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https://www.readbyqxmd.com/read/29160002/a-randomized-double-blind-trial-of-needle-free-injected-lidocaine-versus-topical-anesthesia-for-infant-lumbar-puncture
#1
Ryan Caltagirone, Vidya R Raghavan, Kathleen Adelgais, Genie E Roosevelt
OBJECTIVES: Lumbar punctures (LPs) are commonly performed in febrile infants to evaluate for meningitis, and local anesthesia increases the likelihood of LP success. Traditional methods of local anesthesia require injection which may be painful or topical application which is not effective immediately. Recent advances in needle-free jet injection may offer a rapid alternative to these modalities. We compared a needle-free jet-injection system (J-Tip(™) ) with 1% buffered lidocaine to topical anesthetic (TA) cream for local anesthesia in infant LPs...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29158975/assessment-of-perioperative-stress-in-colorectal-cancer-by-use-of-in-vitro-cell-models-a-systematic-review
#2
Tove Kirkegaard, Mikail Gögenur, Ismail Gögenur
Background: The perioperative period is important for patient outcome. Colorectal cancer surgery can lead to metastatic disease due to release of disseminated tumor cells and the induction of surgical stress response. To explore the overall effects on surgically-induced changes in serum composition, in vitro model systems are useful. Methods: A systematic search in PubMed and EMBASE was performed to identify studies describing in vitro models used to investigate cancer cell growth/proliferation, cell migration, cell invasion and cell death of serum taken pre- and postoperatively from patients undergoing colorectal tumor resection...
2017: PeerJ
https://www.readbyqxmd.com/read/29156176/management-of-patients-with-left-ventricular-assist-devices-requiring-teeth-extraction-is-halting-anticoagulation-appropriate
#3
Visakha Suresh, Muath Bishawi, Michael W Manning, Chetan Patel, Joseph Rogers, Carmelo Milano, Jacob Schroder, Mani Daneshmand, David Powers
PURPOSE: An increasing number of patients with end-stage heart failure are supported with left ventricular assist device (LVAD) implantation and must be maintained on a consistent anticoagulation regimen. Pre-emptive extraction of carious teeth in these patients is necessary to prevent seeding of the implanted device and endocarditis. Thus, the objective of this study was to evaluate bleeding complications after minor oral surgery, specifically teeth extractions, in this unique patient population requiring long-term anticoagulation...
October 31, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29155706/comprehensive-endovascular-and-open-surgical-management-of-cerebral-arteriovenous-malformations
#4
Robert C Rennert, Jeffrey A Steinberg, Vincent J Cheung, David R Santiago-Dieppa, Jeffrey Scott Pannell, Alexander A Khalessi
Arteriovenious malformations (AVMs) are associated with significant morbidity and mortality, and have a rupture risk of ~3% per year. Treatment of AVMs must be tailored specifically to the lesion, with surgical resection being the gold standard for small, accessible lesions. Pre-operative embolization of AVMs can reduce nidal blood flow and remove high-risk AVM features such as intranidal or venous aneurysms, thereby simplifying a challenging neurosurgical procedure. Herein, we describe our approach for the staged endovascular embolization and open resection of AVMs, and highlight the advantages of having a comprehensively trained neurovascular surgeon leading a multi-disciplinary clinical team...
October 20, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29152476/early-recovery-pathway-for-hepatectomy-data-driven-liver-resection-care-and-recovery
#5
REVIEW
Susanne G Warner, Zeljka Jutric, Liana Nisimova, Yuman Fong
In recent years, great progress has been made toward safer hepatobiliary surgical interventions. This has resulted in more widely available treatments for patients who in the past were ineligible for curative resection of primary liver tumors, liver metastases, and advanced biliary tumors. However, the rise in procedures has seen increasingly heterogeneous perioperative management, yielding strikingly disparate outcomes. A number of groups have attempted to standardize perioperative care in an effort to create enhanced recovery pathways (ERPs) and provide clinicians with a dependable roadmap to success following hepatectomy...
