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Anesthesia Safety

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https://www.readbyqxmd.com/read/29452441/assessing-the-safety-and-efficacy-of-regional-anesthesia-for-lower-extremity-microvascular-reconstruction-enhancing-recovery
#1
Qing Zhao Ruan, Shawn Diamond, Scott Zimmer, Matthew L Iorio
BACKGROUND: Perioperative pain, increased sympathetic tone, and peripheral vasospasm may be safely managed with regional nerve blockade during microvascular reconstruction in the lower extremity. Limited reports exist in this setting; therefore, we evaluated our use of peripheral nerve catheters (PNCs) during microvascular limb salvage to determine safety and efficacy for both patient and flap. METHODS: A single-institution, retrospective review of a prospectively maintained database on all patients with lower extremity free tissue transfers between 2012 and 2017 was completed...
February 16, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29446987/dexmedetomidine-decreases-postoperative-pain-and-narcotic-use-in-children-undergoing-alveolar-bone-graft-surgery
#2
Mariela M Lopez, Derrick Zech, Judith L Linton, Steven J Blackwell
OBJECTIVE: Dexmedetomidine is a parenteral agent that combines the benefits of cooperative sedation, anxiolysis, and analgesia without the risks of respiratory depression. Off-label use has been reported in children. We have introduced dexmedetomidine for use in patients having undergone alveolar bone graft (ABG). The objective is to demonstrate the value and safety of postoperative dexmedetomidine infusion in a non-ICU setting following ABG. DESIGN: A retrospective review was performed on patients who underwent ABG by the senior author...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29445296/the-ultrasound-guided-retrolaminar-block-volume-dependent-injectate-distribution
#3
Marija Damjanovska, Tatjana Stopar Pintaric, Erika Cvetko, Kamen Vlassakov
Purpose: The ultrasound-guided retrolaminar block is one of the newer and simpler alternatives to the traditional, often technically challenging, paravertebral (PV) block. Its feasibility, safety, and efficacy have already been clinically demonstrated in patients with multiple rib fractures using higher volumes of local anesthetic, when compared with the traditional approach. The primary aim of this observational anatomical study was to assess the spread of local anesthetic from the retrolaminar injection point to the PV space and its volume dependence...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29441174/comparison-of-propofol-alone-and-in-combination-with-ketamine-or-fentanyl-for-sedation-in-endoscopic-ultrasonography
#4
Shweta A Singh, Kelika Prakash, Sandeep Sharma, Gaurav Dhakate, Vikram Bhatia
Background: We evaluated whether the addition of a small dose of ketamine or fentanyl would lead to a reduction in the total dose of propofol consumed without compromising the safety and recovery of patients having endoscopic ultrasonography (EUS). Methods: A total of 210 adult patients undergoing elective EUS under sedation were included in the study. Patients were randomized into three groups. Patients were premedicated intravenously with normal saline in group 1, 50 µg fentanyl in group 2, and 0...
February 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29434783/the-application-of-nalbuphine-in-patient-controlled-intravenous-analgesia-for-patients-undergoing-subtotal-gastrectomy
#5
Li Yang, Jinjing Wu, Tao Li
The aim of the present study was to investigate the analgesic effect and safety of the application of different doses of nalbuphine in patient-controlled intravenous analgesia (PCIA) for patients undergoing subtotal gastrectomy. A total of 120 patients, who underwent subtotal gastrectomy at our hospital between May, 2015 and January, 2017 under combined spinal epidural combined anesthesia, were selected. The patients received PCIA after surgery. The patients were randomly divided into four groups, including the morphine (MOP group), nalbuphine 60 mg (N60 group), nalbuphine 80 mg (N80 group) and nalbuphine 100 mg (N100 group)...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29434629/transcatheter-versus-surgical-aortic-valve-replacement-in-severe-symptomatic-aortic-stenosis
#6
REVIEW
Tsigkas Grigorios, Despotopoulos Stefanos, Makris Athanasios, Koniari Ioanna, Armylagos Stylianos, Davlouros Periklis, Hahalis George
Aortic stenosis (AS) is the most common type of valvular heart disease in the elderly. Surgical aortic valve replacement (SAVR) has been the standard practice for treating severe, symptomatic AS, but recently new treatment options have emerged. Transcatheter aortic valve replacement (TAVR) is now an established treatment option in patients at high surgical risk. In this review, we focus on recent developments and compare the two treatment methods in specific populations in terms of efficacy and safety (e.g...
January 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29432502/comparison-of-the-effect-of-intravenous-anesthetics-used-for-anesthesia-during-electroconvulsive-therapy-on-the-hemodynamic-safety-and-the-course-of-ect
#7
REVIEW
Rafał Wojdacz, Łukasz Święcicki, Anna Antosik-Wójcińska
Electroconvulsive therapy (ECT) is the treatment method widely used in psychiatric disorders such as depression, bipolar disorder, schizophrenia and schizoaffective disorder. The advantage of ECT is therapeutic response that occurs significantly earlier than during pharmacotherapy. Initially ECTwas used without anesthesia. Then, in the 1950s procedures with general anesthesia were introduced to reduce the complications that may occur during a seizure caused by ECT, such as broken bones, teeth, tendon rupture, muscle damage...
