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https://www.readbyqxmd.com/read/29050059/-ambulant-anesthesia-organization-in-medical-practices-and-hospitals
#1
Frank Vescia, Harald Hofer
Legislation, regulations and rules must be complied with when conducting ambulant surgeries and administering ambulant anesthesia. Additionally, there are social welfare legislation and regulations, as well as technical guidelines and standards that must be complied with, for instance, regarding the management of medical products or the disposal of waste and sewage in medical practices. At a country level, many of these regulatory areas are managed differently by each German state, and in some instances management differs significantly from one state to another...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29049457/association-of-patient-frailty-with-increased-morbidity-after-common-ambulatory-general-surgery-operations
#2
Carolyn D Seib, Holly Rochefort, Kathryn Chomsky-Higgins, Jessica E Gosnell, Insoo Suh, Wen T Shen, Quan-Yang Duh, Emily Finlayson
Importance: Frailty is a measure of decreased physiological reserve that is associated with morbidity and mortality in major elective and emergency general surgery operations, independent of chronological age. To date, the association of frailty with outcomes in ambulatory general surgery has not been established. Objective: To determine the association between frailty and perioperative morbidity in patients undergoing ambulatory general surgery operations. Design, Setting, and Participants: A retrospective cohort study was conducted of 140 828 patients older than 40 years of age from the 2007-2010 American College of Surgeons National Surgical Quality Improvement Program Participant Use File who underwent ambulatory and 23-hour-stay hernia, breast, thyroid, or parathyroid surgery...
October 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29049230/goniosynechialysis-combined-with-cataract-extraction-for-iridoschisis-a-case-report
#3
Zhipeng You, Yan Qin, Guodong Li, Ke Shi
RATIONALE: Iridoschisis is a rare eye disease. In this case report, we described the examination and diagnosis of a case of iridoschisis accompanied by secondary glaucoma. We also observed the effects of treating the patient with a combination of goniosynechialysis and cataract removal. PATIENT CONCERN: A 67-year-old female patient presented with decreased vision in both eyes. An eye examination indicated that visual acuities (VAs) were 20/100 and light perception in the right and left eyes, respectively...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29046933/-regional-anesthesia-are-the-standards-changing
#4
REVIEW
T Volk, C Kubulus
Regional anesthesia has undergone many changes over the years and the increasing use of ultrasound has certainly played an important role in this. Apart from individual case reports in the literature of very different blocking options, some new procedures seem to have become established and can be broadly applied. Among these are blockades, by which ultrasound-guided injection of local anesthetics is carried out in fascial or muscular layers rather than around target nerves (e.g. cervical plexus blocks and truncal blocks)...
October 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29044711/the-surgical-anatomy-of-the-sural-nerve-an-ultrasound-study
#5
Patrick Popieluszko, Ewa Mizia, Brandon Michael Henry, Przemysław A Pękala, Beatrice Sanna, Joyeeta Roy, Marios Loukas, Krzysztof A Tomaszewski
PURPOSE: The aim of this study was (a) to examine the anatomy of the sural nerve (SN) in a sample of ______ patients and (b) to analyze the incidence of different origins of the SN, and the distance of the SN from planned arthroscopic portals. METHODS: An ultrasound (USG) examination of the SN was performed bilaterally on thirty healthy patients with no history of surgery or trauma of the lower limb. The SNs were classified into six main types of pattern, with an additional category for new and unclassified types...
October 17, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/29044064/utility-of-angiotensin-converting-enzyme-activity-in-aqueous-humor-in-the-diagnosis-of-ocular-sarcoidosis
#6
Violeta Mihailovic-Vucinic, Ljubica Popevic, Spasoje Popevic, Mihailo Stjepanovic, Andjelka Aleksic, Anka Stanojevic-Paovic
PURPOSE: Many studies include elevated activity of angiotensin-converting enzyme (ACE) in serum in sarcoidosis and in ocular sarcoidosis as well, but there are only a few analyzing ACE activities in aqueous humor. The aim of this study is to illuminate the diagnostic value of ACE in aqueous humor in patients with ocular sarcoidosis. METHODS: We analyzed twenty patients with ocular sarcoidosis and 18 patients with nonocular involvement. All patients have biopsy-positive sarcoidosis of the lungs and/or mediastinal lymph nodes...
