3,416 results match your criteria Anesthesia Local with Sedation


Awake Fiberoptic Intubation Protocols in the Operating Room for Anticipated Difficult Airway: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Anesth Analg 2019 Mar 20. Epub 2019 Mar 20.

From the Department of Anaesthesia and Intensive Care, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy.

Awake fiberoptic intubation is one of the recommended strategies for surgical patients with anticipated difficult airway, especially when concurrent difficult ventilation is expected. We performed the first systematic review of randomized controlled trials assessing different protocols for awake fiberoptic intubation in anticipated difficult airway, including studies investigating elective awake fiberoptic intubation for scheduled surgery; randomized controlled trials comparing different methods for performing awake fiberoptic intubation; and adult patients with anticipated difficult airway. We excluded studies in the nonoperating theater settings, randomized controlled trials comparing awake fiberoptic intubation with other techniques, and studies based on simulation. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004087DOI Listing

[Initial Experience of a TAVI Program: Analysis of the Anesthetic Decision and its Evolution].

Acta Med Port 2019 Feb 28;32(2):126-132. Epub 2019 Feb 28.

Serviço de Anestesiologia. Hospital de Santa Marta. Centro Hospitalar de Lisboa Central. Lisboa. Portugal.

Introduction: Transcatheter aortic valve implantation is a less invasive option for aortic valve replacement. The number of transcatheter aortic valve implantations under local anesthesia with sedation has been increasing as the team's experience increases and less invasive accesses are used. The aim of this study is to describe the evolution of the anesthetic technique in patients undergoing transcatheter aortic valve implantation at our center over the years, as which was compared. Read More

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http://dx.doi.org/10.20344/amp.10982DOI Listing
February 2019

What is the most effective local anesthesia for transrectal ultrasonography-guided biopsy of the prostate? A systematic review and network meta-analysis of 47 randomized clinical trials.

Sci Rep 2019 Mar 20;9(1):4901. Epub 2019 Mar 20.

Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.

We aimed to compare the effectiveness of various local anesthetic methods for controlling prostate biopsy (PBx) related pain using network meta-analysis. Literature searches were performed on PubMed/Medline, Embase, and Cochrane Library up to March 2018. Forty-seven randomized controlled trials, in which the effectiveness of PBx-related pain was investigated using a visual analogue scale after various local anesthetic methods, were included. Read More

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http://dx.doi.org/10.1038/s41598-019-41412-wDOI Listing

Partial arytenoidectomy in 14 standing horses (2013-2017).

Vet Surg 2019 Mar 18. Epub 2019 Mar 18.

Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois.

Objective: To report our experience with partial arytenoidectomy in sedated standing horses.

Study Design: Retrospective study.

Animals: Fourteen client-owned adult horses. Read More

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http://dx.doi.org/10.1111/vsu.13192DOI Listing
March 2019
1 Read

A Case of Cardiac Arrest for 31 Seconds During Recovery After Intravenous Sedation.

Anesth Prog 2019 ;66(1):33-36

Professor, Department of Anesthesiology, Osaka Dental University, Osaka, Japan.

A 26-year-old woman with a history of feeling nauseated during dental local anesthesia presented to our clinic for tooth extraction under intravenous sedation. Although she had experienced episodes of neurally-mediated syncope, her symptoms were controlled well with drug therapy, stopped 3 years earlier. No syncope episodes developed over the previous 2 years. Read More

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http://dx.doi.org/10.2344/anpr-66-01-04DOI Listing
January 2019

Comparison of Local-Only Anesthesia Versus Sedation in Patients Undergoing Staged Bilateral Carpal Tunnel Release: A Randomized Trial.

Hand (N Y) 2019 Mar 17:1558944719836237. Epub 2019 Mar 17.

1 The Ohio State University Wexner Medical Center, Columbus, USA.

Purpose: Carpal tunnel syndrome is a common disease treated operatively. During the operation, the patient may be wide-awake or sedated. The current literature has only compared separate cohorts. Read More

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http://dx.doi.org/10.1177/1558944719836237DOI Listing

Procedural sedation and analgesia practices in the emergency centre.

Afr J Emerg Med 2019 Mar 13;9(1):8-13. Epub 2018 Oct 13.

Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Introduction: Procedural sedation and analgesia allows the clinician to safely and efficiently administer sedation, analgesia, anxiolysis and sometimes amnesia to facilitate the performance of various procedures in the emergency centre. The aim of this study is to determine current sedation practices, common indications and major obstacles in selected emergency centres across Southern Gauteng, South Africa, with a view to improving future standards and practices.

