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https://www.readbyqxmd.com/read/28645218/wide-awake-anesthesia-in-the-in-office-procedure-room-lessons-learned
#1
Robert E Van Demark, Hillary A Becker, Matthew C Anderson, Vanessa J S Smith
BACKGROUND: Wide-awake local anesthesia and no tourniquet (WALANT) has become more popular in hand surgery. Without a tourniquet, there is no need for preoperative testing or sedation. The use of lidocaine with epinephrine has allowed a larger variety of cases to be done safely in an outpatient setting instead of the hospital. "Minor field sterility," which uses fewer drapes and tools to accomplish the same procedures, is a concept that is also gaining recognition. METHODS: Investigation of hand surgeons performing a majority of cases using WALANT and minor field sterility was the beginning of seeing its potential at our institution...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28641966/no-clinical-difference-comparing-general-regional-and-combination-anesthesia-in-hip-arthroplasty-a-multicenter-cohort-study-regarding-perioperative-pain-management-and-patient-satisfaction
#2
Felix Greimel, Guenther Maderbacher, Florian Zeman, Joachim Grifka, Winfried Meissner, Achim Benditz
BACKGROUND: Steadily increasing numbers of hip arthroplasties are reported in the past years. Different types of anesthetic methods for surgery itself as well as pain management programs have been established. It is one of the main goals to reduce postoperative pain levels and guarantee better and faster mobilization in the postoperative period. The present study aims to compare the use of general and regional spinal anesthesia and their combination regarding perioperative pain management and patient satisfaction...
May 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28625445/prospective-double-blind-randomized-placebo-controlled-clinical-trial-of-the-pectoral-nerves-pecs-block-type-ii
#3
Barbara Versyck, Geert-Jan van Geffen, Patrick Van Houwe
STUDY OBJECTIVE: The aim of this clinical trial was to test the hypothesis whether adding the pectoral nerves (Pecs) block type II to the anesthetic procedure reduces opioid consumption during and after breast surgery. DESIGN: A prospective randomized double blind placebo-controlled study. SETTING: A secondary hospital. PATIENTS: 140 breast cancer stage 1-3 patients undergoing mastectomy or tumorectomy with sentinel node or axillary node dissection...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28625429/automated-anesthesia-carts-reduce-drug-recording-errors-in-medication-administrations-a-single-center-study-in-the-largest-tertiary-referral-hospital-in-china
#4
Ying Wang, Yingying Du, Yingying Zhao, Yang Ren, Wei Zhang
AIM: To clinically evaluate a type of patented automated anesthesia cart in medication administrations in anesthesia. MATERIALS AND METHODS: This was a prospectively randomized open label clinical trial. In 10 designated operating suits in the First Affiliated Hospital of Zhengzhou University, in China. 1066 cases originated from 10,812 medication administrations in anesthesia were randomized. 78 registered anesthesiologists managed the medication. The patients received medication administrations in anesthesia with either an automated or a conventional manual cart...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28623089/optimal-intrathecal-hyperbaric-bupivacaine-dose-with-opioids-for-cesarean-delivery-a-prospective-double-blinded-randomized-trial
#5
Eiko Onishi, Mamoru Murakami, Keiji Hashimoto, Miho Kaneko
BACKGROUND: Single-shot spinal anesthesia is commonly used for cesarean delivery. Achieving adequate anesthesia throughout surgery needs to be balanced with associated complications. We investigated the optimal dose of intrathecal hyperbaric bupivacaine, co-administered with opioids, for anesthesia for cesarean delivery. METHODS: This prospective, randomized, double-blinded, dose-ranging trial included parturients scheduled to undergo cesarean delivery under spinal anesthesia...
April 13, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28620924/childhood-preoperative-anxiolysis-is-sedation-and-distraction-better-than-either-alone-a-prospective-randomized-study
#6
Chrystelle Sola, Audrey Lefauconnier, Sophie Bringuier, Olivier Raux, Xavier Capdevila, Christophe Dadure
BACKGROUND: Preoperative anxiety management receives special attention in pediatric anesthesia. Different pharmacological and nonpharmacological techniques can be employed. This study was designed to assess three different strategies for childhood preoperative anxiolysis: midazolam premedication, midazolam in combination with portable Digital Video-Disk player, or video distraction strategy alone. METHODS: In this prospective randomized study, children aged 2-12 years were assigned to one of the three study groups...
