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Regional anesthesiology

Mariusz Piechota, Anna Piechota
BACKGROUND: The mortality rate in patients with severe liver dysfunction secondary to alcoholic liver disease (ALD) who do not respond to the standard treatment is exceptionally high. OBJECTIVES: The main aim of this study was to evaluate the usefulness of applying extracorporeal liver support techniques to treat this group of patients. PATIENTS AND METHODS: The data from 23 hospital admissions of 21 patients with ALD who were admitted to the department of anesthesiology and intensive therapy (A&IT) at the Dr Wł...
July 2016: Hepatitis Monthly
Gaspar Alberto Motta-Ramírez
BACKGROUND: Trauma is the most common cause of death in young adults. A multidisciplinary trauma team consists of at least a surgical team, an anesthesiology team, radiologic team, and an emergency department team. OBJECTIVE: Recognize the integration of multidisciplinary medical team in managing the trauma patient and which must include the radiologist physician responsible for the institutional approach to the systematization of the trauma patient regarding any radiological and imaging study with emphasis on the FAST (del inglés, Focused Assessment with Sonography in Trauma)/USTA, Whole body computed tomography...
July 2016: Gaceta Médica de México
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September 2016: Regional Anesthesia and Pain Medicine
Gunjan Kumar, Steven K Howard, Alex Kou, T Edward Kim, Alexander J Butwick, Edward R Mariano
OBJECTIVE : Patient education materials (PEM) should be written at a sixth-grade reading level or lower. We evaluated the availability and readability of online PEM related to regional anesthesia and compared the readability and content of online PEM produced by fellowship and nonfellowship institutions. METHODS : With IRB exemption, we constructed a cohort of online regional anesthesia PEM by searching Websites from North American academic medical centers supporting a regional anesthesiology and acute pain medicine fellowships and used a standardized Internet search engine protocol to identify additional nonfellowship Websites with regional anesthesia PEM based on relevant keywords...
August 2, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Miriam I Emons, Frank Petzke, Ulrike M Stamer, Winfried Meißner, Regina Koschwitz, Joachim Erlenwein
OBJECTIVES: This study aimed to summarize the current standard practices for acute pain management in children in Germany and the implementation of these procedures. The last survey on acute pain management in children was performed in 1999, highlighting the need for an up to date review. METHODS: A questionnaire was mailed to German departments of anesthesiology (n = 885), asking for structures and processes of acute pain management in children. Results were compared between hospitals with and without an acute pain service and with and without a pediatric department...
September 2016: Paediatric Anaesthesia
Emily S Carr, Ashley De La Cerda, Katherine Fiala
Complex regional pain syndrome (CRPS) is a neurologic disorder that often results in debilitating chronic pain, but the diagnosis may elude providers as it is one of exclusion. A history of trauma may be elucidated. We report a case of CRPS and review the clinical findings, appropriate workup, and treatment options for the patient. The patient we describe went through an extensive workup before receiving the correct diagnosis. Delay in diagnosis leads to prolonged suffering for the patient and, at times, unnecessary invasive debridement procedures...
July 2016: Proceedings of the Baylor University Medical Center
Dan M J Milstein, Can Ince, Suzanne S Gisbertz, Kofi B Boateng, Bart F Geerts, Markus W Hollmann, Mark I van Berge Henegouwen, Denise P Veelo
Gastric tube reconstruction (GTR) is a high-risk surgical procedure with substantial perioperative morbidity. Compromised arterial blood supply and venous congestion are believed to be the main etiologic factors associated with early and late anastomotic complications. Identifying low blood perfusion areas may provide information on the risks of future anastomotic leakage and could be essential for improving surgical techniques. The aim of this study was to generate a method for gastric microvascular perfusion analysis using laser speckle contrast imaging (LSCI) and to test the hypothesis that LSCI is able to identify ischemic regions on GTRs...
June 2016: Medicine (Baltimore)
Sebastiano Mercadante, Andrea Costanzi, Fabrizio David, Patrizia Villari, Maurizio Musso, Paolo Marchetti, Alessandra Casuccio
BACKGROUND: In the field of hemato-oncology, there is paucity of data assessing models of integration between hemato-oncology and other partner specialties. The aim of this national survey was to gather information about the status of the integration of this kind of activity in hemato-oncologic units existing in Italy. METHODS: A national telephone survey was conducted to gather information about the status of the integration of hemato-oncologic and supportive care/anesthesiological services...
