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Anesthesia outcome

Andrew K Rock, Huy Truong, Yunseo Linda Park, Julie G Pilitsis
Spinal cord stimulation (SCS) has been well established as a safe and effective treatment of pain derived from a wide variety of etiologies. Careful patient selection including a rigorous trial period and psychological evaluation are essential. When patients proceed to permanent implantation, various considerations should be made, such as the type of lead, type of anesthesia, and waveform patterns for SCS. This article discusses the common indications for SCS, patient selection criteria, and pertinent outcomes from randomized clinical trials related to common indications treated with SCS...
April 2019: Neurosurgery Clinics of North America
Luca Cabrini, Martina Baiardo Redaelli, Lorenzo Ball, Martina Filippini, Evgeny Fominskiy, Margherita Pintaudi, Alessandro Putzu, Carmine D Votta, Massimiliano Sorbello, Massimo Antonelli, Giovanni Landoni, Paolo Pelosi, Alberto Zangrillo
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...
March 20, 2019: Anesthesia and Analgesia
Denys Shaydenfish, Flora T Scheffenbichler, Barry J Kelly, Anne-Louise Lihn, Hao Deng, Anahita Nourmahnad, Xinling Xu, Timothy T Houle, Matthias Eikermann, Stuart A Forman
BACKGROUND: The anticholinesterase neostigmine and the muscarinic inhibitor glycopyrrolate are frequently coadministered for the reversal of neuromuscular blockade. This practice can precipitate severe bradycardia or tachycardia, but whether it affects the incidence of cardiovascular complications remains unclear. We hypothesized that anticholinesterase reversal with neostigmine and glycopyrrolate versus no anticholinesterase reversal increases the risk of postoperative cardiovascular complications among adult patients undergoing noncardiac surgery with general anesthesia...
March 14, 2019: Anesthesia and Analgesia
Daniela Kiski, Edward Malec, Christoph Schmidt
PURPOSE OF REVIEW: In recent years, ultrafast-track anesthesia with on-table extubation and concepts of accelerated postoperative care have gained increasing support in pediatric congenital cardiac surgery. It is believed that such approaches might ideally combine economic benefits with a striving for continuous improvement of patient outcomes. The present review summarizes the role of dexmedetomidine (DEX) in this setting. RECENT FINDINGS: DEX is a clinical multipurpose drug that mediates its diverse responses through the activation of α2-adrenoreceptors...
March 15, 2019: Current Opinion in Anaesthesiology
Ignacio García-Basterra, José Maria Rodríguez Del Valle, Antonio García-Ben, José María Rodríguez Sánchez, José Manuel García-Campos
PURPOSE: To review and analyze the surgical outcomes of bilateral medial rectus recession with adjustable suture in acute concomitant esotropia of adulthood (ACEA). METHODS: The charts of all adults diagnosed as having ACEA between 2004 and 2017 were reviewed. Best corrected visual acuity, refractive error, ocular alignment measured in prism diopters (PD), and stereopsis were examined at presentation, 1 day postoperatively, and final follow-up visit (median: 10 months; range: 4 to 144 months)...
March 19, 2019: Journal of Pediatric Ophthalmology and Strabismus
Giovanni Landoni, Vladimir V Lomivorotov, Caetano Nigro Neto, Fabrizio Monaco, Vadim V Pasyuga, Nikola Bradic, Rosalba Lembo, Gordana Gazivoda, Valery V Likhvantsev, Chong Lei, Andrey Lozovskiy, Nora Di Tomasso, Nazar A R Bukamal, Fernanda S Silva, Andrey E Bautin, Jun Ma, Martina Crivellari, Ahmed M G A Farag, Nikolay S Uvaliev, Cristiana Carollo, Marina Pieri, Jan Kunstýř, Chew Yin Wang, Alessandro Belletti, Ludhmila A Hajjar, Evgeny V Grigoryev, Felice E Agrò, Hynek Riha, Mohamed R El-Tahan, A Mara Scandroglio, Abeer M Elnakera, Massimo Baiocchi, Paolo Navalesi, Vladimir A Shmyrev, Luca Severi, Mohammed A Hegazy, Giuseppe Crescenzi, Dmitry N Ponomarev, Luca Brazzi, Renato Arnoni, Dmitry G Tarasov, Miomir Jovic, Maria G Calabrò, Tiziana Bove, Rinaldo Bellomo, Alberto Zangrillo
BACKGROUND: Volatile (inhaled) anesthetic agents have cardioprotective effects, which might improve clinical outcomes in patients undergoing coronary-artery bypass grafting (CABG). METHODS: We conducted a pragmatic, multicenter, single-blind, controlled trial at 36 centers in 13 countries. Patients scheduled to undergo elective CABG were randomly assigned to an intraoperative anesthetic regimen that included a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or to total intravenous anesthesia...
