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Anesthesia And Safety(Regional)

R Galeiras, M Mourelo, S Pértega, M E López, I Esmorís
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. We carried out a retrospective, descriptive study involving 28 patients requiring enzymatic debridement of a limb, trunk or multiple locations, who had been admitted to the Burn Unit of the University Hospital Complex of A Coruña (Spain)...
September 30, 2018: Annals of Burns and Fire Disasters
Carmen L Mueller, Robert Lisbona, Rafik Sorial, Aya Siblini, Lorenzo E Ferri
INTRODUCTION: Although endoscopic resection for early gastric cancer is well established, anatomical resection with regional lymphadenectomy is recommended for lesions at high risk for occult lymph node metastasis (e.g., lymphovascular invasion, poor grade, and deep submucosal invasion). However, 75-95% high-risk early gastric cancer (HR-EGC) patients ultimately have node-negative disease and could potentially have undergone organ-sparing resection. Due to the inadequacy of standard modalities to reliably rule out nodal metastases in HR-EGC patients, sentinel lymph node (SLN) sampling was developed in Asia with promising results...
March 11, 2019: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Syed Reefat Aziz, Daryl I Smith, Rose N Mbaye, Jacob T Gusman, Estefania I Garza, Bokai Wang, Changyong Feng, Nobuyuki-Hai Tran
Background and objectives: Limitations in manpower in health care facilities, both in civilian and military settings, can severely affect patient safety as well as overall outcomes. Regional anesthesia via neural blockade is an effective means of managing uncontrolled acute pain, which has been associated with cardiopulmonary, endocrine, immunologic, and hematologic derangement in addition to the development of potentially life-threatening coagulopathy. We have designed a remote-controlled injection device that may expedite the performance of regional nerve blocks in these situations...
2019: Journal of Pain Research
Ni Bing, Hu Yonsheng, Tao Wei, Shu Wei, Zhu Hongwei
OBJECTIVE: To retrospectively evaluate long-term efficacy and safety of dorsal root entry zone (DREZ) lesion for treatment of neuropathic pain within the lower extremities and perineal region following thoracolumbar spine fracture. METHODS: 42 patients were treated with posterior laminectomy under general anesthesia. The DREZ regions of spinal cord segments were ablated under a microscope. Data regarding pain relief, pain variation over time, and postoperative complications were collected...
February 15, 2019: World Neurosurgery
Michael Conrad Grant, Melinda M Gibbons, Clifford Y Ko, Elizabeth C Wick, Maxime Cannesson, Michael J Scott, Christopher L Wu
Enhanced recovery after surgery (ERAS) protocols for gynecologic (GYN) surgery are increasingly being reported and may be associated with superior outcomes, reduced length of hospital stay, and cost savings. The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery, which is a nationwide initiative to disseminate best practices in perioperative care to more than 750 hospitals across five major surgical service lines in a 5-year period...
February 7, 2019: Regional Anesthesia and Pain Medicine
Carole Lin, Curtis Darling, Ban C H Tsui
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...
January 25, 2019: Drugs & Aging
Edsel B Ing, Justine Philteos, Galina Sholohov, David Ta Kim, Navdeep Nijhawan, Patrick W Mark, Jaclyn Gilbert
This study discusses local anesthetic agents, administration techniques, ancillary considerations, and safety precautions for oculoplastic surgery including eyelid, lacrimal, orbital, and temporal artery biopsy procedures. Methods for reducing patient apprehension and discomfort including systemic premedication, topical pre-anesthetic, visual, auditory and tactile distraction techniques, regional blocks, small gauge needles, warmed lidocaine, and buffered lidocaine are discussed.
2019: Clinical Ophthalmology
A Poggetti, A Del Chiaro, M Nicastro, P Parchi, N Piolanti, M Scaglione
Hardware removal after surgical treatment fracture is one of the most common procedures in orthopaedic daily activity. A percentage from 14.5 to 21 of total removal involves the ankle joint. Trying to reduce the important socio-economic impact of this surgical procedure, we thought to perform it using the Wide Awake Local Anaesthesia Without Tourniquet (WALANT), a particular technique presented by D. Lalonde that associated a local anaesthetic drug with epinephrine in order to obtain an effective haemostatic effect despite the lack of a tourniquet...
