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Anesthesia Safety

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https://www.readbyqxmd.com/read/28527967/feasibility-and-safety-of-the-transbronchial-access-tool-for-peripheral-pulmonary-nodule-and-mass
#1
Mark R Bowling, Craig Brown, Carlos J Anciano
BACKGROUND: Navigational bronchoscopy and other imaging modalities have improved the ability to evaluate pulmonary nodules/mass. Many of these lesions are located outside the bronchial airway and are difficult to access even with these devices. The Transbronchial Access Tool (Medtronic, Minneapolis, MN) allows the bronchoscopist to create a pathway from the bronchial airway, across the lung parenchyma, and into the target lesion. We are reporting the feasibility and safety of this new device...
May 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527780/-youtube-as-a-source-of-spinal-anesthesia-epidural-anesthesia-and-combined-spinal-and-epidural-anesthesia
#2
Serkan Tulgar, Onur Selvi, Talat Ercan Serifsoy, Ozgur Senturk, Zeliha Ozer
INTRODUCTION: Social media as YouTube have become a part of daily life and many studies evaluated health-related YouTube videos. Our aim was to evaluate videos available on YouTube for the conformity to textbook information and their sufficiency as a source for patient information. MATERIAL AND METHOD: A search of the YouTube website was performed using the keywords "spinal anesthesia, epidural anesthesia, combined spinal epidural anesthesia". Firstly, 180 videos were evaluated and the characteristics of the video were noted, and the features of the video too were noted if the video was regarding neuraxial anesthesia...
May 17, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28526153/pharmacology-of-octreotide-clinical-implications-for-anesthesiologists-and-associated-risks
#3
REVIEW
Reza M Borna, Jonathan S Jahr, Susanna Kmiecik, Ken F Mancuso, Alan D Kaye
Many patients presenting with a history of foregut, midgut neuroendocrine tumors (NETs) or carcinoid syndrome can experience life-threatening carcinoid crises during anesthesia or surgery. Clinicians should understand the pharmacology of octreotide and appreciate the use of continuous infusions of high-dose octreotide, which can minimize intraoperative carcinoid crises. We administer a prophylactic 500-μg bolus of octreotide intravenously (IV) and begin a continuous infusion of 500 μg/h for all NET patients...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526152/pharmacologic-properties-of-novel-local-anesthetic-agents-in-anesthesia-practice
#4
REVIEW
Chih H King, Sascha S Beutler, Alan D Kaye, Richard D Urman
Therapeutic duration of traditional local anesthetics when used in peripheral nerve blocks is normally limited. This article describes novel approaches to extend the duration of peripheral nerve blocks currently available or in development. Three newer approaches on extending the duration of peripheral nerve blocks include site-1 sodium channel blockers, novel local anesthetics delivery systems, and novel adjuvants of local anesthetics. Compared with plain amide-based and ester-based local anesthetics, alternative approaches show significant promise in decreasing postoperative pain, rescue opioid requirement, hospital length-of-stay, and overall health care cost, without compromising the established safety profile of traditional local anesthetics...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526145/alpha-2-agonists
#5
REVIEW
Viet Nguyen, Dawn Tiemann, Edward Park, Ali Salehi
Alpha-2 adrenergic receptors are spread throughout the central and peripheral nervous system, specifically in the pontine locus coeruleus, medullospinal tracts, rostral ventrolateral medulla, and the dorsal horn of the spinal cord. Alpha-2 agonist agents cause neuromodulation in these centers, leading to sedation, analgesia, vasodilatation, and bradycardia with little effect on the respiratory drive, which accounts for their good safety profile. The 2 major drugs in this group are clonidine and dexmedetomidine...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28525513/an-observational-assessment-of-anesthesia-capacity-in-madagascar-as-a-prerequisite-to-the-development-of-a-national-surgical-plan
#6
