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https://www.readbyqxmd.com/read/28719887/anesthetic-management-of-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-crs-hipec-the-importance-of-hydro-electrolytic-and-acid-basic-control
#1
Fabrício Tavares Mendonça, Marília Moreira Guimarães, Sérgio Honorato de Matos, Rúbia Garcia Dusi
JUSTIFICATION AND OBJECTIVES: Patients affected by gynecological or gastrointestinal tract neoplasms that evolve to peritoneal carcinomatosis experience a significant drop in their quality of life, high morbidity and short survival times with currently available chemotherapeutic schemes. The surgical treatment based on cytoreduction and the employment of hyperthermic intraperitoneal chemotherapy in the intra-operative period is a true challenge to anesthesiologist. CASE REPORT: A 67 years old patient diagnosed with mucinous adenocarcinoma of the Appendix associated with mucinous carcinomatosis, was submitted to cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), under general anesthesia and epidural block...
July 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28712103/randomised-controlled-trial-of-analgesic-effectiveness-of-three-different-techniques-of-single-shot-interscalene-brachial-plexus-block-using-20-ml-of-0-5-ropivacaine-for-shoulder-arthroscopy
#2
Michał Jan Stasiowski, Michał Kolny, Marek Zuber, Radosław Marciniak, Ewa Chabierska, Przemysław Jałowiecki, Aleksandra Pluta, Bartłomiej Możdżyński
Background Shoulder arthroscopic procedures impose a challenge to anaesthesiologists in terms of postoperative analgesia. Proper pain management after arthroscopic procedures improves patient satisfaction and facilitates early rehabilitation. METHODS: We performed a randomized, prospective clinical study to assess the influence of anthropometric parameters and IBPB technique on the quality of postoperative analgesia. A total of 106 randomly selected patients of ASA I-III status scheduled for elective shoulder arthroscopy ...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28704642/infections-after-shoulder-arthroplasty-are-correlated-with-higher-anesthetic-risk-score-a-case-control-study-in-brazil
#3
Leonardo Hideto Nagaya, Mauro José Costa Salles, Lucas Sadawo Chagas Takikawa, Marcelo Fregoneze, Pedro Doneux, Luciana Andrade da Silva, Guilherme do Val Sella, Alberto Naoki Miyazaki, Sergio Luiz Checchia
PURPOSES: Shoulder arthroplasty (SA) has been performed by many years for the treatment of several conditions, including osteoarthritis and proximal humeral fractures following trauma. Surgical site infection (SSI) following SA remains a challenge, contributing to increased morbidity and costs. Identification of risk factors may help implementing adequate strategies to prevent infection. We aimed to identify pre- and intra-operative risk factors associated with deep infections after SA...
July 10, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28701607/anesthetic-challenges-of-extrinsic-trachea-bronchial-compression-due-to-posterior-mediastinal-mass-our-experience-with-a-large-esophageal-mucocele
#4
Saipriya Tewari, Puneet Goyal, Amit Rastogi, Aarti Agarwal, P K Singh
Large posterior mediastinal masses may lead threatening complications such as critical tracheobronchial compression. Airway management in these individuals is a challenge and being a lower airway obstruction; rescue strategies are limited. We encountered one such case of a large esophageal mucocele causing extrinsic tracheobronchial compression. We have described the anesthetic management of this case using awake fiber-optic assessment followed by intubation. Close communication with the surgical team, meticulous planning of airway management, and early drainage of the mucocele are the cornerstones of management in such patients...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28700368/regional-anesthesia-and-analgesia-in-cancer-care-is-it-time-to-break-the-bad-news
#5
Mir W Sekandarzad, André A J van Zundert, Chris W Doornebal, Markus W Hollmann
PURPOSE OF REVIEW: There is ongoing controversy regarding the tumor-protective effects of regional anesthesia in patients undergoing cancer surgery. Evidence of up-to-date systematic reviews will be presented alongside recent updates on the effects of opioids and local anesthetics. RECENT FINDINGS: In recent years, the literature regarding the effects of regional anesthesia techniques on cancer recurrence has raised many unanswered questions. Ongoing randomized controlled trials may not be able to shed light on the controversial discussion regarding the tumor protective effects of regional anesthesia because the expected effect size and event rate in those studies may be overstated...
