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MINS anaesthesia

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https://www.readbyqxmd.com/read/29762683/peri-procedural-routines-implantation-techniques-and-procedure-related-complications-in-patients-undergoing-implantation-of-subcutaneous-or-transvenous-automatic-cardioverter-defibrillators-results-of-the-european-snapshot-survey-on-s-icd-implantation-esss
#1
Radoslaw Lenarczyk, Serge Boveda, Kristina H Haugaa, Tatjana S Potpara, Pawel Syska, Ewa Jedrzejczyk-Patej, Michel Chauvin, Nicolas Sadoul, Nikolaos Dagres
The aim of this European Heart Rhythm Association (EHRA) prospective snapshot survey is to assess peri-procedural practices, implantation techniques, and short-term procedure-related complications associated with implantation of subcutaneous implantable cardioverter-defibrillator (S-ICD) or transvenous implantable cardioverter-defibrillator (TV-ICD), across tertiary European electrophysiology centres. An internet-based electronic questionnaire concerning implantation settings, peri-procedural routines, techniques, personnel, complications, and patient outcomes was sent to the centres routinely implanting both TV-ICDs and S-ICDs...
May 11, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29757924/placebo-versus-low-dose-ketamine-infusion-in-addition-to-remifentanil-target-controlled-infusion-for-conscious-sedation-during-oocyte-retrieval-a-prospective-double-blinded-randomised-controlled-trial
#2
Hélène I Morue, Shalini Raj-Lawrence, Sarah Saxena, Anne Delbaere, Edgard Engelman, Luc A Barvais
BACKGROUND: Currently, there is no gold standard for monitored anaesthesia care during oocyte retrieval. OBJECTIVE: In our institution, the standard is a conscious sedation technique using a target-controlled infusion (TCI) of remifentanil, titrated to maintain a visual analogue pain score less than 30 mm. This protocol is well accepted by patients but is associated with frequent episodes of respiratory depression. The main objective of this study was to evaluate whether the addition of a continuous intravenous infusion of ketamine could reduce these episodes...
April 30, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29756750/validation-of-the-pmd100tm-and-its-noltm-index-to-detect-nociception-at-different-infusion-regimen-of-remifentanil-in-patients-under-general-anaesthesia
#3
Pierre-André Stöckle, Marco Julien, Rami Issa, Elizabeth Décary, Véronique Brulotte, Pierre Drolet, Margaret Henri, Madeleine Poirier, Jean-François Latulippe, Marc Dorais, Olivier Verdonck, Louis-Philippe Fortier, Philippe Richebé
BACKGROUND: The NOL index is based on multiparametric analysis of heart rate (HR), skin conductance, wave plethysmography, and their time derivative. Our objective was to evaluate the NOL to detect standardized nociceptive stimuli with various remifentanil dosages under general anaesthesia. METHODS: A prospective, observational study at a single center (NCT02602379) included 40 ASA I to III patients undergoing laparotomy under remifentanil-desflurane anaesthesia with epidural analgesia...
May 14, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29754420/the-predictive-value-of-the-heart-rate-variability-derived-analgesia-nociception-index-in-children-anaesthetised-with-sevoflurane-an-observational-pilot-study
#4
Frank Weber, Noortje J E Geerts, Hilde G Roeleveld, Annejet T Warmenhoven, Chantal A Liebrand
BACKGROUND: The heart rate variability (HRV) derived Analgesia Nociception Index (ANI™ ) is a continuous non-invasive tool to assess the nociception/anti-nociception balance in unconscious patients. It has been shown to be superior to hemodynamic variables in detecting insufficient anti-nociception in children, while little is known about its predictive value. METHODS: The primary objective of this prospective observational pilot study in paediatric surgical patients under sevoflurane anaesthesia, was to compare the predictive value of the ANI and heart rate to help decide to give additional opioids...
