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prolonged fasting anesthesia

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https://www.readbyqxmd.com/read/27896927/a-retrospective-review-of-anesthesia-and-perioperative-care-in-children-with-medium-chain-acyl-coa-dehydrogenase-deficiency
#1
Claire Allen, Russell Perkins, Bernd Schwahn
BACKGROUND: Medium-chain acyl-CoA dehydrogenase deficiency is the most common genetically determined disorder of mitochondrial fatty acid oxidation. Decompensation can result in hypoglycemia, seizures, coma, and death but may be prevented by ensuring glycogen stores do not become depleted. Perioperative care is of interest as surgery, fasting, and infection may all trigger decompensation and the safety of anesthetic agents has been questioned. Current guidelines from the British Inherited Metabolic Disease Group advise on administering fluid containing 10% glucose during the perioperative period...
November 29, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27895555/spike-timing-rigidity-is-maintained-in-bursting-neurons-under-pentobarbital-induced-anesthetic-conditions
#2
Risako Kato, Masanori Yamanaka, Eiko Yokota, Noriaki Koshikawa, Masayuki Kobayashi
Pentobarbital potentiates γ-aminobutyric acid (GABA)-mediated inhibitory synaptic transmission by prolonging the open time of GABAA receptors. However, it is unknown how pentobarbital regulates cortical neuronal activities via local circuits in vivo. To examine this question, we performed extracellular unit recording in rat insular cortex under awake and anesthetic conditions. Not a few studies apply time-rescaling theorem to detect the features of repetitive spike firing. Similar to these methods, we define an average spike interval locally in time using random matrix theory (RMT), which enables us to compare different activity states on a universal scale...
2016: Frontiers in Neural Circuits
https://www.readbyqxmd.com/read/27846126/implementation-of-the-american-society-of-anesthesiology-s-guidelines-to-reduce-prolonged-fasting-times-in-pediatric-preoperative-patients-a-best-practice-implementation-project
#3
Carol M Costello
BACKGROUND: The American Society of Anesthesiology (ASA) guidelines for pediatric preoperative fasting have been a standard for well over a decade. However, use of protocols involving an excessive fasting duration exposes patients to the physiological impacts of fluid volume loss. OBJECTIVES: The current project aimed to improve fluid supplementation during presurgical fasting in pediatric patients at an academic medical center. Specific objectives were to increase clinical staff knowledge regarding ASA fasting standards and implement them in specific pediatric patient populations...
October 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27518779/very-long-chain-acyl-coenzyme-a-dehydrogenase-deficiency-and-perioperative-management-in-adult-patients
#4
M M Welsink-Karssies, J A W Polderman, E J Nieveen van Dijkum, B Preckel, W S Schlack, G Visser, C E Hollak, J Hermanides
Surgery and anesthesia pose a threat to patients with very long-chain acyl-CoA dehydrogenase deficiency (VLCADD), because prolonged fasting, stress, and pain are known risk factors for the induction of metabolic derangement. The optimal perioperative management in these patients is unknown and the use of volatile agents and agents dissolved in fatty acids has been related to postoperative metabolic complications. However, the occurrence of metabolic derangement is multifactorial and depends, amongst others, on the severity of the mutation and residual enzyme activity...
August 13, 2016: JIMD Reports
https://www.readbyqxmd.com/read/27494998/laparoscopic-insertion-of-the-peritoneal-catheter-in-ventriculoperitoneal-shunting-review-of-405-consecutive-cases
#5
Ameer Alyeldien, Suzin Jung, Mark Lienert, Martin Scholz, Athanasios K Petridis
BACKGROUND: Based upon our excellent previous experience with 151 adult patients and 39 children whom had the peritoneal catheter in ventriculoperitoneal shunting placed laparoscopically, we continued following this technique as a first-line-procedure in ventriculoperitoneal shunting. Now we analyzed our experience with additional 405 cases for a better comprehension of the complications, advantages and disadvantages of this procedure on this high number of patients. A strict interdisciplinary setting with the maximum of medical intraoperative competence was our goal and therefore better results...
