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https://www.readbyqxmd.com/read/29416252/perioperative-use-of-transthoracic-echocardiography-in-a-patient-with-congenitally-corrected-transposition-of-great-arteries-atrial-septal-defect-and-severe-pulmonary-stenosis-for-lower-segment-cesarean-section
#1
Vikas Saini, Tanvir Samra, Gurpreet Kaur
A 25-year-old female with congenitally corrected transposition of great arteries (CCTGAs), atrial septal defect, and severe pulmonary stenosis underwent lower segment cesarean section at 34 weeks of gestation using combined spinal epidural anesthesia (CSEA). We used transthoracic echocardiography (TTE) for intraoperative monitoring of the cardiovascular system because these patients are reported to have a high prevalence of myocardial perfusion defects, regional wall motion abnormalities, and impaired ventricular contractility...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29311012/anesthetic-management-of-mosaic-turner-s-syndrome-posted-for-elective-cesarean-delivery-after-spontaneous-pregnancy
#2
K Kalopita, L Michala, C Theofanakis, D Valsamidis
Turner's syndrome, one of the most common sex chromosome abnormalities in females, is caused by loss of part or all of an X chromosome. We report a case of mosaic Turner's syndrome, posted for elective cesarean delivery under low-dose sequential combined spinal epidural anesthesia. The unique features of this case were the combination of an anticipated difficult airway and both short stature and scoliosis in the lumbar region. A titrated combined spinal-epidural technique was performed in order to avoid hemodynamic instability, which could have been exacerbated in the presence of cardiovascular deformities that accompany this syndrome in many cases...
November 26, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29284860/effect-of-locally-administered-dexmedetomidine-as-adjuvant-to-levobupivacaine-in-supraclavicular-brachial-plexus-block-double-blind-controlled-study
#3
Bikash Bisui, Swastika Samanta, Sumanta Ghoshmaulik, Amit Banerjee, Tirtha R Ghosh, Suman Sarkar
Context: Brachial plexus block is effective with good postoperative analgesia in upper limb surgery has gained importance as it safe, low cost, and maintains stable hemodynamics intraoperatively. To decrease the onset time and prolong the duration of nerve block bicarbonate, opioids (morphine, fentanyl, etc.), sympathomimetic agents (epinephrine, phenylephrine, etc.), α-2 agonists (clonidine and dexmedetomidine), calcium channel blocker (verapamil), magnesium sulfate, etc., were studied with local anesthetics and their isomers...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28967579/distribution-of-fos-immunoreactive-cells-in-the-ventral-part-of-rat-medulla-following-voluntary-treadmill-exercise
#4
Nao Kumada, Satoshi Koba, Eri Hanai, Tatsuo Watanabe
The ventral part of the medulla, which contains important cardiovascular regions, is reportedly activated during exercise. Nevertheless, it was uncertain which region(s) in the ventral medulla are specifically activated by exercise. The present study aimed to demonstrate a general pattern of exercise-specific distribution of excited neuronal cells in the rat ventral medulla. Via immunohistochemical experiments, we mapped tyrosine hydroxylase- and Fos-immunoreactive cells (TH-IR and Fos-IR cells, respectively) on rat medullary coronal sections following a bout of voluntary treadmill exercise, a comparative control period, or after pharmacologically induced-hypotension under anesthesia...
September 22, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28932733/pectoral-nerve-block-pecs-block-with-sedation-for-breast-conserving-surgery-without-general-anesthesia
#5
Eun-Jin Moon, Seung-Beom Kim, Jun-Young Chung, Jeong-Yoon Song, Jae-Woo Yi
Most regional anesthesia in breast surgeries is performed as postoperative pain management under general anesthesia, and not as the primary anesthesia. Regional anesthesia has very few cardiovascular or pulmonary side-effects, as compared with general anesthesia. Pectoral nerve block is a relatively new technique, with fewer complications than other regional anesthesia. We performed Pecs I and Pec II block simultaneously as primary anesthesia under moderate sedation with dexmedetomidine for breast conserving surgery in a 49-year-old female patient with invasive ductal carcinoma...
