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https://www.readbyqxmd.com/read/29033731/ultrasound-guided-continuous-spinal-anesthesia-for-cesarean-section-in-a-parturient-with-scoliosis-corrected-with-harrington-s-rod-surgery
#1
Amer Majeed, Iftikhar Ahmed, Ghadah Jamaan Alkahtani, Nasser Abdullah Altahtam
With rapid improvement in healthcare in Saudi Arabia, increasing number of women with surgically corrected kyphoscoliosis are likely to present for cesarean section (CS) or vaginal delivery requiring anesthesia or analgesia. Despite the surgical correction, these patients have poor cardiopulmonary reserves which increase the risks associated with general anesthesia. Whereas altered vertebral anatomy from previous surgery and the presence of metal work in spine make performing of regional anesthesia (RA) difficult and unpredictable, we report anesthetic management of such a patient who underwent CS using continuous spinal anesthesia technique...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033726/ultrasound-guided-multilevel-paravertebral-block-versus-local-anesthesia-for-medical-thoracoscopy
#2
Maha A Abo-Zeid, Mohammad M Elgamal, Asem A Hewidy, Amro A Moawad, Alaa Eldin Adel Elmaddawy
BACKGROUND: Local anesthetic infiltration for medical thoracoscopy has an analgesic properties for short duration. Single injection thoracic paravertebral block (PVB) provides limited analgesia. PURPOSE: Comparison between thoracic PVB performed at two or three levels with local infiltration for anesthetic adequacy in adult medical thoracoscopy as a primary outcome and postthoracoscopic analgesia and pulmonary function as secondary outcomes for adult medical thoracoscopy...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033723/postoperative-pain-management-in-patients-undergoing-thoracoscopic-repair-of-pectus-excavatum-a-retrospective-analysis-of-opioid-consumption-and-adverse-effects-in-adolescents
#3
Ralph Beltran, Giorgio Veneziano, Tarun Bhalla, Brian Kenney, Dmitry Tumin, Bruno Bissonnette, Joseph D Tobias
INTRODUCTION: Although the Nuss procedure provides excellent cosmetic results for the correction of pectus excavatum, the provision of analgesia following such procedures can be challenging. METHODS: The current study retrospectively reviews our experience over a 2.5 year period with thoracic epidural analgesia (TE), paravertebral blockade (PVB), and intravenous opioids delivered via patient-controlled analgesia (PCA) to provide postoperative analgesia. RESULTS: The study cohort included 30 patients (mean age = 15...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29030933/technical-success-of-the-ultrasound-guided-supra-inguinal-fascia-iliaca-compartment-block-in-older-children-and-adolescents-for-hip-arthroscopy
#4
Elizabeth Eastburn, Maria A Hernandez, Karen Boretsky
BACKGROUND: Hip arthroscopic surgery is performed on older pediatric patients. Fascia iliaca compartment block has proven efficacy in providing analgesia following hip surgery and can be performed with target location of local anesthetic below or above the inguinal ligament. The reported success of ultrasound-guided infra-inguinal fascia iliaca compartment block is lower when compared to traditional landmark technique, while the reliability of supra-inguinal fascia iliaca compartment block is unreported...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29030929/infection-prevention-in-pediatric-anesthesia-practice
#5
REVIEW
Lizabeth D Martin, Michael Kallile, Siri Kanmanthreddy, Danielle M Zerr
Healthcare-associated infections are an important source of morbidity and mortality in pediatric patients. Anesthesiologists have a unique role in infection prevention. Hand hygiene and anesthesia workspace decontamination decrease infection rates in surgical patients. Standard protocols exist for insertion and handling of central lines, arterial lines, and regional procedures, which should be strictly adhered to in order to prevent infectious complications. Temperature control and timely administration of antibiotics contribute to the prevention of surgical site infections...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29027773/perioperative-pain-management-in-cardiac-surgery-a-systematic-review
#6
Elena Bignami, Alberto Castella, Vincenzo Pota, Francesco Saglietti, Antonio Scognamiglio, Cinzia Trumello, Maria C Pace, Massimo Allegri
BACKGROUND: Every year, more than 1.5 million patients, who undergo cardiac surgery worldwide, are exposed to a series of factors that can trigger acute postoperative pain associated with hemodynamic instability, respiratory complications, and psychological disorders. Through an evaluation of literature data about postoperative pain in cardiac surgery we define unmet needs and potential objectives for future research on this often underestimated problem. METHODS: Following PRISMA Guidelines, a systematic literature search was carried out by two independent researchers on Scopus, CINAHL, the Cochrane Library, and PubMed using the keywords: [(perioperative OR postoperative) analgesia AND "cardiac surgery"]...