September 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27177961/nonsurgical-embryo-recovery-and-transfer-in-sheep-and%C3%A2-goats
#6
REVIEW
Jeferson F Fonseca, Joanna Maria G Souza-Fabjan, Maria Emília F Oliveira, Ceci R Leite, Paula Maria P Nascimento-Penido, Felipe Z Brandão, Khoboso C Lehloenya
The embryo transfer techniques used in small ruminants worldwide are based in surgical procedures. These actions are performed under general anesthesia which needs a combination of animal fasting and drugs for secure animal handling and surgery manipulations. Therefore, it involves risks to animal health and life. The major limiting sequels are adhesions formed by the abdominal surgery, in the ovaries, uterus, or between them. These occurrences can both compromise uterus accessing and oocyte capture and are responsible for decreasing success and limiting successive embryo collections...
July 1, 2016: Theriogenology
https://www.readbyqxmd.com/read/27166876/surgical-fasting-guidelines-in-children-are-we-putting-them-into-practice
#7
Kim Brunet-Wood, Mariska Simons, Amanda Evasiuk, Vera Mazurak, Bryan Dicken, Denise Ridley, Bodil Larsen
BACKGROUND: Patients are traditionally kept fasting (NPO) from midnight prior to surgery, to prevent aspiration during anesthesia. NPO time is continued postoperatively, out of concern for ileus. Prolonged periods of NPO place the pediatric population at risk for under-nutrition. Published guidelines for preoperative NPO times have been shown to be safe. The aim of this study was to investigate current pre- and postoperative feeding practices of children at a pediatric tertiary care hospital...
August 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26734794/fasting-in-elective-surgical-patients-comparison-among-the-time-prescribed-performed-and-recommended-on-perioperative-care-protocols
#8
Saionara Cristina Francisco, Sandra Teixeira Batista, Geórgia das Graças Pena
BACKGROUND: Prolonged preoperative fasting may impair nutritional status of the patient and their recovery. In contrast, some studies show that fasting abbreviation can improve the response to trauma and decrease the length of hospital stay. AIM: Investigate whether the prescribed perioperative fasting time and practiced by patients is in compliance with current multimodal protocols and identify the main factors associated. METHODS: Cross-sectional study with 65 patients undergoing elective surgery of the digestive tract or abdominal wall...
November 2015: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/26585767/rethinking-general-anesthesia-for-cesarean-section
#9
REVIEW
Hiroyiki Sumikura, Hidetomo Niwa, Masaki Sato, Tatsuo Nakamoto, Takashi Asai, Satoshi Hagihira
In this review, we describe the current consensus surrounding general anesthetic management for cesarean section. For induction of anesthesia, rapid-sequence induction using thiopental and suxamethonium has been the recommended standard for a long time. In recent years, induction of anesthesia using propofol, rocuronium, and remifentanil have been gaining popularity. To prevent aspiration pneumonia, a prolonged preoperative fasting and an application of cricoid pressure during induction of anesthesia have been recommended, but these practices may require revision...
April 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/26321152/dopamine-uptake-dynamics-are-preserved-under-isoflurane-anesthesia
#10
Zachary D Brodnik, Rodrigo A España
Fast scan cyclic voltammetry is commonly used for measuring the kinetics of dopamine release and uptake. For experiments using an anesthetized preparation, urethane is preferentially used because it does not alter dopamine uptake kinetics compared to freely moving animals. Unfortunately, urethane is highly toxic, can induce premature death during experiments, and cannot be used for recovery surgeries. Isoflurane is an alternative anesthetic that is less toxic than urethane, produces a stable level of anesthesia over extended periods, and is often used for recovery surgeries...