September 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28889004/quantitative-vascular-neuroimaging-of-the-rat-brain-using-superparamagnetic-nanoparticles-new-insights-on-vascular-organization-and-brain-function
#6
Codi A Gharagouzloo, Liam Timms, Ju Qiao, Zihang Fang, Joseph Nneji, Aniket Pandya, Praveen Kulkarni, Anne L van de Ven, Craig Ferris, Srinivas Sridhar
A method called Quantitative Ultra-Short Time-to-Echo Contrast Enhanced (QUTE-CE) Magnetic Resonance Imaging (MRI) which utilizes superparamagnetic iron oxide nanoparticles (SPIONs) as a contrast agent to yield positive contrast angiograms with high clarity and definition is applied to the whole live rat brain. QUTE-CE MRI intensity data are particularly well suited for measuring quantitative cerebral blood volume (qCBV). A global map of qCBV in the awake resting-state with unprecedented detail was created via application of a 3D MRI rat brain atlas with 173 segmented and annotated brain areas...
September 6, 2017: NeuroImage
https://www.readbyqxmd.com/read/28727707/continuing-anti-thrombotic-medication-during-low-to-intermediate-risk-spinal-procedures-a-retrospective-evaluation
#7
Noud van Helmond, Wesley Day, Kenneth B Chapman
BACKGROUND: The current American Society of Regional Anesthesia (ASRA) guidelines recommend discontinuing anti-thrombotic therapy prior to any interventional spine procedures to decrease the incidence of bleeding complications. However, discontinuing anti-thrombotics may pose considerable danger in terms of cerebrovascular and cardiovascular events. Recent evidence suggests that some spinal interventions may still be performed safely with anti-thrombotics on board and some practitioners thus elect to continue certain anti-thrombotics for these procedures...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28457827/ventilation-distribution-assessed-with-electrical-impedance-tomography-and-the-influence-of-tidal-volume-recruitment-and-positive-end-expiratory-pressure-in-isoflurane-anesthetized-dogs
#8
Aline M Ambrosio, Tatiana P A Carvalho-Kamakura, Keila K Ida, Barbara Varela, Felipe S R M Andrade, Lara L Facó, Denise T Fantoni
OBJECTIVE: To examine the intrapulmonary gas distribution of low and high tidal volumes (VT) and to investigate whether this is altered by an alveolar recruitment maneuver (ARM) and 5 cmH2O positive end-expiratory pressure (PEEP) during anesthesia. STUDY DESIGN: Prospective randomized clinical study. ANIMALS: Fourteen client-owned bitches weighing 26 ± 7 kg undergoing elective ovariohysterectomy. METHODS: Isoflurane-anesthetized dogs in dorsal recumbency were ventilated with 0 cmH2O PEEP and pressure-controlled ventilation by adjusting the peak inspiratory pressure (PIP) to achieve a low (7 mL kg(-1); n = 7) or a high (12 mL kg(-1); n = 7) VT...
March 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28455727/perioperative-considerations-for-patients-with-sickle-cell-disease-a-narrative-review
#9
Narjeet Khurmi, Andrew Gorlin, Lopa Misra
PURPOSE: Approximately 200,000 individuals worldwide are born annually with sickle cell disease (SCD). Regions with the highest rates of SCD include Africa, the Mediterranean, and Asia, where its prevalence is estimated to be 2-6% of the population. An estimated 70,000-100,000 people in the United States have SCD. Due to enhanced newborn screening, a better understanding of this disease, and more aggressive therapy, many sickle cell patients survive into their adult years and present more frequently for surgery...
