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Anesthesia and pain management

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https://www.readbyqxmd.com/read/28214316/pre-and-perioperative-aspects-of-dermatosurgery
#1
Cornelia S L Müller, Wakiko Hubner, Sigrid Thieme-Ruffing, Claudia Pföhler, Thomas Vogt, Thomas Volk, Barbara C Gärtner, Patric Bialas
Dermatosurgery occupies an exceptional position among all surgical disciplines. Above all, this includes the fact that, with very few exceptions, the vast majority of surgical interventions can be performed under local or regional anesthesia, usually in smaller procedure rooms that are spatially separated from larger operating suites. Thus, peri- and postinterventional patient monitoring is the responsibility of the dermatosurgeon and his team. Though inherently smaller, this team still has to observe numerous perioperative requirements that - in larger surgical specialties - would be attended to by a host of various specialists working in concert...
February 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28214095/whether-preventive-low-dose-magnesium-sulphate-infusion-has-an-influence-on-postoperative-pain-perception-and-the-level-of-serum-beta-endorphin-throughout-the-total-abdominal-hysterectomy
#2
K Haryalchi, M Abedinzade, K Khanaki, M M Ghanaie, F M Zadeh
OBJECTIVE: Due to the known role of preventive low dose magnesium sulphate on postoperative pain management, in this randomized, double-blinded, placebo-controlled study, we tried to investigate the possible relationship between low dose intra-operative magnesium sulphate infusion, postoperative analgesia and the level of serum beta-endorphin during total abdominal hysterectomy under general anesthesia. METHODS: Forty women undergoing total abdominal hysterectomy were randomly allocated into 2 groups (20 in each arm)...
February 14, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28205108/water-assisted-colonoscopy
#3
REVIEW
Sergio Cadoni, Felix W Leung
The current review will attempt to describe the important lessons learned from published randomized controlled trials (RCT) comparing water immersion (WI) or water exchange (WE) techniques with gas insufflation colonoscopy. Air insufflation (AI) to distend the colon to permit visualization and passage through the lumen was developed for diagnostic colonoscopy. When screening colonoscopy was adopted, the same AI method was used. Interval cancers, diagnosed within 3 to 5 years after an index screening colonoscopy, appeared to be linked to low adenoma detection rate (ADR)...
February 15, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28195861/perioperative-management-of-a-patient-with-an-intrathecal-drug-delivery-device-infusing-ziconotide-a-case-report
#4
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...
February 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28184271/surgical-excision-of-the-breast-giant-fibroadenoma-under-regional-anesthesia-by-pecs-ii-and-internal-intercostal-plane-block-a-case-report-and-brief-technical-description-a-case-report
#5
Hyungtae Kim, Junho Shim, Ikthae Kim
A 22-years-old female patient at 171 cm and 67 kg visited the Department of Breast Surgery of the hospital with a mass accompanied with pain on the left side breast as chief complaints. Since physical examination revealed a suspected huge mass, breast surgeon decided to perform surgical excision and requested anesthesia to our department. Surgery of breast tumor is often under local anesthesia. However, in case of big size tumor, surgery is usually performed under general anesthesia. The patient feared general anesthesia...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28181199/an-examination-of-disparities-in-pediatric-pain-management-centered-on-socioeconomic-factors-and-hospital-characteristics
#6
Franklin B Chiao, Alan Wang
INTRODUCTION: Very little is known about pediatric pain management resource differences. In contrast, disparities in pain management within the adult population are known to exist. This research examined whether significant differences exist between hospitals in the state of New York and what factors impact these pain resources. METHODS: The study was approved by the institutional review board. A questionnaire was sent to the anesthesia/pediatric/pain directors of every hospital in the state of New York via SurveyMonkey...
