12,285 results match your criteria Current Anaesthesia & Critical Care[Journal]


Hot topics in opioid pharmacology: mixed and biased opioids.

Br J Anaesth 2019 Apr 19. Epub 2019 Apr 19.

Department of Cardiovascular Sciences, University of Leicester, Anaesthesia, Critical Care and Pain Management, Leicester Royal Infirmary, Leicester, UK. Electronic address:

Analgesic design and evaluation have been driven by the desire to create high-affinity high-selectivity mu (μ)-opioid peptide (MOP) receptor agonists. Such ligands are the mainstay of current clinical practice, and include morphine and fentanyl. Advances in this sphere have come from designing pharmacokinetic advantage, as in rapid metabolism for remifentanil. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.bja.2019.03.006DOI Listing

General Anesthesia for a Posttonsillectomy and Adenoidectomy Bleed.

MedEdPORTAL 2016 Sep 30;12:10476. Epub 2016 Sep 30.

Clinical Associate Professor of Anesthesiology, University of Iowa Carver College of Medicine.

Introduction: Providers at all levels should have some understanding of the pathophysiology and be able to manage such a patient in the operating room. In addition, any anesthetists providing pediatric care should be able to identify and understand the importance of other comorbid conditions in these patients. This simulation on posttonsillectomy and adenoidectomy hemorrhage in the pediatric patient presents a challenging case usually encountered in some form by most anesthesia residents during training. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.15766/mep_2374-8265.10476DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464412PMC
September 2016

Transfusion Ethics in a Pediatric Jehovah's Witness Trauma Patient: Simulation Case.

MedEdPORTAL 2016 Sep 1;12:10450. Epub 2016 Sep 1.

Assistant Professor of Anesthesiology, Loma Linda University School of Medicine.

Introduction: Current ethical practice allows for adult patients with decision-making capacity to refuse blood transfusion, even at the cost of high morbidity or mortality. However, for an adult patient who is of the Jehovah's Witness faith, an unwanted blood transfusion confers a psychospiritual cost to the patient and a financial cost to health care entities. The ethical boundaries are increasingly ambiguous with minors who are members of the Jehovah's Witness faith. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.15766/mep_2374-8265.10450DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464417PMC
September 2016

High-Frequency Heart Rate Variability Index: A Prospective, Observational Trial Assessing Utility as a Marker for the Balance Between Analgesia and Nociception Under General Anesthesia.

Anesth Analg 2019 Apr 17. Epub 2019 Apr 17.

Perinatal Environment and Health, Faculté of Médicine, University of Lille, Centre Hospitalier Universitaire, Lille, France.

Background: Maintaining a balance between nociception and analgesia perioperatively reduces morbidity and improves outcomes. Current intraoperative analgesic strategies are based on subjective and nonspecific parameters. The high-frequency heart rate (HR) variability index is purported to assess the balance between nociception and analgesia in patients under general anesthesia. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1213/ANE.0000000000004180DOI Listing

International prospective observational study on intracranial pressure in intensive care (ICU): the SYNAPSE-ICU study protocol.

BMJ Open 2019 Apr 20;9(4):e026552. Epub 2019 Apr 20.

Department of Public Health, Erasmus MC, Rotterdam, Netherlands.

Introduction: Intracranial pressure (ICP) monitoring is commonly used in neurocritical care patients with acute brain injury (ABI). Practice about indications and use of ICP monitoring in patients with ABI remains, however, highly variable in high-income countries, while data on ICP monitoring in low and middle-income countries are scarce or inconsistent. The aim of the SYNAPSE-ICU study is to describe current practices of ICP monitoring using a worldwide sample and to quantify practice variations in ICP monitoring and management in neurocritical care ABI patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2018-026552DOI Listing
April 2019
1 Read

Effect of grape seed extract ointment on cesarean section wound healing: A double-blind, randomized, controlled clinical trial.

Complement Ther Clin Pract 2019 May 20;35:323-328. Epub 2019 Mar 20.

Instructor, East Nursing and Midwifery Care Research Center Instructor, Department of Nursing, Faculty of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran. Electronic address:

Background: and purpose: Complications of the delayed recovery of cesarean section (CS) wound can include stress, discomfort, and dissatisfaction of the mother in the postpartum period. This study tried to determine the effect of grape seed extract ointment on CS wound healing.

Materials And Methods: This is a double-blind, randomized, controlled clinical trial incorporating 129 women eligible for CS in eastern Iran. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S17443881183036
Publisher Site
http://dx.doi.org/10.1016/j.ctcp.2019.03.011DOI Listing
May 2019
1 Read

MRI-guided frame-based stereotactic brainstem biopsy procedure: A single-center experience.

Neurocirugia (Astur) 2019 Apr 15. Epub 2019 Apr 15.

Department of Neurosurgery, Kent Hospital, İzmir, Turkey.

Introduction And Objectives: This study aims at presenting our experience of the MRI-guided frame-based stereotactic brainstem biopsy method, and evaluating the outcomes of the procedure.

