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https://www.readbyqxmd.com/read/29685712/no-difference-in-major-complication-and-readmission-rates-following-simultaneous-bilateral-vs-unilateral-total-hip-arthroplasty
#1
Mina W Morcos, Adam Hart, John Antoniou, Olga L Huk, David J Zukor, Stephane G Bergeron
BACKGROUND: Simultaneous bilateral total hip arthroplasty (THA) is an attractive option for patients with osteoarthritis as it requires a single anesthetic and hospitalization. Nonetheless, serious concerns remain over the perioperative safety and rate of hospital readmission. The purpose of the present study was to compare the rate of 30-day major complications and hospital readmissions between patients undergoing simultaneous bilateral vs unilateral THA using the National Surgical Quality Improvement Program database...
March 27, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29684987/effects-of-nefopam-on-catheter-related-bladder-discomfort-in-patients-undergoing-ureteroscopic-litholapaxy
#2
Yong Woo Cheon, Seon Hwan Kim, Jin Hyub Paek, Jin A Kim, Yong Kyung Lee, Jin Hye Min, Hyung Rae Cho
Background: Patients who undergo urinary catheterization may experience postoperative catheter-related bladder discomfort (CRBD). Previous studies have indicated that drugs with antimuscarinic effects could reduce the incidence and severity of CRBD. Accordingly, this study was carried out to investigate whether nefopam, a centrally acting analgesic with concomitant antimuscarinic effect, reduces the incidence and severity of CRBD. Methods: Sixty patients with American Society of Anesthesiologists physical status I and II and aged 18-70 years who were scheduled to undergo elective ureteroscopic litholapaxy participated in this double-blinded study...
April 24, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29677063/the-anesthesia-perioperative-call-for-help-experience-at-a-quaternary-pediatric-medical-center-analysis-of-67-564-anesthesia-encounters
#3
Bistra G Vlassakova, Sean M Sinnott, Nissa Askins, Matthew X Callahan, Izabela C Leahy, David Zurakowski, Paul R Hickey, Joseph P Cravero
BACKGROUND: During the past several decades, anesthesia has become increasingly safe. Truly major adverse events are rare, and anesthesia quality researchers have instituted programs to evaluate "near miss" or less critical adverse events to evaluate the safety of anesthesia delivery. In this study, we aimed to evaluate calls for emergency help in our institution as a surrogate for pending critical events. We hypothesized that calls would be more common in patients with high American Society of Anesthesiologists (ASA) physical status, history of prematurity, and children with recent respiratory illness compared to those without these characteristics...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29677059/pediatric-perioperative-cardiac-arrest-death-in-the-off-hours-a-report-from-wake-up-safe-the-pediatric-quality-improvement-initiative
#4
Robert E Christensen, Angela C Lee, Marie S Gowen, Mallikarjuna R Rettiganti, Jayant K Deshpande, Jeffrey P Morray
BACKGROUND: Pediatric perioperative cardiac arrest (CA) is a rare but catastrophic event. This case-control study aims to analyze the causes, incidence, and outcomes of all pediatric CA reported to Wake Up Safe. Factors associated with CA and mortality after arrest are examined and possible strategies for improving outcomes are considered. METHODS: CA in children was identified from the Wake Up Safe Pediatric Anesthesia Quality Improvement Initiative, a multicenter registry of adverse events in pediatric anesthesia...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29663067/impact-of-age-on-postoperative-complication-rates-among-elderly-patients-with-hip-fracture-a-retrospective-matched-study
#5
Mitsuhiro Matsuo, Tohru Yamagami, Akiko Higuchi
This study was performed to assess the impact of age of ≥ 90 years on predicting postoperative complications. We retrospectively identified all patients aged ≥ 65 years who underwent surgical repair of hip fractures over a 4.5-year period in our hospital. In total, 261 patients were identified (mean age, 86.2 ± 6.8 years). Ninety-one patients were aged ≥ 90 years (oldest-old group), and the remaining 170 were aged < 89 years (control old group). Postoperative complications developed in 54 of 261 patients (20...
