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Anesthesia and consciousness

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https://www.readbyqxmd.com/read/29333775/-effect-of-dexmedetomidine-on-emergence-agitation-after-general-anesthesia-in-children-undergoing-odontotherapy-in-day-surgery-operating-room
#1
Luo Lin, Zhang Yueming, Li Meisheng, Wang Jiexue, Ji Yang
OBJECTIVE: To study the effectiveness of dexmedetomidine used for general anesthesia maintenance in children undergoing odontotherapy in day-surgery operating room in reducing the incidence of emergence agitation (EA). METHODS: Eighty children undergoing odontotherapy and under general anesthesia in day-surgery operating room were randomized into two groups, group A (n=40) and group B (n=40). Each patient in group A was administered with a bolus dose of dexmedetomidine (1...
December 1, 2017: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
https://www.readbyqxmd.com/read/29331574/a-medicare-cost-analysis-of-mri-versus-ct-based-high-dose-rate-brachytherapy-of-the-cervix-can-mri-based-planning-be-less-costly
#2
Amishi Bajaj, Grant Harmon, John Weaver, Brendan Martin, Michael Mysz, Murat Surucu, John C Roeske, Andre A Konski, William Small, Matthew M Harkenrider
PURPOSE: While some institutions deliver multiple fractions per implant for MRI-based planning, it is common for only one fraction to be delivered per implant with CT-based cervical brachytherapy. The purpose of this study was to compare physician costs, hospital costs, and overall costs for cervical cancer patients treated with either CT-based or MRI-based high-dose-rate (HDR) cervical brachytherapy to determine if MRI-based brachytherapy as described can be financially feasible. METHODS AND MATERIALS: We identified 40 consecutive patients treated with curative intent cervical brachytherapy...
January 10, 2018: Brachytherapy
https://www.readbyqxmd.com/read/29310828/-sedation-using-dexmedetomidine-and-remifentanil-with-local-anesthesia-for-intraoperative-speech-monitoring-a-case-report
#3
Leonardo Riedi de Andrade, Yara Marcondes Machado Castiglia
BACKGROUND AND OBJECTIVE: Some surgical procedures such as laryngoplasty require patients to remain conscious during the intraoperative phase in order to enable speech monitoring. Dexmedetomidine and remifentanil were used in this study, since they promote appropriate patient collaboration with facilitated awakening, and are rapidly eliminated. CASE REPORT: The patient complained of dysphonia, which had resulted from unilateral vocal fold paralysis after previous thyroidectomy...
January 5, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29306214/the-essence-of-the-first-2-5%C3%A2-h-in-the-treatment-of-generalized-convulsive-status-epilepticus
#4
Leena Kämppi, Harri Mustonen, Kaisa Kotisaari, Seppo Soinila
PURPOSE: This study was designed to find realistic cut-offs of the delays predicting outcome after generalized convulsive status epilepticus (GCSE) and serving protocol streamlining of GCSE patients. METHOD: This retrospective study includes all consecutive adult (>16 years) patients (N = 70) diagnosed with GCSE in Helsinki University Central Hospital emergency department over 2 years. We defined ten specific delay parameters in the management of GCSE and determined functional outcome and mortality at hospital discharge...
December 28, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29300003/effects-of-inhalation-anesthesia-vs-total-intravenous-anesthesia-tiva-vs-spinal-epidural-anesthesia-on-deep-vein-thrombosis-after-total-knee-arthroplasty
#5
Lu-Yang Zhou, Wei Gu, Yun Liu, Zheng-Liang Ma
BACKGROUND The objective of the present study was to evaluate the varying efficacy of general anesthesia (GA), combined spinal-epidural anesthesia (CSEA), and total intravenous anesthesia (TIVA) on the occurrence of deep vein thrombosis (DVT) following total knee arthroplasty (TKA). MATERIAL AND METHODS From July 2013 to May 2015, a total of 197 cases of patients who had undergone TKA treatment at either the Drum Tower Hospital or Nanjing General Hospital of Nanjing Military Command were recruited to participate in the study...
January 4, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29288749/enhanced-wakefulness-following-lesions-of-a-mesopontine-locus-essential-for-the-induction-of-general-anesthesia
#6
Sa'ar Lanir-Azaria, Guy Meiri, Tamir Avigdor, Anne Minert, Marshall Devor
The induction of general anesthesia shares many features with the transition from wakefulness to non-rapid eye movement (NREM) sleep, suggesting that the two types of brain-state transition are orchestrated by a common neuronal mechanism. Previous studies revealed a brainstem locus, the mesopontine tegmental anesthesia area (MPTA), that is of singular importance for anesthetic induction. Microinjection there of GABAergic anesthetics induces rapid loss-of-consciousness and lesions render the animal relatively insensitive to anesthetics administered systemically...
