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Anesthesia Safety

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https://www.readbyqxmd.com/read/29232379/comparison-of-nalbuphine-and-sufentanil-for-colonoscopy-a-randomized-controlled-trial
#1
Chaoyi Deng, Xiao Wang, Qianmei Zhu, Yanming Kang, Jinlin Yang, Heng Wang
OBJECTIVES: Nalbuphine is as effective as morphine as a perioperative analgesic but has not been compared directly with sufentanil in clinical trials. The aims of this study were to compare the efficacy and safety of nalbuphine with that of sufentanil in patients undergoing colonoscopy and to determine the optimal doses of nalbuphine in this indication. METHODS: Two hundred and forty consecutive eligible patients aged 18-65 years with an American Society of Anesthesiologists classification of I-II and scheduled for colonoscopy were randomly allocated to receive sufentanil 0...
2017: PloS One
https://www.readbyqxmd.com/read/29231542/-clinical-research-of-electroacupuncture-on-the-analgesic-effect-of-thoracic-perioperative-stage
#2
Mintao Zhou, Yu Li, Xuechang Han, Qunzhi Xing, Yiyao Wang, Xu Dong, Junxiao Chang
OBJECTIVE: To discuss the clinical therapeutic effects of electroacupuncture at Neimadian (Extra) and Neiguan (PC 6) on the analgesic effect of thoracic perioperative stage and its effect mechanism. METHODS: Sixty cases of esophageal cancer with elective radical resection under general anesthesia were divided into an observation group and a control group according to the operation sequence, 30 cases in each one. In the control group, the general anesthesia was simply applied and sufentanil was administered for patient controlled intravenous analgesia (PCIA) after operation...
July 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29229253/can-transesophageal-echocardiography-be-performed-safely-using-a-laryngeal-mask-airway-during-atrial-fibrillation-ablation
#3
Damian Balmforth, Andrew Smith, David Nagore, Richard Schilling, Ben O'Brien
OBJECTIVE: To investigate the feasibility and safety of using a laryngeal mask airway (LMA) compared with a cuffed oral endotracheal tube (COETT) for atrial fibrillation (AF) ablation with transesophageal echocardiography (TEE). DESIGN: Prospective, cohort study. SETTING: A single-center inner-city hospital. PARTICIPANTS: The study comprised adult patients undergoing elective AF ablation with periprocedural TEE over a 3-year period...
November 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29225003/improving-patient-safety-during-procedural-sedation-via-respiratory-volume-monitoring-a-randomized-controlled-trial
#4
Donald M Mathews, Michael J Oberding, Eric L Simmons, Stephen E O'Donnell, Kevin R Abnet, Kathleen MacDonald
STUDY OBJECTIVE: Assess the utility of a respiratory volume monitor (RVM) to reduce the incidence of low minute ventilation events in procedural sedation. DESIGN: Randomized control trial SETTING: Endoscopy suite PATIENTS: Seventy-three total patients (ASA Physical Status 1-3) undergoing upper endoscopies were analyzed. INTERVENTION: Patients were randomized into two groups using a computer generated randomization table: Control (n=41): anesthesia provider was unable to see the screen of the RVM; RVM (n=32): anesthesia provider had access to RVM data to assist with management of the case...
December 7, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29224301/-application-of-bispectral-index-monitoring-in-sedation-and-analgesia-for-flexible-bronchoscopy
#5
S R Fang, Y J Liu, N J Su, Y Shu, W Gu
Objective: To investigate the feasibility of using bispectral index monitoring in sedation and analgesia for bronchoscopy. Methods: Totally 285 patients admitted to the Respiratory Medicine Department of Nanjing First Hospital for bronchoscopy between June 2016 and December 2016 were assigned, according to their own wishes, into a conscious sedation group (171 cases receiving local anesthesia and conscious sedation, 89 males, 82 females, mean age 59±10 years) and a control group (114 cases undergoing local anesthesia, 59 males, 55 females, average age 61±12 years)...