April 16, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29661153/improved-analgesia-and-reduced-post-operative-nausea-and-vomiting-after-implementation-of-an-enhanced-recovery-after-surgery-eras-pathway-for-total-mastectomy
#6
Catherine Chiu, Pedram Aleshi, Laura J Esserman, Christina Inglis-Arkell, Edward Yap, Elizabeth L Whitlock, Monica W Harbell
BACKGROUND: Enhanced Recovery After Surgery (ERAS) pathways have been shown in multiple surgical disciplines to improve outcomes, including reduced opioid consumption, length of stay, and post-operative nausea and vomiting (PONV). However, very few studies describe the application of ERAS to breast surgery and even fewer describe ERAS for outpatient surgery. We describe the implementation and efficacy of an Enhanced Recovery After Surgery (ERAS) pathway for total skin-sparing mastectomy with immediate reconstruction in an outpatient setting...
April 16, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29659439/clotting-factor-concentrations-5-days-after-discontinuation-of-warfarin
#7
Honorio T Benzon, Yogen Asher, Mark C Kendall, Loyda Vida, Robert J McCarthy, David Green
BACKGROUND: The American Society of Regional Anesthesia and Pain Medicine guidelines recommend discontinuation of warfarin and an international normalized ratio (INR) of 1.2 or less before a neuraxial injection. The European and Scandinavian guidelines accept an INR of 1.4 or less. We evaluated INR and levels of clotting factors (CFs) II, VII, IX, and X 5 days after discontinuation of warfarin. METHODS: Patients who discontinued warfarin for 5 days and had an INR of 1...
April 14, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29649026/evidence-review-conducted-for-the-agency-for-healthcare-research-and-quality-safety-program-for-improving-surgical-care-and-recovery-focus-on-anesthesiology-for-colorectal-surgery
#8
Kristen A Ban, Melinda M Gibbons, Clifford Y Ko, Elizabeth C Wick, Maxime Cannesson, Michael J Scott, Michael C Grant, Christopher L Wu
The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery (ISCR), which is a national effort to disseminate best practices in perioperative care to more than 750 hospitals across multiple procedures in the next 5 years. The program will integrate evidence-based processes central to enhanced recovery and prevention of surgical site infection, venous thromboembolic events, catheter-associated urinary tract infections with socioadaptive interventions to improve surgical outcomes, patient experience, and perioperative safety culture...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29643730/transient-femoral-nerve-palsy-following-ilioinguinal-nerve-block-for-inguinal-hernioplasty
#9
Isaac Assam Udo, Kingsley U Umeh, Catherine S Eyo
Background: Elective inguinal hernia repair in young fit patients is preferably done under ilioinguinal nerve block anesthesia in the ambulatory setting to improve throughput, save cost, and increase patient satisfaction. A rare complication of ilioinguinal nerve block is transient femoral nerve palsy (TFNP). Objectives: The aim of this study is to examine the incidence of TFNP among adults undergoing ambulatory inguinal hernia repair under ilioinguinal nerve block...
