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Thoracic anesthesia

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https://www.readbyqxmd.com/read/29150035/thoracic-surgery-considerations-in-obese-patients
#1
REVIEW
Douglas Z Liou, Mark F Berry
The obesity epidemic in the United States has increased greatly over the past several decades, and thoracic surgeons are likely to see obese patients routinely in their practices. Obesity has direct deleterious health effects such as metabolic disorder and cardiovascular disease, and is associated with many cancers. Obese patients who need thoracic surgery pose practical challenges to many of the routine elements in perioperative management. Preoperative assessment of obesity-related comorbid conditions and risk stratification for surgery, thorough intraoperative planning for anesthesia and surgery, and postoperative strategies to optimize pulmonary hygiene and mobility minimize the risk of adverse outcomes...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29148123/donohue-syndrome-a-review-of-literature-case-series-and-anesthetic-considerations
#2
REVIEW
Alana Kirkwood, Grant Stuart, Louise Harding
BACKGROUND: Donohue syndrome is a rare autosomal recessive disorder of insulin resistance, causing a functional defect in insulin receptor function, and affecting the ability of the insulin to bind the receptor. Features include severe hyperinsulinism and fasting hypoglycemia, along with severe failure to thrive despite feeding. An accelerated fasting state results in muscle wasting, decreased subcutaneous fat, and an excess of thick skin. A reduced thoracic diameter is accentuated by increased abdominal distension, which impacts on respiratory reserve...
November 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29145824/observations-on-significant-hemodynamic-changes-caused-by-a-high-concentration-of-epidurally-administered-ropivacaine-correlation-and-prediction-study-of-stroke-volume-variation-and-central-venous-pressure-in-thoracic-epidural-anesthesia
#3
Jeong-Min Hong, Hyeon Jeong Lee, Young-Jae Oh, Ah Rhem Cho, Hyae Jin Kim, Do-Won Lee, Wang-Seok Do, Jae-Young Kwon, Haekyu Kim
BACKGROUND: Thoracic epidural anesthesia (TEA) exacerbates hypotension due to peripheral vasodilator effects following the use of general anesthetics. This study aimed to compare the hemodynamic changes caused by three different concentrations of epidural ropivacaine and to evaluate the performance of the stroke-volume variation (SVV) and central venous pressure (CVP) during TEA with general anesthesia. METHODS: A total of 120 patients were administered 8 mL of ropivacaine solution via epidural injection, following randomization into one of three groups based on the concentration of ropivacaine in the study solution: 0...
November 16, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29142855/single-port-thoracoscopic-treatment-of-thoracic-duct-injury-after-thyroidectomy-with-neck-dissection
#4
Serkan Teksoz, Ezel Ersen, Akif Enes Arikan, Sina Ferahman, Kamil Kaynak, Gianlorenzo Dionigi, Yusuf Bukey
Chylous leakage is a complication of thyroidectomy accompanied by bilateral neck dissection with incidence of 0.5-6.2%. A 51-year-old female patient underwent total thyroidectomy, bilateral and central neck dissection for papillary thyroid carcinoma. In post-operative 4(th) day, left sided chylous leakage was observed as 1,500 cc/day through neck drain. Leakage did not cease after 1-month conservative treatment so single port thoracoscopic intervention was performed. Under general anesthesia, patient was placed in left lateral decubitus position...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29132804/a-randomized-controlled-trial-comparing-the-utility-of-lighted-stylet-and-glidescope-for-double-lumen-endobronchial-intubation
#5
Jee-Eun Chang, Hyerim Kim, Seong-Won Min, Jung-Man Lee, Jung-Hee Ryu, Soohyuk Yoon, Jin-Young Hwang
OBJECTIVE: To compare GlideScope and lighted stylet for double-lumen endobronchial tube (DLT) intubation in terms of intubation time, success rate of first attempt at intubation, difficulty in DLT advancement toward the glottis, and postoperative sore throat and hoarseness. DESIGN: A prospective, randomized study. SETTING: Medical center governed by a university hostpial. PARTICIPANTS: Sixty-two adult patients undergoing thoracic surgery using DLT intubation...
