Farhad Heydari, Sanaz Khalilian, Keihan Golshani, Saeed Majidinejad, Babak Masoumi, Abaris Massoumi
AIM: Pain control is an important aspect of ED patient management, and there are many different protocols used around the world influenced by both availability of local resources as well as staff competency and experience. This study aims to evaluate the use of topical ketamine in acute pain reduction by directly comparing it to lidocaine-prilocaine (EMLA) cream. MATERIALS AND METHODS: In this randomized clinical trial, 300 adult patients classified as level 4 or 5 by ESI triage system were enrolled...
April 3, 2021: American Journal of Emergency Medicine
Konstantinos Tilkeridis, Dimitrios Diamantidis, Anthimos Keskinis, Konstantinos Paraskevopoulos, Christos Chatzipapas, Kenan Gagali, Athanasios N Ververidis
In this article we report a case of stiff, neglected extreme recurvatum knee deformity in a 17-year-old female. This is the first reported case in the literature of an acquired ligamentous stiff extreme knee recurvatum following manipulation under anesthesia and botulinum neurotoxin injection. Μodified Judet quadricepsplasty combined with Ilizarov external hinged frame fixation was implemented. This dual technique can be considered as a rational approach for such an extreme deformity as it stabilizes, progressively corrects, and prevents recurrence...
April 6, 2021: Knee
Junko Ajimi, Junichi Nishiyama, Sadanori Hosoi, Ritsuko Masuda, Masaaki Miura, Toshiyasu Suzuki, Yasunori Niwa, Takeshi Suzuki
OBJECTIVE: Anesthetic management of patients with giant mediastinal tumors is challenging from the perspective of both cardiovascular and respiratory management, and airway assessment is important for both concerns. We report the successful induction of general anesthesia and double-lumen tube intubation in the right lateral position for a patient with a giant mediastinal tumor with tracheal compression, using pre-operative chest radiograph imaging to minimize tracheal compression during induction...
April 20, 2021: Tokai Journal of Experimental and Clinical Medicine
James Jin, Salesi' Akau'ola, Cheng-Har Yip, Peter Nthumba, Emmanuel A Ameh, Stijn de Jonge, Mira Mehes, Iferemi Waiqanabete, Jaymie Henry, Andrew Hill
BACKGROUND: Trauma mortality in low- and middle-income countries (LMICs) remains high compared to high-income countries. Quality improvement processes, interventions, and structure are essential in the effort to decrease trauma mortality. METHODS: A systematic review and meta-analysis of interventional studies assessing quality improvement processes, interventions, and structure in developing country trauma systems was conducted from November 1989 to August 2020 according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
April 9, 2021: World Journal of Surgery
Summit D Bloria, Nidhi B Panda, Kiran Jangra, Hemant Bhagat, Banashree Mandal, Ketan Kataria, Rajeev Chauhan, Ankur Luthra, Shiv Lal Soni, Narender Kaloria, Shalvi Mahajan, Shamik Kr Paul, Shailesh Gupta, Sanket Agrawal, Navneet Singla
BACKGROUND: Fluid imbalance is common after aneurysmal subarachnoid hemorrhage and negatively impacts clinical outcomes. We compared intraoperative goal-directed fluid therapy (GDFT) using left ventricular outflow tract velocity time integral (LVOT-VTI) measured by transesophageal echocardiography with central venous pressure (CVP)-guided fluid therapy during aneurysm clipping in aneurysmal subarachnoid hemorrhage patients. METHODS: Fifty adults scheduled for urgent craniotomy for aneurysm clipping were randomly allocated to 2 groups: group G (n=25) received GDFT guided by LVOT-VTI and group C (n=25) received CVP-guided fluid management...
April 8, 2021: Journal of Neurosurgical Anesthesiology
Carlo Pancaro, Jasmine Purtell, Dana LaBuda, Leif Saager, Thomas T Klumpner, Timur Dubovoy, Baskar Rajala, Shubhangi Singh, Ruth Cassidy, Christie Vahabzadeh, Sean Maxwell, Virgil Manica, David M Eckmann, Jill M Mhyre, Milo C Engoren
BACKGROUND: While flexible epidural catheters reduce the risk of paresthesia and intravascular cannulation, they may be more challenging to advance beyond the tip of a Tuohy needle. This may increase placement time, number of attempts, and possibly complications when establishing labor analgesia. This study investigated the ability to advance flexible epidural catheters through different epidural needles from 2 commonly used, commercially available, epidural kits. METHODS: We hypothesized that the multiorifice wire-reinforced polyamide nylon blend epidural catheters will have a higher rate of successful first attempt insertion than the single-end hole wire-reinforced polyurethane catheters for the establishment of labor analgesia...
