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Anesthesia Safety

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https://www.readbyqxmd.com/read/29677063/the-anesthesia-perioperative-call-for-help-experience-at-a-quaternary-pediatric-medical-center-analysis-of-67-564-anesthesia-encounters
#1
Bistra G Vlassakova, Sean M Sinnott, Nissa Askins, Matthew X Callahan, Izabela C Leahy, David Zurakowski, Paul R Hickey, Joseph P Cravero
BACKGROUND: During the past several decades, anesthesia has become increasingly safe. Truly major adverse events are rare, and anesthesia quality researchers have instituted programs to evaluate "near miss" or less critical adverse events to evaluate the safety of anesthesia delivery. In this study, we aimed to evaluate calls for emergency help in our institution as a surrogate for pending critical events. We hypothesized that calls would be more common in patients with high American Society of Anesthesiologists (ASA) physical status, history of prematurity, and children with recent respiratory illness compared to those without these characteristics...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29673659/effect-of-epidural-anesthesia-in-labor-pregnancy-with-cardiovascular-disease
#2
Hiroaki Tanaka, Chizuko Kamiya, Shinji Katsuragi, Kayo Tanaka, Jun Yoshimatsu, Tomoaki Ikeda
OBJECTIVE: We studied the effect and safety of epidural anesthesia during labor in pregnant women with cardiovascular disease. MATERIALS AND METHODS: In the pregnant women with cardiovascular disease, we compared maternal outcome and suppressive effect on blood pressure retrospectively between the epidural group (anesthetized epidurally during labor) and the no-epidural group (not anesthetized epidurally during labor). RESULTS: A total of 277 patients were included in the analyses...
April 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29672337/neuropsychological-and-behavioral-outcomes-after-exposure-of-young-children-to-procedures-requiring-general-anesthesia-the-mayo-anesthesia-safety-in-kids-mask-study
#3
David O Warner, Michael J Zaccariello, Slavica K Katusic, Darrell R Schroeder, Andrew C Hanson, Phillip J Schulte, Shonie L Buenvenida, Stephen J Gleich, Robert T Wilder, Juraj Sprung, Danqing Hu, Robert G Voigt, Merle G Paule, John J Chelonis, Randall P Flick
BACKGROUND: Few studies of how exposure of children to anesthesia may affect neurodevelopment employ comprehensive neuropsychological assessments. This study tested the hypothesis that exposure to multiple, but not single, procedures requiring anesthesia before age 3 yr is associated with adverse neurodevelopmental outcomes. METHODS: Unexposed, singly exposed, and multiply exposed children born in Olmsted County, Minnesota, from 1994 to 2007 were sampled using a propensity-guided approach and underwent neuropsychological testing at ages 8 to 12 or 15 to 20 yr...
April 19, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29669351/bronchial-thermoplasty-in-severe-asthma-best-practice-recommendations-from-an-expert-panel
#4
Peter I Bonta, Pascal Chanez, Jouke T Annema, Pallav L Shah, Robert Niven
Bronchial thermoplasty (BT) is a bronchoscopic treatment for patients with severe asthma who remain symptomatic despite optimal medical therapy. In this "expert best practice" paper, the background and practical aspects of BT are highlighted. Randomized, controlled clinical trials have shown BT to be safe and effective in reducing severe exacerbations, improving quality of life, and decreasing emergency department visits. Five-year follow-up studies have provided evidence of the functional stability of BT-treated patients with persistence of a clinical benefit...
April 17, 2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29666797/development-and-implementation-of-a-perianesthetic-safety-checklist-in-a-veterinary-university-small-animal-teaching-hospital
#5
Gwennaëlle Menoud, Shannon Axiak Flammer, Claudia Spadavecchia, Mathieu Raillard
Introduction: The use of a surgical safety checklist is recommended by the World Health Organization and is associated with advantages: improved communication and reduced complications and mortality. Adapting checklists to the environment in which they are used improves their efficiency, but their implementation can be challenging. The aim of this study was to develop and implement a perianesthetic safety checklist for a small animal hospital. Materials and methods: A panel of eight anesthesia diplomates and seven residents and doctoral students were gathered...
