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Free Anaesthesia Papers

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91 papers 100 to 500 followers Only Free Anaesthesia Papers
https://www.readbyqxmd.com/read/28039239/non-opioid-analgesics-in-adults-after-major-surgery-systematic-review-with-network-meta-analysis-of-randomized-trials
#1
V Martinez, H Beloeil, E Marret, D Fletcher, P Ravaud, L Trinquart
BACKGROUND: Morphine, and analgesics other than morphine (AOM), are commonly used to treat postoperative pain after major surgery. However, which AOM provides the best efficacy-safety profile remains unclear. METHODS: Randomized trials of any AOM alone or any combination of AOM compared with placebo or another AOM in adults undergoing major surgery and receiving morphine patient-controlled analgesia were included in a network meta-analysis. The outcomes were morphine consumption, pain, incidence of nausea, vomiting at 24 h and severe adverse effects...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27821785/anesthetic-considerations-for-surgery-on-the-aortic-arch
#2
REVIEW
Barbara J Wilkey, Nathaen S Weitzel
Aortic arch surgery requires meticulous teamwork in the true perioperative sense. Planning and communication at all phases from preoperative evaluation, through intraoperative management, to postoperative care should be well coordinated between surgical, anesthesia, perfusion, and intensive care unit teams. This review discusses intraoperative management from the anesthesiologist's perspective, with particular emphasis on transesophageal echo evaluation and coagulation management.
December 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27990270/recent-advances-in-the-management-of-pulmonary-arterial-hypertension
#3
REVIEW
Halley Tsai, Yon K Sung, Vinicio de Jesus Perez
Over the past 20 years, there has been an explosion in the development of therapeutics to treat pulmonary arterial hypertension (PAH), a rare but life-threatening disorder associated with progressive elevation of pulmonary pressures and severe right heart failure. Recently, the field has seen the introduction of riociguat, a soluble guanylate cyclase stimulator, a new endothelin receptor antagonist (macitentan), and oral prostanoids (treprostinil and selexipag). Besides new drugs, there have been significant advances in defining the role of upfront combination therapy in treatment-naïve patients as well as proposed methods to deliver systemic prostanoids by use of implantable pumps...
2016: F1000Research
https://www.readbyqxmd.com/read/27858374/prediction-of-fluid-responsiveness-an-update
#4
REVIEW
Xavier Monnet, Paul E Marik, Jean-Louis Teboul
In patients with acute circulatory failure, the decision to give fluids or not should not be taken lightly. The risk of overzealous fluid administration has been clearly established. Moreover, volume expansion does not always increase cardiac output as one expects. Thus, after the very initial phase and/or if fluid losses are not obvious, predicting fluid responsiveness should be the first step of fluid strategy. For this purpose, the central venous pressure as well as other "static" markers of preload has been used for decades, but they are not reliable...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27785098/single-shot-lamina-thoracic-paravertebral-block-with-ketofol-for-modified-radical-mastectomy
#5
Ambrose Rukewe, Oludolapo O Afuwape, Austin Ugheoke, Akinola A Fatiregun
We describe the use of single-shot lamina thoracic paravertebral block (TPVB) with sedation for a 56-year-old female patient who had modified radical mastectomy with axillary clearance. Two years ago, she suffered vocal cord palsy post thyroidectomy, which was managed with tracheostomy. The tracheostomy tube was removed 8 months later, leaving the patient with persistent hoarseness of voice and left vocal cord palsy. She declined general anesthesia and consented for TPVB. The surgery lasted 95 minutes and was successfully completed with TPVB...
2016: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/27940457/enhanced-recovery-after-surgery-for-primary-hip-and-knee-arthroplasty-a-review-of-the-evidence
#6
E M Soffin, J T YaDeau
Enhanced recovery after surgery (ERAS) protocols produce significant clinical and economic benefits in a range of surgical subspecialties. There is a long tradition of applying clinical pathways to the perioperative care of joint arthroplasty patients. Enhanced recovery after surgery represents the next step in the evolution of standardized care. To date, reports of full ERAS pathways for hip or knee arthroplasty are lacking. In this narrative review, we present the evidence base that can be usefully applied to constructing ERAS pathways for hip or knee arthroplasty...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27785097/regional-anesthesia-or-patient-controlled-analgesia-and-compartment-syndrome-in-orthopedic-surgical-procedures-a-systematic-review
#7
REVIEW
Elizabeth Bs Driscoll, Ana Hosseinzadeh Maleki, Leila Jahromi, Brittany Nelson Hermecz, Lauren E Nelson, Imelda L Vetter, Spencer Evenhuis, Lee Ann Riesenberg
A systematic review of the literature on the use of regional anesthesia (RA) and patient-controlled analgesia (PCA) was conducted in patients who require orthopedic extremity procedures to determine whether either analgesic technique contributes to a delayed diagnosis of compartment syndrome (CS). A total of 34 relevant articles (28 case reports and six research articles) were identified. Of all case report articles published after 2009, the majority (75%) concluded that RA does not put the patient at an increased risk of a delayed diagnosis of CS...