October 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Amit Tyagi, Shivani Rastogi, Manoj Tripathi, Rajlaxmi Bhandari, Prateek Singh Bais, Mahendra Singh
CONTEXT: The continued success of regional anesthetic techniques can be credited due to improved local anesthetic drugs, with lower toxicities and longer duration of action, but still many efforts are being done to increase the duration of the block and postoperative analgesia. Therefore, use of adjuvant drugs for anesthesia is intended to prolong analgesia and preventing deleterious clinical effects of local anesthetics. AIMS: The present study is designed to evaluate effects of intrathecal hyperbaric bupivacaine versus hyperbaric bupivacaine with low dose clonidine on the onset and level of sensory and motor block, the intensity of motor blockade, and time of analgesia required in the postoperative period...
May 2016: Anesthesia, Essays and Researches
Amanda C Faircloth, Arkadiy Dubovoy, Chuck Biddle, Diane Dodd-McCue, John F Butterworth
Background: Randomized controlled trials show that acupuncture and acupressure support anesthesia management by decreasing anxiety, opioid requirements, and treating post-operative nausea and vomiting. Acupuncture and acupressure have demonstrated clinical usefulness but have not yet diffused into mainstream anesthesia practice. To determine why, this study assessed U.S. anesthesia provider's perceptions of acupuncture and acupressure. Methods: After institutional review board approval, 96 anesthesiology departments stratified by geographic region (Northeast, South, West, and Midwest) and institution type (university medical centers, community hospitals, children's hospitals, and veterans affairs hospitals) were selected for participation in an anonymous, pretested, online survey...
April 1, 2016: Medical Acupuncture
P Daeninck, B Gagnon, R Gallagher, J D Henderson, Y Shir, C Zimmermann, B Lapointe
Breakthrough cancer pain (btcp) represents an important element in the spectrum of cancer pain management. Because most btcp episodes peak in intensity within a few minutes, speed of medication onset is crucial for proper control. In Canada, several current provincial guidelines for the management of cancer pain include a brief discussion about the treatment of btcp; however, there are no uniform national recommendations for the management of btcp. That lack, accompanied by unequal access to pain medication across the country, contributes to both regional and provincial variability in the management of btcp...
April 2016: Current Oncology
Ozhan M Turan, Joshua Rosenbloom, Jessica L Galey, Stephanie L Kahntroff, Shobana Bharadwaj, Shafonya M Turner, Andrew M Malinow
Objective Maternal obesity presents several challenges at cesarean section. In an effort to routinely employ a transverse suprapubic skin incision, we often retract the pannus in a rostral direction using adhesive tape placed after induction of anesthesia and before surgical preparation of the skin. We sought to understand the association between taping and neonatal cord blood gases, Apgar scores, and time from skin incision to delivery of the neonate. Study Design This is a retrospective study, performed using prospectively collected anesthesiology records with data supplemented from the patients' medical records...
August 2016: American Journal of Perinatology
Andrea J Traynor, Meredith Aragon, Debashis Ghosh, Ray S Choi, Colleen Dingmann, Zung Vu Tran, Brenda A Bucklin
BACKGROUND: Obstetric Anesthesia Workforce Surveys were conducted in 1981, 1992, and 2001, and the 10-year update was conducted in 2012. Anesthesia providers from US hospitals were surveyed to identify the methods used to provide obstetric anesthesia. Our primary hypothesis was that the provision of obstetric anesthesia services has changed in the past 10 years. METHODS: A sample of hospitals was generated based on the number of births per year and US census region...
June 2016: Anesthesia and Analgesia
Myong-Joo Hong, Yeon-Dong Kim, Yong-Kwan Cheong, Seon-Jeong Park, Seung-Won Choi, Hyon-Joo Hong
Postherpetic neuralgia (PHN) is a disease entity defined as persistent pain after the acute pain of herpes zoster gradually resolves. It is associated with impaired daily activities, resulting in reduced quality of life. General epidemiological data on PHN is necessary for the effective management. However, data on the epidemiology of PHN in Korea is lacking. The aim of this study was to evaluate the epidemiological features of PHN in the general population.We used population-based medical data for 51,448,491 subscribers to the Health Insurance Service in the year of 2013 to analyze of PHN epidemiology in Korea, such as the incidence, regional distribution, seasonal variation, and healthcare resource utilization...
