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Anesthesia management

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83 papers 25 to 100 followers
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
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
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
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
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
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...
2016: Cochrane Database of Systematic Reviews
Simon J Lehtinen, Georgiana Onicescu, Kathy M Kuhn, David J Cole, Nestor F Esnaola
OBJECTIVE: To analyze the association between perioperative normothermia (temperature ≥36°C) and surgical site infections (SSIs) after gastrointestinal (GI) surgery. SUMMARY OF BACKGROUND DATA: Although active warming during colorectal surgery reduces SSIs, there is limited evidence that perioperative normothermia is associated with lower rates of SSI. Nonetheless, hospitals participating in the Surgical Care Improvement Project must report normothermia rates during major surgery...
October 2010: Annals of Surgery
E Chiner, J Signes-Costa, J M Arriero, J Marco, I Fuentes, A Sergado
BACKGROUND: Polysomnography (PSG) is currently the "gold standard" for the diagnosis of the sleep apnoea hypopnoea syndrome (SAHS). Nocturnal oximetry (NO) has been used with contradictory results. A prospective study was performed to determine the accuracy of NO as a diagnostic tool and to evaluate the reduction in the number of PSGs if the diagnosis of SAHS had been established by this method. METHODS: Two hundred and seventy five patients with a clinical suspicion of SAHS were admitted to undergo, in the same night, full PSG and NO...
November 1999: Thorax
Xian Su, Zhao-Ting Meng, Xin-Hai Wu, Fan Cui, Hong-Liang Li, Dong-Xin Wang, Xi Zhu, Sai-Nan Zhu, Mervyn Maze, Daqing Ma
BACKGROUND: Delirium is a postoperative complication that occurs frequently in patients older than 65 years, and presages adverse outcomes. We investigated whether prophylactic low-dose dexmedetomidine, a highly selective α2 adrenoceptor agonist, could safely decrease the incidence of delirium in elderly patients after non-cardiac surgery. METHODS: We did this randomised, double-blind, placebo-controlled trial in two tertiary-care hospitals in Beijing, China. We enrolled patients aged 65 years or older, who were admitted to intensive care units after non-cardiac surgery, with informed consent...
October 15, 2016: Lancet
F Wickham Kraemer, Paul A Stricker, Harshad G Gurnaney, Heather McClung, Marcie R Meador, Emily Sussman, Beverly J Burgess, Brian Ciampa, Jared Mendelsohn, Mohamed A Rehman, Mehernoor F Watcha
BACKGROUND: Bradycardia is a complication associated with inhaled induction of anesthesia with halothane in children with Down syndrome. Although bradycardia has been reported after anesthetic induction with sevoflurane in these children, the incidence is unknown. OBJECTIVES: In this study we compared the incidence and characteristics of bradycardia after induction of anesthesia with sevoflurane in children with Down syndrome to healthy controls. METHODS: We reviewed electronic anesthetic records of 209 children with Down syndrome and 268 healthy control patients who had inhaled induction of anesthesia with sevoflurane over an 8-year period...
November 2010: Anesthesia and Analgesia
G J Mar, M J Barrington, B R McGuirk
Acute compartment syndrome can cause significant disability if not treated early, but the diagnosis is challenging. This systematic review examines whether modern acute pain management techniques contribute to delayed diagnosis. A total of 28 case reports and case series were identified which referred to the influence of analgesic technique on the diagnosis of compartment syndrome, of which 23 discussed epidural analgesia. In 32 of 35 patients, classic signs and symptoms of compartment syndrome were present in the presence of epidural analgesia, including 18 patients with documented breakthrough pain...
January 2009: British Journal of Anaesthesia
Jessica M Booth, Joshua C Pan, Vernon H Ross, Gregory B Russell, Lynne C Harris, Peter H Pan
BACKGROUND: It is unclear whether recognition of epidural catheter failures is delayed with combined spinal epidural technique (CSE) compared to traditional epidural technique (EPID) when used for labor analgesia. The authors hypothesized that recognition of failed catheters is not delayed by CSE. METHODS: Anesthetic, obstetric, and quality assurance records from 2,395 labor neuraxial procedures (1,440 CSE and 955 EPID) performed at Forsyth Medical Center (Winston-Salem, North Carolina) between June 30 and December 31, 2012, were retrospectively analyzed...
September 2016: Anesthesiology
Pamela E Windle, Meggie L Kwan, Honey Warwick, Agnes Sibayan, Charito Espiritu, Jennifer Vergara
Pain with intravenous (IV) insertion is a common fear for preoperative patients. As perianesthesia nurses, we take the necessary measures to minimize the discomfort and anxiety of our patients. Several research studies have found the use of bacteriostatic normal saline (BNS) to produce a less painful, yet equally effective, safer, and less expensive alternative method for intradermal anesthesia. The purpose of this study was to determine whether a difference existed in pain with intradermal injection and pain with venipuncture when intradermal anesthesia was used...
