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jrgAnesthesia

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By Jesse Guscott McMaster Family Practice Anesthesia program director. Medical educator, ER, Anesthesia Twitter:@GuscottJesse
https://www.readbyqxmd.com/read/15637018/anesthetic-management-of-the-parturient-with-ankylosing-spondylitis
#1
R A Bourlier, D J Birnbach
Pregnancy may occur in patients with ankylosing spondylitis, a chronic inflammatory joint disease. This disease, which is included in the group of seronegative spondylarthropathies, may be characterized by both intra- and extra-articular manifestations. Although most pregnant patients with ankylosing spondylitis experience normal spontaneous vaginal deliveries, manifestations of the disease may interfere with labor and delivery as well as the administration of general and regional anesthesia. Therefore, physicians caring for a pregnant patient with ankylosing spondylitis should be aware of the obstetric and anesthetic implications and the ramifications of active disease...
October 1995: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29101667/special-announcement-guidelines-to-the-practice-of-anesthesia-revised-edition-2018
#2
EDITORIAL
Gregory Dobson
No abstract text is available yet for this article.
January 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29044483/hyperbaric-vs-isobaric-bupivacaine-for-spinal-anaesthesia-for-elective-caesarean-section-a-cochrane-systematic-review
#3
REVIEW
B L Sng, N L R Han, W L Leong, R Sultana, F J Siddiqui, P N Assam, E S Chan, K H Tan, A T Sia
Both isobaric and hyperbaric bupivacaine have been used for spinal anaesthesia for elective caesarean section, but it is not clear if one is better than the other. The primary objective of this systematic review was to determine the effectiveness and safety of hyperbaric bupivacaine compared with isobaric bupivacaine administered during spinal anaesthesia for elective caesarean section. We included 10 studies with 614 subjects in the analysis. There was no evidence of differences either in the risk of conversion to general anaesthesia, with a relative risk (95%CI) of 0...
October 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29029049/intraoperative-naloxone-reduces-remifentanil-induced-postoperative-hyperalgesia-but-not-pain-a-randomized-controlled-trial
#4
C-H Koo, S Yoon, B-R Kim, Y J Cho, T K Kim, Y Jeon, J-H Seo
Background: Intraoperative use of a high-dose remifentanil may induce postoperative hyperalgesia. Low-dose naloxone can selectively reverse some adverse effects of opioids without compromising analgesia. We thus hypothesized that the intraoperative use of a high-dose remifentanil combined with a low-dose naloxone infusion reduces postoperative hyperalgesia compared with the use of remifentanil alone. Methods: Patients undergoing elective thyroid surgery were randomly assigned into one of three groups, depending on the intraoperative effect-site concentration of remifentanil, with or without a continuous infusion of naloxone: 4 ng ml-1 remifentanil with 0...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28623089/optimal-intrathecal-hyperbaric-bupivacaine-dose-with-opioids-for-cesarean-delivery-a-prospective-double-blinded-randomized-trial
#5
Eiko Onishi, Mamoru Murakami, Keiji Hashimoto, Miho Kaneko
BACKGROUND: Single-shot spinal anesthesia is commonly used for cesarean delivery. Achieving adequate anesthesia throughout surgery needs to be balanced with associated complications. We investigated the optimal dose of intrathecal hyperbaric bupivacaine, co-administered with opioids, for anesthesia for cesarean delivery. METHODS: This prospective, randomized, double-blinded, dose-ranging trial included parturients scheduled to undergo cesarean delivery under spinal anesthesia...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28604405/operating-room-crisis-checklists-and-emergency-manuals
#6
REVIEW
David L Hepner, Alexander F Arriaga, Jeffrey B Cooper, Sara N Goldhaber-Fiebert, David M Gaba, William R Berry, Daniel J Boorman, Angela M Bader
No abstract text is available yet for this article.