December 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29223665/guidelines-and-checklists-for-short-term-missions-in-global-pediatric-surgery-recommendations-from-the-american-academy-of-pediatrics-delivery-of-surgical-care-global-health-subcommittee-american-pediatric-surgical-association-global-pediatric-surgery-committee
#6
REVIEW
Marilyn Butler, Elizabeth Drum, Faye M Evans, Tamara Fitzgerald, Jason Fraser, Ai-Xuan Holterman, Howard Jen, J Matthew Kynes, Jenny Kreiss, Craig D McClain, Mark Newton, Benedict Nwomeh, James O'Neill, Doruk Ozgediz, George Politis, Henry Rice, David Rothstein, Julie Sanchez, Mark Singleton, Francine S Yudkowitz
INTRODUCTION: Pediatric surgeons, anesthesia providers, and nurses from North America and other high-income countries (HICs) are increasingly engaged in resource-limited areas, with short-term missions (STMs) as the most common form of involvement. However, consensus recommendations currently do not exist for STMs in pediatric general surgery and associated perioperative care. METHODS: The American Academy of Pediatrics (AAP) Delivery of Surgical Care Subcommittee and American Pediatric Surgical Association (APSA) Global Pediatric Surgery Committee, with the American Pediatric Surgical Nurses Association, Inc...
November 15, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29218477/safety-and-efficacy-of-facial-fat-grafting-under-local-anesthesia
#7
Xiaorong Ma, Liming Wu, Tianxiang Ouyang, Wenjia Ge, Jingwen Ke
BACKGROUND: Facial fat grafting under local anesthesia has been widely performed in outpatient departments and private settings in China. The present study aimed to evaluate the safety and efficacy of facial fat grafting under local anesthesia. METHOD: A retrospective study was conducted on 155 patients who underwent facial fat grafting. The clinical data were recorded. Preoperative and postoperative two-dimensional images were acquired to evaluate the effect of facial fat grafting on refining facial contouring, rejuvenation as well as deformity reconstruction...
December 7, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29214081/a-rare-complication-of-a-tap-block-performed-after-caesarean-delivery
#8
Osman Nawazish Salaria, Murlikrishna Kannan, Bryan Kerner, Howard Goldman
The transversus abdominis plane block is a regional anesthesia technique that has become popular. Being a relatively simple procedure, the TAP block has an excellent safety profile and major complications are rare. We present a case of transient femoral nerve palsy occurring after a TAP block with involvement of the sacral plexus for a patient who had undergone a caesarean section.
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/29214061/medical-thoracoscopy-and-its-evolving-role-in-the-diagnosis-and-treatment-of-pleural-disease
#9
REVIEW
Vivek Murthy, Jamie L Bessich
Establishing the etiology of exudative pleural effusions in the setting of an unrevealing pleural fluid analysis often requires biopsies from the parietal pleura. While closed pleural biopsy (CPB) has been a popular minimally-invasive approach, it has a poor diagnostic yield, barring a diagnosis of tuberculous pleurisy. Medical thoracoscopy (MT) is a minimally-invasive ambulatory procedure performed under local anesthesia or moderate sedation which allows for direct visualization of biopsy targets as well as simultaneous therapeutic interventions, including chemical pleurodesis and indwelling tunneled pleural catheter (ITPC) placement...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29210791/design-and-evaluation-of-a-closed-loop-anesthesia-system-with-robust-control-and-safety-system
#10
Nicholas West, Klaske van Heusden, Matthias Görges, Sonia Brodie, Aryannah Rollinson, Christian L Petersen, Guy A Dumont, J Mark Ansermino, Richard N Merchant
BACKGROUND: Closed-loop control of anesthesia involves continual adjustment of drug infusion rates according to measured clinical effect. The NeuroSENSE monitor provides an electroencephalographic measure of depth of hypnosis (wavelet-based anesthetic value for central nervous system monitoring [WAVCNS]). It has previously been used as feedback for closed-loop control of propofol, in a system designed using robust control engineering principles, which implements features specifically designed to ensure patient safety...