April 9, 2021: Anesthesia and Analgesia
Ian Wellington, Antonio Cusano, Joel V Ferreira, Anthony Parrino
BACKGROUND: This study sought to investigate complication rates/perioperative metrics after endoscopic carpal tunnel release (eCTR) via wide-awake, local anesthesia, no tourniquet (WALANT) versus sedation or local anesthesia with a tourniquet. METHODS: Patients aged 18 years or older who underwent an eCTR between April 28, 2018, and December 31, 2019, by 1 of 2 fellowship-trained surgeons at our single institution were retrospectively reviewed. Patients were divided into 3 groups: monitored anesthesia care with tourniquet (MT), local anesthesia with tourniquet (LT), and WALANT...
April 9, 2021: Hand: Official Journal of the American Association for Hand Surgery
Xiu-Fen Li, Chang Liu, Ji-Yuan Liu, Tao Qu, Wei-Lin Pan, Jian Pan, Cheng-Ge Hua
OBJECTIVES: The present study aimed to explore the innervation of the anterior hard palatine and its relationship with individual development stage. Specifically, the effects of anesthesia on patients of different ages were observed, and neurodevelopment in the maxillofacial region was invesitgated. References that are helpful in selecting local anesthesia were provided. METHODS: A total of 182 patients with mixed dentition were randomly divided into the nasopalatine nerve block and greater palatine nerve block groups...
April 1, 2021: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
Maria Ribeiro, Marta Coelho, Teresa Monteiro, João Caldeira
Introduction/Study Goals: Thoracic sympathectomy is considered to be the most effective treatment for hyperhidrosis, a procedure traditionally performed under general anesthesia. Nowadays it's a minimally invasive procedure, which makes it possible to perform under sedation with local anesthesia. The goal in this study was to assess the efficacy and safety of this anesthetic technique in video-assisted thoracic sympathectomy. MATERIAL AND METHODS: The study took place in Centro Hospitalar Universitário Lisboa Norte, between June 2017 and September 2019...
April 8, 2021: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Giuliana Geng-Ramos, Jessica Cronin, Chaitanya Challa, Marjorie Brennan, Andrew Matisoff, Meghan Delaney, Joseph Campos, Md Sohel Rana, Brenna Wyson, Sophie Pestieau
The worldwide spread of the novel SARS-CoV-2 coronavirus (COVID-19) led to significant challenges for healthcare institutions. Our institution implemented guidelines to protect perioperative staff and patients from exposure to COVID-19, including pre-procedural testing.1 Patients who tested positive SARS-CoV-2 had their elective procedure postponed and quarantined as per Center for Disease Control and Prevention (CDC) guidelines.2 A test-based strategy is no longer recommended by the CDC for COVID-19 patients to come off isolation...
April 9, 2021: Paediatric Anaesthesia
Paul J Park, Melvin C Makhni, Meghan Cerpa, Eduardo C Beauchamp, Nathan J Lee, Ronald A Lehman, Lawrence G Lenke
Background: As the opioid epidemic in the United States has continued to gain momentum in recent years, the current study aims to explore the efficacy of ketamine in a traditionally challenging setting regarding pain control, and contribute toward developing an opioid-free intraoperative pain protocol in spinal deformity surgery. Methods: Fifty-four patients who underwent spinal deformity surgery between January 1, 2017 and December 31, 2017 by one senior surgeon were included...
March 2021: Journal of Spine Surgery (Hong Kong)
Abdurahman S Alhissan, Sharat Chandra Pani
Aim: This study aimed to retrospectively evaluate the success of zirconia crowns placed in the anterior teeth of children and evaluate the impact of pulp therapy of the tooth on the rate of failure. Materials and Methods: A total of 70 anterior teeth of 20 children aged between 3 and 5 years who had undergone the placement of zirconia crowns under general anesthesia were followed up for 24 months. Kaplan-Meier Survival curves were plotted for the estimation of two-year survival time...
2021: International Journal of Dentistry
Nadia Shaikh, Brandon Tallman, Yanzhi Wang, Girish Deshpande, Sandeep Tripathi
OBJECTIVE: Propofol is frequently used for outpatient sedation for pediatric patients, some of whom require multiple rounds of sedation for separate procedures within a short period. Anecdotal experience suggests that frequent use of propofol results in escalating doses; however, clinical evidence is unconvincing. This study was designed to evaluate if tolerance develops with frequent administration of propofol for children requiring multiple successive sedations. METHODS: A retrospective chart review of patients requiring multiple doses of propofol for separate procedures from 2011 through 2019 was conducted...