Methods: This was a prospective, questionnaire based, cross-sectional interview of emergency centre managers or their designee of selected private-sector and public-sector hospitals in Southern Gauteng. Read More

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http://dx.doi.org/10.1016/j.afjem.2018.09.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6400002PMC

High Patient Satisfaction With Local Anesthesia and Light Sedation in a Novel Fast-Track Setup for Sacrospinous Fixation.

Female Pelvic Med Reconstr Surg 2019 Mar 8. Epub 2019 Mar 8.

From the Aarhus University Hospital, Skejby, Denmark.

Objectives: Simple prolapse operations can be performed using local anesthesia. However, this has not been the case for advanced pelvic organ prolapse operations. The aim of this study was to investigate the patient-reported feasibility and acceptability of local anesthesia and light sedation for sacrospinous fixation (SSF). Read More

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http://dx.doi.org/10.1097/SPV.0000000000000708DOI Listing
March 2019
1 Read

Noninvasive local correction of loop ileostomy prolapse using a stapling device for a patient in the terminal phase of malignancy.

J Surg Case Rep 2019 Mar 5;2019(3):rjz050. Epub 2019 Mar 5.

Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan.

A 64-year-old woman who underwent surgery for ovarian cancer, but were unable to be resected and were directly infiltrated at the terminal ileum, and the ileostomy in the oral side of the terminal ileum was performed as a palliative operation. Prolapse of the ileostomy appeared approximately 17 months after the operation, and after 19 months, the blood circulation disorder of the intestinal tract and the reduction of prolapse became difficult. Since the patient's systemic condition was poor, anesthesia was not enforced, and an ileostomy reconstruction was performed using a stapling device while performing mild sedation. Read More

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http://dx.doi.org/10.1093/jscr/rjz050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6400171PMC

Procedural sedation and analgesia during enzymatic debridement of burn patients.

Ann Burns Fire Disasters 2018 Sep;31(3):223-227

Critical Care Unit, Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain.

Procedural sedation and analgesia (PSA) is a widely used strategy in various fields to carry out numerous diagnostic and therapeutic procedures. However, there is limited information on its efficacy and safety during enzymatic debridement of burn patients with Nexobrid®. The aim of our study was to describe the U-type PSA procedure in a series of patients requiring enzymatic debridement. Read More

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September 2018
1 Read

Virtual-assisted lung mapping 2.0: preoperative bronchoscopic three-dimensional lung mapping.

Ann Thorac Surg 2019 Mar 5. Epub 2019 Mar 5.

Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan.

Purpose: To better determine suitable resection lines for sublobar lung resection, especially to obtain sufficient resection depth, a novel technique of virtual-assisted lung mapping (VAL-MAP) 2.0 was developed by combining multi-spot dye marks (conventional VAL-MAP) and a deeply placed microcoil.

Description: Using local anesthesia and sedation, multiple dye marks were bronchoscopically made on the lung surface. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2019.01.058DOI Listing

Improving patient outcomes with inguinal hernioplasty-local anaesthesia versus local anaesthesia and conscious sedation: a randomized controlled trial.

Hernia 2019 Mar 7. Epub 2019 Mar 7.

Division of General Surgery, Department of Surgery, Radiology, Anaesthesia and Intensive Care, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston 7, Jamaica.

Purpose: Conscious sedation is regularly used in ambulatory surgery to improve patient outcomes, in particular patient satisfaction. We hypothesized that the addition of conscious sedation would provide greater patient satisfaction with inguinal hernioplasty compared to local anesthesia alone.

Methods: This trial was a single-centre, randomized, placebo-controlled, double-blinded trial where patients undergoing inguinal hernioplasty using local anaesthesia were randomized to receive local anaesthesia alone versus local anaesthesia and conscious sedation. Read More

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http://dx.doi.org/10.1007/s10029-019-01922-yDOI Listing
March 2019
1 Read

Effect of Preperitoneal Versus Epidural Analgesia on Postoperative Inflammatory Response and Pain Following Radical Cystectomy: A Prospective, Randomized Trial.

Clin J Pain 2019 Apr;35(4):328-334

Surgical Oncology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.

Objectives: Continuous wound infiltration of local anesthetics has been proposed as an alternative to epidural analgesia during abdominal surgery. Cytokines have a major role in inflammatory changes caused by surgery. This study aimed to compare the effects of continuous preperitoneal versus epidural analgesia on inflammatory cytokines postoperatively. Read More

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http://dx.doi.org/10.1097/AJP.0000000000000679DOI Listing

Robot-assisted orthotopic and heterotopic ovarian tissue transplantation techniques: surgical advances since our first success in 2000.

