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Risk assessment anesthesia

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https://www.readbyqxmd.com/read/28818338/spinal-anesthesia-for-pediatric-urological-surgery-reducing-the-theoretic-neurotoxic-effects-of-general-anesthesia
#1
Emmett E Whitaker, Brianne Z Wiemann, Daniel G DaJusta, Seth A Alpert, Christina B Ching, Daryl J McLeod, Joseph D Tobias, Venkata R Jayanthi
BACKGROUND: Spinal anesthesia (SA) is an effective technique that has been used in children for years. With growing concern with regard to the risks of general anesthesia (GA), we developed a SA program to provide an alternative option. We present our initial experience with this program. OBJECTIVE: To implement a SA program at a large tertiary care pediatric center and assess the safety and efficacy of the technique as an alternative to GA for urologic surgery...
July 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28818054/comparison-of-the-trapezius-and-the-adductor-pollicis-muscle-as-predictor-of-good-intubating-conditions-a-randomized-controlled-trial
#2
Stefan Soltesz, Christian Stark, Karl G Noé, Michael Anapolski, Thomas Mencke
BACKGROUND: Adequate muscle relaxation is important for ensuring optimal conditions for intubation. Although acceleromyography of the adductor pollicis muscle is commonly used to assess conditions for intubation, we hypothesized that acceleromyography of the trapezius is more indicative of optimal intubating conditions. The primary outcome was the difference between both measurement sites with regard to prediction of good or acceptable intubating conditions. METHODS: Neuromuscular blockade after injection of rocuronium 0...
August 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28810590/diagnosis-and-surgical-treatment-of-cervical-macrocystic-lymphatic-malformations-in-infants
#3
Jing Ma, Ruan Biao, Fan Lou, Ken Lin, Ying-Qin Gao, Mei-Lan Wang, Yan-Li Yang, Tie-Song Zhang
The treatment of lymphatic malformations (LMs) represents a great clinical challenge. The present study reported on the treatment of 68 infants with cervical macrocystic LMs using surgical resection. The cases were retrospectively analyzed. All patients underwent pre-operative ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) examinations. The surgery was performed under general anesthesia with endotracheal intubation. Ultrasonograms showed that 24 cases were monolocular, 44 were multilocular, 16 had no echo, 20 had a uniform low-level echo and 32 had a non-uniform low-level echo...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28806496/anterior-superior-alveolar-nerve-injury-after-extended-endoscopic-medial-maxillectomy-a-preclinical-study-to-predict-neurological-morbidity
#4
Alberto Schreiber, Davide Mattavelli, Marco Ferrari, Vittorio Rampinelli, Davide Lancini, Marco Ravanelli, Giacomo Bertazzoni, Luigi Fabrizio Rodella, Barbara Buffoli, Francesco Doglietto, Piero Nicolai
BACKGROUND: Endoscopic medial maxillectomies (EMMs) are used to optimize exposure of the maxillary sinus and retromaxillary areas. Although in type D EMM (Sturmann-Canfield procedure) the anterior superior alveolar nerve (ASAN) is always at risk of injury, only 29% of patients complained of alveolar process and dental anesthesia. The purpose of this anatomical study is to assess the neural anastomotic network of the ASAN (ASAN-NAN) and describe different extensions of type D EMMs in a preclinical setting...
August 14, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28803768/assessment-of-preoperative-anxiety-in-cardiac-surgery-patients-lacking-a-history-of-anxiety-contributing-factors-and-postoperative-morbidity
#5
Joaquín Hernández-Palazón, Diego Fuentes-García, Luis Falcón-Araña, María José Roca-Calvo, Sebastián Burguillos-López, Paloma Doménech-Asensi, Rubén Jara-Rubio
OBJECTIVES: The aim of this study was to measure the level of preoperative anxiety in patients scheduled for cardiac surgery, identify any influencing clinical factors, and assess the relationship between anxiety and postoperative morbidity. DESIGN: A prospective and consecutive study. SETTING: A single university hospital. PARTICIPANTS: The study comprised 200 patients scheduled for cardiac surgery. INTERVENTIONS: Each patient was asked to grade his or her preoperative anxiety level using the Visual Analogue Scale for Anxiety, Amsterdam Preoperative Anxiety and Information Scale, and set of specific anxiety-related questions...