December 27, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/29284873/optimal-dose-of-dexmedetomidine-retrobulbar-anesthesia-during-phacoemulsification-cataract-surgery
#7
Ahmed Ahmed Nagy, Saber Hamed El-Sayd, Ahmed Abdelaziz Ahmed, Ghada Zin-Eldin Rajab
Background: The cataract surgery anesthesia should be to make the procedure as safe and as satisfactory as possible for all concerned. The recent progress in anesthesia and surgery now allow cataract extraction to be done with minimal physiological changes to the patient. We aimed in the study to compare between two different doses of dexmedetomidine combined with lidocaine and bupivacaine during retrobulbar anesthesia for cataract extraction by phacoemulsification. Materials and Methods: This study was done on forty patients with cataract...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29277298/a-pilot-analysis-of-the-association-between-types-of-monitored-anesthesia-care-drugs-and-outcomes-in-transfemoral-aortic-valve-replacement-performed-without-general-anesthesia
#8
Eric Y Chen, Nitin Sukumar, Feng Dai, Shamsuddin Akhtar, Robert B Schonberger
OBJECTIVE: The types of agents used for monitored anesthesia care (MAC) and their possible differential effects on outcomes have received less study despite increased use over general anesthesia (GA) in transfemoral aortic valve replacements (TAVRs). In this pilot analysis of patients undergoing TAVR using MAC, the authors described the anesthetic agents used and sought to investigate the possible association of anesthetic agent choice with outcomes and the extent to which total weight and time-adjusted doses of anesthetics declined with increasing 10-year age increments...
July 12, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29274102/effect-of-age-on-narcotrend-index-monitoring-during-sevoflurane-anesthesia-in-children-below-2%C3%A2-years-of-age
#9
Nils Dennhardt, Stefanie Arndt, Christiane Beck, Dietmar Boethig, Sebastian Heiderich, Barbara Schultz, Frank Weber, Robert Sümpelmann
BACKGROUND: In older children, different electroencephalogram-based algorithms for measuring depth of anesthesia displayed a similar performance as in adults, but in infants they have not displayed the same reliability so far. According to the individual developmental state, the Narcotrend distinguishes "differentiated" electroencephalograms, which can be classified using the full Narcotrend Index scale, from "undifferentiated" electroencephalograms, which are classified using a scale with fewer stages...
December 23, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29245361/effects-of-remifentanil-with-or-without-midazolam-pretreatment-on-the-95-effective-dose-of-propofol-for-loss-of-consciousness-during-induction-a-randomized-clinical-trial
#10
Jae Chul Koh, Juyeon Park, Na Young Kim, Ann Hee You, Seo Hee Ko, Dong Woo Han
BACKGROUND: Propofol is a rapid, efficient hypnotic agent with antiemetic effects. However, a high dosage is related to hemodynamic abnormalities such as hypotension and bradycardia. Pretreatment with remifentanil can decrease injection pain and stabilize hemodynamics during the induction period. Remifentanil or midazolam in combination with propofol can provide synergistic or additive effects during anesthesia induction. However, the hypnotic doses of propofol required in patients who receive pretreatment with remifentanil or midazolam remain unclear...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29241476/inahta-impact-story-legislative-and-accreditation-requirements-for-office-based-surgery-in-australia
#11
David Tivey, Ning Ma, Joanna Duncan, Yasoba Atukorale, Robyn Lambert, Guy Maddern
BACKGROUND: There is growing trend for some surgical procedures previously performed in hospitals to be done in alternative settings, including office-based facilities. There has been some safety concerns reported in the media, which document serious adverse events following procedures performed in an office-based setting. To understand the current regulatory oversight of surgery in this setting ASERNIP-S conducted a review of the legislative and accreditation process governing these facilities in Australia...
January 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29241232/thromboelastographic-assessment-of-the-impact-of-mexiletine-on-coagulation-abnormalities-induced-by-air-or-normal-saline-intravenous-injections-in-conscious-rats
#12
Joseph L Nates, Davide Cattano, Fernanda S Costa, Jacques E Chelly, Marie-Francoise Doursout
BACKGROUND: Thromboelastography (TEG) in venous air embolism (VAE) has been poorly studied. We induced coagulation abnormalities by VAE in a rat model, assessed by TEG with and without mexiletine, a lidocaine analogue local anesthetic. METHODS: Twenty-three Sprague Dawley rats instrumented under isoflurane anesthesia and allowed to recover five days prior to the experiments were randomized into three experimental groups: 1) VAE (n = 6); 2) VAE and mexiletine (n = 9); and 3) normal saline (NS) alone (control group, n = 8)...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29231349/-effect-of-ear-point-embedding-on-plasma-and-effect-site-concentrations-of-propofol-remifentanil-in-elderly-patients-after-target-controlled-induction
#13
Xiaochun Zheng, Liling Wan, Fei Gao, Jianghu Chen, Wenshao Tu
OBJECTIVE: To observe the clinical effect of ear point embedding on plasma and effect site concentrations of propofol-remifentanil in elderly patients who underwent abdominal external hernia surgery at the time of consciousness and pain disappearing by target-controlled infusion (TCI) and bispectral index (BIS). METHODS: Fifty patients who underwent elective abdominal hernia surgery were randomly assigned into an observation group and a control group, 25 cases in each one...