Fertil Steril 2019 Mar;111(3):604-606

Laboratory of Molecular Reproduction and Fertility Preservation, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut.

Objective: To demonstrate the technical advances since the time we reported the first successful case in 2000 and our modern approach to autologous transplantation of frozen-thawed human ovarian tissue.

Design: A step-by-step video demonstration of three surgical approaches was created by editing the surgical footage obtained during ovarian transplantation procedures.

Setting: Academic. Read More

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http://dx.doi.org/10.1016/j.fertnstert.2018.11.042DOI Listing
March 2019
2 Reads

Wide-Awake Surgical Management of Hand Fractures: Technical Pearls and Advanced Rehabilitation.

Plast Reconstr Surg 2019 Mar;143(3):800-810

Dayton, Ohio; and Rochester, Minn. From the Department of Orthopedic Surgery, Wright-Patterson Air Force Base; and the Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic.

Most unstable metacarpal and phalangeal fractures for which operative treatment is indicated can be reduced and stabilized with either open or closed techniques using local anesthetic with epinephrine instead of intravenous sedation or general anesthesia. With the patient wide-awake during surgery, the hand can be taken through active range of motion to assess fracture stability. In this article, the authors review the rationale and technique for wide-awake, local anesthesia, no tourniquet surgery in the treatment of phalangeal and metacarpal fractures and impart pearls to optimize the patient experience and illustrate common fixation techniques using percutaneous Kirschner wires. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005379DOI Listing
March 2019
4 Reads

Topographic Reconfiguration of Local and Shared Information in Anesthetic-Induced Unconsciousness.

Entropy (Basel) 2018 Jul 10;20(7). Epub 2018 Jul 10.

Department of Anesthesiology, Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI 48109, USA; (Z.H.); (U.L.).

Theoretical consideration predicts that the alteration of local and shared information in the brain is a key element in the mechanism of anesthetic-induced unconsciousness. Ordinal pattern analysis, such as permutation entropy (PE) and symbolic mutual information (SMI), have been successful in quantifying local and shared information in neurophysiological data; however, they have been rarely applied to altered states of consciousness, especially to data obtained with functional magnetic resonance imaging (fMRI). PE and SMI analysis, together with the superb spatial resolution of fMRI recording, enables us to explore the local information of specific brain areas, the shared information between the areas, and the relationship between the two. Read More

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http://dx.doi.org/10.3390/e20070518DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380508PMC
July 2018
3 Reads

Patient Attitudes Toward Local Anesthesia With or Without Sedation for Minor Hand Procedures.

J Surg Orthop Adv 2018 ;27(4):317-320

Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston, South Carolina.

The purpose of this study was to assess patient preferences in this population with respect to anesthesia for minor hand procedures. This prospective cohort study assessed 183 patients undergoing minor hand surgery to determine their preferences for local-only anesthesia with or without sedation and the reasons for their choices. Fifty-six percent of patients preferred local anesthesia with sedation, 43% preferred local-only anesthesia, and 2% had no preference. Read More

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January 2018

Upper-Extremity Venous Access for Children and Adults in Pediatric Cardiac Catheterization Laboratory.

J Invasive Cardiol 2019 Feb 15. Epub 2019 Feb 15.

Texas Children's Hospital, 6651 Main Street, E1920, Houston, TX 77030 USA.

Background: Traditional approaches to pediatric cardiac catheterization have relied on femoral venous access. Upper- extremity venous access may enable cardiac catheterization procedures to be performed safely for diagnostic and interventional catheterizations. The objective of this multicenter study was to demonstrate the feasibility and safety of upper-extremity venous access in a pediatric cardiac catheterization laboratory. Read More

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February 2019
1 Read

Clitoral frenuloreduction: A new surgical intervention.

Authors:
Adam Ostrzenski

Heliyon 2019 Jan 18;5(1):e01098. Epub 2019 Jan 18.

The Institute of Gynecology, Inc., Washington D.C., USA.

Background: A clitoral frenuloreduction surgical intervention has not been described in the medical literature and through clinical-scientific research, a new surgical clitoral frenuloreduction intervention was developed. This procedure is based on the new anatomical discovery of the clitoral infrafrenulum fascial bundle, which is the deep stratum of the clitoral frenulum.

Methods: A descriptive case series clinical research was designed with objectives to: develop a new clitoral frenuloreduction surgical intervention; evaluate surgical outcomes; assess the impact of this operation on genital self-perceived body image; female sexual activities; and to record complications. Read More

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http://dx.doi.org/10.1016/j.heliyon.2018.e01098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348164PMC
January 2019
1 Read

Safety Studies in the Field of Liposuction: A Systematic Review.