March 19, 2019: New England Journal of Medicine
Niroshani S Soysa, Ishani B Soysa, Neil Alles
The aim of the present systematic review and meta-analysis was to address the following Population, Intervention, Comparison, and Outcome question: Is the efficacy of articaine better than lignocaine in adults requiring dental treatment? Four percent articaine was compared with 2% lignocaine for maxillary and mandibular infiltrations and block anesthesia, and with the principal outcome measures of anesthetic success. Using RevMan software, the weighted anesthesia success rates and 95% confidence intervals (CIs) were estimated and compared using a random-effects model...
March 18, 2019: Journal of Investigative and Clinical Dentistry
Nicholas D Black, Laith Malhas, Rongyu Jin, Anuj Bhatia, Vincent W S Chan, Ki Jinn Chin
Background: Iliac crest bone graft (ICBG) harvesting is associated with significant perioperative pain and opioid consumption. Retrospective studies indicate the transversalis fascia plane (TFP) block can provide analgesia for anterior ICBG harvesting. We conducted a randomized controlled trial to establish the efficacy of the TFP block in this setting. Methods: Fifty patients undergoing wrist fusion surgery with anterior ICBG harvesting were randomized to receive a TFP block with either 20 mL of 0...
March 19, 2019: Korean Journal of Anesthesiology
Ruili Li, Hongjun Li
BACKGROUND: Nonseminomatous germ cell tumors (NSGCTs) represent one of the main groups of germ cell tumors (GCTs), and they have a more invasive course than seminomatous GCTs. Human immunodeficiency virus (HIV) positivity is considered to be a risk factor for testicular seminoma patients, but reports about HIV-infected individuals with NSGCTs are rare. CASE PRESENTATION: We report a case of a retroperitoneal mixed extragonadal germ cell tumor in an HIV-infected man who has been diagnosed with bilateral cryptorchidism since birth...
March 18, 2019: BMC Cancer
Wolfgang Baar, Ulrich Goebel, Hartmut Buerkle, Bernd Jaenigen, Kai Kaufmann, Sebastian Heinrich
BACKGROUND: The beneficial effects of epidural analgesia (EDA) in terms of pain control and postoperative convalescence are widely known and led to a frequent use for patients who underwent living donor kidney nephrectomy. The objective of this study was to determine whether general anesthesia (GA) plus EDA compared to GA only, administered for living donor nephrectomy has effects on postoperative graft function in recipients. METHODS: In this monocentric, retrospective cohort analysis we analyzed the closed files of all consecutive donor- recipient pairs who underwent living donor kidney transplantations from 2008 to 2017...
March 18, 2019: BMC Anesthesiology
Linzhi Li, Zhimin Zhang, Zihan Yao, Hongjie Wang, Hebin Wang, Haishui An, Jun Yao
BACKGROUND: Increasing studies have shown that the use of laryngeal mask airways (LMAs) improved the perioperative respiratory adverse events (PRAEs) in children. However, the results of some of these studies still remained controversial as their sample sizes were small. A systematic review and meta-analysis was designed to evaluate the impact of LMAs in decreasing PRAEs in children. METHODS: We searched the Cochrane Library, PubMed, EMBASE and Web of Science up to May 29, 2018 to identify relevant randomized controlled trials (RCTs) which analyzed and evaluated the impact of LMAs in decreasing PRAEs in children...
March 13, 2019: International Journal of Surgery
Minqiang Liu, Zhichao Li, Song Wang, Yong Liu, Xiangpeng Zhong, Renliang He, Fengxian Li
BACKGROUND: It was reported that prolonging the injection time or diluting administration can reduce the incidence of opioid-induced cough. However, the incidence of sufentanil-induced cough (SIC) via a standardized infusion rate is unclear. A mechanical dropper is an infusion filtering device commonly used for intravenous degassing; it can also be used to administer special drugs due to its temporary storage and dilution effect. This study assesses the effectiveness of administration via mechanical dropper on SIC...
March 15, 2019: Trials
Huang Huang, Dongdong Yao, Ramsey Saba, Ethan Y Brovman, Daniel Kang, Penny Greenberg, Richard D Urman
STUDY OBJECTIVE: To provide a contemporary medicolegal analysis of claims brought against anesthesia providers in the United States related to neuraxial blocks for surgery and obstetrics. DESIGN: In this retrospective analysis, we analyzed closed claims data from the Controlled Risk Insurance Company (CRICO) Comparative Benchmarking System (CBS) database between 2007 and 2016. SETTING: Closed claims from inpatient and outpatient settings related to neuraxial anesthesia for surgical procedures and obstetrics...
March 12, 2019: Journal of Clinical Anesthesia
Sandeep Gupta, Arun Kuamr Maurya, Dilip Kumar Pal
OBJECTIVE: To evaluate surgical outcome and spinal anesthetic feasibility of supine percutaneous nephrolithotomy (PCNL) by tubeless and totally tubeless method. MATERIAL AND METHODS: This observational study included a totally 53 patients. Initial diagnosis of renal stone was based on urinary ultrasonography, kidney, ureter and bladder X-ray, and later confirmed by computed tomography urography. PCNL was done with the patient in Galdakao-modified supine Valdivia position...
