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prolonged fasting anesthesia

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https://www.readbyqxmd.com/read/29700894/consensus-statement-on-clear-fluids-fasting-for-elective-pediatric-general-anesthesia
#1
Mark Thomas, Christa Morrison, Richard Newton, Ehrenfried Schindler
Pediatric anesthetic guidelines for the management of preoperative fasting of clear fluids are currently 2 hours. The traditional 2 hours clear fluid fasting time was recommended to decrease the risk of pulmonary aspiration and is not in keeping with current literature. It appears that a liberalized clear fluid fasting regime does not affect the incidence of pulmonary aspiration and in those who do aspirate, the sequelae are not usually severe or long-lasting. With a 2-hour clear fasting policy, the literature suggests that this translates into 6-7 hours actual duration of fasting with several studies up to 15 hours...
May 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29524770/following-up-skin-penetration-of-lidocaine-from-different-vehicles-by-raman-spectroscopic-mapping
#2
Mónika Bakonyi, Attila Gácsi, Anita Kovács, Mária-Budai Szűcs, Szilvia Berkó, Erzsébet Csányi
The application of local anesthetics, usually administered by subcutaneous injection, is common in the course of diagnostic, therapeutic, and cosmetic dermatology procedures. The effective dermal delivery of lidocaine could offer a solution to many adverse effects caused by needle insertion, such as pain, local reactions or toxicity, and additionally, it avoids the disruption of anatomical landmarks. Therefore, novel dermal formulations of local anesthetics are needed to overcome the barrier function of the skin and provide sufficient and prolonged anesthesia...
May 30, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29443724/preoperative-fasting-guidelines-in-pediatric-anesthesia-are-we-ready-for-a-change
#3
Hanna Andersson, Achim Schmitz, Peter Frykholm
PURPOSE OF REVIEW: Study after study shows that prolonged fasting before anesthesia is common in children. Pediatric anesthesiologists around the world are concerned that the current guidelines may be part of the problem. This review focuses on what can be done about it. RECENT FINDINGS: We discuss new insights into the physiology of gastric emptying of different categories of food and drink. The evidence for negative effects of prolonged fasting occurring in spite of implementation of the current guidelines is examined...
February 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29200368/influence-of-fasting-duration-on-body-fluid-and-hemodynamics
#4
Masanori Tsukamoto, Takashi Hitosugi, Takeshi Yokoyama
Fasting before general anesthesia aims to reduce the volume and acidity of stomach contents, which reduces the risk of regurgitation and aspiration. Prolonged fasting for many hours prior to surgery could lead to unstable hemodynamics, however. Therefore, preoperative oral intake of clear fluids 2 hours prior to surgery is recommended to decrease dehydration without an increase in aspiration risk. In this study, we investigated the body fluid composition and hemodynamics of patients undergoing general anesthesia as the first case of the day versus the second subsequent case...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/29032903/single-shot-femoral-nerve-block-does-not-cause-long-term-strength-and-functional-deficits-following-anterior-cruciate-ligament-reconstruction
#5
Kelechi R Okoroha, Lafi Khalil, Edward K Jung, Robert A Keller, Nathan E Marshall, Moneer Abouljoud, Derek Chan, Vasilios Moutzouros
PURPOSE: To determine if patients treated with a single-shot femoral nerve block have strength and functional deficits at 9-month follow-up. METHODS: Forty-three patients who underwent primary anterior cruciate ligament reconstructions were randomized to receive either a preoperative single-shot femoral nerve block or local infiltration anesthesia for primary pain control. All patients underwent a standardized comprehensive rehabilitation program postoperatively...
January 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28856114/total-intravenous-anesthesia-for-neurosurgical-procedures-in-narcoleptic-patients-two-case-reports
#6
Sara Pedrosa, Nuno Lareiro, Pedro Amorim
INTRODUCTION: Narcoleptic patients may be at increased risk of prolonged emergence, postoperative hypersomnia, apneic episodes, and sleep paralysis after general anesthesia. Modafinil is the first-line treatment, however, the implication it has on general anesthesia is not clear. This report present 2 cases of narcoleptic patients medicated with modafinil that were submitted to total intravenous anesthesia for neurosurgical procedures. CASE PRESENTATION: Informed consent was obtained from both patients...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28611004/an-in-situ-forming-phospholipid-based-phase-transition-gel-prolongs-the-duration-of-local-anesthesia-for-ropivacaine-with-minimal-toxicity
#7
Hanmei Li, Tao Liu, Yuxuan Zhu, Qiang Fu, Wanxia Wu, Jie Deng, Li Lan, Sanjun Shi
An injectable, phospholipid-based phase transition gel (PPTG) has been developed for prolonging the release of ropivacaine (RO) for local anesthesia. PPTG was prepared by mixing phospholipids, medium-chain triglyceride and ethanol. Prior to injection, the PPTG is in a sol state with low viscosity. After subcutaneous injection, the PPTG rapidly forms a gel in situ, which acts as a drug release depot as verified by in vitro release profiles and in vivo pharmacokinetics. Administering RO-PPTG to rats led to a significantly smaller initial burst release than administering RO solution or RO base suspension...