2018: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29659423/safety-and-efficacy-of-oki-stenting-used-to-treat-obstructions-in-the-right-mainstem-bronchus
#6
Levent Dalar, Yasin Abul
BACKGROUND: Silicone stenting has been used to palliatively manage respiratory symptoms in patients with airway stenoses. Oki and Saka recently developed stents that can be used to manage stenoses around the carina between the bronchus to the right upper lobe and the bronchus intermedius (termed the primary right carina). The aim of this study was to assess the efficacy and safety of Oki stenting used to treat airway stenosis around the primary right carina. METHODS: We included 5 patients with airway stenoses...
April 13, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29655617/novel-treatment-of-papillomatous-conjunctival-lesions-using-pattern-scanning-laser-photocoagulation-1-year-results
#7
R N Belfort, J Isenberg, A G Castillejos, R Sant'ana, A O Romano
PURPOSE: To evaluate the safety and 1-year effect of pattern scanning laser photocoagulation treatment for pedunculated papillomatous and sessile conjunctival lesions in a low-resource setting with extremely limited operating room access. METHODS: Adult patients with clinical diagnosis of conjunctival papilloma underwent complete ophthalmologic exam including anterior segment photography. After topical anesthesia and toluidine blue 1% instillation, the lesion was treated by pattern scanning photocoagulation using a duration time that varied from 20 to 100 ms and power from 600 to 1800 mW, treating the entire lesion surface with a 2 mm margin...
April 12, 2018: Ocular Surface
https://www.readbyqxmd.com/read/29652272/comparison-of-immediate-extubation-versus-ultrafast-tracking-strategy-in-the-management-of-off-pump-coronary-artery-bypass-surgery
#8
Amarja Sachin Nagre, Nagesh P Jambures
Introduction: Ultrafast tracking of anesthesia (UFTA) is practiced routinely, whereas immediate on-table extubation after off-pump coronary artery bypass (OPCAB) grafting surgery has many concerns. The purpose of our study was to evaluate the safety and feasibility of immediate extubation (IE) versus UFTA. Methods: Sixty patients were enrolled who underwent OPCAB surgery. The two groups IE and UFTA had thirty patients each. Inclusion criteria were patients for OPCAB surgery including left main stenosis...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652112/mucopexy-recto-anal-lifting-mu-ral-a-standardized-minimally-invasive-method-of-managing-symptomatic-hemorrhoids-with-an-innovative-suturing-technique-and-the-hemorpex-system%C3%A2
#9
Claudio Pagano, Contardo Vergani, Carlo Invernizzi, Massimo Bussone, Guido Benegiamo, Marco Venturi
BACKGROUND: Conservative surgery of hemorrhoidal disease is less painful than traditional hemorrhoidectomy, and mucopexy has less risk of serious postoperative complications than stapled hemorrhoidopexy. The aim of this study was to evaluate the safety and effectiveness of a standardized, modified hemorrhoidopexy, named Mucopexy-Recto Anal Lifting (MuRAL),with the HemorPex System (HPS) in patients with symptomatic III and IV degree hemorrhoids. MATERIALS AND METHODS: Patients were enrolled from May 2013 to Dec 2015 and operated on with the MuRAL technique, based on arterial ligation and mucopexy at 6 locations, using a standardized clockwise/anti-clockwise rotation sequence of the HPS anoscope...