April 26, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28797751/outcomes-of-cancer-surgery-after-inhalational-and-intravenous-anesthesia-a-systematic-review
#6
REVIEW
Sinor Soltanizadeh, Thea H Degett, Ismail Gögenur
Perioperative factors are probably essential for different oncological outcomes. This systematic review investigates the literature concerning overall mortality and postoperative complications after cancer surgery with inhalational (INHA) and intravenous anesthesia (TIVA). A search was conducted according to the PRISMA guidelines, including studies with patients undergoing surgery for cancer and where TIVA was compared with INHA. Two investigators identified relevant papers in the databases: PubMed, Scopus, EMBASE and the Cochrane Library...
August 7, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28796275/immature-platelets-as-a-novel-biomarker-for-adverse-cardiovascular-events-in-patients-after-non-cardiac-surgery
#7
Aida Anetsberger, Manfred Blobner, Bernhard Haller, Sebastian Schmid, Katrin Umgelter, Theresa Hager, Clemens Langgartner, Eberhard F Kochs, Karl-Ludwig Laugwitz, Bettina Jungwirth, Isabell Bernlochner
This study evaluates whether immature platelets (IPF) determined in the post anesthesia care unit (PACU) can predict major adverse cardiovascular events (MACE) or other thromboembolic events after intermediate and high-risk surgery. IPF are increased in patients with acute coronary syndrome and recently gained interest as novel biomarker for risk stratification. In this prospective observational trial 732 patients undergoing intermediate or high-risk non-cardiac surgery were enrolled (NCT02097602). IPF was measured preoperatively and postoperatively in the PACU...
August 10, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28795214/derivation-validation-and-application-of-a-pragmatic-risk-prediction-index-for-benchmarking-of-surgical-outcomes
#8
Richard T Spence, David C Chang, Haytham M A Kaafarani, Eugenio Panieri, Geoffrey A Anderson, Matthew M Hutter
BACKGROUND: Despite the existence of multiple validated risk assessment and quality benchmarking tools in surgery, their utility outside of high-income countries is limited. We sought to derive, validate and apply a scoring system that is both (1) feasible, and (2) reliably predicts mortality in a middle-income country (MIC) context. METHODS: A 5-step methodology was used: (1) development of a de novo surgical outcomes database modeled around the American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) in South Africa (SA dataset), (2) use of the resultant data to identify all predictors of in-hospital death with more than 90% capture indicating feasibility of collection, (3) use these predictors to derive and validate an integer-based score that reliably predicts in-hospital death in the 2012 ACS-NSQIP, (4) apply the score in the original SA dataset and demonstrate its performance, (5) identify threshold cutoffs of the score to prompt action and drive quality improvement...
August 9, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28791499/long-term-peripheral-neuropathy-symptoms-in-breast-cancer-survivors
#9
Moaath Mustafa Ali, Machelle Moeller, Lisa Rybicki, Halle C F Moore
PURPOSE: Peripheral neuropathy (PN) is a common and distressing complication from chemotherapy. Symptoms often, but not always, improve with time. The prevalence of long-term PN symptoms in breast cancer survivors is not well known. We sought to explore PN symptoms and associated risk factors among breast cancer survivors at least 2 years out from diagnosis. METHODS: We performed a cross-sectional retrospective study investigating the prevalence of patient-reported numbness, tingling, and anesthesia symptoms as a surrogate for PN in breast cancer survivors...
