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https://www.readbyqxmd.com/read/28419420/reliability-of-pressure-waveform-analysis-to-determine-correct-epidural-needle-placement-in-labouring-women
#1
I Al-Aamri, S H Derzi, A Moore, M F Elgueta, M Moustafa, T Schricker, D Q Tran
Pressure waveform analysis provides a reliable confirmatory adjunct to the loss-of-resistance technique to identify the epidural space during thoracic epidural anaesthesia, but its role remains controversial in lumbar epidural analgesia during labour. We performed an observational study in 100 labouring women of the sensitivity and specificity of waveform analysis to determine the correct location of the epidural needle. After obtaining loss-of-resistance, the anaesthetist injected 5 ml saline through the epidural needle (accounting for the volume already used in the loss-of-resistance)...
April 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28415929/retrospective-analysis-of-a-surgical-innovation-using-the-ideal-framework-radical-cystectomy-with-epidural-anaesthesia
#2
Holger Gerullis, Thorsten H Ecke, Dimitri Barski, Carsten Bantel, Andreas Weyland, Jens Uphoff, Thomas Jansen, Friedhelm Wawroschek, Alexander Winter
Objectives To retrospectively analyse experience of radical cystectomy using spinal/epidural anaesthesia and to classify this method using the IDEAL criteria. Methods Data from patients who had undergone radical cystectomy using spinal/epidural anaesthesia were evaluated retrospectively, focusing on clinical data, intraoperative and perioperative parameters and postoperative complications. Current literature reporting on this technique was reviewed and, together with the present study, evaluated according to the IDEAL recommendations...
April 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28413903/digital-revascularization-and-replantation-using-the-wide-awake-hand-surgery-technique
#3
Jkf Wong, C H Lin, N J Chang, H C Chen, Y T Lin, C C Hsu
The use of local anaesthesia and adrenaline for hand surgery is gaining popularity; however, where vascularity is impaired, wide-awake surgery is considered a contraindication. We present our case series of five digital devascularizations and eight amputations that underwent surgery using the 'wide-awake' anaesthetic technique. A temporary digital tourniquet (< 20 min) was used in three cases to identify structures quickly. The anastomoses were performed under local anaesthesia without a tourniquet. All cases had successful re-establishment of blood flow with good perfusion to the digital tips; no cases were re-explored because of vascular crisis...
April 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28403407/apnoeic-oxygenation-in-adults-under-general-anaesthesia-using-transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-a-physiological-study
#4
I-M Gustafsson, Å Lodenius, J Tunelli, J Ullman, M Jonsson Fagerlund
Background.: Apnoeic oxygenation during anaesthesia has traditionally been limited by the rapid increase in carbon dioxide and subsequent decrease in pH. Using a Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) technique a slower increase in carbon dioxide than earlier studies was seen. Notably, apnoeic oxygenation using THRIVE has not been systematically evaluated with arterial blood gases or in patients undergoing laryngeal surgery. The primary aim of this study was to characterize changes in arterial P O 2 , P CO 2 and pH during apnoeic oxygenation using THRIVE under general anaesthesia...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28403018/prophylactic-atropine-administration-attenuates-the-negative-haemodynamic-effects-of-induction-of-anaesthesia-with-propofol-and-high-dose-remifentanil-a-randomised-controlled-trial
#5
Marieke Poterman, Thomas W L Scheeren, Marieke I van der Velde, Pieter L Buisman, Silvie Allaert, Michel M R F Struys, Alain F Kalmar
BACKGROUND: Induction of anaesthesia with propofol and remifentanil often induces unwanted bradycardia and hypotension, raising concerns regarding tissue oxygenation. The electrophysiological cardiac effects of remifentanil can be reversed by atropine. OBJECTIVE: To investigate if prophylactic administration of atropine can attenuate the negative haemodynamic effects of propofol and a high dose of remifentanil during induction of anaesthesia. DESIGN: A double-blind, randomised controlled trial...
