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https://www.readbyqxmd.com/read/29656945/ketamine-versus-ketamine-pluses-atropine-for-pediatric-sedation-a-meta-analysis
#1
REVIEW
Jiaxiao Shi, Ang Li, Zhijian Wei, Yang Liu, Cong Xing, Hongyu Shi, Han Ding, Dayu Pan, Guangzhi Ning, Shiqing Feng
OBJECTIVES: The application of atropine for pediatric sedation in the emergency department remains controversial. Our objective was to perform a comprehensive review of the literature and assess the clinical indexes in groups with and without atropine use. METHODS: PubMed, EMBASE, and the Cochrane Library were searched for randomized and non-randomized studies that compared ketamine and ketamine plus atropine for pediatric sedation. The risk ratio with 95% confidence interval was calculated using either a fixed- or random-effects model according to the value of I2 ...
April 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29628319/facial-nerve-palsy-and-laryngospasm-as-a-complication-of-local-anaesthesia-during-adenotonsillectomy
#2
Michał Lubszczyk, Anna Łuczyńska-Sopel, Dariusz Polaczkiewicz
Tonsil surgeries are the most frequently performed surgical procedures in ENT departments. We would like to present the case of a 5-year-old patient who suffered from unilateral peripheral facial nerve palsy and laryngeal spasm following adenotonsillectomy. Paresis was observed immediately after the transfer of the patient to the postoperative room. The activity of facial muscles was restored within 2 hours from the beginning of the surgery. We assume that this was the direct effect of an anaesthetic on the extracranial processes of the facial nerve...
April 5, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29622714/hypocalcaemia-in-an-adult-the-importance-of-not-overlooking-the-cause
#3
Catarina Abrantes, Daniela Brigas, Hugo Jorge Casimiro, Margarida Madeira
A 58-year-old male patient was admitted at the São Bernardos's Hospital (Setúbal, Portugal) with generalised muscle spasms, dyspnoea, laryngospasm and bronchospasm in the context of severe hypocalcaemia. Despite efforts to correct serum calcium, it remained below average, leading to question the true cause of hypocalcaemia. Low parathyroid hormone and 25-hydroxyvitamin D, along with facial anomalies, palate defect and cognitive impairment with concomitant psychiatric disorder led to a suspicion of a DiGeorge/velocardiofacial/22q11...
April 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29620011/ictal-laryngospasm-monitored-by-video-eeg-and-polygraphy-a-potential-sudep-mechanism
#4
Nuria Lacuey, Laura Vilella, Johnson P Hampson, Jayakumar Sahadevan, Samden D Lhatoo
A 56-year-old man with refractory bitemporal epilepsy was monitored in the Epilepsy Monitoring Unit (EMU). In a video-EEG captured seizure, brief oroalimentary automatisms were followed by increased inspiratory effort, accompanied by prominent, visible tracheal movements and audible inspiratory stridor. The patient's oxygen saturation rapidly declined to 62%; persistent severe hypoxemia ended with spontaneous effective respiration commencing at seizure end. Subsequent seizures necessitated intensive care unit admission for respiratory distress, and ventilator support...
April 5, 2018: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/29605429/dysfunction-of-nav1-4-a-skeletal-muscle-voltage-gated-sodium-channel-in-sudden-infant-death-syndrome-a-case-control-study
#5
Roope Männikkö, Leonie Wong, David J Tester, Michael G Thor, Richa Sud, Dimitri M Kullmann, Mary G Sweeney, Costin Leu, Sanjay M Sisodiya, David R FitzPatrick, Margaret J Evans, Iona J M Jeffrey, Jacob Tfelt-Hansen, Marta C Cohen, Peter J Fleming, Amie Jaye, Michael A Simpson, Michael J Ackerman, Michael G Hanna, Elijah R Behr, Emma Matthews
BACKGROUND: Sudden infant death syndrome (SIDS) is the leading cause of post-neonatal infant death in high-income countries. Central respiratory system dysfunction seems to contribute to these deaths. Excitation that drives contraction of skeletal respiratory muscles is controlled by the sodium channel NaV1.4, which is encoded by the gene SCN4A. Variants in NaV1.4 that directly alter skeletal muscle excitability can cause myotonia, periodic paralysis, congenital myopathy, and myasthenic syndrome...
March 28, 2018: Lancet
https://www.readbyqxmd.com/read/29593002/angioedema-as-the-presenting-feature-of-systemic-lupus-erythematosus
#6
Naveen Kumar, Deepanjali Surendran, Chanaveerappa Bammigatti
A young female in her early 20s presented with low-grade fever for 1 month, puffiness of face and abdominal distension for 15 days. Evaluation revealed pancytopenia with normocellular marrow, hypocomplementaemia and Coomb's positive haemolytic anaemia. She had angioedema with laryngospasm and worsening facial oedema which had dramatic response to steroids. Further workup lead to a diagnosis of systemic lupus erythematosus with neuropsychiatric involvement. Treatment with pulse steroids and cyclophosphamide resulted in dramatic improvement of her symptoms with no recurrence of angioedema during her follow-up visits...