July 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28697029/malignant-hyperthermia-in-a-morbidly-obese-patient-depletes-community-dantrolene-resources-a-case-report
#6
Fabio Magistris, Jonathan Gamble
During resection of a duodenal carcinoid tumor, a 28-year-old morbidly obese woman developed suspected malignant hyperthermia. This hypermetabolic state posed a diagnostic challenge given the similar intraoperative presentation of carcinoid crisis and malignant hyperthermia. The patient's weight posed therapeutic challenges as massive doses and prolonged administration of dantrolene were required that quickly depleted the available supply. Current dantrolene dosing recommendations are based on actual body weight despite a paucity of literature in obese patients...
July 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28688211/reducing-sedation-time-for-thyroplasty-with-arytenoid-adduction-with-sequential-anesthetic-technique
#7
Charles K Saadeh, Eric B Rosero, Girish P Joshi, Esra Ozayar, Ted Mau
OBJECTIVE: To determine the extent to which a sequential anesthetic technique 1) shortens time under sedation for thyroplasty with arytenoid adduction (TP-AA), 2) affects the total operative time, and 3) changes the voice outcome compared to TP-AA performed entirely under sedation/analgesia. STUDY DESIGN: Case-control study. METHODS: A new sequential anesthetic technique of performing most of the TP-AA surgery under general anesthesia (GA), followed by transition to sedation/analgesia (SA) for voice assessment, was developed to achieve smooth emergence from GA...
July 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28684143/what-s-new-in-clinical-obstetric-anesthesia-in-2015
#8
REVIEW
P E Hess
Each calendar year the Society for Obstetric Anesthesia and Perinatology invites an individual to conduct a review of the medical literature, identifying clinically relevant publications of interest to the obstetric anesthesia provider. This report of that effort covers the publications from 2015 and includes the categories of anesthesia and analgesia, complications of neuraxial procedures, and the effects of anesthesia on the fetus. Neuraxial procedures represent the foundation of obstetric anesthesia; advances in anesthesia and analgesia include novel modes of administration, and refinements in care of the medically complex patient...
March 18, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28682114/effectiveness-of-topical-application-of-ostrich-oil-on-the-healing-of-staphylococcus-aureus-and-pseudomonas-aeruginosa-infected-wounds
#9
Mohammad Reza Farahpour, Mahsa Vahid, Ahmad Oryan
BACKGROUND/AIMS: Management of infected wounds is one of the major challenges that surgeons and nurses face. Several antimicrobial agents have been used, but the toxicity, drug resistance and their effect on the healing process remain a matter of concern. The present study was designed to analyze the accelerative impact of topical application of Ostrich oil on infected wounds in a mouse model. MATERIALS AND METHODS: 72 BALB/c mice were divided into 4 main groups of control-sham, mupirocin and two treatment groups receiving 2% and 4% (V/W) concentrations of Ostrich oil, topically...
July 6, 2017: Connective Tissue Research
https://www.readbyqxmd.com/read/28663656/dilemmas-in-anesthetic-management-of-a-patient-with-history-of-anaphylaxis-to-vecuronium
#10
Nidhi Agrawal, A R Gogia, Madhu Dayal
Anaphylaxis during anesthesia is a life-threatening situation that occurs uncommonly. A 60-year-old woman with a history of anaphylaxis during previous anesthesia is scheduled to undergo elective open cholecystectomy. Her skin tests revealed sensitivity to vecuronium and nonsensitivity to injections of midazolam, fentanyl, and propofol. Due to high incidence of cross sensitivity among neuromuscular drugs, it was thought best to avoid general anesthesia. Spinal anesthesia was planned for the patient. The patient refused to give consent for spinal anesthesia, and she had to be taken up for surgery under general anesthesia...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28662278/topical-brimonidine-gel-for-extended-duration-local-anesthesia
#11
Hyun Jung Kwon, Sang Ju Lee, Jae Min Kim, Kui Young Park
Clinicians have been increasingly using topical anesthetic agents to diminish the pain associated with dermatologic and cosmetic procedures. Among the developed topical anesthetics, lidocaine-based products are the most widely used due to their ample pain relief and minimal side effects.(1) Many local anesthetics and additional techniques have been developed, but the limited duration of local anesthesia is still challenging to the practitioners. This article is protected by copyright. All rights reserved.
