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Anesthesia Safety

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https://www.readbyqxmd.com/read/29051964/identification-of-quality-improvement-areas-in-pediatric-mri-from-analysis-of-patient-safety-reports
#1
Camilo Jaimes, Diana J Murcia, Karen Miguel, Cathryn DeFuria, Pallavi Sagar, Michael S Gee
BACKGROUND: Analysis of safety reports has been utilized to guide practice improvement efforts in adult magnetic resonance imaging (MRI). Data specific to pediatric MRI could help target areas of improvement in this population. OBJECTIVE: To estimate the incidence of safety reports in pediatric MRI and to determine associated risk factors. MATERIALS AND METHODS: In a retrospective HIPAA-compliant, institutional review board-approved study, a single-institution Radiology Information System was queried to identify MRI studies performed in pediatric patients (0-18 years old) from 1/1/2010 to 12/31/2015...
October 19, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29050714/when-does-intraoperative-blood-loss-occur-during-pediatric-scoliosis-correction
#2
Sean Wahlquist, Montri Wongworawat, Scott Nelson
BACKGROUND: The purpose of our study was to assess the relationship between amount of blood loss and surgical stage in pediatric patients undergoing posterior spinal fusion for deformity correction to determine: (1) when the highest rate of blood loss occurred; (2) what percentage of total blood loss occurred during deformity correction and closure; and (3) how to predict remaining blood loss during a procedure. Blood loss following exposure and placement of the final pedicle screw is often underestimated, which may result in lack of sufficient blood product availability...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29049219/risk-assessment-of-morbidly-obese-parturient-in-cesarean-section-delivery-a-prospective-cohort-single-center-study
#3
Xiaohu An, Yanhong Zhao, Ying Zhang, Qiling Yang, Yilong Wang, Weiwei Cheng, Zeyong Yang
BACKGROUND: Up to 40% of women gain excessive weight during pregnancy. Obesity complications and risks in parturient women undergoing cesarean section (CS) with different anesthetic methods remain unknown. This study aimed to assess the safety and risk of obese women undergoing CS delivery with various perioperative anesthetic methods. METHODS: Seven hundred ninety parturient women underwent CS under general anesthesia (GA), intraspinal anesthesia including epidural anesthesia (EA) and combined spinal-epidural anesthesia (CSEA)...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29048703/a-pilot-study-on-the-efficacy-and-safety-of-a-minimally-invasive-surgical-and-anesthetic-approach-for-ventricular-assist-device-implantation
#4
Jonida Bejko, Demetrio Pittarello, Gianclaudio Falasco, Guido Di Gregorio, Vincenzo Tarzia, Giulio Rizzoli, Dario Gregori, Gino Gerosa, Tomaso Bottio
BACKGROUND: The aim of our study was to compare 2 surgical and anesthetic approaches during ventricular assist device implantation. METHODS: 68 patients (50.4 ± 17.1 years old) were supported with the HeartWare® HVAD (32 patients) and the Jarvik 2000 VAD (36 patients) between January 2010 and August 2016. Two surgical techniques were applied: a minimally invasive approach with the aid of paravertebral-block (mini-invasive group, 41 patients) and a standard-surgical-approach with the aid of general anesthesia (27 patients)...
October 16, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29046933/-regional-anesthesia-are-the-standards-changing
#5
REVIEW
T Volk, C Kubulus
Regional anesthesia has undergone many changes over the years and the increasing use of ultrasound has certainly played an important role in this. Apart from individual case reports in the literature of very different blocking options, some new procedures seem to have become established and can be broadly applied. Among these are blockades, by which ultrasound-guided injection of local anesthetics is carried out in fascial or muscular layers rather than around target nerves (e.g. cervical plexus blocks and truncal blocks)...
October 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29046776/the-safety-of-endoscopic-esophageal-procedures-under-general-anesthesia
#6
Go Eun Kim, Duk Kyung Kim, Ji Won Choi, In Sun Chung, Da Woon Jung
BACKGROUND: With the increasing demand for general anesthesia for endoscopic esophageal procedures, anesthesiologists should understand the clinical characteristics of post-procedural complications (PPCs). METHODS: We retrospectively investigated the incidence of and risk factors associated with PPCs of endoscopic esophageal procedures performed under general anesthesia from July 2013 to November 2016. The final analysis included 129 patients; 114 who underwent esophageal endoscopic dissection for esophageal tumors and 15 cases of peroral endoscopic myotomy for achalasia...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29042744/palatal-perforation-a-rare-complication-of-postanesthetic-necrosis
#7
Vidisha Gargi, Ravi Prakash Sasankoti Mohan, Nagaraju Kamarthi, Swati Gupta
The everyday practice of dentistry relies heavily on achieving adequate local anesthesia. Even though the safety record of local anesthetic agents is high, complications do occur. Palate is a favorable site for soft-tissue lesions. Various factors such as direct effects of the drug, blanching of the tissues during injection, relatively poor blood supply, and reactivation of the latent forms of herpes can all promote to tissue ischemia and a lesion in the palate. Among various complications, anesthetic necrotic ulcer is a rare and uncommon condition occurring mostly in the hard palate possibly after a local anesthetic infiltration...