August 8, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28791043/systematic-review-outcomes-by-duration-of-npo-status-prior-to-colonoscopy
#10
REVIEW
Aasma Shaukat, Ashish Malhotra, Nancy Greer, Roderick MacDonald, Joseph Wels, Timothy J Wilt
BACKGROUND/AIMS: Variation exists among anesthesia providers as to acceptable timing of NPO ("nothing by mouth") for elective colonoscopy procedures. There is a need to balance optimal colonic preparation, patient convenience, and scheduling efficiency with anesthesia safety concerns. We reviewed the evidence for the relationship between NPO timing and aspiration incidence and colonoscopy rescheduling. METHODS: We searched MEDLINE (1990-April 2015) for English language studies of any design and included them if at least one bowel preparation regimen was completed within 8 hours of colonoscopy...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28781880/acute-aortic-occlusion-due-to-tumor-embolism-in-a-patient-with-lung-malignancy
#11
Stella Lioudaki, Nikolaos Kontopodis, Stefanos Palioudakis, Anastasios V Koutsopoulos, Ioannis Drositis, Christos V Ioannou
OBJECTIVES: Acute lower limb ischemia caused by tumor embolization is rare, despite the fact that cancer is a common cause of hypercoagulability predisposing to venous thrombosis. Arterial embolization is mostly associated with intracardiac tumors while lung malignancies are the second most common cause of tumor embolism. METHODS: In this report, we present a male patient who developed acute bilateral lower limb ischemia in the immediate postoperative period after a thoracotomy for attempted left upper lobe resection for lung cancer...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28764881/dosimetric-impact-of-intrafraction-changes-in-mr-guided-high-dose-rate-hdr-brachytherapy-for-prostate-cancer
#12
Alexandra Rink, Jette Borg, Anna Simeonov, Gerald O'Leary, Joelle Helou, Cynthia Ménard, Peter Chung, David A Jaffray, Alejandro Berlin
PURPOSE: To assess changes in implant and treatment volumes through the course of a prostate high-dose-rate brachytherapy procedure and their impact on plan quality metrics. METHODS AND MATERIALS: Sixteen MRI-guided high-dose-rate procedures included a post-treatment MR (ptMR) immediately after treatment delivery (135 min between MR scans). Target and organs at risk (OARs) were contoured, and catheters were reconstructed. The delivered treatment plan was applied to the ptMR image set...
July 29, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28762228/-a-systematic-review-and-meta-analysis-of-the-pros-and-cons-of-consuming-liquids-preoperatively
#13
Fang-Tzu Lin, Tsai-Rung Lin, Chia-Wei Liao, Shu-Hui Chen
BACKGROUND: Preoperative anesthesia long time fasting, may increase patient hemodynamic instability during surgery and may affect the patient's post-surgery electrolyte balance. No meta-analysis has been conducted to explore the effects of preoperative liquid intake amount on gastric fluid PH, gastric fluid volume, surgery inhalation of pulmonary complications, and patient self-perceptions quality of care systematic review and meta-analysis of the literature. PURPOSE: To assess the pros and cons of preoperative liquid intake using a systematic review of the literature...
August 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28759491/the-evaluation-of-a-noninvasive-respiratory-volume-monitor-in-pediatric-patients-undergoing-general-anesthesia
#14
Andrea D Gomez-Morad, Joseph P Cravero, Brian C Harvey, Rachel Bernier, Erin Halpin, Brian Walsh, Viviane G Nasr
BACKGROUND: Pediatric patients following surgery are at risk for respiratory compromise such as hypoventilation and hypoxemia depending on their age, comorbidities, and type of surgery. Quantitative measurement of ventilation in nonintubated infants/children is a difficult and inexact undertaking. Current respiratory assessment in nonintubated patients relies on oximetry data, respiratory rate (RR) monitors, and subjective clinical assessment, but there is no objective measure of respiratory parameters that could be utilized to predict early respiratory compromise...