October 7, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29129235/effects-of-intraoperative-nutrients-administration-on-energy-expenditure-during-general-anesthesia
#6
Daizoh Satoh, Noriko Toda, Ichiro Yamamoto
OBJECTIVES: Recent reports have shown that intraoperative infusions of glucose and amino acids exert anticatabolic effects. The appropriate dosages of these amino acids and glucose during general anesthesia remain unknown. METHODS: Patients who underwent esophagectomy for thoracic esophageal cancer were infused with acetated Ringer's solution that contained glucose and amino acids (B1 group [10 patients]: glucose, 3 g/h; amino acids, 1.2 g/h; B2 group [12 patients]: glucose, 4...
January 2018: Nutrition
https://www.readbyqxmd.com/read/29110704/endobronchial-one-way-valves-for-treatment-of-persistent-air-leaks-a-systematic-review
#7
REVIEW
Mei Ding, Ya-Dong Gao, Xian-Tao Zeng, Yi Guo, Jiong Yang
Persistent air leak (PAL) is associated with significant morbidity and mortality, prolonged hospitalization and increased health-care costs. It can arise from a number of conditions, including pneumothorax, necrotizing infection, trauma, malignancies, procedural interventions and complications after thoracic surgery. Numerous therapeutic options, including noninvasive and invasive techniques, are available to treat PALs. Recently, endobronchial one-way valves have been used to treat PAL. We conducted a systematic review based on studies retrieved from PubMed, EMbase and Cochrane library...
November 6, 2017: Respiratory Research
https://www.readbyqxmd.com/read/29106868/the-use-of-ct-scan-in-foreign-body-aspiration-in-children-a-6-years-experience
#8
Vincent Pitiot, Margaux Grall, Dominique Ploin, Eric Truy, Sonia Ayari Khalfallah
INTRODUCTION: A foreign body aspiration is a risky situation, common in pediatric emergency. The "gold standard" to rule out a foreign body or proceed to its extraction, is rigid bronchoscopy (RB) under general anesthesia. However, RB is an intrusive exam with possible complications. Depending on authors, RB in emergency is a procedure at risk of complications in 4-17% of cases. Advances in radiology allow CT-scanners of fast acquisition and high definition, which could be used as an alternative to RB...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29095302/spontaneous-spinal-epidural-hematomas-one-case-report-and-rehabilitation-outcome
#9
Hang Xian, Li-Wei Xu, Cong-Han Li, Jian-Ming Hao, Wei-Xia Wan, Guo-Dong Feng, Ke-Jian Lian, Lin Li
RATIONALE: Spontaneous spinal epidural hematoma (SSEH) is a relatively rare but potentially disabling disease, and the classical presentation of it includes an acute onset of severe, sometimes radiating back or neck pain, followed by signs and symptoms of rapidly evolving nerve root or spinal cord compression. PATIENT CONCERNS: Here, we report a 26-year-old female patient presented with weakness in bilateral lower extremities, progressing to intense paraplegia and anesthesia without recent medical history of trauma, infection, surgery, or drug use...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29090479/utility-of-lung-ultrasonography-for-detection-of-pleural-adhesions-in-dogs
#10
Akiko Uemura, Toshiharu Fukayama, Takashi Tanaka, Ryou Tanaka
OBJECTIVES: To assess lung respiratory movement ("lung sliding") in dogs using B-mode ultrasonography (US) and to develop a method that assesses adhesions between the parietal pleura and the lung. METHODS: Seventeen male beagles were anesthetized, and respiratory management was performed with intermittent positive pressure ventilation. Lung-sliding assessments and adhesion examinations were performed with lung US under general anesthesia before and 2 weeks after thoracotomy...
November 1, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29079570/thoracic-epidural-anesthesia-can-be-effective-for-the-short-term-management-of-ventricular-tachycardia-storm
#11
Duc H Do, Jason Bradfield, Olujimi A Ajijola, Marmar Vaseghi, John Le, Siamak Rahman, Aman Mahajan, Akihiko Nogami, Noel G Boyle, Kalyanam Shivkumar
BACKGROUND: Novel therapies aimed at modulating the autonomic nervous system, including thoracic epidural anesthesia (TEA), have been shown in small case series to be beneficial in treating medically refractory ventricular tachycardia (VT) storm. However, it is not clear when these options should be considered. We reviewed a multicenter experience with TEA in the management of VT storm to determine its optimal therapeutic use. METHODS AND RESULTS: Data for 11 patients in whom TEA was instituted for VT storm between July 2005 and March 2016 were reviewed to determine the clinical characteristics, outcomes, and role in management...
