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https://www.readbyqxmd.com/read/27897312/the-feasibility-of-micro-ultrasound-as-a-tool-to-image-peripheral-nerves
#1
A Chandra, R Eisma, P Felts, S Munirama, G A Corner, C E M Demore, G McLeod
Despite widespread use of ultrasound imaging to guide needle placement, the incidence of transient and permanent nerve damage as a complication of regional anaesthesia has not changed over the last decade. In view of the controversy surrounding intraneural injection there is a need to understand the structural changes caused by subepineural and subperineural needle penetration. Clinical ultrasound machines do not provide adequate anatomical resolution, and anaesthetists have difficulty judging the precise location of the needle tip relative to the epineurium...
November 29, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27895189/how-to-do-it-bedside-ultrasound-to-assist-lumbar-puncture
#2
Stefan Williams, Modar Khalil, Asoka Weerasinghe, Anu Sharma, Richard Davey
For many neurologists, lumbar puncture is the only practical procedure that they undertake on a regular basis. Although anaesthetists and emergency physicians routinely employ ultrasound to assist lumbar puncture, neurologists do not. In this article, we outline the technique that we use for an ultrasound-assisted lumbar puncture, together with the evidence base that suggests that ultrasound has significant benefits. We aim to raise awareness of a method that can make lumbar puncture more likely to succeed and to be more comfortable for the patient...
November 28, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27891033/transthoracic-approach-for-lesions-involving-the-anterior-dorsal-spine-a-multidisciplinary-approach-with-good-outcomes
#3
Srikant Balasubramaniam, Devendra K Tyagi, Sheikh H Zafar, Hemant V Savant
INTRODUCTION: Anterior approach provides excellent visualization and access to the anterior thoracic spine. It may be used alone, in combination with a posterior midline approach or in a staged or sequential fashion. AIMS: To analyse our institutional experience in transthoracic approaches and to determine the safety and benefit of this approach in our patient series. MATERIALS AND METHODS: A total of 16 patients were operated for varying lesions of body of dorsal vertebra by the transthoracic approach...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27885500/a-review-of-anaesthetic-outcomes-in-patients-with-genetically-confirmed-mitochondrial-disorders
#4
A Smith, E Dunne, M Mannion, C O'Connor, I Knerr, A A Monavari, J Hughes, N Eustace, E Crushell
: Mitochondrial disorders are a clinically and biochemically diverse group of disorders which may involve multiple organ systems. General anaesthesia (GA) poses a potential risk of decompensation in children with mitochondrial disorders, and there is little guidance for anaesthetists and other clinicians regarding the optimal anaesthetic agents and perioperative management to provide to patients with mitochondrial disease[15]. The aim of this review was to document adverse events and perioperative complications from GA in patients with genetically confirmed mitochondrial disorders...
November 24, 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27884664/bacterial-contamination-of-saline-used-for-epidural-procedures-in-an-obstetric-setting-a-randomised-comparison-of-two-drawing-up-techniques
#5
M Onofrei, M Y Wee, B Parker, N Wee, S Hill
BACKGROUND: There is little evidence to inform practice regarding the optimum aseptic technique of drawing up saline for epidural insertion. Our regional practice is to draw up saline from a non-sterile packaged plastic ampoule, therefore introducing the risk of bacterial contamination. Usually, the anaesthetist draws up saline directly from the vial held by an assistant using a needle (needle technique). Alternatively, the saline vial is emptied onto a sterile tray by an assistant and then drawn up by the anaesthetist (tray technique)...
October 8, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27869199/ion-mobility-spectrometry-as-a-simple-and-rapid-method-to-measure-the-plasma-propofol-concentrations-for-intravenous-anaesthesia-monitoring
#6
Xin Wang, Qinghua Zhou, Dandan Jiang, Yulei Gong, Enyou Li, Haiyang Li
The plasma propofol concentration is important information for anaesthetists to monitor and adjust the anaesthesia depth for patients during a surgery operation. In this paper, a stand-alone ion mobility spectrometer (IMS) was constructed for the rapid measurement of the plasma propofol concentrations. Without any sample pre-treatment, the plasma samples were dropped on a piece of glass microfiber paper and then introduced into the IMS cell by the thermal desorption directly. Each individual measurement could be accomplished within 1 min...
