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https://www.readbyqxmd.com/read/29658395/delaying-initiation-of-electroconvulsive-treatment-after-administration-of-the-anaesthetic-agent-and-muscle-relaxant-reduces-the-necessity-of-re-stimulation
#1
Márton Asztalos, Peter Matzen, Rasmus W Licht, Kristian Bjørn Hessellund, Alexander Sartorius, René Ernst Nielsen
OBJECTIVES: To investigate the effect of delaying initiation of electroconvulsive therapy (ECT) after administration of anaesthetic agent and muscle relaxant. METHODS: A retrospective cohort study utilizing a case-based analysis comparing number of re-stimulations, length of seizures, number of ECTs per series and stimulation dosage before and after introducing a new treatment regimen. In 2013, ECT was initiated approximately 60-90 seconds after administration of thiopental and succinylcholine...
April 16, 2018: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/29643623/effect-of-dexmedetomidine-infusion-on-hemodynamic-responses-in-microsurgery-of-larynx
#2
Shakuntala Basantwani, Mayuresh Patil, Balasaheb Govardhane, Jyoti Magar, Bharati Tendolkar
Background and Aims: Microlaryngeal surgery is a frequently performed ear, nose, and throat procedure used to diagnose and treat laryngeal disorders. Suspension laryngoscopy causes prolonged stimulation of the deep pressure receptors of the larynx leading to adverse circulatory responses and consequently cardiac complications. In this study, dexmedetomidine infusion was used to assess its effectiveness for attenuation of this hemodynamic stress response. Material and Methods: Sixty patients undergoing elective microlaryngeal surgery randomly received either dexmedetomidine 1 μg/kg over 10 min followed by continuous infusion of 0...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29628594/an-unusual-case-of-a-parturient-with-uncorrected-pentalogy-of-fallot-presenting-for-elective-cesarean-section-delivery-of-twins
#3
Ying Ci Ho, Sek Koon Boey, Abey Matthew Varughese Mathews, Hooi Geok See, Nian Chih Hwang
We present a 31-year-old primigravida with uncorrected pentalogy of Fallot, pregnant with monochorionic-diamniotic twins, undergoing elective lower segment cesarean section at 36 weeks gestation. Preoperative workup included a transthoracic echocardiogram which revealed a large ventricular septal defect of 1.8 cm with bidirectional shunting, a moderate size atrial septal defect of 1.8 cm with predominant left-to-right shunting, an overriding aorta, moderate right ventricular hypertrophy, and severe pulmonary valve stenosis...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29619783/estimation-of-the-effect-site-equilibration-rate-constant-using-the-time-to-peak-effect-of-muscle-relaxants-measured-by-train-of-four-stimulation-during-general-anesthesia-induction
#4
Se Yeon Park, Hyun Jung Kim, Yun Suk Choi, So-Hui Yun, Jong Cook Park
BACKGROUND: The concept of the effect-site concentration of anesthetic agents is important. The effect compartment model can be explained using the concepts of effect-site concentration and effect-site equilibration rate constant ( k e0 ). This study confirms that the time-to-peak effect ( tpe ) can be measured easily in clinical practice by applying a priming dose and train-of-four (TOF) during general anesthesia induction, and k e0 can be calculated from the tpe of the four muscle relaxants that are commonly used in general anesthesia...
April 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29576786/malignant-hyperthermia-report-of-two-cases-with-a-neglected-complication-in-cardiac-surgery
#5
Mahdi Neshati, Manizheh Azadeh, Parinaz Neshati, Tyrone Burnett, Ryan Saenz, Bahman Karbasi, Ghader Shahmohammadi, Eskandar Nourizadeh, Mohsen Rostamzadeh
Malignant hyperthermia (MH) can develop after contact with volatile anesthetics (halothane, enflurane, isoflurane, sevoflurane, and desflurane) as well as succinylcholine and cause hypermetabolism during anesthesia, which is associated with high mortality when untreated. Early diagnosis and treatment could be life-saving. During cardiac surgery, hypothermia and cardiopulmonary bypass make the diagnosis of MH extremely challenging compared with other settings such as general surgery. We herein report 2 cases of MH, graded as "very likely" or "almost certain" based on the MH clinical grading scale...
October 2017: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/29508014/-certain-and-controversial-components-of-rapid-sequence-induction
#6
T Mencke, A Zitzmann, D A Reuter
Rapid sequence induction (RSI) is a specific technique for anesthesia induction, which is performed in patients with an increased risk for pulmonary aspiration (e.g. intestinal obstruction, severe injuries and cesarean section). The incidence of acute respiratory distress syndrome (ARDS) is very low but 10-30% of anesthesia-related deaths are caused by the consequences of ARDS. The classical RSI with its main components (i.e. head-up position, avoidance of positive pressure ventilation and administration of succinylcholine) was published nearly 50 years ago and has remained almost unchanged...