May 13, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29742684/myocardial-injury-after-noncardiac-surgery-incidence-and-predictors-from-a-prospective-observational-cohort-study-at-an-indian-tertiary-care-centre
#5
Rubin George, Vidya P Menon, Fabia Edathadathil, Sabarish Balachandran, Merlin Moni, Dipu Sathyapalan, Preetha Prasanna, Gokuldas S, Jerry Paul, Chandrababu K K, Lakshmi Kumar, Ashok Pillai
Asymptomatic myocardial injury following noncardiac surgery (MINS) is an independent predictor of 30-day mortality and may go unrecognized based on standard diagnostic definition for myocardial infarction (MI). Given lack of published research on MINS in India, our study aims to determine incidence of MINS in patients undergoing noncardiac surgery at our tertiary care hospital, and evaluate the clinical characteristics including 30-day outcome.The prospective observational study included patients >65 years or >45 years with either hypertension (HTN), diabetes mellitus (DM), coronary artery disease (CAD), cerebrovascular accident (CVA), or peripheral arterial disease undergoing noncardiac surgery...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29737315/applicability-of-transoral-endoscopic-parathyroidectomy-through-vestibular-route-for-primary-sporadic-hyperparathyroidism-a-south-indian-experience
#6
P R K Bhargav, M Sabaretnam, V Amar, N Vimala Devi
Introduction: Primary hyperparathyroidism is one of the most common endocrine disorders requiring surgical parathyroidectomy for its definitive treatment. Surgical exploration is traditionally performed through conventional open neck approach. A wide range of minimal access and minimally invasive endoscopic techniques (gas less and with gas) have been attempted in the past two decades. In this context, we evaluated the feasibility and safety of an innovative transoral endoscopic parathyroidectomy (EP) technique, which represents a paradigm shift in transluminal endocrine surgery...
May 4, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29723241/intra-operative-cerebrospinal-fluid-sampling-versus-post-operative-lumbar-puncture-for-detection-of-leptomeningeal-disease-in-malignant-paediatric-brain-tumours
#7
Sharon Y Y Low, Chen Min Wei, Kenneth T E Chang, Chan Yiong Huak, Ng Lee Ping, Seow Wan Tew, David C Y Low
INTRODUCTION: Leptomeningeal disease is a feared sequelae of malignant paediatric brain tumours. Current methods for its detection is the combined use of cranio-spinal MRI, and CSF cytology from a post-operative lumbar puncture. In this study, the authors hypothesize that CSF taken at the start of surgery, either from an external ventricular drain or neuroendoscope will have equal sensitivity for positive tumour cells, in comparison to lumbar puncture. Secondary hypotheses include positive correlation between CSF cytology and MRI findings of LMD...
2018: PloS One
https://www.readbyqxmd.com/read/29720755/a-comparative-study-to-evaluate-ultrasound-guided-transversus-abdominis-plane-block-versus-ilioinguinal-iliohypogastric-nerve-block-for-post-operative-analgesia-in-adult-patients-undergoing-inguinal-hernia-repair
#8
Kirti Kamal, Parul Jain, Teena Bansal, Geeta Ahlawat
Background and Aims: Both transversus abdominis plane (TAP) block and combined ilioinguinal-iliohypogastric (IIN/IHN) blocks are used routinely under ultrasound (USG) guidance for postoperative pain relief in patients undergoing inguinal hernia surgery. This study compares USG guided TAP Vs IIN/IHN block for post-operative analgesic efficacy in adults undergoing inguinal hernia surgery. Methods: Sixty adults aged 18 to 60 with American Society of Anesthesiologsts' grade I or II were included...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29720751/effect-site-concentration-of-propofol-at-induction-and-recovery-of-anaesthesia-a-correlative-dose-response-study
#9
Vasanth Sukumar, Arathi Radhakrishnan, Venkatesh H Keshavan
Background and Aims: Sound knowledge about effect site concentration (Ce) of propofol aids in smooth induction, maintenance and early recovery. We studied the correlation between Ce of propofol at loss of response to verbal command and recovery concentration using target-controlled infusion (TCI) in Indian patients who underwent spine surgeries. Methods: Ninety patients undergoing spine surgeries were included. Total intravenous anaesthesia (TIVA) technique with TCI for propofol using modified Marsh model was used...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29708906/intra-operative-cutaneous-temperature-monitoring-with-zero-heat-flux-technique-3m-spoton-in-comparison-with-oesophageal-and-arterial-temperature-a-prospective-observational-study
#10
Matthieu Boisson, Anouk Alaux, Thomas Kerforne, Olivier Mimoz, Bertrand Debaene, Claire Dahyot-Fizelier, Denis Frasca
BACKGROUND: Continuous monitoring of core temperature is essential during major surgery as a way of improving patient safety. Oesophageal probes or specific arterial catheters are invasive methods used in this setting. A new noninvasive device based on zero-heat-flux (ZHF) technique (SpotOn) seems promising but has been poorly investigated during rapid core temperature changes (RCTC). OBJECTIVE: To assess the accuracy of a SpotOn sensor vs. an oesophageal probe or specific arterial catheter during a slow change in core temperature of less than 1 °C within 30 min and RCTC ≥ 1 °C within 30 min...