Linden S Baxter, Vaonandianina A Ravelojaona, Hasiniaina N Rakotoarison, Alison Herbert, Emily Bruno, Kristin L Close, Vanessa Andean, Hery H Andriamanjato, Mark G Shrime, Michelle C White
BACKGROUND: The global lack of anesthesia capacity is well described, but country-specific data are needed to provide country-specific solutions. We aimed to assess anesthesia capacity in Madagascar as part of the development of a Ministry of Health national surgical plan. METHODS: As part of a nationwide surgical safety quality improvement project, we surveyed 19 of 22 regional hospitals, representing surgical facilities caring for 75% of the total population. The assessment was divided into 3 areas: anesthesia workforce density, infrastructure and equipment, and medications...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28525512/parecoxib-supplementation-to-morphine-analgesia-decreases-incidence-of-delirium-in-elderly-patients-after-hip-or-knee-replacement-surgery-a-randomized-controlled-trial
#7
Dong-Liang Mu, Da-Zhi Zhang, Dong-Xin Wang, Geng Wang, Chun-Jing Li, Zhao-Ting Meng, Ya-Wei Li, Chao Liu, Xue-Ying Li
BACKGROUND: Severe pain and high-dose opioids are both associated with increased risk of postoperative delirium. The authors investigated whether parecoxib-supplemented IV morphine analgesia could decrease the incidence of delirium in elderly patients after total hip or knee replacement surgery. METHODS: In a randomized, double-blind, 2-center trial, patients of 60 years or older who underwent elective total hip or knee replacement surgery were assigned in a 1:1 ratio to receive either parecoxib (40 mg at the end of surgery and then every 12 hours for 3 days) or placebo (normal saline)...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28516271/three-dimensional-image-fusion-guidance-for-transjugular-intrahepatic-portosystemic-shunt-placement
#8
Vania Tacher, Arthur Petit, Haytham Derbel, Luigi Novelli, Manuel Vitellius, Fourat Ridouani, Alain Luciani, Alain Rahmouni, Christophe Duvoux, Chady Salloum, Mélanie Chiaradia, Hicham Kobeiter
INTRODUCTION: To assess the safety, feasibility and effectiveness of image fusion guidance with pre-procedural portal phase computed tomography with intraprocedural fluoroscopy for transjugular intrahepatic portosystemic shunt (TIPS) placement. MATERIALS AND METHODS: All consecutive cirrhotic patients presenting at our interventional unit for TIPS creation from January 2015 to January 2016 were prospectively enrolled. Procedures were performed under general anesthesia in an interventional suite equipped with flat panel detector, cone-beam computed tomography (CBCT) and image fusion technique...
May 17, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28515594/radiofrequency-ablation-of-osteoid-osteoma-in-common-and-technically-challenging-locations-in-pediatric-population
#9
Shaileshkumar Garge, Shyamkumar N Keshava, Vinu Moses, George K Chiramel, Munawwar Ahmed, Suraj Mammen, Vrisha Madhuri
CONTEXT: Percutaneous radiofrequency ablation (RFA) of osteoid osteoma has a high technical and clinical success rate. However, there is limited data on its use in the pediatric population, especially in technically challenging locations. OBJECTIVE: To assess the safety and efficacy of computed tomography (CT)-guided percutaneous RFA of osteoid osteoma in pediatric population. PATIENTS AND METHODS: From June 2009 to May 2014, 30 patients with osteoid osteoma were treated with CT-guided RFA in common (25 cases) and technically challenging (five cases: four near articular surface and one in sacrum) locations...
January 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28511794/application-of-end-tidal-carbon-dioxide-monitoring-via-distal-gas-samples-in-ventilated-neonates
#10
Ziying Jin, Maoying Yang, Ru Lin, Wenfang Huang, Jiangmei Wang, Zhiyong Hu, Qiang Shu
BACKGROUND: Previous research has suggested correlations between the end-tidal partial pressure of carbon dioxide (PETCO2) and the partial pressure of arterial carbon dioxide (PaCO2) in mechanically ventilated patients, but both the relationship between PETCO2 and PaCO2 and whether PETCO2 accurately reflects PaCO2 in neonates and infants are still controversial. This study evaluated remote sampling of PETCO2 via an epidural catheter within an endotracheal tube to determine the procedure's clinical safety and efficacy in the perioperative management of neonates...
