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current opinion anesthesia

Alessandra Vari, Afshin Gangi
PURPOSE: The Cardiovascular and Interventional Radiological Society of Europe (CIRSE) prompted an initiative to frame the current European status of anesthetic practices for interventional radiology, in consideration of the current variability of IR suite settings, staffing and anesthetic practices reported in the literature and of the growing debate on sedation administered by non-anesthesiologists, in Europe. METHODS: Anonymous online survey available to all European CIRSE members to assess IR setting, demographics, peri-procedural care, anesthetic management, resources and staffing, pain management, data collection, safety, management of emergencies and personal opinions on the role CIRSE should have in promoting anesthetic care for interventional radiology...
January 17, 2017: Cardiovascular and Interventional Radiology
Indira Malik, Rachna Wadhwa
Percutaneous nephrolithotomy (PCNL), a minimally invasive method for removal of renal calculi, was initially started in the 1950s but gained popularity about two decades later and has now become standard practice for management. There has been an immense improvement in technique and various guidelines have been established for treatment of renal stones. However, it has its own share of complications which can be attributed to surgical technique as well as anesthesia related complications. PubMed and Google search yielded more than 30 articles describing the different complications seen in this procedure, out of which 15 major articles were selected for writing this review...
2016: Anesthesiology Research and Practice
Alexis C Gimovsky, Vincenzo Berghella
BACKGROUND: Guidelines for management of the second stage have been proposed since the 1800s and were created largely by expert opinion. Current retrospective data are mixed regarding differences in maternal and neonatal outcomes with a prolonged second stage. There are no randomized controlled trials that have evaluated whether extending the second stage of labor beyond current American College of Obstetricians and Gynecologists recommendations is beneficial. OBJECTIVE: The purpose of this study was to evaluate whether extending the length of labor in nulliparous women with prolonged second stage affects the incidence of cesarean delivery and maternal and neonatal outcomes...
March 2016: American Journal of Obstetrics and Gynecology
Deborah R Whitley
PURPOSE: Unplanned hospital readmissions after the administration of general anesthesia for ambulatory procedures may contribute to loss of reimbursement and assessment of financial penalties. Pediatric patients represent a unique anesthetic risk. The purpose of this integrative literature review was to ascertain specific criteria used to evaluate discharge readiness for pediatric patients after anesthesia. DESIGN: This study is an integrative review of literature...
February 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Jens W Krombach, William A Edwards, James D Marks, Oliver C Radke
BACKGROUND: The use of printed or electronic checklists and other cognitive aids has gained increasing interest from anesthesia providers and professional societies. While these aids are not currently considered standard of care, the perceptions of the clinician might have an impact on their adoption. OBJECTIVES: We conducted a comprehensive survey to study the current opinions of anesthesia provider on the use of checklists and other cognitive aids. PATIENTS AND METHODS: A questionnaire was developed by a departmental checklist focus group, which aimed to identify the perception of health care checklists in general as well as specific checklists for routine and crisis situations in anesthesia...
August 2015: Anesthesiology and Pain Medicine
H David Rosen, Deborah Mervitz, Joseph P Cravero
INTRODUCTION: Pediatric emergence agitation/delirium (ED) is a cluster of behaviors seen in the early postanesthetic period with negative emotional consequences for families and increased utilization of healthcare resources. Many studies have looked at identifying risk factors for ED and at pharmacologic regimens to prevent ED. There are few published reports on treatment options and efficacy for established ED episodes, and essentially no data concerning current practice in the treatment of ED...
February 2016: Paediatric Anaesthesia
Kavitha Patil, Vinod Kumar, Karishma Munoli
BACKGROUND: Ocular disturbances such as blurring of vision, mydriasis, palpebral ptosis, diplopia, ptosis, enophthalmos, miosis, and blindness (temporary or permanent) are rare complications due to intra-oral local anesthesia. Currently, the guidelines to dentists on preventing and caring for such ocular problems are lacking. Hence, we evaluated the knowledge and attitudes of dentists toward ocular complications of intra-oral anesthesia as a means to assess the need for such guidelines...