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28538645/increased-mortality-in-trauma-patients-who-develop-post-intubation-hypotension
#7
Robert S Green, Michael B Butler, Mete Erdogan
BACKGROUND: Post-intubation hypotension (PIH) is common and associated with poor outcomes in critically ill patient populations requiring emergency endotracheal intubation (ETI). The importance of PIH in the trauma population remains unclear. The objective of this study was to determine the prevalence of PIH in trauma patients and assess the association of PIH with patient outcomes. METHODS: Retrospective case series of adult (≥16 years) patients who were intubated on arrival at a tertiary trauma center in Halifax, Nova Scotia, Canada between 2000 and 2015...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28513831/avoidance-versus-use-of-neuromuscular-blocking-agents-for-improving-conditions-during-tracheal-intubation-or-direct-laryngoscopy-in-adults-and-adolescents
#8
REVIEW
Lars H Lundstrøm, Christophe Hv Duez, Anders K Nørskov, Charlotte V Rosenstock, Jakob L Thomsen, Ann Merete Møller, Søren Strande, Jørn Wetterslev
BACKGROUND: Tracheal intubation during induction of general anaesthesia is a vital procedure performed to secure a patient's airway. Several studies have identified difficult tracheal intubation (DTI) or failed tracheal intubation as one of the major contributors to anaesthesia-related mortality and morbidity. Use of neuromuscular blocking agents (NMBA) to facilitate tracheal intubation is a widely accepted practice. However, because of adverse effects, NMBA may be undesirable. Cohort studies have indicated that avoiding NMBA is an independent risk factor for difficult and failed tracheal intubation...
May 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28243855/optimal-propofol-induction-dose-in-morbidly-obese-patients-a-randomized-controlled-trial-comparing-the-bispectral-index-and-lean-body-weight-scalar
#9
RANDOMIZED CONTROLLED TRIAL
Yamini Subramani, Waleed Riad, Frances Chung, Jean Wong
PURPOSE: Propofol dosing based on total body weight (TBW) can lead to overdosing in morbidly obese (MO) patients. Our aim was to determine whether an induction dose of propofol based on a bispectral index (BIS) target is better for achieving loss of consciousness in MO patients than dosing based on lean body weight (LBW). METHODS: Sixty MO patients with a body mass index (BMI) of ≥ 40 kg·m(-2) were randomized to either BIS- or LBW-based propofol dosing groups...
May 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28326467/malignant-hyperthermia-susceptibility-in-patients-with-exertional-rhabdomyolysis-a-retrospective-cohort-study-and-updated-systematic-review
#10
Natalia Kraeva, Alexander Sapa, James J Dowling, Sheila Riazi
INTRODUCTION: Two potentially fatal syndromes, malignant hyperthermia (MH), an adverse reaction to general anesthesia, and exertional rhabdomyolysis (ER) share some clinical features, including hyperthermia, muscle rigidity, tachycardia, and elevated serum creatine kinase. Some patients with ER have experienced an MH event and/or have been diagnosed as MH susceptible (MHS). In order to assess the relationship between ER and MH further, we conducted a retrospective cohort study summarizing clinical and genetic information on Canadian patients with ER who were diagnosed as MHS...
July 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28109012/the-impact-of-a-soiled-airway-on-intubation-success-in-the-emergency-department-when-using-the-glidescope-or-the-direct-laryngoscope
#11
John C Sakles, G Judson Corn, Patrick Hollinger, Brittany Arcaris, Asad E Patanwala, Jarrod M Mosier
BACKGROUND: The objective was to determine the impact of a soiled airway on firstpass success when using the GlideScope video laryngoscope or the direct laryngoscope for intubation in the emergency department (ED). METHODS: Data were prospectively collected on all patients intubated in an academic ED from July 1, 2007, to June 30, 2016. Patients ≥ 18 years of age, who underwent rapid sequence intubation by an emergency medicine resident with the GlideScope or the direct laryngoscope, were included in the analysis...
May 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27262287/the-comparison-of-adductor-canal-block-with-femoral-nerve-block-following-total-knee-arthroplasty-a-systematic-review-with-meta-analysis
#12
REVIEW
Xing-Qi Zhao, Nan Jiang, Fei-Fei Yuan, Lei Wang, Bin Yu
PURPOSE: Although several studies have compared the clinical efficacy of an adductor canal block (ACB) to that of a femoral nerve block (FNB) for analgesia after total knee arthroplasty (TKA), disputes mainly exist in the recovery of quadriceps strength and mobilization ability between the two methods. The aim of the present study was to compare, in a systematic review and meta-analysis, the clinical efficacy of ACB with that of FNB. METHODS: We systematically searched randomized controlled trials comparing FNB with ACB for analgesia after TKA in Pubmed and the Cochrane Library from inception to April 30th 2015...