October 8, 2015: Neuroscience Letters
https://www.readbyqxmd.com/read/26306695/the-ventrolateral-preoptic-nucleus-is-required-for-propofol-induced-inhibition-of-locus-coeruleus-neuronal-activity
#11
Yu Zhang, Tian Yu, Jie Yuan, Bu-Wei Yu
The mechanisms underlying the unconsciousness of general anesthesia are not completely understood. Accumulating evidence indicates the ventrolateral preoptic nucleus (VLPO) in the endogenous sleep circuits may contribute to loss of consciousness (LOC) induced by GABA-enhancing anesthetics. However, there are few studies that look into distinct sleep pathway in the sleep-wake system. In the neural pathway from VLPO to the locus coeruleus (LC), we compared the inhibition effect of propofol on the LC activity before and after VLPO lesion in vivo rats...
December 2015: Neurological Sciences
https://www.readbyqxmd.com/read/26057879/speed-spinal-anesthesia-revisited-new-drugs-and-their-clinical-effects
#12
REVIEW
Hinnerk Wulf, Karl Hampl, Thorsten Steinfeldt
PURPOSE OF REVIEW: Spinal anesthesia (SPA) has not been popular for day-case surgery because of prolonged neurologic blockade with long-acting local anesthetics such as bupivacaine, thereby delaying discharge. Although the intermediate duration of action of lidocaine and mepivacaine appears to be more suitable for day-case surgery, their use is not deemed appropriate by many because of a high incidence of transient neurologic symptoms (TNSs). The present review summarizes recent clinical data on the intrathecal use of alternative local anesthetics and adjuvants that may offer valuable alternatives to general anesthesia in day-case surgery...
October 2013: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/25757552/cafedrine-theodrenaline-in-anaesthesia-influencing-factors-in-restoring-arterial-blood-pressure
#13
A R Heller, J Heger, M Gama de Abreu, M P Müller
BACKGROUND: Hypotensive states that require fast stabilisation of blood pressure can occur during anaesthesia. In 1963, the 20:1 mixture of cafedrine/theodrenaline (Akrinor) was introduced in Germany for use in anaesthesia and emergency medicine in the first-line management of hypotensive states. Though on the market for many years, few pharmacodynamic data are available on this combination net beta-mimetic agent. AIM: This study aimed to examine the drug combination in real-life clinical practice and recorded time to 10 % mean arterial blood pressure (MAP) increase and heart rate...
March 2015: Der Anaesthesist
https://www.readbyqxmd.com/read/25427337/safety-of-a-no-fast-protocol-for-tracheotomy-in-critical-care
#14
Trevor Hartl, Donald Anderson, Jasna Levi
With modern anesthesia, aspiration is an exceedingly rare complication, and we have learned that a prolonged fast can result in serious adverse effects in critically ill patients. We discuss the no-fast protocol implemented at Vancouver General Hospital in 2007 for intubated, tube-fed adult patients who underwent elective open tracheotomy.
November 25, 2014: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/25190943/safety-profile-of-fast-track-extubation-in-pediatric-congenital-heart-disease-surgery-patients-in-a-tertiary-care-hospital-of-a-developing-country-an-observational-prospective-study
#15
Mohammad Irfan Akhtar, Mohammad Hamid, Fauzia Minai, Amina Rehmat Wali, Anwar-Ul-Haq, Muneer Aman-Ullah, Khalid Ahsan
BACKGROUND AND AIMS: Early extubation after cardiac operations is an important aspect of fast-track cardiac anesthesia. In order to reduce or eliminate the adverse effects of prolonged ventilation in pediatric congenital heart disease (CHD) surgical patients, the concept of early extubation has been analyzed at our tertiary care hospital. The current study was carried out to record the data to validate the importance and safety of fast-track extubation (FTE) with evidence. MATERIALS AND METHODS: A total of 71 patients, including male and female aged 6 months to 18 years belonging to risk adjustment for congenital heart surgery-1 category 1, 2, and 3 were included in this study...
