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anaesthesia review

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60 papers 25 to 100 followers
By Akhilesh Tiwari Dual trainee (Anaesthesia and Intensive Care)
https://www.readbyqxmd.com/read/28288050/pain-management-modalities-after-total-knee-arthroplasty-a-network-meta-analysis-of-170-randomized-controlled-trials
#1
Abdullah Sulieman Terkawi, Dimitris Mavridis, Daniel I Sessler, Megan S Nunemaker, Khaled S Doais, Rayan Sulieman Terkawi, Yazzed Sulieman Terkawi, Maria Petropoulou, Edward C Nemergut
BACKGROUND: Optimal analgesia for total knee arthroplasty remains challenging. Many modalities have been used, including peripheral nerve block, periarticular infiltration, and epidural analgesia. However, the relative efficacy of various modalities remains unknown. The authors aimed to quantify and rank order the efficacy of available analgesic modalities for various clinically important outcomes. METHODS: The authors searched multiple databases, each from inception until July 15, 2016...
May 2017: Anesthesiology
https://www.readbyqxmd.com/read/28306680/anaesthesia-in-patients-with-liver-disease
#2
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/27977430/long-term-consequences-of-acute-kidney-injury-in-the-perioperative-setting
#3
Carlos E Palant, Richard L Amdur, Lakhmir S Chawla
PURPOSE OF REVIEW: Recent studies indicate that acute kidney injury (AKI) and chronic kidney disease (CKD) are interconnected syndromes. Although the majority of patients who suffer an episode of AKI will recover laboratory indices suggesting complete or near complete recovery of renal function, a significant portion of post-AKI survivors will develop major kidney events, including development of late-stage CKD, need for renal replacement therapies, and death. RECENT FINDINGS: Our review highlights epidemiology of adverse post-AKI events, association of AKI with late development of nonrenal adverse outcomes, use of bedside equations that facilitate prognostication of adverse renal outcomes of AKI, and how variability in serum creatinine values in individual patients, even among those with normal baseline renal function may indicate risk for the development of CKD...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28167634/management-of-patients-on-non-vitamin-k-antagonist-oral-anticoagulants-in-the-acute-care-and-periprocedural-setting-a-scientific-statement-from-the-american-heart-association
#4
REVIEW
Amish N Raval, Joaquin E Cigarroa, Mina K Chung, Larry J Diaz-Sandoval, Deborah Diercks, Jonathan P Piccini, Hee Soo Jung, Jeffrey B Washam, Babu G Welch, Allyson R Zazulia, Sean P Collins
Non-vitamin K oral anticoagulants (NOACs) are now widely used as alternatives to warfarin for stroke prevention in atrial fibrillation and management of venous thromboembolism. In clinical practice, there is still widespread uncertainty on how to manage patients on NOACs who bleed or who are at risk for bleeding. Clinical trial data related to NOAC reversal for bleeding and perioperative management are sparse, and recommendations are largely derived from expert opinion. Knowledge of time of last ingestion of the NOAC and renal function is critical to managing these patients given that laboratory measurement is challenging because of the lack of commercially available assays in the United States...
March 7, 2017: Circulation
https://www.readbyqxmd.com/read/28186222/postoperative-pulmonary-complications
#5
A Miskovic, A B Lumb
Postoperative pulmonary complications (PPCs) are common, costly, and increase patient mortality. Changes to the respiratory system occur immediately on induction of general anaesthesia: respiratory drive and muscle function are altered, lung volumes reduced, and atelectasis develops in > 75% of patients receiving a neuromuscular blocking drug. The respiratory system may take 6 weeks to return to its preoperative state after general anaesthesia for major surgery. Risk factors for PPC development are numerous, and clinicians should be aware of non-modifiable and modifiable factors in order to recognize those at risk and optimize their care...
