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33 papers 25 to 100 followers
https://www.readbyqxmd.com/read/29135598/cardiac-arrest-in-the-operating-room-resuscitation-and-management-for-the-anesthesiologist-part-1
#1
Vivek K Moitra, Sharon Einav, Karl-Christian Thies, Mark E Nunnally, Andrea Gabrielli, Gerald A Maccioli, Guy Weinberg, Arna Banerjee, Kurt Ruetzler, Gregory Dobson, Matthew McEvoy, Michael F O'Connor
Cardiac arrest in the operating room and procedural areas has a different spectrum of causes (ie, hypovolemia, gas embolism, and hyperkalemia), and rapid and appropriate evaluation and management of these causes require modification of traditional cardiac arrest algorithms. There is a small but growing body of literature describing the incidence, causes, treatments, and outcomes of circulatory crisis and perioperative cardiac arrest. These events are almost always witnessed, frequently known, and involve rescuer providers with knowledge of the patient and their procedure...
November 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29090735/learning-from-the-law-a-review-of-21%C3%A2-years-of-litigation-for-pain-during-caesarean-section
#2
K McCombe, D G Bogod
The large majority of caesarean sections in the UK are now carried out under neuraxial anaesthesia. Although this technique is widely accepted as being the safest option in most circumstances, the use of regional anaesthesia increases the risk of patients experiencing intra-operative discomfort or pain. Pain during operative obstetric delivery is the commonest successful negligence claim relating to regional anaesthesia against obstetric anaesthetists in the UK. In the following article, using a database of over 360 cases spanning 21 years, we break down and examine the recurrent components of medicolegal claims concerning pain during caesarean section and consider how anaesthetists might avoid litigation...
November 1, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29023316/septic-shock-resuscitation-in-the-first-hour
#3
Nicholas Simpson, Francois Lamontagne, Manu Shankar-Hari
PURPOSE OF REVIEW: We reviewed the recent advances in the initial approach to resuscitation of sepsis and septic shock patients. RECENT FINDINGS: Sepsis and septic shock are life-threatening emergencies. Two key interventions in the first hour include timely antibiotic therapy and resuscitation. Before any laboratory results, the need for resuscitation is considered if a patient with suspected infection has low blood pressure (BP) or impaired peripheral circulation found at clinical examination...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28615115/circulatory-collapse-in-a-parturient-undergoing-cesarean-delivery-a-diagnostic-dilemma
#4
M M Tawfik, M E Taman, A I Tarbay, M Sayed, K A Awad
Embolic events including thromboembolism, air embolism, and amniotic fluid embolism can cause cardiovascular collapse during cesarean delivery. Differentiation between the three conditions is challenging because they share many of the initial clinical and echocardiographic findings, but an accurate, definitive diagnosis allows the administration of specific therapy that may help in saving the life of the mother and/or the fetus. We report a case of cardiovascular collapse during cesarean delivery under general anesthesia; massive pulmonary thromboembolism was suspected and unfractionated heparin was administered...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28617519/pain-and-opioid-use-after-total-shoulder-arthroplasty-with-injectable-liposomal-bupivacaine-versus-interscalene-block
#5
Marc R Angerame, John A Ruder, Susan M Odum, Nady Hamid
Postoperative pain control is a significant concern after total shoulder arthroplasty. Injectable periarticular liposomal bupivacaine, which has been found to decrease opioid use after orthopedic procedures, has been proposed as a viable alternative to regional anesthesia. This study compared the efficacy of liposomal bupivacaine vs interscalene block among patients undergoing total shoulder arthroplasty. A retrospective review was conducted of 79 patients who underwent anatomic total shoulder arthroplasty performed by a single surgeon between January 2013 and April 2015...
September 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/26650426/a-clinical-comparison-of-intravenous-and-epidural-local-anesthetic-for-major-abdominal-surgery
#6
COMPARATIVE STUDY
Abdullah S Terkawi, Siny Tsang, Ali Kazemi, Steve Morton, Roy Luo, Daniel T Sanders, Lindsay A Regali, Heather Columbano, Nicole Y Kurtzeborn, Marcel E Durieux
BACKGROUND: Epidural analgesia provides good pain control after many postoperative procedures, but it can lead to complications, has some contraindications, and occasionally fails. Intravenous lidocaine infusion has been suggested as an alternative. We assessed, in our clinical practice, the effects of perioperative intravenous lidocaine infusion compared with epidural analgesia for major abdominal surgery. METHODS: We conducted a retrospective review of patients who had received intravenous lidocaine (1 mg/kg per hour) perioperatively after a major abdominal surgery...