October 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29026809/spontaneously-resolved-macrocystic-lymphatic-malformations-predictive-variables-and-outcomes
#7
Michael J Phang, Douglas J Courtemanche, Marija Bucevska, Claudia Malic, Jugpal S Arneja
INTRODUCTION: Lymphatic malformations are benign, low-flow vascular malformations that typically present at or near birth. Due to morbidity associated with operative treatment, nonoperative treatment with injection of sclerosant has become the mainstay of therapy. Over the past 15 years, several patients at our centre with macrocystic (>2 cm cyst size) lymphatic malformations have seen their lesions resolve spontaneously while awaiting treatment. In this study, we review features of these patients that may contribute to spontaneous resolution...
February 2017: Plastic Surgery
https://www.readbyqxmd.com/read/29021888/a-good-short-term-outcome-in-delayed-decompression-of-cauda-equina-syndrome-in-klebsiella-pneumoniae-spinal-epidural-abscess-a-case-report
#8
J Hanifah, J Joehaimey, M I Yusof
Spinal epidural abscess is a severe, generally pyogenic, infection of the epidural space of spinal cord or cauda equina. The swelling caused by the abscess leads to compression or vascular disruption of neurological structures that requires urgent surgical decompression to avoid significant permanent disability. We share a rare case of Klebsiella pneumoniae spinal epidural abscess secondary to haematogenous spread of previous lung infection that presented late at our centre with cauda equina syndrome that showed good short-term outcome in delayed decompression...
July 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29020710/fluorescent-imaging-evaluation-of-lidocaine-distribution-following-bier-block-in-the-upper-extremity
#9
Andrea L Gale, Shari R Liberman, Suzanne Berry, Dmitry Zavlin, Anthony Echo
INTRODUCTION: Bier block regional anesthesia has been used as an alternative to general anesthesia for years. Despite multiple theories and multiple techniques to delineate the location of the action of lidocaine during Bier block anesthesia, there has not been a consensus on the location of action. The purpose of this study was to use fluorescent imaging to further investigate the site of action of lidocaine during Bier block. MATERIALS AND METHODS: Three patients with carpal tunnel syndrome underwent open carpal tunnel release with Bier block anesthesia performed in the standard fashion with 1cc of Indocyanine green (IcG) mixed with lidocaine...
October 12, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29019815/an-international-multicenter-observational-study-of-cerebral-oxygenation-during-infant-and-neonatal-anesthesia
#10
Vanessa A Olbrecht, Justin Skowno, Vanessa Marchesini, Lili Ding, Yifei Jiang, Christopher G Ward, Gaofeng Yu, Huacheng Liu, Bernadette Schurink, Laszlo Vutskits, Jurgen C de Graaff, Francis X McGowan, Britta S von Ungern-Sternberg, Charles Dean Kurth, Andrew Davidson
BACKGROUND: General anesthesia during infancy is associated with neurocognitive abnormalities. Potential mechanisms include anesthetic neurotoxicity, surgical disease, and cerebral hypoxia-ischemia. This study aimed to determine the incidence of low cerebral oxygenation and associated factors during general anesthesia in infants. METHODS: This multicenter study enrolled 453 infants aged less than 6 months having general anesthesia for 30 min or more. Regional cerebral oxygenation was measured by near-infrared spectroscopy...