December 30, 2017: Psychiatria Polska
https://www.readbyqxmd.com/read/29431909/dermatologic-surgery-in-children-an-update-on-indication-anesthesia-analgesia-and-potential-perioperative-complications
#8
REVIEW
Diana Crisan, Karin Scharffetter-Kochanek, Sabine Kastler, Maria Crisan, Avram Manea, Katja Wagner, Lars Alexander Schneider
BACKGROUND: Children undergoing dermatosurgical procedures require, unlike adults, particular attention; the administration of various analgesics, anesthetics or sedatives requires a thorough knowledge of drug pharmacokinetics and pharmacodynamics. Furthermore, there are concerns that drugs used for sedation/general anesthesia may result in anesthetic/analgesic complications in children undergoing surgery, with a risk of impaired mental development. OBJECTIVES: Based on our clinical experience and a literature review, we illustrate the most commonly used analgesic, anesthetic and sedative drugs in pediatric dermatosurgery, and identify risk factors and complications following dermatosurgical procedures...
February 12, 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/29425771/early-outcomes-with-fast-track-evar-in-teaching-and-nonteaching-hospitals
#9
Hiranya A Rajasinghe, Larry E Miller, Zvonimir Krajcer
PURPOSE: To determine feasibility, safety, and effectiveness of a fast-track endovascular aneurysm repair (EVAR) protocol at teaching and nonteaching hospitals. METHODS: Patients underwent a fast-track EVAR protocol comprised of bilateral percutaneous access using a 14 Fr stent graft, avoidance of general anesthesia and intensive care admission, and next-day discharge. Patients were followed through 1 month post-treatment. Participating hospitals were categorized by teaching status (teaching vs...
February 6, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29421914/the-safety-of-deep-sedation-with-propofol-controlled-by-the-endoscopist-in-endoscopic-retrograde-cholangiopancreatography-ercp-a-prospective-study-in-a-tertiary-hospital
#10
Lara Luzón Solanas, Leticia Ollero Domenche, Eva María Sierra Moros, José Val Pérez, María Teresa Soria San Teodoro, Teresa Giménez Júlvez, Rafael Uribarrena Amezaga
INTRODUCTION: propofol administered by an endoscopist with a trained nurse has evolved as an alternative to anesthesia monitoring and is increasingly common in the routine clinical practice, even in advanced endoscopy. OBJECTIVE: to evaluate the safety of deep sedation with endoscopist-controlled propofol in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). MATERIAL AND METHODS: this was a prospective study in patients undergoing ERCP under deep sedation with propofol...
February 9, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29421068/lean-and-green-hand-surgery
#11
REVIEW
Robert E Van Demark, Vanessa J S Smith, Anthony Fiegen
Health care in the United States is both expensive and wasteful. The cost of health care in the United States continues to increase every year. Health care spending for 2016 is estimated at $3.35 trillion. Per capita spending ($10,345 per person) is more than twice the average of other developed countries. The United States also leads the world in solid waste production (624,700 metric tons of waste in 2011). The health care industry is second only to the food industry in annual waste production. Each year, health care facilities in the United States produce 4 billion pounds of waste (660 tons per day), with as much as 70%, or around 2...
February 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29417586/office-based-esophageal-dilation-in-head-and-neck-cancer-safety-feasibility-and-cost-analysis
#12
Rebecca J Howell, Melissa A Schopper, John Paul Giliberto, Ryan M Collar, Sid M Khosla
OBJECTIVE: To review experience, safety, and cost of office-based esophageal dilation in patients with history of head and neck cancer (HNCA). METHODS: The medical records of patients undergoing esophageal dilation in the office were retrospectively reviewed between August 2015 and May 2017. Patients were given nasal topical anesthesia. Next, a transnasal esophagoscopy (TNE) was performed. If the patient tolerated TNE, we proceeded with esophageal dilation using Seldinger technique with the CRE™ Boston Scientific (Boston Scientific Corp...