April 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28403017/effects-of-different-fresh-gas-flows-with-or-without-a-heat-and-moisture-exchanger-on-inhaled-gas-humidity-in-adults-undergoing-general-anaesthesia-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#6
José R C Braz, Mariana G Braz, Yoko Hayashi, Regina H G Martins, Marluci Betini, Leandro G Braz, Regina El Dib
BACKGROUND: The minimum inhaled gas absolute humidity level is 20 mgH2O l for short-duration use in general anaesthesia and 30 mgH2O l for long-duration use in intensive care to avoid respiratory tract dehydration. OBJECTIVE: The aim is to compare the effects of different fresh gas flows (FGFs) through a circle rebreathing system with or without a heat and moisture exchanger (HME) on inhaled gas absolute humidity in adults undergoing general anaesthesia. DESIGN: Systematic review and meta-analyses of randomised controlled trials...
April 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28396995/mid-term-outcomes-after-percutaneous-cryoablation-of-symptomatic-abdominal-wall-endometriosis-comparison-with-surgery-alone-in-a-single-institution
#7
Julie Maillot, Jean Luc Brun, Vincent Dubuisson, Marc Bazot, Nicolas Grenier, François H Cornelis
OBJECTIVES: To compare the outcomes of percutaneous image-guided cryoablation of symptomatic abdominal wall endometriosis (AWE) versus surgery alone. METHODS: From 2004 to 2016, cryoablation or surgery alone was performed under local (n = 5) or general anaesthesia (n = 15) for AWE in a single institution in 7 (mean age, 36.1 years) and 13 (mean age, 31.9 years) patients, respectively. Fifteen lesions were treated by cryoablation (mean size, 2.3 cm; range, 0...
April 10, 2017: European Radiology
https://www.readbyqxmd.com/read/28385346/timing-of-surgical-antimicrobial-prophylaxis-a-phase-3-randomised-controlled-trial
#8
Walter P Weber, Edin Mujagic, Marcel Zwahlen, Marcel Bundi, Henry Hoffmann, Savas D Soysal, Marko Kraljević, Tarik Delko, Marco von Strauss, Lukas Iselin, Richard X Sousa Da Silva, Jasmin Zeindler, Rachel Rosenthal, Heidi Misteli, Christoph Kindler, Peter Müller, Ramon Saccilotto, Andrea Kopp Lugli, Mark Kaufmann, Lorenz Gürke, Daniel Oertli, Evelin Bucheli-Laffer, Julia Landin, Andreas F Widmer, Christoph A Fux, Walter R Marti
BACKGROUND: Based on observational studies, administration of surgical antimicrobial prophylaxis (SAP) for the prevention of surgical site infection (SSI) is recommended within 60 min before incision. However, the precise optimum timing is unknown. This trial compared early versus late administration of SAP before surgery. METHODS: In this phase 3 randomised controlled superiority trial, we included general surgery adult inpatients (age ≥18 years) at two Swiss hospitals in Basel and Aarau...
April 3, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28384962/comparison-of-intravenous-dexmedetomidine-with-midazolam-in-prolonging-spinal-anaesthesia-with-ropivacaine
#9
Balwinder Kaur Rekhi, Tejinderpal Kaur, Divya Arora, Pankaj Dugg
INTRODUCTION: Midazolam and dexmedetomidine both being sedatives, but the latter with additional analgesic properties is expected to prolong the duration of sensory and motor block obtained with spinal anaesthesia. AIM: To compare intravenous dexmedetomidine with midazolam and placebo with respect to sensory and motor block duration, analgesia, and sedation in patients undergoing lower limb and lower abdominal surgeries with intrathecal ropivacaine anaesthesia. MATERIALS AND METHODS: In this single blind placebo controlled trial, 60 patients, classified as American Society of Anaesthesiologists' (ASA) physical status I-II, were randomized into three groups (n=20 per group)...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28362031/comparison-of-anaesthetic-gas-consumption-and-stability-of-anaesthesia-using-automatic-and-manual-control-over-the-course-of-anaesthesia
#10
Tomasz Skalec, Agnieszka Górecka-Dolny, Stanisław Zieliński, Mirosław Gibek, Łukasz Stróżecki, Andrzej Kübler
BACKGROUND: The automatic control module of end-tidal volatile agents (EtC) was designed to reduce the consumption of anaesthetic gases, increase the stability of general anaesthesia and reduce the need for adjustments in the settings of the anaesthesia machine. The aim of this study was to verify these hypotheses. METHODS: The course of general anaesthesia with the use of the EtC module was analysed for haemodynamic stability, depth of anaesthesia, end-expiratory concentration of anaesthetic, number of ventilator key presses, fentanyl supply, consumption of volatile agents and anaesthesia and operation times...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28356683/a-study-on-total-intravenous-anesthesia-in-orthognathic-surgical-procedures
#11
P L Vasundhar, Gokkulakrishnan Sadhasivam, Satya Bhushan, Siva Kalyan, Kho Chai Chiang
AIMS AND OBJECTIVE: To assess the use of propofol for induction and maintenance of anaesthesia among patients undergoing various combinations of orthognathic surgical procedures. MATERIALS AND METHODS: Following Preoperative evaluation, patients were given Fentanyl (2 micrograms/kg) intravenously. Induction (2 mg/kg) and maintenance (10 mg/kg/hr) of anaesthesia was achieved by Propofol infusion. Blood Pressure and heart rate were maintained at >70 or 80 mm Hg and >50 respectively and were monitored continuously...