October 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29043507/extraction-of-mandibular-premolars-and-molars-comparison-between-local-infiltration-via-pressure-syringe-and-inferior-alveolar-nerve-block-anesthesia
#7
Daniel G E Thiem, Florian Schnaith, Caroline M E Van Aken, Anne Köntges, Vinay V Kumar, Bilal Al-Nawas, Peer W Kämmerer
OBJECTIVES: The purpose of this study was to evaluate the anesthetic efficiency of local infiltration anesthesia administered with a pressure syringe (P-INF) via a special technique versus direct block anesthesia of the inferior alveolar nerve (IANB) for tooth extraction in the posterior mandible. MATERIALS AND METHODS: In a prospective randomized study, 101 teeth in 101 patients were extracted in the posterior mandible under local anesthesia whereby two different administration techniques were used (P-INF n = 48; IANB n = 53)...
October 17, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29042744/palatal-perforation-a-rare-complication-of-postanesthetic-necrosis
#8
Vidisha Gargi, Ravi Prakash Sasankoti Mohan, Nagaraju Kamarthi, Swati Gupta
The everyday practice of dentistry relies heavily on achieving adequate local anesthesia. Even though the safety record of local anesthetic agents is high, complications do occur. Palate is a favorable site for soft-tissue lesions. Various factors such as direct effects of the drug, blanching of the tissues during injection, relatively poor blood supply, and reactivation of the latent forms of herpes can all promote to tissue ischemia and a lesion in the palate. Among various complications, anesthetic necrotic ulcer is a rare and uncommon condition occurring mostly in the hard palate possibly after a local anesthetic infiltration...
July 2017: Contemporary Clinical Dentistry
https://www.readbyqxmd.com/read/29042718/are-local-anesthesia-vials-similar-to-champagne-do-they-lose-their-potency-once-opened-an-in-vitro-study
#9
P S Gopinath Thilak, Sameep S Shetty, Jagadeesh Chandra, Kavana Gowda
BACKGROUND AND OBJECTIVES: Epinephrine is volatile and unstable on exposure to air. Addition of sodium metabisulfite as an antioxidant has been effective, but there are no clear-cut consensus on its efficiency in retarding the oxidation that sets in once the anesthetic vials are kept open with a needle in situ. There is a paucity of scientific data regarding the risks of reuse of anesthetic vials following the use of cartridges, a common practice in western countries. It is our endeavor to shed light on the constant change in pH, drug deterioration, and instability that sets in an anesthetic vial with a needle in situ...
July 2017: Contemporary Clinical Dentistry
https://www.readbyqxmd.com/read/29042063/-pharmacokinetic-and-clinical-effects-of-two-bupivacaine-concentrations-on-axillary-brachial-plexus-block
#10
Leonardo H C Ferraro, Alexandre Takeda, Cleber N Barreto, Bernadete Faria, Nilson A Assunção
INTRODUCTION: The risk of systemic bupivacaine toxicity is a persistent problem, which makes its pharmacokinetic study fundamental for regional anesthesia safety. There is little evidence of its influence on plasma peak at different concentrations. The present study compares two bupivacaine concentrations to establish how the concentration affects this drug plasma peak in axillary brachial plexus block. Postoperative latency and analgesia were also compared. METHODS: 30 patients were randomized...
October 14, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29039144/transoral-endoscopic-thyroidectomy-via-a-vestibular-approach-why-and-how
#11
Gianlorenzo Dionigi, Young Jun Chai, Ralph P Tufano, Angkoon Anuwong, Hoon Yub Kim
The transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a novel, scar-free surgical procedure that does not require visible incisions. Indications for TOETVA are as follows: predicted gland width on diagnostic imaging ≤10 cm; a thyroid volume outline of <45 mL or dominant nodule dimension of ≤50 mm; three or four Bethesda lesions; a primary papillary microcarcinoma without local or distant metastasis; and patient request for optimal esthetic results. Contraindications are as follows: patients unfit for general anesthesia; precedent radiation in the head, neck, upper mediastinum; antecedent neck surgery; recurrent goiter; a gland volume of >45 mL or main nodule diameter of >50 mm; and documentation of lymph node or distant metastases, tracheal/esophageal infiltration, preoperative laryngeal nerve palsy, hyperthyroidism, mediastinal goiter, or an oral abscess...
October 16, 2017: Endocrine
https://www.readbyqxmd.com/read/29038635/pleomorphic-adenoma-of-soft-palate-unusual-occurrence-of-the-major-tumor-in-minor-salivary-gland-a-case-report-and-literature-review
#12
Deepak Passi, Hari Ram, Shubha Ranjan Dutta, Laxman Revansidha Malkunje
Salivary gland tumours constitute about less than 4 % of all head and neck tumours. Pleomorphic adenoma, also called benign mixed tumour, is the most common tumour of the salivary glands. About 80-90 % of these tumours occur in the major salivary glands mainly parotid gland and 10 % of them occur in the minor salivary glands. The most common site for pleomorphic adenoma of the minor salivary glands is the palate, followed by the lips and the cheeks. Other rare sites include the floor of the mouth, tongue, tonsil, pharynx, retromolar area and the nasal cavity...