March 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29569985/predictive-risk-factors-of-failed-laryngeal-mask-airway-insertion-at-first-attempt
#7
Jia Wang, Xiaoping Shi, Tao Xu, Geng Wang
Objectives A failed first attempt at laryngeal mask airway (LMA) insertion could increase the risk of laryngospasm, hypoxemia, and postoperative sore throat. This study was performed to investigate the risk factors for failed first-attempt LMA placement. Methods In total, 461 patients who underwent general anesthesia with a Supreme LMA (Teleflex Medical, Shanghai, China) and who had an American Society of Anesthesiologists (ASA) physical status of I to III were prospectively enrolled. The LMA was inserted after anesthetic induction...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29569250/impact-of-upper-respiratory-tract-infections-on-perioperative-outcomes-of-children-undergoing-therapeutic-cardiac-catheterisation
#8
S Zhang, S Ding, M Cai, J Bai, M Zhang, Y Huang, J Zheng
BACKGROUND: Recent upper respiratory tract infection (URI) is associated with increased incidence of perioperative complications in children undergoing open heart surgery. As a result, surgery is often postponed. However, the effect of recent URI on the incidence of perioperative complications in children undergoing therapeutic cardiac catheterisation is unknown. We investigated the perioperative outcomes of congenital heart disease (CHD) children with recent URI who underwent elective therapeutic catheterisation...
March 22, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29560077/higher-mallampati-scores-are-not-associated-with-more-adverse-events-during-pediatric-procedural-sedation-and-analgesia
#9
Maya S Iyer, Raymond D Pitetti, Melissa Vitale
Introduction: Procedural sedation and analgesia (PSA) is used by non-anesthesiologists (NAs) outside of the operating room for several types of procedures. Adverse events during pediatric PSA that pose the most risk to patient safety involve airway compromise. Higher Mallampati scores may indirectly indicate children at risk for airway compromise. Medical governing bodies have proposed guidelines for PSA performed by NAs, but these recommendations rarely suggest using Mallampati scores in pre-PSA evaluations...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29542031/an-explanation-for-sudden-death-in-epilepsy-sudep
#10
REVIEW
Mark Stewart
This review traces the examination of autonomic, cardiovascular, and respiratory derangements associated with seizure activity in the clinical and preclinical literature generally, and in the author's animal model specifically, and concludes with the author's views on the potential mechanisms for sudden death in epilepsy (SUDEP). An animal model that employs kainic acid-induced seizures on a background of urethane anesthesia has permitted unprecedented access to the behavior of autonomic, cardiovascular, and respiratory systems during seizure activity...
March 14, 2018: Journal of Physiological Sciences: JPS
https://www.readbyqxmd.com/read/29534408/-chinese-expert-consensus-on-tetanus-immunization
#11
(no author information available yet)
Tetanus is an acute specific infection caused by obligate anaerobes, which is still a serious public health problem. Tetanus bacterium is an obligate anaerobic bacterium, widely distributed in nature, which can exist in dust, soil, human or animal excrement. The bacteria invade the body primarily through the skin or mucosal wounds, and most commonly in trauma and burn patients, unclean newborns, and unsafe surgical instruments. Exotoxin produced by tetanus bacteria can cause temporary changes in the central nervous system, manifested as systemic skeletal muscle persistence and paroxysmal spasm, severe cases of laryngospasm, asphyxia, lung infections and organ failure, which is a very serious and potentially fatal disease...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29531602/survey-about-the-extubation-practice-among-anaesthesiologists-in-kosovo
#12
Nehat Baftiu, Islam Krasniqi, Kastriot Haxhirexha, Rudin Domi
BACKGROUND: Tracheal extubations may be performed before or after awakening from anaesthesia. The advantage of extubation during anaesthesia may avoid all the unpleasant effects of fully awake extubation such as severe hypertension and tachycardia, malignant dysrhythmias, myocardial ischemia laryngospasm, and cough induced high intraocular and intracranial pressure. AIM: To show the current practice of performing extubations in Kosovo, as well as the advantage and disadvantage in performing this procedure in an awake patient or inpatient in light anaesthesia...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29497484/comparing-the-efficacy-and-safety-of-laryngeal-mask-airway-streamlined-liner-of-the-pharyngeal-airway-and-i-gel-following-tracheal-extubation
#13
Hesameddin Modir, Esmail Moshiri, Bijan Yazdi, Abolfazl Mohammadbeigi, Amirreza Modir
Adverse events following surgical operations are common complications due to removal of tracheal tube in contrast to the tracheal intubation. Awareness about the new methods and strategies for tracheal tube extubation is necessary for a safe and successful extubation. Therefore, we aimed to assess the safety and efficacy of laryngeal mask airway (LMA), streamlined liner of the pharyngeal airway (SLIPA) and I-gel in extubation time of tracheal tube. A one-single randomized clinical trial was conducted in 105 eligible patients in three groups including LMA, SLIPA and I-gel...
