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Anesthesia and pain management

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https://www.readbyqxmd.com/read/28079663/general-anesthesia-and-fabry-disease-a-case-report
#1
Stefan Krüger, Albina Nowak, Torben Christoph Müller
Fabry disease is an inherited X-linked disorder characterized by the absence (in men) or deficiency (in women) in α-galactosidase A activity that causes a progressive accumulation of glycosphingolipids within lysosomes of cells of all the major organ systems. The subsequent organ damage that manifests in childhood and early adulthood presents a widely variable clinical picture of pain, hypertension, and cardiac, renal, nervous system, and lung dysfunction. We present 2 female patients with Fabry disease who required general anesthesia twice for gynecological and trauma surgery, respectively, and discuss their perioperative management based on new information in the medical literature...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28074028/assessment-of-postoperative-pain-control-with-an-elastomeric-pain-pump-following-cardiothoracic-surgery
#2
Anuvrat Chopra, Jeff Hurren, Susan Szpunar, Stephanie B Edwin
OBJECTIVE: To assess the effectiveness of local anesthesia, delivered via elastomeric pump to manage pain in patients undergoing cardiothoracic surgery. METHODS: A retrospective, comparative analysis evaluating adult cardiothoracic surgery patients (by median sternotomy) who received continuous infusion bupivacaine + traditional methods of pain control (N = 100) or traditional pain control alone (N = 100) from July 2011-October 2013. The primary efficacy end point was total postoperative opioid requirements for 96 hours following surgery...
January 10, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28059804/bupivacaine-increases-the-rate-of%C3%A2-motoneuron-death-following-peripheral%C3%A2-nerve-injury
#3
Susanna C Byram, Scott W Byram, Nicholas M Miller, Keith N Fargo
BACKGROUND: Appropriate management of pain after an injury or surgical procedure has been shown to improve patient outcomes. While infrequent, nerve damage resulting from regional anesthesia can be devastating, however the mechanism remains unknown. Local anesthetics are neurotoxic yet are frequently applied to sites where peripheral nerves are regenerating. Therefore, understanding their effects on injured and growing neurons may have important implications for clinical practice. OBJECTIVE: The purpose of this study was to determine if local anesthetics exacerbate the rate of motoneuron death following axotomy...
January 4, 2017: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/28058845/ultrasensitive-phototriggered-local-anesthesia
#4
Changyou Zhan, Weiping Wang, Claudia Santamaria, Bruce Wang, Alina Rwei, Brian P Timko, Daniel S Kohane
An injectable local anesthetic producing repeatable on-demand nerve block would be desirable for pain management. Here we present a phototriggerable device to achieve repeatable and adjustable on-demand local anesthesia in superficial or deep tissues, consisting of gold nanorods attached to low temperature sensitive liposomes (LTSL). The particles were loaded with tetrodotoxin and dexmedetomidine. Near-infrared light (NIR, 808 nm, continuous wave) could heat gold nanorods at low fluence (short duration and low irradiance), leading to rapid release of payload...
January 6, 2017: Nano Letters
https://www.readbyqxmd.com/read/28042274/effectiveness-of-behavioral-modification-techniques-with-visual-distraction-using-intrasulcular-local-anesthesia-in-hearing-disabled-children-during-pulp-therapy
#5
Kausar Sadia Fakhruddin, Mehmet Omer Gorduysus, Hisham El Batawi
OBJECTIVE: Assessing the effectiveness of behavioral modification techniques in combination with visual distraction with/without video eyewear using computerized delivery system-intrasulcular (CDS-IS) during the application of local anesthetic in hearing-impaired pediatric patients undergoing pulp therapy of primary molars. MATERIALS AND METHODS: This randomized, crossover clinical study includes 15 children (7 boys and 8 girls), mean age was 6.1 years. Children were randomly distributed into two groups (Group A, n = 7; Group B, n = 8)...
October 2016: European Journal of Dentistry
https://www.readbyqxmd.com/read/28038489/anesthesia-and-pain-management-in-traditional-iranian-medicine
#6
REVIEW
Alireza Salehi, Faranak Alembizar, Ayda Hosseinkhani
Studying the history of science could help develop an understanding of the contributions made by ancient nations towards scientific advances. Although Iranians had an important impact on the improvement of science, the history of Iranian medicine seems not to have been given enough attention by historians. The present study focused on the history of anesthesia and pain management in Iranian medical history. In this regard, related books such as Avesta and Shahnameh were studied in order to obtain the history of anesthesiology in Iranian pre Islamic era...
December 2016: Acta Medico-historica Adriatica: AMHA
https://www.readbyqxmd.com/read/28033693/comparison-of-morphine-suppository-and-diclofenac-suppository-for-pain-management-after-elective-caesarean-section
#7
Atossa Mahdavi, Zeinab Telkabadi, Ashraf Aleyasin, Marzieh Agha Hosseini, Leili Safdarian, Ali Momenzadeh
This study investigated efficacy and side effects of Morphine suppository for pain management after the first elective caesarean delivery in comparison to Diclofenac suppository. One hundred women aged 18-40 with term pregnancies undergoing elective caesarean section for the first time participated in this prospective project. Exclusion criteria included drug sensitivity, fetal malformations or defects, and complications during the cesarean operation. After same spinal anesthesia and same surgical techniques and in the recovery room patients consecutively received 100 mg diclofenac suppository or 10 mg morphine suppository...
