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Anesthesia management

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108 papers 25 to 100 followers
https://www.readbyqxmd.com/read/27555197/the-effects-of-caudal-or-intravenous-dexmedetomidine-on-postoperative-analgesia-produced-by-caudal-bupivacaine-in-children-a-randomized-controlled-double-blinded-study
#1
Khaled R Al-Zaben, Ibraheem Y Qudaisat, Aboud N Alja'bari, Omar A Ababneh, Al-Motassem M Yousef, Abdulrahman M Al-Shudifat
STUDY OBJECTIVES: The aim of this study was to compare the effects of caudal and intravenous (IV) dexmedetomidine (1 μg/kg) on postoperative analgesia after caudal bupivacaine in pediatric patients undergoing lower abdominal and perineal surgeries. DESIGN: A randomized controlled double-blind study. SETTING: University-affiliated teaching hospital. PATIENTS: Seventy-five American Society of Anesthesiologists I children, aged 1 to 6 years...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/25537312/the-ekg-in-hypothermia-and-hyperthermia
#2
REVIEW
Hardik H Doshi, Michael C Giudici
Hypothermia and hyperthermia are relatively common clinical conditions that are associated with significant morbidity and mortality, especially if not promptly recognized and treated. Both of these conditions associated with extreme alterations in core body temperatures can be accompanied by alteration in cardiac function, often with manifest EKG changes. However, some of the EKG changes associated with hypothermia and heat stroke are non-specific and lead to diagnostic dilemmas. We here present 2 clinical cases, one each for hypothermia and hyperthermia to describe the EKG changes associated with these clinical conditions...
March 2015: Journal of Electrocardiology
https://www.readbyqxmd.com/read/26936022/a-comparison-of-intranasal-dexmedetomidine-for-sedation-in-children-administered-either-by-atomiser-or-by-drops
#3
COMPARATIVE STUDY
B L Li, N Zhang, J X Huang, Q Q Qiu, H Tian, J Ni, X R Song, V M Yuen, M G Irwin
Intranasal dexmedetomidine has been used successfully for sedation in children. A mucosal atomisation device delivers an atomised solution to the nasal mucosa which facilitates rapid and effective delivery of medication to the systemic circulation. We compared intranasal delivery of dexmedetomidine in a dose of 3 μg.kg(-1) by either atomiser or drops from a syringe in children < 3 years old undergoing transthoracic echocardiography. Two hundred and seventy-nine children were randomly assigned to one or other group...
May 2016: Anaesthesia
https://www.readbyqxmd.com/read/20802055/the-anesthetic-considerations-of-tracheobronchial-foreign-bodies-in-children-a-literature-review-of-12-979-cases
#4
REVIEW
Christina W Fidkowski, Hui Zheng, Paul G Firth
Asphyxiation by an inhaled foreign body is a leading cause of accidental death among children younger than 4 years. We analyzed the recent epidemiology of foreign body aspiration and reviewed the current trends in diagnosis and management. In this article, we discuss anesthetic management of bronchoscopy to remove objects. The reviewed articles total 12,979 pediatric bronchoscopies. Most aspirated foreign bodies are organic materials (81%, confidence interval [CI] = 77%-86%), nuts and seeds being the most common...
October 2010: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27535672/the-preoperative-incidence-of-deep-vein-thrombosis-dvt-and-its-correlation-with-postoperative-dvt-in-patients-undergoing-elective-surgery-for-femoral-neck-fractures
#5
Kai Song, Yao Yao, Zhen Rong, Yeshuai Shen, Minghao Zheng, Qing Jiang
INTRODUCTION: Data on the incidence of preoperative deep vein thrombosis (DVT) in patients, who are waiting for elective hip replacement for femoral neck fractures, are limited. Our primary goal was to determine the prevalence and risk factors of preoperative DVT in acute hip fracture patients awaiting hemi- or total hip arthroplasty using venography. The secondary objective was to find a possible relationship between preoperative and postoperative DVT. METHODS: We enrolled 119 consecutive patients with subcapital femoral neck fracture, who were awaiting hip replacement at our institution...
