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https://www.readbyqxmd.com/read/28346035/one-needle-is-better-than-two-the-philosophy-surrounding-use-of-local-anesthesia-in-northern-india
#1
Maria Story
The author, an internal medicine resident in the United States, participated in an international elective through her postgraduate training program in a rural hospital in northern India. While performing a thoracentesis, she notes that local anesthesia has not been administered, which is seemingly the standard of care at this hospital. Several questionnaire studies about pain services and pain management in India are reviewed, and they reveal insights and severe limitations to effective management of hospitalized patients' pain...
March 27, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28345802/the-association-between-caudal-anesthesia-and-increased-risk-of-postoperative-surgical-complications-in-boys-undergoing-hypospadias-repair
#2
Brad M Taicher, Jonathan C Routh, John B Eck, Sherry S Ross, John S Wiener, Allison K Ross
INTRODUCTION: Recent reports have suggested that caudal anesthesia may be associated with an increased risk of postoperative surgical complications. We examined our experience with caudal anesthesia in hypospadias repair to evaluate for increased risk of urethrocutaneous fistula or glanular dehiscence. METHODS: All hypospadias repairs performed by a single surgeon in 2001-2014 were reviewed. Staged or revision surgeries were excluded. Patient age, weight, hypospadias severity, surgery duration, month and year of surgery, caudal anesthesia use, and postoperative complications were recorded...
March 27, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28345075/ultrasonographic-detection-of-airway-obstruction-in-a-model-of-obstructive-sleep-apnea
#3
Amal Isaiah, Reuben Mezrich, Jeffrey Wolf
Purpose Obstructive sleep apnea (OSA) is a common clinical disorder characterized by repetitive airway obstruction during sleep. The gold standard for diagnosis of OSA, polysomnogram (PSG), cannot anatomically localize obstruction. Precise identification of obstruction has potential to improve outcomes following surgery. Current diagnostic modalities that provide this information require anesthesia, involve ionizing radiation or disrupt sleep. To mitigate these problems, we conceived that ultrasound (US) technology may be adapted (i) to detect, quantify and localize airway obstruction and (ii) for translational application to home-based testing for OSA...
February 2017: Ultrasound International Open
https://www.readbyqxmd.com/read/28344949/the-effect-of-anesthesia-on-the-ventilatory-functions-of-patients-with-maxillo-mandibular-fixation
#4
B I Akhiwu, H O Akhiwu, B D Saheeb, M M Habeeb
BACKGROUND: Maxillo-mandibular fixation (MMF) is a procedure still routinely practiced in developing countries. AIM: To determine the variations in pulmonary functions readings between cases treated under general anesthesia (GA) and those treated under local anesthesia (LA). METHODOLOGY: A descriptive hospital-based study of 106 patients was carried out from January 2011- December 2012. Information was obtained using a questionnaire and all study subjects had their baseline lung functions and their post-operative daily lung function parameters measured for the first week and then weekly for the next five weeks...
April 2016: Journal of the West African College of Surgeons
https://www.readbyqxmd.com/read/28344528/surgical-approach-and-anesthetic-modality-for-carpal-tunnel-release-a-nationwide-database-study-with-health-care-cost-implications
#5
Brock D Foster, Lakshmanan Sivasundaram, Nathanael Heckmann, Jeremiah R Cohen, William C Pannell, Jeffrey C Wang, Alidad Ghiassi
Background: Carpal tunnel release (CTR) is commonly performed for carpal tunnel syndrome once conservative treatment has failed. Operative technique and anesthetic modality vary by surgeon preference and patient factors. However, CTR practices and anesthetic trends have, to date, not been described on a nationwide scale in the United States. Methods: The PearlDiver Patient Records Database was used to search Current Procedural Terminology codes for elective CTR from 2007 to 2011. Anesthetic modality (eg, general and regional anesthesia vs local anesthesia) and surgical approach (eg, endoscopic vs open) were recorded for this patient population...
March 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28344180/benefit-and-complications-of-frame-based-stereotactic-biopsy-in-old-and-very-old-patients
#6
Johanna Quick-Weller, Julia Tichy, Nazife Dinc, Stephanie Tritt, Sae-Yeon Won, Bedjan Behmanesh, Markus Bruder, Volker Seifert, Lutz Weise, Gerhard Marquardt
OBJECTIVE: Stereotactic biopsy is an everyday procedure implemented in numerous neurosurgical departments. The procedure is performed in order to obtain tumor tissue of unclear diagnosis. Going in hand with low complication rates and high diagnostic yield, stereotactic biopsies can be performed in adults and children likewise for histopathological evaluation of lesions in eloquent localizations. Little is known, however, whether aged patients do benefit from stereotactic biopsy or rather the therapy that is derived from histopathological results...
March 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28341956/improvement-on-the-neo-umbilicoplasty-technique-and-review-of-the-literature
#7
Valderi Vieira da Silva Júnior, Francis Régis Soares de Sousa
INTRODUCTION: The umbilicus is an important component of body esthetics, and its absence or dysmorphia may give rise to psychological discomfort, making it a common concern in surgical planning. Many techniques of umbilicus reconstruction have been proposed, each with its own limitations in terms of esthetics, risk of stenosis or final positioning. Reconstruction techniques may involve skin grafting, cartilage, purse-string suture and flaps. One of the most promising approaches is scarless neo-umbilicoplasty...