Patients And Methods: The current study involved 18 cases that underwent MRI-guided frame-based stereotactic biopsy for brainstem lesions between 2011 and 2018 in our clinic. The relevant data regarding the technique of the biopsy procedure, morbidity, histopathological diagnosis it yields and diagnostic accuracy was retrospectively analyzed. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S11301473193002
Publisher Site
http://dx.doi.org/10.1016/j.neucir.2019.03.001DOI Listing
April 2019
1 Read

Current status of rheumatic heart disease in India.

Indian Heart J 2019 Jan - Feb;71(1):85-90. Epub 2019 Jan 4.

Department of Anaesthesia, IGMC Shimla, India.

The rheumatic heart disease continues to be an important cause of disease burden in India, affecting the population in their prime and productive phase of the life. The prevalence of rheumatic heart disease is varied in different Indian studies, because of the inclusion of different populations at different point of times and using different screening methods for the diagnosis. The data on incidence and prevalence on a nationally represented sample are lacking. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S00194832183054
Publisher Site
http://dx.doi.org/10.1016/j.ihj.2018.12.007DOI Listing
January 2019
2 Reads

Obtaining and Modeling Variability in Travel Times From Off-Site Satellite Clinics to Hospitals and Surgery Centers for Surgeons and Proceduralists Seeing Office Patients in the Morning and Performing a To-Follow List of Cases in the Afternoon.

Anesth Analg 2019 Apr 15. Epub 2019 Apr 15.

From the Department of Anesthesiology, Pain Management and Perioperative Medicine, University of Miami, Miami, Florida.

Background: Hospitals achieve growth in surgical caseload primarily from the additive contribution of many surgeons with low caseloads. Such surgeons often see clinic patients in the morning then travel to a facility to do 1 or 2 scheduled afternoon cases. Uncertainty in travel time is a factor that might need to be considered when scheduling the cases of to-follow surgeons. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1213/ANE.0000000000004148DOI Listing

Respiratory Physiology for the Anesthesiologist.

Anesthesiology 2019 Apr 12. Epub 2019 Apr 12.

From the Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts (L.B.) the Department of Emergency, Anesthesia and Critical Care, Foundation IRCCS Ospedale Maggiore Policlinico, and Department of Surgical Pathophysiology and Transplantation, University of Milan, Milan, Italy (A.P.).

Respiratory function is fundamental in the practice of anesthesia. Knowledge of basic physiologic principles of respiration assists in the proper implementation of daily actions of induction and maintenance of general anesthesia, delivery of mechanical ventilation, discontinuation of mechanical and pharmacologic support, and return to the preoperative state. The current work provides a review of classic physiology and emphasizes features important to the anesthesiologist. Read More

View Article

Download full-text PDF

Source
http://Insights.ovid.com/crossref?an=00000542-900000000-9661
Publisher Site
http://dx.doi.org/10.1097/ALN.0000000000002666DOI Listing
April 2019
1 Read

Recent developments and current controversies in short stay endovascular aneurysm repair.

J Cardiovasc Surg (Torino) 2019 Apr 15. Epub 2019 Apr 15.

St George's Vascular Institute, St George's Hospital, London, UK.

Introduction: Short stay endovascular aneurysm repair pathways (SS-EVAR) provide potential advantages to both healthcare providers and patients. However, these benefits must be carefully balanced against the inherent risks to patient safety and tariff penalties associated with unplanned readmissions.

Evidence Acquisition: A literature review was performed using the databases MEDLINE, Embase and Cochrane Library up until March 2019. Read More

View Article

Download full-text PDF

Source
https://www.minervamedica.it/index2.php?show=R37Y9999N00A190
Publisher Site
http://dx.doi.org/10.23736/S0021-9509.19.10952-4DOI Listing
April 2019
2 Reads

Update in Neurocritical Care: a summary of the 2018 Paris international conference of the French Society of Intensive Care.

Ann Intensive Care 2019 Apr 16;9(1):47. Epub 2019 Apr 16.

Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Route de Lennik, 808, 1070, Brussels, Belgium.

The 2018 Paris Intensive Care symposium entitled "Update in Neurocritical Care" was organized in Paris, June 21-22, 2018, under the auspices of the French Intensive Care Society. This 2-day post-graduate educational symposium comprised several chapters, aiming first to provide all-board intensivists with current standards for the clinical assessment of altered consciousness states (including coma and delirium) and peripheral nervous system in critically ill patients, monitoring of brain function (specifically, electro-encephalography) and best practices for sedation-analgesia-delirium management. An update on the treatment of specific severe brain pathologies-including ischaemic/haemorrhagic stroke, cerebral venous thrombosis, hypoxic-ischaemic brain injury, immune-mediated and infectious encephalitis and refractory status epilepticus-was also provided. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13613-019-0523-xDOI Listing
April 2019
1 Read

Manipulation under anaesthesia for frozen shoulders: outdated technique or well-established quick fix?