November 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29210723/safe-labeling-practices-to-minimize-medication-errors-in-anesthesia-5-case-reports-and-review-of-the-literature
#11
Smita Prakash, Parul Mullick, Ajay Kumar, Mridula Pawar
Drug error is a significant hazard to patient health. Poor, incorrect, and inconsistent labeling of injectable medicines and fluids, and the devices used to deliver these, has been identified as a patient safety issue. We report 5 cases of medication error as a consequence of incorrect or inappropriate labeling and analyze their cause. Recommendations for safe and practical labeling practices in anesthesia based on a review of the literature are presented. Implementation of the recommended labeling practices can reduce the risk of medication error and contribute to the safe administration of drugs...
November 27, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29209128/role-of-combined-propofol-and-sufentanil-anesthesia-in-endoscopic-injection-sclerotherapy-for-esophageal-varices
#12
Yang Yu, Sheng-Lin Qi, Yong Zhang
AIM: To investigate the efficacy and safety of a combination of sufentanil and propofol injection in patients undergoing endoscopic injection sclerotherapy (EIS) for esophageal varices (EVs). METHODS: Patients with severe EVs who underwent EIS with sufentanil and propofol anesthesia between April 2016 and July 2016 at our hospital were reviewed. Although EIS and sequential therapy were performed under endotracheal intubation, we only evaluated the efficacy and safety of anesthesia for the first EIS procedure...
November 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29208758/respiratory-volume-monitoring-reduces-hypoventilation-and-apnea-in-subjects-undergoing-procedural-sedation
#13
Robert H Nichols, Justin A Blinn, Thuan M Ho, Robert A McQuitty, Michael P Kinsky
INTRODUCTION: The use of monitored anesthesia care for endoscopic procedures increases the risk of respiratory depression, necessitating careful monitoring of patient ventilation. We examined the effectiveness of an impedance-based respiratory volume monitor (RVM) in improving the safety of patients undergoing upper and lower gastrointestinal endoscopies under total intravenous anesthesia. We hypothesized that feedback from the RVM would allow anesthesiologists to maintain adequate ventilation, which would reduce the duration of respiratory depression (ie, hypoventilation and apnea) compared to a blinded control group...
December 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29205687/ultrasound-guided-pudendal-nerve-block-in-children-a-new-technique-of-ultrasound-guided-transperineal-approach
#14
Isabelle Gaudet-Ferrand, Pablo De La Arena, Sophie Bringuier, Olivier Raux, Laurent Hertz, Nicolas Kalfa, Chrystelle Sola, Christophe Dadure
BACKGROUND: Transperineal pudendal nerve block guided by nerve stimulator is used in pediatric anesthesia as an alternative to caudal analgesia in perineal surgery. The risk of rectal puncture or intravascular injection is inherent to this blinded technique. We described a new technique of transperineal pudendal nerve block, with ultrasound guidance, to improve safety of the technique. AIMS: The first goal of this study was to describe this new technique and to test its feasibility...
December 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29202646/submucosal-diclofenac-for-acute-postoperative-pain-in-third-molar-surgery-a-randomized-controlled-clinical-trial
#15
P Gorecki, K D Rainsford, P Taneja, Y Bulsara, D Pearson, D Saund, B Ahmed, T Dietrich
Diclofenac sodium is a widely used nonsteroidal anti-inflammatory drug (NSAID) for relief of inflammatory pain. A recent formulation combines this drug with hydroxypropyl-β-cyclodextrin (HPβCD) to improve its solubility and to enable subcutaneous administration. Previous studies confirmed the efficacy of this combination. This study's aim was to evaluate the efficacy, safety, and local tolerability of diclofenac HPβCD administered as a local submucosal injection prior to lower third molar surgery. We conducted a prospective, randomized, double-blind, placebo-controlled, parallel-group phase II single-center study...