October 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27780181/benefit-and-harm-of-adding-ketamine-to-an-opioid-in-a-patient-controlled-analgesia-device-for-the-control-of-postoperative-pain-systematic-review-and-meta-analyses-of-randomized-controlled-trials-with-trial-sequential-analyses
#6
Benjamin Assouline, Martin R Tramèr, Lukas Kreienbühl, Nadia Elia
Ketamine is often added to opioids in patient-controlled analgesia devices. We tested whether in surgical patients, ketamine added to an opioid patient-controlled analgesia decreased pain intensity by ≥25%, cumulative opioid consumption by ≥30%, the risk of postoperative nausea and vomiting by ≥30%, the risk of respiratory adverse effects by ≥50%, and increased the risk of hallucination not more than 2-fold. In addition, we searched for evidence of dose-responsiveness. Nineteen randomized trials (1349 adults, 104 children) testing different ketamine regimens added to various opioids were identified through searches in databases and bibliographies (to 04...
August 29, 2016: Pain
https://www.readbyqxmd.com/read/28039248/effect-of-anaesthesia-type-on-postoperative-mortality-and-morbidities-a-matched-analysis-of-the-nsqip-database
#7
N N Saied, M A Helwani, L M Weavind, Y Shi, M S Shotwell, P P Pandharipande
BACKGROUND: The anaesthetic technique may influence clinical outcomes, but inherent confounding and small effect sizes makes this challenging to study. We hypothesized that regional anaesthesia (RA) is associated with higher survival and fewer postoperative organ dysfunctions when compared with general anaesthesia (GA). METHODS: We matched surgical procedures and type of anaesthesia using the US National Surgical Quality Improvement database, in which 264,421 received GA and 64,119 received RA...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/25231491/the-prevention-of-delirium-and-complications-associated-with-surgical-treatments-podcast-study-protocol-for-an-international-multicentre-randomised-controlled-trial
#8
RANDOMIZED CONTROLLED TRIAL
Michael S Avidan, Bradley A Fritz, Hannah R Maybrier, Maxwell R Muench, Krisztina E Escallier, Yulong Chen, Arbi Ben Abdallah, Robert A Veselis, Judith A Hudetz, Paul S Pagel, Gyujeong Noh, Kane Pryor, Heiko Kaiser, Virendra Kumar Arya, Ryan Pong, Eric Jacobsohn, Hilary P Grocott, Stephen Choi, Robert J Downey, Sharon K Inouye, George A Mashour
INTRODUCTION: Postoperative delirium is one of the most common complications of major surgery, affecting 10-70% of surgical patients 60 years and older. Delirium is an acute change in cognition that manifests as poor attention and illogical thinking and is associated with longer intensive care unit (ICU) and hospital stay, long-lasting cognitive deterioration and increased mortality. Ketamine has been used as an anaesthetic drug for over 50 years and has an established safety record. Recent research suggests that, in addition to preventing acute postoperative pain, a subanaesthetic dose of intraoperative ketamine could decrease the incidence of postoperative delirium as well as other neurological and psychiatric outcomes...
September 17, 2014: BMJ Open
https://www.readbyqxmd.com/read/19293690/comparison-of-two-insertion-techniques-of-proseal-laryngeal-mask-airway-standard-versus-90-degree-rotation
#9
RANDOMIZED CONTROLLED TRIAL
Jung-won Hwang, Hee-Pyoung Park, Young-Jin Lim, Sang-Hwan Do, Sang-Chul Lee, Young-Tae Jeon
BACKGROUND: This study compared two insertion techniques of ProSeal laryngeal mask airway. METHODS: A total of 160 female patients (American Society of Anesthesiologists physical status I or II; age 18-80 yrs) undergoing gynecologic surgery were randomly allocated to the standard or rotational technique groups. In the standard technique group (n = 80), ProSeal laryngeal mask airway insertion was performed by a single experienced user using digital manipulation. In the rotational technique group (n = 80), the ProSeal laryngeal mask airway was rotated counter clockwise through 90 degrees in the mouth and advanced until the resistance of the hypopharynx was felt, and then straightened out in the hypopharynx (n = 80)...