November 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27867134/residual-anxiety-after-high-fidelity-simulation-in-anaesthesiology-an-observational-prospective-pilot-study
#7
Jean-Noël Evain, Lana Zoric, Laurent Mattatia, Olivier Picard, Jacques Ripart, Philippe Cuvillon
BACKGROUND: High fidelity simulation (HFS) in anaesthesiology intentionally provides stress on students, but anxiety may be detrimental if it goes on through debriefing. The primary goal of this study was to estimate the proportion of students with significant anxiety remaining after debriefing (Residual Anxiety: RA). Secondary goals were to evaluate the instructors' ability to estimate students' RA and to identify potential risk factors for high RA. SUBJECTS AND METHODS: Following IRB approval and informed consent, data from a cohort of subjects were prospectively collected by an independent expert...
November 17, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27862496/the-meaning-of-person-centred-care-in-the-perioperative-nursing-context-from-the-patient-s-perspective-an-integrative-review
#8
REVIEW
Erebouni Arakelian, Christine Leo Swenne, Susan Lindberg, Gudrun Rudolfsson, Ann-Christin von Vogelsang
AIMS AND OBJECTIVES: To determine the meaning of person-centred care from the patient's perspective and in the context of perioperative nursing. BACKGROUND: Person-centred care (PCC) is used but not defined in the perioperative context. The concept indicates an interest in the patient's own experience of health, illness, needs and preferences. As with many terms that are frequently used, there is a tendency for person-centred care to mean different things to different people in different contexts...
November 9, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27836449/microbial-flora-on-cell-phones-in-an-orthopedic-surgery-room-before-and-after-decontamination
#9
J Murgier, J-F Coste, E Cavaignac, X Bayle-Iniguez, P Chiron, P Bonnevialle, J-M Laffosse
INTRODUCTION: Cell-phones are the typical kind of object brought into the operating room from outside by hospital staff. A great effort is made to reduce the level of potentially contaminating bacteria in the operating room, and introducing these devices may run counter to good practice. The study hypothesis was that cell-phones are colonized by several strains of bacteria and may constitute a source of nosocomial contamination. The main study objective was to screen for bacterial colonies on the surfaces of cell-phones introduced in an orthopedic surgery room...
November 8, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27832755/experience-of-the-use-of-ketamine-to-manage-opioid-withdrawal-in-an-addicted-woman-a-case-report
#10
Laurence Lalanne, Chloe Nicot, Jean-Philippe Lang, Gilles Bertschy, Eric Salvat
BACKGROUND: Opioids are good painkillers, but many patients treated with opioids as painkillers developed a secondary addiction. These patients need to stop misusing opioids, but the mild-to-severe clinical symptoms associated with opioid withdrawal risk increasing their existing pain. In such cases, ketamine, which is used by anaesthetists and pain physicians to reduce opioid medication, may be an effective agent for managing opioid withdrawal. CASE PRESENTATION: We describe the case of a woman who developed a severe secondary addiction to opioids in the context of lombo-sciatic pain...
November 10, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27832551/anaesthetic-implications-of-the-changing-management-of-patients-with-mucopolysaccharidosis
#11
H A Hack, Rwm Walker, P Gardiner
The mucopolysaccharidoses are a group of inherited metabolic disorders that are renowned for presenting clinical problems, particularly related to cardiac, airway, and skeletal abnormalities, in children during anaesthesia. The changing clinical management of the mucopolysaccharidoses can be described in three phases. An initial phase of accumulation and dissemination of knowledge about the management of this rare disease with a growing recognition that untreated Hurler syndrome and more severe forms of other phenotypes such as Hunter syndrome and Maroteaux-Lamy syndrome were associated with severe complications under anaesthesia...
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27824242/anaesthetists-and-burnout-syndrome-what-strategies-can-prevent-this-dangerous-combination
#12
Marco Caruselli, Fabrice Michel
No abstract text is available yet for this article.
November 8, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27818682/current-trends-in-neuromuscular-blockade-management-and-monitoring-amongst-singaporean-anaesthetists
#13
Wendy H Teoh, Thomas Ledowski, Phillip S Tseng
Introduction. This survey aimed to investigate the attitudes/practice pertaining the use, management, and monitoring of neuromuscular blockade amongst Singaporean anaesthetists. Methods. All specialist accredited anaesthetists registered with the Singapore Medical Council were invited to complete an anonymous online survey. Results. The response rate was 39.5%. Neuromuscular monitoring (NM) was used routinely by only 13.1% despite the widespread availability of monitors. 82% stated residual NMB (RNMB) was a significant risk factor for patient outcome, but only 24% believed NMB monitoring should be compulsory in all paralyzed patients...