March 24, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28341953/giant-rhinophyma-a-rare-case-of-total-nasal-obstruction-and-restitutio-ad-integrum
#8
Andreas Wolter, Till Scholz, Jutta Liebau
Rhinophyma is considered the end stage in the development of rosacea, accompanied by hypertrophy of the sebaceous glands, which causes an enlargement of the nose. It is an uncommon condition that often results in both functional and cosmetic impairment. A large variety of surgical and nonsurgical treatments have been published to treat it. Closure is usually obtained by wound granulating in by secondary intention, skin grafting or local flaps. Rarely these lesions can attain a giant size and pose a challenge in surgical treatment...
March 24, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28340389/minilaparotomy-without-general-anesthesia-for-the-treatment-of-sigmoid-volvulus-in-high-risk-patients-a-case-series-of-4-patients
#9
Ernesto L Enrique, Kareem A Hamdy
BACKGROUND: Sigmoid volvulus (SV) is a common cause of large bowel obstruction worldwide. Presenting symptoms can be nonspecific and varied amongst the elderly population, making medical and surgical management challenging. This population is at markedly increase risk of complications and mortality with surgery under general anesthesia. In this case series, we describe 4 cases of sigmoid volvulus in octogenarians. GOALS: To demonstrate that sigmoid colectomy under local anesthesia, with or without intravenous conscious sedation, is feasible and can be done safely and with a low rate of converting to a general anesthetic...
March 2, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28336421/percutaneous-planter-fasciitis-release-under-local-anesthesia-a-prospective-study
#10
Ramji Lal Sahu
PURPOSE: Plantar fasciitis is the most common cause of pain on the bottom of the heel. It occurs when the strong band of the tissue supporting the arch of foot becomes irritated and inflamed. The majority of patients can be treated conservatively but some resistant cases need surgery eventually. This study aims to evaluate the outcome results of percutaneous planter fascia release under local anesthesia for chronic planter fasciitis. METHODS: This prospective study was conducted in the Department of Orthopaedic Surgery in the School of Medical Science and Research, Sharda University, India from December 2010 to December 2013...
February 24, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28333776/transcanal-endoscopic-ear-surgery-for-middle-ear-cholesteatoma
#11
Eran Glikson, Ruth Yousovich, Jobran Mansour, Michael Wolf, Lela Migirov, Yisgav Shapira
OBJECTIVE: To evaluate the clinical parameters, outcomes, and complications of transcanal endoscopic ear surgeries for middle ear cholesteatoma. STUDY DESIGN: Retrospective study. SETTING: Tertiary university-affiliated medical center. PATIENTS: Adult patients (age >18) who underwent transcanal endoscopic ear surgeries for cholesteatoma, between March 2009 and March 2015. INTERVENTION: Transcanal endoscopic surgery was indicated when the cholesteatoma did not extend posterior to the anterior limb of the lateral semicircular canal...
March 22, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28333299/bilateral-breast-reduction-without-opioid-analgesics-a-comparative-study
#12
Fereydoun Don Parsa, Justin Cheng, Brad Stephan, Nikki Castel, Leslie Kim, Daniel Murariu, Alan A Parsa
Background: Breast reduction has traditionally been performed under general anesthesia with adjunct opioid use. However, opioids are associated with a wide variety of adverse effects, including nausea, vomiting, constipation, postoperative sedation, dizziness, and addiction. Objectives: This study compares bilateral breast reduction using a multimodal opioid-free pain management regimen vs traditional general anesthesia with adjunct opioids. Methods: A total of 83 female patients were enrolled in this study...
March 3, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28330928/surgery-for-cancer-a-trigger-for-metastases
#13
REVIEW
Samer Tohme, Richard L Simmons, Allan Tsung
Surgery is a crucial intervention and provides a chance of cure for patients with cancer. The perioperative period is characterized by an increased risk for accelerated growth of micrometastatic disease and increased formation of new metastatic foci. The true impact for cancer patients remains unclear. This review summarizes the often fragmentary clinical and experimental evidence supporting the role of surgery and inflammation as potential triggers for disease recurrence. Surgery induces increased shedding of cancer cells into the circulation, suppresses antitumor immunity allowing circulating cells to survive, upregulates adhesion molecules in target organs, recruits immune cells capable of entrapping tumor cells, and induces changes in the target tissue and in the cancer cells themselves to enhance migration and invasion to establish at the target site...
March 22, 2017: Cancer Research
https://www.readbyqxmd.com/read/28328759/topical-ropivacaine-in-prevention-of-post-tonsillectomy-pain-in-adults
#14
Hanna Kaisa Tolska, Annika Takala, Karin Blomgren, Katri Hamunen, Vesa Kontinen
BACKGROUND: Post-tonsillectomy pain is 1 of the most intense postoperative pain conditions. However, optimal and sufficient postoperative analgesic treatment remains unclear. We investigated the effect of topical ropivacaine for post-tonsillectomy pain in 160 adult outpatient surgery patients over 2 postoperative weeks. METHODS: At the end of tonsillectomy, 2 swabs soaked in either 1% ropivacaine or saline were packed into the tonsillar beds for 5 minutes. We used ibuprofen and a combination of acetaminophen (500 mg)-codeine (30 mg) tablets as postoperative analgesics for 2 weeks...