February 8, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28178175/the-effect-of-nicardipine-on-the-surgical-pleth-index-during-thyroidectomy-under-general-anesthesia-a-prospective-double-blind-randomized-controlled-trial
#7
Young Ju Won, Byung Gun Lim, Gwi Eun Yeo, Min Ki Lee, Dong Kyu Lee, Heezoo Kim, Il Ok Lee, Myoung Hoon Kong
BACKGROUND: The effectiveness of surgical pleth index (SPI) for managing nociception-antinociception balance during general anesthesia with vasodilators, including nicardipine has not been demonstrated. We aimed to compare the time course during surgery in SPI values in patients receiving nicardipine or remifentanil infusion during thyroidectomy. METHODS: Forty patients undergoing thyroidectomy were randomly assigned to receive nicardipine (group N; n = 19) or remifentanil (group R; n = 21) along with induction (propofol, fentanyl, and rocuronium) and maintenance (50% desflurane/nitrous oxide in oxygen) anesthesia (goal bispectral index [BIS] ∼50)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28176903/analysis-of-perioperative-pain-management-in-vascular-surgery-indicates-that-practice-does-not-adhere-with-guidelines-a-retrospective-cross-sectional-study
#8
Krste Boric, Matija Boric, Teo Boric, Livia Puljak
BACKGROUND: Inadequate treatment of pain related to surgery may be associated with complications and prolonged recovery time and increased morbidity and mortality rates. We investigated perioperative pain management in vascular surgery and compared it with the relevant guidelines for the treatment of perioperative pain. METHODS: We conducted a retrospective study on 501 patients who underwent vascular surgery at the University Hospital Split, Croatia. We collected the following data from patients' charts: age, gender, premedication, preoperative patient's physical status, type of surgery, duration of surgery and anesthesia, type of anesthesia, postoperative analgesia, and need for intensive care...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28164055/proximal-tibial-epiphysis-injury-flexion-type-salter-harris-type-1
#9
Pratik Israni, Mangesh Panat
INTRODUCTION: Fractures of the proximal tibial epiphysis rare. It has been estimated that fractures of the upper tibial epiphysis account for 0.5-3.1% of all epiphyseal injuries. Who had no neurovascular deficit, with fixed extension deformity at the left knee was treated early with closed reduction techniques. CASE REPORT: We present a case of a 16-year-old boy who while playing cricket on the road was hit by a car. The patient presented in emergency room with extremely swollen knee and soft tissue swelling (hemarthrosis), he was unable to lift his leg actively due to severe pain because of hamstrings spasm, and he had no wound over his left knee and had no other associated injuries...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28158165/ketamine-an-update-on-cellular-and-subcellular-mechanisms-with-implications-for-clinical-practice
#10
Gary J Iacobucci, Ognjen Visnjevac, Leili Pourafkari, Nader Djalal Nader
BACKGROUND: Ketamine is one of the oldest hypnotic agents used to provide an anesthetic agent with analgesic properties and minimal suppressive effects on respiration. The ability of ketamine in modulating glutamatergic (N-methyl D-aspartate) pain receptors has made this anesthetic drug a new option for the management of patients with chronic pain syndromes. Further preclinical and clinical findings suggest ketamine may have wide ranging effects on both cognition and development. Recent advances have revealed an unprecedented role for ketamine in the acute management of depression...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28145964/laparoscopic-assisted-rectus-sheath-block-as-a-novel-technique-is-effective-and-safe-a-randomized-controlled-trial
#11
Dai Miyazaki, Toshiaki Shichinohe, Yuma Ebihara, Yo Kurashima, Soichi Murakami, Takehiro Noji, Toru Nakamura, Takahiro Tsuchikawa, Keisuke Okamura, Satoshi Hirano
PURPOSE: We developed laparoscopic-assisted rectus sheath block (LRSB) as a novel technique and report on its safety and effectiveness. METHODS: Patients were randomly enrolled to an LRSB or control group (n=19 each). In the LRSB group, after the umbilical wound was closed, local anesthetic was injected transcutaneous at each of 4 sites (3 cm above and below the umbilicus bilaterally) with 10 mL of 0.25% levobupivacaine, laparoscopically. The control group received conventional postoperative pain management...
February 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28132951/local-regional-anesthesia-in-the-management-of-stingray-stings-experience-of-the-bouffard-medical-surgical-hospital-in-djibouti
#12
C Vanoye, G Lacroix, E Le Gonidec, A Couret, A Benois, V Peigne
Stingray injuries are very painful. Systemic analgesics are ineffective, and the use of local-regional anesthesia has been reported. This retrospective descriptive study reviewed all cases of stingray injuries seen at the emergency department of the Bouffard Hospital (Djbouti, Africa) between 2011 and 2014. The study included 35 patients. Most of the injuries (n= 31, 89%) concerned the lower limbs. Median pain intensity was 6 [5-8] on a visual analog scale of 0 (no pain) to 10. The following systemic medications were administered: acetaminophen to 13 (27%) patients, morphine to 8 (23%), and tramadol to 6 (17%)...
January 27, 2017: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/28126454/ultrasound-guided-retroclavicular-approach-infraclavicular-brachial-plexus-block-for-upper-extremity-emergency-procedures
#13
Josh Luftig, Daniel Mantuani, Andrew A Herring, Arun Nagdev
The America Society of Anesthesiology guidelines recommend multimodal analgesia that combines regional anesthetic techniques with pharmacotherapy to improve peri-procedural pain management and reduce opioid related complications. Commonly performed emergency procedures of the upper extremity such as fracture and dislocation reduction, wound debridement, and abscess incision and drainage are ideal candidates for ultrasound-guided (USG) regional anesthesia of the brachial plexus. However, adoption of regional anesthesia by emergency practitioners has been limited by concerns for potential complications and perceived technical difficulty...