EFORT Open Rev 2019 Mar 19;4(3):98-109. Epub 2019 Mar 19.

Department of Orthopaedic Surgery, Amphia Hospital, The Netherlands.

Manipulation under anaesthesia (MUA) for frozen shoulder (FS) leads to a considerable increase in range of motion and Oxford shoulder score, a significant reduction in pain and around 85% satisfaction.A clearly defined indication for MUA in FS patients cannot be extracted from this review or the available literature. The associating criteria before proceeding to MUA vary widely. Read More

View Article

Download full-text PDF

Source
https://online.boneandjoint.org.uk/doi/10.1302/2058-5241.4.1
Publisher Site
http://dx.doi.org/10.1302/2058-5241.4.180044DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440298PMC
March 2019
4 Reads

Current sedation practices in paediatric audiology clinics in gauteng, South Africa.

Int J Pediatr Otorhinolaryngol 2019 Apr 11;122:93-98. Epub 2019 Apr 11.

Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa. Electronic address:

Aim: The aim was to describe the current practices in sedation during AEP testing in infants and young children in Gauteng.

Methods: An exploratory qualitative research design was employed, where telephonic and face-to face interviews were conducted with 48 participants in paediatric audiology clinics that have AEP testing facilities in Gauteng, South Africa. Qualitative analysis was done, with inductive thematic analysis used for open ended questions. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S01655876193016
Publisher Site
http://dx.doi.org/10.1016/j.ijporl.2019.04.007DOI Listing
April 2019
1 Read

Intralesional radiofrequency treatment for venous lake.

Int J Dermatol 2019 Apr 16. Epub 2019 Apr 16.

Department of Dermatology, Venereology and Leprology, Government Medical College and Hospital, Chandigarh, India.

Background: Venous lakes are asymptomatic, cosmetically unacceptable vascular malformations commonly present over the lips. Most of the lesions do not warrant any therapeutic intervention.

Objective: We herein report a 20-year-old male patient with venous lake who was treated using intralesional radiofrequency (RF) by modified insulated intravenous cannula as an extended probe. Read More

View Article

Download full-text PDF

Source
https://onlinelibrary.wiley.com/doi/abs/10.1111/ijd.14308
Publisher Site
http://dx.doi.org/10.1111/ijd.14308DOI Listing
April 2019
1 Read

Long-term effects of neonatal pain.

Authors:
Suellen M Walker

Semin Fetal Neonatal Med 2019 Apr 5. Epub 2019 Apr 5.

Clinical Neurosciences (Pain Research), UCL Great Ormond Street Institute of Child Health, United Kingdom; Department of Anaesthesia and Pain Medicine, Great Ormond Street Hospital NHS Foundation Trustvd, United Kingdom. Electronic address:

Pain experienced during neonatal intensive care management can influence neurodevelopmental outcome and the somatosensory and/or emotional components of pain response in later life. Alterations in biological factors (e.g. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.siny.2019.04.005DOI Listing

Global Brain Drain: How Can the Maslow Theory of Motivation Improve Our Understanding of Physician Migration?

Int J Environ Res Public Health 2019 Apr 2;16(7). Epub 2019 Apr 2.

Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.

The migration of physicians from low-resource to high-resource settings is a prevalent global phenomenon that is insufficiently understood. Most low-income countries are severely understaffed with physicians, and the emigration of the already limited number of physicians to other countries can significantly reduce access to healthcare in the source country. Despite a growing interest in global capacity building in these countries by academic and non-governmental organizations in high-income countries, efforts to stem physician migration have been mostly unsuccessful. Read More

View Article

Download full-text PDF

Source
https://www.mdpi.com/1660-4601/16/7/1182
Publisher Site
http://dx.doi.org/10.3390/ijerph16071182DOI Listing
April 2019
1 Read

Chemical Hip Denervation for Inoperable Hip Fracture.

Anesth Analg 2019 Apr 9. Epub 2019 Apr 9.

Department of Orthopaedics and Traumatology, Tuen Mun Hospital, Tuen Mun, Hong Kong.

Background: Hip fracture is a challenging geriatric problem for the health care professionals, especially in patients with multiple comorbidities. In patients with inoperable hip fracture secondary to severe comorbid conditions, the pain can lead to significant challenges in nursing care. With the current understanding of the innervation of hip joint, we are now able to perform selective chemical denervation of the articular branches of femoral and obturator nerves to manage the pain associated with inoperable hip fracture. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1213/ANE.0000000000004172DOI Listing
April 2019
7 Reads

Understanding Lactatemia in Human Sepsis: Potential Impact for Early Management.

Am J Respir Crit Care Med 2019 Apr 15. Epub 2019 Apr 15.

Regions Hospital, St. Paul, Minnesota, United States.

Rationale: Hyperlactatemia in sepsis may derive from a prevalent impairment of oxygen supply/demand and/or oxygen utilization. Discriminating between these two mechanisms may be relevant for the early fluid resuscitation strategy.

