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https://www.readbyqxmd.com/read/28796131/beyond-ultrasound-guidance-for-regional-anesthesiology
#1
De Q Tran, André P Boezaart, Joseph M Neal
Despite its popularity, ultrasound (US)-guided regional anesthesiology is associated with significant limitations. The latter can be attributed to either the US machine (ie, decreased ability to insonate deep neural structures, as well as the thoracic spine) or the operator. Shortcomings associated with the operator can be explained by errors in perception (ie, ambiguous criteria for needle/catheter tip-to-nerve proximity and subparaneural local anesthetic injection) or interpretation. Perhaps the greatest confusion afflicting US-guided regional anesthesiology originates from an intellectual misconception pertaining to its application...
September 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28794840/virtual-reality-distraction-decreases-routine-intravenous-sedation-and-procedure-related-pain-during-preoperative-adductor-canal-catheter-insertion-a-retrospective-study
#2
Pooja G Pandya, T Edward Kim, Steven K Howard, Erica Stary, Jody C Leng, Oluwatobi O Hunter, Edward R Mariano
BACKGROUND: Virtual reality (VR) distraction is a nonpharmacological method to prevent acute pain that has not yet been thoroughly explored for anesthesiology. We present our experience using VR distraction to decrease routine intravenous sedation for patients undergoing preoperative perineural catheter insertion. METHODS: This 1-month quality improvement project involved all elective unilateral primary total knee arthroplasty patients who received a preoperative adductor canal catheter...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28777464/preliminary-experience-using-eye-tracking-technology-to-differentiate-novice-and-expert-image-interpretation-for-ultrasound-guided-regional-anesthesia
#3
Lindsay K Borg, T Kyle Harrison, Alex Kou, Edward R Mariano, Ankeet D Udani, T Edward Kim, Cynthia Shum, Steven K Howard
OBJECTIVES: Objective measures are needed to guide the novice's pathway to expertise. Within and outside medicine, eye tracking has been used for both training and assessment. We designed this study to test the hypothesis that eye tracking may differentiate novices from experts in static image interpretation for ultrasound (US)-guided regional anesthesia. METHODS: We recruited novice anesthesiology residents and regional anesthesiology experts. Participants wore eye-tracking glasses, were shown 5 sonograms of US-guided regional anesthesia, and were asked a series of anatomy-based questions related to each image while their eye movements were recorded...
August 4, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28772011/brain-molecular-changes-and-behavioral-alterations-induced-by-propofol-anesthesia-exposure-in-peripubertal-rats
#4
Željko Pavković, Kosara Smiljanić, Selma Kanazir, Desanka Milanović, Vesna Pešić, Sabera Ruždijić
BACKGROUND: Propofol is commonly used in modern anesthesiology. Some findings suggest that it is highly addictive. AIM: In this study it was examined whether propofol anesthesia exposure was able to induce behavioral alterations and brain molecular changes already described in addictive drug usage in peripubertal rats, during the onset of mid/periadolescence as a developmental period with increasing vulnerability to drug addiction. METHODS: The expression of D1 dopamine receptor, a dopamine, and cAMP-regulated phosphoprotein with a Mr 32 000; Ca(2+) /calmodulin-dependent protein kinase IIα; and Finkel-Biskis-Jinkins murine osteosarcoma viral oncogene homolog-B was examined in peripubertal rats 4, 24, and 48 hour after propofol anesthesia exposure by Western blot and immunohistochemistry...
