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Anaesthesia and management

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https://www.readbyqxmd.com/read/29330267/case-of-acute-severe-postpartum-urinary-incontinence-an-extravesical-subsphincteric-prolapsed-ureterocoele
#1
Jai H Seth, Roger Walker
A 32-year-old woman presents to outpatients 10 days postpartum, with symptoms of an intermittent vaginal lump and urinary incontinence. Vaginal examination revealed no demonstrable prolapse or stress incontinence. A swelling in the bladder was noted during an antenatal scan suggesting a ureterocoele. She was referred for pelvic floor physiotherapy in the first instance. Forty-eight hours later, she represented to casualty with discomforting vaginal lump symptoms and continuous urinary incontinence. At this stage on vaginal inspection, there was an evident dusky lump emerging from the urethra with continuous incontinence...
January 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29328847/an-anaesthesia-perspective-on-carotid-body-tumour-cbt-excision-a-twenty-year-case-series-at-the-singapore-general-hospital
#2
Deanna Wj Ng, Chris I Yam, Loong T Wong, Darren Lk Koh
Carotid body tumours (CBT) are extremely rare neoplasms that arise from chemoreceptor cells at the bifurcation of the carotid artery. This rarity poses a challenge for the anaesthetist when dealing with surgeries for the removal of CBT. Reports of associated perioperative morbidity range from twenty to forty percent. This paper reviews the perioperative anaesthetic management of CBT patients and challenges in our institution's 20 year experience on 13 surgical CBT resections.
October 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29328846/a-review-of-nausea-and-vomiting-in-the-anaesthetic-and-post-anaesthetic-environment
#3
Claire Matthews
Postoperative nausea and vomiting (PONV) has long been known as a complication of anaesthesia and surgery. This paper focuses on the assessment of the risk factors related to PONV along with the strategies and interventions which can be put in place to manage the condition. The pharmacological and multi-modal treatment methods of managing the risk factors that contribute to PONV are discussed.
October 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29326765/pneumocephalus-following-combined-spinal-epidural-anaesthesia-for-total-knee-arthroplasty-a-case-report
#4
Y W Chew, V K Suppan, S R Ashutosh, M M Tew, J H Jimmy-Tan
The authors describe a case of pneumocephalus following epidural anaesthesia for total knee arthroplasty. Multiple attempts in locating the epidural space for the anaesthesia and the use of loss of resistance to air (LORA) technique were identified as the source of air entry. Supportive management was given including high flow oxygenation therapy and spontaneous reabsorption of air was noted five days after surgery. The presence of pneumocephalus should be kept in mind if patient develops neurological complications postoperatively following epidural anaesthesia...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29313907/adverse-drug-reactions
#5
REVIEW
K Patton, D C Borshoff
Adverse drug reactions are a cause of significant morbidity and mortality to patients and a source of financial burden to the healthcare system. Of the wide spectrum of adverse drug reactions, the most concerning to the anaesthetist remain anaphylaxis and malignant hyperthermia. Although the incidence of anaphylaxis under anaesthesia is difficult to ascertain, it occurs commonly enough that most anaesthetists will manage at least one case in their career. The wide range of drugs given in the peri-operative period and the variable presentation in the anaesthetised patient can delay diagnosis and treatment, and adversely affect outcome...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29313905/renal-complications-of-anaesthesia
#6
REVIEW
J McKinlay, E Tyson, L G Forni
Peri-operative acute kidney injury is common, accounting for 30-40% of all in-hospital cases of acute kidney injury. It is associated with clinically significant morbidity and mortality even with what was hitherto regarded as relatively trivial increases in serum creatinine, and carries over a 12-fold relative risk of death following major abdominal surgery. Comorbid conditions such as diabetes, hypertension, liver disease and particularly pre-existing chronic kidney disease, as well as the type and urgency of surgery, are major risk factors for the development of postoperative acute kidney injury...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29313904/peripheral-nerve-injury-arising-in-anaesthesia-practice
#7
REVIEW
D W Hewson, N M Bedforth, J G Hardman
In this article, we will discuss the pathophysiology of peripheral nerve injury in anaesthetic practice, including factors which increase the susceptibility of nerves to damage. We will describe a practical and evidence-based approach to the management of suspected peripheral nerve injury and will go on to discuss major nerve injury patterns relating to intra-operative positioning and to peripheral nerve blockade. We will review the evidence surrounding particular strategies to reduce the incidence of peripheral nerve injury during nerve blockade, including nerve localisation methods, timing of blocks, needle techniques and design, injection pressure-monitoring and local anaesthetic and adjunct choice...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29313881/stiripentol-for-the-treatment-of-super-refractory-status-epilepticus-with-cross-sensitivity
#8
Y Uchida, K Terada, Y Madokoro, T Fujioka, M Mizuno, T Toyoda, D Kato, N Matsukawa
BACKGROUND: Cross-sensitivity of rash has been reported between various antiepileptic drugs (AEDs). However, few studies have determined the frequency and management of cross-sensitivity in patients with super-refractory status epilepticus (SRSE). AIMS OF THE STUDY: To examine the optimal AED for treating SRSE with cross-sensitivity. METHODS: We performed a retrospective review of adult patients with SRSE treated at Nagoya City University Hospital, in which we investigated the frequency of cross-sensitivity among patients with SRSE and their clinical and medical profiles...
