collection
https://read.qxmd.com/read/26599796/saline-flush-after-rocuronium-bolus-reduces-onset-time-and-prolongs-duration-of-effect-a-randomized-clinical-trial
#21
RANDOMIZED CONTROLLED TRIAL
Sayaka Ishigaki, Kenichi Masui, Tomiei Kazama
BACKGROUND: Circulatory factors modify the onset time of neuromuscular-blocking drugs. Therefore, we hypothesized that infusion of a saline flush immediately after rocuronium administration would shorten the onset time without influencing the duration of the rocuronium effect. METHODS: Forty-eight patients were randomly allocated to the control or saline flush group. Anesthesia was induced and maintained with propofol and remifentanil, and all patients received 0...
March 2016: Anesthesia and Analgesia
https://read.qxmd.com/read/26446688/anesthetic-considerations-in-hellp-syndrome
#22
REVIEW
M del-Rio-Vellosillo, J J Garcia-Medina
BACKGROUND: HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) is an obstetric complication with heterogonous presentation and multisystemic involvement. It is characterized by microangiopathic hemolytic anemia, elevated liver enzymes by intravascular breakdown of fibrin in hepatic sinusoids and reduction of platelet circulation by its increased consumption. METHODS: In terms of these patients' anesthetic management, it is essential to consider some details: (1) effective, safe perioperative management by a multidisciplinary approach, and quick, good communication among clinical specialists to achieve correct patient management; (2) neuroaxial block, particularly spinal anesthesia, is the first choice to do the cesarean if there is only moderate, but not progressive thrombocytopenia; (3) if a general anesthesia is required, it is necessary to control the response to stress produced by intubation, especially in patients with either severe high blood pressure or neurological signs, or to prevent major cerebral complications; (4) invasive techniques, e...
February 2016: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/26608876/randomised-controlled-trial-of-spinal-anaesthesia-with-bupivacaine-or-2-chloroprocaine-during-caesarean-section
#23
RANDOMIZED CONTROLLED TRIAL
S Maes, M Laubach, J Poelaert
BACKGROUND: Neuraxial anaesthesia is the desired method for Caesarean section. Bupivacaine is a well-known local anaesthetic. It has a long duration of action and can cause unpredictable levels of anaesthesia with subsequent prolonged discharge time. 2-Chloroprocaine has a rapid onset of action, producing an excellent sensory and motor block and has a rapid hydrolysis in the bloodstream by pseudocholinesterase. We compared bupivacaine and 2-chloroprocaine for spinal anaesthesia during Caesarean section...
May 2016: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/26608792/the-impact-of-medical-errors-on-swiss-anesthesiologists-a-cross-sectional-survey
#24
LETTER
Beate Schroeter
No abstract text is available yet for this article.
April 2016: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/26418698/survival-after-perioperative-cardiopulmonary-resuscitation-providing-an-evidence-base-for-ethical-management-of-do-not-resuscitate-orders
#25
REVIEW
Shona Kalkman, Lotty Hooft, Johanne M Meijerman, Johannes T A Knape, Johannes J M van Delden
Automatic suspension of do-not-resuscitate (DNR) orders during general anesthesia does not sufficiently address a patient's right to self-determination and is a practice still observed among anesthesiologists today. To provide an evidence base for ethical management of DNR orders during anesthesia and surgery, the authors performed a systematic review of the literature to quantify the survival after perioperative cardiopulmonary resuscitation (CPR). Results show that the probability of surviving perioperative CPR ranged from 32...
March 2016: Anesthesiology
https://read.qxmd.com/read/26385661/liberal-transfusion-strategy-improves-survival-in-perioperative-but-not-in-critically-ill-patients-a-meta-analysis-of-randomised-trials
#26
REVIEW
E Fominskiy, A Putzu, F Monaco, A M Scandroglio, A Karaskov, F R B G Galas, L A Hajjar, A Zangrillo, G Landoni
BACKGROUND: Guidelines support the use of a restrictive strategy in blood transfusion management in a variety of clinical settings. However, recent randomized controlled trials (RCTs) performed in the perioperative setting suggest a beneficial effect on survival of a liberal strategy. We aimed to assess the effect of liberal and restrictive blood transfusion strategies on mortality in perioperative and critically ill adult patients through a meta-analysis of RCTs. METHODS: We searched PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials, Transfusion Evidence Library, and Google Scholar up to 27 March 2015, for RCTs performed in perioperative or critically ill adult patients, receiving a restrictive or liberal transfusion strategy, and reporting all-cause mortality...
