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https://www.readbyqxmd.com/read/29470316/protecting-the-brain-with-xenon-anesthesia-for-neurosurgical-procedures
#1
Anna Rylova, Mervyn Maze
Xenon possesses some, but not all, of the clinical features of an ideal anesthetic agent. Besides well-known advantages of rapid awakening, stable hemodynamics and lack of biotransformation, preclinical data lead to the expectation of xenon's advantageous use for settings of acute ongoing brain injury; a single randomized clinical trial using an imaging biomarker for assessing brain injury corroborated xenon's preclinical efficacy in protecting the brain from further injury. In this review, we discuss the mechanisms and hence the putative applications of xenon for brain protection in neurosurgery...
February 21, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29468091/surgical-technical-evidence-review-for-elective-total-joint-replacement-conducted-for-the-ahrq-safety-program-for-improving-surgical-care-and-recovery
#2
REVIEW
Christopher P Childers, Anaar E Siletz, Emily S Singer, Claire Faltermeier, Q Lina Hu, Clifford Y Ko, Gregory J Golladay, Stephen L Kates, Elizabeth C Wick, Melinda Maggard-Gibbons
Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29458333/pre-anesthetic-assessment-with-three-core-questions-for-the-detection-of-obstructive-sleep-apnea-in-childhood-an-observational-study
#3
Joerg Schnoor, Thilo Busch, Nazar Turemuratov, Andreas Merkenschlager
BACKGROUND: Children with obstructive sleep apnea are at high risk for perioperative airway obstruction. Many "at risk" children may remain unrecognized. The aim of this study is to find a clinically practicable test to identify obstructive sleep apnea in childhood. METHODS: In this pilot study, we prospectively compared four parental questionnaires with the respective findings of subsequent sleep laboratory testing in children. Right before sleep laboratory testing, children's parents answered both the Pediatric Sleep Questionnaire, a subscale of the Sleep Related Breathing Disorder questionnaire (PSQ-SRBD-Subscale), and an eight-item questionnaire derived from it...
February 20, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29453720/cytotoxic-effect-of-chlorpyrifos-is-associated-with-activation-of-nrf-2-ho-1-system-and-inflammatory-response-in-tongue-of-male-wistar-rats
#4
Norhan M El-Sayed, Amal A M Ahmed, Manar A A Selim
Repeated administration of chlorpyrifos (CPF), an organophosphate pesticide, can increase the risk of oral cytotoxicity. The current study was designed to assess the mechanism by which CPF mediates its cytotoxic effect on lingual mucosa of rats. Twenty-four male Wistar rats were used in the present study and divided into three groups: group I: healthy rats (negative control), group II: rats treated with CPF 1/40 LD50 (3.375 mg/kg, orally/daily) for 28 days, group III: rats treated with CPF 1/10 LD50 (13.5 mg/kg, orally/daily) for 28 days...
February 16, 2018: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/29447771/topographical-distribution-of-perioperative-cerebral-infarction-associated-with-transcatheter-aortic-valve-implantation
#5
Jonathon P Fanning, Allan J Wesley, Darren L Walters, Andrew A Wong, Adrian G Barnett, Wendy E Strugnell, David G Platts, John F Fraser
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is associated with a high incidence of cerebrovascular injury. As these injuries are thought to be primarily embolic, neuroprotection strategies have focused on embolic protection devices. However, the topographical distribution of cerebral emboli and how this impacts on the effectiveness of these devices have not been thoroughly assessed. Here, we evaluated the anatomical characteristics of magnetic resonance imaging (MRI)-defined cerebral ischemic lesions occurring secondary to TAVI to enhance our understanding of the distribution of cardioembolic phenomena...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29447402/intraoperative-endotracheal-cuff-pressure-study-how-education-and-availability-of-manometers-help-guide-safer-pressures
#6
Gregory J Stevens, Joel W Warfel, James K Aden, Scott D Blackwell
Introduction: Endotracheal intubation is a medical procedure that is often indicated in both the perioperative and critical care environments. Cuffed endotracheal tubes (ETT) allow for safer and more efficient delivery of positive pressure ventilation, as well as create a barrier to reduce the risk of micro-aspiration and anesthetic pollution in the operating room environment. Over-inflation of the endotracheal cuff can lead to serious and harmful sequelae. This study aimed to assess if departmental education paired with ready access to a manometer to assess cuff pressure would result in an improvement in the proportion of ETT cuff pressures in the goal range...