February 8, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29416457/assessment-of-procedural-skills-in-residents-working-in-a-research-and-training-institute-an-effort-to-ensure-patient-safety-and-quality-control
#13
Kamlesh Kumari, Tanvir Samra, B Naveen Naik, Vikas Saini
Background: To ensure patient safety, it is important to regularly assess the knowledge and practical skills of anesthesia trainees. This study was conducted to evaluate the competency of the residents and the impact of various corrective measures in the form of didactic lectures and clinical skill demonstrations on the conduct of various procedural skills by the residents. Materials and Methods: Ninety-five junior residents were enrolled in this study. Assessment of competency of 1st, 2nd, and 3rd year residents in performing various procedure skills of anesthesia was done in two stages using procedure specific checklist (PSC) and Global Rating Scales (GRSs)...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29416456/evaluation-of-safety-and-efficacy-of-regional-anesthesia-compared-with-general-anesthesia-in-thoracoscopic-lung-biopsy-procedure-on-patient-with-idiopathic-pulmonary-fibrosis
#14
Waseem M Hajjar, Sami A Al-Nassar, Ghaida S Al-Sugair, Alaa Al-Oqail, Shahd Al-Mansour, Rand Al-Haweel, Adnan W Hajjar
Background: Interstitial lung diseases are diseases that need histology diagnosis or obtaining a lung biopsy to establish the diagnosis. Surgical biopsies are performed usually using the thoracoscopy technique under general anesthesia (GA) although this procedure is still associated with morbidity rate. The aim of this study is to determine the effectiveness and safety of regional anesthesia (RA) compared with GA in thoracoscopic lung biopsy procedures done on patients with idiopathic pulmonary fibrosis (IPF)...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29416230/etomidate-derivatives-novel-pharmaceutical-agents-in-anesthesia
#15
REVIEW
Raymond J Malapero, Michael P Zaccagnino, Ethan Y Brovman, Alan David Kaye, Richard D Urman
Etomidate is an imidazole derivative that possesses important sedative properties employed in anesthesia practice, however, etomidate has a number of well-know side effects which limit its use in certain subpopulations and over long periods of time, mostly related to dose-dependent adrenal suppression. This review focuses on novel etomidate derivatives with an emphasis on pharmacological properties which afford improved safety profile and potentially desirable clinical effects. The pharmacology and clinical investigation of some of these etomidate derivatives, e...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29407363/society-of-family-planning-clinical-guidelines-pain-control-in-surgical-abortion-part-1-local-anesthesia-and-minimal-sedation
#16
REVIEW
Rebecca H Allen, Rameet Singh
Satisfactory pain control for women undergoing surgical abortion is important for patient comfort and satisfaction. Clinicians ought to be aware of the safety and efficacy of different pain control regimens. This document will focus on nonpharmacologic modalities to reduce pain and pharmacologic interventions up to the level of minimal sedation. For surgical abortion without intravenous medications, a multimodal approach to pain control may combine a dedicated emotional-support person, visual or auditory distraction, administration of local anesthesia to the cervix with buffered lidocaine, and a preoperative nonsteroidal anti-inflammatory drug...
January 30, 2018: Contraception
https://www.readbyqxmd.com/read/29405600/conscious-sedation-for-tavr-a-wave-of-the-future
#17
EDITORIAL
Christina Tan, Larry S Dean
As indications for TAVR continue to grow, experienced centers strive to adopt further minimally invasive techniques and continue to improve outcomes. Meta-analysis of the available data demonstrate that conscious sedation is associated with decreased ICU and hospitalization time, and is not associated with decreased procedural efficacy or safety. Randomized Controlled clinical Trial data will be needed to confirm observational findings suggesting decreased mortality with conscious sedation versus general anesthesia...
February 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29404730/laparoscopic-total-extraperitoneal-hernia-repair-under-regional-anesthesia-a-systematic-review-of-the-literature
#18
REVIEW
Ioannis Baloyiannis, Konstantinos Perivoliotis, Chamaidi Sarakatsianou, George Tzovaras
BACKGROUND: General anesthesia has been used as a standard for laparoscopic inguinal hernia repair including both techniques (Trans-Abdominal Pre-Peritoneal repair and the Total Extra-Peritoneal repair), while regional anesthesia has been occasionally applied in high risk patients where general anesthesia is contraindicated. In case of the total extraperitoneal repair (TEP), several authors have attempted to perform TEP repair under regional anesthesia and reported on the safety and feasibility of this procedure...
February 5, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29402220/design-of-a-novel-multifunction-decision-support-display-for-anesthesia-care-alertwatch%C3%A2-or
#19
Kevin K Tremper, Jenny J Mace, Jan M Gombert, Theodore T Tremper, Justin F Adams, James P Bagian
BACKGROUND: This paper describes the design of a multifunction alerting display for intraoperative anesthetic care. The design was inspired by the multifunction primary flight display used in modern aviation. RESULTS: The display retrieves live data from multiple sources; the physiologic monitors, the anesthesia information management system, the laboratory values and comorbidities from patient's problem summary list, medical history or history & physical. This information is integrated into a display composed of readily identifiable icons of organ systems, which are color coded to signify normal range, marginal range, abnormal range (by green, yellow, red respectively) and orange outlines for comorbidities/risk factors...
February 5, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29398586/prospective-study-of-enhanced-recovery-after-surgery-protocol-in-children-undergoing-reconstructive-operations
#20
K O Rove, M A Brockel, A F Saltzman, M I Dönmez, K E Brodie, D J Chalmers, B T Caldwell, V M Vemulakonda, D T Wilcox
BACKGROUND: Enhanced recovery after surgery (ERAS) protocol is a set of peri-operative strategies to increase speed of recovery. ERAS is well established in adults but has not been well studied in children. OBJECTIVE: The purpose of the current study was to establish the safety and efficacy of an ERAS protocol in pediatric urology patients undergoing reconstructive operations. It was hypothesized that ERAS would reduce length of stay and decrease complications when compared with historical controls...
February 1, 2018: Journal of Pediatric Urology
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