March 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28095040/consensus-statement-by-the-american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-on-the-comprehensive-type-2-diabetes-management-algorithm-2017-executive-summary
#6
Alan J Garber, Martin J Abrahamson, Joshua I Barzilay, Lawrence Blonde, Zachary T Bloomgarden, Michael A Bush, Samuel Dagogo-Jack, Ralph A DeFronzo, Daniel Einhorn, Vivian A Fonseca, Jeffrey R Garber, W Timothy Garvey, George Grunberger, Yehuda Handelsman, Irl B Hirsch, Paul S Jellinger, Janet B McGill, Jeffrey I Mechanick, Paul D Rosenblit, Guillermo E Umpierrez
A1C = hemoglobin A1C AACE = American Association of Clinical Endocrinologists ACCORD = Action to Control Cardiovascular Risk in Diabetes ACCORD BP = Action to Control Cardiovascular Risk in Diabetes Blood Pressure ACEI = angiotensin-converting enzyme inhibitor ADVANCE = Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation AGI = alpha-glucosidase inhibitor apo B = apolipoprotein B ASCVD = atherosclerotic cardiovascular disease BAS = bile acid sequestrant BMI = body mass index BP = blood pressure CHD = coronary heart disease CKD = chronic kidney disease CVD = cardiovascular disease DASH = Dietary Approaches to Stop Hypertension DPP-4 = dipeptidyl peptidase 4 eGFR = estimated glomerular filtration rate FDA = Food and Drug Administration GLP-1 = glucagon-like peptide 1 HDL-C = high-density lipoprotein cholesterol IMPROVE-IT = Improved Reduction of Outcomes: Vytorin Efficacy International Trial LDL-C = low-density lipoprotein cholesterol LDL-P = low-density lipoprotein particle Look AHEAD = Look Action for Health in Diabetes NPH = neutral protamine Hagedorn OSA = obstructive sleep apnea SFU = sulfonylurea SGLT-2 = sodium glucose cotransporter-2 SMBG = self-monitoring of blood glucose T2D = type 2 diabetes TZD = thiazolidinedione VADT = Veterans Affairs Diabetes Trial...
February 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28131123/update-in-the-management-of-patients-with-preeclampsia
#7
REVIEW
Nerlyne K Dhariwal, Grant C Lynde
Hypertensive disorders of pregnancy complicate approximately 10% of all deliveries in the United States and are a leading cause of maternal and fetal morbidity and mortality. Preeclampsia is defined as hypertension in association with proteinuria, thrombocytopenia, impaired liver function, renal insufficiency, pulmonary edema, or new-onset cerebral or visual disturbances. The greatest risk factor for the development of preeclampsia is a history of preeclampsia. There currently is no effective means for the prevention of preeclampsia...
March 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28114177/perioperative-use-of-intravenous-lidocaine
#8
Lauren K Dunn, Marcel E Durieux
No abstract text is available yet for this article.
April 2017: Anesthesiology
https://www.readbyqxmd.com/read/28053053/acute-on-chronic-liver-failure-an-update
#9
REVIEW
Ruben Hernaez, Elsa Solà, Richard Moreau, Pere Ginès
Acute-on-chronic liver failure (ACLF) is a syndrome characterised by acute decompensation of chronic liver disease associated with organ failures and high short-term mortality. Alcohol and chronic viral hepatitis are the most common underlying liver diseases. Up to 40%-50% of the cases of ACLF have no identifiable trigger; in the remaining patients, sepsis, active alcoholism and relapse of chronic viral hepatitis are the most common reported precipitating factors. An excessive systemic inflammatory response seems to play a crucial role in the development of ACLF...