April 12, 2018: Minerva Chirurgica
https://www.readbyqxmd.com/read/29649026/evidence-review-conducted-for-the-agency-for-healthcare-research-and-quality-safety-program-for-improving-surgical-care-and-recovery-focus-on-anesthesiology-for-colorectal-surgery
#10
Kristen A Ban, Melinda M Gibbons, Clifford Y Ko, Elizabeth C Wick, Maxime Cannesson, Michael J Scott, Michael C Grant, Christopher L Wu
The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery (ISCR), which is a national effort to disseminate best practices in perioperative care to more than 750 hospitals across multiple procedures in the next 5 years. The program will integrate evidence-based processes central to enhanced recovery and prevention of surgical site infection, venous thromboembolic events, catheter-associated urinary tract infections with socioadaptive interventions to improve surgical outcomes, patient experience, and perioperative safety culture...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29643726/early-versus-delayed-oral-feeding-after-uncomplicated-cesarean-section-under-spinal-anesthesia-a-randomized-controlled-trial
#11
Adamu O Ogbadua, Teddy E Agida, Godwin O Akaba, Olumide A Akitoye, Bissallah A Ekele
Objective: The objective of this study is to compare the safety of early versus delayed oral feeding after uncomplicated cesarean section (CS) under spinal anesthesia. Methods: This was a randomized, controlled trial that enrolled 152 women who had uncomplicated CS under spinal anesthesia between January 2014 and June 2014. Women in the early feeding group had sips of oral fluid 6 h postoperatively while those in the delayed feeding group were on nil per oral for the first 24 h after surgery before commencement on liquid diet...
January 2018: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/29643629/intraoperative-neurophysiological-monitoring-team-s-communiqu%C3%A3-with-anesthesia-professionals
#12
Anurag Tewari, Lisa Francis, Ravi N Samy, Dean C Kurth, Joshua Castle, Tiffany Frye, Mohamed Mahmoud
Background and Aims: Intraoperative neurophysiological monitoring (IONM) is the standard of care during many spinal, vascular, and intracranial surgeries. High-quality perioperative care requires the communication and cooperation of several multidisciplinary teams. One of these multidisciplinary services is intraoperative neuromonitoring (IONM), while other teams represent anesthesia and surgery. Few studies have investigated the IONM team's objective communication with anesthesia providers...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29643628/pediatric-critical-incidents-reported-over-15-years-at-a-tertiary-care-teaching-hospital-of-a-developing-country
#13
Shemila Abbasi, Fauzia Anis Khan, Sobia Khan
Background and Aims: The role of critical incident (CI) reporting is well established in improving patient safety but only a limited number of available reports relate to pediatric incidents. Our aim was to analyze the reported CIs specific to pediatric patients in our database and to reevaluate the value of this program in addressing issues in pediatric anesthesia practice. Material and Methods: Incidents related to pediatric population from neonatal period till the age of 12 years were selected...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29628834/comparison-of-analgesic-efficacy-and-safety-of-continuous-epidural-infusion-versus-local-infiltration-and-systemic-opioids-in-video-assisted-thoracoscopic-surgery-decortication-in-pediatric-empyema-patients
#14
Priyanka Pradeep Karnik, Nandini Malay Dave, Madhu Garasia
Introduction: The stripping of the densely innervated and inflamed parietal pleura in empyema during video-assisted thoracoscopic surgery (VATS) decortication can lead to significant pain and major postoperative respiratory compromise. Hence, we compared the analgesic efficacy of continuous epidural infusion versus local infiltration and systemic opioids in children undergoing VATS decortications. Methodology: Following ethics approval and informed consent, forty patients from 1 to 12 years of age were randomized into two groups, Group E (epidural) and Group L (local infiltration) after induction of anesthesia...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628777/a-study-on-the-efficacy-and-safety-of-combining-dental-surgery-with-tonsillectomy-in-pediatrics
#15
Faizaan Syed, Joshua C Uffman, Dmitry Tumin, Catherine M Flaitz, Joseph D Tobias, Vidya T Raman
Purpose: Few data exist on combining pediatric surgical procedures under a single general anesthetic encounter (general anesthesia). We compared perioperative outcomes of combining dental surgical procedures with tonsillectomy during one anesthetic vs separate encounters. Methods: We classified elective tonsillectomy ± adenoidectomy and restorative dentistry as combined (group C) or separate (group S). Outcomes included anesthesia time, recovery duration, the need for overnight hospital stay, and postoperative complications...
