Anesthesia

The rate at which stimulation is applied to peripheral nerves is critical to generating high-quality intraoperative somatosensory evoked potentials (SSEPs) in a timely manner. Guidelines based on a limited study and anecdotal evidence present differing, incorrect, or incomplete stimulation rate recommendations. We examined the effect stimulating the ulnar and tibial nerves at 1.05, 2.79, 5.69, and 8.44 Hz had on cortical, subcortical, and peripheral response amplitude and latency in 10 subjects with neuromuscular blockade (NMB) and 10 without NMB in the operating room under general anesthesia...

The management of acute ischemic stroke primarily revolves around the timely restoration of blood flow (recanalization/reperfusion) in the occluded vessel and maintenance of cerebral perfusion through collaterals before reperfusion. Mechanical thrombectomy is the most effective treatment for acute ischemic stroke due to large vessel occlusions in appropriately selected patients. Judicious management of blood pressure before, during, and after mechanical thrombectomy is critical to ensure good outcomes by preventing progression of cerebral ischemia as well hemorrhagic conversion, in addition to optimizing systemic perfusion...

PURPOSE: Hypotension is a risk factor for adverse perioperative outcomes. Preoperative transthoracic echocardiography has been extended for preoperative risk assessment before noncardiac surgery. This study aimed to develop a machine learning model to predict postinduction hypotension risk using preoperative echocardiographic data and compared it with conventional statistic models. We also aimed to identify preoperative echocardiographic factors that cause postinduction hypotension. METHODS: In this retrospective observational study, we extracted data from electronic health records of patients aged >18 years who underwent general anesthesia at a single tertiary care center between April 2014 and September 2019...

OBJECTIVE: To describe the use of the serratus anterior plane block (SAPB) in the prehospital and retrieval environment including the ability to accurately identify those patients with thoracic trauma and clinically suspected rib fractures who would benefit from this procedure. METHODS: This is a retrospective case series of all patients with thoracic trauma and clinically suspected rib fractures who received SAPB by a prehospital and retrieval medical team in New South Wales, Australia, between 2018 and 2021...

Neonatal exposure to general anesthetics has been associated with neurotoxicity and morphologic changes in the developing brain. Isoflurane is a volatile anesthetic widely used in pediatric patients to induce general anesthesia, analgesia, and perioperative sedation. In the present study, we investigated the effects of a single neonatal isoflurane (3% in oxygen, 2 h) exposure in rats at postnatal day (PND) 7, in short-term (24 h - PND8) and long-term (adulthood) protocols. In PND8, ex vivo analysis of hippocampal and frontal cortex slices evaluated cell viability and susceptibility to in vitro glutamate challenge...

BACKGROUND: Despite the existence of internationally consistent guidelines for the management of pain, efficient regional anesthesia techniques, safe pain medications, and organizational structures, e.g., acute pain services, various studies have shown that pain is still common among both surgical and non-surgical in-patients. OBJECTIVE: The primary objective of this study was to evaluate, on a multi-center basis, the point pain prevalence of surgical and non-surgical in-patients...

BACKGROUND: The incidence of a large number of diseases relevant to thoracic surgery increases with age; however, old age is still frequently considered a contraindication per se for curative interventions and extensive surgical procedures. OBJECTIVE: Overview of the current relevant literature, derivation of recommendations for patient selection as well as preoperative, perioperative and postoperative optimization. MATERIAL AND METHODS: Analysis of the current study situation...

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No abstract text is available yet for this article.

Surveying the AORN membership for research studies Key words: perioperative research study, research grant, incentive, sample size, power analysis. Informed consent document validity Key words: surgical consent forms, anesthesia consent forms, canceled procedures, rescheduled procedures, documentation. Internet technology updates and fire alarms Key words: 3G phaseout, 5G technology, fire alarm system, cellular communicator, communication loss. Documenting versus recording Key words: documentation, record keeping, logbook, patient health care record (HCR), patient health care information...

No abstract text is available yet for this article.

Degenerative disorders of the retina (including age-related macular degeneration), which originate primarily at or within the retinal pigmented epithelial (RPE) layer, lead to a progressive disorganization of the retinal anatomy and the deterioration of visual function. The substitution of damaged RPE cells (RPEs) with in vitro cultured RPE cells using a subretinal cell carrier has shown potential for re-establishing the anatomical structure of the outer retinal layers and is, therefore, being further studied...

