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Vasopressor and Anesthesia

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https://www.readbyqxmd.com/read/28920051/comparison-of-1-and-2-minute-sitting-positions-versus-immediately-lying-down-on-hemodynamic-variables-after-spinal-anesthesia-with-hyperbaric-bupivacaine-in-elective-cesarean-section
#1
Pooran Hajian, Mahshid Nikooseresht, Tayebe Lotfi
BACKGROUND: Hypotension is one of the most common complications of spinal anesthesia in parturients undergoing cesarean section. In this regard, the patient's position may affect the incidence of hypotension. OBJECTIVES: In this clinical trial, we evaluated the effects of 1- and 2-minute sitting positions versus immediately lying down after spinal anesthesia on hypotension and vasopressor requirements. METHODS: A total of 72 parturients, scheduled for cesarean section under spinal anesthesia, were randomly divided into 3 groups (24 subjects per group)...
April 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28918427/safety-of-monitored-anesthesia-care-using-propofol-based-sedation-for-pleuroscopy
#2
Erik Vakil, Mona Sarkiss, David Ost, Macarena R Vial, Roberto F Casal, Georgie A Eapen, Horiana B Grosu
BACKGROUND: The optimal approach to sedation for pleuroscopy remains undefined. Propofol is the favored sedative-hypnotic for many proceduralists but has a narrow therapeutic window and the risk for oversedation is high. Propofol-based sedation administered by anesthesiologists and the routine use of end-tidal capnography and bispectral index (BIS) monitoring may attenuate risks of complications. OBJECTIVES: The purpose of our study was to evaluate the safety and efficacy of monitored anesthesia care for pleuroscopy...
September 16, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28913488/bilateral-thoracic-paravertebral-nerve-blocks-for-placement-of-percutaneous-radiologic-gastrostomy-in-patients-with-amyotrophic-lateral-sclerosis-a-case-series
#3
Arun Kalava, Steven Clendenen, J Mark McKinney, Elird Bojaxhi, Roy A Greengrass
BACKGROUND AND AIMS: To assess the efficacy of bilateral thoracic paravertebral nerve blocks (PVB) in providing procedural anesthesia and post-procedural analgesia for placement of percutaneous radiologic gastrostomy tubes (PRG) in patients with amyotrophic lateral sclerosis (ALS). METHODS: We prospectively observed 10 patients with ALS scheduled for PRG placement that had bilateral thoracic PVBs at thoracic 7, 8, and 9 levels with administration of a mixture of 3 mL of 1% ropivacaine, 0...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28893702/risk-factors-associated-with-perioperative-myocardial-infarction-in-major-open-vascular-surgery
#4
Danielle C Sutzko, Elizabeth A Andraska, Andrea T Obi, Peter K Henke, Nicholas H Osborne
BACKGROUND: Among patients undergoing non-cardiac surgery, major vascular surgery is associated with a high risk of perioperative myocardial infarction (MI). Currently there are no perioperative MI risk calculators accounting for intraoperative and postoperative risk factors in vascular surgery patients. We aimed to investigate specific risk factors for perioperative MI after major open vascular surgery to determine which patients are at highest risk of MI, and the association of perioperative MI with perioperative transfusion...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28874164/radiation-free-cmr-diagnostic-heart-catheterization-in-children
#5
Kanishka Ratnayaka, Joshua P Kanter, Anthony Z Faranesh, Elena K Grant, Laura J Olivieri, Russell R Cross, Ileen F Cronin, Karin S Hamann, Adrienne E Campbell-Washburn, Kendall J O'Brien, Toby Rogers, Michael S Hansen, Robert J Lederman
BACKGROUND: Children with heart disease may require repeated X-Ray cardiac catheterization procedures, are more radiosensitive, and more likely to survive to experience oncologic risks of medical radiation. Cardiovascular magnetic resonance (CMR) is radiation-free and offers information about structure, function, and perfusion but not hemodynamics. We intend to perform complete radiation-free diagnostic right heart catheterization entirely using CMR fluoroscopy guidance in an unselected cohort of pediatric patients; we report the feasibility and safety...
