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cardiac surgery and anesthesia

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https://www.readbyqxmd.com/read/28727703/intrathecal-morphine-improves-hemodynamic-parameters-and-analgesia-in-patients-undergoing-aortic-valve-replacement-surgery-a-prospective-double-blind-randomized-trial
#1
Hamed Elgendy, Hatem A R Helmy
BACKGROUND: Intrathecal morphine (ITM) has been used in hopes of providing good postoperative analgesia in cardiac surgery. Little is known about its use in isolated aortic valve replacement surgery. OBJECTIVES: To evaluate the effects of 7 µ/kg ITM administration in aortic valve replacement in regards to hemodynamics, pain score, and postoperative complications when compared to general anesthesia alone. STUDY DESIGN: A randomized, double-blind trial...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28723765/perioperative-management-of-intracardiac-leiomyomatosis-an-observational-cohort-study
#2
Jiaying Xu, Min Wei, Qi Miao, Bin Zhu, Chunhua Yu, Yuguang Huang
Intracardiac leiomyomatosis (ICLM) is a rare condition in which the benign tumor extends into the right heart chambers through inferior vena cava. The best surgical approach still remains unclear.We present a retrospective cohort of 36 patients diagnosed with ICLM in Peking Union Medical College Hospital between 2002 and 2016.The mean patient age was 44.5 (range 25-55) years. The clinical manifestations were various, including shortness of breath, chest tightness, edema of the lower extremities, palpitations, syncope, etc...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28716819/effect-of-type-2-diabetes-surgical-incision-and-volatile-anesthesia-on-hemodynamics-in-the-rat
#3
Carol T Bussey, Regis R Lamberts
Diabetic patients have increased cardiac complications during surgery, possibly due to impaired autonomic regulation. Anesthesia lowers blood pressure and heart rate (HR), whereas surgical intervention has opposing effects. The interaction of anesthesia and surgical intervention on hemodynamics in diabetes is unknown, despite being a potential perioperative risk factor. We aimed to determine the effect of diabetes on the integrative interaction between hemodynamics, anesthesia, and surgical incision. Zucker type 2 diabetic rats (DM) and their nondiabetic littermates (ND) were implanted with an intravenous port for drug delivery, and a radiotelemeter to measure mean arterial blood pressure (MAP) and derive HR (total n = 50)...
July 2017: Physiological Reports
https://www.readbyqxmd.com/read/28704248/low-end-tidal-carbon-dioxide-at-the-onset-of-emergent-trauma-surgery-is-associated-with-nonsurvival-a-case-series
#4
Roman Dudaryk, Danielle K Bodzin, Juliet J Ray, Craig S Jabaley, Richard R McNeer, Richard H Epstein
BACKGROUND: End-tidal carbon dioxide (EtCO2) is a valuable marker of the return of adequate circulation following cardiac arrest due to medical causes. Previously, the prognostic value of capnography in trauma has been studied among limited populations in prehospital and emergency department settings. We aimed to investigate the relationship between early intraoperative EtCO2 and nonsurvival of patients undergoing emergency surgery at a level 1 academic trauma center as a case series...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28701611/the-utility-of-targeted-perioperative-transthoracic-echocardiography-in-managing-an-adult-patient-with-anomalous-origin-of-the-left-coronary-artery-pulmonary-artery-for-noncardiac-surgery
#5
Anudeep Jafra, Suman Arora, Aveek Jayant
Congenital coronary artery anomalies as a whole are uncommon. Abnormal origin of the left coronary artery from the pulmonary artery (ALCAPA) is probably the most common congenital coronary defect. An overwhelming majority of the patients with untreated ALCAPA do not survive to adulthood. As yet, there is no consensus on the management of adults with ALCAPA. We describe a patient with breast malignancy and incidentally detected ALCAPA; primacy was given to treatment of the oncologic condition as a first step...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28701593/neutrophil-gelatinase-associated-lipocalin-as-a-biomarker-for-predicting-acute-kidney-injury-during-off-pump-coronary-artery-bypass-grafting
#6
Muralidhar Kanchi, R Manjunath, Jos Massen, Lloyd Vincent, Kumar Belani
BACKGROUND: Acute kidney injury (AKI) following cardiac surgery is a major complication resulting in increased morbidity, mortality, and economic burden. In this study, we assessed the usefulness of estimating serum neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker in predicting AKI in patients with stable chronic kidney disease (CKD) and undergoing off-pump coronary artery bypass grafting (OP-CABG). PATIENTS AND METHODS: We prospectively studied sixty nondialysis-dependent CKD patients with estimated glomerular filtration rate <60 ml/min/1...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28698428/-thoracoscopic-pericardial-fenestration-for-refractory-pericardial-effusion-with-cardiac-tamponade-report-of-a-case
#7
Jun Maeda
We performed thoracoscopic pericardial fenestration for a 70-year-old man who suffered from refractory pericardial effusion with cardiac tamponade. Under general anesthesia with differential lung ventilation, pericardial fenestration followed by needle aspiration of the enough pericardial effusion to obtain the working space was carried out by thoracoscopic surgery through the left thoracic space. Postoperative course was uneventful and reaccumulation of the pericardial fluid has not been observed more than 2 years after surgery...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28697490/the-influence-of-blood-pressure-on-fetal-aortic-distensibility-an-animal-validation-study
#8
Christoph Wohlmuth, Kenneth J Moise, Ramesha Papanna, Ciprian Gheorghe, Anthony Johnson, Yisel Morales, Helena M Gardiner
BACKGROUND/AIMS: Aortic distension waveforms describe the change in diameter or cross-sectional area over the cardiac cycle. We aimed to validate the association of aortic fractional area change (AFAC) with blood pressure (BP) in a fetal lamb model. METHODS: Four pregnant ewes underwent open fetal surgery under general anesthesia at 107-120 gestational days. A 4-Fr catheter was introduced into the fetal femoral artery and vein, or the carotid artery and jugular vein...
