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https://www.readbyqxmd.com/read/28319550/continuous-transversus-abdominis-plane-nerve-blocks-does-varying-local-anesthetic-delivery-method-automatic-repeated-bolus-versus-continuous-basal-infusion-influence-the-extent-of-sensation-to-cold-a-randomized-triple-masked-crossover-study-in-volunteers
#1
Bahareh Khatibi, Engy T Said, Jacklynn F Sztain, Amanda M Monahan, Rodney A Gabriel, Timothy J Furnish, Johnathan T Tran, Michael C Donohue, Brian M Ilfeld
BACKGROUND: It remains unknown whether continuous or scheduled intermittent bolus local anesthetic administration is preferable for transversus abdominis plane (TAP) catheters. We therefore tested the hypothesis that when using TAP catheters, providing local anesthetic in repeated bolus doses increases the cephalad-caudad cutaneous effects compared with a basal-only infusion. METHODS: Bilateral TAP catheters (posterior approach) were inserted in 24 healthy volunteers followed by ropivacaine 2 mg/mL administration for a total of 6 hours...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28213055/electrophysiological-measurements-that-can-explain-and-guide-temporary-accelerated-pacing-to-avert-re-occurrence-of-torsade-de-pointes-arrhythmias-in-the-canine-chronic-atrioventricular-block-model
#2
Sofieke C Wijers, Alexandre Bossu, Albert Dunnink, Jet D M Beekman, Rosanne Varkevisser, Alfonso Aranda Hernández, Mathias Meine, Marc A Vos
BACKGROUND: Pacing at higher rates is known to suppress torsade de pointes (TdP) arrhythmias. Nevertheless, exact application and mechanism need further clarification. In the anesthetized canine chronic atrioventricular block model, ventricular remodeling is responsible for a high and reproducible incidence of TdP upon a challenge with dofetilide. OBJECTIVE: We used this model to investigate by what mechanism accelerated pacing averts TdP and what repolarization parameter could be used to guide temporary accelerated pacing (TAP)...
February 14, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28144162/thoracic-epidural-catheter-for-postoperative-pain-control-following-an-ineffective-transversus-abdominis-plane-block-using-liposome-bupivacaine
#3
Brian D Terrien, David Espinoza, Charles C Stehman, Gabriel A Rodriguez, Nicholas C Connolly
A 24-year-old female with a history of ulcerative colitis underwent colectomy. The patient received an ineffective transversus abdominis plane (TAP) block with liposome bupivacaine (Exparel) intraoperatively and was started on a hydromorphone patient-controlled analgesia 5 hours after the TAP block, which did not relieve her pain. A continuous thoracic epidural (CTE) was then placed after blood levels of bupivacaine were drawn, and the patient immediately experienced significant pain relief. The combined use of liposome bupivacaine and bupivacaine CTE infusion in the postoperative management of this patient demonstrated no safety concerns, provided excellent analgesia and plasma concentrations of bupivacaine remained far below toxic levels...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28118232/transversus-abdominis-plane-block-and-free-flap-abdominal-tissue-breast-reconstruction-is-there-a-true-reduction-in-postoperative-narcotic-use
#4
Cedric Hunter, Afaaf Shakir, Arash Momeni, Anna Luan, Lauren Steffel, Jean-Louis Horn, Dung Nguyen, Gordon K Lee
INTRODUCTION: The use of the transversus abdominis plane (TAP) block is increasing in abdominally based autologous tissue breast reconstruction as a method to provide postoperative donor site analgesia. The purpose of this study was to evaluate the efficacy of the TAP block in the immediate postoperative period. METHODS: A retrospective analysis of all patients who underwent autologous microsurgical breast reconstruction over a 2-year period (2013-2015) was conducted...