March 5, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29504412/extreme-variability-in-succinylcholine-dose-for-muscle-relaxation-in-electroconvulsive-therapy
#7
Ethan O Bryson, Charles H Kellner, Erin H Li, Amy S Aloysi, Matthew Majeske
OBJECTIVES: To determine what dose of succinylcholine falls outside the range of 2 SD above or below the mean optimal dose of 0.9 mg/kg used for electroconvulsive therapy (ECT). METHODS: In this retrospective chart review, for all patients who received ECT at our institution within the 5-year study period, the initial dose of succinylcholine in milligrams per kilogram was compared with subsequent doses after adjustments were made for individual patient responses...
March 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/29497193/use-of-modified-bilateral-electroconvulsive-therapy-during-pregnancy-a-case-series
#8
Sandeep Grover, Pooja Sikka, Shiv Sajan Saini, Neeru Sahni, Subho Chakrabarti, Devakshi Dua, Anisha Aggarwal, Anita Thakur, Shallu Dhiman, Amal Jolly, Swapnajeet Sahoo, Aseem Mehra, Aditya Somani
There is limited literature on the use of electroconvulsive therapy (ECT) during pregnancy. ECT is considered as a treatment of last resort during pregnancy. In this case series, we present the data of five patients who were administered ECT during pregnancy. The use of ECT required multidisciplinary approach involving psychiatrist, gynecologist, anesthetist and neonatologist. Two patients received ECT during the second trimester and three patients received ECT during the third trimester. In all the patients, ECT was administered by placing the patients in the left lateral position, glycopyrrolate was used for premedication, thiopentone was used for induction, and succinylcholine was used for muscle relaxation...
October 2017: Indian Journal of Psychiatry
https://www.readbyqxmd.com/read/29480319/-abortive-course-of-malignant-hyperthermia-following-preclinical-induction-of-general-anesthesia-using-succinylcholine
#9
D Helf, D Schneiderbanger, C K Markus, S Johannsen, F Schuster
In a 59-year-old woman with a perforating eyeball injury to the right eye, the emergency physician induced a preclinical general anesthesia with propofol, fentanyl and the depolarizing muscle relaxant succinylcholine. Anesthesia was maintained using propofol and remifentanil infusion throughout the preoperative period and the subsequent surgical procedure. Postoperatively, isolated rhabdomyolysis with an increase in serum creatine kinase to >20,000 U/l was observed. The diagnosis of malignant hyperthermia (MH) susceptibility could be confirmed in the patient 4 months after the acute event by the in vitro contracture test and detection of the MH causative mutation p...
February 26, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29458799/rocuronium-versus-succinylcholine-revisited-succinylcholine-remains-the-best-choice
#10
Jan M Shoenberger, William K Mallon
No abstract text is available yet for this article.
March 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29413725/current-practices-and-safety-of-medication-use-during-rapid-sequence-intubation
#11
Christine M Groth, Nicole M Acquisto, Tina Khadem
PURPOSE: Characterize medication practices during and immediately after rapid sequence intubation (RSI) by provider/location and evaluate adverse drug events. MATERIALS AND METHODS: This was a multicenter, observational, cross-sectional study of adult and pediatric intensive care unit and emergency department patients over a 24-h period surrounding first intubation. RESULTS: A total of 404 patients from 34 geographically diverse institutions were included (mean age 58 ± 22 years, males 59%, pediatric 8%)...
January 30, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29284874/low-dose-succinylcholine-to-facilitate-laryngeal-mask-airway-insertion-a-comparison-of-two-doses
#12
Leah R George, Raj Sahajanandan, Sarah Ninan
Background and Aims: Around the world, the use of the laryngeal mask airway (LMA) is becoming more common for different surgeries accounting for it being the dominant choice of airway in numerous surgeries. Although propofol is known to blunt the laryngeal reflexes often patient movement, coughing, and gagging occur on insertion. This study aims to identify the optimum dose of succinylcholine required to facilitate LMA insertion comparing placebo, 0.1 mg/kg and 0.25 mg/kg of succinylcholine...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284858/the-influence-of-two-different-doses-of-magnesium-sulfate-on-intraocular-pressure-variations-after-injection-of-succinylcholine-and-endotracheal-intubation-a-prospective-randomized-parallel-three-arm-double-blind-placebo-controlled-clinical-trial
#13
Hany Mahmoud Yassin, Ahmed Tohamy Abdel Moneim, Ahmed Sherin Mostafa Bayoumy, Hasan Metwally Bayoumy, Sameh Galal Taher
Background: The use of succinylcholine for rapid sequence induction in patients with open globe injuries may be detrimental to the eye. Aim: The aim of this study is to determine if the premedication with magnesium sulfate (MgSO4 ) could attenuate the increase in intraocular pressure (IOP) associated with succinylcholine injection and intubation. Setting: Operation theaters in a tertiary care University Hospital between December 2014 and July 215...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284841/a-retrospective-analysis-on-anesthetic-management-during-rigid-bronchoscopy-in-children-with-foreign-body-aspiration-propofol-and-sevoflurane-with-controlled-ventilation
#14
Rashmi Venkatesh Annigeri, Rashmi Suresh Patil