June 16, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28618130/benefits-of-an-individualized-perioperative-plan-for-children-with-autism-spectrum-disorder
#7
Jo S Swartz, Karen E Amos, Mirna Brindas, Linda G Girling, M Ruth Graham
BACKGROUND: Perioperative care for children with autism spectrum disorder may be challenging. Previous investigators recommend development of an individualized perioperative management plan with caregiver involvement. AIM: The primary goal was to determine the usefulness of an individualized plan based on the decision to provide preoperative sedation stratified by autism spectrum severity level. Secondary goals were to assess the effectiveness of the plan based on subjective assessment of patient behavior at induction of anesthesia and caregiver satisfaction...
June 15, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28611538/breast-conserving-surgery-under-local-anesthesia-in-elderly-patients-with-severe-cardiorespiratory-comorbidities-a-hospital-based-case-control-study
#8
Hasan Karanlik, Berkay Kılıç, Ilknur Yıldırım, Süleyman Bademler, Ilker Ozgur, Burak Ilhan, Semen Onder
INTRODUCTION: We report the feasibility and safety of local anesthesia (LA) in patients having breast-conserving surgery (BCS). METHODS: 37 patients with American Society of Anesthesiologists (ASA) score of 4 having BCS under LA and 54 age-matched subjects with ASA score of 3-4 having BCS under general anesthesia (GA) were included. Patients were retrospectively evaluated for the follow-up duration, duration of surgery, postoperative satisfaction scores (1-10), complication and survival time for locoregional recurrence and overall survival rates...
March 2017: Breast Care
https://www.readbyqxmd.com/read/28608239/transnasal-endoscopic-ultrasound-guided-reduction-of-maxillary-sinus-wall-fracture
#9
Hyung Chae Yang, Young Yoon Kim, Seoung Min Jin, Hyesu You, Jung Hyun Han, Kwang Il Nam
Surgical morbidity from open reduction and internal fixation (ORIF) of maxillary sinus wall fracture often surpasses the benefits of ORIF. Hence, the authors devised transnasal endoscopic-assisted reduction of maxillary sinus wall fracture (TERM) without internal fixation as a minimally invasive surgery for maxillary sinus wall fracture. The purpose of this study was to investigate the feasibility of TERM in cadavers and patients. Six cadavers were dissected to evaluate the feasibility of TERM. In addition, 20 patients with maxillary sinus wall fractures who underwent TERM in a tertiary hospital from August of 2013 to December of 2015 were enrolled in this study...
June 12, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28604179/bolus-administration-of-intravenous-lidocaine-reduces-pain-after-an-elective-caesarean-section-findings-from-a-randomised-double-blind-placebo-controlled-trial
#10
Afshin Gholipour Baradari, Abolfazl Firouzian, Farshad Hasanzadeh Kiabi, Amir Emami Zeydi, Mohammad Khademloo, Zeinab Nazari, Masoumeh Sanagou, Maedeh Ghobadi, Ensieh Fooladi
We conducted a randomised double-blind, placebo-controlled trial to assess whether a bolus dose of lidocaine during the induction of general anaesthesia would reduce postoperative pain over 24 h. Level of satisfaction with pain control at 48 h after surgery and Apgar score were also examined. A total of 100 women aged 20-35 years, who were candidates for elective caesarean section (CS) were randomised to receive either 1.5 mg/kg lidocaine or placebo during the induction of general anaesthesia. Results showed that lidocaine decreased pain intensity over 24 h after surgery (p < ...
July 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28602533/outpatient-and-inpatient-unicompartmental-knee-arthroplasty-procedures-have-similar-short-term-complication-profiles
#11
Patawut Bovonratwet, Nathaniel T Ondeck, Vineet Tyagi, Stephen J Nelson, Lee E Rubin, Jonathan N Grauer
BACKGROUND: Advances in surgical techniques and anesthesia have made performing unicompartmental knee arthroplasty (UKA) in the outpatient setting a possibility. The touted benefits of outpatient surgery include higher patient satisfaction and reduced costs. However, detailed information on the perioperative outcomes of outpatient compared with inpatient UKA in a large, national patient population in the United States has never been reported. The present study compares perioperative complications between outpatient and inpatient UKAs in the National Surgical Quality Improvement Program database...