July 2014: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/25107500/anesthetic-management-of-comprehensive-dental-restoration-in-a-child-with-glutaric-aciduria-type-1-using-volatile-sevoflurane
#16
Wei-Nung Teng, Su-Man Lin, Dau-Ming Niu, Yi-Min Kuo, Kwok-Hon Chan, Chun-Sung Sung
Glutaric aciduria type 1 (GA1) is a rare, inherited mitochondrial disorder that results from deficiency of mitochondrial glutaryl-CoA dehydrogenase. Most patients develop neurological dysfunction early in life, which leads to severe disabilities. We present a 37-month-old girl with GA1 manifested as macrocephaly and hypotonia who received comprehensive dental restoration surgery under general anesthesia with sevoflurane. She was placed on specialized fluid management during a preoperative fasting period and anesthesia was administered without complications...
October 2014: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/25057840/alterations-in-the-functional-connectivity-of-frontal-lobe-networks-preceding-emergence-delirium-in-children
#17
Jessica C Martin, David T J Liley, A Simon Harvey, Levin Kuhlmann, Jamie W Sleigh, Andrew J Davidson
BACKGROUND: This study aimed to characterize the electroencephalogram in children who emerged with emergence delirium (ED) compared with children without ED using methods that involved the assessment of cortical functional connectivity. METHODS: Children aged 5 to 15 yr had multichannel electroencephalographic recordings during induction and emergence from anesthesia during minor surgical procedures. Of these, five children displayed ED after sevoflurane anesthesia...
October 2014: Anesthesiology
https://www.readbyqxmd.com/read/24783622/-efficacy-and-safety-of-remifentanil-based-regimen-for-postoperative-pain-management-in-abdominal-surgery-patients-a-double-blind-study-with-low-dose-remifentanil-infusion-of-0-02-microg-x-kg-1-x-min-1
#18
RANDOMIZED CONTROLLED TRIAL
Yukiko Nagasaka, Masaki Wakamatsu, Hiroko Hirano, Reimi Shirasaki, Takeshi Kaida, Asami Machino
BACKGROUND: Remifentanil is a powerful analgesic with fast onset and ultra-short duration of action. Its context-sensitive half-time is consistently short even after a prolonged infusion. Remifentanil is effective for providing better postoperative analgesia, but this method is not generally accepted in Japan. The present study was conducted to document efficacy and safety of low-dose remifentanil infusion in postoperative patients. METHODS: Forty patients undergoing abdominal surgery were studied prospectively...
April 2014: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/24748347/audit-on-preoperative-fasting-of-elective-surgical-patients-in-an-african-academic-medical-center
#19
Endale Gebreegziabher Gebremedhn, Vidhya Bates Nagaratnam
BACKGROUND: Preoperative fasting is a requisite before anesthesia. The main reason for preoperative fasting is to reduce gastric volume and acidity and thus decrease the risk of pulmonary aspiration. However, preoperative fasting is usually prolonged beyond the recommended time for various reasons. Despite the many adverse effects of prolonged fasting, patients sometimes fasted for a prolonged time when surgery was delayed for different reasons at the University of Gondar Hospital. The aim of this study was to assess the duration of preoperative fasting for elective surgery...
September 2014: World Journal of Surgery
https://www.readbyqxmd.com/read/24521192/analgesic-considerations-for-liver-transplantation-patients
#20
REVIEW
Sher-Lu Pai, Stephen Aniskevich, Eduardo S Rodrigues, Timothy S Shine
Orthotopic liver transplantation (OLT) recipients have been reported to have decreased perioperative opioid and intraoperative inhalational anesthetic requirements when compared to patients without liver disease undergoing other types of major abdominal surgeries. The severity of the liver disease and the process of the transplantation itself may alter the pharmacokinetic and pharmacodynamic effects of different pain medications. Chemical injury of the liver and the high degree of surgical stress may also increase the levels of neuropeptides involved in pain modulation...
2015: Current Clinical Pharmacology
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