February 13, 2018: Military Medicine
https://www.readbyqxmd.com/read/29446038/preoperative-evaluation-of-the-elderly-surgical-patient-and-anesthesia-challenges-in-the-xxi-century
#7
Gabriella Bettelli
Universally recognized goals of preoperative anesthesia assessment are the evaluation of patient's health status to define the entity of the surgical risk, and the anticipation of possible complications while optimizing and planning preventive strategies. Data obtained by Comprehensive Geriatric Assessment (CGA) and frailty evaluation are of extreme usefulness in surgical risk evaluation in older patients and in the decision about surgery. It is from the team-based discussion of such results that the most appropriate treatment can be individuated, surgery invasiveness and duration critically analyzed and if needed modified, and the best perioperative strategy carefully tailored...
February 14, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29436137/caudal-and-intravenous-dexamethasone-as-an-adjuvant-to-pediatric-caudal-block-a-systematic-review-and-meta-analysis
#8
REVIEW
Change Zhu, Saiji Zhang, Zhiqing Gu, Yiru Tong, Rong Wei
BACKGROUND: Dexamethasone has become a popular additive for regional anesthesia. The aim of this meta-analysis was to assess the effectiveness of this additive on the duration of postoperative analgesia, postoperative vomiting, and possible adverse events in pediatrics. METHODS: We searched databases, conference records, and registered trials for randomized controlled trials. The databases included the Cochrane Library, JBI Database of Systematic Reviews, PubMed, ISI Web of Knowledge, Science-Direct, and Embase...
March 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29430407/anesthetic-considerations-in-patients-undergoing-bariatric-surgery-a-review-article
#9
REVIEW
Hassan Soleimanpour, Saeid Safari, Sarvin Sanaie, Mehdi Nazari, Seyed Moayed Alavian
Context: This article discusses the anesthetic considerations in patients undergoing bariatric surgery in the preoperative, intraoperative, and postoperative phases of surgery. Evidence Acquisition: This review includes studies involving obese patients undergoing bariatric surgery. Searches have been conducted in PubMed, MEDLINE, EMBASE, Google Scholar, Scopus, and Cochrane Database of Systematic Review using the terms obese, obesity, bariatric, anesthesia, perioperative, preoperative, perioperative, postoperative, and their combinations...
August 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29424629/parental-satisfaction-with-being-present-in-the-operating-room-during-the-induction-of-anesthesia-prior-to-pediatric-neurosurgical-intervention-a-qualitative-analysis
#10
Hena Waseem, Rachael S Mazzamurro, Alec H Fisher, Subasish Bhowmik, Rifat A Zaman, Angeline Andrew, David F Bauer
OBJECTIVE Parental presence in the operating room during the induction of anesthesia (PPIA) has been shown to decrease parent and child anxiety and increase satisfaction with patient experience in outpatient otolaryngological procedures, such as tympanostomy tube placement. PPIA for other procedures, such as a major neurosurgical intervention, has been a practice at the authors' institutions for many years. This practice is not universally accepted across the United States, and the potential benefits for patients and families have not been formally evaluated...
February 9, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29420315/prolonged-catheter-use-and-infection-in-regional-anesthesia-a-retrospective-registry-analysis
#11
Hagen Bomberg, Ina Bayer, Stefan Wagenpfeil, Paul Kessler, Hinnerk Wulf, Thomas Standl, André Gottschalk, Jens Döffert, Werner Hering, Jürgen Birnbaum, Claudia Spies, Bernd Kutter, Jörg Winckelmann, Simone Liebl-Biereige, Winfried Meissner, Oliver Vicent, Thea Koch, Daniel I Sessler, Thomas Volk, Alexander Raddatz
BACKGROUND: Prolonged catheter use is controversial because of the risk of catheter-related infection, but the extent to which the risk increases over time remains unknown. We thus assessed the time-dependence of catheter-related infection risk up to 15 days. METHODS: Our analysis was based on the German Network for Regional Anesthesia, which includes 25 centers. We considered 44,555 patients who had surgery between 2007 and 2014 and had continuous regional anesthesia as well as complete covariable details...
