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Anaesthetics

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https://www.readbyqxmd.com/read/29457215/the-effect-of-anaesthetic-technique-during-primary-breast-cancer-surgery-on-neutrophil-lymphocyte-ratio-platelet-lymphocyte-ratio-and-return-to-intended-oncological-therapy
#1
A Ní Eochagáin, D Burns, B Riedel, D I Sessler, D J Buggy
Inflammation and immunosuppression contribute to the pathogenesis of cancer. An increased neutrophil-lymphocyte ratio reflects these processes and is associated with adverse cancer outcomes. Whether anaesthetic technique for breast cancer surgery influences these factors, and potentially cancer recurrence, remains unknown. We conducted a secondary analysis in patients enrolled in an ongoing trial of anaesthetic technique on breast cancer recurrence. The primary hypothesis was that postoperative neutrophil-lymphocyte ratio is lower in patients allocated to receive propofol-paravertebral rather than inhalational agent-opioid anaesthesia for primary breast cancer surgery...
February 19, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29456834/a-retrospective-report-2003-2013-of-the-complications-associated-with-the-use-of-a-one-man-head-and-tail-rope-recovery-system-in-horses-following-general-anaesthesia
#2
Maria Chie Niimura Del Barrio, Florent David, J M Lynne Hughes, David Clifford, Hans Wilderjans, Rachel Bennett
Background: The mortality rate of horses undergoing general anaesthesia is high when compared to humans or small animal patients. One of the most critical periods during equine anaesthesia is recovery, as the horse attempts to regain a standing position. This study was performed in a private equine practice in Belgium that uses a purpose-designed one-man (head and tail) rope recovery system to assist the horse during the standing process.The main purpose of the retrospective study was to report and analyse complications and the mortality rate in horses during recovery from anaesthesia using the described recovery system...
2018: Irish Veterinary Journal
https://www.readbyqxmd.com/read/29456391/the-use-of-thromboelastography-to-measure-the-influence-inclusion-of-a-local-anesthetic-agent-has-on-the-mechanical-and-kinetic-properties-of-fibrin
#3
Laura Kearney, Derek Whelan, Brian D O'Donnell, Anthony J P Clover
Context: Delivery of slow-release local anesthesia has considerable potential for postoperative analgesia. Fibrin gel has shown huge potential for drug delivery, but has not been fully investigated for the delivery of local anesthetics nor has whether incorporation of anesthetic drugs into fibrin alters its mechanical properties. Aims: This study aimed to evaluate the effects of bupivacaine inclusion on the mechanical and kinetic properties of fibrin as measured by thromboelastography (TEG)...
January 2018: Journal of Natural Science, Biology, and Medicine
https://www.readbyqxmd.com/read/29455911/trauma-theatre-productivity-does-the-individual-surgeon-anaesthetist-or-consultant-presence-matter
#4
Gareth S Turnbull, Mounir Hakimi, George J McLauchlan
INTRODUCTION: With rising NHS clinical and financial demands, improving theatre efficiency is essential to maintain quality of patient care. Consistent teams and consultant presence have been shown to improve outcomes and productivity in elective orthopaedic surgery. The aim of this study was to investigate the impact on trauma theatre productivity of different surgeons and anaesthetists working together in a Major Trauma Centre. The influence of consultant presence and weekend operating on productivity was also considered...
February 12, 2018: Injury
https://www.readbyqxmd.com/read/29454629/postoperative-pain-and-analgesia-administration-in-children-after-urological-outpatient-procedures
#5
A Schröder, F A Campbell, W A Farhat, J L Pippi Salle, D J Bägli, A J Lorenzo, M A Koyle
INTRODUCTION: There are limited data about pain patterns, analgesic requirements and factors predicting opioid requirements of children undergoing outpatient urologic surgery. This prospective study aimed to assess recovery profiles and pain medication requirements. METHODS: Patients between 6 months and 12 years of age were recruited prospectively between December 2013 and June 2014. Demographic and operative characteristics were collected. Following discharge home, the parents were asked to administer both acetaminophen and ibuprofen Q6H at a weight-adjusted dose, based on a schedule, until the end of postoperative day 2, and to administer the medication as required on postoperative day 3...