September 6, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28872734/xenon-as-an-adjuvant-to-sevoflurane-anesthesia-in-children-younger-than-4%C3%A2-years-of-age-undergoing-interventional-or-diagnostic-cardiac-catheterization-a-randomized-controlled-clinical-trial
#6
Sarah Devroe, Roselien Meeusen, Marc Gewillig, Bjorn Cools, Koen Poesen, Robert Sanders, Steffen Rex
BACKGROUND: Xenon has repeatedly been demonstrated to have only minimal hemodynamic side effects when compared to other anesthetics. Moreover, in experimental models, xenon was found to be neuroprotective and devoid of developmental neurotoxicity. These properties could render xenon attractive for the anesthesia in neonates and infants with congenital heart disease. However, experience with xenon anesthesia in children is scarce. AIMS: We hypothesized that in children undergoing cardiac catheterization, general anesthesia with a combination of sevoflurane with xenon results in superior hemodynamic stability, compared to sevoflurane alone...
September 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28872480/a-random-allocation-graded-dose-response-study-of-norepinephrine-and-phenylephrine-for-treating-hypotension-during-spinal-anesthesia-for-cesarean-delivery
#7
Warwick D Ngan Kee
BACKGROUND: Norepinephrine has been investigated as a potential alterative to phenylephrine for maintaining blood pressure during spinal anesthesia for cesarean delivery with the advantage of less depression of maternal heart rate and cardiac output. However, the relative potencies of these two vasopressors have not been fully determined in this context. METHODS: In a random-allocation, graded dose-response study, 180 healthy patients undergoing spinal anesthesia for elective cesarean delivery received a single bolus of norepinephrine in one of six different doses ranging from 4 to 12 µg or phenylephrine in one of six different doses ranging from 60 to 200 µg to treat the first episode of hypotension...
September 5, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28870386/-the-antimicrobial-activity-of-ephedrine-and-admixture-of-ephedrine-and-propofol-an-in-vitro-study
#8
Serkan Tulgar, Elcin Akduman Alasehir, Onur Selvi
INTRODUCTION: Propofol and Ephedrine are commonly used during anesthesia maintenance, the former as a hypnotic agent and the later as a vasopressor. The addition of propofol to ephedrine or administration of ephedrine before propofol injection is useful for decreasing or preventing propofol related hemodynamic changes and vascular pain. This in vitro study evaluated the antibacterial effect on common hospital-acquired infection pathogens of ephedrine alone or combined with propofol. MATERIAL AND METHOD: The study was performed in two stages...
September 1, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28860857/preventing-nausea-and-vomiting-in-women-undergoing-regional-anesthesia-for-cesarean-section-challenges-and-solutions
#9
REVIEW
Yvonne Jelting, Christian Klein, Thomas Harlander, Leopold Eberhart, Norbert Roewer, Peter Kranke
BACKGROUND: Intraoperative nausea and vomiting (IONV) or postoperative nausea and vomiting (PONV) affecting women undergoing regional anesthesia for cesarean section is an important clinical problem since these techniques are used widely. There are burdens of literature about IONV/PONV and several in parturient and cesarean. However, it needs more attention. The underlying mechanisms of IONV and PONV in the obstetrical setting mainly include hypotension due to sympathicolysis during neuraxial anesthesia, bradycardia owing to an increased vagal tone, the visceral stimulation via the surgical procedure and intravenously administered opioids...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28856631/implications-of-entropy-and-surgical-pleth-index-guided-general-anaesthesia-on-clinical-outcomes-in-critically-ill-polytrauma-patients-a-prospective-observational-non-randomized-single-centre-study
#10
Alexandru Florin Rogobete, Dorel Sandesc, Carmen Alina Cradigati, Mirela Sarandan, Marius Papurica, Sonia Elena Popovici, Corina Vernic, Ovidiu Horea Bedreag
Being highly unstable, the critically ill polytrauma patient represents a challenge for the anaesthesia team. The aim of this study was to compare the Entropy and Surgical Pleth Index (SPI)-guided general anaesthesia with standard haemodynamic monitoring methods used in the critically ill polytrauma patients and to evaluate the incidence of hemodynamic events, as well as the opioid and vasopressor demand. 72 patients were included in this prospective observational study, divided in two groups, the ESPI Group (N = 37, patients that benefited from Entropy and SPI monitoring) and the STDR Group (N = 35 patients that benefited from standard hemodynamic monitoring)...