August 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28402089/perioperative-management-of-obstructive-sleep-apnea-a-systematic-review
#10
Ruggero Corso, Vincenzo Russotto, Cesare Gregoretti, Davide Cattano
Obstructive sleep apnea (OSA) is the leading sleep disordered breathing condition, with a prevalence rate of moderate to severe OSA of approximately 10 - 17% in the general population. Its prevalence in the surgical population seems to be higher. However, a proportion of up to 60% of patients may not have a formal diagnosis at the moment of preoperative visit. OSA is associated with a number of comorbidities and increased perioperative risks. However, most interventions for the perioperative management of OSA patients lack high quality evidence...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27900415/-management-of-anesthesia-in-endovascular-interventions
#11
REVIEW
T Rössel, R Paul, T Richter, S Ludwig, T Hofmockel, A R Heller, T Koch
Cardiovascular diseases are one of the leading causes of morbidity and mortality in Germany. In these patients, the high-risk profile necessitates an interdisciplinary and multimodal approach to treatment. Endovascular interventions and vascular surgery have become established as an important element of this strategy in the past; however, the different anatomical localizations of pathological vascular alterations make it necessary to use a wide spectrum of procedural options and methods; therefore, the requirements for management of anesthesia are variable and necessitate a differentiated approach...
December 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27816131/anesthesia-patients-with-concomitant-cardiac-and-hepatic-dysfunction
#12
REVIEW
Julianne Ahdout, Michael Nurok
Anesthesia and surgery in patients with hepatic and cardiac dysfunction poses a challenge for anesthesiologists. It is imperative to optimize these patients perioperatively. Cirrhosis is associated with a wide range of cardiovascular abnormalities. Cirrhotic cardiomyopathy is characterized by blunted contractile responsiveness or systolic incompetence, and/or diastolic dysfunction. In liver disease, anesthetic drug distribution, metabolism, and elimination may be altered. Among patients with liver disease, propofol is a reasonable anesthetic choice and cisatracurium is the preferred neuromuscular blocker...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27632347/adrb2-gly16gly-genotype-cardiac-output-and-cerebral-oxygenation-in-patients-undergoing-anesthesia-for-abdominal-aortic-aneurysm-surgery
#13
Jonatan Myrup Staalsø, Kim Zillo Rokamp, Niels D Olesen, Lars Lonn, Niels H Secher, Niels V Olsen, Teit Mantoni, Ulf Helgstrand, Henning B Nielsen
BACKGROUND: Gly16arg polymorphism of the adrenergic β2-receptor is associated with the elevated cardiac output (Q) in healthy gly16-homozygotic subjects. We questioned whether this polymorphism also affects Q and regional cerebral oxygen saturation (SCO2) during anesthesia in vascular surgical patients. METHODS: One hundred sixty-eight patients (age 71 ± 6 years) admitted for elective surgery were included. Cardiovascular variables were determined before and during anesthesia by intravascular pulse contour analysis (Nexfin) and SCO2 by cerebral oximetry (INVOS 5100C)...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27594753/anesthetic-management-of-urgent-cesarean-section-with-undiagnosed-transposition-of-great-arteries
#14
Nurullah Yilmaz, Ersin Koksal, Gokce Ultan Ozgen, Ersan Ozen, Ahmet Dilek, Deniz Karakaya, Fatma Ulger
We consider that general anesthesia will be an appropriate and safe method as regional methods could lead to significant time loss in the prevention or minimization of complications. High blockage required for regional anesthetic methods in pregnant women with TGA and the maintenance of hemodynamic stability may become difficult due to neuroaxial sympathectomy even if a successful neuroaxial block has been provided. Agents with minimal effect on cardiovascular functions should be preferred for anesthesia induction and maintenance and close hemodynamic monitoring should be done during intraoperative and postoperative periods...
June 2016: Medical Archives
https://www.readbyqxmd.com/read/27525256/molecular-and-integrative-physiological-effects-of-isoflurane-anesthesia-the-paradigm-of-cardiovascular-studies-in-rodents-using-magnetic-resonance-imaging
#15
REVIEW
Christakis Constantinides, Kathy Murphy
To-this-date, the exact molecular, cellular, and integrative physiological mechanisms of anesthesia remain largely unknown. Published evidence indicates that anesthetic effects are multifocal and occur in a time-dependent and coordinated manner, mediated via central, local, and peripheral pathways. Their effects can be modulated by a range of variables, and their elicited end-effect on the integrative physiological response is highly variable. This review summarizes the major cellular and molecular sites of anesthetic action with a focus on the paradigm of isoflurane (ISO) - the most commonly used anesthetic nowadays - and its use in prolonged in vivo rodent studies using imaging modalities, such as magnetic resonance imaging (MRI)...