Objectives: Understanding the relationship between central venous oxygen saturation (ScvO2), lactate and base excess to better determine the origin of lactate. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1164/rccm.201812-2342OCDOI Listing
April 2019
1 Read
12.996 Impact Factor

Perioperative opioid analgesia-when is enough too much? A review of opioid-induced tolerance and hyperalgesia.

Lancet 2019 Apr;393(10180):1558-1568

Institute for Academic Anaesthesia, Division of Systems Medicine, School of Medicine, Ninewells Hospital, University of Dundee, Dundee, UK.

Opioids are a mainstay of acute pain management but can have many adverse effects, contributing to problematic long-term use. Opioid tolerance (increased dose needed for analgesia) and opioid-induced hyperalgesia (paradoxical increase in pain with opioid administration) can contribute to both poorly controlled pain and dose escalation. Hyperalgesia is particularly problematic as further opioid prescribing is largely futile. Read More

View Article

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S01406736193043
Publisher Site
http://dx.doi.org/10.1016/S0140-6736(19)30430-1DOI Listing
April 2019
2 Reads

Upper-Extremity Nerve Decompression Under Local Anesthesia: A Systematic Review of Methods for Reduction of Postoperative Pain and Opioid Consumption.

Hand (N Y) 2019 Apr 15:1558944719843635. Epub 2019 Apr 15.

2 Division of Plastic & Reconstructive Surgery, McGill University Health Centre, Montreal, QC, Canada.

Background: Opioid abuse is a major health concern in North America. Data have shown an alarming increase in opioid-related deaths and complications, which has shed light on current prescription practices across many specialties, including hand surgery. To that end, we sought to conduct a focused literature review to determine the available modalities to decrease postoperative pain and opioid consumption following upper-extremity nerve decompression procedures, taking advantage of the homogeneity and inherent pain pathways of this specific patient cohort. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/1558944719843635DOI Listing
April 2019
1 Read

Extracellular RNAs-TLR3 signaling contributes to cognitive decline in a mouse model of postoperative cognitive dysfunction.

Brain Behav Immun 2019 Apr 10. Epub 2019 Apr 10.

Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China. Electronic address:

Postoperative cognitive dysfunction (POCD) is considered a severe complication after surgery among elderly patients. Toll-like receptor 3 (TLR3) has recently been reported to play an important role in hippocampus-dependent working memory. However, the role of TLR3 in the development of POCD remains unclear. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.bbi.2019.04.024DOI Listing

Contemporary Management of Aortic Arch Aneurysm.

Semin Thorac Cardiovasc Surg 2019 Apr 10. Epub 2019 Apr 10.

Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth). Electronic address:

Background: The management of the aortic arch aneurysm is becoming increasingly complex and multidisciplinary. It has evolved since the first successful repair by DeBakey and colleagues in 1957. After these initial repairs, the improvement in open surgical techniques, cardiopulmonary bypass, anesthesia, and perioperative care were the primary drivers of the decrease in morbidity and mortality associated with repair. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1053/j.semtcvs.2019.03.011DOI Listing
April 2019
3 Reads

Long-term impairment of social behavior, vocalizations and motor activity induced by bilateral lesions of the fastigial nucleus in juvenile rats.

Brain Struct Funct 2019 Apr 12. Epub 2019 Apr 12.

Department of Neurosurgery, Medical School Hannover, Carl-Neuberg-Str.1, 30625, Hannover, Germany.

The cerebellum is increasingly recognized to be involved in limbic and cognitive-associative functioning. Cerebellar cognitive affective syndromes may result from various types of injuries. Cerebellar mutism may occur in children after resection of midline tumors in the posterior fossa, which has been thought to be related to damage to the cerebellar vermis. Read More

View Article

Download full-text PDF

Source
http://link.springer.com/10.1007/s00429-019-01871-3
Publisher Site
http://dx.doi.org/10.1007/s00429-019-01871-3DOI Listing
April 2019
2 Reads

Population pharmacokinetics of palonosetron and model-based assessment of dosing strategies.

J Anesth 2019 Apr 11. Epub 2019 Apr 11.

Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju, South Korea.

Purpose: Palonosetron is the most recent 5-hydroxytryptamine-3 receptor antagonist, and its fixed dose of 0.075 mg is indicated for the prevention of postoperative nausea and vomiting. This study aimed to examine whether fixed dosing is more appropriate than body size-based dosing through the development of a population pharmacokinetic model and model-based simulations. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00540-019-02641-5DOI Listing
April 2019
1 Read

The influence of mode of anaesthesia for caesarean delivery on neonatal Apgar scores in the Czech Republic and Slovakia: secondary analysis of the results of an international survey in 2015.

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019 Apr 9. Epub 2019 Apr 9.

Department of Anaesthesiology and Intensive Care Medicine, L. Pasteur University Hospital, Kosice, Slovakia.

Aims: The purpose of this international survey was to describe the impact of current practices and techniques of caesarean section on the neonatal Apgar score in the Czech Republic (CZE) and Slovakia (SVK).