July 2017: Contemporary Clinical Dentistry
https://www.readbyqxmd.com/read/29042063/-pharmacokinetic-and-clinical-effects-of-two-bupivacaine-concentrations-on-axillary-brachial-plexus-block
#8
Leonardo H C Ferraro, Alexandre Takeda, Cleber N Barreto, Bernadete Faria, Nilson A Assunção
INTRODUCTION: The risk of systemic bupivacaine toxicity is a persistent problem, which makes its pharmacokinetic study fundamental for regional anesthesia safety. There is little evidence of its influence on plasma peak at different concentrations. The present study compares two bupivacaine concentrations to establish how the concentration affects this drug plasma peak in axillary brachial plexus block. Postoperative latency and analgesia were also compared. METHODS: 30 patients were randomized...
October 14, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29040377/safest-practices-for-autologous-buttock-augmentation-with-fat-grafting-using-a-roller-pump-injection-technique
#9
Marc Everett, Rolando Morales, German Newall, Paul F Fortes, Kristi L Hustak, Christopher K Patronella, Henry A Mentz
Background: Autologous buttock augmentation with fat grafting has emerged as one of the preeminent modalities for body contouring employed by plastic surgeons today. Since 2009, we have used the roller pump injection technique. Objectives: This procedure can be performed safely without specialized equipment and eliminates the tasks of manual graft preparation and injection. We describe our technique and standard safety measures. The anatomy of and complications associated with liposuction and fat grafting were recorded and reviewed...
June 23, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29037350/prospective-study-of-safety-and-effectiveness-in-the-use-of-radiofrequency-ablation-for-incompetent-great-saphenous-vein-%C3%A2-12%C3%A2-mm
#10
Maday Cabrero Fernandez, Isaac Martinez Lopez, Manuela Maria Hernandez Mateo, Pablo Marques de Marino, Iñaki Cernuda Artero, Francisco Javier Serrano Hernando
OBJECTIVE: The objective of this study was to assess the outcomes of radiofrequency ablation (RFA) in incompetent great saphenous vein (GSV) according to its diameter. METHODS: This was a prospective single-center study including all patients treated with RFA from September 2014 to December 2015. The sample was divided according to the maximum GSV diameter measured on duplex ultrasound scan (A, <12 mm; B, ≥12 mm). Second-generation catheters (ClosureFast; Covidien, Mansfield, Mass) and tumescent anesthesia were used...
November 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29032966/safety-and-efficacy-of-uninterrupted-perioperative-enteral-feeding-in-pediatric-burn-patients
#11
Folasade Imeokparia, Morgan Johnson, Rajan K Thakkar, Sheila Giles, Teresa Capello, Renata Fabia
INTRODUCTION: Burn injuries are a significant cause of morbidity. Early enteral nutrition has been shown to improve outcomes, however enteral nutrition is often held for procedures receiving general anesthesia. Limited data is available on uninterrupted perioperative nutrition in pediatric burn patients. METHODS: A single, American Burn Association verified burn center database was queried for patients ≤18 years of age with ≥15% total body surface area (TBSA) burn injuries who underwent surgeries with general anesthesia...
October 9, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29027772/supraglottic-airway-devices-indications-contraindications-and-management
#12
Joanna Gordon, Richard M Cooper, Matteo Parotto
Supraglottic airway devices (SADs) have become an essential tool in airway management. Over the past three decades, these devices have been increasingly adopted as an alternative to face mask ventilation and/or endotracheal intubation. The range of proposed uses and features have increased significantly. They are used in pre- and in-hospital settings, elective and emergency anesthesia, in spontaneously breathing and ventilated patients, as conduits for intubation, as a bridge to extubation and for airway rescue...
October 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29024359/paravalvular-leak-closure-under-intracardiac-echocardiographic-guidance
#13
Neil Ruparelia, Jacob Cao, James D Newton, Neil Wilson, Matthew J Daniels, Oliver J Ormerod
OBJECTIVES: The objective of this study was to determine the safety and efficacy of intracardiac echocardiography (ICE) to guide percutaneous paravalvular leak (PVL) closure. BACKGROUND: PVL following surgical valve replacement occurs in 2%-15% of patients. Percutaneous treatment is an accepted management strategy in patients deemed to be too high risk for redo surgery. This is most commonly performed with transesophageal (TOE) guidance requiring general anesthesia that both potentially further increase the risk of intervention...
October 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29017364/can-patients-safely-be-admitted-to-a-ward-after-craniotomy-for-resection-of-intra-axial-brain-tumors
#14
Farhan A Mirza, Catherine Wang, Thomas Pittman
OBJECTIVE: We reviewed the safety of our practice of admitting patients who have undergone a craniotomy for resection of an intra-axial brain tumor to a floor bed instead of an ICU. We also tried to quantify the risk that patients electively admitted to the ICU would develop a problem that could not have been effectively managed on the ward. METHODS: A retrospective chart review was performed of both adult and pediatric patients who underwent craniotomy by the senior author for resection of an intra-axial brain tumor between January 2012 and December 2015...