July 2015: Journal of Natural Science, Biology, and Medicine
Joseph M Neal, Sandra L Kopp, Jeffrey J Pasternak, William L Lanier, James P Rathmell
BACKGROUND AND OBJECTIVES: In March 2012, the American Society of Regional Anesthesia and Pain Medicine convened its second Practice Advisory on Neurological Complications in Regional Anesthesia and Pain Medicine. This update is based on the proceedings of that conference and relevant information published since its conclusion. This article updates previously described information on the pathophysiology of spinal cord injury and adds new material on spinal stenosis, blood pressure control during neuraxial blockade, neuraxial injury subsequent to transforaminal procedures, cauda equina syndrome/local anesthetic neurotoxicity/arachnoiditis, and performing regional anesthetic or pain medicine procedures in patients concomitantly receiving general anesthesia or deep sedation...
September 2015: Regional Anesthesia and Pain Medicine
Giorgio Ivani, Santhanam Suresh, Claude Ecoffey, Adrian Bosenberg, Per-Anne Lonnqvist, Elliot Krane, Francis Veyckemans, David M Polaner, Marc Van de Velde, Joseph M Neal
BACKGROUND AND OBJECTIVES: Some topics in the clinical management of regional anesthesia in children remain controversial. To evaluate and come to a consensus regarding some of these topics, The European Society of Regional Anaesthesia and Pain Therapy (ESRA) and the American Society of Regional Anesthesia and Pain Medicine (ASRA) developed a joint committee practice advisory on pediatric regional anesthesia (PRA). METHODS: Representatives from both ASRA and ESRA comprised the joint committee practice advisory on PRA...
September 2015: Regional Anesthesia and Pain Medicine
Babatunde Babasola Osinaike
BACKGROUND: Hemodynamic monitoring (HM) and optimization of cardiac output and parameters of dynamic fluid responsiveness is said to improve perioperative outcome in high-risk surgical patients (HRSP). There is insufficient data to determine the burden of care and HM practices in HRSP in Nigeria. Hence, the need to assess and document the current hemodynamic management practices of anesthetists in Nigeria regarding patients undergoing high-risk surgery. METHODS: An electronic mail (E-mail) based survey was conducted among 180 consultant members of the Nigeria Society of Anaesthetists...
July 2015: Indian Journal of Critical Care Medicine
Rohesh J Fernando, Fred E Shapiro, Noah M Rosenberg, Angela M Bader, Richard D Urman
OBJECTIVES: Checklists are tools that are developed to complete tasks by drawing on specific and relevant knowledge and supporting communication at critical times. If checklists were designed specifically for patient use, they could promote patient engagement, potentially leading to improved quality of care. Physicians of all specialties, nurses, patients, patient advocates, and administrators can take an active role in checklist development and dissemination. METHODS: Our method to investigate concepts in developing a customizable patient checklist included a literature search concerning existing checklists and resources currently available to patients...
June 10, 2015: Journal of Patient Safety
Joel J Napeñas, Omar Kujan, Paolo G Arduino, Suma Sukumar, Sheila Galvin, Marinka Baričević, John Costella, Rakefet Czerninski, Douglas E Peterson, Peter B Lockhart
OBJECTIVES: Current recommendations for safe and effective dental management are less than optimal for some medical conditions because of limited evidence, conflicting conclusions, or both. This review (1) compiled and evaluated dental management recommendations for select medical conditions; (2) summarized recommendations and their assigned levels of evidence; (3) identified areas of conflict, ambiguity, or both; and (4) identified issues that warrant future research, enhanced consensus statements, or both...
August 2015: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Khaled Mahmoud-Tawfik, Ellie Heidari, David Craig, Abdel Rahman Tawfik
OBJECTIVE: This research explores the attitudes of medical professionals towards fasting patients prior to the use of conscious sedation. MATERIALS AND METHODS: Questionnaires were completed by a total of 113 dentists, anaesthetists and dental nurses in order to identify current practices and opinions concerning the employment of pre-operative fasting in the context of conscious sedation in dentistry. RESULTS: Seventy-eight (69%) respondents did not recommend fasting, compared with 35 (31%) who did...
January 2015: SAAD Digest
J C Duncan, M Ross, S Rhind, E Clutton, D J Shaw
Day One Skills (DOS) were introduced by the Royal College of Veterinary Surgeons (RCVS) in 2006 as a guideline for minimum skills required by a veterinary graduate. However, the RCVS anaesthesia DOS are broad and do not specify differences in skills required for different species. The aims of this study were: (1) to determine which anaesthesia skills were considered essential for day one practice by UK-based veterinary practitioners (GPs) and anaesthetists; and (2) to explore current opinions on veterinary undergraduate anaesthesia training...