October 11, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29016368/perioperative-point-of-care-ultrasound-in-ambulatory-anesthesia-thinking-beyond-nerve-blocks
#11
Ranjit Deshpande, Davinder Ramsingh
PURPOSE OF REVIEW: Ultrasound has become readily available in the perioperative area. In this review, we aim to bring forth some uses of ultrasound beyond that in regional anesthesia. RECENT FINDINGS: Critical care and emergency physicians have embraced ultrasound in their respective fields. We as anesthesiologists and practitioners of acute care medicine are not immune to this penetration. There is been a lot of recent literature on the various uses of perioperative point of care ultrasound...
October 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28991571/wrist-arthroscopy-under-portal-site-local-anesthesia-without-tourniquet-and-sedation
#12
REVIEW
Siu-Cheong Jeffrey Justin Koo, Pak-Cheong Ho
We had developed the technique of portal site local anaesthesia (PSLA) for wrist arthroscopy. Two percent lidocaine with 1:200,000 epinephrine is injected through a 25G needle to various portal sites. The radiocarpal joint is then distended with saline injection and portal is created with transverse superficial skin incision followed by dilation with curved hemostat. The patient is neither sedated, nor under general or regional anaesthesia. Tourniquet is not routinely used. PSLA can achieve satisfactory comfort level in 88% of our 111 patients without any complication...
November 2017: Hand Clinics
https://www.readbyqxmd.com/read/28991122/peripheral-nerve-blocks-for-hip-fractures-a-cochrane-review
#13
Joanne Guay, Martyn J Parker, Richard Griffiths, Sandra L Kopp
BACKGROUND: This review focuses on the use of peripheral nerve blocks as preoperative analgesia, as postoperative analgesia, or as a supplement to general anesthesia for hip fracture surgery and tries to determine if they offer any benefit in terms of pain on movement at 30 minutes after block placement, acute confusional state, myocardial infarction/ischemia, pneumonia, mortality, time to first mobilization, and cost of analgesic. METHODS: Trials were identified by computerized searches of Cochrane Central Register of Controlled Trials (2016, Issue 8), MEDLINE (Ovid SP, 1966 to 2016 August week 1), Embase (Ovid SP, 1988 to 2016 August week 1), and the Cumulative Index to Nursing and Allied Health Literature (EBSCO, 1982 to 2016 August week 1), trials registers, and reference lists of relevant articles...
October 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28986337/improving-neuromuscular-monitoring-and-reducing-residual-neuromuscular-blockade-with-e-learning-protocol-for-the-multicenter-interrupted-time-series-invert-study
#14
Jakob Louis Demant Thomsen, Ole Mathiesen, Daniel Hägi-Pedersen, Lene Theil Skovgaard, Doris Østergaard, Jens Engbaek, Mona Ring Gätke
BACKGROUND: Muscle relaxants facilitate endotracheal intubation under general anesthesia and improve surgical conditions. Residual neuromuscular blockade occurs when the patient is still partially paralyzed when awakened after surgery. The condition is associated with subjective discomfort and an increased risk of respiratory complications. Use of an objective neuromuscular monitoring device may prevent residual block. Despite this, many anesthetists refrain from using the device. Efforts to increase the use of objective monitoring are time consuming and require the presence of expert personnel...
October 6, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28982261/time-to-institutional-review-board-approval-with-local-versus-central-review-in-a-multicenter-pragmatic-trial
#15
Mark D Neuman, Lakisha J Gaskins, Tracy Ziolek
BACKGROUND/AIMS: Central institutional review board (IRB) review will be required for National Institutes of Health-funded multisite human subjects research as of January 2018, with similar requirements extending to most US multisite human research in 2020. Nonetheless, little is known regarding the relative efficiency of central versus local IRB review for multicenter studies. We compared the amount of time required for central versus local IRB review and approval for sites in one ongoing multicenter randomized trial...