October 27, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29078680/nonintubated-uniportal-vats-pulmonary-anatomical-resections
#12
REVIEW
Carlos Galvez, Jose Navarro-Martinez, Sergio Bolufer, Francisco Lirio, Julio Sesma, Juan Manuel Corcoles
Nonintubated procedures have widely developed during the last years, thus nowadays major anatomical resections are performed in spontaneously breathing patients in some centers. In an attempt for combining less invasive surgical approaches with less aggressive anesthesia, nonintubated uniportal video-assisted thoracic surgery (VATS) lobectomies and segmentectomies have been proved feasible and safe, but there are no comparative trials and the evidence is still poor. A program in nonintubated uniportal major surgery should be started in highly experienced units, overcoming first a learning period performing minor procedures and a training program for the management of potential crisis situations when operating on these patients...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29078594/challenges-in-complex-video-assisted-thoracoscopic-surgery-and-spontaneous-respiration-video-assisted-thoracoscopic-surgery-procedures
#13
REVIEW
Jingpei Li, Hui Liu, Jun Liu, Xusen Zou, Lili Mo, Hui Pan, Guilin Peng, Wenlong Shao, Lindsey Hamblin, Lixia Liang, Qinglong Dong, Jianxing He
The push for minimally invasive techniques had led to the development of many surgical tools and the innovation and completion of ever more complex operations. To achieve faster postoperative recovery of patients, we have been dedicated to the development of surgical skills that have allowed us to successfully complete many procedures under video-assisted thoracoscopic surgery (VATS) that are complex even with open approach. Specifically, sleeve, trachea, and carina resections and reconstructions using either general or spontaneous respiration anesthesia (SRA) techniques...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29078573/nonintubated-video-assisted-thoracic-surgery-lobectomy-for-lung-cancer
#14
Ming-Hui Hung, Shun-Mao Yang, Jin-Shing Chen
Nonintubated video-assisted thoracic surgery (VATS) is now well established and is performed in different institutions as a safe and versatile procedure in selected patients. To share the surgical and anesthetic techniques for nonintubated VATS, we present a 56-year-old female patient who underwent nonintubated VATS left upper lobectomy for primary non-small cell lung cancer. Our patient was sedated in a spontaneous breathing status using a target-controlled infusion of propofol. Additionally, regional anesthesia using intercostal block and left-sided intrathoracic vagal block enabled us to do left upper lobectomy and mediastinal lymph node dissection without difficulty...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29076477/-features-of-diagnostic-and-surgical-tactics-for-suicidal-and-autoaggressive-thoracic-and-abdominal-lesions
#15
M M Abakumov, E V Tatarinova, A P Vilk, O V Zubareva, Sh N Danielyan
AIM: To analyze diagnostic and surgical tactics for suicidal and autoaggressive thoracic and abdominal lesions. MATERIAL AND METHODS: We have analyzed the features of emergency surgical care depending on type of patients' behavior at admission. There were 516 patients with suicidal and autoaggressive thoracic and abdominal lesions. RESULTS AND DISCUSSION: Depressive (34%) and adequate (46%) patients were examined routinely. Inadequate (aggressive) behavior is inappropriate for instrumental examination while medical sedation may be followed by significant hemodynamic disorders in patients with severe lesions...