March 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28072798/reliability-and-safety-of-contra-lateral-oblique-view-for-interlaminar-epidural-needle-placement
#5
Richard Derby, Irina Melnik, Jongwoo Choi, Sang-Hoon Lee, Jeong-Eun Lee
Cord trauma is a risk with a cervical and thoracic interlaminar epidural approach to the epidural space. Intermittent lateral fluoroscopic imaging to detect needle depth is often cumbersome and may be difficult to interpret. In comparison, the contra-lateral oblique (CLO) fluoroscopic view is efficient and easy to interpret. However, the in vivo reliability and safety of this technique has not been formally investigated.The senior author collected fluoroscopic images on 278 consecutive patients undergoing an interlaminar epidural block at the T1-T2 level performed using a 17 gauge Tuohy needle...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/27996199/chronic-postsurgical-pain-outcomes-in-breast-reconstruction-patients-receiving-perioperative-transversus-abdominis-plane-catheters-at-the-donor-site-a-prospective-cohort-follow-up-study
#6
Justin Oh, M Gabrielle Pagé, Toni Zhong, Stuart McCluskey, Coimbatore Srinivas, Anne C O'Neill, James Kahn, Joel Katz, Stefan O P Hofer, Hance Clarke
BACKGROUND: Chronic postsurgical pain (CPSP) is a debilitating and costly condition. Risk factors for CPSP after autologous breast reconstruction have not been clearly established. Previously, we demonstrated that transversus abdominis plane (TAP) catheters delivering intermittent local anesthetic reduced postoperative morphine consumption. This prospective follow-up study aimed to (1) compare the incidence of CPSP after autologous breast reconstruction between patients who received postoperative intermittent TAP catheters with bupivacaine or saline boluses and (2) assess the factors that contribute to the development and maintenance of CPSP in this study cohort...
December 20, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27956680/analgesic-efficacy-of-bilateral-continuous-transversus-abdominis-plane-blocks-using-an-oblique-subcostal-approach-in-patients-undergoing-laparotomy-for-gynaecological-cancer-a-prospective-randomized-triple-blind-placebo-controlled-study
#7
T Yoshida, K Furutani, Y Watanabe, N Ohashi, H Baba
BACKGROUND: The analgesic efficacy of continuous transversus abdominis plane (TAP) blocks in comparison with that of single-injection TAP blocks is not clear. This randomized, triple-blind, placebo-controlled trial investigated the benefits of adding continuous TAP blocks to single-injection TAP blocks after a laparotomy. METHODS: Eighty consecutive patients undergoing midline laparotomy for gynaecological cancer were randomized and received bilateral TAP infusions with either ropivacaine 0...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27919308/outbreak-of-pantoea-agglomerans-bloodstream-infections-at-an-oncology-clinic-illinois-2012-2013
#8
Brian R Yablon, Raymund Dantes, Victoria Tsai, Rachel Lim, Heather Moulton-Meissner, Matthew Arduino, Bette Jensen, Megan Toth Patel, Michael O Vernon, Yoran Grant-Greene, Demian Christiansen, Craig Conover, Alexander Kallen, Alice Y Guh
OBJECTIVE To determine the source of a healthcare-associated outbreak of Pantoea agglomerans bloodstream infections. DESIGN Epidemiologic investigation of the outbreak. SETTING Oncology clinic (clinic A). METHODS Cases were defined as Pantoea isolation from blood or catheter tip cultures of clinic A patients during July 2012-May 2013. Clinic A medical charts and laboratory records were reviewed; infection prevention practices and the facility's water system were evaluated. Environmental samples were collected for culture...
December 6, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27733219/ultrasound-guided-transversus-abdominis-plane-block-improves-postoperative-analgesia-and-early-recovery-in-patients-undergoing-retroperitoneoscopic-urologic-surgeries-a-randomized-controlled-double-blinded-trial-%C3%A2
#9
RANDOMIZED CONTROLLED TRIAL
Ge Qu, Xu-Lei Cui, Hong-Ju Liu, Zhi-Gang Ji, Yu-Guang Huang
<strong>Objective</strong> To evaluate the effects of ultrasound-guided transversus abdominis plane (TAP) block on postoperative analgesia and early recovery in patients undergoing retroperitoneoscopic urologic surgeries. <strong>Methods</strong> This was a randomized, controlled, double-blinded trial. Eligible patients scheduled for retroperitoneoscopic urologic surgeries were randomly assigned to two groups. Group TAP received ultrasound-guided TAP block with 0.5% ropivacaine 20 ml at 30 minutes before surgery, and Group C received TAP sham block with normal saline...
September 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/27684535/sensory-topography-of-oral-structures
#10
Shethal Bearelly, Steven W Cheung
Importance: Sensory function in the oral cavity and oropharynx is integral to effective deglutition and speech production. The main hurdle to evaluation of tactile consequences of upper aerodigestive tract diseases and treatments is access to a reliable clinical tool. We propose a rapid and reliable procedure to determine tactile thresholds using buckling monofilaments to advance care. Objective: To develop novel sensory testing monofilaments and map tactile thresholds of oral cavity and oropharyngeal structures...