February 28, 2015: Veterinary Record
Maura E Ryan, Susan Palasis, Gaurav Saigal, Adam D Singer, Boaz Karmazyn, Molly E Dempsey, Jonathan R Dillman, Christopher E Dory, Matthew Garber, Laura L Hayes, Ramesh S Iyer, Catherine A Mazzola, Molly E Raske, Henry E Rice, Cynthia K Rigsby, Paul R Sierzenski, Peter J Strouse, Sjirk J Westra, Sandra L Wootton-Gorges, Brian D Coley
Head trauma is a frequent indication for cranial imaging in children. CT is considered the first line of study for suspected intracranial injury because of its wide availability and rapid detection of acute hemorrhage. However, the majority of childhood head injuries occur without neurologic complications, and particular consideration should be given to the greater risks of ionizing radiation in young patients in the decision to use CT for those with mild head trauma. MRI can detect traumatic complications without radiation, but often requires sedation in children, owing to the examination length and motion sensitivity, which limits rapid assessment and exposes the patient to potential anesthesia risks...
October 2014: Journal of the American College of Radiology: JACR
Hristina N Natcheva, James E Silberzweig, Christine P Chao, Alan M Cohen, Jeremy D Collins, Lawrence T Dauer, Robert G Dixon, Kathleen Gross, Ziv J Haskal, John D Statler, Michael S Stecker, Adam B Winick, Boris Nikolic
PURPOSE: To survey the status quo of ancillary staffing in predominantly hospital-based interventional radiology (IR) suites and to assess interventional radiologist attitudes toward current IR procedure room staffing availability and appropriateness. MATERIALS AND METHODS: Invitations to an online survey composed of 26 questions focused on levels of IR suite ancillary staffing as well as operators' opinions of current IR procedure room staffing were sent via email to 2,284 active Society of Interventional Radiology members...
November 2014: Journal of Vascular and Interventional Radiology: JVIR
A K Aljafari, S Scambler, J E Gallagher, M T Hosey
OBJECTIVES: To: 1, Explore opinions of parents of children undergoing caries treatment under general anaesthesia (GA) regarding delivery of oral health advice; 2, Discover current oral health practices and beliefs; 3, Inform further research and action. METHODS: Qualitative study using semi-structured interviews and thematic data analysis, sampling parents of children aged 3-10 years undergoing GA tooth extraction due to dental caries. RESULTS: Twenty nine parents were interviewed (mean age 38...
June 2014: Community Dental Health
T Steinfeldt, U Schwemmer, T Volk, M Neuburger, T Wiesmann, A R Heller, O Vicent, A Stanek, M Franz, H Wulf, P Kessler
The German Society of Anaesthesiology and Intensive Care Medicine (Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin, DGAI) established an expert panel to develop preliminary recommendations for nerve localization in peripheral regional anesthesia. Based on expert knowledge and the relatively limited data, the recommendations state how ultrasound and/or electrical nerve stimulation should be used in daily practice, and where and when local anesthetics should be injected. Moreover, it was defined under which conditions a peripheral nerve block under general anesthesia or deep sedation is applicable...
July 2014: Der Anaesthesist
Andreas H Taenzer, Benjamin J Walker, Adrian T Bosenberg, Lynn Martin, Santhanam Suresh, David M Polaner, Christie Wolf, Elliot J Krane
BACKGROUND AND OBJECTIVES: The impact of the patient state at time of placement of regional blocks on the risk of complications is unknown. Current opinion is based almost entirely on case reports, despite considerable interest in the question. Analyzing more than 50,000 pediatric regional anesthesia blocks from an observational prospective database, we determined the rate of adverse events in relation to the patient's state at the time of block placement. Primary outcomes considered were postoperative neurologic symptoms (PONSs) and local anesthetic systemic toxicity (LAST)...
July 2014: Regional Anesthesia and Pain Medicine
Michael Brinkers, Nico Gerth, Giselher Pfau, Thomas Hachenberg
The current scientific opinion on the success of a therapy is that patients having undergone a successful therapy are satisfied. However, in reality, it is possible that patients with poor living conditions are satisfied (well-being paradox) whereas patients treated successfully are not (dissonance). The higher the psychological distress, the more rare is the assumption that successful therapy is an equivalent of satisfaction. Satisfaction depends more on fulfillment of patient expectations and involvement of the physicians...
February 2014: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
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