2017: Khirurgiia
https://www.readbyqxmd.com/read/29072862/lymph-drainage-from-the-chylocyst-induced-hemodilution-in-an-in-vivo-rabbit-study
#16
Kumiko Ajima, Yoshiko Kawai, Daisuke Maejima, Shigeru Suzuki, Sachiho Yano, Moyuru Hayashi, Atsushi Katsumata, Maki Kaidoh, Yumiko Yokoyama, Toshio Ohhashi
To confirm our previous study that abdominal respiration has induced hemodilution in human subjects, we performed in-vivo experiments involving anesthetized rabbits. Fifteen 6- to 7-month-old male Japanese white rabbits were used in the animal experiments. Anesthesia was maintained with 2.5%-3.0% isoflurane under N2O + 100% O2 inhalation. Ventilation was maintained at 40 mL/breath for 20 breaths/min. Physiological saline solution was administered at rated 18 mL/h during the experiments. First, we attempted to evaluate lymph flow through the thoracic duct using Sonazoid-based contrast-enhanced ultrasound (CEUS)-guided method and then investigated the effects of manual lymph drainage of the chylocyst on the numbers of red blood cells (RBC), hematocrit (Ht) levels, and the blood concentrations of total protein (TP) and hemoglobin (Hb)...
October 26, 2017: Lymphatic Research and Biology
https://www.readbyqxmd.com/read/29062457/late-type-iii-endoleak-after-thoracic-endovascular-aneurysm-repair-and-previous-infrarenal-stent-graft-implantation-a-case-report-and-review-of-the-literature
#17
Jerzy Leszczyński, Waldemar Macioch, Witold Chudziński, Zbigniew Gałązka
Thoracic endovascular aortic repair (TEVAR) effectively improved the results of thoracic aortic aneurysm treatment. TEVAR is a less invasive procedure that can be performed under local anesthesia with shorter hospital stay. The perioperative morbidity and mortality rates are lower for endovascular than open repair, but the rate of secondary interventions is higher for TEVAR. We report a case of an elderly man with synchronous abdominal and thoracic aortic aneurysms. A type III dangerous endoleak was recognized 3 years after TEVAR...
September 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29037478/five-hundred-seventy-six-cases-of-video-assisted-thoracic-surgery-utilizing-local-anesthesia-and-sedation-lessons-learned
#18
Mark R Katlic
BACKGROUND: General anesthesia and endotracheal intubation are a luxury rather than a necessity for many video-assisted thoracic surgery (VATS) operations. Twenty-three years ago the author began utilizing local anesthesia and sedation for pleural disease and subsequently for pericardial and lung disease. STUDY DESIGN: The records of all patients undergoing VATS utilizing local anesthesia and sedation at hospitals of the Geisinger Health System (Danville and Wilkes-Barre, PA) June 1, 2002 to June 30, 2011 and the Lifebridge Health System (Baltimore, MD) July 1, 2011 to March 1, 2017 were retrospectively reviewed...
October 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29033727/ultrasound-assessment-of-cranial-spread-during-caudal-blockade-in-children-effect-of-different-volumes-of-local-anesthetic
#19
Chandni Sinha, Amarjeet Kumar, Shalini Sharma, Akhilesh Kumar Singh, Somak Majumdar, Ajeet Kumar, Nishant Sahay, Bindey Kumar, U K Bhadani
BACKGROUND: Ultrasound-guided caudal block injection is a simple, safe, and effective method of anesthesia/analgesia in pediatric patients. The volume of caudal drug required has always been a matter of debate. MATERIALS AND METHODS: This present prospective, randomized, double-blinded study aimed to measure extent of the cranial spread of caudally administered levobupivacaine in Indian children by means of real-time ultrasonography. Ninety American Society of Anesthesiologists I/II children scheduled for urogenital surgeries were enrolled in this trial...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033726/ultrasound-guided-multilevel-paravertebral-block-versus-local-anesthesia-for-medical-thoracoscopy
#20
Maha A Abo-Zeid, Mohammad M Elgamal, Asem A Hewidy, Amro A Moawad, Alaa Eldin Adel Elmaddawy
BACKGROUND: Local anesthetic infiltration for medical thoracoscopy has an analgesic properties for short duration. Single injection thoracic paravertebral block (PVB) provides limited analgesia. PURPOSE: Comparison between thoracic PVB performed at two or three levels with local infiltration for anesthetic adequacy in adult medical thoracoscopy as a primary outcome and postthoracoscopic analgesia and pulmonary function as secondary outcomes for adult medical thoracoscopy...
October 2017: Saudi Journal of Anaesthesia
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