October 2015: British Journal of Anaesthesia
https://read.qxmd.com/read/26391674/soft-tissue-injuries-after-direct-laryngoscopy
#27
JOURNAL ARTICLE
J Mourão, J Moreira, J Barbosa, J Carvalho, J Tavares
STUDY OBJECTIVE: The study objective is to determine the incidence of oral soft tissue trauma during classic direct laryngoscopy for tracheal intubation and the risk factors associated with it. DESIGN: This is a prospective observational study. SETTING: The setting is at a ward. PATIENTS: The patients are adults submitted to elective interventions in general surgery requiring tracheal intubation by classic direct laryngoscopy...
December 2015: Journal of Clinical Anesthesia
https://read.qxmd.com/read/26372144/neosaxitoxin-versus-traditional-local-anesthetics-mechanism-of-action-and-sites-of-notable-effect
#28
COMPARATIVE STUDY
James P Rathmell, Gary Strichartz, Jonathan Wanderer
No abstract text is available yet for this article.
October 2015: Anesthesiology
https://read.qxmd.com/read/26376279/ultrasound-guided-subclavian-vein-catheterization-a-systematic-review-and-meta-analysis-several-facts-need-to-be-noticed
#29
LETTER
Libing Jiang, Mao Zhang, Yuefeng Ma
No abstract text is available yet for this article.
October 2015: Critical Care Medicine
https://read.qxmd.com/read/26378705/clinical-research-methodology-3-randomized-controlled-trials
#30
REVIEW
Daniel I Sessler, Peter B Imrey
Randomized assignment of treatment excludes reverse causation and selection bias and, in sufficiently large studies, effectively prevents confounding. Well-implemented blinding prevents measurement bias. Studies that include these protections are called randomized, blinded clinical trials and, when conducted with sufficient numbers of patients, provide the most valid results. Although conceptually straightforward, design of clinical trials requires thoughtful trade-offs among competing approaches-all of which influence the number of patients required, enrollment time, internal and external validity, ability to evaluate interactions among treatments, and cost...
October 2015: Anesthesia and Analgesia
https://read.qxmd.com/read/26378704/clinical-research-methodology-2-observational-clinical-research
#31
REVIEW
Daniel I Sessler, Peter B Imrey
Case-control and cohort studies are invaluable research tools and provide the strongest feasible research designs for addressing some questions. Case-control studies usually involve retrospective data collection. Cohort studies can involve retrospective, ambidirectional, or prospective data collection. Observational studies are subject to errors attributable to selection bias, confounding, measurement bias, and reverse causation-in addition to errors of chance. Confounding can be statistically controlled to the extent that potential factors are known and accurately measured, but, in practice, bias and unknown confounders usually remain additional potential sources of error, often of unknown magnitude and clinical impact...
October 2015: Anesthesia and Analgesia
https://read.qxmd.com/read/26378703/clinical-research-methodology-1-study-designs-and-methodologic-sources-of-error
#32
REVIEW
Daniel I Sessler, Peter B Imrey
Clinical research can be categorized by the timing of data collection: retrospective or prospective. Clinical research also can be categorized by study design. In case-control studies, investigators compare previous exposures (including genetic and other personal factors, environmental influences, and medical treatments) among groups distinguished by later disease status (broadly defined to include the development of disease or response to treatment). In cohort studies, investigators compare subsequent incidences of disease among groups distinguished by one or more exposures...
October 2015: Anesthesia and Analgesia
https://read.qxmd.com/read/26378707/systematic-reviews-and-meta-analyses-of-randomized-controlled-trials-on-perioperative-outcomes-an-urgent-need-for-critical-reappraisal
#33
REVIEW
Henrik Kehlet, Girish P Joshi
No abstract text is available yet for this article.
October 2015: Anesthesia and Analgesia
https://read.qxmd.com/read/26378712/exparel%C3%A2-a-new-local-anesthetic-with-special-safety-concerns
#34
LETTER
Mark Burbridge, Richard A Jaffe
No abstract text is available yet for this article.
