collection
https://read.qxmd.com/read/33588730/putative-roles-of-astrocytes-in-general-anesthesia
#1
REVIEW
Daniel K Mulkey, Michelle L Olsen, Mengchan Ou, Colin M Cleary, Guizhi Du
General anesthetics are a mainstay of modern medicine, and although much progress has been made towards identifying molecular targets of anesthetics and neural networks contributing to endpoints of general anesthesia, our understanding of how anesthetics work remains unclear. Reducing this knowledge gap is of fundamental importance to prevent unwanted and life-threatening side-effects associated with general anesthesia. General anesthetics are chemically diverse, yet they all have similar behavioral endpoints, and so for decades, research has sought to identify a single underlying mechanism to explain how anesthetics work...
2022: Current Neuropharmacology
https://read.qxmd.com/read/33764684/effect-of-basal-forebrain-somatostatin-and-parvalbumin-neurons-in-propofol-and-isoflurane-anesthesia
#2
JOURNAL ARTICLE
Shuang Cai, Ai-Chen Tang, Tian-Yuan Luo, Shao-Cheng Yang, Huanhuan Yang, Cheng-Xi Liu, Yue Shu, Yun-Chao Pan, Yu Zhang, Liang Zhou, Tian Yu, Shou-Yang Yu
AIMS: The basal forebrain (BF) plays an essential role in wakefulness and cognition. Two subtypes of BF gamma-aminobutyric acid (GABA) neurons, including somatostatin-expressing (GABASOM ) and parvalbumin-positive (GABAParv ) neurons, function differently in mediating the natural sleep-wake cycle. Since the loss of consciousness induced by general anesthesia and the natural sleep-wake cycle probably share similar mechanisms, it is important to clarify the accurate roles of these neurons in general anesthesia procedure...
July 2021: CNS Neuroscience & Therapeutics
https://read.qxmd.com/read/33979490/management-of-the-difficult-airway
#3
REVIEW
Thomas Heidegger
New England Journal of Medicine, Volume 384, Issue 19, Page 1836-1847, May 2021.
May 13, 2021: New England Journal of Medicine
https://read.qxmd.com/read/32861339/pulmonary-hypertension-a-brief-guide-for-clinicians
#4
REVIEW
Stacy A Mandras, Hirsch S Mehta, Anjali Vaidya
Pulmonary hypertension (PH) is classified into 5 clinical subgroups: pulmonary arterial hypertension (PAH), PH due to left-sided heart disease, PH due to chronic lung disease, chronic thromboembolic PH (CTEPH), and PH with an unclear and/or multifactorial mechanisms. A range of underlying conditions can lead to these disorders. Overall, PH affects approximately 1% of the global population, and over half of patients with heart failure may be affected. Cardiologists are therefore likely to encounter PH in their practice...
September 2020: Mayo Clinic Proceedings
https://read.qxmd.com/read/32991330/the-diagnostic-accuracy-of-noninvasive-methods-to-measure-the-intracranial-pressure-a-systematic-review-and-meta-analysis
#5
JOURNAL ARTICLE
Amr Sallam, Ahmed Abdelaal Ahmed Mahmoud M Alkhatip, Mohamed Gomaa Kamel, Mohamed Khaled Hamza, Hany Mahmoud Yassin, Hisham Hosny, Mohamed I Younis, Eslam Ramadan, Haytham Zien Algameel, Mohamed Abdelhaq, Mohamed Abdelkader, Kerry E Mills, Hassan Mohamed
BACKGROUND: Although invasive monitoring is the standard method for intracranial pressure (ICP) measurement, it is not without potential for serious complications. Noninvasive methods have been proposed as alternatives to invasive ICP monitoring. The study aimed to investigate the diagnostic accuracy of the currently available noninvasive methods for intracranial hypertension (ICH) monitoring. METHODS: We searched 5 databases for articles evaluating the diagnostic accuracy of noninvasive methods in diagnosing ICH in PubMed, Institute of Science Index, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase...