November 2018: Journal of Biological Regulators and Homeostatic Agents
Daryl S Henshaw, James D Turner, Sean W Dobson, Jonathan Douglas Jaffe, John Wells Reynolds, Christopher J Edwards, Robert S Weller
BACKGROUND: The term "Wrong-Site Surgery (WSS)" is commonly associated with surgical procedures; however, The Joint Commission (TJC) considers any invasive procedure, not just a surgical procedure, performed on the wrong side, at the wrong site, or on the wrong patient to be a WSS. For anesthesia providers, this means that a wrong-site nerve block (WSNB) also constitutes a WSS and would be considered a sentinel event by TJC. In an attempt to combat WSNB, the American Society of Regional Anesthesia and Pain Medicine published guidelines in 2014 recommending the use of a preprocedural checklist before performing regional blocks...
January 13, 2019: Regional Anesthesia and Pain Medicine
Geoffrey S Cohn, Dean Corbett, Abi Tenen, Minas Coroneo, James McAlister, Jennifer P Craig, Trevor Gray, David Kent, Neil Murray, Con Petsoglou, Stephanie N Baba, Edward J Holland
Purpose: We assess the safety and effectiveness of intranasal neurostimulation to promote tear production via the nasolacrimal pathway in subjects with dry eye disease. Methods: A multicenter, randomized, controlled, double-masked pilot study was conducted in adults with dry eye diagnosis and at least one eye with corneal fluorescein staining ≥2 in at least one region or a sum of all regions ≥5 (National Eye Institute grading), basal Schirmer test score ≤10 mm, a cotton-swab stimulated Schirmer score ≥7 mm higher, and an Ocular Surface Disease Index score ≥23...
January 2, 2019: Investigative Ophthalmology & Visual Science
Anna Krigel, Ling Chen, Jason D Wright, Benjamin Lebwohl
BACKGROUND AND AIMS: The use of anesthesia assistance (AA) for outpatient colonoscopy has been increasing over the past decade, raising concern over its effects on procedure safety, quality, and cost. We performed a nationwide claims-based study to determine regional, patient-related, and facility-related patterns of anesthesia use as well as cost implications of AA for payers. METHODS: We analyzed the Premier Perspective database to identify patients undergoing outpatient colonoscopy at over 600 acute-care hospitals throughout the United States from 2006 through 2015, with or without AA...
January 5, 2019: Clinical Gastroenterology and Hepatology
Alessandro De Cassai, Daniele Bonvicini, Christelle Correale, Ludovica Sandei, Serkan Tulgar, Tommaso Tonetti
INTRODUCTION: The erector spinae plane (ESP) block is an interfascial block proposed to provide analgesia for chronic thoracic pain. It consists in an injection of local anesthetic in a plane between the transverse process and the erector spinae muscles group. EVIDENCE ACQUISITION: We performed a systematic review of literature following the PRISMA Statement Guidelines. The bibliographic search was conducted on September 2018. We included articles indexed in MEDLINE, EMBASE, Cochrane Library and Google Scholar...
March 2019: Minerva Anestesiologica
Ahmed Zaghloul Foad, Mohammed Ahmed Mansour, Mahmoud Badry Ahmed, Hany R Elgamal, Hany Elmekawey Elmekawey Ibrahim, Abdelraheem Elawamy
Background: Retrobulbar regional eye block aims to ensure eye globe akinesia and anesthesia during ophthalmic surgery, and despite the rarity of occurrence of complications due to the blind needle passage while performing either peribulbar or retrobulbar block, some of them are serious and may be life threatening. Aim: The aim of this study was to estimate the accuracy and safety of real-time ultrasound-guided retrobulbar regional anesthesia in comparison with the blind technique for cataract surgery...