AIM: To compare the outcomes of the conventional syringe and the outcomes of the vibraject-assisted injection (VAI) in terms of the pain of the needle insertion during various intraoral injections of local anesthesia in children aged 6-9 years. MATERIALS AND METHODS: A total number of 75 children aged 6-9 years were selected from patients visiting the pediatric dental clinic at Damascus University. The children were assigned into three equal groups (25 children each) according to the type of intraoral injection needed for the treatment: Groups [Group I: received upper buccal infiltrations (UBI), Group II: received posterior palatal infiltrations (PPI), and Group III: received inferior alveolar nerve block (IANB)]...

BACKGROUND: Hearing loss was proposed as a factor affecting development of cognitive impairment in elderly. Deficits cannot be explained primarily by dysfunctional neuronal networks within the central auditory system. We here tested the impact of hearing loss in adult rats on motor, social, and cognitive function. Furthermore, potential changes in the neuronal activity in the medial prefrontal cortex (mPFC) and the inferior colliculus (IC) were evaluated. MATERIALS AND METHODS: In adult male Sprague Dawley rats hearing loss was induced under general anesthesia with intracochlear injection of neomycin...

A 67-year old male with intussusception due to sigmoid colonic caner was treated. For making correct classification of antegrade or retrograde type, multidetector-computed tomography in longitudinal views seemed optimal to demonstrate anatomical type. This radiological modality made to identify this instead of ultrasound sonography (US) could reveal details of surrounding information. Under intestinal obstruction due to intussusception, cancer-related information such as lymph nodal involvement could be visible using not US but MDCT because of air collection around lesions...

Introduction Many obstetrical patients from rural areas in the United States lack hospitals that provide labor and delivery care. Our objective was to examine the effects of such patients on caseloads of cesarean deliveries at Iowa hospitals with level III maternal care, as defined by the Iowa Department of Public Health (e.g., with obstetric anesthesiologists). Methods This retrospective longitudinal study included every discharge with cesarean delivery in the state of Iowa from October 2015 through June 2021...

Type A aortic dissection is rare in young females; however, it is associated with a high mortality rate. This case report describes a 30-year-old female at 38 weeks of gestation who presented with acute onset chest pain and hypotension responsive to intravenous fluid therapy. Transthoracic echocardiogram and chest computed tomography angiography confirmed a type A aortic dissection. The patient was transported urgently to the operating room for a Cesarean section and aortic dissection repair. Following induction of general anesthesia, the baby was delivered, oxytocin infusion was started, and a Bakri balloon was placed in the uterus...

Remimazolam is an ultrashort-acting benzodiazepine that causes minimal hemodynamic changes. We present two patients, with reduced ejection fraction, who underwent remimazolam anesthesia for transcatheter edge-to-edge repair of the mitral valve with the MitraClip system. In case 1, the patient's vitals were stable throughout the surgery. However, in case 2, which had a lower cardiac output, the patient's blood pressure decreased remarkably after anesthesia induction. Though remimazolam does not alter the cardiac output, it reportedly has vasodilatory effects...

BACKGROUND: Breast angiosarcoma is a rare malignant tumor, accounting for approximately 0.04% of all breast malignancies. Angiosarcoma of the breast with hypofibrinogenemia is even rarer and has not been described in man. Breast angiosarcoma is associated with high metastatic potential and poor prognosis, and there is no specific manifestation in imaging. At present, surgery is considered to be the only effective treatment. There is no unified standard for postoperative adjuvant radiotherapy and chemotherapy...

This study aimed to compare the analgesic effects of an injectable protocol using multimodal analgesia with or without opioids in cats undergoing ovariohysterectomy (OVH). Thirty-two healthy cats were enrolled in a prospective, blinded, randomized trial after the caregiver's written consent. Cats received a combination of ketamine (4 mg/kg), midazolam (0.25 mg/kg) and dexmedetomidine (40 μg/kg), and either buprenorphine (20 μg/kg) or saline (same volume as buprenorphine) intramuscularly [opioid-sparing (OSA) and opioid-free anesthesia (OFA) groups, respectively]...