Dermatol Surg 2019 Feb;45(2):171-182

Laser and Skin Surgery Center of Indiana, Indianapolis, Indiana.

Background: There is an increasing demand for safety standards for cosmetic treatments. With regard to liposuction, interdisciplinary consensus is lacking, especially regarding treatment setting and physician specialty.

Objective: A solid, independent interpretation of scientific data on safety requires a systematic approach, which is the aim of this study. Read More

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http://dx.doi.org/10.1097/DSS.0000000000001707DOI Listing
February 2019
7 Reads

Practical Regional Anesthesia Guide for Elderly Patients.

Drugs Aging 2019 03;36(3):213-234

Department of Anesthesiology, Perioperative and Pain Medicine, Lucille Packard Children's Hospital, Stanford University, School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA.

Ultrasound-guided regional anesthesia is an important part of the practice of anesthesia for the elderly population, the growth of which will continue to outpace that of the younger population due to improvements in lifespan worldwide. The elderly patient is uniquely vulnerable to the effects of systemic anesthetic drugs, and our understanding of the potential toxicities that general anesthetics can have on the elderly brain and body continues to evolve. Aging impacts both the pharmacokinetics and pharmacodynamics of sedative medications and local anesthetics. Read More

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http://link.springer.com/10.1007/s40266-018-00631-y
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http://dx.doi.org/10.1007/s40266-018-00631-yDOI Listing
March 2019
3 Reads

Comparison of bupivacaine plus intrathecal fentanyl and bupivacaine alone for spinal anesthesia with intravenous dexmedetomidine sedation: a randomized, double-blind, noninferiority trial.

Reg Anesth Pain Med 2019 Jan 23. Epub 2019 Jan 23.

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea

Background And Objectives: Fentanyl is widely used as an intrathecal adjuvant to local anesthetics to enhance the duration of spinal anesthesia. Recent evidence suggests that intravenous dexmedetomidine prolongs the duration of spinal anesthesia. This noninferiority study evaluated whether bupivacaine alone could provide a noninferior duration of block compared with bupivacaine and fentanyl when intravenous dexmedetomidine was administered intraoperatively. Read More

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http://dx.doi.org/10.1136/rapm-2018-100084DOI Listing
January 2019
11 Reads

Characterization of post-surgical critical patients with infections associated with healthcare after prolonged perfusion of remifentanil.

Rev Assoc Med Bras (1992) 2018 Aug;64(8):736-742

. Departamento de Farmacología e Instituto de Neurociencias. Facultad de Medicina, Universidad de Granada, Granada, Spain.

Introduction: Healthcare associated infections (HAI) are the most frequent complication of hospitalized patients. The aim of this study was to describe the clinical and epidemiological characteristics of critically ill post-surgical patients with a diagnosis of healthcare associated infections, after a pattern of sedoanalgesia of at least 4 days.

Methods: All patients over 18 years of age with a unit admission of more than 4 days were consecutively selected. Read More

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http://dx.doi.org/10.1590/1806-9282.64.08.736DOI Listing
August 2018
2 Reads

Intravitreal injection of low-dose gentamicin for the treatment of recurrent or persistent uveitis in horses: Preliminary results.

BMC Vet Res 2019 Jan 16;15(1):29. Epub 2019 Jan 16.

Faculty of Veterinary Medicine, University of Leipzig, Department for Horses, Leipzig, Germany.

Background: Despite appropriate medical therapy, many horses with equine recurrent uveitis continue to suffer from recurrent bouts of inflammation. Surgical intervention via the pars plana vitrectomy or suprachoroidal cyclosporine implant placement may control and/or prevent recurrences, however, these procedures may be contraindicated, unavailable, or declined by an owner. Thus, an effective adjunctive treatment option may help to improve the clinical outcomes in those situations. Read More

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http://dx.doi.org/10.1186/s12917-018-1722-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6335700PMC
January 2019
3 Reads

[Subcutaneous defibrillator implantation with ultrasound-guided serratus block using the two-incision technique: our experience].

G Ital Cardiol (Rome) 2019 Jan;20(1):41-45

U.O.C. Cardiologia-UTIC.

Background: The aim of this study was to report our experience with subcutaneous defibrillator (S-ICD) implantation.

Methods: At our hospital, 7 procedures of S-ICD implantation were performed; 4 of these with ultrasound-guided serratus anterior plane block (SAPB) and 3 with usual local anesthesia followed by sedation.