August 2006: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
John P A Ioannidis
There is increasing concern that most current published research findings are false. The probability that a research claim is true may depend on study power and bias, the number of other studies on the same question, and, importantly, the ratio of true to no relationships among the relationships probed in each scientific field. In this framework, a research finding is less likely to be true when the studies conducted in a field are smaller; when effect sizes are smaller; when there is a greater number and lesser preselection of tested relationships; where there is greater flexibility in designs, definitions, outcomes, and analytical modes; when there is greater financial and other interest and prejudice; and when more teams are involved in a scientific field in chase of statistical significance...
August 2005: PLoS Medicine
Charles H Brown, Andrew S Azman, Allan Gottschalk, Simon C Mears, Frederick E Sieber
Low intraoperative Bispectral Index (BIS) values may be associated with increased mortality. In a previously reported trial to prevent delirium, we randomized patients undergoing hip fracture repair under spinal anesthesia to light (BIS >80) or deep (BIS approximately 50) sedation. We analyzed survival of patients in the original trial. Among all patients, mortality was equivalent across sedation groups. However, among patients with serious comorbidities (Charlson score >4), 1-year mortality was reduced in the light (22...
May 2014: Anesthesia and Analgesia
Frederick E Sieber, Khwaji J Zakriya, Allan Gottschalk, Mary-Rita Blute, Hochang B Lee, Paul B Rosenberg, Simon C Mears
OBJECTIVE: To determine whether limiting intraoperative sedation depth during spinal anesthesia for hip fracture repair in elderly patients can decrease the prevalence of postoperative delirium. PATIENTS AND METHODS: We performed a double-blind, randomized controlled trial at an academic medical center of elderly patients (>or=65 years) without preoperative delirium or severe dementia who underwent hip fracture repair under spinal anesthesia with propofol sedation...
January 2010: Mayo Clinic Proceedings
Mark A Gerhardt, Vit B Gunka, Robert J Miller
CONTEXT: Epidural anesthesia for labor pain is frequently complicated by maternal hypotension. OBJECTIVE: To test whether continuous epidural infusion (CEI) of local anesthetic, without bolus administration, lowers the incidence of hypotension in parturient patients. METHODS: In a single-blind clinical study, subjects were randomly assigned to CEI-only (10 mL/h of 0.2% ropivacaine hydrochloride without bolus) or control (10 mL of 0.2% ropivacaine hydrochloride per hour with 10-mL bolus) epidural dosing groups...
December 2006: Journal of the American Osteopathic Association
Ronald B George, Terrence K Allen, Ashraf S Habib
BACKGROUND: The current standard labor epidural analgesic regimens consist of a local anesthetic in combination with an opioid delivered via continuous epidural infusion (CEI). With CEI local anesthetic, doses may be large with resulting profound motor blockade potentially affecting the incidence of instrumental deliveries. In this systematic review of randomized controlled trials (RCTs), we compared the effect of intermittent epidural bolus (IEB) to standard CEI dosing with or without patient-controlled epidural analgesia on patient satisfaction, the need for manual anesthesia interventions, labor progression, and mode of delivery in healthy women receiving labor epidural analgesia...
January 2013: Anesthesia and Analgesia
Stavros I Tyritzis, Konstantinos G Stravodimos, Ioanna Vasileiou, Georgia Fotopoulou, Georgios Koritsiadis, Vasileios Migdalis, Anastasios Michalakis, Constantinos A Constantinides
We compared the analgesic efficacy of spinal and general anaesthesia following transurethral procedures. 97 and 47 patients underwent transurethral bladder tumour resection (TUR-B) and transurethral prostatectomy (TUR-P), respectively. Postoperative pain was recorded using an 11-point visual analogue scale (VAS). VAS score was greatest at discharge from recovery room for general anaesthesia (P = 0.027). The pattern changed significantly at 8 h and 12 h for general anaesthesia's efficacy (P = 0.017 and P = 0...
2011: ISRN Urology
Dusanka Zaric, Christian Christiansen, Nathan L Pace, Yodying Punjasawadwong
Lidocaine has been used for spinal anesthesia since 1948, seemingly without causing concern. However, during the last 10 years, a number of reports have appeared implicating lidocaine as a possible cause of neurologic complications after spinal anesthesia. Follow-up of patients who received uncomplicated spinal anesthesia revealed that some of them developed pain in the lower extremities--transient neurologic symptoms (TNS). In this study, we sought to compare the frequency of 1) TNS and 2) neurologic complications after spinal anesthesia with lidocaine with that after other local anesthetics...
June 2005: Anesthesia and Analgesia
2016-06-14 04:33:48
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