March 2017: Gut
https://www.readbyqxmd.com/read/28045707/practice-guidelines-for-preoperative-fasting-and-the-use-of-pharmacologic-agents-to-reduce-the-risk-of-pulmonary-aspiration-application-to-healthy-patients-undergoing-elective-procedures-an-updated-report-by-the-american-society-of-anesthesiologists-task-force
#10
https://www.readbyqxmd.com/read/27940454/acute-traumatic-coagulopathy-pathophysiology-and-resuscitation
#11
J W Simmons, M F Powell
Acute Traumatic Coagulopathy occurs immediately after massive trauma when shock, hypoperfusion, and vascular damage are present. Mechanisms for this acute coagulopathy include activation of protein C, endothelial glycocalyx disruption, depletion of fibrinogen, and platelet dysfunction. Hypothermia and acidaemia amplify the endogenous coagulopathy and often accompany trauma. These multifactorial processes lead to decreased clot strength, autoheparinization, and hyperfibrinolysis. Furthermore, the effects of aggressive crystalloid administration, haemodilution from inappropriate blood product transfusion, and prolonged surgical times may worsen clinical outcomes...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27940453/perioperative-management-of-the-bleeding-patient
#12
K Ghadimi, J H Levy, I J Welsby
Perioperative bleeding remains a major complication during and after surgery, resulting in increased morbidity and mortality. The principal causes of non-vascular sources of haemostatic perioperative bleeding are a preexisting undetected bleeding disorder, the nature of the operation itself, or acquired coagulation abnormalities secondary to haemorrhage, haemodilution, or haemostatic factor consumption. In the bleeding patient, standard therapeutic approaches include allogeneic blood product administration, concomitant pharmacologic agents, and increasing application of purified and recombinant haemostatic factors...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27940455/sepsis-for-the-anaesthetist
#13
M E Nunnally
Sepsis is as a dysregulated systemic response to infection. Morbidity and mortality of the syndrome are very high worldwide. Recent definitions have redefined criteria for sepsis. The new definition (Sepsis-3) classifies sepsis as infection with organ dysfunction (the old 'severe sepsis'). Septic patients are at risk for secondary injuries, thus aggressive source control, resuscitation, and antibiotic therapy are the mainstays of management. Central to sepsis physiology is vasodilated shock. Many patients respond to i...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27847704/treatment-of-postoperative-pain-in-pediatric-operations-comparing-the-efficiency-of-bupivacaine-bupivacaine-dexmedetomidine-and-bupivacaine-fentanyl-for-caudal-block
#14
Hashem Jarineshin, Fereydoon Fekrat, Aida Kargar Kermanshah
BACKGROUND: Caudal analgesia is a common method for postoperative pain management in pediatric patients. Additive agents such as opioids and α2 agonists have been used to enhance the analgesic effects of local anesthetics for caudal block. OBJECTIVES: The aim of this study was to compare the additive effects of dexmedetomidine and fentanyl on bupivacaine-induced caudal analgesia in pediatric patients who had undergone elective inguinal hernia repair. METHODS: This randomized, double-blind clinical trial included children aged 1 - 5 years who were divided into three groups: the bupivacaine group (Group B) received 0...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27845976/understanding-intravenous-general-anesthetics
#15
James P Rathmell, Stuart Forman, Jonathan P Wanderer
No abstract text is available yet for this article.
December 2016: Anesthesiology
https://www.readbyqxmd.com/read/27841822/vasopressin-versus-norepinephrine-in-patients-with-vasoplegic-shock-after-cardiac-surgery-the-vancs-randomized-controlled-trial
#16
Ludhmila Abrahao Hajjar, Jean Louis Vincent, Filomena Regina Barbosa Gomes Galas, Andrew Rhodes, Giovanni Landoni, Eduardo Atsushi Osawa, Renato Rosa Melo, Marcia Rodrigues Sundin, Solimar Miranda Grande, Fabio A Gaiotto, Pablo Maria Pomerantzeff, Luis Oliveira Dallan, Rafael Alves Franco, Rosana Ely Nakamura, Luiz Augusto Lisboa, Juliano Pinheiro de Almeida, Aline Muller Gerent, Dayenne Hianae Souza, Maria Alice Gaiane, Julia Tizue Fukushima, Clarice Lee Park, Cristiane Zambolim, Graziela Santos Rocha Ferreira, Tânia Mara Strabelli, Felipe Lourenco Fernandes, Ligia Camara, Suely Zeferino, Valter Garcia Santos, Marilde Albuquerque Piccioni, Fabio Biscegli Jatene, Jose Otavio Costa Auler, Roberto Kalil Filho
BACKGROUND: Vasoplegic syndrome is a common complication after cardiac surgery and impacts negatively on patient outcomes. The objective of this study was to evaluate whether vasopressin is superior to norepinephrine in reducing postoperative complications in patients with vasoplegic syndrome. METHODS: This prospective, randomized, double-blind trial was conducted at the Heart Institute, University of Sao Paulo, Sao Paulo, Brazil, between January 2012 and March 2014...