April 12, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28511195/safety-aspects-of-postanesthesia-care-unit-discharge-without-motor-function-assessment-after-spinal-anesthesia-a-randomized-multicenter-semiblinded-noninferiority-controlled-trial
#11
Eske Kvanner Aasvang, Christoffer Calov Jørgensen, Mogens Berg Laursen, Jacob Madsen, Søren Solgaard, Mogens Krøigaard, Per Kjærsgaard-Andersen, Hans Mandøe, Torben Bæk Hansen, Jørgen Ulrich Nielsen, Niels Krarup, Annette Elisabeth Skøtt, Henrik Kehlet
BACKGROUND: Postanesthesia care unit (PACU) discharge without observation of lower limb motor function after spinal anesthesia has been suggested to significantly reduce PACU stay and enhance resource optimization and early rehabilitation but without enough data to allow clinical recommendations. METHODS: A multicenter, semiblinded, noninferiority randomized controlled trial of discharge from the PACU with or without assessment of lower limb motor function after elective total hip or knee arthroplasty under spinal anesthesia was undertaken...
June 2017: Anesthesiology
https://www.readbyqxmd.com/read/28506947/comparison-of-bilateral-transversus-abdominis-plane-block-and-wound-infiltration-with-bupivacaine-for-postoperative-analgesia-after-cesarean-delivery
#12
Ümit Görkem, Kamuran Koçyiğit, Cihan Toğrul, Tayfun Güngör
OBJECTIVE: The study aimed to compare efficacy, safety, pain intensity and analgesic consumption in patients receiving either bilateral transversus abdominis plane (TAP) block or wound infiltration with bupivacaine after cesarean delivery (CD). MATERIAL AND METHODS: A total of 216 parturient women undergoing CD under general anesthesia were randomly allocated into five groups: i) controls (group 1), ii) TAP placebo (group 2), iii) TAP (group 3), iv) wound infiltration placebo (group 4), and, v) wound infiltration (group 5)...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28504359/changing-the-paradigm-for-diagnostic-mri-in-pediatrics-don-t-hold-your-breath
#13
Melissa M Masaracchia, Michael J Tsapakos, Nancy J McNulty, Michael L Beach
Increasingly complex pediatric patients and improvements in technology warrant reevaluation of the risk associated with anesthesia for diagnostic imaging. Although magnetic resonance imaging is the imaging modality of choice for children given the potentially harmful effects of computerized tomography-associated ionizing radiation, we dare to suggest that certain patients would benefit from the liberalization of our current standard. Incorporating the use of newer computerized tomography technology may improve safety for those that are already at higher risk for adverse events...
May 15, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28503363/focused-ultrasound-for-essential-tremor-review-of-the-evidence-and-discussion-of-current-hurdles
#14
REVIEW
Mohammad Rohani, Alfonso Fasano
BACKGROUND: While there is no breakthrough progress in the medical treatment of essential tremor (ET), in the past decades several remarkable achievements happened in the surgical field, such as radiofrequency thalamotomy, thalamic deep brain stimulation, and gamma knife thalamotomy. The most recent advance in this area is magnetic resonance-guided focused ultrasound (MRgFUS). METHODS: The purpose of this review is to discuss the new developments and trials of MRgFUS in the treatment of ET and other tremor disorders...
2017: Tremor and Other Hyperkinetic Movements
https://www.readbyqxmd.com/read/28502599/a-novel-retrieval-technique-for-ureteral-stents-under-ultrasound-guidance-in-male-patients
#15
Taile Jing, Chao Zhang, Lei Jiang
OBJECTIVE: To simply retrieve Double-J stents in male patients under ultrasound guidance, a novel technique is developed and evaluated for efficiency, safety and tolerability. MATERIALS AND METHODS: Fifty-six male patients, ranging from 23 to 65 years old, were recruited from March to December 2015. Thirty patients (32 stents) underwent Double-J retrieval by ultrasound-guided and 26 patients (28 stents) underwent cystoscopy retrieval separately. Clinical outcomes were compared between groups...