Methods: All Czech and Slovak departments that provide obstetric anaesthesia were invited to participate in a one-month (November 2015) prospective study that monitored in details all peripartum anaesthetic practices, delivered by anaesthesiologists. Participating centers recorded all data on-line in the CLADE-IS database (Masaryk University, CZE). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.5507/bp.2019.008DOI Listing
April 2019
1 Read

Safety of Beach Chair Position Shoulder Surgery: A Review of the Current Literature.

Anesth Analg 2019 Apr 3. Epub 2019 Apr 3.

From the Department of Anesthesiology, NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine, Evanston, Illinois.

Although uncommon, severe neurological events have been reported in patients undergoing shoulder surgery in the beach chair position. The presumed etiology of central nervous system injury is hypotension and subsequent cerebral hypoperfusion that occurs after alterations in positioning under general anesthesia. Most clinical trials have demonstrated that beach chair positioning results in reductions in regional brain oxygenation, cerebral blood flow, and jugular bulb oxygenation, as well as impairment in cerebral autoregulation and electroencephalographic/processed electroencephalographic variables. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1213/ANE.0000000000004133DOI Listing
April 2019
3 Reads

Repurposing vitamin D for treatment of human malignancies targeting tumor microenvironment.

Acta Pharm Sin B 2019 Mar 6;9(2):203-219. Epub 2018 Sep 6.

Laboratory of Molecular Pharmacology, Department of Pharmacology, School of Pharmacy, Southwest Medical University, Luzhou 646000, China.

Tumor cells along with a small proportion of cancer stem cells exist in a stromal microenvironment consisting of vasculature, cancer-associated fibroblasts, immune cells and extracellular components. Recent epidemiological and clinical studies strongly support that vitamin D supplementation is associated with reduced cancer risk and favorable prognosis. Experimental results suggest that vitamin D not only suppresses cancer cells, but also regulates tumor microenvironment to facilitate tumor repression. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.apsb.2018.09.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437556PMC
March 2019
1 Read

Propofol for sedation for direct current cardioversion.

Ann Card Anaesth 2019 Apr-Jun;22(2):113-121

Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.

Direct current cardioversion is a low-risk and standard procedure to restore normal sinus rhythm in patients with tachyarrhythmias. It requires sedation to facilitate the procedure, as it is painful and distressful. The preferred anesthetic drug must be short acting, producing conscious sedation, to enable rapid recovery after the procedure. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.4103/aca.ACA_72_18DOI Listing
April 2019
1 Read

The kneeling test is a valid method of assessing kneeling tolerance.

Knee Surg Sports Traumatol Arthrosc 2019 Apr 9. Epub 2019 Apr 9.

Perth Orthopaedic and Sports Medicine Centre, West Perth, Australia.

Purpose: No quantitative test exists to reliably assess kneeling tolerance before and after surgery. The aim of this study was to validate a kneeling test, designed to quantify kneeling tolerance.

Method: A total of 179 participants (324 knees) were enrolled into the study, including 124 asymptomatic knees, 98 with osteoarthritis (OA), 85 following total knee arthroplasty (TKA) and 17 following anterior cruciate ligament reconstruction (ACLR). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00167-019-05505-3DOI Listing
April 2019
5 Reads

Alfaxalone Causes Reduction of Glycinergic IPSCs, but Not Glutamatergic EPSCs, and Activates a Depolarizing Current in Rat Hypoglossal Motor Neurons.

Front Cell Neurosci 2019 22;13:100. Epub 2019 Mar 22.

Faculty of Medicine, School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia.

We investigated effects of the neuroactive steroid anesthetic alfaxalone on intrinsic excitability, and on inhibitory and excitatory synaptic transmission to hypoglossal motor neurons (HMNs). Whole cell recordings were made from HMNs in brainstem slices from 7 to 14-day-old Wistar rats. Spontaneous, miniature, and evoked inhibitory post-synaptic currents (IPSCs), and spontaneous and evoked excitatory PSCs (EPSCs) were recorded at -60 mV. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.3389/fncel.2019.00100DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440435PMC

A Facial Recognition Mobile App for Patient Safety and Biometric Identification: Design, Development, and Validation.

JMIR Mhealth Uhealth 2019 Apr 8;7(4):e11472. Epub 2019 Apr 8.

Institute of Human Environment Interface Biology, Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.

Background: Patient verification by unique identification is an important procedure in health care settings. Risks to patient safety occur throughout health care settings by failure to correctly identify patients, resulting in the incorrect patient, incorrect site procedure, incorrect medication, and other errors. To avoid medical malpractice, radio-frequency identification (RFID), fingerprint scanners, iris scanners, and other technologies have been implemented in care settings. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.2196/11472DOI Listing

Analgesic efficacy of the Pecs II block: a systematic review and meta-analysis.

Anaesthesia 2019 May;74(5):663-673

Department of Anaesthesia, Toronto Western Hospital, University of Toronto, ON, Canada.