May 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28598921/virtual-reality-as-an-adjunctive-nonpharmacological-sedative-during-orthopedic-surgery-under-regional-anesthesia-a-pilot-and-feasibility-study
#12
Peter Y Chan, Simon Scharf
This pilot study assessed the feasibility and potential for any possible sedation sparing effect of immersive virtual reality (IVR) therapy on patients undergoing joint replacement surgery under regional anesthesia. Nine participants were given IVR, regional anesthetic, and sedation. Ten received conventional care. Mean propofol usage was 155 ± 45 mg/h in the conventional care group and 63 ± 21 mg/h in the IVR group (P = .088, mean difference -91.6 mg/h, 95% confidence interval -200 to 16.87 mg/h). There was no significant difference in postoperative satisfaction between the 2 groups...
June 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28583338/distal-corporal-anchoring-stitch-a-technique-to-address-distal-corporal-crossovers-and-impending-lateral-extrusions-of-a-penile-prosthesis
#13
Gabriele Antonini, Gian Maria Busetto, Francesco Del Giudice, Matteo Ferro, Benjamin I Chung, Simon L Conti, Alfredo Suarez Sarmiento, Arianna Pacchiarotti, Ettore De Berardinis, Paul E Perito
BACKGROUND: Unidentified distal crossovers, delayed distal crossovers, and impending lateral extrusion are complications of penile prosthesis implant insertion but are not as common as prosthesis infection or mechanical failure. AIM: To evaluate results of a surgical technique, the distal corporal anchoring stitch, that addresses fixation of the penile prosthesis in patients with these complications. METHODS: A lateral sub-coronal incision is used on the side where the crossover or laterally extruding cylinder should be positioned...
June 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28583057/auricular-acupressure-in-the-prevention-of-postoperative-nausea-and-emesis-a-randomized-controlled-trial
#14
Cynthia Feng, Jovan Popovic, Richard Kline, Jung Kim, Rafael Matos, Sarah Lee, Joseph Bosco
INTRODUCTION: Successful antiemesis contributes significantly to quality, safety, and patient satisfaction. Patients undergoing general anesthesia often experience postoperative nausea and vomiting (PONV). Acupressure offers a side effect-free alternative to common first-line antiemetics. Because the patient may perceive needle acupuncture as uncomfortable, acupressure is a desirable alternative for the prevention of PONV. METHODS: This study was a randomized, prospective, double-blinded clinical trial investigating the effect of acupressure in patients with a history of PONV and motion sickness...
April 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28580079/the-effect-of-triazolam-premedication-on-anxiety-sedation-and-amnesia-in-general-anesthesia
#15
Taehee Pyeon, Shiyoung Chung, Injae Kim, Seongheon Lee, Seongwook Jeong
BACKGROUND: Benzodiazepines have been used preoperatively as part of an anesthesia regimen to attenuate the anxiety of patients. In this study, we aimed to examine the effect of oral triazolam, a short-acting benzodiazepine, on anxiety, sedation, and amnesia. METHODS: Ninety patients, aged 20-55 years, were randomly assigned to receive no premedication, or to receive triazolam 0.25 mg or 0.375 mg 1 h before anesthesia. Anxiety score, sedation score, blood pressure, heart rate and psychomotor performance were measured on the evening before surgery and on the day of surgery...
June 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28551060/-efficiency-of-bupivacaine-and-association-with-dexmedetomidine-in-transversus-abdominis-plane-block-ultrasound-guided-in-postoperative-pain-of-abdominal-surgery
#16
Recep Aksu, Gülçin Patmano, Cihangir Biçer, Ertan Emek, Aliye Esmaoğlu Çoruh
BACKGROUND AND OBJECTIVES: We aimed to evaluate the effect of bupivacaine and dexmedetomidine added to bupivacaine used in tranversus abdominis plane (TAP) block on postoperative pain and patient satisfaction in patients undergoing lower abdominal surgery. METHODS: Patients submitted to lower abdominal surgery were enrolled in the study. After anesthesia induction, ultrasound guided TAP block was performed. TAP block was obtained with 21mL 0.9% saline in Group C (n=31), 20mL 0...