September 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28767599/investigation-of-the-status-quo-of-massive-blood-transfusion-in-china-and-a-synopsis-of-the-proposed-guidelines-for-massive-blood-transfusion
#5
Jiang-Cun Yang, Qiu-Shi Wang, Qian-Li Dang, Yang Sun, Cui-Xiang Xu, Zhan-Kui Jin, Ting Ma, Jing Liu
The aim of this study was to provide an overview of massive transfusion in Chinese hospitals, identify the important indications for massive transfusion and corrective therapies based on clinical evidence and supporting experimental studies, and propose guidelines for the management of massive transfusion. This multiregion, multicenter retrospective study involved a Massive Blood Transfusion Coordination Group composed of 50 clinical experts specializing in blood transfusion, cardiac surgery, anesthesiology, obstetrics, general surgery, and medical statistics from 20 tertiary general hospitals across 5 regions in China...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28738348/colistin-resistance-in-kpc-2-and-shv-5-producing-klebsiella-pneumoniae-clinical-isolates-in-bulgaria
#6
Encho Savov, Iva Todorova, Lida Politi, Angelina Trifonova, Maja Borisova, Elena Kioseva, Athanassios Tsakris
BACKGROUND/AIMS: Colistin resistance is increasingly recognized among carbapenemase-producing Klebsiella pneumoniae isolates in several European regions. The current study documents the appearance of colistin resistance among KPC-2 and SHV-5-produning K. pneumoniae strains in Bulgaria. METHODS: Four colistin-resistant K. pneumoniae isolates were recovered from 2 patients hospitalized in the anesthesiology and resuscitation clinic of a tertiary care university hospital in Sofia, Bulgaria...
July 22, 2017: Chemotherapy
https://www.readbyqxmd.com/read/28663645/prophylactic-use-of-intravenous-clonidine-compared-to-tramadol-in-prevention-of-intraoperative-shivering-under-regional-anesthesia
#7
Sarmila Guha Banerjee, Pallab Kumar Nath, Rita Halder, Ujjwal Bandyopadhyay
OBJECTIVES: This study aimed to evaluate the relative efficacy of prophylactic intravenous (IV) clonidine and tramadol for control of intraoperative shivering following spinal anesthesia. MATERIALS AND METHODS: After institutional ethical clearance, 142 patients were chosen from either gender, aged 20-60 years, physical status American Society of Anesthesiology Class I and II scheduled for elective infraumbilical surgery under spinal anesthesia. Patients were randomized into two groups: Group C (n = 71) received injection clonidine 50 μg) IV in 100 ml normal saline (NS) over 10 min and Group T (n = 71) received injection tramadol 50 mg IV...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663619/comparison-of-the-effects-of-four-subdoses-of-dextroketamine-to-reduce-pain-during-posterior-brachial-plexus-block-a-randomized-double-blind-study
#8
Luiz Eduardo Imbellon, Marildo A Gouveia, Geraldo Borges de Morais Filho
BACKGROUND: The needle puncture produces discomfort during regional anesthesia. Sedation and local anesthesia are used to promote analgesia and amnesia. The main objective of this study was to compare the efficacy of four subanesthetic doses of dextroketamine for pain relief during brachial plexus block via the posterior approach. MATERIALS AND METHODS: Patients American Society of Anesthesiology I and II programed for elective surgery under brachial plexus block were distributed at randomized into four groups of twenty patients...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28633155/regional-anesthesia-and-pain-medicine-us-anesthesiology-resident-training-the-year-2015
#9
Joseph M Neal, Anne Gravel Sullivan, Richard W Rosenquist, Dan J Kopacz
BACKGROUND AND OBJECTIVES: The Anesthesiology Review Committee of the Accreditation Council for Graduate Medical Education sets core requirements for residency program accreditation. We periodically report and analyze the US anesthesiology residents' training experience in regional anesthesia and pain medicine. METHODS: Resident caseload, procedure, and pain medicine evaluation data were aggregated for the resident cohort who graduated in 2015. These data were analyzed for present-day experience and compared with previous reports from years 1980, 1990, and 2000 graduates...