January 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27940455/sepsis-for-the-anaesthetist
#7
M E Nunnally
Sepsis is as a dysregulated systemic response to infection. Morbidity and mortality of the syndrome are very high worldwide. Recent definitions have redefined criteria for sepsis. The new definition (Sepsis-3) classifies sepsis as infection with organ dysfunction (the old 'severe sepsis'). Septic patients are at risk for secondary injuries, thus aggressive source control, resuscitation, and antibiotic therapy are the mainstays of management. Central to sepsis physiology is vasodilated shock. Many patients respond to i...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27940457/enhanced-recovery-after-surgery-for-primary-hip-and-knee-arthroplasty-a-review-of-the-evidence
#8
E M Soffin, J T YaDeau
Enhanced recovery after surgery (ERAS) protocols produce significant clinical and economic benefits in a range of surgical subspecialties. There is a long tradition of applying clinical pathways to the perioperative care of joint arthroplasty patients. Enhanced recovery after surgery represents the next step in the evolution of standardized care. To date, reports of full ERAS pathways for hip or knee arthroplasty are lacking. In this narrative review, we present the evidence base that can be usefully applied to constructing ERAS pathways for hip or knee arthroplasty...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27087980/fluid-therapy-in-the-perioperative-setting-a-clinical-review
#9
REVIEW
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
https://www.readbyqxmd.com/read/26300519/a-systematic-review-and-meta-regression-analysis-of-prophylactic-gabapentin-for-postoperative-pain
#10
REVIEW
B Doleman, T P Heinink, D J Read, R J Faleiro, J N Lund, J P Williams
We searched MEDLINE, Embase, CINAHL, AMED and CENTRAL databases until December 2014 and included 133 randomised controlled trials of peri-operative gabapentin vs placebo. Gabapentin reduced mean (95% CI) 24-h morphine-equivalent consumption by 8.44 (7.26-9.62) mg, p < 0.001, whereas more specific reductions in morphine equivalents were predicted (R(2)  = 90%, p < 0.001) by the meta-regression equation: 3.73 + (-0.378 × control morphine consumption (mg)) + (-0.0023 × gabapentin dose (mg)) + (-1...
October 2015: Anaesthesia
https://www.readbyqxmd.com/read/26545144/obstructive-sleep-apnea-pain-and-opioids-is-the-riddle-solved
#11
REVIEW
Karen K Lam, Samuel Kunder, Jean Wong, Anthony G Doufas, Frances Chung
PURPOSE OF REVIEW: Perioperative opioid-based pain management of patients suffering from obstructive sleep apnea (OSA) may present challenges because of concerns over severe ventilatory compromise. The interaction between intermittent hypoxia, sleep fragmentation, pain, and opioid responses in OSA, is complex and warrants a special focus of perioperative outcomes research. RECENT FINDINGS: Life-threatening opioid-related respiratory events are rare. Epidemiologic evidence suggests that OSA together with other serious renal and heart disease, is among those conditions predisposing patients for opioid-induced ventilatory impairment (OIVI) in the postoperative period...
February 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/26977893/opioid-prescribing-for-chronic-pain-not-for-the-faint-of-heart
#12
Mitchell H Katz
No abstract text is available yet for this article.
May 1, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/26889623/does-magnesium-sulfate-as-an-adjuvant-of-local-anesthetics-facilitate-better-effect-of-perineural-nerve-blocks-a-meta-analysis-of-randomized-controlled-trials
#13
Mengzhu Li, Shuqing Jin, Xiang Zhao, Zhendong Xu, Xiu Ni, Lingling Zhang, Zhiqiang Liu
OBJECTIVES: To investigate the efficacy and safety of magnesium sulfate as an adjuvant of local anesthetics in perineural nerve blocks. MATERIALS AND METHODS: Randomized controlled trials studying the effect and safety of magnesium sulfate in perineural nerve blocks were retrieved from online databases. The mean difference (MD), risk ratio, and their corresponding 95% confidence intervals (CIs) were calculated using RevMan 5.3 statistical software. RESULTS: Seven trials evaluating 493 patients were included...