January 31, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29453466/effects-of-intrathecal-dexmedetomidine-as-an-adjuvant-to-hyperbaric-bupivacaine-for-spinal-anaesthesia-in-adults-undergoing-elective-infra-umbilical-surgery
#6
Binod Gautam, Sujata Niroula, Mona Sharma, Sushila Moktan Lama
INTRODUCTION: Various adjuvants to local anaesthetic are used to improve quality and duration of spinal anaesthesia. Dexmedetomidine, a novel alpha-2 adrenergic agonist, has been proposed to augment local anaesthetic effects. This study aims to investigate effects of intrathecal Dexmedetomidine on duration of analgesia and duration of sensory block during spinal anaesthesia. METHODS: In this randomized double-blind study 38 patients were allocated into each of two groups...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29452813/incidence-characteristics-and-predictive-factors-for-medication-errors-in-paediatric-anaesthesia-a-prospective-incident-monitoring-study
#7
C Gariel, B Cogniat, F-P Desgranges, D Chassard, L Bouvet
BACKGROUND: Medication errors are not uncommon in hospitalized patients. Paediatric patients may have increased risk for medication errors related to complexity of weight-based dosing calculations or problems with drug preparation and dilution. This study aimed to determine the incidence of medication errors in paediatric anaesthesia in a university paediatric hospital, and to identify their characteristics and potential predictive factors. METHODS: This prospective incident monitoring study was conducted between November 2015 and January 2016 in an exclusively paediatric surgical centre...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452809/test-of-neural-inertia-in-humans-during-general-anaesthesia
#8
M H Kuizenga, P J Colin, K M E M Reyntjens, D J Touw, H Nalbat, F H Knotnerus, H E M Vereecke, M M R F Struys
BACKGROUND: Neural inertia is defined as the tendency of the central nervous system to resist transitions between arousal states. This phenomenon has been observed in mice and Drosophila anaesthetized with volatile anaesthetics: the effect-site concentration required to induce anaesthesia in 50% of the population (C50 ) was significantly higher than the effect-site concentration for 50% of the population to recover from anaesthesia. We evaluated this phenomenon in humans using propofol or sevoflurane (both with or without remifentanil) as anaesthetic agents...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452806/steroid-administration-after-anaesthetic-induction-with-etomidate-does-not-reduce-in-hospital-mortality-or-cardiovascular-morbidity-after-non-cardiac-surgery
#9
R Komatsu, J You, S Rajan, Y Kasuya, D I Sessler, A Turan
BACKGROUND: We tested the primary hypothesis that corticosteroid administration after etomidate exposure reduces a composite of in-hospital mortality and cardiovascular morbidity after non-cardiac surgery. METHODS: We evaluated ASA physical status III and IV patients who had non-cardiac surgery with general anaesthesia at the Cleveland Clinic. Amongst 4275 patients in whom anaesthesia was induced with etomidate, 804 were also given steroid intraoperatively, mostly dexamethasone at a median dose of 6 mg...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452805/perioperative-cardiopulmonary-exercise-testing-cpet-consensus-clinical-guidelines-on-indications-organization-conduct-and-physiological-interpretation
#10
D Z H Levett, S Jack, M Swart, J Carlisle, J Wilson, C Snowden, M Riley, G Danjoux, S A Ward, P Older, M P W Grocott
The use of perioperative cardiopulmonary exercise testing (CPET) to evaluate the risk of adverse perioperative events and inform the perioperative management of patients undergoing surgery has increased over the last decade. CPET provides an objective assessment of exercise capacity preoperatively and identifies the causes of exercise limitation. This information may be used to assist clinicians and patients in decisions about the most appropriate surgical and non-surgical management during the perioperative period...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452802/moving-to-human-trials-for-argon-neuroprotection-in-neurological-injury-a-narrative-review
#11
REVIEW
A J Gardner, D K Menon
Despite the global burden of brain injury, neuroprotective agents remain elusive. There are no clinically effective therapies which reduce mortality or improve long-term cognitive outcome. Ventilation could be an easily modifiable variable in resuscitation; gases are relatively simple to administer. Xenon is the prototypic agent of a new generation of experimental treatments which show promise. However, use is hindered by its prohibitive cost and anaesthetic properties. Argon is an attractive option, being cheaper, easy to transport, non-sedating, and mechanistically distinct from xenon...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452797/reconceptualising-stroke-research-to-inform-the-question-of-anaesthetic-neurotoxicity
#12
EDITORIAL
P E Vlisides, M S Avidan, G A Mashour
No abstract text is available yet for this article.