2016: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/27804108/tracheal-extubation-of-the-adult-intensive-care-patient-with-a-predicted-difficult-airway-a-narrative-review
#14
REVIEW
D J Sturgess, K B Greenland, S Senthuran, F A Ajvadi, A van Zundert, M G Irwin
Management of the difficult airway is an important, but as yet poorly-studied, component of intensive care management. Although there has been a strong emphasis on prediction and intubation of the difficult airway, safe extubation of the patient with a potentially difficult airway has not received the same attention. Extubation is a particularly vulnerable time for the critically ill patient and, because of the risks involved and the consequences of failure, it warrants specific consideration. The Royal College of Anaesthetists 4th National Audit Project highlighted differences in the incidence and consequences of major complications during airway management between the operating room and the critical care environment...
November 2, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27800646/examining-the-impact-of-regular-aspirin-use-and-pik3ca-mutations-on-survival-in-stage-2-colon-cancer
#15
Caitlin Murphy, Natalie Turner, Hui-Li Wong, Mathu Sinnathamby, Jeanne Tie, Belinda Lee, Jayesh Desai, Iain Skinner, Michael Christie, Ryan Hutchinson, Sebastian Lunke, Paul Waring, Peter Gibbs, Ben Tran
BACKGROUND: Data suggest aspirin improves survival in CRC harbouring PIK3CA mutations. The impact of aspirin is thought predominantly to be via an anti-inflammatory effect. AIMS: To explore the effect of aspirin use on survival in a real world cohort of Stage 2 colon cancer (CC) patients. METHODS: A prospective CRC database identified patients diagnosed with stage 2 CC between 2000 and 2011. PIK3CA mutation status was determined by next generation sequencing...
November 1, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27799175/evaluation-of-clinical-practice-in-perioperative-patient-blood-management
#16
D M Baron, P G H Metnitz, T Fellinger, B Metnitz, A Rhodes, S A Kozek-Langenecker
BACKGROUND: Several guidelines have been published to facilitate implementation of patient blood management (PBM). This study was performed to evaluate clinical practices in PBM. METHODS: An online survey based on the guidelines for the management of severe perioperative bleeding from the European Society of Anaesthesiology (ESA) was conducted among ESA members. We assessed characteristic data of participating physicians, preoperative assessment of bleeding risk and anaemia, intraoperative transfusion practices, specific pharmacologic treatment of significant bleeding, and clinical use of PBM algorithms...
November 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27797094/comparison-of-the-techniques-for-the-identification-of-the-epidural-space-using-the-loss-of-resistance-technique-or-an-automated-syringe-results-of-a-randomized-double-blind-study
#17
Larysa Duniec, Piotr Nowakowski, Jakub Sieczko, Marcin Chlebus, Tomasz Łazowski
BACKGROUND: The conventional, loss of resistance technique for identification of the epidural space is highly dependent on the anaesthetist's personal experience and is susceptible to technical errors. Therefore, an alternative, automated technique was devised to overcome the drawbacks of the traditional method. The aim of the study was to compare the efficacy of epidural space identification and the complication rate between the two groups - the automatic syringe and conventional loss of resistance methods...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27778076/a-retrospective-one-year-estimation-of-the-volume-and-nature-of-surgical-and-anaesthetic-services-delivered-to-the-populations-of-the-fako-division-of-the-south-west-region-of-cameroon-an-urgent-call-for-action
#18
Alain Chichom-Mefire, Victor Mbome Njie, Vincent Verla, Julius Atashili
BACKGROUND: Surgery-related conditions account for the majority of admissions in primary referral hospitals in Sub-Saharan Africa. The role of surgery in the reduction of global disease burden is well recognized, but there is a great qualitative and quantitative disparity in the delivery of surgical and anaesthetic services between countries. This study aims at estimating the nature and volume of surgery delivered in an entire administrative division of Cameroon. METHODS: In this retrospective survey conducted during the year 2013, we used a standard tool to analyse the infrastructure and human resources involved in the delivery of surgical and anaesthetic services in the Fako division in the south-west region of Cameroon...
October 24, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27770438/fifty-percent-of-anaesthetists-are-worse-than-average-at-understanding-statistics-and-risk
#19
B Gibbison
No abstract text is available yet for this article.
October 22, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27745624/toward-french-a-closed-claims-database-supplemental-data-supporting-the-involvement-of-anaesthetists-in-the-postoperative-period
#20
Sylvain Ausset
No abstract text is available yet for this article.
October 2016: Anaesthesia, Critical Care & Pain Medicine
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