October 2017: Medical Gas Research
https://www.readbyqxmd.com/read/29450783/-laryngospasm-in-amyotrophic-lateral-sclerosis-a-case-report
#14
Andrea Spielberger, Stefan Lorenzl
Laryngospasm in amyotrophic lateral sclerosis is a symptom seldom described in neurological literature. Despite the self limiting character it means a life threatening condition for the patient himself. This case report and the following discussion tries to look upon underlying causes and options of therapy.
February 15, 2018: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29416449/effect-of-intravenous-lidocaine-on-the-incidence-of-postextubation-laryngospasm-a-double-blind-placebo-controlled-randomized-trial
#15
Khalid Ibrahim Aljonaieh
Objectives: The study aimed to test the effect of intraoperative intravenous (IV) lidocaine on the incidence of postextubation laryngospasm in adult patients. Methods: The prospective randomized clinical trial was conducted at tertiary care hospital in Riyadh, between January and December 2012. Seventy-two patients undergoing laparoscopic cholecystectomy were randomly assigned to receive either placebo ( n = 36) or IV lidocaine ( n = 36), 1 mg/kg bolus after desflurane was discontinued...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29416448/intravenous-lidocaine-and-postextubation-laryngospasm
#16
EDITORIAL
Muhammad Faisal Khan, Ullah Saleem
No abstract text is available yet for this article.
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29406183/efficacy-of-a-new-dual-channel-laryngeal-mask-airway-the-lma-%C3%A2-gastro%C3%A2-airway-for-upper-gastrointestinal-endoscopy-a-prospective-observational-study
#17
N C S Terblanche, C Middleton, D L Choi-Lundberg, M Skinner
BACKGROUND: Significant cardiorespiratory events are frequent in patients undergoing gastrointestinal endoscopy. Central to the occurrence of respiratory events is an unsecured airway. This study sought to determine the efficacy of a new laryngeal mask airway, the LMA® GastroTM Airway (Teleflex Medical, Athlone, Ireland), in patients undergoing upper gastrointestinal endoscopy. New design features include a dedicated channel for oesophageal intubation and separate channel with terminal cuff for lung ventilation...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29358491/ketamine-procedural-sedation-in-the-emergency-department-of-an-urban-tertiary-hospital-in-dar-es-salaam-tanzania
#18
Zlatan Coralic, Hendry R Sawe, Juma A Mfinanga, Alfredo Cortez, Jennifer Koehl, Hannah Siroker, Teri A Reynolds
STUDY OBJECTIVE: We describe ketamine procedural sedations and associated adverse events in low-acuity and high-acuity patients in a resource-limited ED. METHODS: This was a prospective observational study of ketamine procedural sedations at the Emergency Medical Department at the Muhimbili National Hospital in Dar es Salaam, Tanzania. We observed consecutive procedural sedations and recorded patient demographics, medications, vital signs, pulse oximetry, capnography and a priori defined adverse events (using standard definitions in emergency medicine sedation guidelines)...
April 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29343232/intravenous-dexmedetomidine-pre-medication-reduces-the-required-minimum-alveolar-concentration-of-sevoflurane-for-smooth-tracheal-extubation-in-anesthetized-children-a-randomized-clinical-trial
#19
Meiqin Di, Zhuqing Yang, Dansi Qi, Hongyan Lai, Junzheng Wu, Huacheng Liu, Xuefei Ye, Wangning ShangGuan, Qingquan Lian, Jun Li
BACKGROUND: It has been known that Dexmedetomidine pre-medication enhances the effects of volatile anesthetics, reduces the need of sevoflurane, and facilitates smooth extubation in anesthetized children. This present study was designed to determine the effects of different doses of intravenous dexmedetomidine pre-medication on minimum alveolar concentration of sevoflurane for smooth tracheal extubation (MACEX ) in anesthetized children. METHODS: A total of seventy-five pediatric patients, aged 3-7 years, ASA physical status I and II, and undergoing tonsillectomy were randomized to receive intravenous saline (Group D0 ), dexmedetomidine 1 μg∙kg-1 (Group D1 ), or dexmedetomidine 2 μg∙kg-1 (Group D2 ) approximately 10 min before anesthesia start...
January 17, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29316032/optimum-time-for-intravenous-cannulation-after-induction-with-sevoflurane-oxygen-and-nitrous-oxide-in-children-without-any-premedication
#20
Abm Kamrul Hasan, Raman Sivasankar, Salil G Nair, Wamia U Hasan, Zulaidi Latif
BACKGROUND: Intravenous cannulation is usually done in children after inhalational induction with volatile anesthetic agents. The optimum time for safe intravenous cannulation after induction with sevoflurane, oxygen, and nitrous oxide has been studied in premedicated children, but there is no information for the optimum time for cannulation with inhalational induction in children without premedication. AIMS: The aim of this study was to determine the optimum time for intravenous cannulation after the induction of anesthesia with sevoflurane, oxygen, and nitrous oxide in children without any premedication...
February 2018: Paediatric Anaesthesia
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