2016: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/27871631/-benefit-of-general-anesthesia-monitored-by-bispectral-index-compared-with-monitoring-guided-only-by-clinical-parameters-systematic-review-and-meta-analysis
#8
Carlos Rogério Degrandi Oliveira, Wanderley Marques Bernardo, Victor Moisés Nunes
BACKGROUND: The bispectral index parameter is used to guide the titration of general anesthesia; however, many studies have shown conflicting results regarding the benefits of bispectral index monitoring. The objective of this systematic review with meta-analysis is to evaluate the clinical impact of monitoring with the bispectral index parameter. METHODS: The search for evidence in scientific information sources was conducted during December 2013 to January 2015, the following primary databases: Medline/PubMed, LILACS, Cochrane, CINAHL, Ovid, SCOPUS and TESES...
January 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/26660675/pharmacological-adjuncts-to-stop-bleeding-options-and-effectiveness
#9
M Panteli, I Pountos, P V Giannoudis
Severe trauma and massive haemorrhage represent the leading cause of death and disability in patients under the age of 45 years in the developed world. Even though much advancement has been made in our understanding of the pathophysiology and management of trauma, outcomes from massive haemorrhage remain poor. This can be partially explained by the development of coagulopathy, acidosis and hypothermia, a pathological process collectively known as the "lethal triad" of trauma. A number of pharmacological adjuncts have been utilised to stop bleeding, with a wide variation in the safety and efficacy profiles...
June 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27842708/-effects-of-different-levels-of-end-expiratory-pressure-on-hemodynamic-respiratory-mechanics-and-systemic-stress-response-during-laparoscopic-cholecystectomy
#10
Oznur Sen, Yasemin Erdogan Doventas
OBJECTIVE: General anesthesia causes reduction of functional residual capacity. And this decrease can lead to atelectasis and intrapulmonary shunting in the lung. In this study we want to evaluate the effects of 5 and 10cmH2O PEEP levels on gas exchange, hemodynamic, respiratory mechanics and systemic stress response in laparoscopic cholecystectomy. METHODS: American Society of Anesthesiologist I-II physical status 43 patients scheduled for laparoscopic cholecystectomy were randomly selected to receive external PEEP of 5cmH2O (PEEP 5 group) or 10cmH2O PEEP (PEEP 10 group) during pneumoperitoneum...
January 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27806241/case-23-2016-a-man-with-somnolence-after-orthopedic-surgery
#11
LETTER
Alden W Dudley
No abstract text is available yet for this article.
November 3, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27774838/tranexamic-acid-in-patients-undergoing-coronary-artery-surgery
#12
Paul S Myles, Julian A Smith, Andrew Forbes, Brendan Silbert, Mohandas Jayarajah, Thomas Painter, D James Cooper, Silvana Marasco, John McNeil, Jean S Bussières, Shay McGuinness, Kelly Byrne, Matthew T V Chan, Giovanni Landoni, Sophie Wallace
Background Tranexamic acid reduces the risk of bleeding among patients undergoing cardiac surgery, but it is unclear whether this leads to improved outcomes. Furthermore, there are concerns that tranexamic acid may have prothrombotic and proconvulsant effects. Methods In a trial with a 2-by-2 factorial design, we randomly assigned patients who were scheduled to undergo coronary-artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo. The results of the tranexamic acid comparison are reported here...
12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/27592289/echocardiography-as-a-guide-for-fluid-management
#13
REVIEW
John H Boyd, Demetrios Sirounis, Julien Maizel, Michel Slama
BACKGROUND: In critically ill patients at risk for organ failure, the administration of intravenous fluids has equal chances of resulting in benefit or harm. While the intent of intravenous fluid is to increase cardiac output and oxygen delivery, unwelcome results in those patients who do not increase their cardiac output are tissue edema, hypoxemia, and excess mortality. Here we briefly review bedside methods to assess fluid responsiveness, focusing upon the strengths and pitfalls of echocardiography in spontaneously breathing mechanically ventilated patients as a means to guide fluid management...