Surgery is the primary therapeutic intervention for breast cancer and can result in significant postoperative pain. We searched the current literature and performed a meta-analysis in order to compare the analgesic efficacy of the pectoral type-2 (Pecs II) block with systemic analgesia alone and with a thoracic paravertebral block for breast cancer surgery. Primary outcome was postoperative opioid consumption in the first 24 h after surgery. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1111/anae.14607DOI Listing
May 2019
1 Read

Peripheral nerve stimulation: black, white and shades of grey.

Br J Neurosurg 2019 Apr 7:1-5. Epub 2019 Apr 7.

a Department of Neurosurgery , Rajendra Institute of Medical Sciences , Ranchi , India.

Unbearable chronic neuropathic pain, which can often not be resolved by conservative pain management techniques, calls for peripheral nerve stimulation. The technique, based on the Gate control hypothesis, uses low intensity current to block depolarization and conduction of neuronal membrane. Conditions such as intractable migraine, occipital and trigeminal neuralgia, burn injury pain, transformed migraine, among others, which cause intense pain can be treated by PNS, especially when the pain is localised and can be traced back to a specific nerve. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1080/02688697.2018.1538479DOI Listing
April 2019
1 Read

[Ultrasound imaging has a potential to exhibit biotechnical advance in perioperative pain management].

Orv Hetil 2019 Apr;160(15):573-584

Klinikai Központ, Janus Pannonius Klinikai Tömb, Aneszteziológiai és Intenzív Terápiás Intézet, Fájdalomterápiás Tanszék, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs, Ifjúság u. 13., 7624.

The perioperative pain management - instead of the efforts, guidelines and protocols - is underestimated and undertreated. Even in the case of general anaesthesia, the nervous system is overwhelmed by copious quantities of nociceptive stimuli at surgical incision. Stress and pain-modulation processes are triggered which can have significant influence on the outcome. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1556/650.2019.31374DOI Listing
April 2019
1 Read

Sudden cardiac death associated with cardiac catheterization in Williams syndrome: a case report and review of literature.

Cardiol Young 2019 Apr 5:1-5. Epub 2019 Apr 5.

Department of Pediatrics, Division of Pediatric Critical Care Medicine,Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health,Indianapolis, IN,USA.

Williams syndrome is a rare genetic disease that affects elastin production, leading to medium and large vessel stenoses and other abnormalities. Cardiac manifestations of Williams syndrome are the most life-threatening, occurring in 80% of children. Children with Williams syndrome are known to be at risk for sudden cardiac death. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1017/S1047951119000295DOI Listing
April 2019
1 Read

Evaluation of acute corneal damage induced by 222-nm and 254-nm ultraviolet light in Sprague-Dawley rats.

Free Radic Res 2019 Apr 5:1-151. Epub 2019 Apr 5.

a Department of Ophthalmology , Faculty of Medicine , Shimane University , Izumo , Japan.

Two hundred twenty-two nanometers ultraviolet (UV) light produced by a krypton-chlorine excimer lamp is harmful to bacterial cells but not skin. However, the effects of 222-nm UV light exposure to the eye are not fully known. We evaluated acute corneal damage induced by 222- and 254-nm UV light in albino rats. Read More

View Article

Download full-text PDF

Source
https://www.tandfonline.com/doi/full/10.1080/10715762.2019.1
Publisher Site
http://dx.doi.org/10.1080/10715762.2019.1603378DOI Listing
April 2019
4 Reads

Protocol for a systematic review and meta-analysis of the efficacy of acupuncture and electroacupuncture against chemotherapy-induced peripheral neuropathy.

Medicine (Baltimore) 2019 Apr;98(14):e15098

Institute for Integrative Medicine, Catholic Kwandong University International St. Mary's Hospital, Incheon.

Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) occurs in approximately 30% to 40% of patients who receive chemotherapy; however, standardized treatment for CIPN has not yet been developed. Acupuncture is widely used to treat CIPN in Korea, but its efficacy has not been investigated. The purpose of this study is to review the current literature on the efficacy of acupuncture and electroacupuncture (EA) in treating CIPN. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/MD.0000000000015098DOI Listing
April 2019
2 Reads

Normothermic Machine Perfusion Enhances Intraoperative Hepatocellular Synthetic Capacity: A Propensity-Score Matched Analysis.

Transplantation 2019 Apr 1. Epub 2019 Apr 1.

The Liver Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, UK.

Background: Normothermic machine perfusion (NMP) of liver grafts is increasingly being incorporated in clinical practice. Current evidence has shown NMP plays a role in reconditioning the synthetic and energy capabilities of grafts. Intraoperative coagulation profile is a surrogate of graft quality and preservation status; however, to date this aspect has not been documented. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/TP.0000000000002720DOI Listing
April 2019
2 Reads

A Quality Improvement Project to Increase Adherence to a Pain, Agitation, and Delirium Protocol in the Intensive Care Unit.

