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Anesthesia issues

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104 papers 1000+ followers
By Faye Kehler Family Physician and GP Anesthetist since 1987 interested in all aspects of Medicine
T E F Abbott, G L Ackland, R A Archbold, A Wragg, E Kam, T Ahmad, A W Khan, E Niebrzegowska, R N Rodseth, P J Devereaux, R M Pearse
BACKGROUND: Increased baseline heart rate is associated with cardiovascular risk and all-cause mortality in the general population. We hypothesized that elevated preoperative heart rate increases the risk of myocardial injury after non-cardiac surgery (MINS). METHODS: We performed a secondary analysis of a prospective international cohort study of patients aged ≥45 yr undergoing non-cardiac surgery. Preoperative heart rate was defined as the last measurement before induction of anaesthesia...
August 2016: British Journal of Anaesthesia
David A Story
No abstract text is available yet for this article.
August 2016: Anesthesia and Analgesia
P H Rosenberg
No abstract text is available yet for this article.
September 2016: Acta Anaesthesiologica Scandinavica
Anders Winther Voldby, Birgitte Brandstrup
BACKGROUND: Perioperative hypovolemia and fluid overload have effects on both complications following surgery and on patient survival. Therefore, the administration of intravenous fluids before, during, and after surgery at the right time and in the right amounts is of great importance. This review aims to analyze the literature concerning perioperative fluid therapy in abdominal surgery and to provide evidence-based recommendations for clinical practice. RESULTS: Preoperative oral or intravenous administration of carbohydrate containing fluids has been shown to improve postoperative well-being and muscular strength and to reduce insulin resistance...
2016: Journal of Intensive Care
Stephen T McSorley, Paul G Horgan, Donald C McMillan
BACKGROUND: This meta-analysis examined the impact of preoperative corticosteroids on interleukin 6 (IL-6), C-reactive protein (CRP), and complications following surgery for gastrointestinal cancer. METHODS: A systematic review was performed using appropriate keywords. Random-effects meta-analysis was performed. RESULTS: 11 RCTs with 474 patients, were included. Corticosteroids were significantly associated with lower IL-6 on postoperative day 1 (mean difference -148pg/mL, 95% CI -205 to -92, p<0...
May 2016: Critical Reviews in Oncology/hematology
Terese T Horlocker, Denise J Wedel, John C Rowlingson, F Kayser Enneking, Sandra L Kopp, Honorio T Benzon, David L Brown, John A Heit, Michael F Mulroy, Richard W Rosenquist, Michael Tryba, Chun-Su Yuan
The actual incidence of neurologic dysfunction resulting from hemorrhagic complications associated with neuraxial blockade is unknown. Although the incidence cited in the literature is estimated to be less than 1 in 150,000 epidural and less than 1 in 220,000 spinal anesthetics, recent epidemiologic surveys suggest that the frequency is increasing and may be as high as 1 in 3000 in some patient populations.Overall, the risk of clinically significant bleeding increase with age,associated abnormalities of the spinal cord or vertebral column, the presence of an underlying coagulopathy, difficulty during needle placement,and an indwelling neuraxial catheter during sustained anticoagulation( particularly with standard heparin or low-molecular weight heparin)...
January 2010: Regional Anesthesia and Pain Medicine
Lisa Hartling, Andrea Milne, Michelle Foisy, Eddy S Lang, Douglas Sinclair, Terry P Klassen, Lisa Evered
BACKGROUND: Sedation is increasingly used to facilitate procedures on children in emergency departments (EDs). This overview of systematic reviews (SRs) examines the safety and efficacy of sedative agents commonly used for procedural sedation in children in the ED or similar settings. METHODS: We followed standard SR methods: comprehensive search; dual study selection, quality assessment, data extraction. We included SRs of children (1 month to 18 years) where the indication for sedation was procedure-related and performed in the ED...
May 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Hakki Unlugenc, Mediha Turktan, Ismail Cuneyt Evruke, Murat Gunduz, Refik Burgut, Hacer Yapicioglu-Yildizdas, Geylan Isik
PURPOSE: Spinal anesthesia for caesarean delivery is often associated with hypotension. This study was conducted to evaluate the effects of rapid crystalloid (Lactated Ringer's solution; LRS) or colloid (hydroxyethyl starch; HES) cohydration with a second intravenous access line on the incidence of hypotension and ephedrine requirement during spinal anesthesia for cesarean section. METHODS: We studied 90 women with uncomplicated pregnancies undergoing elective cesarean section under spinal anesthesia...
October 2015: Middle East Journal of Anesthesiology
Wonki Kim, In Ho Song, Yong Hoon Lim, Mi-Ryoung Kim, Young Eun Kim, Jae Ha Hwang, In Keyoung Kim, Sang Woo Song, Jin Wook Kim, Woong-Woo Lee, Han-Joon Kim, Cheolyoung Kim, Hee Chan Kim, In Young Kim, Hee Pyoung Park, Dong Gyu Kim, Beom Seok Jeon, Sun Ha Paek
We investigated the effect of propofol and fentanyl on microelectrode recording (MER) and its clinical applicability during subthalamic nucleus (STN) deep brain stimulation (DBS) surgery. We analyzed 8 patients with Parkinson's disease, underwent bilateral STN DBS with MER. Their left sides were done under awake and then their right sides were done with a continuous infusion of propofol and fentanyl under local anesthesia. The electrode position was evaluated by preoperative MRI and postoperative CT. The clinical outcomes were assessed at six months after surgery...