2016: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27486405/altered-differential-control-of-sympathetic-outflow-following-sedentary-conditions-role-of-subregional-neuroplasticity-in-the-rvlm
#16
Madhan Subramanian, Patrick J Mueller
Despite the classically held belief of an "all-or-none" activation of the sympathetic nervous system, differential responses in sympathetic nerve activity (SNA) can occur acutely at varying magnitudes and in opposing directions. Sympathetic nerves also appear to contribute differentially to various disease states including hypertension and heart failure. Previously we have reported that sedentary conditions enhanced responses of splanchnic SNA (SSNA) but not lumbar SNA (LSNA) to activation of the rostral ventrolateral medulla (RVLM) in rats...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27160623/-sedated-non-intubated-bilateral-thoracoscopic-sympathectomy-r3-r4
#17
José Manuel Mier-Odriozola
Non-intubated thoracic surgery entails procedures performed through regional anesthesia method in awake or mildly sedated, spontaneously ventilating patients. This method represents advantages for the cardiovascular system, and reduces the orotracheal trauma, postoperative atelectasis, and pneumonia. It also possibly reduces costs. Other theoretical advantages are: easier acceptance of surgery, attenuated stress hormone and immune response, and possibly a better survival in oncological surgery. We show a 34-year-old woman with sever palmar-axillary hyperhidrosis...
March 2016: Gaceta Médica de México
https://www.readbyqxmd.com/read/26995947/-placenta-percreta-a-severe-obstetric-complication-despite-correct-diagnosis-a-case-report
#18
Karolina Gruca-Stryjak, Mariola Ropacka-Lesiak, Grzegorz Breborowicz
This paper presents a case of a pregnant woman with a history of two cesarean sections. The patient was admitted to the hospital because of vaginal bleeding. The ultrasound revealed a placenta covering the internal os. The placenta was characterized by heterogeneous echogenicity with visible irregular hypoechogenic areas and blurred border between the placenta and the cervix. Rich vascularity was observed on the border of the placenta, urethra and the urinary bladder. Cystoscopy showed severe congestion around the urethra...
December 2015: Ginekologia Polska
https://www.readbyqxmd.com/read/26983833/serious-adverse-events-within-30%C3%A2-days-of-groin-hernia-surgery
#19
H Nilsson, U Angerås, G Sandblom, P Nordin
PURPOSE: To analyze severe complications after groin hernia repair with respect to age, ASA score, hernia anatomy, method of repair and method of anesthesia, using nationwide registers. The annual rate of 20 million groin hernia operations throughout the world renders severe complications, although rare, important both for the patient, the clinician, and the health economist. METHODS: Two nationwide registers, the Swedish Hernia Register and the National Swedish Patient Register were linked to find intraoperative complications, severe cardiovascular events and severe surgical adverse events within 30 days of groin hernia surgery...
June 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/26982116/the-obese-patient-undergoing-nonbariatric-surgery
#20
REVIEW
Thomas Bluth, Paolo Pelosi, Marcelo Gama de Abreu
PURPOSE OF REVIEW: This article provides the reader with recent findings on the pathophysiology of comorbidities in the obese, as well as evidence-based treatment options to deal with perioperative respiratory challenges. RECENT FINDINGS: Our understanding of obesity-associated asthma, obstructive sleep apnea, and obesity hypoventilation syndrome is still expanding. Routine screening for obstructive sleep apnea using the STOP-Bang score might identify high-risk patients that benefit from perioperative continuous positive airway pressure and close postoperative monitoring...
June 2016: Current Opinion in Anaesthesiology
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