July 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28627724/comparative-echogenicity-of-an-epidural-catheter-and-2-new-catheters-designed-for-ultrasound-guided-continuous-peripheral-nerve-blocks
#10
Daniel M Moy, T Edward Kim, T Kyle Harrison, Jody C Leng, Brendan Carvalho, Steven K Howard, Cynthia Shum, Alex Kou, Edward R Mariano
Visualization of the catheter during ultrasound-guided continuous nerve block performance may be difficult but is an essential skill for regional anesthesiologists. The objective of this in vitro study was to evaluate 2 newer catheters designed for enhanced echogenicity and compare them to a widely used catheter not purposely designed for ultrasound guidance. Outcomes were the numbers of first-place rankings among all 3 catheters and scores on individual echogenicity criteria as assessed by 2 blinded reviewers...
June 19, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28526159/anticoagulation-and-neuraxial-peripheral-anesthesia
#11
REVIEW
Mudit Kaushal, Ryan E Rubin, Alan D Kaye, Karina Gritsenko
Novel anticoagulants (NAGs) have emerged as the preferred alternatives to vitamin K antagonists. In patients being considered for regional anesthesia, these drugs present a layer of complexity in the preprocedure evaluation. There are no established tests to monitor anticoagulant activity and our experience is short with these drugs. These authors believe it is important to review the relevant hematology, orthopedics, and anesthesiology literature to provide a valuable reference for the clinician who is met with these challenges...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28425888/-satisfa%C3%A3-%C3%A3-o-com-o-internato-m%C3%A3-dico-em-portugal
#12
Miguel Bigotte Vieira, Pedro Godinho, Nuno Gaibino, Raquel Dias, Agostinho Sousa, Inês Madanelo, Francisco Ribeiro-Mourão, Mariana Brandão, Sónia Duarte, Tiago Meirinhos, Ana Luísa Catarino, Cláudio Espírito Santo, Ricardo Caiado, Ricardo Marques, Ana Gonçalves Ferreira, Carlos Ramalheira, João Valente Jorge, Marta Losada, Mário Santos, Edson Oliveira, João Paulo Farias, José Manuel Silva
INTRODUCTION: In the last years, the global context of medical education and Medical Residency programs in Portugal suffered substantial changes. The primary objective of this study was to evaluate and characterize medical residents ́ satisfaction with medical residency programs in Portugal and to identify features that could be improved. MATERIAL AND METHODS: We utilized as model the survey Postgraduate Hospital Educational Environment Measure that has been developed in the United Kingdom and is speci cally targeted to medical residents...
December 30, 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28410820/-optimizing-post-operative-pain-management-in-latin-america
#13
João Batista Santos Garcia, Patricia Bonilla, Durval Campos Kraychette, Fernando Cantú Flores, Elizabeth Diaz Perez de Valtolina, Carlos Guerrero
Post-operative pain management is a significant problem in clinical practice in Latin America. Insufficient or inappropriate pain management is in large part due to insufficient knowledge, attitudes and education, and poor communications at various levels. In addition, the lack of awareness of the availability and importance of clear policies and guidelines for recording pain intensity, the use of specific analgesics and the proper approach to patient education have led to the consistent under-treatment of pain management in the region...
April 11, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28367291/learning-curves-for-three-specific-procedures-by-anesthesiology-residents-using-the-learning-curve-cumulative-sum-lc-cusum-test
#14
Gregoire Weil, Cyrus Motamed, David J Biau, Marie Laurence Guye
BACKGROUND: The learning curve cumulative sum (LC-CUSUM) test is an innovative tool that allows quantitative monitoring of individual medical performance during the learning process by determining when a predefined acceptable level of performance is reached. This study used the LC-CUSUM test to monitor the learning process and failure rate of anesthesia residents training for specific subspecialty anesthesia procedures. METHODS: The study included 490 tracheal punctures (TP) for jet ventilation, 340 thoracic epidural analgesia (TEA) procedures, and 246 fiberoptic nasal intubations (FONI) performed by 18 residents during their single 6-month rotation...