June 29, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28659824/hypersensitivity-of-vagal-pulmonary-afferents-induced-by-tumor-necrosis-factor-alpha-in-mice
#12
Ruei-Lung Lin, Qihai Gu, Lu-Yuan Lee
Tumor necrosis factor alpha (TNFα), a pro-inflammatory cytokine, plays a significant role in the pathogenesis of allergic asthma. Inhalation of TNFα also induces airway hyperresponsiveness in healthy human subjects, and the underlying mechanism is not fully understood. A recent study reported that TNFα caused airway inflammation and a sustained elevation of pulmonary chemoreflex responses in mice, suggesting a possible involvement of heightened sensitivity of vagal pulmonary C-fibers. To investigate this possibility, the present study aimed to investigate the effect of a pretreatment with TNFα on the sensitivity of vagal pulmonary afferents in anesthetized mice...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28657491/novel-noninvasive-method-of-cerebrovascular-blood-volume-assessment-using-brain-bioimpedance
#13
Mohamad Hakam Tiba, Brendan M McCracken, Sardar Ansari, Ashwin Belle, Brandon C Cummings, Venkatakrishna Rajajee, Parag G Patil, Hasan B Alam, Kevin R Ward
Cerebro-vascular autoregulation (CAR) is the ability of vessels to modulate their tone in response to changes in pressure. CAR, as an auto-protective mechanism is critical in preventing secondary brain injury post trauma. Monitoring of changes in cerebral blood volume might be valuable in evaluating CAR and response to various therapies. In this study, we utilized an ocular-brain bioimpedance interface to assess real time changes in cerebral blood volume in response to a number of physiologic challenges. We hypothesize that changes in brain bioimpedance (dz) would track changes in cerebral blood volume...
June 28, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28651520/surgical-anesthesia-with-a-combination-of-t12-paravertebral-block-and-lumbar-plexus-sacral-plexus-block-for-hip-replacement-in-ankylosing-spondylitis-care-compliant-4-case-reports
#14
Xijian Ke, Ji Li, Yong Liu, Xi Wu, Wei Mei
BACKGROUND: Anesthesia management for patients with severe ankylosing spondylitis scheduled for total hip arthroplasty is challenging due to a potential difficult airway and difficult neuraxial block. We report 4 cases with ankylosing spondylitis successfully managed with a combination of lumbar plexus, sacral plexus and T12 paravertebral block. CASE PRESENTATION: Four patients were scheduled for total hip arthroplasty. All of them were diagnosed as severe ankylosing spondylitis with rigidity and immobilization of cervical and lumbar spine and hip joints...
June 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28648141/anesthetic-management-of-spontaneous-cervical-epidural-hematoma-during-pregnancy-a-case-report
#15
Mehdi Samali, Abdelghafour Elkoundi, Achraf Tahri, Mustapha Bensghir, Charki Haimeur
BACKGROUND: Spontaneous spinal epidural hematoma during pregnancy is a quite rare event requiring emergent decompressive surgery in the majority of cases to prevent permanent neurological damage. Therefore, there is little data in the literature regarding anesthetic management of cervical localization during pregnancy. The potential for difficult airway management with the patient under general anesthesia is one of the major concerns that needs to be addressed to prevent further cord compression...