December 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/26897642/paravertebral-block-versus-thoracic-epidural-for-patients-undergoing-thoracotomy
#14
REVIEW
Joyce H Y Yeung, Simon Gates, Babu V Naidu, Matthew J A Wilson, Fang Gao Smith
BACKGROUND: Operations on structures in the chest (usually the lungs) involve cutting between the ribs (thoracotomy). Severe post-thoracotomy pain can result from pleural (lung lining) and muscular damage, costovertebral joint (ribcage) disruption and intercostal nerve (nerves that run along the ribs) damage during surgery. Poor pain relief after surgery can impede recovery and increase the risks of developing complications such as lung collapse, chest infections and blood clots due to ineffective breathing and clearing of secretions...
February 21, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26890472/long-term-results-of-stenting-versus-endarterectomy-for-carotid-artery-stenosis
#15
RANDOMIZED CONTROLLED TRIAL
Thomas G Brott, George Howard, Gary S Roubin, James F Meschia, Ariane Mackey, William Brooks, Wesley S Moore, Michael D Hill, Vito A Mantese, Wayne M Clark, Carlos H Timaran, Donald Heck, Pierre P Leimgruber, Alice J Sheffet, Virginia J Howard, Seemant Chaturvedi, Brajesh K Lal, Jenifer H Voeks, Robert W Hobson
BACKGROUND: In the Carotid Revascularization Endarterectomy versus Stenting Trial, we found no significant difference between the stenting group and the endarterectomy group with respect to the primary composite end point of stroke, myocardial infarction, or death during the periprocedural period or any subsequent ipsilateral stroke during 4 years of follow-up. We now extend the results to 10 years. METHODS: Among patients with carotid-artery stenosis who had been randomly assigned to stenting or endarterectomy, we evaluated outcomes every 6 months for up to 10 years at 117 centers...
March 17, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26890473/endarterectomy-stenting-or-neither-for-asymptomatic-carotid-artery-stenosis
#16
EDITORIAL
J David Spence, A Ross Naylor
No abstract text is available yet for this article.
March 17, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26647407/ketamine-for-analgosedation-in-the-intensive-care-unit-a-systematic-review
#17
Asad E Patanwala, Jennifer R Martin, Brian L Erstad
OBJECTIVE: To evaluate the evidence for the use of intravenous ketamine for analgosedation in the intensive care unit. METHODS: MEDLINE and EMBASE were queried from inception until July 2015. Search terms used included ketamine, intensive care, and critical care. The search retrieved 584 articles to be screened for inclusion. The intent was to include randomized controlled studies using sustained intravenous infusions (>24 hours) of ketamine in the critically ill patients...
July 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/26658199/perioperative-acute-kidney-injury
#18
REVIEW
O Goren, I Matot
Perioperative acute kidney injury (AKI) is not uncommon and is associated with considerable morbidity and mortality. Recently, several definition systems for AKI were proposed, incorporating both small changes of serum creatinine and urinary output reduction as diagnostic criteria. Novel biomarkers are under investigation as fast and accurate predictors of AKI. Several special considerations regarding the risk of AKI are of note in the surgical patient. Co-morbidities are important risk factors for AKI. The surgery in itself, especially emergency and major surgery in the critically ill, is associated with a high incidence of AKI...
December 2015: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26670803/a-new-analgesic-paradigm-for-pediatric-tonsillectomy-are-we-dragging-our-heels
#19
EDITORIAL
Mohamad Ahmad, David Sommerfreund
No abstract text is available yet for this article.
March 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26655725/practice-guidelines-for-the-prevention-detection-and-management-of-respiratory-depression-associated-with-neuraxial-opioid-administration-an-updated-report-by-the-american-society-of-anesthesiologists-task-force-on-neuraxial-opioids-and-the-american-society
#20
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