December 1, 2017: Journal of Dental Research
https://www.readbyqxmd.com/read/29200678/radiofrequency-ablation-of-osteoid-osteoma-in-common-and-technically-challenging-locations-in-pediatric-population
#16
Shaileshkumar Garge, Shyamkumar Nidugala Keshava, Vinu Moses, George Koshy, 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: The objective of this study was to assess the safety and efficacy of CT-guided percutaneous RFA of osteoid osteoma in pediatric population. Subjects and Methods: From June 2009 to May 2014, thirty 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...
July 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29200480/stitchless-percutaneous-endoscopic-cervical-discectomy-are-we-moving-towards-day-care-discectomy-procedure
#17
Sunil M Nadkarni, Pavankumar Kohli, Bhupesh Patel, Satishchandra Gore, Bhagyashree S Kulkarni
Background: STITCHLESS percutaneous endoscopic cervical discectomy s[PECD] is safe, precise, targeted, and a complete endoscopic procedure to treat soft cervical disc herniation with unilateral radiculopathy. It allows direct visualization of herniated fragment and its removal, inspection of decompressed nerve root in an awake and aware patient. It reduces the risk related to general anesthesia and to the neurological structures. However, all the patients treated with PECD can be candidates for anterior cervical discectomy and fusion (ACDF)...
November 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29198854/efficacy-and-safety-of-transversus-abdominis-plane-blocks-versus-thoracic-epidural-anesthesia-in-patients-undergoing-major-abdominal-oncologic-resections-a-prospective-randomized-controlled-trial
#18
Tamer M Shaker, Joseph T Carroll, Mathew H Chung, Tracy J Koehler, Brian R Lane, Andrea M Wolf, G Paul Wright
BACKGROUND: The purpose of this study was to compare patient outcomes for thoracic epidural anesthesia (TEA) with transversus abdominis plane (TAP) blocks. METHODS: A prospective, randomized trial was performed for patients undergoing abdominal oncologic surgeries. RESULTS: There were 32 TAP and 35 TEA subjects. The TEA group demonstrated increased episodes of hypotension in the first 24 h (3 v 0.6, p = 0.02). There was no difference in 24-48 h fluid balance between the groups...
November 16, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29191560/msbis-a-multi-step-biomedical-informatics-screening-approach-for-identifying-medications-that-mitigate-the-risks-of-metoclopramide-induced-tardive-dyskinesia
#19
Dong Xu, Alexandrea G Ham, Rickey D Tivis, Matthew L Caylor, Aoxiang Tao, Steve T Flynn, Peter J Economen, Hung K Dang, Royal W Johnson, Vaughn L Culbertson
In 2009 the U.S. Food and Drug Administration (FDA) placed a black box warning on metoclopramide (MCP) due to the increased risks and prevalence of tardive dyskinesia (TD). In this study, we developed a multi-step biomedical informatics screening (MSBIS) approach leveraging publicly available bioactivity and drug safety data to identify concomitant drugs that mitigate the risks of MCP-induced TD. MSBIS includes (1) TargetSearch (http://dxulab.org/software) bioinformatics scoring for drug anticholinergic activity using CHEMBL bioactivity data; (2) unadjusted odds ratio (UOR) scoring for indications of TD-mitigating effects using the FDA Adverse Event Reporting System (FAERS); (3) adjusted odds ratio (AOR) re-scoring by removing the effect of cofounding factors (age, gender, reporting year); (4) logistic regression (LR) coefficient scoring for confirming the best TD-mitigating drug candidates...
November 22, 2017: EBioMedicine
https://www.readbyqxmd.com/read/29191343/an-age-based-approach-to-dermatologic-surgery-kids-are-not-just-little-people
#20
Breton Yates, James Whalen, Hanspaul Makkar
Surgical dermatologic procedures in children pose unique challenges that differ from those in adults. Child and parental anxiety, along with procedural anxiety in adults, necessitate different approaches. Special considerations are reviewed in the application of topical anesthesia and administration of local anesthesia in children as opposed to adults, and the use and safety of general anesthesia in children is highlighted. In addition, management of postprocedural analgesia differs in children, largely due to concern for safety of opioids in children...
November 2017: Clinics in Dermatology
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