August 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29224301/-application-of-bispectral-index-monitoring-in-sedation-and-analgesia-for-flexible-bronchoscopy
#14
S R Fang, Y J Liu, N J Su, Y Shu, W Gu
Objective: To investigate the feasibility of using bispectral index monitoring in sedation and analgesia for bronchoscopy. Methods: Totally 285 patients admitted to the Respiratory Medicine Department of Nanjing First Hospital for bronchoscopy between June 2016 and December 2016 were assigned, according to their own wishes, into a conscious sedation group (171 cases receiving local anesthesia and conscious sedation, 89 males, 82 females, mean age 59±10 years) and a control group (114 cases undergoing local anesthesia, 59 males, 55 females, average age 61±12 years)...
December 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29215547/hypnosis-as-an-effective-and-inexpensive-option-to-control-pain-in-transcatheter-ablation-of-cardiac-arrhythmias
#15
Umberto Barbero, Federico Ferraris, Milena Muro, Carlo Budano, Matteo Anselmino, Fiorenzo Gaita
: Supportive care for pain relief and back discomfort during electrophysiology interventions is usually needed in the electrophysiology lab, especially in long-lasting procedures like atrial fibrillation ablation. Although this is usually achieved with conventional pharmacologic anesthesia, hypnosis has recently aroused interest as a reliable tool to complement and possibly enhance conscious sedation. We collected five case of percutaneous arrhythmia ablation in which, after informed consent, hypnosis was performed by nurse anesthetists in the cath lab...
January 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29212921/bold-temporal-variability-differentiates-wakefulness-from-anesthesia-induced-unconsciousness
#16
Alex T Baria, Maria Virginia Centeno, Mariam E Ghantous, Pei-Ching Chang, Daniele Procissi, A Vania Apkarian
Even though a number of findings, based on information content or information integration, are shown to define neural underpinnings characteristic of a conscious experience, the neurophysiological mechanism of consciousness is still poorly understood. Here, we investigated the brain activity and functional connectivity changes that occur in the isoflurane anesthetized unconscious state in contrast to the awake-state in rats (awake and/or anesthetized n=68 rats). We examined nine information measures previously shown to distinguish between conscious states; BOLD variability, functional connectivity strength, modularity, weighted modularity, efficiency, clustering coefficient, small-worldness, and spatial and temporal Lempel-Ziv complexity measure...
December 6, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29205686/ultrasound-guided-lower-forearm-median-nerve-block-in-open-surgery-for-trigger-thumb-in-1-to-3-year-old-children-a-randomized-trial
#17
Wei Liu, Jianxia Liu, Xingqin Tan, Shouyong Wang
BACKGROUND AND AIM: Trigger thumb is a common hand disability in children and is primarily treated with open surgery. A conscious median nerve block can usually meet the requirements for trigger thumb-releasing surgery in adults; however, its effectiveness in children requires further clarification. The present study aims to demonstrate whether ultrasound-guided lower forearm median nerve blockade is a viable option for children undergoing open surgery for trigger thumb. METHODS: A prospective randomized study was designed to compare median nerve blocks guided by ultrasonography with those guided by anatomic landmarks...
December 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29204316/acute-dystonic-reaction-following-general-anesthetic-agent-use
#18
Jiraporn Jitprapaikulsan, Prachaya Srivanitchapoom
Background: A 36-year-old Thai female who underwent a thymectomy under general anesthesia developed acute abnormal movements in the craniofacial region immediately after awakening with preserved consciousness. Phenomenology: Intermittent abnormal movements included oculogyric crisis; tongue protrusion; blepharospasm; and oro-mandibular dystonia consisting of risus sardonicus, jaw opening, and right torticollis. Educational value: An acute dystonic reaction can be a complication of either single or combined general anesthetic agents...
2017: Tremor and Other Hyperkinetic Movements
https://www.readbyqxmd.com/read/29201851/postoperative-subarachnoid-hemorrhage-and-multipunctate-intracerebral-hemorrhages-following-evacuation-of-bilateral-chronic-subdural-hematomas
#19
Won-Bae Seung, Ju Ho Jeong
Chronic subdural hematoma (CSDH) can be easily treated by burr hole surgery. However, several complications including intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and acute subdural hematoma are rare after evacuation of a CSDH. A 77-year-old man was admitted with right hemiparesis and dysarthria. A brain computed tomography (CT) scan revealed a bilateral CSDH with midline shifting toward the right side. The patient got the burr hole trephination with the catheters insertion in the both sides of parietal area under the local anesthesia...
October 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29198818/comparison-of-general-anesthesia-and-conscious-sedation-during-computed-tomography-guided-radiofrequency-ablation-of-t1a-renal-cell-carcinoma
#20
Hae Jin Kim, Byung Kwan Park, In Sun Chung
PURPOSE: Percutaneous radiofrequency ablation is so painful that this treatment requires pain control such as conscious sedation or general anesthesia. It is still unclear which type of anesthesia is better for treatment outcomes of renal cell carcinoma. This study aimed to compare general anesthesia and conscious sedation in treating patients with renal cell carcinoma with radiofrequency ablation. METHODS: Between 2010 and 2015, 51 patients with biopsy-proven renal cell carcinomas (<4 cm) were treated with computed tomography-guided radiofrequency ablation...
November 30, 2017: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
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