October 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#6
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29149820/mechanisms-of-cardioprotection-of-halogenated-agents-during-extracorporeal-circulation-in-cardiac-surgery
#7
M Ramirez Aliaga, J J Escalona Belmonte, Alicia Ramirez-Fernandez, M Rubio Navarro, J Cruz Manas
The implementation of cardioprotective strategies involving pre-, intra-, and postoperative interventions is key during cardiac surgery requiring extracorporeal circulation (ECC). The primary goal of this study was to review the physiopathology of and protection strategies against myocardial damage secondary to ECC during cardiac surgery. The administration of halogenated anesthetics for cardiac anesthesia is commonplace due to their well-known cardioprotective effects and their capacity to ensure hypnosis...
November 16, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29145742/improving-mechanical-thrombectomy-time-metrics-in-the-angiography-suite-stroke-cart-parallel-workflows-and-conscious-sedation
#8
Fabio Settecase, David B McCoy, Robert Darflinger, Matthew D Alexander, Daniel L Cooke, Christopher F Dowd, Steven W Hetts, Randall T Higashida, Van V Halbach, Matthew R Amans
Purpose Earlier reperfusion of large-vessel occlusion (LVO) stroke improves functional outcomes. We hypothesize that use of a stroke cart in the angiography suite, containing all commonly used procedural equipment in a mechanical thrombectomy, combined with parallel staff workflows, and use of conscious sedation when possible, improve mechanical thrombectomy time metrics. Methods We identified 47 consecutive LVO patients who underwent mechanical thrombectomy at our center, retrospectively and prospectively from implementation of these three workflow changes (19 pre- and 28 post-)...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29139363/cryosurgery-for-facial-and-scalp-lesions-of-basal-cell-carcinoma-a-study-in-29-elderly-patients
#9
Satish Savant, Sandeep Savant, Virendra N Sehgal
Basal cell carcinoma (BCC) is one of the pre-eminent tumors of the epidermis, recognized by explicit clinical-pathologic characteristics. It is relatively uncommon in South Asia including India and is amenable to a variety of modalities, including cryosurgery. The outcome of cryosurgery was evaluated in 18 men and 11 women, aged 58 to 83 years, who were treated with two freeze-thaw cycles of liquid nitrogen under local anesthesia, after requisite preparations. Of the 29 patients, 27 had complete clearance of the lesions in the course of 3 years of follow-up, while only 2 had a recurrence, one at 17 months and one at 23 months...
2017: Skinmed
https://www.readbyqxmd.com/read/29137871/-anesthesia-and-alzheimer-s-disease-current-perceptions
#10
REVIEW
Ana Filipa Vieira da Silva Ferreira Marques, Teresa Alexandra Santos Carvalho Lapa
BACKGROUND AND OBJECTIVES: It has been speculated that the use of anesthetic agents may be a risk factor for the development of Alzheimer's disease. The objective of this review is to describe and discuss pre-clinical and clinical data related to anesthesia and this disease. CONTENT: Alzheimer's disease affects about 5% of the population over 65 years old, with age being the main risk factor and being associated with a high morbidity. Current evidence questions a possible association between anesthesia, surgery, and long-term cognitive effects, including Alzheimer's disease...
November 11, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29137628/hypertonic-saline-for-prevention-of-delirium-in-geriatric-patients-who-underwent-hip-surgery
#11
Xi Xin, Fei Xin, Xuguang Chen, Qi Zhang, Yanan Li, Shuping Huo, Chongfu Chang, Qiujun Wang
BACKGROUND: Postoperative delirium (POD) is a common disorder in the elderly patients, and neuroinflammation is the possible underlying mechanism. This study is designed to determine whether or not hypertonic saline (HS) pre-injection can alleviate POD in aged patients. METHODS: This prospective study recruited 120 geriatric patients who underwent hip surgery. The patients were randomly divided into two groups: control group (NS group) and HS group. Patients in the NS group were pre-injected with 4 mL/kg isotonic saline, and those in the HS group were pre-injected with 4 mL/kg 7...