Results: Surgical operations were not burdened with peri- and postprocedural complications, with only one event of limited hematoma of the thoracic wall. Read More

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http://dx.doi.org/10.1714/3079.30719DOI Listing
January 2019
1 Read

On-table extubation in neonates undergoing anoplasty: an experience of anesthetic management on the concept of fast-tracking anesthesia: A pilot study.

Medicine (Baltimore) 2019 Jan;98(2):e14098

Department of Anesthesiology, Sichuan University West China Hospital.

Fast-track anesthesia (FTA) is difficult to achieve in neonates due to immature organ function and high rates of perioperative events. As a high-risk population, neonates require prolonged postoperative mechanical ventilation, which may lead to contradictions in cases where neonatal intensive care unit resources and ventilator facilities are limited. The choice of anesthesia strategy and anesthetic can help achieve rapid postoperative rehabilitation and save hospitalization costs. Read More

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http://dx.doi.org/10.1097/MD.0000000000014098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336589PMC
January 2019
14 Reads

Methodological approaches to botulinum toxin for the treatment of chronic pelvic pain, vaginismus, and vulvar pain disorders.

Int Urogynecol J 2019 Jan 7. Epub 2019 Jan 7.

National Institute of Neurological Disorders and Stroke, National Institutes of Health, Building 31; Room B2 B32, 9000 Rockville Pike, Bethesda, MD, USA.

Introduction And Hypothesis: Botulinum toxin (BoNT) is increasingly used for pain, especially with muscle spasm. We describe our methodology for BoNT treatment of chronic pelvic pain (CPP) in women and place it in the context of the literature on techniques for this use.

Methods: Databases were searched using terms "botulinum toxin," "pelvic pain," and "vaginismus. Read More

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http://link.springer.com/10.1007/s00192-018-3831-z
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http://dx.doi.org/10.1007/s00192-018-3831-zDOI Listing
January 2019
8 Reads

Application of sedation-agitation scale in conscious sedation before bronchoscopy in children.

Medicine (Baltimore) 2019 Jan;98(1):e14035

Department of Pediatric Pulmonology and Immunology, West China Second University Hospital of Sichuan University.

This retrospective study investigated the application of the sedation-agitation scale (SAS) in pediatric bronchoscopy by observing its effects on sedative dosages and adverse reactions.Children who underwent sedation before bronchoscopy, during the period from January 2014 to June 2017, were divided into control and SAS groups. Patients in the control group were administered a single dose of 0. Read More

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http://dx.doi.org/10.1097/MD.0000000000014035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6344143PMC
January 2019
3 Reads

Conscious Sedation for Pediatric Peritonsillar Abscess: Comparison of Anesthetic Approaches.

Otolaryngol Head Neck Surg 2019 Jan 1:194599818821905. Epub 2019 Jan 1.

2 Division of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Utah, Salt Lake City, Utah, USA.

Objective: To compare the efficacy, safety, and cost of incision and drainage (I&D) for pediatric patients with peritonsillar abscesses (PTAs) under conscious sedation (CS) versus unsedated (awake) and general anesthesia (GA).

Study Design: Case series with chart review.

Setting: Tertiary pediatric hospital. Read More

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http://dx.doi.org/10.1177/0194599818821905DOI Listing
January 2019
1 Read

Viscous lidocaine solution versus lidocaine spray for pharyngeal local anesthesia in upper gastroesophageal endoscopy.

J Res Med Sci 2018 28;23:102. Epub 2018 Nov 28.

Department of Gastroenterology and Hepatology, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: Advantage of using local sedation during upper gastrointestinal endoscopy (UGE) is still challenging. In the current study, the effect of lidocaine spray versus lidocaine viscous solution for pharyngeal local anesthesia during UGE has been compared.

Materials And Methods: This is a randomized clinical trial conducted on 130 patients conducting UGE in 2013. Read More

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http://dx.doi.org/10.4103/jrms.JRMS_579_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282542PMC
November 2018
10 Reads

Percutaneous Thermal Ablation for Lung Cancer: An Update.

Surg Technol Int 2018 Dec 20;34. Epub 2018 Dec 20.

Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI.

Lung cancer remains the leading cause of cancer death in the United States, and accounts for more deaths than breast, colon, and prostate cancer combined. Over the past decade, percutaneous thermal ablative therapy (PTA) has become a useful adjunctive therapy in combination with longer-standing methods, or as a standalone treatment. The physiologic basis of thermal ablation is that coagulative necrosis and cell death occur at temperatures above 60°C. Read More

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December 2018
10 Reads

Postoperative Pain Management Strategies and Delirium After Transapical Aortic Valve Replacement: A Randomized Controlled Trial.