June 26, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28646903/human-adipose-tissue-mesenchymal-stromal-cells-and-their-extracellular-vesicles-act-differentially-on-lung-mechanics-and-inflammation-in-experimental-allergic-asthma
#16
Ligia Lins de Castro, Debora Gonçalves Xisto, Jamil Zola Kitoko, Fernanda Ferreira Cruz, Priscilla Christina Olsen, Patricia Albuquerque Garcia Redondo, Tatiana Paula Teixeira Ferreira, Daniel Jay Weiss, Marco Aurélio Martins, Marcelo Marcos Morales, Patricia Rieken Macedo Rocco
BACKGROUND: Asthma is a chronic inflammatory disease that can be difficult to treat due to its complex pathophysiology. Most current drugs focus on controlling the inflammatory process, but are unable to revert the changes of tissue remodeling. Human mesenchymal stromal cells (MSCs) are effective at reducing inflammation and tissue remodeling; nevertheless, no study has evaluated the therapeutic effects of extracellular vesicles (EVs) obtained from human adipose tissue-derived MSCs (AD-MSC) on established airway remodeling in experimental allergic asthma...
June 24, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28645320/acromegaly-discovered-during-a-routine-out-patient-surgical-procedure-a-case-report
#17
Chukwudi O Chiaghana, Julia M Bauerfeind, Cheri A Sulek, J Christopher Goldstein, Caleb A Awoniyi
BACKGROUND: Acromegaly is a rare syndrome in which there is unregulated hypersecretion of growth hormone. The anesthetic management of patients with this disorder is particularly challenging due to pre-existing cardiovascular and respiratory dysfunction, as well as recognized difficulties with airway management. Because of the insidious progression of the disease and the presence of nonspecific signs and symptoms, diagnosis is often made late when characteristic acromegalic features become apparent...
June 24, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28635347/ketamine-and-international-regulations
#18
Yanhui Liao, Yi-Lang Tang, Wei Hao
BACKGROUND: Ketamine is an anesthetic commonly used in low-income countries and has recently been shown to be effective for treatment-resistant depression. However, the illicit manufacturing, trafficking, and nonmedical use of ketamine are increasing globally, and its illicit use poses major public health challenges in many countries. OBJECTIVES: To review the nonmedical use of ketamine in selected countries and its regulatory control. METHODS: We conducted a review of literature identified from searches of the China National Knowledge Infrastructure (CNKI) (1979-2016) and PubMed databases, supplemented by additional references identified by the authors...
September 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28614863/-anesthetic-management-in-thoracic-trauma-patients
#19
Alf Kozian, Astrid Bergmann, Thomas Hachenberg, Thomas Schilling
In daily practice, management of patients with blunt thoracic trauma is challenging for the anesthetist. Injuries of airways, lungs, diaphragm, heart and large vessels are the main difficulties.Respiratory and circulatory physiology in general is affected by general anesthesia, which may result in an increased number of perioperative complications. Therefore, anesthetic management of patients with thoracic trauma needs to address different clinical topics: management of difficult airways, intrinsic effects of anesthetics and mechanical ventilation on respiratory and cardiac function, the adequate replacement of blood loss as well as type and extent of the surgical intervention...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28608134/venoarterial-pco2-to-arteriovenous-oxygen-content-difference-ratio-is-a-poor-surrogate-for-anaerobic-metabolism-in-hemodilution-an-experimental-study
#20
Arnaldo Dubin, Gonzalo Ferrara, Vanina Siham Kanoore Edul, Enrique Martins, Héctor Saúl Canales, Carlos Canullán, Gastón Murias, Mario Omar Pozo, Elisa Estenssoro
BACKGROUND: The identification of anaerobic metabolism in critically ill patients is a challenging task. Observational studies have suggested that the ratio of venoarterial PCO2 (Pv-aCO2) to arteriovenous oxygen content difference (Ca-vO2) might be a good surrogate for respiratory quotient (RQ). Yet Pv-aCO2/Ca-vO2 might be increased by other factors, regardless of anaerobic metabolism. At present, comparisons between Pv-aCO2/Ca-vO2 and RQ have not been performed. We sought to compare these variables during stepwise hemorrhage and hemodilution...
December 2017: Annals of Intensive Care
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