Background: Bronchoscopic removal of foreign body in the airway is one of the important life-saving procedure and demands skill and expertise on the part of the surgeon and anesthesiologist. Aim: To study the outcome of controlled ventilation during rigid bronchoscopy in children with foreign body aspiration. Materials and Methods: A review of fifty cases of foreign body in the bronchi, from January 2014 to December 2015 was undertaken in Vittal Institute of Child Care Hospital, Dharwad, through patient case records...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284835/to-evaluate-the-efficacy-of-intravenous-infusion-of-dexmedetomidine-as-premedication-in-attenuating-the-rise-of-intraocular-pressure-caused-by-succinylcholine-in-patients-undergoing-rapid-sequence-induction-for-general-anesthesia-a-randomized-study
#15
Raj Bahadur Singh, Sanjay Choubey, Saurabh Mishra
Context: Laryngoscopy and intubation performed during RSI lead to choroidal blood volume increase and an eventual rise in intraocular pressure (IOP). Use of succinylcholine (SCh) causes an undesirable rise in IOP which is further aggravated by laryngoscopy and endotracheal intubation. Dexmedetomidine is a highly selective centrally acting α2 adrenergic agonist that has IOP lowering properties. Aims: This study aims to evaluate the efficacy of intravenous (i.v.) infusion of dexmedetomidine (0...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29245345/incidence-of-malignant-hyperthermia-in-patients-undergoing-general-anesthesia-protocol-for-a-systematic-review-and-meta-analysis
#16
REVIEW
Junyong In, Eun Jin Ahn, Dong Kyu Lee, Hyun Kang
BACKGROUND: Malignant hyperthermia (MH) continues to be of potential concern for clinicians whenever inhalational anesthetic agents or succinylcholine are used, because MH is a potentially fatal metabolic disorder. METHODS: A systematic and comprehensive search will be performed using MEDLINE, EMBASE, and Google Scholar, for studies published up to November 2017. Peer-reviewed prospective cohort studies, retrospective cohort studies, and cross-sectional studies or reports issued by government organizations reporting the incidence or prevalence of MH will be eligible for inclusion...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29214627/a-12-month-descriptive-analysis-of-emergency-intubations-at-brooke-army-medical-center-a-national-emergency-airway-registry-study
#17
Michael D April, Steven G Schauer, Calvin A Brown Rd, Patrick C Ng, Jessie Fernandez, Andrea E Fantegrossi, Joseph K Maddry, Shane Summers, Daniel J Sessions, Robert M Barnwell, Mark Antonacci
Emergency airway management is a critical skill for military healthcare providers. Our goal was to describe the Emergency Department (ED) intubations at Brooke Army Medical Center (BAMC) over a 12-month period. MATERIAL AND METHODS: Physicians performing endotracheal intubations in the BAMC ED complete data collection forms for each intubation event as part of the National Emergency Airway Registry, including patient demographics, intubation techniques, success and failure rates, adverse events, and patient disposition...
October 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/29209787/-different-levels-of-experience-with-anesthetic-agents-of-german-emergency-physicians-results-of-an-online-survey
#18
A Luckscheiter, M Fischer, W Zink
BACKGROUND AND OBJECTIVE: In 2015 practice management guidelines on prehospital emergency anesthesia in adults were published in Germany. The aim of the present study was to evaluate whether emergency physicians follow these guidelines in daily practice and to assess their level of experience with the use of anesthetic agents. MATERIAL AND METHODS: In an online survey the way of induction of preclinical anesthesia (including preoxygenation time and applied monitoring techniques) was assessed with the help of virtual scenarios based on the guidelines...
January 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29166296/emergency-intubations-in-a-high-volume-pediatric-emergency-department
#19
Jen Heng Pek, Gene Yong-Kwang Ong
INTRODUCTION: Resuscitation of critically ill children can be chaotic, and emergency airway management is often fraught with difficulties. This study aimed to characterize the Singaporean landscape of tracheal intubation in a pediatric emergency unit, placing emphasis on safety outcomes, procedural process of care, and provider training. METHODS: A retrospective review of all cases presented to the KK Women's and Children's Hospital from January 2009 to December 2013 with intubation carried out within the pediatric emergency unit was done...
November 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29162438/peri-intubation-factors-affecting-emergency-physician-choice-of-paralytic-agent-for-rapid-sequence-intubation-of-trauma-patients
#20
Jason R West, Catherine Lott, Lee Donner, Marc Kanter, Nicholas D Caputo
INTRODUCTION: No study has assessed predictors of physician choice between the succinylcholine (Succ) and rocuronium (Roc) for rapid sequence intubation (RSI) during the initial resuscitation of trauma patients in the emergency department (ED). METHODS: We retrospectively evaluated of the use of Succ and Roc for adult trauma patients undergoing RSI at a Level 1 trauma center. The primary outcome was to identify factors affecting physician choice of paralytic agent for RSI analyzed by cluster analysis using pre-intubation vital signs and early mortality...
November 18, 2017: American Journal of Emergency Medicine
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