May 24, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28546664/early-maternal-feeding-versus-traditional-delayed-feeding-after-cesarean-section-a-pilot-study
#17
Sukesh Kumar Kathpalia
BACKGROUND: Cesarean section is on the rise all over the world; it has become a safe surgery due to better anesthesia, asepsis, blood transfusion and antibiotics. Traditionally, the patients are kept nil orally till they pass flatus. This study was performed to find out acceptance and tolerability of early feeding, its side effects and complications if any. METHODS: This comparative study was conducted in a service hospital. There were two groups of 70 cases each where one was administered early feeding and the second group was put on standard delayed feeding as is traditionally done in most of the hospitals...
June 2017: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/28538983/assocation-of-a-surgical-task-during-training-with-team-skill-acquisition-among-surgical-residents-the-missing-piece-in-multidisciplinary-team-training
#18
Jessica L Sparks, Dustin L Crouch, Kathryn Sobba, Douglas Evans, Jing Zhang, James E Johnson, Ian Saunders, John Thomas, Sarah Bodin, Ashley Tonidandel, Jeff Carter, Carl Westcott, R Shayn Martin, Amy Hildreth
Importance: The human patient simulators that are currently used in multidisciplinary operating room team training scenarios cannot simulate surgical tasks because they lack a realistic surgical anatomy. Thus, they eliminate the surgeon's primary task in the operating room. The surgical trainee is presented with a significant barrier when he or she attempts to suspend disbelief and engage in the scenario. Objective: To develop and test a simulation-based operating room team training strategy that challenges the communication abilities and teamwork competencies of surgeons while they are engaged in realistic operative maneuvers...
May 24, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28538371/comparison-of-the-efficacy-and-safety-of-2-lidocaine-hcl-with-different-epinephrine-concentration-for-local-anesthesia-in-participants-undergoing-surgical-extraction-of-impacted-mandibular-third-molars-a-multicenter-randomized-double-blind-crossover-phase-iv
#19
RANDOMIZED CONTROLLED TRIAL
Myong-Hwan Karm, Fiona Daye Park, Moonkyu Kang, Hyun Jeong Kim, Jeong Wan Kang, Seungoh Kim, Yong-Deok Kim, Cheul-Hong Kim, Kwang-Suk Seo, Kyung-Hwan Kwon, Chul-Hwan Kim, Jung-Woo Lee, Sung-Woon Hong, Mi Hyoung Lim, Seung Kwan Nam, Jae Min Cho
BACKGROUND: The most commonly impacted tooth is the third molar. An impacted third molar can ultimately cause acute pain, infection, tumors, cysts, caries, periodontal disease, and loss of adjacent teeth. Local anesthesia is employed for removing the third molar. This study aimed to evaluate the efficacy and safety of 2% lidocaine with 1:80,000 or 1:200,000 epinephrine for surgical extraction of bilateral impacted mandibular third molars. METHODS: Sixty-five healthy participants underwent surgical extraction of bilateral impacted mandibular third molars in 2 separate visits while under local anesthesia with 2% lidocaine with different epinephrine concentration (1:80,000 or 1:200,000) in a double-blind, randomized, crossover trial...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28535561/effectiveness-of-lateral-decubitus-position-for-preventing-post-dural-puncture-headache-a-meta-analysis
#20
Andres Zorrilla-Vaca, Jeetinder Kaur Makkar
BACKGROUND: Post-dural puncture headache (PDPH) is a relatively common complication of lumbar punctures for spinal anesthesia or neurologic diagnosis. For many years, a high number of drugs has been evaluated to treat PDPH, yet there is a minority to prevent this complication. The lateral decubitus position instead of sitting position during lumbar puncture has become an interesting approach because of its feasibility and patient satisfaction. OBJECTIVES: In this meta-analysis we hypothesized that lateral decubitus position is an effective manner to prophylactically reduce the incidence of PDPH...
May 2017: Pain Physician
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