February 8, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29416346/prediction-of-emergence-agitation-using-withdrawal-reaction-following-rocuronium-injection-in-preschool-aged-patients-undergoing-inguinal-herniorrhaphy-a-preliminary-exploratory-observational-trial
#12
Dae Hee Kim, Go Un Roh, Young Bok Lee, Chang Ik Choi, Jae Moon Lee, Yun Jeong Chae
Purpose: The development of emergence agitation (EA) is associated with several factors including age, preoperative anxiety, postoperative pain, anesthesia method, and surgery type. No studies have investigated whether the withdrawal reaction following rocuronium injection can predict the occurrence of EA. Therefore, we investigated this relationship in preschool-aged children undergoing inguinal herniorrhaphy, and which grade of withdrawal reaction is appropriate for identifying patients at risk of experiencing EA...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29401106/csf-beta-amyloid-1-42-concentration-predicts-delirium-following-elective-arthroplasty-surgery-in-an-observational-cohort-study
#13
Emma L Cunningham, Bernadette McGuinness, Daniel F McAuley, Jamie Toombs, Tim Mawhinney, Seamus O'Brien, David Beverland, Jonathan M Schott, Michael P Lunn, Henrik Zetterberg, Anthony P Passmore
OBJECTIVE: To test the hypothesis that APOE ε4 status and cerebrospinal fluid (CSF) Aβ42, T-tau and P-tau would independently predict the risk of postoperative delirium. BACKGROUND: Delirium following surgery is common and associated with adverse outcomes. Age and cognitive impairment are consistent risk factors for postoperative delirium. METHODS: This observational cohort study recruited 282 participants aged 65 years or older, without a diagnosis of dementia, admitted for primary elective hip or knee arthroplasty...
February 2, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29398999/the-fascia-iliaca-block-as-the-primary-intraoperative-anesthesia-for-hip-fracture-surgery-a-preliminary-study
#14
Joseph J Ruzbarsky, Elizabeth B Gausden, Elan M Goldwyn, Isaac P Lowenwirt, Vitaly Kotlyar
Background: Early surgical intervention for hip fractures in the elderly has proven efficacious. However, surgical delays commonly occur in this patient population due to comorbid conditions that put these patients at a high risk for hypotension-related complications of general or neuraxial anesthesia or anticoagulants that delay the safe use of neuraxial anesthesia. Questions/Purposes: The questions/purposes of this study are (1) to investigate if a fascia iliaca block in conjunction with light to moderate sedation could provide adequate analgesia throughout open surgery for intertrochanteric hip fractures (AO/OTA 31-1) without requiring conversion to general anesthesia with airway support and (2) to assess its perioperative complication profile...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/29397894/prophylactic-use-of-alpha-1-adrenergic-blocking-agents-for-prevention-of-postoperative-urinary-retention-a-review-meta-analysis-of-randomized-clinical-trials
#15
REVIEW
Amandeep Ghuman, S W de Jonge, Simon D Dryden, Timothy Feeney, Daniel H Buitrago, P Terry Phang
BACKGROUND: Alpha-1 adrenergic blockers used to treat postoperative urinary retention (POUR) may also have a preventative role. Here we assess the evidence behind their prophylactic use on POUR prevention. STUDY DESIGN: PRISMA guidelines were followed. All studies reviewed for eligibility, data extraction, and risk of bias assessment. Pooled risk ratios with 95% confidence intervals calculated using a random effects model. Heterogeneity assessed using Forest plots, I2 statistic and Chi-squared Cochran's Q-statistic...
February 2, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29397248/safety-and-feasibility-of-endovascular-aortic-aneurysm-repair-as-day-surgery
#16
Stephen C Hanley, Oren Steinmetz, Eva S Mathieu, Daniel Obrand, Kent Mackenzie, Marc-Michel Corriveau, Cherrie Z Abraham, Heather L Gill
OBJECTIVE: The adoption of endovascular aneurysm repair (EVAR) during the past two decades has led to significantly shorter length of stay as well as lower hospital resource use. Currently, most patients are admitted to the hospital after EVAR; however, there are no standard observation periods, and timing of discharge is based on clinical judgment. The aim of this study was to confirm the safety and feasibility of performing EVAR as outpatient surgery. METHODS: We developed criteria to identify patients for potential same-day discharge (infrarenal aneurysm, low perioperative risk, to be accompanied for first 24 hours)...