August 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28487877/preoperative-fasting-among-adult-patients-for-elective-surgery-in-a-kenyan-referral-hospital
#8
George Njoroge, Lucy Kivuti-Bitok, Samuel Kimani
Background. Preoperative fasting (POF) is physiologically and precautionary important during anesthesia and surgery. POF from midnight has been practiced despite the recommended shorter practice. Objective. Assessing preoperative fasting among adult patients scheduled for elective surgery at Kenyatta National Hospital (KNH). Methods. A descriptive cross-sectional study involving 65 surgical patients. A questionnaire of mixed questions on demographics, reasons, source of instructions, opinion on instructions, time, premedication practices, outcome, and complains on NPO was used...
2017: International Scholarly Research Notices
https://www.readbyqxmd.com/read/28394849/inhibition-of-voltage-gated-na-channels-by-bupivacaine-is-enhanced-by-the-adjuvants-buprenorphine-ketamine-and-clonidine
#9
Carsten Stoetzer, Christine Martell, Jeanne de la Roche, Andreas Leffler
BACKGROUND AND OBJECTIVES: Regional anesthesia includes application of local anesthetics (LAs) into the vicinity of peripheral nerves. Prolongation or improvement of nerve blocks with LAs can be accomplished by coapplication with adjuvants, including buprenorphine, ketamine, and clonidine. While the mechanisms mediating prolonged or improved LA-induced effects by adjuvants are poorly understood, we hypothesized that they are likely to increase LA-induced block of voltage-gated Na channels...
July 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28094665/fdg-pet-reproducibility-in-tumor-bearing-mice-comparing-a-traditional-suv-approach-with-a-tumor-to-brain-tissue-ratio-approach
#10
Morten Busk, Ole L Munk, Steen Jakobsen, Jørgen Frøkiær, Jens Overgaard, Michael R Horsman
BACKGROUND: Current [F-18]-fluorodeoxyglucose positron emission tomography (FDG-PET) procedures in tumor-bearing mice typically includes fasting, anesthesia, and standardized uptake value (SUV)-based quantification. Such procedures may be inappropriate for prolonged multiscan experiments. We hypothesize that normalization of tumor FDG retention relative to a suitable reference tissue may improve accuracy as this method may be less susceptible to uncontrollable day-to-day changes in blood glucose levels, physical activity, or unnoticed imperfect tail vein injections...
May 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28068408/pharmacokinetics-of-lidocaine-hydrochloride-administered-with-or-without-adrenaline-for-the-paravertebral-brachial-plexus-block-in-dogs
#11
Amélie Choquette, Eric Troncy, Martin Guillot, France Varin, Jérôme R E Del Castillo
Adrenaline is known to prolong the duration of local anesthesia but its effects on the pharmacokinetic processes of local anesthetic drugs are not fully understood. Our objective was to develop a compartmental model for quantification of adrenaline's impact on the pharmacokinetics of perineurally-injected lidocaine in the dog. Dogs were subjected to paravertebral brachial plexus block using lidocaine alone or adrenalinated lidocaine. Data was collected through a prospective, randomised, blinded crossover protocol performed over three periods...
2017: PloS One
https://www.readbyqxmd.com/read/27896927/a-retrospective-review-of-anesthesia-and-perioperative-care-in-children-with-medium-chain-acyl-coa-dehydrogenase-deficiency
#12
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...
January 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27895555/spike-timing-rigidity-is-maintained-in-bursting-neurons-under-pentobarbital-induced-anesthetic-conditions
#13
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
#14
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
#15
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...
2017: JIMD Reports
https://www.readbyqxmd.com/read/27494998/laparoscopic-insertion-of-the-peritoneal-catheter-in-ventriculoperitoneal-shunting-review-of-405-consecutive-cases
#16
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
#17
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
#18
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
#19
COMPARATIVE STUDY
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
#20
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
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