April 2009: Anesthesiology
https://www.readbyqxmd.com/read/21680859/learning-endotracheal-intubation-using-a-novel-videolaryngoscope-improves-intubation-skills-of-medical-students
#10
RANDOMIZED CONTROLLED TRIAL
Frank Herbstreit, Philipp Fassbender, Helge Haberl, Clemens Kehren, Jürgen Peters
INTRODUCTION: Teaching endotracheal intubation to medical students is a task provided by many academic anesthesia departments. We tested the hypothesis that teaching with a novel videolaryngoscope improves students' intubation skills. METHODS: We prospectively assessed in medical students (2nd clinical year) intubation skills acquired by intubation attempts in adult anesthetized patients during a 60-hour clinical course using, in a randomized fashion, either a conventional Macintosh blade laryngoscope or a videolaryngoscope (C-MAC®)...
September 2011: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/8744658/the-regional-anesthesia-learning-curve-what-is-the-minimum-number-of-epidural-and-spinal-blocks-to-reach-consistency
#11
D J Kopacz, J M Neal, J E Pollock
BACKGROUND AND OBJECTIVES: Wide variability exists in the amount of regional anesthesia practice to which residents are exposed during training. The number of attempts at various blocks before a trainee becomes proficient at performing these regional anesthetic techniques is not known. This study addresses the question: What is the minimum number of blocks a resident must perform to reach consistency during training in these techniques? METHODS: Every regional anesthetic technique attempted by all beginning CA-1 anesthesiology residents (n = 7) during their first 6 months of training (July 1993 to December 1993) were recorded on a daily basis...
May 1996: Regional Anesthesia
https://www.readbyqxmd.com/read/24508083/effect-of-cold-water-cooling-of-tonsillar-fossa-and-pharyngeal-mucosa-on-post-tonsillectomy-pain
#12
RANDOMIZED CONTROLLED TRIAL
Jae Min Shin, Jang Yul Byun, Byoung Joon Baek, Jae Yong Lee
PURPOSE: Post-tonsillectomy pain is a notable concern and thermal injury produced by electric surgical devices is considered a main cause. Intraoperative cooling of the tonsillar fossa and pharyngeal mucosa with cold water has effectively reduced postoperative pain, but no studies have fully evaluated the effects of this technique with a proper study design. We assessed mucosal cooling in two groups of patients undergoing the same surgical technique by a single surgeon, with one group receiving cold-water cooling and the other group as a control...
May 2014: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/26378695/obstetric-neuraxial-anesthesia-contraindicated-really-time-to-rethink-old-dogma
#13
COMMENT
William Camann
No abstract text is available yet for this article.
October 2015: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/16139497/low-dose-sequential-combined-spinal-epidural-an-anaesthetic-technique-for-caesarean-section-in-patients-with-significant-cardiac-disease
#14
E L Hamlyn, C A Douglass, F Plaat, J A Crowhurst, G M Stocks
In the United Kingdom, cardiac disease is the second most common cause of all maternal deaths. The best anaesthetic technique for caesarean section in these patients has yet to be established. We describe a low-dose combined spinal-epidural technique in four high-risk obstetric patients who presented to this unit. Invasive monitoring was used in each case, and drugs with significant cardiovascular effects were avoided or used with extreme caution. Multidisciplinary team involvement, including serial echocardiography in the antenatal period, is strongly recommended...
October 2005: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/16103385/intubation-depth-markings-allow-an-improved-positioning-of-endotracheal-tubes-in-children
#15
Markus Weiss, Christian Balmer, Alexander Dullenkopf, Walter Knirsch, Andreas Ch Gerber, Urs Bauersfeld, Felix Berger
OBJECTIVES: To evaluate the position of the new Microcuff pediatric tracheal tube, based upon intubation depth markings. METHODS: With Institutional Ethics Committee approval and informed parental consent, we included patients from birth (> or = 3 kg) to 16 yr undergoing interventional cardiac catheterization requiring general anesthesia with orotracheal intubation. The intubation depth mark of the tracheal tube was placed between the vocal cords by direct laryngoscopy...