November 14, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29134322/correlative-factors-analysis-of-postural-related-ocular-cyclotorsion-with-image-guided-system
#12
Fangkun Zhao, Ling Li, Wenkai Zhou, Dong Shi, Yu Fan, Liwei Ma
PURPOSE: To explore the correlation between ocular cyclotorsion induced by sitting and supine positions as well as other selected factors, validated by an image-guided system. STUDY DESIGN: A cross-sectional study conducted in 73 inpatients (85 eyes) who received intraocular operations in China Medical University. METHODS: The ocular cyclotorsion degree was recorded using an image-guided system (Verion Reference Unit, Alcon) by comparing images captured in sitting position, as well as pre- and post-different anesthesia methods in the supine position...
November 13, 2017: Japanese Journal of Ophthalmology
https://www.readbyqxmd.com/read/29130022/evaluation-of-postgraduates-following-implementation-of-a-focus-assessed-transthoracic-echocardiography-fate-training-course-a-pilot-study
#13
Stephen C Haskins, Jinhui Zhao, Jemiel A Nejim, Kara Fields, Sean Garvin, Sumudu Dehipawala, James D Beckman, Angie Zhang, James A Osorio, Christopher Tanaka
At our institution, implementation of a formal training course in Basic Focus Assessed Transthoracic Echocardiography (FATE) was associated with an improvement in anesthesia trainees' ability to obtain transthoracic echocardiography (TTE) images. Total image acquisition scores improved by a median (Q1, Q3) 9.1 (2.9,14.7) percentage points from pre-to post-hands-on FATE course (n=20; p=0.001). Participants who returned for a subsequent assessment 5 months following the course demonstrated a median (Q1, Q3) 18...
September 2017: Journal of Anesthesia & Clinical Research
https://www.readbyqxmd.com/read/29122625/comparison-of-intraoperative-and-early-postoperative-outcomes-of-caudal-versus-dorsal-penile-nerve-blocks-for-outpatient-penile-surgeries
#14
Katherine H Chan, Aali Shah, Elizabeth A Moser, Konrad Szymanski, Benjamin M Whittam, Rosalia Misseri, Martin Kaefer, Richard Rink, Mark P Cain
OBJECTIVE: To compare intraoperative and 1-hour postoperative outcomes in caudal versus dorsal penile nerve block (DPNB) patients undergoing penile surgeries. MATERIAL AND METHODS: We performed a retrospective cohort study of males <10 years old undergoing penile procedures (2013-2015) using the Pediatric Regional Anesthesia Network, Pediatric Health Information System databases and our medical records. The primary outcome was a maximum Faces Limbs Activity Crying Consolability pain score > 3...
November 6, 2017: Urology
https://www.readbyqxmd.com/read/29122588/anesthesia-for-patients-with-tracheal-bronchus
#15
K M Lai, M H Hsieh, F Lam, C Y Chen, T L Chen, C C Chang
Tracheal bronchus is a congenital anatomical variant of patients with accessory bronchus in the right upper lobe deriving directly from the supracarinal trachea. Pre-operative consultation with the anesthesiologist is important for patient safety and can avoid adverse effects induced by endotracheal intubation. In this report, we described a case of tracheal bronchus in which general anesthesia was performed for video-assisted thoracoscopic surgery. We discussed some of the issues surrounding to complications in tracheal bronchus...
October 26, 2017: Asian J Anesthesiol
https://www.readbyqxmd.com/read/29121400/dexamethasone-as-an-adjuvant-to-peripheral-nerve-block
#16
REVIEW
Carolyne Pehora, Annabel Me Pearson, Alka Kaushal, Mark W Crawford, Bradley Johnston
BACKGROUND: Peripheral nerve block (infiltration of local anaesthetic around a nerve) is used for anaesthesia or analgesia. A limitation to its use for postoperative analgesia is that the analgesic effect lasts only a few hours, after which moderate to severe pain at the surgical site may result in the need for alternative analgesic therapy. Several adjuvants have been used to prolong the analgesic duration of peripheral nerve block, including perineural or intravenous dexamethasone. OBJECTIVES: To evaluate the comparative efficacy and safety of perineural dexamethasone versus placebo, intravenous dexamethasone versus placebo, and perineural dexamethasone versus intravenous dexamethasone when added to peripheral nerve block for postoperative pain control in people undergoing surgery...
