial infarction size...
December 5, 2017: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/29198854/efficacy-and-safety-of-transversus-abdominis-plane-blocks-versus-thoracic-epidural-anesthesia-in-patients-undergoing-major-abdominal-oncologic-resections-a-prospective-randomized-controlled-trial
#16
Tamer M Shaker, Joseph T Carroll, Mathew H Chung, Tracy J Koehler, Brian R Lane, Andrea M Wolf, G Paul Wright
BACKGROUND: The purpose of this study was to compare patient outcomes for thoracic epidural anesthesia (TEA) with transversus abdominis plane (TAP) blocks. METHODS: A prospective, randomized trial was performed for patients undergoing abdominal oncologic surgeries. RESULTS: There were 32 TAP and 35 TEA subjects. The TEA group demonstrated increased episodes of hypotension in the first 24 h (3 v 0.6, p = 0.02). There was no difference in 24-48 h fluid balance between the groups...
November 16, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29191649/multilevel-thoracic-paravertebral-block-using-ropivacaine-with-without-dexmedetomidine-in-video-assisted-thoracoscopic-surgery
#17
Jianghui Xu, Xiaoyu Yang, Xiaobing Hu, Xiaofeng Chen, Jun Zhang, Yingwei Wang
OBJECTIVES: Thoracic paravertebral block (TPVB) is reported to have advantages in postoperative pain management in unilateral thoracic surgeries. Previous studies have demonstrated that dexmedetomidine could be used as an adjuvant to local anesthetics, with the aim of prolonging the duration of neural blockade. However, little is known about whether such a combination could improve the quality of postoperative analgesia compared with local anesthetic only when TPVB is used for patients undergoing video-assisted thoracoscopic surgery (VATS)...
June 15, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29188414/velocity-pressure-loops-for-continuous-assessment-of-ventricular-afterload-influence-of-pressure-measurement-site
#18
Jona Joachim, Fabrice Vallée, Arthur Le Gall, Joaquim Matéo, Stéphanie Lenck, Sandrine Millasseau, Emmanuel Houdart, Alexandre Mebazaa, Etienne Gayat
VPloop, the graphical representation of pressure versus velocity, and its characteristic angles, GALA and β, can be used to monitor cardiac afterload during anesthesia. Ideally VPloop should be measured from pressure and velocity obtained at the same arterial location but standard of care usually provide either radial or femoral pressure waveforms. The purpose of this study was to look at the influence of arterial sites and the use of a transfer function (TF) on VPloop and its related angles. Invasive pressure signals were recorded in 25 patients undergoing neuroradiology intervention under general anesthesia with transesophageal flow velocity monitoring...
November 29, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29183368/incidence-of-orthostatic-hypotension-and-cardiovascular-response-to-postoperative-early-mobilization-in-patients-undergoing-cardiothoracic-and-abdominal-surgery
#19
Masatoshi Hanada, Yuichi Tawara, Takuro Miyazaki, Shuntaro Sato, Yosuke Morimoto, Masato Oikawa, Hiroshi Niwa, Kiyoyuki Eishi, Takeshi Nagayasu, Susumu Eguchi, Ryo Kozu
BACKGROUND: In cardiothoracic and abdominal surgery, postoperative complications remain major clinical problems. Early mobilization has been widely practiced and is an important component in preventing complications, including orthostatic hypotension (OH) during postoperative management. We investigated cardiovascular response during early mobilization and the incidence of OH after cardiothoracic and abdominal surgery. METHODS: In this prospective observational study, we consecutively analyzed data from 495 patients who underwent elective cardiothoracic and abdominal surgery...
November 28, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29183341/kinetics-and-dissolution-of-intratracheally-administered-nickel-oxide-nanomaterials-in-rats
#20
Naohide Shinohara, Guihua Zhang, Yutaka Oshima, Toshio Kobayashi, Nobuya Imatanaka, Makoto Nakai, Takeshi Sasaki, Kenji Kawaguchi, Masashi Gamo
BACKGROUND: The toxicokinetics of nanomaterials are an important factor in toxicity, which may be affected by slow clearance and/or distribution in the body. METHODS: Four types of nickel oxide (NiO) nanoparticles were single-administered intratracheally to male F344 rats at three doses of 0.67-6.0 mg/kg body weight. The rats were sacrificed under anesthesia and the lung, thoracic lymph nodes, bronchoalveolar lavage fluid, liver, and other organs were sampled for Ni burden measurement 3, 28, and 91 days post-administration; Ni excretion was measured 6 and 24 h after administration...
November 28, 2017: Particle and Fibre Toxicology
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