January 3, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29304181/public-opinion-towards-castration-without-anaesthesia-and-lack-of-access-to-pasture-in-beef-cattle-production
#9
Dayane Lemos Teixeira, Rafael Larraín, Oscar Melo, María José Hötzel
Recent publications have shown that citizens in developing nations are gaining interest in farm animal welfare. The aims of this study were to assess the opinion of Chilean citizens about surgical castration without anaesthesia and lack of access to pasture in beef cattle production, to investigate how involvement in livestock production influences opinions, and to evaluate if different types of information would affect their opinion towards these management practices. The study was carried out in the Metropolitan Region of Santiago, Chile, and consisted of two surveys with 400 participants in each study...
2018: PloS One
https://www.readbyqxmd.com/read/29300271/obstructive-sleep-apnoea-in-adults-peri-operative-considerations-a-narrative-review
#10
Martin Roesslein, Frances Chung
: Obstructive sleep apnoea (OSA) is a common breathing disorder of sleep with a prevalence increasing in parallel with the worldwide rise in obesity. Alterations in sleep duration and architecture, hypersomnolence, abnormal gas exchange and also associated comorbidities may all feature in affected patients.The peri-operative period poses a special challenge for surgical patients with OSA who are often undiagnosed, and are at an increased risk for complications including pulmonary and cardiovascular, during that time...
January 2, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29299973/how-anaesthesiologists-understand-difficult-airway-guidelines-an-interview-study
#11
Kati Knudsen, Ulrika Pöder, Ulrica Nilsson, Marieann Högman, Anders Larsson, Jan Larsson
BACKGROUND: In the practice of anaesthesia, clinical guidelines that aim to improve the safety of airway procedures have been developed. The aim of this study was to explore how anaesthesiologists understand or conceive of difficult airway management algorithms. METHODS: A qualitative phenomenographic design was chosen to explore anaesthesiologists' views on airway algorithms. Anaesthesiologists working in three hospitals were included. Individual face-to-face interviews were conducted...
January 4, 2018: Upsala Journal of Medical Sciences
https://www.readbyqxmd.com/read/29295777/hereditary-haemorrhagic-telangiectasia-in-pregnancy-regional-and-general-anaesthesia
#12
M Crawford, R Burns, S Cooper, T Mackay
Hereditary haemorrhagic telangiectasia, also known as Osler-Weber-Rendu disease, is a rare autosomal dominant multisystem disorder, characterised by mucocutaneous telangiectases and arteriovenous malformations affecting any organ. The physiological changes in pregnancy pose significant obstetric and anaesthetic challenges for women affected by the disease. The optimal timing and mode of delivery requires careful consideration; and the benefits and risks of both regional and general anaesthetic techniques must be carefully considered, depending on the organs affected...
