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Anesthesia management

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118 papers 25 to 100 followers
https://www.readbyqxmd.com/read/28386401/the-efficacy-and-safety-of-intravenous-lidocaine-for-analgesia-in-the-older-adult-a-literature-review
#1
REVIEW
Harriet Daykin
Opioids remain the mainstay of analgesia for the treatment of moderate to severe acute pain. Even in the young, the use of opioids can be associated with an increased incidence of post-operative complications such as respiratory depression, vomiting, pruritus, excessive sedation, slowing of gastrointestinal function, and urinary retention. The need to manage acute pain in the older patient is becoming more common as the population ages, and increasingly older patients are undergoing more major surgery. Medical conditions are more common in older people and can result in the requirement of systemic analgesia for fractures, malignancy, nociceptive or neuropathic pain and peripheral vascular disease...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28186263/change-in-end-tidal-carbon-dioxide-outperforms-other-surrogates-for-change-in-cardiac-output-during-fluid-challenge
#2
K Lakhal, M A Nay, T Kamel, B Lortat-Jacob, S Ehrmann, B Rozec, T Boulain
Background.: During fluid challenge, volume expansion (VE)-induced increase in cardiac output (Δ VE CO) is seldom measured. Methods.: In patients with shock undergoing strictly controlled mechanical ventilation and receiving VE, we assessed minimally invasive surrogates for Δ VE CO (by transthoracic echocardiography): fluid-induced increases in end-tidal carbon dioxide (Δ VE E'CO2 ); pulse (Δ VE PP), systolic (Δ VE SBP), and mean systemic blood pressure (Δ VE MBP); and femoral artery Doppler flow (Δ VE FemFlow)...
March 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26171895/non-pharmacological-interventions-for-assisting-the-induction-of-anaesthesia-in-children
#3
REVIEW
Anne Manyande, Allan M Cyna, Peggy Yip, Cheryl Chooi, Philippa Middleton
BACKGROUND: Induction of general anaesthesia can be distressing for children. Non-pharmacological methods for reducing anxiety and improving co-operation may avoid the adverse effects of preoperative sedation. OBJECTIVES: To assess the effects of non-pharmacological interventions in assisting induction of anaesthesia in children by reducing their anxiety, distress or increasing their co-operation. SEARCH METHODS: In this updated review we searched CENTRAL (the Cochrane Library 2012, Issue 12) and searched the following databases from inception to 15 January 2013: MEDLINE, EMBASE, PsycINFO and Web of Science...
July 14, 2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/19247779/an-evidence-based-review-of-parental-presence-during-anesthesia-induction-and-parent-child-anxiety
#4
REVIEW
Josie Chundamala, James G Wright, Sheelagh M Kemp
PURPOSE: The purpose of this evidence-based review was to examine the effect of parental presence during anesthesia induction on parents' and children's anxiety. SOURCE: MEDLINE (1950 to 2008) and EMBASE (1980 to 2008) were searched. Studies were restricted to randomized controlled trials (RCTs) and comparative studies only (levels of evidence I-III). PRINCIPAL FINDINGS: Fourteen studies that provided level II or level III evidence were included (nine RCTs, four prospective comparative studies, and one retrospective comparative study)...
January 2009: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/25851018/efficacy-of-dexmedetomidine-on-postoperative-shivering-a-meta-analysis-of-clinical-trials
#5
REVIEW
Zhen-Xiu Liu, Feng-Ying Xu, Xiao Liang, Miao Zhou, Liang Wu, Jing-Ru Wu, Jian-Hua Xia, Zui Zou
PURPOSE: Shivering is a frequent complication in the postoperative period. The aim of the current meta-analysis was to assess the efficacy of dexmedetomidine on postoperative shivering. METHODS: Two researchers independently searched PubMed, EMBASE and the Cochrane Central Register of Controlled Trials for controlled clinical trials. The meta-analysis was performed by Review Manager. RESULTS: Thirty-nine trials with 2,478 patients were included in this meta-analysis...