January 2018: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/29643630/comparison-of-pretreatment-with-dexmedetomidine-with-midazolam-for-prevention-of-etomidate-induced-myoclonus-and-attenuation-of-stress-response-at-intubation-a-randomized-controlled-study
#10
Swarnendu Dey, Meenakshi Kumar
Background and Aims: Myoclonus is a common problem during induction of anesthesia with etomidate. A variety of drugs have been used to decrease the incidence of myoclonus. In this study we compared the effects of dexmedetomidine and midazolam pretreatment on the incidence of etomidate induced myoclonus. We also studied the effects of these drugs on attenuation of stress response at laryngoscopy and intubation on induction with etomidate. Material and Methods: Eighty adult patients (18 to 60 years age) of either sex, American Society of Anestheiologists physical status I and II undergoing elective general surgeries under general anesthesia were randomly allocated into two groups...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29643620/opioid-free-anesthesia-for-breast-cancer-surgery-an-observational-study
#11
Swagata Tripathy, Satyajit Rath, Suresh Agrawal, P Bhaskar Rao, A Panda, T S Mishra, Sukdev Nayak
Background and Aims: Opioids are associated with postoperative nausea, vomiting, drowsiness, and increased analgesic requirement. A nonopioid anesthesia technique may reduce morbidity, enable day care surgery, and possibly decrease tumor recurrence. We compared opioid-free, nerve block-based anesthesia with opioid-based general anesthesia for breast cancer surgery in a prospective cohort study. Material and Methods: Twenty four adult American Society of Anesthesiologists grade I-III patients posted for modified radical mastectomy (MRM) with axillary dissection were induced with propofol and maintained on isoflurane (0...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29628839/a-prospective-randomized-controlled-study-to-evaluate-and-compare-glidescope-with-macintosh-laryngoscope-for-ease-of-endotracheal-intubation-in-adult-patients-undergoing-elective-surgery-under-general-anesthesia
#12
Anudeep Jafra, Satinder Gombar, Dheeraj Kapoor, Harpreet Singh Sandhu, Kamlesh Kumari
Background: The aim of the study was to compare the ease the intubation using GlideScope video laryngoscope and Macintosh laryngoscope in adult patients undergoing elective surgery under general anesthesia. Materials and Methods: A total of 200 American Society of Anesthesiologists I-II patients of either sex, in the age group of 18-60 years were included in the study. Patients were randomly allocated to two groups. We assessed ease of intubation depending on time to tracheal intubation, number of attempts, glottic view (Cormack-Lehane grade [CL grade] and percentage of glottis opening [POGO]) and intubation difficulty score (IDS), hemodynamic variables and any intra- and post-operative adverse events...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628827/a-prospective-randomized-study-on-the-impact-of-low-dose-dexamethasone-on-perioperative-blood-glucose-concentrations-in-diabetics-and-nondiabetics
#13
Athul M Purushothaman, Vinayak Seenappa Pujari, Nalini B Kadirehally, Yatish Bevinaguddaiah, Pratheek R Reddy
Background: Dexamethasone is a potent corticosteroid when administered alone or in combination alone has proven efficacious in preventing nausea and vomiting (PONV) perioperatively. However, the administration of even a single dose has been associated with hyperglycemia. This is the first study that evaluates the effect of two low-doses of dexamethasone (4 and 8 mg) on blood glucose concentrations among diabetics and nondiabetics in patients who have received spinal anesthesia. Materials and Methods: After obtaining ethical clearance and patient consent, 180 American Society of Anesthesiologists 1-3 patients undergoing the elective infraumbilical surgeries under spinal anesthesia aged between 18 and 70 years were included in this study...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628591/comparison-of-levobupivacaine-and-levobupivacaine-with-dexmedetomidine-in-infraumbilical-surgeries-under-spinal-anesthesia
#14
Amar Parkash Kataria, Vishal Jarewal, Rajan Kumar, Ankush Kashyap
Introduction: Spinal anesthesia is a widely used technique providing faster onset with effective and uniformly distributed sensory and motor block. Due to decreased cardiovascular and central nervous system toxicity, levobupivacaine is a good alternative for spinal anesthesia. Dexmedetomidine when used intrathecally is associated with prolonged motor and sensory block, hemodynamic stability, and less requirement of rescue analgesia in 24 h. Materials and Methods: A prospective, randomized study was carried out which included 60 adult patients between the age group of 20 and 65 years of physical status American Society of Anesthesiologists Classes I and II who underwent infraumbilical surgeries...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628583/pressure-controlled-volume-guaranteed-mode-improves-respiratory-dynamics-during-laparoscopic-cholecystectomy-a-comparison-with-conventional-modes
#15
Apoorwa Kothari, Deepa Baskaran