July 12, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28690837/the-application-of-remote-ischemic-conditioning-in-cardiac-surgery
#9
REVIEW
Zeljko J Bosnjak, Zhi-Dong Ge
Perioperative myocardial ischemia and infarction are the leading causes of morbidity and mortality following anesthesia and surgery. The discovery of endogenous cardioprotective mechanisms has led to testing of new methods to protect the human heart. These approaches have included ischemic pre-conditioning, per-conditioning, post-conditioning, and remote conditioning of the myocardium. Pre-conditioning and per-conditioning include brief and repetitive periods of sub-lethal ischemia before and during prolonged ischemia, respectively; and post-conditioning is applied at the onset of reperfusion...
2017: F1000Research
https://www.readbyqxmd.com/read/28678115/a-theoretical-model-of-flow-disruptions-for-the-anesthesia-team-during-cardiovascular-surgery
#10
Albert Boquet, Tara Cohen, Fawaaz Diljohn, Jennifer Cabrera, Scott Reeves, Scott Shappell
OBJECTIVES: This investigation explores flow disruptions observed during cardiothoracic surgery and how they serve to disconnect anesthesia providers from their primary task. We can improve our understanding of this disengagement by exploring what we call the error space or the accumulated time required to resolve disruptions. METHODS: Trained human factors students observed 10 cardiac procedures for disruptions impacting the anesthesia team and recorded the time required to resolve these events...
July 3, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28671280/impact-of-obstructive-sleep-apnea-in-transsphenoidal-pituitary-surgery-an-analysis-of-inpatient-data
#11
Sei Y Chung, Michael J Sylvester, Varesh R Patel, Michael Zaki, Soly Baredes, James K Liu, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: Although previous studies have reported increased perioperative complications among obstructive sleep apnea (OSA) patients undergoing any surgery requiring general anesthesia, there is a paucity of literature addressing the impact of OSA on postoperative transsphenoidal surgery (TSS) complications. The aim of this study was to analyze postoperative outcomes in transsphenoidal pituitary surgery patients with OSA. Secondarily, we examined patient characteristics and comorbidities...
July 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28669704/low-pressure-robot-assisted-radical-prostatectomy-with-the-airseal-system-at-olv-hospital-results-from-a-prospective-study
#12
Sabrina La Falce, Giacomo Novara, Giorgio Gandaglia, Paolo Umari, Geert De Naeyer, Frederiek D'Hondt, Jean Beresian, Rik Carette, Martin Penicka, Yujiing Mo, Geert Vandenbroucke, Alexandre Mottrie
BACKGROUND: Limited studies examined effects of pneumoperiotneum during robot-assisted radical prostatectomy (RARP) and with AirSeal. The aim of this study was to assess the effect on hemodynamics of a lower pressure pneumoperitoneum (8 mmHg) with AirSeal, during RARP in steep Trendelenburg 45° (ST). MATERIALS AND METHODS: This is an institutional review board-approved, prospective, interventional, single-center study including patients treated with RARP at OLV Hospital by one extremely experienced surgeon (July 2015-February 2016)...
June 2, 2017: Clinical Genitourinary Cancer
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
#13
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/28652958/lidocaine-induced-systemic-toxicity-a-case-report-and-review-of-literature
#14
Badar Hasan, Talal Asif, Maryam Hasan
For the past 50 years, local anesthetics such as lidocaine have been commonly used in various clinical settings. Its use is not just limited to anesthesia and surgery but is also frequently utilized in internal medicine and in primary care setting for bedside procedures. Despite its widespread use, most physicians are not familiar with the life-threatening manifestations of lidocaine toxicity and its treatment. Our case demonstrates a successful resuscitation after cardiac arrest in a healthy 33-year-old female with systemic lidocaine toxicity after she received lidocaine as a local anesthetic...