January 2017: Anesthesiology
https://www.readbyqxmd.com/read/27806987/assessment-and-classification-of-patients-with-myocardial-injury-and-infarction-in-clinical-practice
#17
REVIEW
Andrew R Chapman, Philip D Adamson, Nicholas L Mills
Myocardial injury is common in patients without acute coronary syndrome, and international guidelines recommend patients with myocardial infarction are classified by aetiology. The universal definition differentiates patients with myocardial infarction due to plaque rupture (type 1) from those due to myocardial oxygen supply-demand imbalance (type 2) secondary to other acute illnesses. Patients with myocardial necrosis, but no symptoms or signs of myocardial ischaemia, are classified as acute or chronic myocardial injury...
January 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27820709/current-status-of-neuromuscular-reversal-and-monitoring-challenges-and-opportunities
#18
Sorin J Brull, Aaron F Kopman
Postoperative residual neuromuscular block has been recognized as a potential problem for decades, and it remains so today. Traditional pharmacologic antagonists (anticholinesterases) are ineffective in reversing profound and deep levels of neuromuscular block; at the opposite end of the recovery curve close to full recovery, anticholinesterases may induce paradoxical muscle weakness. The new selective relaxant-binding agent sugammadex can reverse any depth of block from aminosteroid (but not benzylisoquinolinium) relaxants; however, the effective dose to be administered should be chosen based on objective monitoring of the depth of neuromuscular block...
January 2017: Anesthesiology
https://www.readbyqxmd.com/read/27803982/magnesium-in-obstetric-anesthesia-and-intensive-care
#19
REVIEW
Marija S Kutlesic, Ranko M Kutlesic, Tatjana Mostic-Ilic
Magnesium, one of the essential elements in the human body, has numerous favorable effects that offer a variety of possibilities for its use in obstetric anesthesia and intensive care. Administered as a single intravenous bolus dose or a bolus followed by continuous infusion during surgery, magnesium attenuates stress response to endotracheal intubation, and reduces intraoperative anesthetic and postoperative analgesic requirements, while at the same time preserving favorable hemodynamics. Applied as part of an intrathecal or epidural anesthetic mixture, magnesium prolongs the duration of anesthesia and diminishes total postoperative analgesic consumption with no adverse maternal or neonatal effects...
February 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/27765010/dexamethasone-does-not-diminish-sugammadex-reversal-of-neuromuscular-block-clinical-study-in-surgical-patients-undergoing-general-anesthesia
#20
Katja Rezonja, Tomaz Mars, Ales Jerin, Gordana Kozelj, Neva Pozar-Lukanovic, Maja Sostaric
BACKGROUND: Sugammadex reverses neuromuscular block (NMB) through binding aminosteroid neuromuscular blocking agents. Although sugammadex appears to be highly selective, it can interact with other drugs, like corticosteroids. A prospective single-blinded randomized clinical trial was designed to explore the significance of interactions between dexamethasone and sugammadex. METHODS: Sixty-five patients who were anesthetized for elective abdominal or urological surgery were included...
October 21, 2016: BMC Anesthesiology
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