Background: Pneumoperitoneum and altered positioning 1in laparoscopic cholecystectomy predispose to alterations in cardiorespiratory physiology. We compared the effects of volume controlled, pressure controlled, and the newly introduced pressure controlled-volume guaranteed ventilation (PCV-VG) modes of ventilation on respiratory mechanics and oxygenation during laparoscopic cholecystectomy. Materials and Methods: Seventy-five physical status American Society of Anesthesiologists Classes I and II patients with normal lungs undergoing laparoscopic cholecystectomy were randomly allocated to receive volume controlled ventilation (VCV), pressure-controlled ventilation (PCV), or PCV-VG modes of ventilation during general anesthesia...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628580/comparison-of-intravenous-bolus-and-infusion-of-dexmedetomidine-on-characteristics-of-subarachnoid-block
#16
Tripti Vatsalya, Chandrakant Waikar, Madhurima Singh
Aims: Dexmedetomidine is very dynamic drug, used for analgesia, sedation, blunting the laryngoscopic responses and as adjuvants in regional anesthesia. Studies have shown that intravenous (iv) dexmedetomidine given during spinal anesthesia increases the quality of subarachnoid block (SAB). In this study, we compare the two iv regimen of dexmedetomidine on analgesic effect of spinal anesthesia. One is bolus dose of dexmedetomidine and other is infusion during the surgery, both given after induction of spinal anesthesia...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628579/incidence-of-postspinal-headache-and-low-backache-following-the-median-and-paramedian-approaches-in-spinal-anesthesia
#17
Balwinderjit Singh, Amartej Singh Sohal, Iqbal Singh, Subash Goyal, Prabhjot Kaur, Joginder Pal Attri
Background and Aims: Postspinal headache and low backache are common complaints following spinal anesthesia which regresses spontaneously but sometimes becomes very troublesome for the patient as well as for the anesthesiologists. The aim of this study was to evaluate the incidence of postspinal headache and low backache after spinal anesthesia in lower abdominal surgery. Materials and Methods: One hundred patients of 18-60 years of age group with patients physical status the American Society of Anesthesiologists Class I or II after due consent divided into equal numbers of two groups: median (M) approach and paramedian (P) approach scheduled for lower abdominal surgery...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628568/comparison-of-prophylactic-intravenous-magnesium-sulfate-with-tramadol-for-postspinal-shivering-in-elective-cesarean-section-a-placebo-controlled-randomized-double-blind-pilot-study
#18
Roopa Sachidananda, K Basavaraj, Safiya I Shaikh, G Umesh, Triveni Bhat, B Arpitha
Background and Aims: Cesarean sections are performed mostly under spinal anesthesia. Shivering is one of the distressing complications. The aim of the study was to compare the efficacy of intravenous (i.v) magnesium sulfate and tramadol with placebo (normal saline) on postspinal shivering in elective cesarean section when used as prophylaxis. Methods: One hundred and thirty-five pregnant women between 18 and 35 years age, belonging to the American Society of Anesthesiologists' physical Status II, undergoing elective cesarean section under spinal anesthesia were enrolled into the study...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628567/comparison-of-upper-lip-bite-test-and-ratio-of-height-to-thyromental-distance-with-other-airway-assessment-tests-for-predicting-difficult-endotracheal-intubation
#19
D Shobha, Maitri Adiga, D Devika Rani, Sudheesh Kannan, S S Nethra
Background and Aims: Unanticipated difficult intubation or the failed intubation in operating room and in emergency department is an imperative source of anesthesia-related patient's mortality. The aim of this study is to compare the predictive value of upper lip bite test (ULBT) and ratio of height to thyromental distance (RHTMD) with other commonly used preoperative airway assessment tests for predicting difficult intubation in Indian population. Materials and Methods: In this prospective, single-blinded observational study, 260 adult patients of either sex, belonging to American Society of Anesthesiologists physical Status I and II undergoing elective surgical procedure under general anesthesia were included in the study...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628566/comparison-of-the-laryngeal-mask-airways-laryngeal-mask-airway-classic-and-laryngeal-mask-airway-proseal-in-children
#20
Chetan B Bhat, Kiran A Honnannavar, Mallanna B Police Patil, Mahantesh S Mudakanagoudar
Introduction: In the past 25 years with the development of various supraglottic airway devices, the armamentarium for airway management has increased. In our study, the laryngeal mask airway (LMA)-ProSeal is compared with the LMA-Classic with respect to as follows: (a) Ease of insertion and number of insertion attempts, (b) Device positional stability and possible oropharyngeal leak, (c) Airway trauma, and (d) Hemodynamic changes; in children aged 3-15 years undergoing elective surgery under general anesthesia, hypothesizing that these would be different...
January 2018: Anesthesia, Essays and Researches
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