December 4, 2018: Turkish Journal of Urology
Bingdong Tao, Kun Liu, Dandan Wang, Mengmeng Ding, Ping Zhao
More than 30% of patients who undergo surgery will experience postoperative nausea and vomiting (PONV) if no prophylactic treatments are used. Although numerous studies have been performed to investigate the factors related to PONV, the effect of perioperative intravenous oxycodone on the incidence of PONV has not been well investigated. In this study, gynecological patients (grade I-II, aged 18-65 years, scheduled to undergo elective gynecological laparoscopic surgery under general anesthesia) were randomized to the oxycodone group or the sufentanil group...
March 15, 2019: Journal of Clinical Pharmacology
Swapna S Shanbhag, James Chodosh, Hajirah N Saeed
Amniotic membrane (AM) transplantation, when performed in the acute phase in Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) for patients with ocular complications, is known to reduce the morbidity of ocular complications in the chronic phase. In conditions such as SJS/TEN, AM needs to be secured to the ocular surface as well as the eyelids. Previously, techniques of securing a large sheet of AM with fibrin glue to the ocular surface and with sutures and bolsters to the eyelids have been described in the acute phase of SJS/TEN...
March 11, 2019: Ocular Surface
Lisa Q Rong, Mohamed K Kamel, Mohamed Rahouma, Ajita Naik, Kritika Mehta, Ahmed A Abouarab, Antonino Di Franco, Michelle Demetres, Taylor L Mustapich, Meghann M Fitzgerald, Kane O Pryor, Mario Gaudino
STUDY OBJECTIVE: We performed a systematic comparison of high-dose and low-dose opioid anesthesia in cardiac surgery. DESIGN: Systematic review and meta-analysis of randomized controlled trials (RCTs). SETTING: Operating room. PATIENTS: 1400 adult patients undergoing cardiac surgery using general anesthesia. INTERVENTIONS: All RCTs comparing the effects of various doses of intravenous opioids (morphine, fentanyl, sufentanil, and remifentanil) during adult cardiac surgery using general anesthesia published until May 2018 (full-text English articles reporting data from human subjects) were included...
March 11, 2019: Journal of Clinical Anesthesia
Alisha M Smith, Paul Young, Colleen C Blosser, Aaron T Poole
OBJECTIVE: To evaluate the association of a standardized, structured approach to in-hospital postcesarean delivery pain management with maternal opioid use after cesarean delivery. METHODS: We conducted a retrospective cohort study of women who underwent cesarean delivery before and after a quality improvement intervention at a single tertiary care center. A multidisciplinary task force revised electronic order sets for all patients who underwent cesarean delivery with neuraxial anesthesia...
March 11, 2019: Obstetrics and Gynecology
Rebecca Y Klinger, Mary Cooter, Tiffany Bisanar, Niccolò Terrando, Miles Berger, Mihai V Podgoreanu, Mark Stafford-Smith, Mark F Newman, Joseph P Mathew, James A Blumenthal, Jorn A Karhausen, Miklos D Kertai, Vijay Krishnamoorthy, Yi-Ju Li, Madhav Swaminathan, David S Warner, Bonita L Funk, Rachele Brassard, Yanne Toulgoat-Dubois, Peter Waweru, Michael A Babyak, James A Blumenthal, Jeffrey N Browndyke, Kathleen A Welsh-Bohmer, Michael H Sketch, Ellen R Bennett, Carmelo Graffagnino, Daniel T Laskowitz, Warren J Strittmatter, Kevin Collins, Greg Smigla, Ian Shearer, Thomas A D'Amico, Mani A Daneshmand, Jeffrey G Gaca, Donald D Glower, Jack Haney, David Harpole, Mathew G Hartwig, G Chad Hughes, Jacob A Klapper, Shu S Lin, Andrew J Lodge, Carmelo A Milano, Ryan P Plichta, Jacob N Schroeder, Peter K Smith, Betty C Tong
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: Preclinical and clinical studies suggest that lidocaine might be neuroprotective, which could benefit surgical patients at risk of neurologic compromise WHAT THIS ARTICLE TELLS US THAT IS NEW: This multicenter trial of intravenous lidocaine administered during and after cardiac surgery did not show an effect on cognition at 6 weeks postoperatively BACKGROUND:: Cognitive decline after cardiac surgery occurs frequently and persists in a significant proportion of patients...
March 11, 2019: Anesthesiology
Kannan Sridharan, Gowri Sivaramakrishnan
BACKGROUND: Opioid analgesics are commonly used along with propofol during general anesthesia. Due to dearth of data on the quality of anesthesia achieved with the this combination, the present meta-analysis was carried out. METHODS: Electronic databases were searched for appropriate studies using suitable search strategy. Randomized clinical trials comparing the combination of remifentanil/sufentanil/alfentanil with propofol with fentanyl and propofol, were included...
March 13, 2019: Current Clinical Pharmacology
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