2021: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Metages Hunie, Efrem Fenta, Simegnew Kibret, Diriba Teshome
Background: Spinal anesthesia block is the most widely practiced anesthesia technique due to its safety margin. It is an invasive procedure that could be associated with a variety of complications like total spinal, cardiovascular collapse, meningitis, paralysis, and even death. The aim of this study to assess the current practice of spinal anesthesia. Methods: A Cross-sectional study design was conducted in Debre Tabor Comprehensive Specialized Hospital from November 01 to December 15, 2020...
2021: Local and Regional Anesthesia
Zhi-Yuan Chen, Yi Zhang, Jian-Hua Wu, Xiao-Hua Gao, Chun-Ling Huang, Yu-Mei Lin, Xiao-Ting Xu, Yan Li
Background: Penehyclidine hydrochloride is a selective antagonist of M1 and M3 receptors. Clinical studies suggest that it is a potential drug for the treatment of chronic obstructive pulmonary disease (COPD). The purpose of this study was to evaluate the effect of penehyclidine hydrochloride on the inflammatory response of lung tissue during mechanical ventilation in rats with COPD and explore the role of the c-Jun N-terminal kinase/stress-activated protein kinase (JNK/SAPK) signaling pathway...
2021: International Journal of Chronic Obstructive Pulmonary Disease
Lyahn K Hwang, David W Nash, Adam Yedlin, Nicolas Greige, Jessie Larios-Valencia, Curtis Choice, Aravind Pothula
PURPOSE: Pain is a common side effect of intravenous injection of propofol. We conducted a randomized, prospective, single-blinded controlled trial to assess the efficacy of vibration analgesia on pain during propofol infusion in ambulatory surgery. METHODS: After institutional review board approval, 100 patients undergoing elective ambulatory surgery with general anesthesia were randomized into 2 groups. A control group (n = 50) consisted of patients who received infusion of propofol without vibration analgesia...
March 18, 2021: Annals of Plastic Surgery
Basil Nwaoz, Catherine J Sinnott, Annet Kuruvilla, Noel B Natoli
PURPOSE: Interest in labiaplasty as a way to alter and improve genital appearance has been on the rise. Labiaplasty procedures can be performed in the office setting under local anesthesia. However, these procedures are often performed under general anesthesia for patient comfort and to facilitate the operative technique and to potentially improve outcomes. Outcomes after labiaplasty performed under general anesthesia as compared with that performed under local anesthesia in the office setting have not been well-defined...
March 31, 2021: Annals of Plastic Surgery
Thomas N Steele, Lauren E Blaha, Olivia P Madan, Nicholas J Walker, Malcolm W Marks
INTRODUCTION: Reconstruction of soft tissue defects after skin cancer excision remains a challenge. Options for reconstruction are numerous, including primary repair, local tissue rearrangement, and skin grafts, among others. In this series, the authors present a novel technique: The triangular dart flap. This is a single-stage tissue rearrangement that uses the redundant tissue of the dog-ear to aid in the closure of these wounds. METHODS: A retrospective review was conducted of all patients undergoing local tissue rearrangements by the senior author from 2009 to 2018...
April 5, 2021: Annals of Plastic Surgery
Rachel Joyce Kearns, Martin Shaw, Piotr S Gromski, Stamatina Iliodromiti, Jill P Pell, Deborah A Lawlor, Scott M Nelson
BACKGROUND: The fetus is vulnerable to maternal drug exposure. We determined associations of exposure to spinal, epidural, or general anesthesia on neonatal and childhood development outcomes during the first 1000 days of life. METHODS: Population-based study of all singleton, cesarean livebirths of 24+0 to 43+6 weeks gestation between January 2007 and December 2016 in Scotland, stratified by urgency with follow-up to age 2 years. Models were adjusted for: maternal age, weight, ethnicity, socioeconomic status, smoking, drug-use, induction, parity, previous cesarean or abortion, pre-eclampsia, gestation, birth weight, and sex...
April 8, 2021: Regional Anesthesia and Pain Medicine
Manazir Athar, Sania Parveen, Mayank Yadav, Obaid Ahmed Siddiqui, Farah Nasreen, Shahna Ali, Mohd Azam Haseen
OBJECTIVE: Cardiac surgical pain is of moderate-to-severe intensity. Ineffective pain control may lead to increased cardiopulmonary complications and poor surgical outcomes. This study aimed to assess the efficacy of ultrasound-guided erector spinae plane block in providing analgesia in adult cardiac surgeries. DESIGN: Prospective, randomized, double-blinded clinical trial. SETTINGS: Single-center, tertiary care hospital with university affiliation...
March 8, 2021: Journal of Cardiothoracic and Vascular Anesthesia
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