September 2014: Journal of Korean Medical Science
Michelle M McCarthy, ShiNung Ching, Miles A Whittington, Nancy Kopell
Dynamics of neuronal networks can be altered in at least two ways: by changes in connectivity, that is, the physical architecture of the network, or changes in the amplitudes and kinetics of the intrinsic and synaptic currents within and between the elements making up a network. We argue that the latter changes are often overlooked as sources of alterations in network behavior when there are also structural (connectivity) abnormalities present; indeed, they may even give rise to the structural changes observed in these states...
August 2012: Current Opinion in Neurobiology
Justin J Wright, Peter D Goodnight, Matthew D McEvoy
Loss of dopaminergic neurons from the substantia nigra characterizes the classical pathology of Parkinson's disease, but persistent activation of N-methyl-D-aspartate receptors is also a major component. During difficult airway management in a patient with advanced Parkinson's disease, the use of low-dose (20 mg) i.v. ketamine resulted in complete abolition of severe tremor and dysarthria. This led to the current case report in which low-dose ketamine was used for preoperative sedation and dyskinesia attenuation...
March 2009: Anesthesia and Analgesia
Nita Khandelwal, Sarah Khorsand, Steven H Mitchell, Aaron M Joffe
BACKGROUND: Based on the data from elective surgical patients, positioning patients in a back-up head-elevated position for preoxygenation and tracheal intubation can improve patient safety. However, data specific to the emergent setting are lacking. We hypothesized that back-up head-elevated positioning would be associated with a decrease in complications related to tracheal intubation in the emergency room environment. METHODS: This retrospective study was approved by the University of Washington Human Subjects Division (Seattle, WA)...
April 2016: Anesthesia and Analgesia
Erin J Aiello Bowles, Eric B Larson, Ryan P Pong, Rod L Walker, Melissa L Anderson, Onchee Yu, Shelly L Gray, Paul K Crane, Sascha Dublin
OBJECTIVES: To evaluate the associations between anesthesia and dementia or Alzheimer's disease (AD) risk using prospectively collected data. DESIGN: Cohort study. PARTICIPANTS: Community-dwelling members of the Adult Changes in Thought cohort aged 65 and older and free of dementia at baseline (N = 3,988). MEASUREMENTS: Participants self-reported all prior surgical procedures with general or neuraxial (spinal or epidural) anesthesia at baseline and reported new procedures every 2 years...
March 2016: Journal of the American Geriatrics Society
I Ahmad, C R Bailey
No abstract text is available yet for this article.
January 2016: Anaesthesia
Michael S Avidan, Alex S Evers
No abstract text is available yet for this article.
February 2016: Anesthesiology
S S C Wong, M G Irwin
Cardiovascular complications are an important cause of morbidity and mortality after non-cardiac surgery. Pre-operative identification of high-risk individuals and appropriate peri-operative management can reduce cardiovascular risk. It is important to continue chronic beta-blocker and statin therapy. Statins are relatively safe and peri-operative initiation may be beneficial in high-risk patients and those scheduled for vascular surgery. The pre-operative introduction of beta-blockers reduces myocardial injury but increases rates of stroke and mortality, possibly due to hypotension...
January 2016: Anaesthesia
Robert S Green, Michael B Butler
BACKGROUND: Postintubation hypotension (PIH) is an adverse event associated with poor outcomes in emergency department endotracheal intubations. Study objective was to determine the incidence of PIH and its impact on outcomes following tracheal intubation in a general anesthesia population. METHODS: Structured chart audit of adult patients intubated for a vascular surgery procedure at a tertiary care center over a 3-year period. Outcomes included in-hospital mortality, extended intensive care unit length of stay (ICU LOS), and requirement for postoperative (postop) hemodialysis or mechanical ventilation...
July 27, 2015: Journal of Intensive Care Medicine
Barynia Backeljauw, Scott K Holland, Mekibib Altaye, Andreas W Loepke
BACKGROUND: Anesthetics induce widespread cell death, permanent neuronal deletion, and neurocognitive impairment in immature animals, raising substantial concerns about similar effects occurring in young children. Epidemiologic studies have been unable to sufficiently address this concern, in part due to reliance on group-administered achievement tests, inability to assess brain structure, and limited control for confounders. METHODS: We compared healthy participants of a language development study at age 5 to 18 years who had undergone surgery with anesthesia before 4 years of age (n = 53) with unexposed peers (n = 53) who were matched for age, gender, handedness, and socioeconomic status...
July 2015: Pediatrics
Joseph Miller, Chuan-Xing Ho, Joy Tang, Richard Thompson, Jared Goldberg, Ahmed Amer, Bashar Nahab
OBJECTIVES: The primary objective of this study was to test if fasting volunteers exhibit fluid responsiveness using noninvasive hemodynamic measurements. The secondary objective was to test a passive leg raise (PLR) maneuver as a diagnostic predictor of fluid responsiveness. METHODS: This was a quasi-experimental design involving healthy volunteers. Subjects were excluded for pregnancy and congestive heart failure. Following a 12-hour fast, subjects had baseline hemodynamic monitoring recorded using noninvasive, continuous pulse contour analysis...
February 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
S Murthy, D L Hepner, Z Cooper, A M Bader, M D Neuman
As the population of the world is rapidly ageing, the amount of surgery being performed in older patients is also increasing. Special attention is required for the anaesthetic and perioperative management of these patients. The clinical and non-clinical issues specific to older surgical patients are reviewed, with a special emphasis on areas of debate related to anaesthesia care in this group. These issues include the role of frailty and disability in preoperative assessment, choice of anaesthesia technique for hip fracture, postoperative delirium, and approaches to shared decision-making before surgical procedures...
December 2015: British Journal of Anaesthesia
2016-01-12 23:55:15
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