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Anesthesia Safety

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https://www.readbyqxmd.com/read/27914146/pregnancy-and-delivery-in-a-generalized-dystonia-patient-treated-with-internal-globus-pallidal-deep-brain-stimulation-a-case-report
#1
Hye Ran Park, Jae Meen Lee, Hyeyoung Park, Chae Won Shin, Han Joon Kim, Hee Pyoung Park, Dong Gyu Kim, Beom Seok Jeon, Sun Ha Paek
Internal globus pallidus (GPi) deep brain stimulation (DBS) has been widely accepted as an effective treatment modality of medically refractory dystonia. However, there have been few studies regarding the safety issue of pregnancy and childbirth related with DBS. This report describes a female patient who was pregnant and delivered a baby after GPi DBS surgery. A 33-year-old female patient with acquired generalized dystonia underwent bilateral GPi DBS implantation. She obtained considerable improvement in both movement and disability after DBS implantation...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27912973/micro-ureteroscopy-for-the-treatment-of-distal-ureteral-calculi-in-children
#2
Mehmet Mazhar Utanğaç, Ahmet Ali Sancaktutar, Abdulkadir Tepeler
OBJECTIVE: The objective of this study was to demonstrate the efficacy and safety of micro-ureteroscopy (micro-URS) in the management of distal ureteral stones in the pediatric population. MATERIALS AND METHODS: A total of 11 children, who had undergone micro-URS between September 2015 and April 2016 with the indication of distal ureteral calculi in two referral centers, were retrospectively evaluated. The procedures were performed with the patient in the lithotomy position under general anesthesia using the standard URS technique with a micro-ureteroscope that has a caliber of 4...
November 17, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27911264/percutaneous-radiologically-guided-gastrostomy-tube-placement-comparison-of-antegrade-transoral-and-retrograde-transabdominal-approaches
#3
Zachary M Haber, Hearns W Charles, Jonathan S Gross, Daniel Pflager, Amy R Deipolyi
PURPOSE: We aimed to compare the antegrade transoral and the retrograde transabdominal approaches for fluoroscopy-guided percutaneous gastrostomy tube (G-tube) placement. METHODS: Following institutional review board approval, all G-tubes at two academic hospitals (January 2014 to May 2015) were reviewed retrospectively. Retrograde approach was used at Hospital 1 and both antegrade and retrograde approaches were used at Hospital 2. Chart review determined type of anesthesia used during placement, dose of radiation used, fluoroscopy time, procedure time, medical history, and complications...
December 2, 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/27902493/intravenous-amisulpride-for-the-prevention-of-postoperative-nausea-and-vomiting-two-concurrent-randomized-double-blind-placebo-controlled-trials
#4
Tong J Gan, Peter Kranke, Harold S Minkowitz, Sergio D Bergese, Johann Motsch, Leopold Eberhart, David G Leiman, Timothy I Melson, Dominique Chassard, Anthony L Kovac, Keith A Candiotti, Gabriel Fox, Pierre Diemunsch
BACKGROUND: Two essentially identical, randomized, double-blind, placebo-controlled, parallel-group phase III studies evaluated the efficacy of intravenous amisulpride, a dopamine D2/D3 antagonist, in the prevention of postoperative nausea and vomiting in adult surgical patients. METHODS: Adult inpatients undergoing elective surgery during general anesthesia and having at least two of the four Apfel risk factors for postoperative nausea and vomiting were enrolled at 9 U...
November 30, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27900707/fluoroscopy-guided-biodegradable-spacer-implantation-using-local-anesthesia-safety-and-efficacy-study-in-patients-with-massive-rotator-cuff-tears
#5
E Gervasi, E Maman, A Dekel, E Cautero
BACKGROUND: The management of massive rotator cuff tears (MRCTs) is challenging and associated with a high failure rates. Studies have shown that advanced age, lower American Society of Anesthesiologists physical status score and concomitant comorbidities are associated with higher risks of death and postoperative complications. This study was designed to assess the safety and efficacy of fluoroscopy-guided biodegradable spacer implantation under local anesthesia, in patients with MRCT and comorbidities completely or partially contraindicating surgeries under general anesthesia...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27898510/the-effect-of-implementation-of-preoperative-and-postoperative-care-elements-of-a-perioperative-surgical-home-model-on-outcomes-in-patients-undergoing-hip-arthroplasty-or-knee-arthroplasty
#6
Thomas R Vetter, Joydip Barman, James M Hunter, Keith A Jones, Jean-Francois Pittet
BACKGROUND: The Perioperative Surgical Home (PSH) seeks to remedy the currently highly fragmented and expensive perioperative care in the United States. The 2 specific aims of this health services research study were to assess the association between the preoperative and postoperative elements of an initial PSH model and a set of (1) clinical, quality, and patient safety outcomes and (2) operational and financial outcomes, in patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA)...