J Cardiothorac Vasc Anesth 2018 Nov 14. Epub 2018 Nov 14.

Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, Canada. Electronic address:

Objective(s): This study was designed to compare 2 different perioperative analgesia strategies with respect to the incidence of postoperative delirium after a transapical approach for transcatheter aortic valve replacement (TAVR). The authors hypothesized that perioperative thoracic paravertebral analgesia with a local anesthetic would decrease opioid consumption and in turn reduce the incidence of postoperative delirium when compared with systemic opioid-based analgesia after a transapical TAVR procedure.

Design: Prospective, randomized controlled clinical trial. Read More

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http://dx.doi.org/10.1053/j.jvca.2018.11.010DOI Listing
November 2018
2 Reads

Feasibility and clinical outcomes of ureteral stenting in the office procedural suite.

Can J Urol 2018 Dec;25(6):9596-9600

MD/PhD Program, Texas A & M Health Science Center College of Medicine, Temple, Texas, USA.

Introduction: Stent placement is a common procedure for addressing obstructive uropathy. However, lack of operating room (OR) availability can substantially delay this procedure. In this study, we sought to assess the feasibility, safety, and efficacy of this procedure in a clinical setting using nitrous oxide (N2O) and local anesthesia. Read More

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December 2018
4 Reads

Septoplasty Under Local Anesthesia.

Authors:
Bojan Obradovic

J Craniofac Surg 2018 Dec 13. Epub 2018 Dec 13.

Dental/Medical Center of Maxillofacial Surgery "Aleja-Centar," Banja Luka, Bosnia and Herzegovina.

Septoplasty is usually performed under general anesthesia or local anesthesia with sedation. Nevertheless, septoplasty under pure local anesthesia is also feasible and it shows a great potential for fast-track surgery. This article presents a patient with nasal septal deviation where septoplasty was managed under local anesthesia at an outpatient clinic. Read More

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http://Insights.ovid.com/crossref?an=00001665-900000000-9514
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http://dx.doi.org/10.1097/SCS.0000000000005071DOI Listing
December 2018
18 Reads

Effectiveness of Hysteroscopic Techniques for Endometrial Polyp Removal: The Italian Multicenter Trial.

J Minim Invasive Gynecol 2018 Dec 7. Epub 2018 Dec 7.

Department of Women's Health and Territorial Medicine (Dr. De Angelis), University of Rome "La Sapienza", Rome, Italy.

Study Objective: To compare the effectiveness and safety of different techniques of hysteroscopic polypectomy.

Design: Multicenter, prospective observational trial (Canadian Task Force classification II-2).

Setting: Nineteen Italian gynecologic departments (university-affiliated or public hospitals). Read More

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http://dx.doi.org/10.1016/j.jmig.2018.12.002DOI Listing
December 2018
4 Reads

Sedation versus general anesthesia for transcatheter aortic valve replacement.

J Thorac Dis 2018 Nov;10(Suppl 30):S3588-S3594

Department of Anesthesia & Perioperative Medicine, University of Western Ontario, London, ON, Canada.

There is currently significant controversy regarding the best anesthesia management for patients undergoing transcatheter aortic valve replacement (TAVR). Some institutions primarily use general anesthesia (GA) but many institutions primarily use moderate sedation. Much of the controversy is due to the limited evidence base available to inform this decision and the strong feelings and pre-conceived notions about the optimal anesthesia technique which exist amongst anesthesiologists, cardiologists, and cardiac surgeons. Read More

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http://dx.doi.org/10.21037/jtd.2018.08.89DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6242923PMC
November 2018

Anterior mediastinal masses - A multidisciplinary pathway for safe diagnostic procedures.

J Pediatr Surg 2019 Feb 6;54(2):251-254. Epub 2018 Nov 6.

Department of Paediatric Surgery, St Georges Hospital NHS Trust, London, UK. Electronic address:

Objective: The objective of this study was to report our multidisciplinary diagnostic approach for patients with anterior mediastinal masses (AMM).

Methods: A retrospective review of patients with AMM at a tertiary pediatric surgical oncology centre (January 2011-December 2016) was performed. We analyzed data on clinical presentation, mode of tissue diagnosis, anesthetic techniques, and complications. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00223468183074
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http://dx.doi.org/10.1016/j.jpedsurg.2018.10.080DOI Listing
February 2019
14 Reads

Carpal Tunnel Syndrome: Retrospective Analysis of 60 Consecutive Cases of Ambulatory Surgical Treatment With Local Anesthesia.

Hand (N Y) 2018 Dec 2:1558944718813721. Epub 2018 Dec 2.