September 4, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27440628/preoperative-heart-rate-and-myocardial-injury-after-non-cardiac-surgery-results-of-a-predefined-secondary-analysis-of-the-vision-study
#14
T E F Abbott, G L Ackland, R A Archbold, A Wragg, E Kam, T Ahmad, A W Khan, E Niebrzegowska, R N Rodseth, P J Devereaux, R M Pearse
BACKGROUND: Increased baseline heart rate is associated with cardiovascular risk and all-cause mortality in the general population. We hypothesized that elevated preoperative heart rate increases the risk of myocardial injury after non-cardiac surgery (MINS). METHODS: We performed a secondary analysis of a prospective international cohort study of patients aged ≥45 yr undergoing non-cardiac surgery. Preoperative heart rate was defined as the last measurement before induction of anaesthesia...
August 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27659469/contrast-induced-acute-kidney-injury
#15
REVIEW
Peter A McCullough, James P Choi, Georges A Feghali, Jeffrey M Schussler, Robert M Stoler, Ravi C Vallabahn, Ankit Mehta
Coronary angiography and percutaneous intervention rely on the use of iodinated intravascular contrast for vessel and chamber imaging. Despite advancements in imaging and interventional techniques, iodinated contrast continues to pose a risk of contrast-induced acute kidney injury (CI-AKI) for a subgroup of patients at risk for this complication. There has been a consistent and graded signal of risk for associated outcomes including need for renal replacement therapy, rehospitalization, and death, according to the incidence and severity of CI-AKI...
September 27, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27566811/management-of-bleeding-in-vascular-surgery
#16
REVIEW
Y E Chee, S E Liu, M G Irwin
Management of acute coagulopathy and blood loss during major vascular procedures poses a significant haemostatic challenge to anaesthetists. The acute coagulopathy is multifactorial in origin with tissue injury and hypotension as the precipitating factors, followed by dilution, hypothermia, acidemia, hyperfibrinolysis and systemic inflammatory response, all acting as a self-perpetuating spiral of events. The problem is confounded by the high prevalence of antithrombotic agent use in these patients and intraoperative heparin administration...
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27058509/the-half-life-of-infusion-fluids-an-educational-review
#17
Robert G Hahn, Gordon Lyons
An understanding of the half-life (T1/2) of infused fluids can help prevent iatrogenic problems such as volume overload and postoperative interstitial oedema. Simulations show that a prolongation of the T1/2 for crystalloid fluid increases the plasma volume and promotes accumulation of fluid in the interstitial fluid space. The T1/2 for crystalloids is usually 20 to 40 min in conscious humans but might extend to 80 min or longer in the presence of preoperative stress, dehydration, blood loss of <1 l or pregnancy...
July 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27233380/prevention-of-contrast-associated-acute-kidney-injury-what-should-we-do
#18
EDITORIAL
Steven D Weisbord, Paul M Palevsky
No abstract text is available yet for this article.
October 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/26945358/impact-of-albumin-on-coagulation-competence-and-hemorrhage-during-major-surgery-a-randomized-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
Kirsten C Rasmussen, Michael Højskov, Pär I Johansson, Irina Kridina, Thomas Kistorp, Lisbeth Salling, Henning B Nielsen, Birgitte Ruhnau, Tom Pedersen, Niels H Secher
For patients exposed to a massive blood loss during surgery, maintained coagulation competence is important. It is less obvious whether coagulation competence influences bleeding during elective surgery where patients are exposed to infusion of a crystalloid or a colloid. This randomized controlled trial evaluates whether administration of 5% human albumin (HA) or lactated Ringer solution (LR) affects coagulation competence and in turn blood loss during cystectomy due to bladder cancer. Forty patients undergoing radical cystectomy were included to receive either 5% HA (n = 20) or LR (n = 20)...
March 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26976277/crystalloid-fluid-therapy
#20
REVIEW
Sumeet Reddy, Laurence Weinberg, Paul Young
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency medicine 2016. Other selected articles can be found online at http://www.biomedcentral.com/collections/annualupdate2016. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.
March 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
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