April 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28269192/a-probabilistic-framework-based-on-slic-superpixel-and-gaussian-processes-for-segmenting-nerves-in-ultrasound-images
#15
Julian Gil Gonzalez, Mauricio A Alvarez, Alvaro A Orozco
We deal with an important problem in the field of anesthesiology known as automatic segmentation of nerve structures depicted in ultrasound images. This is important to aid the experts in anesthesiology, in order to carry out Peripheral Nerve Blocking (PNB). Ultrasound imaging has gained recent interest for performing PNB procedures since it offers a non-invasive visualization of the nerve and the anatomical structures around it. However, the location of these nerves in ultrasound images is a difficult task for the specialist due to the artifacts (i...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28267069/upgrading-a-social-media-strategy-to-increase-twitter-engagement-during-the-spring-annual-meeting-of-the-american-society-of-regional-anesthesia-and-pain-medicine
#16
Eric S Schwenk, Kellie M Jaremko, Rajnish K Gupta, Ankeet D Udani, Colin J L McCartney, Anne Snively, Edward R Mariano
Microblogs known as "tweets" are a rapid, effective method of information dissemination in health care. Although several medical specialties have described their Twitter conference experiences, Twitter-related data in the fields of anesthesiology and pain medicine are sparse. We therefore analyzed the Twitter content of 2 consecutive spring meetings of the American Society of Regional Anesthesia and Pain Medicine using publicly available online transcripts. We also examined the potential contribution of a targeted social media campaign on Twitter engagement during the conferences...
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28227422/a-probabilistic-framework-based-on-slic-superpixel-and-gaussian-processes-for-segmenting-nerves-in-ultrasound-images
#17
Julian Gil Gonzalez, Mauricio A Alvarez, Alvaro A Orozco, Julian Gil Gonzalez, Mauricio A Alvarez, Alvaro A Orozco, Mauricio A Alvarez, Julian Gil Gonzalez, Alvaro A Orozco
We deal with an important problem in the field of anesthesiology known as automatic segmentation of nerve structures depicted in ultrasound images. This is important to aid the experts in anesthesiology, in order to carry out Peripheral Nerve Blocking (PNB). Ultrasound imaging has gained recent interest for performing PNB procedures since it offers a non-invasive visualization of the nerve and the anatomical structures around it. However, the location of these nerves in ultrasound images is a difficult task for the specialist due to the artifacts (i...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28184270/randomized-comparison-of-popliteal-sciatic-perineural-catheter-tip-migration-and-dislocation-in-a-cadaver-model-using-two-catheter-designs
#18
Lauren Steffel, Steven K Howard, Lindsay Borg, Edward R Mariano, Jody C Leng, T Edward Kim
BACKGROUND: New catheter-over-needle (CON) technology for continuous peripheral nerve blockade has emerged, but its effect on the risk of perineural catheter tip dislocation is unknown. Less flexible catheters may be more likely to migrate away from the nerve with simulated patient movement. In the present study, we evaluated catheter tip migration between CON catheters and traditional catheter-through-needle (CTN) catheters during ultrasound-guided short-axis in-plane (SAX-IP) insertion...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28144687/-trial-sequential-analysis-sample-size-calculation-for-reliable-meta-analyses
#19
REVIEW
S Weibel, P Kranke
BACKGROUND: Meta-analyses have a great impact on medical decision-making. Random errors are, however, often the reason for misinterpretation of interventional effects in meta-analyses. OBJECTIVE: The aim of this article is to introduce authors and readers of meta-analyses to the problem of random errors. The article presents trial sequential analysis (TSA) as a suitable and user-friendly method that adjusts for the risk of random errors in meta-analyses. MATERIAL AND METHODS: The practical application of TSA is illustrated and exemplified using regional anesthesiology procedures versus conventional pain therapy with respect to the prevention of persistent postoperative pain after breast cancer surgery or thoracotomy...
February 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28126454/ultrasound-guided-retroclavicular-approach-infraclavicular-brachial-plexus-block-for-upper-extremity-emergency-procedures
#20
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...
May 2017: American Journal of Emergency Medicine
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