October 2015: Anesthesia and Analgesia
https://read.qxmd.com/read/26358179/tachyphylaxis-to-local-anaesthetics-what-is-the-clinical-evidence-a-systematic-review
#35
REVIEW
U E Kongsgaard, M U Werner
BACKGROUND: Tachyphylaxis or acute tolerance to local anaesthetics has been reported, but the prevalence in clinical analgesia is obscure, and the mechanisms behind this phenomenon remain unclear. We sought to examine the clinical significance of tachyphylaxis from the available literature. METHODS: We performed a systematic review of the literature utilising the databases PubMed and Embase employing the search terms [Tachyphylaxis AND Local Anaesthetics AND Human] AND [Tolerance AND Local Anaesthetics AND Human]...
January 2016: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/26373922/prediction-of-postoperative-pain-from-assessment-of-pain-induced-by-venous-cannulation-and-propofol-infusion
#36
JOURNAL ARTICLE
A K M Persson, F D Pettersson, L-E Dyrehag, J Åkeson
BACKGROUND: Postoperative pain may lead to delayed mobilization, persisting pain, and psychosocial distress. There are no simple and reliable techniques for prediction of postoperative pain. This study was designed to evaluate if pain induced by venous cannulation or propofol injection can be used to predict postoperative pain. METHODS: This prospective study included 180 patients scheduled for laparoscopic cholecystectomy. Pain intensity associated with peripheral venous cannulation and administration of propofol preoperatively and pain intensity, and use of opioid postoperatively was recorded...
February 2016: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/26347411/neuraxial-and-peripheral-nerve-blocks-in-patients-taking-anticoagulant-or-thromboprophylactic-drugs-challenges-and-solutions
#37
REVIEW
Jinlei Li, Thomas Halaszynski
Incidence of hemorrhagic complications from neuraxial blockade is unknown, but classically cited as 1 in 150,000 epidurals and 1 in 220,000 spinals. However, recent literature and epidemiologic data suggest that for certain patient populations the frequency is higher (1 in 3,000). Due to safety concerns of bleeding risk, guidelines and recommendations have been designed to reduce patient morbidity/mortality during regional anesthesia. Data from evidence-based reviews, clinical series and case reports, collaborative experience of experts, and pharmacology used in developing consensus statements are unable to address all patient comorbidities and are not able to guarantee specific outcomes...
2015: Local and Regional Anesthesia
https://read.qxmd.com/read/26332858/the-effect-of-intravenous-midazolam-on-postoperative-nausea-and-vomiting-a-meta-analysis
#38
REVIEW
Michael C Grant, Jimin Kim, Andrew J Page, Deborah Hobson, Elizabeth Wick, Christopher L Wu
BACKGROUND: Research has shown that high-risk surgical patients benefit from a multimodal therapeutic approach to prevent postoperative nausea and vomiting (PONV). Our group sought to investigate the effect of administering IV midazolam on PONV. METHODS: This meta-analysis included 12 randomized controlled trials (n = 841) of adults undergoing a variety of surgical procedures that investigated the effect of both preoperative and intraoperative IV midazolam on PONV in patients undergoing general anesthesia...
March 2016: Anesthesia and Analgesia
https://read.qxmd.com/read/26338081/oxytocin-use-during-caesarean-sections-in-denmark-are-we-getting-the-dose-right
#39
JOURNAL ARTICLE
B N Kjaer, M Krøigaard, L H Garvey
BACKGROUND: In Denmark, an iv bolus of 10 IU oxytocin was traditionally given after delivery to prevent atony during caesarean sections. Randomized controlled trials have shown that lower iv bolus doses have same efficacy with fewer side effects and many countries now recommend a 5 IU maximum dose. The aims of this study were to investigate whether patients referred for allergy testing after oxytocin exposure had dose-related side effects to oxytocin rather than true allergic reactions and to investigate whether updated international recommendations on lower bolus doses had been implemented in practice...
January 2016: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/26316813/regional-anesthesia-for-the-trauma-patient-improving-patient-outcomes
#40
REVIEW
Jeff Gadsden, Alicia Warlick
Trauma is a significant health problem and a leading cause of death in all age groups. Pain related to trauma is frequently severe, but is often undertreated in the trauma population. Opioids are widely used to treat pain in injured patients but have a broad range of undesirable effects in a multitrauma patient such as neurologic and respiratory impairment and delirium. In contrast, regional analgesia confers excellent site-specific pain relief that is free from major side effects, reduces opioid requirement in trauma patients, and is safe and easy to perform...
2015: Local and Regional Anesthesia
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