January 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27589973/parylene-mems-patency-sensor-for-assessment-of-hydrocephalus-shunt-obstruction
#11
Brian J Kim, Willa Jin, Alexander Baldwin, Lawrence Yu, Eisha Christian, Mark D Krieger, J Gordon McComb, Ellis Meng
Neurosurgical ventricular shunts inserted to treat hydrocephalus experience a cumulative failure rate of 80 % over 12 years; obstruction is responsible for most failures with a majority occurring at the proximal catheter. Current diagnosis of shunt malfunction is imprecise and involves neuroimaging studies and shunt tapping, an invasive measurement of intracranial pressure and shunt patency. These patients often present emergently and a delay in care has dire consequences. A microelectromechanical systems (MEMS) patency sensor was developed to enable direct and quantitative tracking of shunt patency in order to detect proximal shunt occlusion prior to the development of clinical symptoms thereby avoiding delays in treatment...
October 2016: Biomedical Microdevices
https://www.readbyqxmd.com/read/27507582/transversus-abdominis-plane-block-or-intravenous-lignocaine-in-open-prostate-surgery-a-randomized-controlled-trial
#12
RANDOMIZED CONTROLLED TRIAL
I Maquoi, J L Joris, C Dresse, S Vandenbosch, I Venneman, J-F Brichant, G A Hans
BACKGROUND AND OBJECTIVES: Transversus abdominis plane block (TAP) and intravenous lignocaine are two analgesic techniques frequently used after abdominal surgery. We hypothesized that these two techniques improve post-operative analgesia after open prostate surgery and sought to compare their efficacy on immediate post-operative outcome after open prostate surgery. METHODS: After ethics committee approval, 101 patients were enrolled in this prospective study and randomly allocated to receive bilateral ultrasound-guided TAP (n = 34), intravenous lignocaine (n = 33) or placebo (n = 34)...
November 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27355866/awake-sedated-or-anaesthetised-for-regional-anaesthesia-block-placements-a-retrospective-registry-analysis-of-acute-complications-and-patient-satisfaction-in-adults
#13
Christine Kubulus, Kathrin Schmitt, Noemi Albert, Alexander Raddatz, Stefan Gräber, Paul Kessler, Thorsten Steinfeldt, Thomas Standl, André Gottschalk, Winfried Meissner, Stefan P Wirtz, Jürgen Birnbaum, Jan Stork, Thomas Volk, Hagen Bomberg
BACKGROUND: Whether adults should be awake, sedated or anaesthetised during establishment of regional anaesthesia is still debated and there is little information on the relative safety of each. In paediatric practice, there is often little choice but to use sedation or anaesthesia as otherwise the procedures would be too distressing and patient movement would be hazardous. OBJECTIVE(S): The objective of this study was to evaluate complications related to central and peripheral regional block and patient satisfaction in awake, sedated and anaesthetised adult patients...
October 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27338522/postoperative-analgesia-after-caesarean-section-with-transversus-abdominis-plane-block-or-continuous-infiltration-wound-catheter-a-randomized-clinical-trial-tap-vs-infiltration-after-caesarean-section
#14
RANDOMIZED CONTROLLED TRIAL
Fanny Klasen, Aurélie Bourgoin, François Antonini, Emma Dazeas, Florence Bretelle, Claude Martin, Karine Baumstarck, Marc Leone
OBJECTIVE: Single shot transversus abdominis plane (TAP) block and continuous local anesthetic infiltration wound catheter (CLAIWC) decreased the morphine consumption after caesarean section. The aim of this study was to compare the analgesic efficacy of CLAIWC and ultrasound-guided TAP block. METHOD: Sixty patients undergoing caesarean section were prospectively randomized. After the caesarean section, the postoperative analgesia was randomized to either a CLAIWC localized below the fascia with an elastomeric pump for 48hours or a bilateral ultrasound-guided TAP block with injection of ropivacaine...