January 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29396602/subthalamic-deep-brain-stimulation-under-general-anesthesia-and-neurophysiological-guidance-while-on-dopaminergic-medication-comparative-cohort-study
#17
Mohammed Jamil Asha, Benjamin Fisher, Jamilla Kausar, Hayley Garratt, Hari Krovvidi, Colin Shirley, Anwen White, Ramesh Chelvarajah, Ismail Ughratdar, James A Hodson, Hardev Pall, Rosalind D Mitchell
OBJECTIVES: The authors have previously reported on the technical feasibility of subthalamic nucleus deep brain stimulation (STN DBS) under general anesthesia (GA) with microelectrode recording (MER) guidance in Parkinsonian patients who continued dopaminergic therapy until surgery. This paper presents the results of a prospective cohort analysis to verify the outcome of the initial study, and report on wider aspects of clinical outcome and postoperative recovery. METHODS: All patients in the study group continued dopaminergic therapy until GA was administered...
February 2, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29390504/relationship-between-general-anesthesia-and-alzheimer-disease-a-protocol-for-a-systematic-review-and-meta-analysis
#18
Geun Joo Choi, Hyun Kang, Chong Wha Baek, Yong Hun Jung, Jeong Wook Kim, Young Cheol Woo
BACKGROUND: Alzheimer disease (AD) entails a long-term progressive decline in the cognitive ability to think and remember, and it has become a major concern for patients receiving surgery and anesthesia. However, studies investigating the relationship between general anesthesia and AD have yielded inconsistent results. Therefore, we plan to perform a systematic review and meta-analysis to determine the relationship between general anesthesia and AD, and to verify whether general anesthesia is an independent risk factor for AD...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29390005/design-and-construction-of-an-optimized-transmit-receive-hybrid-birdcage-resonator-to-improve-full-body-images-of-medium-sized-animals-in-7t-scanner
#19
Nibardo Lopez Rios, Philippe Pouliot, Konstantinos Papoutsis, Alexandru Foias, Nikola Stikov, Frédéric Lesage, Mathieu Dehaes, Julien Cohen-Adad
The purpose of this work was to develop an optimized transmit/receive birdcage coil to extend the possibilities of a 7T preclinical MRI system to conduct improved full body imaging in medium-sized animals, such as large New Zealand rabbits. The coil was designed by combining calculation and electromagnetic simulation tools. The construction was based on precise mechanical design and careful building practice. A 16-leg, 20 cm long, 16 cm inner diameter, shielded quadrature hybrid structure was selected. Coil parameters were assessed on the bench and images were acquired on phantoms and rabbits...
2018: PloS One
https://www.readbyqxmd.com/read/29374469/perioperative-incidence-of-airway-obstructive-and-hypoxemic-events-in-patients-with-confirmed-or-suspected-sleep-apnea-a-prospective-randomized-pilot-study-comparing-propofol-remifentanil-and-sevoflurane-remifentanil-anesthesia
#20
Philipp Fassbender, Silja Bürgener, Ali Haddad, Marie-Therese Silvanus, Jürgen Peters
BACKGROUND: Obstructive sleep apnea (OSA) is a risk factor for perioperative complications but data on anesthesia regimen are scarce. METHODS: In patients with established or strongly suspected OSA, we assessed in a prospective, randomized design the effects on nocturnal apnea-hypopnea-index (AHI) and oxygen saturation (SpO 2 ) of propofol/remifentanil or sevoflurane/remifentanil based anesthesia. Patients were selected by a history for OSA and / or a positive STOP - questionnaire and received general anesthesia using remifentanil (12 μg/kg/h) combined either with propofol (4-6 mg/kg/h, n = 27) or sevoflurane (approx...
January 27, 2018: BMC Anesthesiology
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