November 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29119285/lateral-femoral-notch-depth-is-not-associated-with-increased-rotatory-instability-in-acl-injured-knees-a-quantitative-pivot-shift-analysis
#17
Ajay C Kanakamedala, Jeremy M Burnham, Thomas R Pfeiffer, Elmar Herbst, Marcin Kowalczuk, Adam Popchak, James Irrgang, Freddie H Fu, Volker Musahl
PURPOSE: A deep lateral femoral notch (LFN) on lateral radiographs is indicative of ACL injury. Prior studies have suggested that a deep LFN may also be a sign of persistent rotatory instability and a concomitant lateral meniscus tear. Therefore, the purpose of this study was to evaluate the relationship between LFN depth and both quantitative measures of rotatory knee instability and the incidence of lateral meniscus tears. It was hypothesized that greater LFN depth would be correlated with increased rotatory instability, quantified by lateral compartment translation and tibial acceleration during a quantitative pivot shift test, and incidence of lateral meniscus tears...
November 8, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29112966/lengthening-of-knee-flexor-muscles-by-percutaneous-needle-tenotomy-description-of-the-technique-and-preliminary-results
#18
Alexis Schnitzler, François Genêt, Aurélie Diebold, Laurence Mailhan, Claire Jourdan, Philippe Denormandie
BACKGROUND: Knee flexion contractures occur frequently in non-ambulatory, aged persons and persons with central nervous system lesions, rendering positioning and nursing care difficult. There are often risks associated with surgical interventions. OBJECTIVE: To evaluate the effectiveness of percutaneous needle tenotomy to lengthen the knee flexor muscles and improve passive function. METHODS: This was a retrospective study of all patients who underwent percutaneous needle tenotomy between 2012 and 2014...
2017: PloS One
https://www.readbyqxmd.com/read/29108407/periprocedural-analgesic-efficacy-of-a-single-pre-emptive-administration-of-propacetamol-in-catheter-ablation-for-atrial-fibrillation-a-randomized-controlled-trial
#19
Sung Yeon Ham, Jong-Wook Song, Jae-Kwang Shim, Woo Kyung Lee, Hee-Jung Kim, Young-Lan Kwak
BACKGROUND: Anesthetic care for termination of atrial fibrillation with catheter ablation poses significant challenges due to significant pain lengthy procedure. A delicate polypharmacy combining anaesthetic agents to minimize respiratory depression and hemodynamic changes and to provide satisfactory sedation and analgesia is needed. METHODS: Ninety-eight patients were randomized into two groups receiving either two gram of propacetamol or normal saline intravenously for 20 min before anesthesia...
November 6, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29107354/effects-of-extracorporeal-shock-wave-mediated-transdermal-local-anesthetic-drug-delivery-on-rat-caudal-nerves
#20
Jer-Junn Luh, Wan-Ting Huang, Kwan-Hwa Lin, Yi-You Huang, Po-Ling Kuo, Wen-Shiang Chen
Cavitation plays a substantial role in the clinical effects of extracorporeal shock wave therapy (ESWT). It is also generally accepted as a major mechanism in sonophoresis. To identify the enhancing effect of extracorporeal shock wave-mediated transdermal drug delivery, 24 Wistar rats were randomly assigned to four groups: (i) topical application of a eutectic mixture of local anesthetics (EMLA); (ii) 1-MHz ultrasound; (iii) ESWT pre-treatment combined with EMLA application; (iv) ESWT concurrent with EMLA application on rat tails...
October 27, 2017: Ultrasound in Medicine & Biology
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