January 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28121757/the-perinatal-birth-environment-communication-strategies-and-processes-for-adherence-to-a-standardized-guideline-in-women-undergoing-second-stage-labor-with-epidural-anesthesia
#14
Samantha A Sommerness, Rebecca Gams, Phillip N Rauk, Ananta Bangdiwala, Daniel V Landers, Melissa D Avery, Charles Hirt, Kristi Miller, Amy Millar, Suzin Cho, Andrea Shields
Key to any perinatal safety initiative is buy-in and strong leadership from obstetric and pediatric providers, advanced practice nurses, and labor and delivery nurses in collaboration with ancillary staff. In the fall of 2007, executives of a large Midwestern hospital system created the Zero Birth Injury Initiative. This multidisciplinary group sought to eliminate birth injury using the Institute of Healthcare Improvement Perinatal Bundles. Concurrently, the team implemented a standardized second-stage labor guideline for women who choose epidural analgesia for pain management to continue the work of eliminating birth injuries in second-stage labor...
January 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28118226/intraoperative-placement-of-pectoral-nerve-block-catheters-description-of-a-novel-technique-and-review-of-the-literature
#15
Katharine M Hinchcliff, Jared R Hylton, Hakan Orbay, Michael S Wong
Regional and neuraxial anesthesia for pain management after breast surgery is not widely used despite data showing improved postoperative pain control and patient satisfaction scores. We report a case of a 61-year-old woman who underwent bilateral mastectomies, and received postoperative analgesia via pectoral nerves 1 and 2 nerve blocks. This case highlights a previously undescribed technique of prolonged postoperative pain control by intraoperative placement of pectoral nerves 1 and 2 regional anesthesia catheters under direct visualization...
January 23, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28114178/practice-advisory-for-the-prevention-diagnosis-and-management-of-infectious-complications-associated-with-neuraxial-techniques-an-updated-report-by-the-american-society-of-anesthesiologists-task-force-on-infectious-complications-associated-with-neuraxial-techniques
#16
https://www.readbyqxmd.com/read/28106160/evaluation-of-three-block-anesthesia-methods-for-pain-management-during-mandibular-third-molar-extraction-a-meta-analysis
#17
Fanyuan Yu, Yao Xiao, Hanghang Liu, Fanzi Wu, Feng Lou, Dian Chen, Mingru Bai, Dingming Huang, Chenglin Wang, Ling Ye
A patient's pain during mandibular third molar extraction often creates problems for a dental surgeon and can also cause immense patient discomfort, such as decreased quality of life, serious complications, or even danger to the patients' lives. Effective pain management is therefore of great importance. Conventional block anesthesia method often fails to control such pain completely during an operation. Therefore, two available alternatives, Gow-Gates (G-G) and Vazirani-Akinosi (V-A) methods, have been developed...
January 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28097415/anesthesia-practices-for-interventional-radiology-in-europe
#18
Alessandra Vari, Afshin Gangi
PURPOSE: The Cardiovascular and Interventional Radiological Society of Europe (CIRSE) prompted an initiative to frame the current European status of anesthetic practices for interventional radiology, in consideration of the current variability of IR suite settings, staffing and anesthetic practices reported in the literature and of the growing debate on sedation administered by non-anesthesiologists, in Europe. METHODS: Anonymous online survey available to all European CIRSE members to assess IR setting, demographics, peri-procedural care, anesthetic management, resources and staffing, pain management, data collection, safety, management of emergencies and personal opinions on the role CIRSE should have in promoting anesthetic care for interventional radiology...
January 17, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28096581/role-of-preemptive-tapentadol-in-reduction-of-postoperative-analgesic-requirements-after-laparoscopic-cholecystectomy
#19
Ghanshyam Yadav, Gaurav Jain, Abhishek Samprathi, Annavi Baghel, Dinesh Kumar Singh
BACKGROUND AND AIMS: Poorly managed acute postoperative pain may result in prolonged morbidity. Various pharmacotherapies have targeted this, but research on an ideal preemptive analgesic continues, taking into account drug-related side effects. Considering the better tolerability profile of tapentadol, we assessed its role as a preemptive analgesic in the reduction of postoperative analgesic requirements, after laparoscopic cholecystectomy. MATERIAL AND METHODS: In a prospective-double-blinded fashion, sixty patients posted for above surgery, were randomized to receive tablet tapentadol 75 mg (Group A) or starch tablets (Group B) orally, an hour before induction of general anesthesia...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28096580/randomized-double-blind-comparison-of-remifentanil-and-alfentanil-in-patients-undergoing-laparoscopic-cholecystectomy-using-total-intravenous-anesthesia
#20
José M Beleña, Mónica Núñez, Alfonso Vidal, Diego Anta
BACKGROUND AND AIMS: To compare the use of remifentanil and alfentanil to suppress intraoperative adrenergic response of pain and the influence of these drugs on the recovery profile in patients undergoing laparoscopic cholecystectomy using a total intravenous anesthesia (TIVA) technique. MATERIAL AND METHODS: One hundred patients undergoing elective laparoscopic cholecystectomy were randomized to be managed with either remifentanil (group R) or alfentanil (group A)...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
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