December 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27185705/transversus-abdominis-plane-block-as-the-primary-anesthetic-for-peritoneal-dialysis-catheter-surgery
#15
Daryl S Henshaw, Matthew L Baker, Robert S Weller, Jon Wellington Reynolds, Jonathan Douglas Jaffe
STUDY OBJECTIVE: The primary goal of this study was to determine whether transversus abdominis plane (TAP) blocks were effective as the primary anesthetic technique for insertion and/or removal of peritoneal dialysis catheters. DESIGN: This study is a descriptive case series investigation. SETTING: Operating rooms at a tertiary care academic medical center. PATIENTS: Twenty-four patients, American Society of Anesthesiologists (ASA) physical status 3 and 4, were included in this study...
June 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27112311/pharmacokinetics-of-phenobarbital-in-microenema-via-macy-catheter-versus-suppository
#16
Y W Francis Lam, Ansom Lam, Brad Macy
CONTEXT: The oral route is compromised for nearly all patients approaching death. When agitation, seizures, or other intractable symptoms occur, a quick, discreet, comfortable, and effective alternate route for medication delivery that is easy to administer in the home setting is highly desirable. OBJECTIVES: To characterize the early absorption profile, variability, and comfort of phenobarbital given in microenema suspensions delivered via the Macy Catheter(®) (MC) vs...
June 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27088020/a-lethal-case-of-sphingomonas-paucimobilis-bacteremia-in-an-immunocompromised-patient
#17
Nata Pratama Hardjo Lugito, Cucunawangsih, Andree Kurniawan
Sphingomonas paucimobilis is a yellow-pigmented, glucose nonfermenting, aerobic, Gram negative bacillus of low pathogenicity. This organism was found in the implantation of indwelling catheters, sterile intravenous fluid, or contaminated hospital environment such as tap and distilled water, nebulizer, ventilator, and hemodialysis device. A 55-year-old female was hospitalized for diabetic foot ulcer in the presence of multiple comorbidities: diabetes mellitus, colonic tuberculosis, end-stage renal disease, and indwelling catheters for central venous catheter and hemodialysis...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27042909/diagnosis-and-treatment-of-idiopathic-normal-pressure-hydrocephalus
#18
REVIEW
Michael A Williams, Jan Malm
PURPOSE OF REVIEW: This article provides neurologists with a pragmatic approach to the diagnosis and treatment of idiopathic normal pressure hydrocephalus (iNPH), including an overview of: (1) key symptoms and examination and radiologic findings; (2) use of appropriate tests to determine the patient's likelihood of shunt responsiveness; (3) appropriate referral to tertiary centers with expertise in complex iNPH; and (4) the contribution of neurologists to the care of patients with iNPH following shunt surgery...
April 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27010421/ventriculoperitoneal-shunt-malfunction-caused-by-proximal-catheter-fat-obstruction
#19
Cezar José Mizrahi, Sergey Spektor, Emil Margolin, Yigal Shoshan, Eliel Ben-David, José E Cohen, Samuel Moscovici
Ventriculoperitoneal (VP) shunt placement is the mainstay of treatment for hydrocephalus, yet shunts remain vulnerable to a variety of complications. Although fat droplet migration into the subarachnoid space and cerebrospinal fluid pathways following craniotomy has been observed, a VP shunt obstruction with fat droplets has never been reported to our knowledge. We present the first reported case of VP shunt catheter obstruction by migratory fat droplets in a 55-year-old woman who underwent suboccipital craniotomy for removal of a metastatic tumor of the left medullocerebellar region, without fat harvesting...
August 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27005290/local-wound-infiltration-plus-transversus-abdominis-plane-tap-block-versus-local-wound-infiltration-in-laparoscopic-colorectal-surgery-and-eras-program
#20
Corrado Pedrazzani, Nicola Menestrina, Margherita Moro, Gianluca Brazzo, Guido Mantovani, Enrico Polati, Alfredo Guglielmi
BACKGROUND: Few data are available on TAP block in laparoscopic colorectal surgery and ERAS program. The aim of this prospective study was to evaluate local wound infiltration plus TAP block compared to local wound infiltration in the management of postoperative pain, nausea and vomiting, ileus and use of opioids in the context of laparoscopic colorectal surgery and ERAS program. METHODS: From March 2014 to March 2015, 48 patients were treated by laparoscopic resection and ERAS program for colorectal cancer and diverticular disease at the Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust...
November 2016: Surgical Endoscopy
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