July 2016: National Journal of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28355229/surgery-increases-cell-death-and-induces-changes-in-gene-expression-compared-with-anesthesia-alone-in-the-developing-piglet-brain
#12
Kevin D Broad, Go Kawano, Igor Fierens, Eridan Rocha-Ferreira, Mariya Hristova, Mojgan Ezzati, Jamshid Rostami, Daniel Alonso-Alconada, Badr Chaban, Jane Hassell, Bobbi Fleiss, Pierre Gressens, Robert D Sanders, Nicola J Robertson
In a range of animal species, exposure of the brain to general anaesthesia without surgery during early infancy may adversely affect its neural and cognitive development. The mechanisms mediating this are complex but include an increase in brain cell death. In humans, attempts to link adverse cognitive development to infantile anaesthesia exposure have yielded ambiguous results. One caveat that may influence the interpretation of human studies is that infants are not exposed to general anaesthesia without surgery, raising the possibility that surgery itself, may contribute to adverse cognitive development...
2017: PloS One
https://www.readbyqxmd.com/read/28328950/repeated-anaesthesia-with-isoflurane-and-medetomidine-midazolam-fentanyl-in-guinea-pigs-and-its-influence-on-physiological-parameters
#13
Sabrina Schmitz, Sabine Tacke, Brian Guth, Julia Henke
Repeated anaesthesia may be required in experimental protocols and in daily veterinary practice, but anaesthesia is known to alter physiological parameters in GPs (Cavia porcellus, GPs). This study investigated the effects of repeated anaesthesia with either medetomidine-midazolam-fentanyl (MMF) or isoflurane (Iso) on physiological parameters in the GP. Twelve GPs were repeatedly administered with MMF or Iso in two anaesthesia sets. One set consisted of six 40-min anaesthesias, performed over 3 weeks (2 per week); the anaesthetic used first was randomized...
2017: PloS One
https://www.readbyqxmd.com/read/28316083/energy-metabolism-in-the-rat-cortex-under-thiopental-anaesthesia-measured-in-vivo-by-13-c-mrs
#14
Sarah Sonnay, João M N Duarte, Nathalie Just, Rolf Gruetter
Barbiturates, commonly used as general anaesthetics, depress neuronal activity and thus cerebral metabolism. Moreover, they are likely to disrupt the metabolic support of astrocytes to neurons, as well as the uptake of nutrients from circulation. By employing (13) C magnetic resonance spectroscopy (MRS) in vivo at high magnetic field, we characterized neuronal and astrocytic pathways of energy metabolism in the rat cortex under thiopental anaesthesia. The neuronal tricarboxylic acid (TCA) cycle rate was 0.46 ± 0...