October 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28971170/comparison-of-riva-and-infraclavicular-block-in-forearm-and-hand-surgery
#16
Zubeyir Sivrikaya, Guldem Turan, Reyhan Cetiner, Dilek Subasi, Gulcin Ozturk, Asu Ozgultekin, Osman Ekinci
OBJECTIVE: The aim of this study was to compare 2 techniques that are widely used in hand, wrist, and forearm: regional intravenous anesthesia (RIVA) and infraclavicular brachial block. METHODS: A total of 100 patients who were aged 18 to 85 years and who underwent hand, wrist, or forearm surgery of at least 30 minutes duration were included. RIVA was applied to Group 1 patients with administration of 40 mL of prilocaine (3 mg/kg). Ultrasonography-guided infraclavicular block was performed on Group 2 patients with 20 mL of 1% prilocaine...
2017: Northern Clinics of Istanbul
https://www.readbyqxmd.com/read/28969950/prevalence-and-risk-factors-for-lateral-femoral-cutaneous-nerve-palsy-in-the-beach-chair-position
#17
Ari J Holtzman, Christopher D Glezos, Eric J Feit, Konrad I Gruson
PURPOSE: To report on the prevalence of lateral femoral cutaneous nerve (LFCN) palsy in patients who had undergone shoulder surgery in the beach chair position and to identify patient and surgical risk factors for its development. METHODS: We retrospectively reviewed the medical records of 397 consecutive patients who underwent either open or arthroscopic shoulder surgery in the beach chair position by a single surgeon. Patient demographic and surgical data including age, gender, weight, body mass index (BMI), diabetes, procedure duration, and anesthesia type (general, regional, regional/general) were recorded...
September 29, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28967579/distribution-of-fos-immunoreactive-cells-in-the-ventral-part-of-rat-medulla-following-voluntary-treadmill-exercise
#18
Nao Kumada, Satoshi Koba, Eri Hanai, Tatsuo Watanabe
The ventral part of the medulla, which contains important cardiovascular regions, is reportedly activated during exercise. Nevertheless, it was uncertain which region(s) in the ventral medulla are specifically activated by exercise. The present study aimed to demonstrate a general pattern of exercise-specific distribution of excited neuronal cells in the rat ventral medulla. Via immunohistochemical experiments, we mapped tyrosine hydroxylase- and Fos-immunoreactive cells (TH-IR and Fos-IR cells, respectively) on rat medullary coronal sections following a bout of voluntary treadmill exercise, a comparative control period, or after pharmacologically induced-hypotension under anesthesia...
September 22, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28966151/the-long-and-winding-road-thoracic-myelopathy-associated-with-occipitocervical-davf
#19
Angelique Sao-Mai Do, Joseph Kapurch, Ravi Kumar, John Port, Jeffrey W Miller, Jamie J Van Gompel
Spinal DAVFs have diverse presentations. MRIs reveal spinal cord swelling in only 45-74%. We present an unusual case of a 57 yo male with a craniocervical junction DAVFs in which the edema appeared in the thoracolumbar region skipping the cervical spinal cord. A case report and literature review from a tertiary referral center. In our patient, symptoms progressed over 3 months from low back and radicular pain to weakness, saddle anesthesia, and urinary retention. MRI showed T2 hyperintensity from T3-4 to the conus medullaris (Fig 1 a,b)...
September 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28965442/the-impact-of-curve-severity-on-obstetric-complications-and-regional-anesthesia-utilization-in-pregnant-patients-with-adolescent-idiopathic-scoliosis-a-preliminary-analysis
#20
Emily W Chan, Stephen R Gannon, Chevis N Shannon, Jeffrey E Martus, Gregory A Mencio, Christopher M Bonfield
OBJECTIVE Adolescent idiopathic scoliosis (AIS), the most common type of scoliosis, often presents immediately prior to a woman's childbearing years; however, research investigating the impact of AIS on women's health, particularly pregnancy delivery outcomes, is sparse, with existing literature reporting mixed findings. Similarly limited are studies examining the change in scoliotic curve during or after pregnancy. Therefore, this study aims to determine 1) the impact of scoliotic curvature on obstetric complications (preterm births, induction of labor, and urgent/emergency caesarean section delivery), 2) regional anesthetic decision making and success during delivery for these patients, and 3) the effect of pregnancy on curve progression...
October 2017: Neurosurgical Focus
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