November 28, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27896927/a-retrospective-review-of-anesthesia-and-perioperative-care-in-children-with-medium-chain-acyl-coa-dehydrogenase-deficiency
#7
Claire Allen, Russell Perkins, Bernd Schwahn
BACKGROUND: Medium-chain acyl-CoA dehydrogenase deficiency is the most common genetically determined disorder of mitochondrial fatty acid oxidation. Decompensation can result in hypoglycemia, seizures, coma, and death but may be prevented by ensuring glycogen stores do not become depleted. Perioperative care is of interest as surgery, fasting, and infection may all trigger decompensation and the safety of anesthetic agents has been questioned. Current guidelines from the British Inherited Metabolic Disease Group advise on administering fluid containing 10% glucose during the perioperative period...
November 29, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27893492/safety-of-local-intracutaneous-lidocaine-anesthesia-used-by-dermatologic-surgeons-for-skin-cancer-excision-and-postcancer-reconstruction-quantification-of-standard-injection-volumes-and-adverse-event-rates
#8
Murad Alam, Matthew R Schaeffer, Amelia Geisler, Emily Poon, Scott W Fosko, Divya Srivastava
BACKGROUND: Intracutaneous lidocaine is used for anesthesia in dermatologic surgery for skin cancer excision and repair with exceedingly low incidence of reported adverse events. OBJECTIVE: To measure (1) the quantity of lidocaine typically used for facial skin cancer excision and reconstruction; and (2) the frequency and character of associated adverse events. METHODS: Survey study of dermatologic surgeons with longitudinal reporting. Reported practice during 10 business days: (1) mean volume of 1% lidocaine per skin cancer excision; (2) maximum per excision; (3) mean per reconstruction; and (4) maximum per reconstruction...
December 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/27891005/endobronchial-ultrasound-guided-transbronchial-needle-aspiration-of-thyroid-report-of-two-cases-and-systematic-review-of-literature
#9
Karan Madan, Saurabh Mittal, Vijay Hadda, Deepali Jain, Anant Mohan, Randeep Guleria
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive and safe technique for a sampling of mediastinal lesions. Indications for EBUS-TBNA have gradually expanded since its introduction. The usual approach to cytological sampling of the thyroid gland is percutaneous ultrasound-guided fine needle aspiration (US-FNA) performed under local anesthesia. US-FNA may be risky or not feasible in intrathoracic/substernal thyroid location. Feasibility of aspirating thyroid lesions with EBUS-TBNA has been occasionally reported...
November 2016: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/27890061/preoperative-screening-for-sleep-disordered-breathing-in-children-a-systematic-literature-review
#10
Erin E Bauer, Rebecca Lee, Yasmine N Campbell
Clinicians frequently underestimate or do not assess sleep-disordered breathing (SDB) in children in ambulatory surgical centers. Identifying the disorder and obtaining information relevant to anesthesia management can be assisted by the use of a standard questionnaire during preoperative assessment. We wanted to determine whether a preoperative screening tool increases clinician awareness of SDB in children and leads to a decrease in perioperative respiratory adverse events. We reviewed 21 articles to identify reliable screening tools for pediatric SDB in ambulatory surgical centers and selected six articles for the review...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27885537/safety-analysis-of-bariatric-patients-undergoing-outpatient-upper-endoscopy-with-non-anesthesia-administered-propofol-sedation
#11
Tyler McVay, John C Fang, Linda Taylor, Alexander Au, Wesley Williams, Angela P Presson, Ragheed Al-Dulaimi, Eric Volckmann, Anna Ibele
BACKGROUND: Non-anesthesia administered propofol (NAAP) has been shown to be a safe and effective method of sedation for patients undergoing gastrointestinal endoscopy. Bariatric surgery patients are potentially at a higher risk for sedation-related complications due to co-morbidities including obstructive sleep apnea. The outcomes of NAAP in bariatric patients have not been previously reported. METHODS: In this retrospective cohort study, severely obese patients undergoing pre-surgical outpatient esophagogastroduodenoscopy (EGD) were compared to non-obese control patients (BMI ≤ 25 kg/m(2)) undergoing diagnostic EGD at our institution from March 2011-September 2015 using our endoscopy database...