July 27, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28759404/upper-respiratory-infections-and-airway-adverse-events-in-pediatric-procedural-sedation
#15
Michael D Mallory, Curtis Travers, Courtney E McCracken, James Hertzog, Joseph P Cravero
BACKGROUND: Upper respiratory infections (URIs) are associated with airway adverse events (AAEs) during general anesthesia. There have been no large studies examining the relationship between URIs and AAEs during pediatric procedural sedation. We hypothesized that there would be a relationship between URI status and AAEs in pediatric procedural sedation. METHODS: We examined prospectively collected data from the Pediatric Sedation Research Consortium database. Specific questions regarding URI status were added to the database to facilitate our analysis...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/28757825/sternomental-distance-and-sternomental-displacement-as-predictors-of-difficult-laryngoscopy-and-intubation-in-adult-patients
#16
Smita Prakash, Parul Mullick, Shyam Bhandari, Amitabh Kumar, Anoop Raj Gogia, Rajvir Singh
BACKGROUND: Several morphometric airway measurements have been used to predict difficult laryngoscopy (DL). This study evaluated sternomental distance (SMD) and sternomental displacement (SMDD, difference between SMD measured in neutral and extended head position), as predictors of DL and difficult intubation (DI). MATERIALS AND METHODS: We studied 610 adult patients scheduled to receive general anesthesia with tracheal intubation. SMD, SMDD, physical, and airway characteristics were measured...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28754301/high-dose-rate-brachytherapy-boost-for-prostate-cancer-comparison-of-three-different-fractionation-schemes
#17
Alexander T Falk, Sylvain Demontoy, Emmanuel Chamorey, Marie-Eve Chand, Mathieu Gautier, David Azria, Sara Zaki, Daniel Chevallier, Daniel Lam Cham Kee, Jean-Michel Hannoun-Lévi
PURPOSE: Dose escalation for prostate cancer can be achieved with a combination of external beam radiotherapy (EBRT) and brachytherapy (BT) boost to increase local control. For high-dose-rate (HDR)-BT, optimal fractionation remains under debate. The objective was to assess the clinical outcome of three schemes of HDR-BT boost. METHODS AND MATERIALS: Retrospective single institution data collection was performed. Patients received 46 Gy EBRT then an HDR-BT boost: 3 × 6 Gy, 2 × 9 Gy, or 1 × 14 Gy...
July 25, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28753166/comparison-between-the-cobra-perilaryngeal-airway-and-laryngeal-mask-airways-under-general-anesthesia-a-systematic-review-and-meta-analysis
#18
Rui Xu, Yun Zhu, Qing Fan, Xia Shen, Wen Xian Li
The complication rate and efficacy of the Cobra Perilaryngeal Airway (CobraPLA) and laryngeal mask airways (LMAs®) have been evaluated in the published literature, but the conclusions have been inconsistent. The aim of this systematic review and meta-analysis was thus to assess the performance of the CobraPLA and LMAs under general anesthesia. We searched PubMed, Embase, and the Cochrane Library for randomized controlled trials comparing the CobraPLA with LMAs under general anesthesia. The LMAs used for comparison were the classic LMA (CLMA) and the unique LMA (ULMA)...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742771/perioperative-amino-acid-infusion-for-preventing-hypothermia-and-improving-clinical-outcomes-during-surgery-under-general-anesthesia-a-systematic-review-and-meta-analysis
#19
Yoshitaka Aoki, Yukie Aoshima, Kazuyuki Atsumi, Ryo Kaminaka, Rintaro Nakau, Kyoko Yanagida, Makiko Kora, Shunsuke Fujii, Junichiro Yokoyama
Amino acid (AA) infusion is sometimes selected to avoid hypothermia during general anesthesia. However, the widespread clinical use of AA infusion therapy has not been established. This study aimed to clarify the evidence that AA infusion can increase patient body temperature and improve clinical outcomes using the Grading of Recommendations Assessment, Development, and Evaluation system. We searched MEDLINE (PubMed), Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi (Japana Centra Revuo Medicina) in November 2015...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28738010/effects-of-the-%C3%AE-2-adrenoceptor-agonist-medetomidine-on-the-distribution-and-clearance-of-alfaxalone-during-coadministration-by-constant-rate-infusion-in-dogs
#20
Rachel C Bennett, Kati M Salla, Marja R Raekallio, Mika Scheinin, Outi M Vainio
OBJECTIVE To assess the possible impact of medetomidine on concentrations of alfaxalone in plasma, when coadministered as a constant rate infusion (CRI) to dogs, and to determine the possible impact of medetomidine on the cardiopulmonary effects of alfaxalone during CRI. ANIMALS 8 healthy adult Beagles. PROCEDURES 3 treatments were administered in a randomized crossover design as follows: 1 = saline (0.9% NaCl) solution injection, followed in 10 minutes by induction of anesthesia with alfaxalone (loading dose, 2...
August 2017: American Journal of Veterinary Research
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