August 30, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28856114/total-intravenous-anesthesia-for-neurosurgical-procedures-in-narcoleptic-patients-two-case-reports
#11
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/28804498/feasibility-of-cervical-epidural-anesthesia-for-breast-cancer-surgery
#12
Manuel Wenk, Christina Massoth, Daniel M Pöpping, Michael Möllmann
BACKGROUND: Effects of perioperative cervical level neuraxial blocks on the dissemination of cancer metastases have become a matter of substantial interest. However, experience with these catheters has been limited and data on feasibility and efficacy is sparse. METHODS: Data from 39 patients scheduled to undergo breast cancer surgery while awake with a cervical epidural alone was retrospectively analyzed. RESULTS: In 26 patients (66,7%, 95% CI 51,7-81,7) the cervical epidural catheter was sufficient for surgery...
2017: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/28759487/aortocaval-compression-syndrome-time-to-revisit-certain-dogmas
#13
Allison J Lee, Ruth Landau
More than 70 years ago, the phenomenon of "postural shock" in the supine position was described in healthy women in late pregnancy. Since then, avoidance of the supine position has become a key component of clinical practice. Indeed, performing pelvic tilt in mothers at term to avoid aortocaval compression is a universally adopted measure, particularly during cesarean delivery. The studies on which this practice is based are largely nonrandomized, utilized a mix of anesthetic techniques, and were conducted decades ago in the setting of avoidance of vasopressors...
July 27, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28738447/comparison-of-local-versus-general-anesthesia-in-patients-undergoing-transcatheter-aortic-valve-replacement-a-meta-analysis
#14
Pedro A Villablanca, Divyanshu Mohananey, Katarina Nikolic, Sripal Bangalore, David P Slovut, Verghese Mathew, Vinod H Thourani, Josep Rode's-Cabau, Iván J Núñez-Gil, Tina Shah, Tanush Gupta, David F Briceno, Mario J Garcia, Jacob T Gutsche, John G Augoustides, Harish Ramakrishna
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is typically performed under general anesthesia (GA). However, there is increasing data supporting the safety of performing TAVR under local anesthesia/conscious sedation (LA). We performed a meta-analysis to gain better understanding of the safety and efficacy of LA versus GA in patients with severe aortic stenosis undergoing TAVR. METHODS AND RESULTS: We comprehensively searched EMBASE, PubMed, and Web of Science...
July 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28713516/sequential-compression-pump-effect-on-hypotension-due-to-spinal-anesthesia-for-cesarean-section-a-double-blind-clinical-trial
#15
Fatemeh Javaherforoosh Zadeh, Mostafa Alqozat, Reza Akhond Zadeh
BACKGROUND: Spinal anesthesia (SA) is a standard technique for cesarean section. Hypotension presents an incident of 80-85% after SA in pregnant women. OBJECTIVE: To determine the effect of intermittent pneumatic compression of lower limbs on declining spinal anesthesia induced hypotension during cesarean section. METHODS: This double-blind clinical prospective study was conducted on 76 non-laboring parturient patients, aged 18-45 years, with the American Society of Anesthesiologist physical status I or II who were scheduled for elective cesarean section at Razi Hospital, Ahvaz, Iran from December 21, 2015 to January 20, 2016...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28707996/effect-of-the-degree-of-head-elevation-on-the-incidence-and-severity-of-venous-air-embolism-in-cranial-neurosurgical-procedures-with-patients-in-the-semisitting-position
#16
Hatice Türe, M Volkan Harput, Nural Bekiroğlu, Özgül Keskin, Özge Köner, Uğur Türe
OBJECTIVE The semisitting position of a patient confers numerous advantages in various neurosurgical procedures, but venous air embolism is one of the associated complications of this position. To date, no prospective studies of the relationship between the degree of head elevation and the rate and severity of venous air embolism for patients undergoing a procedure in this position have been performed. In this study, the authors compared changes in the severity of venous air embolism according to the degree of head elevation (30° or 45°) in patients undergoing an elective cranial neurosurgical procedure in the semisitting position...