November 24, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27876446/gastrostomy-tube-placement-is-safe-in-advanced-amyotrophic-lateral-sclerosis
#12
Manisha Kak, Naoum P Issa, Raymond P Roos, Bobbie Jean Sweitzer, Ori Gottlieb, Amy Guralnick, Steven R White, Carol E Semrad, Betty Soliven, Joumana Baroody, Kourosh Rezania
OBJECTIVES: To evaluate the safety and effect on survival of insertion of a gastrostomy tube (G-tube) in patients with amyotrophic lateral sclerosis (ALS) who have upright forced vital capacity (uFVC) ≤ 50% predicted. Current guidelines, which are based on higher rates of post-procedure complications in ALS patients with advanced respiratory dysfunction, have led to a recommendation to perform G-tube insertion before the FVC drops to <50% predicted, even when the patient has no significant dysphagia...
November 23, 2016: Neurological Research
https://www.readbyqxmd.com/read/27875053/pharmacological-reversal-agents-in-dental-practice-keys-to-patient-safety
#13
Mark Donaldson, Jason H Goodchild
Though uncommon, medical emergencies in the dental office are harrowing occurrences that can be the result of adverse drug reactions. Pharmacological antagonists have been developed for administration as reversal agents in emergency situations in which patients may have an untoward effect, typically caused by too much medication. Dental practitioners should be familiar with these agents to keep patients safe and help mitigate drug-induced medical emergencies. This article reviews the pharmacokinetic and pharmacodynamic principles of pharmacological antagonists; it emphasizes six specific reversal agents as they relate to the clinical practice of dentistry: naloxone, flumazenil, epinephrine, diphenhydramine, phentolamine, and atropine...
November 2016: Compendium of Continuing Education in Dentistry
https://www.readbyqxmd.com/read/27871603/prophylactic-phenylephrine-infusion-for-the-prevention-of-hypotension-after-spinal-anesthesia-in-the-elderly-a-randomized-controlled-clinical-trial
#14
Fabrice Ferré, Philippe Marty, Laura Bruneteau, Virgine Merlet, Benoît Bataille, Anne Ferrier, Claude Gris, Matt Kurrek, Olivier Fourcade, Vincent Minville, Agnes Sommet
STUDY OBJECTIVE: Hypotension frequently occurs during spinal anesthesia (SA), especially in the elderly. Phenylephrine is effective to prevent SA-induced hypotension during cesarean delivery. The objective of this study was to evaluate the efficacy and safety of prophylactic infusion of phenylephrine after SA for orthopedic surgery in the elderly. DESIGN: This prospective, randomized, double-blind, and placebo-controlled study included 54 patients older than 60 years undergoing elective lower limb surgery under SA (injection of 10 mg of isobaric bupivacaine with 5 μg of sufentanyl)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871583/sugammadex-given-for-rocuronium-induced-neuromuscular-blockade-in-infants-a-retrospect%C3%A4-ve-study
#15
Ozlem Ozmete, Cagla Bali, Oya Yalcin Cok, Hatice Evren Eker Turk, Nesrın Bozdogan Ozyilkan, Soner Civi, Anıs Aribogan
STUDY OBJECTIVE: To evaluate the efficacy and safety of sugammadex in reversing profound neuromuscular block induced by rocuronium in infant patients. DESIGN: Retrospective observational study. SETTING: University teaching hospital. PATIENTS: Twenty-six infants (2-12 months of age; 3-11 kg) with an American Society of Anesthesiologists classification I, II, or III who were scheduled to undergo neurosurgical procedures were included in the study...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871557/effect-of-adjunctive-dexmedetomidine-on-postoperative-intravenous-opioid-administration-in-patients-undergoing-thyroidectomy-in-an-ambulatory-setting
#16
Kristin Long, Joseph Ruiz, Spencer Kee, Alicia Kowalski, Farzin Goravanchi, Jeff Cerny, Katy French, Mike Hernandez, Nancy Perrier, Elizabeth Rebello