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452205/impaired-cerebral-microcirculation-induced-by-ammonium-chloride-in-rats-is-due-to-cortical-adenosine-release
#13
Peter Nissen Bjerring, Esben Jannik Bjerrum, Fin Stolze Larsen
BACKGROUND: Liver failure results in hyperammonaemia, impaired regulation of cerebral microcirculation, encephalopathy and death. However, the key mediator that alters cerebral microcirculation remains unidentified. In this study we show that topical ammonium significantly increases periarteriolar adenosine tone on the brain surface of healthy rats and is associated with a disturbed microcirculation. METHODS: Cranial windows were prepared in anaesthetized Wistar rats...
February 13, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29451906/brain-changes-due-to-hypoxia-during-light-anaesthesia-can-be-prevented-by-deepening-anaesthesia-a-study-in-rats
#14
Setayesh R Tasbihgou, Mina Netkova, Alain F Kalmar, Janine Doorduin, Michel M R F Struys, Regien G Schoemaker, Anthony R Absalom
In anaesthetic practice the risk of cerebral ischemic/hypoxic damage is thought to be attenuated by deep anaesthesia. The rationale is that deeper anaesthesia reduces cerebral oxygen demand more than light anaesthesia, thereby increasing the tolerance to ischemia or hypoxia. However, evidence to support this is scarce. We thus investigated the influence of light versus deep anaesthesia on the responses of rat brains to a period of hypoxia. In the first experiment we exposed adult male Wistar rats to deep or light propofol anaesthesia and then performed [18F]- Fludeoxyglucose (FDG) Positron Emission Tomography (PET) scans to verify the extent of cerebral metabolic suppression...
2018: PloS One
https://www.readbyqxmd.com/read/29451416/refinement-of-in-vivo-optical-imaging-development-of-a-real-time-respiration-monitoring-system
#15
Ana L Gomes, Stuart Gilchrist, Veerle Kersemans, Marcus Westcott, Sean Smart
In vivo optical imaging enables detection and quantification of light-emitting compounds from the whole body in small animals such as the mouse, but it typically requires the use of anaesthetics for subject immobilisation due to long exposure times. Excessively deep anaesthesia can result in unacceptably compromised physiology, whilst excessively light anaesthesia can result in animals waking up. Here we report a respiratory monitoring setup for an in vivo bioluminescence and fluorescence imaging device which simultaneously allows real-time adaptive control of anaesthesia depth in multiple animals to (i) potentially increase the consistency between animals, (ii) ensure animals are maintained within minimally intrusive, adequate anaesthetic plane and (iii) provide a valuable refinement strategy for a common challenge within animal-based research...
January 1, 2018: Laboratory Animals
https://www.readbyqxmd.com/read/29448876/evaluation-of-injectable-anaesthesia-with-five-medetomidine-midazolam-based-combinations-in-egyptian-fruit-bats-rousettus-aegyptiacus
#16
Avishag Tuval, Liora Las, Yael Shilo-Benjamini
Egyptian fruit bats are increasingly used as model animals in neuroscience research. Our aim was to characterize suitable injectable anaesthesia for this species, possibly replacing inhalant anaesthesia, thus minimizing occupational health hazards. Eight bats were randomly assigned by a crossover design for subcutaneously administered combinations of medetomidine-midazolam with: saline (MM-Sal), ketamine (MM-Ket), fentanyl (MM-Fen), morphine (MM-Mor), or butorphanol (MM-But). The anaesthetic depth and vital signs were monitored at baseline and every 10 min until bats recovered...
