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Anesthesia management

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97 papers 25 to 100 followers
https://www.readbyqxmd.com/read/24508083/effect-of-cold-water-cooling-of-tonsillar-fossa-and-pharyngeal-mucosa-on-post-tonsillectomy-pain
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/10320158/the-effect-of-intravenous-lactated-ringer-s-solution-versus-0-9-sodium-chloride-solution-on-serum-osmolality-in-human-volunteers
#10
RANDOMIZED CONTROLLED TRIAL
E L Williams, K L Hildebrand, S A McCormick, M J Bedel
UNLABELLED: Animal studies have shown that large volumes of IV lactated Ringer's solution (LR) decrease serum osmolality, thereby increasing cerebral water. These studies have led to recommendations to limit LR to avoid cerebral edema in neurosurgical patients. Eighteen healthy human volunteers aged 20-48 yr received 50 mL/kg LR over 1 h on one occasion and 0.9% sodium chloride (NS) on another. Venous samples were taken at baseline (T1), at infusion end (T2), and 1 h after T2 (T3). Time until first urination was noted...
May 1999: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/24238105/the-relationship-between-head-and-neck-position-and-endotracheal-tube-intracuff-pressure-in-the-pediatric-population
#11
Hiromi Kako, Senthil G Krishna, Archana S Ramesh, Meredith N Merz, Charles Elmaraghy, Jonathan Grischkan, Kris R Jatana, James Ruda, Joseph D Tobias
BACKGROUND: Over the past few years, there has been a change in clinical practice with a transition to the use of cuffed instead of uncuffed endotracheal tubes (ETTs) in pediatric patients. These changes have led to concerns regarding unsafe intracuff pressures in pediatric patients, which may result in postoperative morbidity. To avoid these issues, it is generally suggested that the intracuff pressure be maintained at ≤30 cmH2 O. The current study prospectively assesses the changes in intracuff pressure related to alterations in head and neck position in pediatric patients...
March 2014: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/19639372/head-rotation-flexion-and-extension-alter-endotracheal-tube-position-in-adults-and-children
#12
Jin-Tae Kim, Hyun-Jung Kim, Wonsik Ahn, Hee-Soo Kim, Jae-Hyon Bahk, Sang-Chul Lee, Chong-Sung Kim, Seong-Deok Kim
PURPOSE: The purpose of this study was to evaluate the effect of head rotation in adults and children on endotracheal tube (ETT) position and to confirm previous results regarding the influence of head flexion and extension on ETT position. METHODS: After inducing anesthesia in 24 young adults and 22 children (aged 1-9 yr), ETTs were secured on the right corner of each of their mouths. Using a fiberoptic bronchoscope, the distance from the carina to the tip of the ETT was measured with each patient's head and neck placed in a neutral position, flexed, extended, rotated to the right, and rotated to the left...
October 2009: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/18313809/the-history-of-0-9-saline
#13
REVIEW
Sherif Awad, Simon P Allison, Dileep N Lobo
BACKGROUND & AIMS: We aimed to trace the historical origins of 0.9% saline, how it came to be used so commonly today, and to consider whether its continued use can be justified. METHODS: We searched the Medline, Science Citation Index, ScienceDirect and Google databases using the key words saline, physiological, salt solution, sodium chloride, 0.9%, intravenous, injection, fluid, cholera, resuscitation, parenteral, history, historical and origins. RESULTS: The use of 0...
April 2008: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27763895/low-versus-standard-urine-output-targets-in-patients-undergoing-major-abdominal-surgery-a-randomized-noninferiority-trial
#14
Jevon R Puckett, John W Pickering, Suetonia C Palmer, John L McCall, Michal T Kluger, Janak De Zoysa, Zoltan H Endre, Mattias Soop
OBJECTIVE: To determine whether a low perioperative minimum urine output target is safe and fluid sparing when compared with the standard target. BACKGROUND: A minimum hourly urine output of 0.5 mL/kg is a key target guiding perioperative fluid therapy. Few data support this standard practice, which may contribute to perioperative fluid overloading. METHODS: We randomized patients without significant risk factors for acute kidney injury undergoing elective colectomy to a minimum urine output target of 0...