August 2005: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/12100762/effects-of-norepinephrine-epinephrine-and-norepinephrine-dobutamine-on-systemic-and-gastric-mucosal-oxygenation-in-septic-shock
#16
RANDOMIZED CONTROLLED TRIAL
Shao-Xia Zhou, Hai-Bo Qiu, Ying-Zi Huang, Yi Yang, Rui-Qiang Zheng
AIM: To compare the effects of dopamine, norepinephrine, epinephrine, and the combination of norepinephrine and dobutamine on systemic and gastric mucosal oxygen metabolism in patients with septic shock. METHODS: Sixteen patients with septic shock were enrolled in the present study. Each patient received dopamine firstly, then in a random succession epinephrine, norepinephrine, or norepinephrine-dobutamine, a mean systemic arterial pressure adjusted to >9.31 kPa...
July 2002: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/23835589/relationship-between-intraoperative-mean-arterial-pressure-and-clinical-outcomes-after-noncardiac-surgery-toward-an-empirical-definition-of-hypotension
#17
Michael Walsh, Philip J Devereaux, Amit X Garg, Andrea Kurz, Alparslan Turan, Reitze N Rodseth, Jacek Cywinski, Lehana Thabane, Daniel I Sessler
BACKGROUND: Intraoperative hypotension may contribute to postoperative acute kidney injury (AKI) and myocardial injury, but what blood pressures are unsafe is unclear. The authors evaluated the association between the intraoperative mean arterial pressure (MAP) and the risk of AKI and myocardial injury. METHODS: The authors obtained perioperative data for 33,330 noncardiac surgeries at the Cleveland Clinic, Ohio. The authors evaluated the association between intraoperative MAP from less than 55 to 75 mmHg and postoperative AKI and myocardial injury to determine the threshold of MAP where risk is increased...
September 2013: Anesthesiology
https://www.readbyqxmd.com/read/19039097/managerial-leadership-and-ischaemic-heart-disease-among-employees-the-swedish-wolf-study
#18
A Nyberg, L Alfredsson, T Theorell, H Westerlund, J Vahtera, M Kivimäki
OBJECTIVE: To investigate the association between managerial leadership and ischaemic heart disease (IHD) among employees. METHODS: Data on 3122 Swedish male employees were drawn from a prospective cohort study (WOLF). Baseline screening was carried out in 1992-1995. Managerial leadership behaviours (consideration for individual employees, provision of clarity in goals and role expectations, supplying information and feedback, ability to carry out changes at work successfully, and promotion of employee participation and control) were rated by subordinates...
January 2009: Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/25046776/double-duty-does-epidural-labor-analgesia-reduce-both-pain-and-postpartum-depression
#19
EDITORIAL
Katherine L Wisner, Catherine Susan Stika, Crystal T Clark
No abstract text is available yet for this article.
August 2014: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/16244006/multimodal-analgesia-with-gabapentin-and-local-anesthetics-prevents-acute-and-chronic-pain-after-breast-surgery-for-cancer
#20
RANDOMIZED CONTROLLED TRIAL
Argyro Fassoulaki, Argyro Triga, Aikaterini Melemeni, Constantine Sarantopoulos
We evaluated the effect of multimodal analgesia on acute and chronic pain after breast surgery for cancer. Fifty patients scheduled for breast cancer surgery were blindly randomized to receive gabapentin, eutectic mixture of local anesthetics cream, and ropivacaine in the wound or three placebos. Pain (visual analog scale) and analgesics were recorded in the postanesthesia care unit (PACU) 3, 6, and 9 h and 8 days after surgery. Three and 6 mo later, patients were assessed for chronic pain. The treatment group consumed less paracetamol in the PACU (469 versus 991 mg; P < 0...
November 2005: Anesthesia and Analgesia
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