November 13, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29286529/unanticipated-difficult-airway-management-in-children-the-consensus-statement-of-the-paediatric-anaesthesiology-and-intensive-care-section-and-the-airway-management-section-of-the-polish-society-of-anaesthesiology-and-intensive-therapy-and-the-polish-so
#13
Wojciech Walas, Dawid Aleksandrowicz, Maria Borszewska-Kornacka, Tomasz Gaszyński, Ewa Helwich, Marek Migdał, Andrzej Piotrowski, Grażyna Siejka, Tomasz Szczapa, Alicja Bartkowska-Śniatkowska
Tracheal intubation may be defined as an artificial airway established in order to provide mechanical ventilation of the lungs during surgical procedures under general anaesthesia, treatment in an intensive care unit, as well as in emergency situations. Difficulties encountered during intubation may cause hypoxia, hypoxic brain injury and, in extreme situations, may result in the patient's death. There may be unanticipated and anticipated difficult airway. Children form a specific group of patients as there are significant differences in both anatomy and physiology...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29284856/proseal-laryngeal-mask-airway-versus-cuffed-endotracheal-tube-for-laparoscopic-surgical-procedures-under-general-anesthesia-a-random-comparative-study
#14
Suchita Shailesh Parikh, Shivam Bipin Parekh, Chaula Doshi, Varsha Vyas
Context: The Proseal LMA(PLMA), which has been designed especially for positive pressure ventilation and protection against aspiration can act as an alternative to Endotracheal Tube (ETT) as an effective airway device for patients undergoing elective Laparoscopic surgeries. Aims: To compare the efficacy and safety of PLMA with ETT in patients undergoing Laparoscopic surgeries under general anaesthesia. Settings and Design: A prospective, randomized study was conducted in a tertiary care teaching hospital with 60 patients of ASA grade I/II undergoing elective Laparoscopic surgery under general anaesthesia...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284075/atraumatic-restorative-treatment-versus-conventional-restorative-treatment-for-managing-dental-caries
#15
REVIEW
Mojtaba Dorri, Maria José Martinez-Zapata, Tanya Walsh, Valeria Cc Marinho, Aubrey Sheiham Deceased, Carlos Zaror
BACKGROUND: Dental caries is a sugar-dependent disease that damages tooth structure and, due to loss of mineral components, may eventually lead to cavitation. Dental caries is the most prevalent disease worldwide and is considered the most important burden of oral health. Conventional treatment methods (drill and fill) involve the use of rotary burs under local anaesthesia. The need for an electricity supply, expensive handpieces and highly trained dental health personnel may limit access to dental treatment, especially in underdeveloped regions...
December 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29249272/successful-spinal-anaesthesia-in-a-patient-with-a-tarlov-cyst
#16
N Pfund, A Oh, A Cyna
Perineural (Tarlov) cysts are cerebrospinal fluid-containing perineural sacs that are usually located in the sacral spine. While often asymptomatic, they can cause progressive neurological symptoms including pain, paraesthesia and weakness. We present a case of a 24-year-old patient who had uneventful spinal anaesthesia at the L3-4 level for an elective caesarean section. Prior to her procedure, she had reported a two-year history of intermittent back pain and lower-limb paraesthesia, secondary to an S1 segment perineural cyst...
December 14, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29242749/setting-the-research-and-implementation-agenda-for-equitable-access-to-surgical-care-in-south-africa
#17
REVIEW
Sarah Rayne, Sule Burger, Stephanie Van Straten, Bruce Biccard, Mathume Joseph Phaahla, Martin Smith
South Africa is an upper-middle-income country with widespread social and geographical inequality of surgical provision. The National Forum on Surgery and Anaesthesia in South Africa brought together various stakeholders, including government, societies, academic clinicians and the biomedical industry, to define the core strategy for a national surgical plan. During the forum, presentations and breakaway workshops explored and reported the challenges and opportunities these stakeholders may have in sustaining and improving surgical provision in South Africa...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29242655/evaluation-of-the-role-of-dexmedetomidine-in-improvement-of-the-analgesic-profile-of-thoracic-paravertebral-block-in-thoracic-surgeries-a-randomised-prospective-clinical-trial
#18
Mohamed Elsayed Hassan, Essam Mahran
Background and Aims: Thoracic paravertebral block (TPB) is one of the effective methods for management of post-operative pain in thoracic surgeries. The aim of the study was to evaluate effectiveness of addition of dexmedetomidine to paravertebral block with bupivacaine in improving the postoperative pain relief and pulmonary functions in patients undergoing thoracic surgeries. Methods: A prospective randomized double-blinded study was performed on forty patients scheduled for thoracic surgery...
October 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29238683/flexible-laryngoscopy-in-management-of-congenital-stridor
#19
Prasanna Kumar Saravanam, Vinoth Manimaran
The incidence of congenital stridor is on rise due to improved neonate and infant survival rate. The gold standard investigation for evaluation of stridor is rigid laryngotracheobronchoscopy, but this is invasive and requires general anesthesia. Flexible fibreoptic laryngoscopy, a relatively simple and less invasive procedure can be done under topical anaesthesia for evaluation of stridor. In this study, we have presented our experience of flexible laryngoscopy in children with congenital stridor, their results and management...
December 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/29238673/sialendoscopic-approach-in-management-of-juvenile-recurrent-parotitis
#20
P P Singh, M Goyal, A Goyal
To assess the role of sialendoscopy as a diagnostic and therapeutic modality in juvenile recurrent parotitis. Juvenile recurrent parotitis (JRP) is the second most frequent salivary gland disease in childhood and is characterized by recurrent non suppurative and non obstructive parotid inflammation. These attacks influence the quality of life and can even lead to gland destruction, and there are no definitive treatment to avoid them. Sialendoscopic dilatation is emerging as the new treatment modality in this aspect...
December 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
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