May 10, 2017: Urology
https://www.readbyqxmd.com/read/28499653/customized-hinged-covered-metallic-stents%C3%A2-for-the-treatment-of-benign-main-bronchial-stenosis
#16
Xinwei Han, Quazi Al-Tariq, Yanle Zhao, Lei Li, Zhe Cheng, Huaqi Wang, Chao Liu, Dechao Jiao, Gang Wu
BACKGROUND: To address the limitations of silicone stents, we designed a hinged self-expandable covered metallic stent. The aim of this study was to evaluate the safety and efficacy of the customized stents in clinical applications. METHODS: This was a retrospective analysis. Under conscious sedation and local anesthesia, the stents were implanted or removed by interventional radiologists, with fluoroscopic guidance. RESULTS: Of 24 patients with benign main bronchial stenosis, stents were successfully placed in 21 (87...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28497449/percutaneous-us-guided-renal-cryoablation-using-3d-modeling
#17
Leonid M Rapoport, Shmuel Cytron, Mikhail E Enikeev, Dmitry G Tsarichenko, Dmitry V Enikeev, Denis V Chinenov
INTRODUCTION: The article describes the first experience of performing percutaneous ultrasound (US)-guided cryoablation of renal tumor and assesses the safety and short-term results of treatment. MATERIALS AND METHODS: Twelve patients were subjected to US-guided cryoablation of renal tumor in 2015. The tumor size in 11 patients was up to 3.0 cm (T1а); in one female patient, 4.5 cm (T1b). Tumors were assessed according to the PADUA score. In eight patients, it was 6-7 (low); in three patients, 8-9 (average); in one, 10 (high)...
May 10, 2017: Urologia
https://www.readbyqxmd.com/read/28495814/automated-control-of-mechanical-ventilation-during-general-anaesthesia-study-protocol-of-a-bicentric-observational-study-avas
#18
Dirk Schädler, Georg Miestinger, Tobias Becher, Inéz Frerichs, Norbert Weiler, Christoph Hörmann
INTRODUCTION: Automated control of mechanical ventilation during general anaesthesia is not common. A novel system for automated control of most of the ventilator settings was designed and is available on an anaesthesia machine. METHODS AND ANALYSIS: The 'Automated control of mechanical ventilation during general anesthesia study' (AVAS) is an international investigator-initiated bicentric observational study designed to examine safety and efficacy of the system during general anaesthesia...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28494905/role-of-sugammadex-in-accelerating-postoperative-discharge-a-meta-analysis
#19
REVIEW
Michele Carron, Francesco Zarantonello, Nadia Lazzarotto, Paola Tellaroli, Carlo Ori
STUDY OBJECTIVE: Sugammadex has been introduced for reversal of neuromuscular blockade (NMB) induced by rocuronium (or vecuronium). Although its efficacy and safety have been established, data are conflicting as to whether it accelerates discharge to the surgical ward compared with neostigmine, which is traditionally used for reversing NMB. The object of this systematic review and meta-analysis was to review the research comparing sugammadex and neostigmine in the context of patient discharge after general anesthesia...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28489162/endoscopic-sleeve-gastroplasty-for-obesity-treatment-two-years-of-experience
#20
Gontrand Lopez-Nava, M P Galvão, I Bautista-Castaño, J P Fernandez-Corbelle, M Trell, N Lopez
Background: Bariatric endoscopic techniques are minimally invasive and induce gastric volume reduction to treat obesity. Aim : To evaluate endoscopic sleeve gastroplasty (Apollo method) using a suturing method directed at the greater curvature, as well as the perioperative care, two year safety and weight loss. Method: Prospective single-center study over 154 patients (108 females) using the endoscopic sleeve gastroplasty procedure under general anesthesia with overnight inpatient observation...
January 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
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