STUDY OBJECTIVE: Two of the most feared complications for patients undergoing thyroid surgery are pain and postoperative nausea and vomiting. Thyroidectomy is considered high risk for postoperative nausea and vomiting, and recent studies have looked at adjuncts to treat pain, limit narcotic use, "fast-track" the surgical process, and enhance recovery without compromising the patient's safety. One such perioperative medication of interest is dexmedetomidine (Dex), a centrally acting α-2 agonist that has been associated with reducing pain and postoperative opioid consumption...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871553/fascia-iliaca-block-associated-only-with-deep-sedation-in-high-risk-patients-taking-p2y12-receptor-inhibitors-for-intramedullary-femoral-fixation-in-intertrochanteric-hip-fracture-a-series-of-3-cases
#17
Carlos Rodrigues Almeida, Emília Milheiro Francisco, Vítor Pinho-Oliveira, José Pedro Assunção
OBJECTIVE: We present a series of 3 cases in which the impact in outcome was, first of all, related to the capacity to offer early and safer treatment to some hip fracture high-risk patients using a fascia iliaca block (FIB; ropivacaine 0,5% 20 cc and mepivacaine 1,3% 15 cc, given 30 minutes before incision) associated only with deep sedation, contributing to better practice and outcome. CASE REPORTS: All elderly patients were American Society of Anesthesiologists IV patients, under P2Y12 receptor inhibitors, suffering from an intertrochanteric fracture, and purposed for intramedullary femoral fixation (IMF)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871517/guidelines-for-preoperative-investigations-for-elective-surgery-at-queen-elizabeth-hospital-effects-on-practices-outcomes-and-costs
#18
Judith Nicholls, Pamela S Gaskin, Justin Ward, Yasodananda K Areti
STUDY OBJECTIVE: We endeavor to assess the impact of introduction of guidelines for preoperative investigations (PIs) on anesthetic practices and costs and compare their efficacy to current practices. DESIGN: A prospective study. SETTING: Queen Elizabeth Hospital, Barbados. PATIENTS: Participants comprised all patients undergoing general, epidural, spinal, and regional anesthesia, with the exception of emergency cases or instances where an anesthesiologist was not required...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27867330/use-of-caudal-analgesia-supplemented-with-low-dose-of-morphine-in-children-who-undergo-renal-surgery
#19
Boris Chertin, Alexander Zeldin, Stanislav Kocherov, Alexander Ioscovich, Israel A Ostrovsky, Yaacov Gozal
INTRODUCTION: To test the efficacy and safety of caudal anesthesia (CA) supplemented by low dose morphine in children who undergo renal surgery. MATERIALS AND METHODS: Forty patients aged 2 months-14 years were enrolled and randomly divided into two groups of 20 patients each: Group A (bupivacaine 0.2% with fentanyl); Group B (bupivacaine with morphine). The duration of surgery and hospitalization time were recorded. Postoperative pain score was measured by Face Legs Activity Cry Consolability scale and Wong-Baker Faces scale for those who are older...
October 2016: Current Urology
https://www.readbyqxmd.com/read/27863823/general-endotracheal-vs-non-endotracheal-regional-anesthesia-for-elective-inguinal-hernia-surgery-in-very-preterm-neonates-a-single-institution-experience
#20
Jean Gurria, Phillip Kuo, Angie Kao, Luisa Christensen, AiXuan Holterman
BACKGROUND: Very pre-term infants (VP) at <32 weeks post menstrual age PMA have a high incidence of bronchopulmonary dysplasia BPD. BPD places them at risk for pulmonary-related perioperative complications from general endotracheal anesthesia GE during elective inguinal hernia repair. METHODS: A retrospective cohort study was done to compare pulmonary-related perioperative risks between VP patients undergoing non-emergent inguinal hernia repair prior to NICU discharge under GE (n=58) vs regional anesthesia RA (n=37)...
October 27, 2016: Journal of Pediatric Surgery
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