3 Centro Universitário Serra dos Órgãos, Teresópolis, Brazil.

Background: The purpose of this study was to evaluate the safety and efficacy of ambulatory open surgical treatment for carpal tunnel syndrome with local anesthesia and without tourniquet ischemia, sedation by an anesthesiologist, or hospitalization.

Methods: A retrospective analysis of 60 consecutive cases performed during 1 year was conducted, excluding other compressive or noncompressive neuropathies. The criteria for treatment efficacy were improvements in symptoms and recurrence rates, and the safety criterion was the presence of complications. Read More

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http://dx.doi.org/10.1177/1558944718813721DOI Listing
December 2018
2 Reads

Percutaneous laser ablation of benign thyroid nodules: a one year follow-up study.

Einstein (Sao Paulo) 2018 Nov 29;16(4):eAO4279. Epub 2018 Nov 29.

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

Objective: To evaluate safety and effectiveness of nodule volume reduction and thyroid function after percutaneous laser ablation treatment in patients with benign nonfunctioning thyroid nodules.

Methods: Prospective single-center study, from January 2011 to October 2012, which evaluated 30 euthyroid and thyroid antibodies negative patients with benign solitary or dominant nodule with indication of treatment due to compressive symptoms and aesthetic disturbances. The clinical and laboratory (thyroid ultrasound, TSH, FT4, TG, TG-Ab, TPO-Ab and TRAb levels) evaluations were performed before the procedure, and periodically 1 week, 3 months and 6 months after. Read More

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https://journal.einstein.br/pt-br/article/ablacao-percutanea
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http://dx.doi.org/10.31744/einstein_journal/2018AO4279DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276810PMC
November 2018
13 Reads

[Use of the autologous dorsal dermis in reconstruction of the posterior palpebral lamella in blepharopoiesis].

Ann Chir Plast Esthet 2019 Feb 30;64(1):44-53. Epub 2018 Nov 30.

Département de chirurgie plastique, reconstructrice, brûlés, plaies et cicatrisation, CHU Lapeyronie, 371, avenue de Doyen Gaston Giraud, 34295 Montpellier, France. Electronic address:

Objectives: Blepharopoiesis represents a double aesthetic and functional challenge. If anterior lamellar reconstruction is less discussed, the variety of posterior lamellar substitutes testifies that none is ideal. We report here our experience of the use of autologous dermal dermis as posterior lamellar substitutes in bilamellar blepharopoiesis. Read More

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http://dx.doi.org/10.1016/j.anplas.2018.07.006DOI Listing
February 2019
4 Reads

[Combination of clonidine-bupivacaine in caudal epidural anesthesia for hypospadias surgery in children: prospective, randomized, blind study].

Rev Bras Anestesiol 2019 Jan - Feb;69(1):27-34. Epub 2018 Oct 25.

Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Belo Horizonte, MG, Brasil; Faculdade de Minas (Faminas), Belo Horizonte, MG, Brasil. Electronic address:

Background And Objectives: The combination of clonidine with local anesthetic administered for epidural anesthesia via caudal route seems to improve the quality of postoperative analgesia, but with conflicting results. This study compared the postoperative analgesia of three different doses of clonidine combined with bupivacaine in caudal epidural anesthesia in children undergoing hypospadias repair.

Methods: Eighty children aged 1 to 10 years, candidates for surgical repair of hypospadias, were randomly divided into four groups of 20 patients to receive general anesthesia combined with caudal epidural anesthesia with bupivacaine 0. Read More

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http://dx.doi.org/10.1016/j.bjan.2018.09.008DOI Listing
October 2018
4 Reads

The Canadian Model for Instituting Wide-Awake Hand Surgery in Our Hospitals.

Hand Clin 2019 Feb;35(1):21-27

Department of Plastic and Reconstructive Surgery, Dalhousie University, Suite C204, 600 Main Street, Saint John, New Brunswick E2K1J5, Canada.

Clinic-based hand surgery performed under local anesthetic has been steadily increasingly performed in Canada for 50 years. The drive for its development stems from the Canadian health care system's finite funding structure and resources. Benefits have extended far beyond cost and garbage reduction. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07490712183009
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http://dx.doi.org/10.1016/j.hcl.2018.08.001DOI Listing
February 2019
9 Reads

Latest Advances in Wide Awake Hand Surgery.