December 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/29037659/the-accuracy-of-wide-field-ultrasound-biomicroscopy-in-localizing-extraocular-rectus-muscle-insertions-in-strabismus-reoperations
#13
Arash Mirmohammadsadeghi, Vahideh Manuchehri, Mohammad Reza Akbari
PURPOSE: To compare the accuracy of widefield ultrasound biomicroscopy (UBM) with mechanical intraoperative measurements of the distance between rectus muscle insertions and the corneal limbus in strabismus reoperations. METHODS: Subjects with a history of horizontal rectus muscle surgery who required further surgery on horizontal rectus muscle(s) were recruited prospectively. All widefield UBM measurements were carried out under topical anesthesia using a 50 MHz linear probe without immersion cup and external caliper...
October 13, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/29037478/five-hundred-seventy-six-cases-of-video-assisted-thoracic-surgery-utilizing-local-anesthesia-and-sedation-lessons-learned
#14
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/29036005/in-office-sutureless-correction-of-prolapsed-subconjunctival-orbital-fat
#15
Eva Raparia, Leon Rafailov, Roman Shinder
PURPOSE: To describe a minimally invasive, sutureless, small incision surgical technique for the treatment of subconjunctival orbital fat prolapse (SOFP) performed using local anesthesia in an office setting. METHODS: Retrospective study of the surgical outcome of 45 patients with either bilateral or unilateral SOFP treated by a single surgeon (R.S.) between July 2010 and February 2015. RESULTS: Forty-five patients (39 male, 6 female) had a mean age of 67 years...
October 10, 2017: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29034961/a-randomized-trial-of-automated-intermittent-ropivacaine-administration-vs-continuous-infusion-in-an-interscalene-catheter
#16
J Oxlund, A H Clausen, S Venø, M D Nielsen, M Pall, T Strøm, P Toft
BACKGROUND: Ultrasound-guided interscalene nerve block with ropivacaine as local anesthetic agent given as boluses or continuous infusion is the preferred pain management after major shoulder surgery. The use of automated intermittent boluses has been shown to be superior to continuous infusion in sciatic and epidural nerve block. HYPOTHESIS: Automated intermittent boluses reduce pain after major shoulder surgery. METHODS: Seventy patients aged 18-75 years, scheduled for major shoulder surgery under general anesthesia with interscalene nerve block were included in this randomized controlled trial...
October 16, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29034443/prospective-clinical-study-comparing-intraligamentary-anesthesia-and-inferior-alveolar-nerve-block-for-extraction-of-posterior-mandibular-teeth
#17
P W Kämmerer, A Adubae, I Buttchereit, D G E Thiem, M Daubländer, B Frerich
OBJECTIVES: The aim of the study was to compare the efficacy of intraligamentary anesthesia (ILA) with conventional inferior alveolar nerve block (IANB) for extraction of mandibular posterior teeth. MATERIALS AND METHODS: In a prospective clinical trial, a total of 301 mandibular posterior teeth were extracted in 266 patients. Randomization was conducted into those who received ILA (patients n = 98; teeth n = 105) and those who received IANB (patient n = 140; teeth n = 140)...
October 15, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29033727/ultrasound-assessment-of-cranial-spread-during-caudal-blockade-in-children-effect-of-different-volumes-of-local-anesthetic
#18
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
#19
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
https://www.readbyqxmd.com/read/29033722/effect-of-intravenous-phenylephrine-infusion-on-dose-requirement-of-intrathecal-plain-levobupivacaine-for-cesarean-section-a-placebo-controlled-preliminary-study
#20
Asha Tyagi, Aanchal Kakkar, Namrata Niwal, Medha Mohta, Ashok Kumar Sethi
BACKGROUND: Phenylephrine infusion has been shown to decrease rostral spread of plain and hyperbaric local anesthetic (LA) when compared to ephedrine infusion. However, it does not result in higher dose requirement of hyperbaric LA for cesarean section. There is no trial evaluating the effect of phenylephrine infusion on ED50 of a plain intrathecal LA. METHODS: Pregnant patients with term uncomplicated singleton pregnancy undergoing elective cesarean section were given combined spinal-epidural anesthesia...
October 2017: Saudi Journal of Anaesthesia
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