July 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28704246/the-effect-of-glycopyrrolate-on-the-incidence-of-hypotension-and-vasopressor-requirement-during-spinal-anesthesia-for-cesarean-delivery-a-meta-analysis
#17
Selina D Patel, Ashraf S Habib, Sioned Phillips, Brendan Carvalho, Pervez Sultan
BACKGROUND: The objective of this meta-analysis was to determine the efficacy of glycopyrrolate at reducing spinal hypotension during cesarean delivery. METHODS: A literature search was performed to identify randomized controlled trials investigating the effect of glycopyrrolate on spinal-induced hypotension during cesarean delivery. Primary outcomes were intraoperative hypotension and vasopressor requirement (phenylephrine equivalents). Secondary outcomes included heart rate (HR), nausea and vomiting, dry mouth, and Apgar scores...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28689624/neonatal-effects-after-vasopressor-during-spinal-anesthesia-for-cesarean-section-a-multicenter-randomized-controlled-trial
#18
K Uerpairojkit, R Anusorntanawat, A Sirisabya, M Chaichalothorn, S Charuluxananan
BACKGROUND: Placental transfer of ephedrine causes fetal effects when compared with phenylephrine. This study compared their drug effects on neonatal parameters after cesarean delivery under spinal anesthesia. METHODS: Three-hundred-and-fifty-four women undergoing elective cesarean delivery who needed intravenous vasopressor following spinal anesthesia were randomized into two groups. Group E received boluses of ephedrine 6mg, and Group P phenylephrine 100µg, titrated to maintain systolic blood pressure near baseline values...
July 6, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28678073/prophylactic-norepinephrine-infusion-for-preventing-hypotension-during-spinal-anesthesia-for-cesarean-delivery
#19
Warwick D Ngan Kee, Shara W Y Lee, Floria F Ng, Kim S Khaw
BACKGROUND: The use of norepinephrine for maintaining blood pressure (BP) during spinal anesthesia for cesarean delivery has been described recently. However, its administration by titrated manually controlled infusion in this context has not been evaluated. METHODS: In a double-blinded, randomized controlled trial, 110 healthy women having spinal anesthesia for elective cesarean delivery were randomly allocated to 1 of 2 groups. In group 1, patients received an infusion of 5 μg/mL norepinephrine that was started at 30 mL/h (2...
July 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28669885/evaluation-of-gastric-microcirculation-by-laser%C3%A2-speckle-contrast-imaging-during-esophagectomy
#20
RANDOMIZED CONTROLLED TRIAL
Rikard Ambrus, Michael P Achiam, Niels H Secher, Morten B S Svendsen, Kim Rünitz, Mette Siemsen, Lars B Svendsen
BACKGROUND: Thoracic epidural anesthesia (TEA) may provoke hypotension, and that, as well as the use of vasopressors and the surgical technique, could affect splanchnic microcirculation, in which the surgical target organ is of particular interest. This study used laser speckle contrast imaging (LSCI) to monitor gastric microcirculation during esophagectomy. STUDY DESIGN: Forty-five patients undergoing open esophagectomy were randomized to primary activation (EA; 25 patients) or no intraoperative activation (LA; 20 patients) of TEA...
September 2017: Journal of the American College of Surgeons
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