March 19, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28298789/caudal-epidural-analgesia-in-pediatric-patients-comparison-of-0-25-levobupivacaine-and-0-25-ropivacaine-in-terms-of-motor-blockade-and-postoperative-analgesia
#15
P Praveen, R Remadevi, N Pratheeba
CONTEXT: Ropivacaine and Levo-Bupivacaine have been safely used for caudal anaesthesia in children, but there are limited studies comparing the efficacy of 0.25% Ropivacaine and 0.25% Levo-Bupivacaine for caudal anaesthesia in infraumbilical surgeries. AIMS: The aim of this study was to compare the incidence of motor blockade and postoperative analgesia with 0.25% ropivacaine and 0.25% levobupivacaine for the caudal block in children receiving infraumbilical surgery...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298758/comparison-of-analgesic-efficacy-of-dexmedetomidine-and-midazolam-as-adjuncts-to-lignocaine-for-intravenous-regional-anesthesia
#16
Bharti Gupta, Ravinder Kumar Verma, Sudershan Kumar, Geeta Chaudhary
BACKGROUND: Intravenous regional anesthesia (IVRA) is safe, technically simple, and cost-effective technique compared to general anesthesia with success rates of 94-98% for upper and lower limb surgeries. The main disadvantage of this procedure is its limited duration for surgery, lack of postoperative analgesia, and tourniquet pain. To overcome this disadvantage, various adjuvants to lignocaine have been studied from time to time. AIM: To compare the analgesic efficacy of dexmedetomidine and midazolam as adjuncts to lignocaine for IVRA for forearm and hand surgeries...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28284189/changes-in-intraocular-pressure-and-optic-nerve-sheath-diameter-in-patients-undergoing-robotic-assisted-laparoscopic-prostatectomy-in-steep-45%C3%A2-trendelenburg-position
#17
Sebastian Blecha, Marion Harth, Felix Schlachetzki, Florian Zeman, Christiane Blecha, Pierre Flora, Maximilian Burger, Stefan Denzinger, Bernhard M Graf, Horst Helbig, Michael T Pawlik
BACKGROUND: To evaluate changes in intraocular pressure (IOP) and intracerebral pressure (ICP) reflected by the optic nerve sheath diameter (ONSD) in patients undergoing robotic-assisted laparoscopic prostatectomy (RALP) in permanent 45° steep Trendelenburg position (STP). METHODS: Fifty-one patients undergoing RALP under a standardised anaesthesia. IOP was perioperatively measured in awake patients (T0) and IOP and ONSD 20 min after induction of anaesthesia (T1), after insufflation of the abdomen in supine position (T2), after 30 min in STP (T3), when controlling Santorini's plexus in STP (T4) and before awakening while supine (T5)...
March 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28281769/long-term-surgical-anaesthesia-with-isoflurane-in-human-habituated-nile-crocodiles
#18
George F Stegmann, Catherine J A Williams, Craig Franklin, Tobias Wang, Michael Axelsson
A suitable long-term anaesthetic technique was required for implantation of physiological sensors and telemetric devices in sub-adult Nile crocodiles (Crocodylus niloticus) to allow the collection of physiological data. Five Nile crocodiles with a median body mass of 24 kg were used. After manual capture, they were blindfolded and 0.2 mL (1 mg/mL) medetomidine was administered intramuscularly in four of the animals which had an estimated body mass between 20 kg and 30 kg. One crocodile with an estimated body mass of 50 kg received 0...
February 24, 2017: Journal of the South African Veterinary Association
https://www.readbyqxmd.com/read/28275524/high-single-scrotal-incision-orchidopexy-as-the-standard-technique-in-infants-aged-6-24%C3%A2-months
#19
Ahmed Mohey, Tarek M Gharib, Rabea G Omar, Ahmed Sebaey, Basheer N Elmohamady, Wael Kandeel
OBJECTIVE: To prospectively investigate the effectiveness of high single scrotal-incision orchidopexy (HSSIO) for palpable undescended testis (PUDT) in infants aged 6-24 months. PATIENTS AND METHODS: From March 2012 to July 2014, 46 age range-restricted (6-24 months) infants with 57 PUDT underwent HSSIO after obtaining written consent from their parents. The exclusion criteria were ectopic, retractile testes and recurrent cases. All infants were examined before surgery in the outpatient department and after anaesthesia induction immediately before surgery...
March 2017: Arab Journal of Urology
https://www.readbyqxmd.com/read/28275517/percutaneous-nephrolithotomy-in-complete-supine-flank-free-position-in-comparison-to-prone-position-a-single-centre-experience
#20
Nadeem Sohail, Amjad Albodour, Khalid Mohammed Abdelrahman
OBJECTIVES: To assess the outcomes of performing percutaneous nephrolithotomy (PCNL) in a modified supine position, more feasible for surgeons, anaesthetists, and operating theatre staff, as well as for the patient himself, and evaluating it in comparison to the standard prone position. PATIENT AND METHODS: A retrospective, case-control study was conducted between January 2011 and December 2015. In all, 197 patient's records were reviewed. The initial 101 patients were operated upon in prone position...
March 2017: Arab Journal of Urology
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