November 2016: Acta Medica Iranica
https://www.readbyqxmd.com/read/28018749/focused-training-for-humanitarian-responders-in-regional-anesthesia-techniques-for-a-planned-randomized-controlled-trial-in-a-disaster-setting
#8
Adam R Aluisio, Carrei Teicher, Tess Wiskel, Allysia Guy, Adam Levine
BACKGROUND: Lower extremity trauma during earthquakes accounts for the largest burden of geophysical disaster-related injuries. Insufficient pain management is common in disaster settings, and regional anesthesia (RA) has the potential to reduce pain in injured patients beyond current standards. To date, no prospective research has evaluated the use of RA in a disaster setting. This cross-sectional study assesses knowledge translation and skill acquisition outcomes for lower extremity RA performed with and without ultrasound guidance among a cohort of Médecins Sans Frontières (MSF) volunteers who will function as proceduralists in a planned randomized controlled trial evaluating the efficacy of RA for pain management in an earthquake setting...
November 16, 2016: PLoS Currents
https://www.readbyqxmd.com/read/28018078/subungual-osteochondroma-nail-sparing-excision
#9
Anurag Tiwari, Nidhi Agrawal, Tarun Verma, Hitesh Lal
Subungual osteochondroma is a relatively uncommon benign bone tumor affecting mostly children and young adults, and is a major source of pain and nail deformity. Treatment consists of marginal excision and meticulous wound closure. In this report, we present three cases of subungual osteochondroma arising from the dorsal aspect of distal phalanx of the great toe, which were managed by marginal excision with preservation of nail apparatus under digital block anesthesia with the use of a ring tourniquet. We emphasize on the use of ring tourniquet made by glove's finger and the technique of preserving the nail apparatus to prevent nail deformity...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28017175/anesthesia-for-cesarean-section-in-a-patient-with-isolated-unilateral-absence-of-a-pulmonary-artery
#10
Tomonori Furuya, Ryoji Iida, Jyumpei Konishi, Jitsu Kato, Takahiro Suzuki
BACKGROUND AND OBJECTIVES: Congenital unilateral absence of a pulmonary artery (UAPA) is a rare anomaly. Although there are several reports regarding pregnancy in patients with unilateral absence of a pulmonary artery, there are no case reports describing anesthesia for Cesarean section in a patient with unilateral absence of a pulmonary artery. CASE REPORT: We present a patient with unilateral absence of a pulmonary artery who underwent Cesarean sections twice at the ages of 24 and 26 years under spinal anesthesia for surgery and epidural analgesia for postoperative pain relief...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28009616/spinal-anesthesia-improves-early-pain-levels-following-surgical-treatment-of-tibial-plateau-fractures
#11
Arthur Manoli, Arthur Atchabahian, Roy I Davidovitch, Kenneth A Egol
OBJECTIVES: to determine the effect of spinal anesthesia (SA) on short term outcomes when compared to general anesthesia (GA) in operatively managed tibial plateau fractures. DESIGN: This is an IRB-approved retrospective review of prospectively collected data. SETTING: Two level 1 trauma centers. PARTICIPANTS: One hundred and twelve patients with a surgically managed tibial plateau fracture were identified within a registry of patients...
December 14, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28008258/incidence-risk-factors-and-phenomenological-characteristics-of-postoperative-delirium-in-patients-receiving-intravenous-patient-controlled-analgesia-a-prospective-cohort-study
#12
Yao Tsung Lin, Kuo Mao Lan, Li-Kai Wang, Chin-Chen Chu, Su-Zhen Wu, Chia-Yu Chang, Jen-Yin Chen
BACKGROUND: Intravenous patient-controlled analgesia (IVPCA) is a common method of relieving pain which is a risk factor of postoperative delirium (POD). However, research concerning POD in IVPCA patients is limited. OBJECTIVE: We aimed to determine the incidence, risk factors, and phenomenological characteristics of POD in patients receiving IVPCA. METHODS: A prospective, cohort study was conducted in post-general anesthesia IVPCA patients aged ≥60 years...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28002212/ambulatory-surgical-centers-a-review-of-complications-and-adverse-events
#13
Charles A Goldfarb, Anchal Bansal, Robert H Brophy
An increasing number of orthopaedic surgeries are performed at ambulatory surgical centers (ASCs), as is exemplified by the 272% population-adjusted increase in outpatient rotator cuff repairs from 1996 to 2006. Outpatient surgery is convenient for patients and cost effective for the healthcare system. The rate of complications and adverse events following orthopaedic surgeries at ASCs ranges from 0.05% to 20%. The most common complications are pain and nausea, followed by infection, impaired healing, and bleeding; these are affected by surgical and patient risk factors...