April 27, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29701428/anaesthetic-management-in-a-duchennne-muscle-dystrophy-patient-for-treatment-of-recurrent-pneumothorax
#11
Sara Mota, Liuba Germanova, Joana Cortesão, Teresa Paiva
INTRODUCTION: Duchenne muscular dystrophy (DMD) is an x linked recessive disorder. Long term prognosis is ominous, with development of respiratory distress and cardiomyopathy in advanced stage of the disease and expected death in the teens-to-mid 20s due to respiratory or cardiac failure. Peri-operative management of this patients is challenging due to difficult airway anatomy (macroglossia, limited neck and mandibular mobility). Additionally, they are at risk of developing malignant hyperthermia, rhabdomyolysis and hyperkalemic cardiac arrest when exposed to halogenated inhalational anaesthetics and depolarizing muscle relaxants...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29680809/impact-of-dexmedetomidine-infusion-during-general-anaesthesia-on-incidence-of-postoperative-delirium-in-elderly-patients-after-major-non-cardiac-surgery-study-protocol-of-a-randomised-double-blinded-and-placebo-controlled-trial
#12
Bo-Jie Wang, Chun-Jing Li, Jian Hu, Huai-Jin Li, Chao Guo, Zhen-Han Wang, Qiao-Chu Zhang, Dong-Liang Mu, Dong-Xin Wang
INTRODUCTION: Delirium is a common complication in the elderly after surgery and is associated with worse outcomes. Multiple risk factors are related with postoperative delirium, such as exposure to general anaesthetics, pain and postoperative inflammatory response. Preclinical and clinical studies have shown that dexmedetomidine attenuated neurotoxicity induced by general anaesthetics, improved postoperative analgesia and inhibited inflammatory response after surgery. Several studies found that intraoperative use of dexmedetomidine can prevent postoperative delirium, but data were inconsistent...
April 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29671874/pain-assessment-by-pupil-dilation-reflex-in-response-to-noxious-stimulation-in-anaesthetized-adults
#13
D Wildemeersch, N Peeters, V Saldien, M Vercauteren, G Hans
BACKGROUND: In response to noxious stimulation, pupillary dilation reflex (PDR) occurs even in anaesthetized patients. The aim of the study was to evaluate the ability of pupillometry with an automated increasing stimulus intensity to monitor intraoperative opioid administration. METHODS: Thirty-four patients undergoing elective surgery were enrolled. Induction by propofol anaesthesia was increased progressively until the sedation depth criteria (SeD) were attained...
April 19, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29671866/isocapnic-hyperventilation-provides-early-extubation-after-head-and-neck-surgery-a-prospective-randomized-trial
#14
K Hallén, P Jildenstål, O Stenqvist, J Oras, S-E Ricksten, S Lindgren
BACKGROUND: Isocapnic hyperventilation (IHV) shortens recovery time after inhalation anaesthesia by increasing ventilation while maintaining a normal airway carbon dioxide (CO2 )-level. One way of performing IHV is to infuse CO2 to the inspiratory limb of a breathing circuit during mechanical hyperventilation (HV). In a prospective randomized study, we compared this IHV technique to a standard emergence procedure (control). METHODS: Thirty-one adult ASA I-III patients undergoing long-duration (>3 hours) sevoflurane anaesthesia for major head and neck surgery were included and randomized to IHV-treatment (n = 16) or control (n = 15)...