July 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28096514/tonsillectomy-for-obstructive-sleep-disordered-breathing-a-meta-analysis
#6
REVIEW
Sivakumar Chinnadurai, Atia K Jordan, Nila A Sathe, Christopher Fonnesbeck, Melissa L McPheeters, David O Francis
CONTEXT: The effectiveness of tonsillectomy or adenotonsillectomy (hereafter, "tonsillectomy") for obstructive sleep-disordered breathing (OSDB) compared with watchful waiting with supportive care is poorly understood. OBJECTIVE: To compare sleep, cognitive or behavioral, and health outcomes of tonsillectomy versus watchful waiting with supportive care in children with OSDB. DATA SOURCES: Medline, Embase, and the Cochrane Library. STUDY SELECTION: Two investigators independently screened studies against predetermined criteria...
February 2017: Pediatrics
https://www.readbyqxmd.com/read/28248702/norepinephrine-intermittent-intravenous-boluses-to-prevent-hypotension-during-spinal-anesthesia-for-cesarean-delivery-a-sequential-allocation-dose-finding-study
#7
Desire N Onwochei, Warwick D Ngan Kee, Lillia Fung, Kristi Downey, Xiang Y Ye, Jose C A Carvalho
BACKGROUND: The use of phenylephrine as the first-line agent for prevention and treatment of maternal hypotension during cesarean delivery (CD) may reduce cardiac output, posing a theoretical risk to mother and fetus. Norepinephrine has been suggested as a potential alternative, because its β-adrenergic effects might result in greater heart rate and cardiac output than phenylephrine. The use of norepinephrine to prevent and treat hypotension during CD is new, and its use as a bolus has not been fully determined in this context...
February 28, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26106831/ketorolac-use-and-postoperative-complications-in-gastrointestinal-surgery
#8
Meera Kotagal, Timo W Hakkarainen, Vlad V Simianu, Sara J Beck, Rafael Alfonso-Cristancho, David R Flum
OBJECTIVE: To study the association between ketorolac use and postoperative complications. BACKGROUND: Nonsteroidal anti-inflammatory drugs may impair wound healing and increase the risk of anastomotic leak in colon surgery. Studies to date have been limited by sample size, inability to identify confounding, and a focus limited to colon surgery. METHODS: Ketorolac use, reinterventions, emergency department (ED) visits, and readmissions in adults (≥ 18 years) undergoing gastrointestinal (GI) operations was assessed in a nationwide cohort using the MarketScan Database (2008-2012)...
January 2016: Annals of Surgery
https://www.readbyqxmd.com/read/17959952/intraoperative-esmolol-infusion-in-the-absence-of-opioids-spares-postoperative-fentanyl-in-patients-undergoing-ambulatory-laparoscopic-cholecystectomy
#9
RANDOMIZED CONTROLLED TRIAL
Vincent Collard, Giovanni Mistraletti, Ali Taqi, Juan Francisco Asenjo, Liane S Feldman, Gerald M Fried, Franco Carli
BACKGROUND: The use of opioids during ambulatory surgery can delay hospital discharge or cause unexpected hospital admission. Preliminary studies using an intraoperative continuous infusion of esmolol in place of an opioid have inconsistently reported a postoperative opioid-sparing effect. In this study, we compared esmolol versus either intermittent fentanyl or continuous remifentanil on postoperative opioid-sparing, side effects, and time of discharge. METHODS: Ninety patients (consisting of three groups) were enrolled in this prospective, randomized, and observer-blinded study...
November 2007: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27685346/the-optimal-analgesic-block-for-total-knee-arthroplasty
#10
Thomas Fichtner Bendtsen, Bernhard Moriggl, Vincent Chan, Jens Børglum
Peripheral nerve block for total knee arthroplasty is ideally motor sparing while providing effective postoperative analgesia. To achieve these goals, one must understand surgical dissection techniques, distribution of nociceptive generators, sensory innervation of the knee, and nerve topography in the thigh.
November 2016: Regional Anesthesia and Pain Medicine
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
#11
RANDOMIZED CONTROLLED TRIAL
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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