2018: Local and Regional Anesthesia
Zheng Gong, Jun Li, Yuling Zhong, Xuehai Guan, Ailan Huang, Li Ma
Effects of dexmedetomidine on postoperative cognitive function in patients undergoing coronary artery bypass grafting were investigated. Eighty patients undergoing systemic anesthesia with extracorporeal coronary artery bypass grafting in The People's Hospital of Guangxi Zhuang Autonomous Region from January 2015 to August 2017 were selected and randomly divided into the observation group (n=40) and control group (n=40). The two groups were treated with dexmedetomidine and equal volume of normal saline, respectively...
December 2018: Experimental and Therapeutic Medicine
Ellen M Soffin, Melinda M Gibbons, Elizabeth C Wick, Stephen L Kates, Maxime Cannesson, Michael J Scott, Michael C Grant, Samantha S Ko, Christopher L Wu
Enhanced recovery after surgery (ERAS) protocols represent patient-centered, evidence-based, multidisciplinary care of the surgical patient. Although these patterns have been validated in numerous surgical specialities, ERAS has not been widely described for patients undergoing hip fracture (HFx) repair. As part of the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery, we have conducted a full evidence review of interventions that form the basis of the anesthesia components of the ERAS HFx pathway...
December 7, 2018: Anesthesia and Analgesia
Y Chung, J W Choi, H C Kim, S H Kim, S I Choi
INTRODUCTION: Laparoscopic total extraperitoneal peritoneal (TEP) repair has become increasingly popular since its introduction. The purpose of this study is to establish the safety and feasibility of TEP in elderly patients compared to that in younger patients. METHODS: The clinical records of patients who received TEP hernia repair from August 2007 to September 2016 were reviewed. The patients were categorized into two groups: younger than 70 and 70 years or older...
December 3, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Stephen Tabiri, Katie W Russell, Frank E Gyamfi, Ali Jalali, Raymond R Price, Micah G Katz
INTRODUCTION: Inguinal hernia repair is a common procedure and a priority for public health efforts in Ghana. It is essential that inguinal hernia repair be performed in a safe, efficient manner to justify its widespread use. Local anesthesia has many favorable properties and has been shown to be superior, compared to regional or general anesthesia, in terms of pain control, safety profile, cost-effectiveness, resources required, and time to discharge. Local anesthesia is recommended for open repair of reducible hernias, provided clinician experience, by multiple international guidelines...
2018: PloS One
Fady Samy Saad, Samia Yehia El Baradie, Maha Abdel Wahab Abdel Aliem, Mohamed Metwally Ali, Tamer Ahmed Mahmoud Kotb
Background: Thoracotomy needs adequate powerful postoperative analgesia. This study aims to compare the safety and efficacy of ultrasound (US)-guided serratus anterior plane block (SAPB) and thoracic paravertebral block (TPVB) for perioperative analgesia in cancer patients having lung lobectomy. Patients and Methods: This clinical trial involved 90 patients with lung cancer scheduled for lung lobectomy randomly divided into three groups according to the type of preemptive regional block...
October 2018: Saudi Journal of Anaesthesia
(no author information available yet)
Systemic toxicity from local anesthetics can occur in any of the wide range of situations in which these agents are used. This practical guide is created to generate a shared awareness of the prevention, diagnosis, and treatment of local anesthetic systemic toxicity among all medical professionals who perform nerve blocks. Systemic toxicity of local anesthetic is induced by an increase of its protein-unbound plasma concentration. Initial symptoms are characterized by central nervous system signs such as excitation, convulsions, followed by loss of consciousness and respiratory arrest...
November 11, 2018: Journal of Anesthesia
Shabana Z Shafy, Mohammed Hakim, Mauricio Arce Villalobos, Gregory D Pearson, Giorgio Veneziano, Joseph D Tobias
Duchenne muscular dystrophy (DMD), first described in 1834, is an X-linked dystrophinopathy, leading to early onset skeletal muscle weakness. Life expectancy is reduced to early adulthood as a result of involvement of voluntary skeletal muscles with respiratory failure, orthopedic deformities, and associated cardiomyopathy. Given its multisystem involvement, surgical intervention may be required to address the sequelae of the disease process. We present a 36-year-old adult with DMD, who required anesthetic care during surgical debridement of an ischial pressure sore...
2018: Local and Regional Anesthesia
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