April 19, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29661412/pharmacokinetic-pharmacodynamic-model-for-propofol-for-broad-application-in-anaesthesia-and-sedation
#15
D J Eleveld, P Colin, A R Absalom, M M R F Struys
BACKGROUND: Pharmacokinetic (PK) and pharmacodynamic (PD) models are used in target-controlled-infusion (TCI) systems to determine the optimal drug administration to achieve a desired target concentration in a central or effect-site compartment. Our aim was to develop a PK-PD model for propofol that can predict the bispectral index (BIS) for a broad population, suitable for TCI applications. METHODS: Propofol PK data were obtained from 30 previously published studies, five of which also contained BIS observations...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661382/comparison-of-target-controlled-infusion-and-manual-infusion-for-propofol-anaesthesia-in-children
#16
J Mu, T Jiang, X B Xu, V M Yuen, M G Irwin
BACKGROUND: One major criticism of prolonged propofol-based total i.v. anaesthesia (TIVA) in children is the prolonged recovery time. As target-controlled infusion (TCI) obviates the need to manually calculate the infusion rate, the use of TCI may better match clinical requirements, reduce propofol dose, and shorten recovery time. METHODS: Children of ASA grade 1, aged 1-12 yr, were recruited and randomly assigned to TCI or manual infusion. Children in the TCI group had propofol delivered by TCI...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29660910/pneumoperitoneum-induced-ischemia-reperfusion-injury-of-the-peritoneum-preconditioning-may-reduce-the-negative-side-effects-caused-by-carbon-dioxide-pneumoperitoneum-pilot-study
#17
Tünde Gyöngyvér Veres, Ildikó Takács, Tibor Nagy, Gábor Jancsó, Ariella Kondor, László Pótó, András Vereczkei
INTRODUCTION: Laparoscopy is more beneficial than the conventional open technique, however the pneumoperitoneum created may have an ischemic side effect. OBJECTIVE: Our aim was to evaluate the protective effects of preconditioning during laparoscopic cholecystectomies (LC). METHODS: 30 patients were randomized into 2 groups: I. PreC (preconditioning: 5 min. inflation, 5 min. deflation, followed by conventional LC), II: LC (conventional LC)...
April 13, 2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29657848/medial-subvastus-versus-the-medial-parapatellar-approach-for-total-knee-replacement-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#18
James R Berstock, James R Murray, Michael R Whitehouse, Ashley W Blom, Andrew D Beswick
Twenty randomized controlled trials comprising 1893 primary total knee replacements were included in this review.The subvastus approach conferred superior results for mean difference (MD) in time to regain an active straight leg raise (1.7 days, 95% confidence interval [CI] 1.0 to 2.3), visual analogue score for pain on day one (0.8 points on a scale out of 10, 95% CI 0.2 to 1.4) and total range of knee movement at one week (7°, 95% CI 3.2 to 10.7). The subvastus approach also resulted in fewer lateral releases (odds ratio 0...
March 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29652895/complications-after-transcatheter-aortic-valve-implantation-using-transfemoral-and-transapical-approach-in-general-anaesthesia
#19
Fabian Würschinger, Sigrid Wittmann, Sophia Goldfuß, Nina Zech, Kurt Debl, Michael Hilker, Bernhard M Graf, York A Zausig
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure used to treat degenerative heart valve disease. The implantation requires a highly specific and interdisciplinary management approach. Currently, TAVI is performed with the patient under local or general anaesthesia. METHODS: This study was a retrospective analysis of all TAVI procedures performed at the University Hospital of Regensburg between January 2009 and July 2015...
2018: PloS One
https://www.readbyqxmd.com/read/29643554/effectiveness-of-transnasal-humidified-rapid-insufflation-ventilatory-exchange-versus-traditional-preoxygenation-followed-by-apnoeic-oxygenation-in-delaying-desaturation-during-apnoea-a-preliminary-study
#20
Sunil Rajan, Nandhini Joseph, Pulak Tosh, Dilesh Kadapamannil, Jerry Paul, Lakshmi Kumar
Background and Aims: Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) during apnoea has shown to delay desaturation. The primary objective was to compare time to desaturate to <90% during apnoea with THRIVE versus traditional preoxygenation followed by apnoeic oxygenation. Methods: This prospective, randomised, single-blinded study was conducted in 10 adult patients presenting for direct laryngoscopy under general anaesthesia without endotracheal intubation...
March 2018: Indian Journal of Anaesthesia
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