Authors:
Donald H Lalonde

Hand Clin 2019 Feb;35(1):1-6

Division of Plastic Surgery, Dalhousie University, Dalhousie Medicine New Brunswick, Suite C204, 600 Main Street, Saint John, New Brunswick E2K 1J5, Canada. Electronic address:

Injection of tumescent local anesthesia should no longer be painful. WALANT anesthesia, strong sutures, a slightly bulky repair, intraoperative testing of active movement, and judicious venting of the A2 and A4 pulleys improve results in flexor tendon repair. WALANT K wire finger fracture reduction permits intraoperative testing of K wire stability with active movement to facilitate early protected movement at 3 to 5 days after surgery. Read More

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http://dx.doi.org/10.1016/j.hcl.2018.08.002DOI Listing
February 2019
11 Reads

Intrathecal administration of nusinersen in adolescent and adult SMA type 2 and 3 patients.

J Neurol 2019 Jan 20;266(1):183-194. Epub 2018 Nov 20.

Department of Orthopedic Surgery, RKU-University and Rehabilitation Clinics, Ulm University, Ulm, Germany.

Spinal muscular atrophy is a genetic motor neuron disease that leads to progressive muscular atrophy and muscle weakness. In December 2016, the Food and Drug Administration, and in June 2017, the European Medicines Agency approved the antisense oligonucleotide nusinersen for treatment of spinal muscular atrophy. Nusinersen has to be repeatedly administered intrathecally. Read More

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http://dx.doi.org/10.1007/s00415-018-9124-0DOI Listing
January 2019
17 Reads

Initial outcomes of local anaesthetic freehand transperineal biopsies in the outpatient setting.

BJU Int 2018 Nov 15. Epub 2018 Nov 15.

Department of Urology, Guy's at St Thomas' Hospitals, London, UK.

Introduction: Systematic transperineal (TP) and targeted prostate biopsies can be achieved using a freehand access system through perineal punctures, with the potential for reduced morbidity and enabling the procedure under local anesthesia (LA), particularly sepsis.

Objectives: To evaluate the histopathological outcomes, morbidity and tolerability of freehand TP prostate biopsies using the PrecisionPoint access system under local anaesthetic (LA) in the day surgery and outpatient environments.

Methods: 176 patients underwent freehand TP prostate biopsies from May 2016 to November 2017. Read More

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http://doi.wiley.com/10.1111/bju.14620
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http://dx.doi.org/10.1111/bju.14620DOI Listing
November 2018
17 Reads
3.530 Impact Factor

Evaluation of thoracolumbar interfascial plane block for postoperative analgesia after herniated lumbar disc surgery: A randomized clinical trial.

Saudi J Anaesth 2018 Oct-Dec;12(4):559-564

Department of Anesthesia and Intensive Care, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Background: Thoracolumbar interfascial plane (TLIP) block involves injection of local anesthetics between multifidus and longissimus muscles at the 3 lumbar vertebral level assuming that it can block the dorsal rami of thoracolumbar nerves.

Objective: The objective of this study was to evaluate the analgesic effects gained after performing TLIP block (analogous to the transversus abdominis plane [TAP] block, but intended for the back) in patients undergoing lumbar discectomy.

Methodology: This was a prospective, randomized, double-blinded, controlled clinical trial. Read More

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http://dx.doi.org/10.4103/sja.SJA_177_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6180699PMC
November 2018
2 Reads

Nil per os guidelines: what is changing, what is not, and what should?

Minerva Anestesiol 2018 Dec 30;84(12):1413-1419. Epub 2018 Oct 30.

Departments of General Anesthesiology and Outcomes Research, Cleveland Clinic, Cleveland, OH, USA.

Preoperative nil per os (NPO) guidelines have been in existence since the recognition of the risk of perioperative aspiration. These guidelines aim at reducing the risk for gastric content aspiration to the lowest possible, to avoid associated morbidity, unplanned hospital and/or an intensive care admission. Thus, such guidelines are not only considered for patients having major surgeries, but more so in those having ambulatory surgery including those performed at non-operating room anesthesia locations. Read More

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https://www.minervamedica.it/index2.php?show=R02Y9999N00A181
Publisher Site
http://dx.doi.org/10.23736/S0375-9393.18.13042-2DOI Listing
December 2018
28 Reads

Response to "Facelift Under Local Anesthesia With Oral Sedation".

Aesthet Surg J 2018 Nov;38(12):NP230

Plastic surgeon in private practice in Chesterfield, MO.

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http://dx.doi.org/10.1093/asj/sjy251DOI Listing
November 2018

Facelift Under Local Anesthesia With Oral Sedation.

Aesthet Surg J 2018 Nov;38(12):NP229

Retired plastic surgeon in Carmel, IN.

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http://dx.doi.org/10.1093/asj/sjy243DOI Listing
November 2018