October 11, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29016544/investigation-of-the-efficacy-and-safety-of-topical-vibration-anesthesia-to-reduce-pain-from-cosmetic-botulinum-toxin-a-injections-in-chinese-patients-a-multicenter-randomized-self-controlled-study
#15
Yiming Li, Weiwei Dong, Min Wang, Ning Xu
BACKGROUND: Vibration has been proved to be effective to reduce pain during facial cosmetic injections, but it has not been studied in Chinese patients. OBJECTIVE: To investigate the efficacy and safety of vibration for pain reduction associated with cosmetic botulinum toxin A (BTX-A) injections in Chinese patients. MATERIALS AND METHODS: In this prospective, randomized, split-face and right-left, self-controlled study, 53 patients received BTX-A injections for rhytid reduction, lower face, shoulder, and leg reshaping...
October 6, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28994673/an-innovative-technique-to-improve-safety-of-volatile-anesthetics-suction-from-the-cardiopulmonary-bypass-circuit
#16
Francesco De Simone, Luigi Cassarà, Salvatore Sardo, Elena Scarparo, Omar Saleh, Caetano Nigro Neto, Alberto Zangrillo, Giovanni Landoni
CONTEXT: Myocardial injury during cardiac surgery on cardiopulmonary bypass (CPB) is a major determinant of morbidity and mortality. Preclinical and clinical evidence of dose- and time-related cardioprotective effects of volatile anesthetic drugs exist and their use during the whole surgery duration could improve perioperative cardiac protection. Even if administering volatile agents during CPB are relatively easy, technical problems, such as waste gas scavenging, may prevent safe and manageable administration of halogenated vapors during CPB...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28993089/a-two-cohort-feasibility-study-on-polyglycolic-acid-yarn-implantation-for-abolition-of-saphenous-vein-reflux
#17
Thomas M Proebstle, Bettina Kleis-Fischer, Thomas Möhler, Oliver Goeckeritz, Ian J Franklin, Jose I Almeida
OBJECTIVE: The objective of this study was to evaluate the feasibility and safety of a polyglycolic acid (PGA) yarn implant for nonthermal ablation of saphenous vein reflux. METHODS: In two consecutive cohort studies (TAHOE I and TAHOE II), the feasibility of abolition of great saphenous vein (GSV) reflux by implantation of a PGA yarn was tested under ultrasound guidance in 51 and 30 patients, respectively. The use of tumescent local anesthesia was not required...
October 6, 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28991115/preventing-adverse-events-in-cataract-surgery-recommendations-from-a-massachusetts-expert-panel
#18
Karen C Nanji, Sarah A Roberto, Michael G Morley, Joseph Bayes
Massachusetts health care facilities reported a series of cataract surgery-related adverse events (AEs) to the state in recent years, including 5 globe perforations during eye blocks performed by 1 anesthesiologist in a single day. The Betsy Lehman Center for Patient Safety, a nonregulatory Massachusetts state agency, responded by convening an expert panel of frontline providers, patient safety experts, and patients to recommend strategies for mitigating patient harm during cataract surgery. The purpose of this article is to identify contributing factors to the cataract surgery AEs reported in Massachusetts and present the panel's recommended strategies to prevent them...
October 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28984638/the-future-of-nonoperating-room-anesthesia-in-the-21st-century-emphasis-on-quality-and-safety
#19
Steven D Boggs, Sheila R Barnett, Richard D Urman
PURPOSE OF REVIEW: Nonoperating room anesthesia (NORA) has grown from an insignificant percentage of total anesthesia cases into a major percentage of anesthesia workload over the past 30 years. This trend evidences no signs of abating. RECENT FINDINGS: With the rapid development of novel interventional techniques in cardiology, radiology, gastroenterology and pulmonary medicine and other areas, the core responsibilities of the anesthesia provider will no longer be confined to delivering care in traditional operating rooms...
October 3, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28984521/idiopathic-intracranial-hypertension-120-day-clinical-radiological-and-manometric-outcomes-after-stent-insertion-into-the-dural-venous-sinus
#20
Hasan Asif, Claudia L Craven, Almas H Siddiqui, Syed N Shah, Samir A Matloob, Lewis Thorne, Fergus Robertson, Laurence D Watkins, Ahmed K Toma
OBJECTIVE Idiopathic intracranial hypertension (IIH) is commonly associated with venous sinus stenosis. In recent years, transvenous dural venous sinus stent (DVSS) insertion has emerged as a potential therapy for resistant cases. However, there remains considerable uncertainty over the safety and efficacy of this procedure, in particular the incidence of intraprocedural and delayed complications and in the longevity of sinus patency, pressure gradient obliteration, and therapeutic clinical outcome. The aim of this study was to determine clinical, radiological, and manometric outcomes at 3-4 months after DVSS in this treated IIH cohort...
October 6, 2017: Journal of Neurosurgery
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