October 19, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27655179/neurodevelopmental-assessment-in-kindergarten-in-children-exposed-to-general-anesthesia-before-the-age-of-4-years-a-retrospective-matched-cohort-study
#15
M Ruth Graham, Marni Brownell, Daniel G Chateau, Roxana D Dragan, Charles Burchill, Randal R Fransoo
BACKGROUND: Animal studies demonstrate general anesthetic (GA) toxicity in the developing brain. Clinical reports raise concern, but the risk of GA exposure to neurodevelopment in children remains uncertain. METHODS: The authors undertook a retrospective matched cohort study comparing children less than 4 yr of age exposed to GA to those with no GA exposure. The authors used the Early Development Instrument (EDI), a 104-component questionnaire, encompassing five developmental domains, completed in kindergarten as the outcome measure...
October 2016: Anesthesiology
https://www.readbyqxmd.com/read/21042500/role-of-hypertonic-saline-and-mannitol-in-the-management-of-raised-intracranial-pressure-in-children-a-randomized-comparative-study
#16
Piyush Upadhyay, V N Tripathi, R P Singh, D Sachan
OBJECTIVE: To compare the efficacy and side effects of 3% hypertonic saline and mannitol in the management of raised intracranial pressure in children. DESIGN: Prospective randomized study. SETTING: Pediatric intensive care unit (PICU) in a tertiary care hospital. SUBJECT: 200 patients with raised intracranial pressure. MATERIALS AND METHODS: Patients were randomized into two statistically comparable groups; Group A (n = 98) was treated with mannitol while Group B (n = 100) was treated with 3% hypertonic saline...
January 2010: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/23842193/death-or-neurologic-injury-after-tonsillectomy-in-children-with-a-focus-on-obstructive-sleep-apnea-houston-we-have-a-problem
#17
Charles J Coté, Karen L Posner, Karen B Domino
BACKGROUND: Obesity is epidemic in the United States and with it comes an increased incidence of obstructive sleep apnea (OSA). Evidence regarding opioid sensitivity as well as recent descriptions of deaths after tonsillectomy prompted a survey of all members of the Society for Pediatric Anesthesia regarding adverse events in children undergoing tonsillectomy. METHODS: An electronic survey was sent to 2377 members of the Society for Pediatric Anesthesia. Additionally, data from the American Society of Anesthesiologists Closed Claims Project were obtained...
June 2014: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26735156/acute-vision-loss-secondary-to-epidural-blood-patch-terson-syndrome
#18
Gabriel L Pagani-Estévez, John J Chen, James C Watson, Jacqueline A Leavitt
BACKGROUND AND OBJECTIVES: Lumbar epidural blood patch (EBP) is a commonly used procedure to treat postdural puncture headache. We present a case of vision loss immediately following an EBP. CASE REPORT: A 49-year-old woman with idiopathic intracranial hypertension received an EBP for postdural puncture headache at an outside facility without fluoroscopic guidance and in the seated position. The patient experienced syncope during the procedure as 25 mL of autologous blood was rapidly injected...
March 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/23305109/serious-complications-associated-with-spinal-and-epidural-anaesthesia-in-finland-from-2000-to-2009
#19
M T Pitkänen, U Aromaa, D A Cozanitis, J G Förster
BACKGROUND: Analyses of closed claims provide insight into the characteristics of rare complications. Serious complications related to spinal and epidural blocks are relatively rare. In Finland, all malpractice cases are primarily handled by the Patient Insurance Centre (PIC) within a 'no-fault scheme'. METHODS: All claims attributed to central neuraxial blocks and settled by the PIC during the period, 2000-2009 were analysed. The number of spinal and epidural procedures performed during this time was estimated based on a questionnaire sent to all surgical hospitals in Finland in 2009, surveying the numbers and types of neuraxial blocks carried out in 2008...
May 2013: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27098439/active-body-surface-warming-systems-for-preventing-complications-caused-by-inadvertent-perioperative-hypothermia-in-adults
#20
REVIEW
Eva Madrid, Gerard Urrútia, Marta Roqué i Figuls, Hector Pardo-Hernandez, Juan Manuel Campos, Pilar Paniagua, Luz Maestre, Pablo Alonso-Coello
BACKGROUND: Inadvertent perioperative hypothermia is a phenomenon that can occur as a result of the suppression of the central mechanisms of temperature regulation due to anaesthesia, and of prolonged exposure of large surfaces of skin to cold temperatures in operating rooms. Inadvertent perioperative hypothermia has been associated with clinical complications such as surgical site infection and wound-healing delay, increased bleeding or cardiovascular events. One of the most frequently used techniques to prevent inadvertent perioperative hypothermia is active body surface warming systems (ABSW), which generate heat mechanically (heating of air, water or gels) that is transferred to the patient via skin contact...
April 21, 2016: Cochrane Database of Systematic Reviews
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