Dimens Crit Care Nurs 2019 May/Jun;38(3):174-181

Wendy Yan, DNP, CRNA, is a Nurse Anesthetist at Duke Regional Hospital. Brett T. Morgan, DNP, CRNA, is Director of the Nurse Anesthesia Program and an assistant professor at Duke University School of Nursing. Peter Berry, MSN, RN, CNL, CCRN, is nurse manager at the intensive care unit of Duke Raleigh Hospital. Mary K. Matthys, BSN, RN, CCRN, is clinical lead at the intensive care unit of Duke Raleigh Hospital. Julie A. Thompson, PhD, is a research associate and a statistical consultant at Duke University School of Nursing. Benjamin A. Smallheer, PhD, RN, ACNP-BC, FNP-BC, CCRN, CNE, is lead faculty of the Adult-Gerontology Acute Care Nurse Practitioner Program at Duke University School of Nursing. He actively practices within the Critical Care Setting at Duke Raleigh Hospital and has expertise in Pulmonary Critical Care. His current areas of research interest are the care of the aging critical care population, the implementation of innovative educational strategies to prepare Nurse Practitioner students for entry to practice, and gender-associated incivility experienced by male nursing students in the academic environment.

Background: In recent years, the incidence of delirium has grown to epidemic proportions in the intensive care setting with up to 80% of mechanically ventilated patients being affected. This can lead to adverse patient outcomes such as increased lengths of hospital stay, increased mortality rates, and increased long-term cognitive impairment.

Objectives: The objective of this project is to determine whether a quality improvement project can increase adherence to an existing pain, agitation, and delirium (PAD) protocol for enhanced patient outcomes. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/DCC.0000000000000353DOI Listing
April 2019
2 Reads

Pediatric Risk Stratification Is Improved by Integrating Both Patient Comorbidities and Intrinsic Surgical Risk.

Anesthesiology 2019 Mar 28. Epub 2019 Mar 28.

From the Division of Cardiac Anesthesia (V.G.N., J.A.D.) Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts (S.J.S., D.Z.) the Division of Cardiac Anesthesia, Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario Canada (D.F).

What We Already Know About This Topic: Risk stratification models to predict perioperative mortality in pediatric surgical populations are based on patient comorbidities, but do not take into consideration the intrinsic risk of the surgical procedures.

What This Article Tells Us That Is New: Surgical procedures identified by specialty are not independent risk factors for perioperative mortality in pediatric patients. However, in multivariable predictive algorithms, the interaction of patient comorbidities with the intrinsic risk of the surgical procedure strongly predicts 30-day mortality. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1097/ALN.0000000000002659DOI Listing
March 2019
5 Reads

Perioperative hemostatic management in the cirrhotic patient: a position paper on the behalf of the Liver Intensive Care Group of Europe (LICAGE).

Minerva Anestesiol 2019 Apr 2. Epub 2019 Apr 2.

Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands.

Recent data demonstrated that amongst patients undergoing elective surgery the prevalence of cirrhosis is 0.8% equating to approximately 25 million cirrhotic patients undergoing surgery each year worldwide. Overall, the presence of cirrhosis is independently associated with 47% increased risk of postoperative complications and over two and a half increased risk of in-hospital mortality in patients undergoing elective surgery. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.23736/S0375-9393.19.13468-2DOI Listing
April 2019
2 Reads

Implementation of Enhanced Recovery after Surgery (ERAS) Program in Perioperative Management of Gastric Cancer Surgery: a Nationwide Survey in Korea.

J Gastric Cancer 2019 Mar 12;19(1):72-82. Epub 2019 Feb 12.

Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea.

Purpose: Despite its clinical benefits, enhanced recovery after surgery (ERAS) is less widely implemented for gastric cancer surgery. This nationwide survey investigated the current status of the implementation of ERAS in perioperative care for gastric cancer surgery in South Korea.

Materials And Methods: This survey enrolled 89 gastric surgeons from 52 institutions in South Korea. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.5230/jgc.2019.19.e3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441777PMC
March 2019
2 Reads

Recommendations for good practice for sedation in assisted conception.

Hum Fertil (Camb) 2019 Apr 3:1-9. Epub 2019 Apr 3.

c Department of Anaesthesia , Derriford Hospital , Plymouth , UK.

Conscious sedation is a commonly used approach to provide pain relief during transvaginal oocyte retrieval. It has been shown to be effective with high levels of acceptability and patient satisfaction. Fundamental Standards and Development Standards in safe sedation practice have been set out by the Royal College of Anaesthetists and they recommend that Royal Colleges, in association with the relevant sub-specialty organizations, should develop guidelines on sedation methods appropriate to clinical practice in their sphere of influence. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1080/14647273.2019.1596245DOI Listing

Clear fluids are the solution to the fasting drought. The SPANZA perspective.

Authors:
Ben Turner

Paediatr Anaesth 2019 Apr 2. Epub 2019 Apr 2.

Department of Anaesthesia and Pain Management, The Royal Children's Hospital, Melbourne.