January 1, 2018: Laboratory Animals
https://www.readbyqxmd.com/read/29446060/effect-of-adding-midazolam-to-bupivacaine-during-rectus-sheath-block-a-randomised-controlled-trial
#17
A Ammar, K Mahmoud, Z Kasemy
BACKGROUND: Various adjuvants have been tried to improve quality and increase duration of local anaesthetics during various nerve blocks. We aimed to evaluate the effect of adding midazolam to bupivacaine on rectus sheath (RS) block in patients undergoing umbilical or epigastric hernia repair. METHODS: In all, 60 adult patients were divided into two equal groups, each group included 30 patients. Group I received 20 ml of bupivacaine hydrochloride 0.25% + midazolam 50 μg/kg in 2 ml saline 0...
February 14, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29443073/percutaneous-contrast-echocardiography-guided-intramyocardial-injection-and-cell-delivery-in-a-large-preclinical-model
#18
Alejandro Giraldo, Jesús Talavera López, Maria Josefa Fernandez-Del-Palacio, Obdulio García-Nicolás, Juan Seva, Gavin Brooks, José María Moraleda
Cell and gene therapy are exciting and promising strategies for the purpose of cardiac regeneration in the setting of heart failure with reduced ejection fraction (HFrEF). Before they can be considered for use, and implemented in humans, extensive preclinical studies are required in large animal models to evaluate the safety, efficacy, and fate of the injectate (e.g., stem cells) once delivered into the myocardium. Small rodent models offer advantages (e.g., cost effectiveness, amenability for genetic manipulation); however, given inherent limitations of these models, the findings in these rarely translate into the clinic...
January 21, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29442191/measurement-and-implications-of-the-distance-between-the-sphenopalatine-ganglion-and-nasal-mucosa-a-neuroimaging-study
#19
Joan Crespi, Daniel Bratbak, David Dodick, Manjit Matharu, Kent Are Jamtøy, Irina Aschehoug, Erling Tronvik
BACKGROUND: Historical reports describe the sphenopalatine ganglion (SPG) as positioned directly under the nasal mucosa. This is the basis for the topical intranasal administration of local anaesthetic (LA) towards the sphenopalatine foramen (SPF) which is hypothesized to diffuse a distance as short as 1 mm. Nonetheless, the SPG is located in the sphenopalatine fossa, encapsulated in connective tissue, surrounded by fat tissue and separated from the nasal cavity by a bony wall. The sphenopalatine fossa communicates with the nasal cavity through the SPF, which contains neurovascular structures packed with connective tissue and is covered by mucosa in the nasal cavity...
February 13, 2018: Journal of Headache and Pain
https://www.readbyqxmd.com/read/29442160/peri-articular-injection-of-an-analgesic-mixture-in-primary-total-hip-arthroplasty-an-effective-strategy-for-pain-control-during-the-first-post-operative-day
#20
Maria Bautista, Meilyn Muskus, Adolfo Llinás, Guillermo Bonilla, Carlos Guerrero, Jairo Moyano
BACKGROUND: Previous studies of soft tissue infiltration in hip arthroplasty present variable results. The purpose of this study is to identify whether injection of an analgesic mixture improves pain management during the immediate post-operative period. MATERIALS AND METHODS: This cohort study compared 129 patients that received peri-articular soft tissue injection with 20 ml of 0.25% bupivacaine and 2 ml of ketorolac (30 mg/1 ml) in 28 ml of saline solution, with 71 patients who did not received injections...
February 13, 2018: International Orthopaedics
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