2018: Clinical, Cosmetic and Investigational Dentistry
https://www.readbyqxmd.com/read/29628562/comparative-study-between-propofol-and-dexmedetomidine-for-conscious-sedation-in-patients-undergoing-outpatient-colonoscopy
#16
Harish Karanth, Sumesh Murali, Reshma Koteshwar, Vasanth Shetty, Karunakara Adappa
Introduction: Colonoscopy is a mildly painful procedure requiring conscious sedation. Though propofol is a widely used anesthetic agent in day-care procedures due to its rapid onset and quick recovery has a drawback of requiring resuscitation maneuvers more often than the conventional methods. Dexmedetomidine, a newly introduced, highly selective α2 -adrenergic receptor agonist possessing hypnotic, sedative, anxiolytic, sympatholytic, and analgesic properties with impressive safety margin, needs to be explored for use in conscious sedation for colonoscopy procedure among South Indian population...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628558/comparison-of-inhalational-vital-capacity-induction-with-sevoflurane-to-intravenous-induction-with-propofol-for-insertion-of-laryngeal-mask-airway-in-adults-a-randomized-study
#17
Vinaya Udaybhaskar, Amol Singam, Himanshu Dodeja, Karuna Taksande
Background: Since the development of laryngeal mask airway (LMA) by Dr. Brain, it is extensively used for airway management; satisfactory insertion of LMA requires administration of an induction agent and suppression of airway reflexes. Among intravenous agents, propofol has been the drug of choice in view of better safety profile, relaxation and depression of upper airway reflexes. Sevoflurane on the other hand, with pleasant odor, nonirritating to the airways and with bronchodilator property are best among the volatile induction agents...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628546/hemodynamic-responses-and-safety-of-sedation-following-premedication-with-dexmedetomidine-and-fentanyl-during-fiberoptic-assisted-intubation-in-patients-with-predicted-difficult-airway
#18
Sunil Rajan, Rittick Talukdar, Pulak Tosh, Jerry Paul, Bindu K Vasu, Lakshmi Kumar
Background: Awake fiberoptic intubation (AFOI) is the gold standard for the management of predicted difficult airway, and inappropriate sedation is a major cause leading to its failure. Aims: The primary objective was to compare the heart rate (HR) changes that accompany AFOI following sedation with dexmedetomidine and fentanyl. Secondary objectives included comparison of changes in blood pressure, patient comfort, ease of intubation, and degree of sedation. Settings and Designs: This prospective double-blinded randomized study was conducted in a tertiary care institution...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29625464/safety-studies-for-a-44-channel-suprachoroidal-retinal-prosthesis-a-chronic-passive-study
#19
Carla J Abbott, David A X Nayagam, Chi D Luu, Stephanie B Epp, Richard A Williams, Cesar M Salinas-LaRosa, Joel Villalobos, Ceara McGowan, Mohit N Shivdasani, Owen Burns, Jason Leavens, Jonathan Yeoh, Alice A Brandli, Patrick C Thien, Jenny Zhou, Helen Feng, Chris E Williams, Robert K Shepherd, Penelope J Allen
Purpose: Following successful clinical outcomes of the prototype suprachoroidal retinal prosthesis, Bionic Vision Australia has developed an upgraded 44-channel suprachoroidal retinal prosthesis to provide a wider field of view and more phosphenes. The aim was to evaluate the preclinical passive safety characteristics of the upgraded electrode array. Methods: Ten normal-sighted felines were unilaterally implanted with an array containing platinum electrodes (44 stimulating and 2 returns) on a silicone carrier near the area centralis...
March 1, 2018: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/29625334/efficacy-and-safety-of-interscalene-block-combined-with-general-anesthesia-for-arthroscopic-shoulder-surgery-a-meta-analysis
#20
Siyi Yan, Yanjun Zhao, Huan Zhang
STUDY OBJECTIVE: There is controversy regarding the efficacy and safety of using interscalene block (ISB) combined with general anesthesia (GA) for arthroscopic shoulder surgery. Our meta-analysis was undertaken to evaluate the utility of this approach. MEASUREMENTS: We searched the PubMed, Cochrane Library, EMBASE, CNKI, VIP and ClinicalTrials.gov databases for randomized controlled trials. The primary endpoint was extubation time. Secondary endpoints included intraoperative heart rate, pain scores on the day of and 1 day after the operation, intraoperative systolic blood pressure and adverse events...
April 3, 2018: Journal of Clinical Anesthesia
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