October 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/28487139/a-multicenter-randomized-trial-of-ramped-position-vs-sniffing-position-during-endotracheal-intubation-of-critically-ill-adults
#13
RANDOMIZED CONTROLLED TRIAL
Matthew W Semler, David R Janz, Derek W Russell, Jonathan D Casey, Robert J Lentz, Aline N Zouk, Bennett P deBoisblanc, Jairo I Santanilla, Yasin A Khan, Aaron M Joffe, William S Stigler, Todd W Rice
BACKGROUND: Hypoxemia is the most common complication during endotracheal intubation of critically ill adults. Intubation in the ramped position has been hypothesized to prevent hypoxemia by increasing functional residual capacity and decreasing the duration of intubation, but has never been studied outside of the operating room. METHODS: Multicenter, randomized trial comparing the ramped position (head of the bed elevated to 25°) with the sniffing position (torso supine, neck flexed, and head extended) among 260 adults undergoing endotracheal intubation by pulmonary and critical care medicine fellows in four ICUs between July 22, 2015, and July 19, 2016...
October 2017: Chest
https://www.readbyqxmd.com/read/28455599/an-update-on-the-management-of-postoperative-nausea-and-vomiting
#14
REVIEW
Xuezhao Cao, Paul F White, Hong Ma
Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) remain common and distressing complications following surgery. PONV and PDNV can delay discharge and recovery and increase medical costs. The high incidence of PONV has persisted in part because of the tremendous growth in ambulatory surgery and the increased emphasis on earlier mobilization and discharge after both minor and major operations. Pharmacological management of PONV should be tailored to the patients' risk level using the PONV and PDNV scoring systems to minimize the potential for these adverse side effects in the postoperative period...
August 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28420641/should-we-intubate-patients-during-cardiopulmonary-resuscitation
#15
EDITORIAL
Carl L Gwinnutt
No abstract text is available yet for this article.
April 18, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28429198/managing-the-perioperative-patient-on-direct-oral-anticoagulants
#16
Jordan Leitch, Janet van Vlymen
PURPOSE: Patients are increasingly treated with direct oral anticoagulants (DOACs) for the prevention of stroke due to non-valvular atrial fibrillation and for the treatment of venous thromboembolism. When these patients present for urgent or emergent surgical procedures, they present a challenge to the anesthesiologist who must manage perioperative risk due to anticoagulation. The purpose of this module is to review the literature surrounding the perioperative management of DOACs. Timing, laboratory monitoring, and availability of reversal agents are important considerations to optimize patients being treated with DOACs who require emergent surgery...
June 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/22091897/anesthesia-and-myasthenia-gravis
#17
REVIEW
L Blichfeldt-Lauridsen, B D Hansen
Myasthenia gravis (MG) is a disease affecting the nicotinic acetylcholine receptor of the post-synaptic membrane of the neuromuscular junction, causing muscle fatigue and weakness. The myasthenic patient can be a challenge to anesthesiologists, and the post-surgical risk of respiratory failure has always been a matter of concern. The incidence and prevalence of MG have been increasing for decades and the disease is underdiagnosed. This makes it important for the anesthesiologist to be aware of possible signs of the disease and to be properly updated on the optimal perioperative anesthesiological management of the myasthenic patient...
January 2012: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28306680/anaesthesia-in-patients-with-liver-disease
#18
REVIEW
Malgorzata H Starczewska, Wint Mon, Peter Shirley
PURPOSE OF REVIEW: The purpose of this review is to summarize the most recent up to date research data and recommendations regarding anaesthetic management of patients with liver disease undergoing surgery. The incidence of chronic liver disease (CLD) continues to rise and perioperative mortality and morbidity remains unacceptably high in this group. Meticulous preoperative assessment and carefully planned anaesthetic management are vital in improving outcomes in patients with liver disease undergoing surgery...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28247242/practical-dosing-of-propofol-in-morbidly-obese-patients
#19
EDITORIAL
Ban C H Tsui, Luke Murtha, Hendrikus J M Lemmens
No abstract text is available yet for this article.
May 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28186265/pulmonary-aspiration-during-procedural-sedation-a-comprehensive-systematic-review
#20
S M Green, K P Mason, B S Krauss
Background: Although pulmonary aspiration complicating operative general anaesthesia has been extensively studied, little is known regarding aspiration during procedural sedation. Methods: We performed a comprehensive, systematic review to identify and catalogue published instances of aspiration involving procedural sedation in patients of all ages. We sought to report descriptively the circumstances, nature, and outcomes of these events. Results: Of 1249 records identified by our search, we found 35 articles describing one or more occurrences of pulmonary aspiration during procedural sedation...
March 1, 2017: British Journal of Anaesthesia
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