March 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28328609/evaluation-of-dentoalveolar-trauma-in-children-and-adolescents-a-modified-classification-system-and-surgical-treatment-strategies-for-its-management
#15
Nadia Theologie-Lygidakis, Ourania K Schoinohoriti, Minas Leventis, Ioannis Iatrou
OBJECTIVE: To retrospectively analyze dentoalveolar trauma in pediatric patients, propose a modified classification, and delineate an approach for its urgent care from the surgeon's perspective. PATIENTS AND METHODS: Clinical records of patients, attended at the 'A. and P. Kyriakou' Children's Hospital Department of Oral and Maxillofacial Surgery from 2000 to 2015, were retrieved and data were analyzed. RESULTS: A total of 365 cases of dentoalveolar trauma, affecting 363 children and adolescents (221 males and 142 females), with an age range from 1 to 15 years, were treated in the authors' department...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28327261/sex-differences-in-pediatric-dental-pain-perception
#16
Gabriela F Almeida, Daniele L Longo, Mariana Trevizan, Fabrício K de Carvalho, Paulo Nelson-Filho, Erika C Küchler, Alexandra M Queiroz
PURPOSE: To evaluate sex-related differences in dental pain perception in children. METHODS: Fifty-two children who received a dental procedure with local anesthesia were selected to participate. Pain perception levels were assessed with the Wong-Baker FACES Pain Rating Scale. Twenty-four and 48 hours following the procedure, the parents were contacted by phone for a verbal survey to assess their child's postoperative pain. Age, type of dental procedure, and behavior were also evaluated as covariables...
September 15, 2016: Journal of Dentistry for Children
https://www.readbyqxmd.com/read/28325432/wide-awake-ultrasound-guided-percutaneous-extensor-central-slip-tenotomy-for-chronic-mallet-finger-a-prospective-study-of-14-cases-with-videos
#17
T Apard, G Candelier
The central slip tenotomy described by Fowler is an effective option for treating chronic mallet finger in order to avoid swan neck deformity of the finger. In a prospective study of 14 cases (13 failures of conservative treatment and one case of untreated mallet finger), we performed percutaneous ultrasound-guided central slip tenotomy with a 19 G needle using the wide-awake local anesthesia and no tourniquet (WALANT) technique. The mean extensor lag before surgery was 28° (range 20°-40°) and three patients had a swan neck deformity...
April 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28323191/the-feasibility-and-safety-of-separate-carotid-artery-stenting-using-the-restrict-protective-method-for-bilateral-carotid-stenosis
#18
Tomotaka Ohshima, Ishu Bishnori, Kojiro Ishikawa, Shunsaku Goto, Taiki Yamamoto, Yoko Kato
BACKGROUND: and Purpose: The treatment strategy for bilateral carotid stenosis (BCS) is not clear. We report our experience of treating 12 patients with BCS using separate carotid artery stenting (CAS) using the restrict protective method. The order of treatment site and the protective method are also discussed. MATERIALS AND METHODS: Between April 2012 and November 2016, 24 lesions in 12 patients (range, 44-83 years; mean, 71 years; 1 woman) underwent CAS at Kariya Toyota General Hospital...
March 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28321983/chloroprocaine-for-epidural-anesthesia-in-infants-and-children
#19
REVIEW
Giorgio Veneziano, Joseph D Tobias
Continuous epidural infusions are an effective and safe method of providing anesthesia and postoperative analgesia in infants and children with multiple advantages over systemic medications, including earlier tracheal extubation, decreased perioperative stress response, earlier return of bowel function, and decreased exposure to volatile anesthetic agents with uncertain long-term neurocognitive effects. Despite these benefits, local anesthetic toxicity remains a concern in neonates and infants because of their decreased metabolic capacity for amide local anesthetics...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28321842/cutaneous-surgery-under-local-anesthesia-in-very-elderly-patients-90%C3%A2-years-of-age-and-older-is-as-safe-as-in-elderly-patients-ranging-in-age-from-75-to-80%C3%A2-years-old
#20
Taichi Imamura, Yasuhiro Nakamura, Ryota Tanaka, Yukiko Teramoto, Yuri Asami, Hiroshi Maruyama, Yasuhiro Fujisawa, Manabu Fujimoto, Akifumi Yamamoto
BACKGROUND: The number of very elderly patients who require surgery for cutaneous tumors is increasing. However, there is limited information on the safety of cutaneous surgery in such patients. METHODS: To evaluate the safety of cutaneous surgery in patients 90 years of age and older, we retrospectively reviewed the elderly patients who underwent surgery for cutaneous tumors under local anesthesia. Consecutive patients 90 years of age and older and 75-80 years old were included in the elderly group and the control group...
March 21, 2017: International Journal of Dermatology
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