We thank Dr. Lerman for his considered response to the endorsement of the Consensus Statement on clear fluids fasting for elective pediatric general anesthesia(1) by SPANZA. SPANZA,as other societies have, independently reviewed the current literature, including that referenced by Dr Lerman before endorsing a one hour clear fluid fasting policy. Read More

View Article

Download full-text PDF

Source
https://onlinelibrary.wiley.com/doi/abs/10.1111/pan.13644
Publisher Site
http://dx.doi.org/10.1111/pan.13644DOI Listing
April 2019
4 Reads

Integrated Otolaryngology-Anesthesiology Clinical Skills and Simulation Rotation: A Novel 1-Month Intern Curriculum.

Ann Otol Rhinol Laryngol 2019 Apr 2:3489419840682. Epub 2019 Apr 2.

1 Department of Otolaryngology-Head & Neck Surgery, Michigan Medicine, Ann Arbor, Michigan, USA.

Objectives:: Current Accreditation Council for Graduate Medical Education (ACGME) requirements allow PGY-1 otolaryngology-head and neck surgery (ORL-HNS) residents to spend 6 months on service, prompting reconsideration of educational best practices for the first-year resident experience. The aim of this study was to determine feasibility and value of a 1-month PGY-1 otolaryngology clinical skills rotation integrated with anesthesiology to complement clinical ORL-HNS rotations.

Methods:: Our institution developed a 1-month rotation focusing on procedural simulation and airway management as a collaborative effort between ORL-HNS and anesthesiology. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1177/0003489419840682DOI Listing
April 2019
1 Read

Morpheus and the Underworld-Interventions to Reduce the Risks of Opioid Use After Surgery: ORADEs, Dependence, Cancer Progression, and Anastomotic Leakage.

J Gastrointest Surg 2019 Apr 1. Epub 2019 Apr 1.

Department of Upper Gastrointestinal Surgery, Liverpool Hospital, Suite 6, Level 2, 171 Bigge St, Liverpool, Sydney, NSW, 2170, Australia.

Background: Perioperative pain management is a key element of enhanced recovery after surgery (ERAS) programs. A multimodal approach to analgesia as part of a coordinated ERAS includes the reduction of opioid use. This review aims to discuss opioid-related adverse events, strategies to reduce opioid use after surgery, and the relevance to the present "opioid crisis" in North America. Read More

View Article

Download full-text PDF

Source
http://link.springer.com/10.1007/s11605-019-04167-3
Publisher Site
http://dx.doi.org/10.1007/s11605-019-04167-3DOI Listing
April 2019
6 Reads

Interventional Techniques to Management of Cancer-Related Pain: Clinical and Critical Aspects.

Cancers (Basel) 2019 Mar 29;11(4). Epub 2019 Mar 29.

Main Regional Center for Cancer Pain and Supportive/Palliative Care, Anesthesia and Intensive Care Unit, and Pain Relief and Palliative Care Unit, La Maddalena Cancer Center, 90145 Palermo, Italy.

Interventional techniques to manage cancer-related pain may be efficient treatment modalities in patients unresponsive or unable to tolerate systemic opioids. However, indication and selection of the right technique demand knowledge, which is still incipient among clinicians. The present article summarizes the current evidence regarding the five most essential groups of interventional techniques to treat cancer-related pain: Neuraxial analgesia, minimally invasive procedures for vertebral pain, sympathetic blocks for abdominal cancer pain, peripheral nerve blocks, and percutaneous cordotomy. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.3390/cancers11040443DOI Listing
March 2019
1 Read

Management of primary graft failure after heart transplantation: Preoperative risks, perioperative events, and postoperative decisions.

Clin Transplant 2019 Apr 1:e13557. Epub 2019 Apr 1.

Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York.

Primary graft failure (PGF) after heart transplantation (HT) is a devastating and unexpected event characterized by failure of the graft to adequately support recipient circulation necessitating high doses of vasopressors and inotropes and/or temporary mechanical circulatory support. Although it represents an increasingly common event in the current era, there remains a high degree of variability in prevalence, reported risk factors, and approach to this clinical entity. The purpose of the current review is to highlight preoperative considerations including known incidence and risk factors, perioperative issues involving the identification and management of PGF, and postoperative decisions related to weaning of mechanical circulatory support and titration of immunosuppressive therapy. Read More

View Article

Download full-text PDF

Source
https://onlinelibrary.wiley.com/doi/abs/10.1111/ctr.13557
Publisher Site
http://dx.doi.org/10.1111/ctr.13557DOI Listing
April 2019
5 Reads

More about the basic assumptions of t-test: normality and sample size.

Korean J Anesthesiol 2019 Apr 1. Epub 2019 Apr 1.

Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Inje, Korea.

Background: Most of parametric statistics starts with the basic assumptions on the distribution of populations. Preceding conditions required to analyze t-test include the measured values in ratio scale or interval scale, simple random extraction, normal distribution of data, appropriate sample size and homogeneity of variance. Normality test is a kind of hypothesis test which has the type I and II errors as like the other hypothesis tests. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.4097/kja.d.18.00292DOI Listing
April 2019
1 Read