January 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27993587/percutaneous-needle-tenotomy-for-the-treatment-of-muscle-and-tendon-contractures-in-adults-with-brain-damage-results-and-complications
#14
Flavia Coroian, Claire Jourdan, Jérome Froger, Claire Anquetil, Olivier Choquet, Bertand Coulet, Isabelle Laffont
OBJECTIVE: To study the results and complications of percutaneous needle tenotomy (PNT) of superficial retracted tendons in brain damaged patients. Muscle and tendon contractures are common in this population and can lead to severe functional impairment. Care management is commonly based on open surgical tenotomy. PNT is a mini-invasive surgical procedure suspected to be safer among frail patients. DESIGN: Prospective observational study SETTING: University Hospital Physical Medicine and Rehabilitation (PM&R) and Orthopedic Surgery Departments...
December 16, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27990189/effects-of-modification-of-pain-protocol-on-incidence-of-post-operative-nausea-and-vomiting
#15
Ran Schwarzkopf, Nimrod Snir, Zachary T Sharfman, Joseph B Rinehart, Michael-David Calderon, Esther Bahn, Brian Harrington, Kyle Ahn
BACKGROUND: A Perioperative Surgical Home (PSH) care model applies a standardized multidisciplinary approach to patient care using evidence-based medicine to modify and improve protocols. Analysis of patient outcome measures, such as postoperative nausea and vomiting (PONV), allows for refinement of existing protocols to improve patient care. We aim to compare the incidence of PONV in patients who underwent primary total joint arthroplasty before and after modification of our PSH pain protocol...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27984226/intraperitoneal-instillation-of-lidocaine-improves-postoperative-analgesia-at-cesarean-delivery-a-randomized-double-blind-placebo-controlled-trial
#16
Ruchira Patel, Jose C A Carvalho, Kristi Downey, Marcelo Kanczuk, Paul Bernstein, Naveed Siddiqui
BACKGROUND: Cesarean delivery is a commonly performed procedure worldwide. Despite improvements in balanced multimodal analgesia, there remains a proportion of women for whom postoperative pain relief and patient satisfaction are still inadequate. Intraperitoneal instillation of local anesthetic has been shown to be effective in reducing postoperative pain after abdominal surgery. We sought to investigate the effect of intraperitoneal instillation of lidocaine on postcesarean delivery pain as part of a multimodal analgesia regimen...
December 15, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27973938/anesthetic-management-of-a-patient-with-ehlers-danlos-syndrome
#17
Naohiro Ohshita, Masahiko Kanazumi, Kaname Tsuji, Hiroaki Yoshida, Shosuke Morita, Yoshihiro Momota, Yasuo M Tsutsumi
We describe the case of a 37-year-old woman who had been diagnosed with Ehlers-Danlos syndrome (EDS) 4 years earlier and was scheduled to undergo removal of synovial chondromatosis in the temporomandibular joint. EDS is a heritable connective tissue disorder and has 6 types. In this case, the patient was classified into EDS hypermobility type. The major clinical feature of this type is joint hypermobility. The patient had sprain or subluxation of the elbows and ankles and dislocation of the knees. Anticipated problems during general anesthesia would be affected by the disease type...
2016: Anesthesia Progress
https://www.readbyqxmd.com/read/27941483/perioperative-management-of-a-patient-with-an-intrathecal-drug-delivery-device-infusing-ziconotide
#18
Sephalie Patel, Osama Hafez, Wade J Sexton, David A Edwards
Intrathecal ziconotide is used for the treatment of chronic pain and is delivered by an implanted drug delivery device. Anesthesiologists should be familiar with the perioperative management of the pump as well as the potential adverse events related to continued ziconotide infusion during general anesthesia. A case is presented demonstrating the perioperative management of an intrathecal drug delivery device infusing ziconotide in a patient presenting for radical cystectomy with pelvic lymphadenectomy and ileal conduit diversion...
December 9, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27935778/anesthesia-involvement-in-palliative-care
#19
Amanda C Faircloth
Palliative care teams require multidisciplinary support. While this is an emerging area in anesthesia practice, there are many avenues for certified registered nurse anesthetists (CRNAs) to share their unrivaled clinical knowledge. CRNAs may become involved with or consult on palliative sedation, medical management, interventional pain management, terminal wean/extubation, and organ donation. Additionally, CRNAs need to understand the unique needs of this patient population so that they can appropriately care for palliative care patients presenting to the operating room for palliative surgery...
January 2017: Annual Review of Nursing Research
https://www.readbyqxmd.com/read/27925241/vertebral-subluxation-repair-in-a-pet-goat
#20
Sara Nannarone, Enrico Bellezza, Yves P Moens, Paula Larenza Menzies
OBJECTIVES: To describe the perioperative management, including surgery, anesthesia, metabolic derangements, and physiotherapy, in a goat referred for paraparesis secondary to a road traffic accident. STUDY DESIGN: Case report. ANIMALS: 2-year-old mixed breed dwarf 44 kg female pet goat. METHODS: Clinical examination showed symptoms of early compensatory stages of shock, paraparesis with hyperextension of the thoracic limbs, pain on palpation of the thoracolumbar spine, increased patellar reflexes of both pelvic limbs without superficial sensitivity, but preserved deep pain sensation...
December 7, 2016: Veterinary Surgery: VS
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