April 2016: Medicine (Baltimore)
Christine L Mai, Zulfiqar Ahmed, Aubrey Maze, Fatima Noorulla, Myron Yaster
Dr. Alvin 'Al' Hackel (1932-) Professor Emeritus of Anesthesiology, Perioperative and Pain Medicine, and Pediatrics at the Stanford University School of Medicine, has been an influential pioneer in shaping the scope and practice of pediatric anesthesia. His leadership helped to formally define the subspecialty of pediatric anesthesiology ('who is a pediatric anesthesiologist?') and the importance of specialization and regionalization of expertise in both patient transport and perioperative care. His enduring impact on pediatric anesthesia and critical care practice was recognized in 2006 by the American Academy of Pediatrics when it bestowed upon him the profession's highest lifetime achievement award, the Robert M...
May 2016: Paediatric Anaesthesia
T Kyle Harrison, T Edward Kim, Alex Kou, Cynthia Shum, Edward R Mariano, Steven K Howard
Ultrasound-guided regional anesthesia (UGRA) requires an advanced procedural skill set that incorporates both sonographic knowledge of relevant anatomy as well as technical proficiency in needle manipulation in order to achieve a successful outcome. Understanding how to differentiate a novice from an expert in UGRA using a quantifiable tool may be useful for comparing educational interventions that could improve the rate at which one develops expertise. Exploring the gaze pattern of individuals performing a task has been used to evaluate expertise in many different disciplines, including medicine...
June 2016: Journal of Anesthesia
Ankeet Deepak Udani, T Kyle Harrison, Edward R Mariano, Ryan Derby, Jack Kan, Toni Ganaway, Cynthia Shum, David M Gaba, Pedro Tanaka, Alex Kou, Steven K Howard
BACKGROUND AND OBJECTIVES: Simulation-based education strategies to teach regional anesthesia have been described, but their efficacy largely has been assumed. We designed this study to determine whether residents trained using the simulation-based strategy of deliberate practice show greater improvement of ultrasound-guided regional anesthesia (UGRA) skills than residents trained using self-guided practice in simulation. METHODS: Anesthesiology residents new to UGRA were randomized to participate in either simulation-based deliberate practice (intervention) or self-guided practice (control)...
March 2016: Regional Anesthesia and Pain Medicine
Benjamin Heller, Adam Levine
This is the case of an 80-year-old female who presented for evacuation of a neck hematoma on POD#3 after a parathyroidectomy. Her medical history included coronary artery disease with a drug-eluding stent, off aspirin for 2 weeks. She had a significant hematoma from the hyoid bone extending down to below the suprasternal notch. She reported hoarseness. The anesthesiology team provided regional anesthesia with bilateral superficial cervical blocks, supplemented with minimal sedation for patient compliance. The surgical team used no adjuvant local anesthetic...
October 2015: Middle East Journal of Anesthesiology
Monu Yadav, P Bhanu Kumar, Madhavi Singh, Ramachandran Gopinath
UNLABELLED: The spinal anesthesia has the definitive advantage that profound nerve block can be produced in a large part of the body by the relatively simple injection of a small amount of local anesthetic. BACKGROUND AND AIMS: The use of adjuvant drugs with local anesthetics for spinal is intended to improve the success of regional anesthesia. The present study evaluated magnesium sulfate in two different doses and fentanyl as an adjuvant to bupivacaine for spinal anesthesia...
September 2015: Anesthesia, Essays and Researches
Celalettin Altun, Hale Borazan, Osman Şahin, Kazım Gezginç
OBJECTIVE: We aimed to compare the effects of general and spinal anesthesia on cognitive functions in pregnant patients undergoing elective cesarean section. MATERIAL AND METHODS: Seventy-five American Society of Anesthesiology (ASA) I pregnant patients aged 18-40 years who were scheduled to undergo elective cesarean section were divided into three groups. Group sevoflurane (Group S) and Group desflurane (Group D) were administered general anesthesia, whereas Group regional (Group R) was administered spinal anesthesia...
2015: Journal of the Turkish German Gynecological Association
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