May 25, 2017: Curēus
https://www.readbyqxmd.com/read/28647806/pre-anesthetic-stroke-volume-variation-can-predict-cardiac-output-decrease-and-hypotension-during-induction-of-general-anesthesia
#15
Takashi Juri, Koichi Suehiro, Sayaka Tsujimoto, Shigemune Kuwata, Akira Mukai, Katsuaki Tanaka, Tokuhiro Yamada, Takashi Mori, Kiyonobu Nishikawa
This study aimed to assess the reliability of stroke volume variation (SVV) in predicting cardiac output (CO) decrease and hypotension during induction of general anesthesia. Forty-five patients undergoing abdominal surgery under general anesthesia were enrolled. Before induction of anesthesia, patients were required to maintain deep breathing (6-8 times/min), and pre-anesthetic SVV was measured for 1 min by electrical cardiometry. General anesthesia was induced with propofol, remifentanil, rocuronium, and sevoflurane...
June 24, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28643999/dexmedetomidine-and-general-anesthesia-a-narrative-literature-review-of-its-major-indications-for-use-in-adults-undergoing-non-cardiac-surgery
#16
Arthur Davy, Julien Fessler, Marc Fischler, Morgan le Guen
BACKGROUND: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. METHODS: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords "Dexmedetomidine, Dexdor, Precedex and Dexdomitor". The research ended in December 2016...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28629872/sevoflurane-relieves-lung-function-deterioration-after-cardiopulmonary-bypass
#17
Adam L Balogh, Ferenc Peták, Gergely H Fodor, Roberta Sudy, Barna Babik
OBJECTIVE: To investigate sevoflurane's potential to alleviate the detrimental pulmonary changes after cardiopulmonary bypass (CPB). DESIGN: Prospective, randomized clinical investigation. SETTING: University hospital. PARTICIPANTS: One hundred ninety patients undergoing elective cardiac surgery. INTERVENTIONS: Ninety-nine patients under intravenous anesthesia were administered 1 minimal alveolar concentration of sevoflurane for 5 minutes after being weaned from CPB (group SEV); intravenous anesthesia was maintained in the other 91 patients (group CTRL)...
February 24, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28625460/perioperative-use-of-angiotensin-converting-enzyme-inhibitors-and-angiotensin-receptor-antagonists
#18
REVIEW
Luis Mario Vaquero Roncero, David Sánchez Poveda, Joaquín José Valdunciel García, María Elisa Sánchez Barrado, José María Calvo Vecino
STUDY OBJECTIVE: Clinical repercussions of perioperative treatment with ACEIs/ARBs. DESIGN: Systematic review according to PRISMA statement. SETTING: Perioperative period. PATIENTS: 29 studies 11 cases/cases series, 12 observational studies and 6 randomized studies. MEASUREMENTS: Arterial blood pressure differences, refractory hypotension, other comorbidities. MAIN RESULTS: The studies show different results regarding the topics measured...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28625438/efficacy-of-prophylactic-doses-of-intravenous-nitroglycerin-in-preventing-myocardial-ischemia-under-general-anesthesia-a-systematic-review-and-meta-analysis-with-trial-sequential-analysis
#19
REVIEW
Hiroshi Hoshijima, Yohei Denawa, Takahiro Mihara, Risa Takeuchi, Norifumi Kuratani, Tsutomu Mieda, Yoshinori Iwase, Toshiya Shiga, Zen'ichiro Wajima, Hiroshi Nagasaka
STUDY OBJECTIVE: To evaluate the efficacy of intravenous nitroglycerin (TNG) in preventing intraoperative myocardial ischemia (MI) under general anesthesia. Moreover, we analyzed the hemodynamic changes in heart rate (HR), mean blood pressure (MBP), and pulmonary capillary wedge pressure (PCWP) associated with TNG administration both before and after the induction of anesthesia. DESIGN: Meta-analysis. SETTING: Operating room, cardiac surgery or non-cardiac surgery, all surgeries were elective measurements...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28602219/tranexamic-acid-leads-to-paradoxical-coagulation-changes-during-cardiac-surgery-a-pilot-rotational-thromboelastometry-study
#20
Rajiv Sharma, Hayley L Letson, Samuel Smith, Geoffrey P Dobson
BACKGROUND: Tranexamic acid (TXA) is increasingly used during major surgery with the goal to reduce excessive bleeding, transfusion requirements, and reexploration. Our aim was to examine the effect of TXA on coagulation at different times during cardiac surgery using rotational thromboelastometry. MATERIALS AND METHODS: Nineteen adult males (EuroSCORE 4-5) were recruited consecutively for first-time cardiopulmonary bypass (CPB) surgery. Ten patients received TXA at anesthesia and nine received no TXA...
May 8, 2017: Journal of Surgical Research
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