March 1, 2021: Anesthesia and Analgesia
https://read.qxmd.com/read/32737881/guideline-on-anaesthesia-and-sedation-in-breastfeeding-women-2020-guideline-from-the-association-of-anaesthetists
#6
JOURNAL ARTICLE
J Mitchell, W Jones, E Winkley, S M Kinsella
Breastfeeding has many health benefits for the mother and infant. Women who are breastfeeding may require anaesthesia or sedation. Concerns regarding the passage of drugs into breast milk may lead to inconsistent advice from professionals. This can sometimes result in the interruption of feeding for 24 hours or longer after anaesthesia, or expressing and discarding ('pumping and dumping') breast milk; this may contribute to early cessation of breastfeeding. However, there are data regarding the transfer of most anaesthetic drugs into breast milk...
November 2020: Anaesthesia
https://read.qxmd.com/read/30957884/analgesic-efficacy-of-the-pecs-ii-block-a-systematic-review-and-meta-analysis
#7
JOURNAL ARTICLE
B Versyck, G-J van Geffen, K-J Chin
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. Secondary outcomes were pain scores at 0, 3, 6, 9 and 24 h after surgery, intra-operative opioid consumption, time to first analgesic request and incidence of postoperative nausea and vomiting...
May 2019: Anaesthesia
https://read.qxmd.com/read/32777122/anesthetic-considerations-for-patients-with-the-kasabach-merritt-phenomenon
#8
JOURNAL ARTICLE
Arvind Chandrakantan, Brittany E Bryant, Lisa Hensch, Adam C Adler
No abstract text is available yet for this article.
October 2020: Paediatric Anaesthesia
https://read.qxmd.com/read/30950522/intra-operative-analgesia-with-remifentanil-vs-dexmedetomidine-a-systematic-review-and-meta-analysis-with-trial-sequential-analysis
#9
REVIEW
S Grape, K R Kirkham, J Frauenknecht, E Albrecht
Intra-operative remifentanil is associated with increased postoperative analgesic requirements and opioid consumption. Dexmedetomidine has characteristics suggesting it may substitute for intra-operative remifentanil during general anaesthesia, but existing literature has reported conflicting results. We undertook this meta-analysis to investigate whether general anaesthesia including dexmedetomidine would result in less postoperative pain than general anaesthesia including remifentanil. The MEDLINE and PubMed electronic databases were searched up to October 2018...
June 2019: Anaesthesia
https://read.qxmd.com/read/30649072/systematic-review-and-meta-analysis-sometimes-bigger-is-indeed-better
#10
JOURNAL ARTICLE
Thomas R Vetter
Clinicians encounter an ever increasing and frequently overwhelming amount of information, even in a narrow scope or area of interest. Given this enormous amount of scientific information published every year, systematic reviews and meta-analyses have become indispensable methods for the evaluation of medical treatments and the delivery of evidence-based best practice. The present basic statistical tutorial thus focuses on the fundamentals of a systematic review and meta-analysis, against the backdrop of practicing evidence-based medicine...
March 2019: Anesthesia and Analgesia
https://read.qxmd.com/read/28258555/propofol-induction-normalizing-the-dose-in-morbidly-obese-patients
#11
EDITORIAL
John H P Friesen
No abstract text is available yet for this article.
May 2017: Canadian Journal of Anaesthesia
https://read.qxmd.com/read/30610849/better-with-ultrasound-subclavian-central-venous-catheter-insertion
#12
REVIEW
Scott J Millington, Manoj M Lalu, Michel Boivin, Seth Koenig
The insertion of a subclavian central venous catheter is generally associated with a high rate of success and a favorable risk profile. The use of ultrasound for procedural guidance has been demonstrated to further increase the rate of success and reduce the risk of specific mechanical complications, especially in patients with difficult surface anatomy. Many individual ultrasound techniques have been described in the literature; this article presents a systematic approach for incorporating these tools into bedside practice and includes a series of illustrative figures and narrated video presentations to demonstrate the techniques described...
May 2019: Chest
https://read.qxmd.com/read/29687891/videolaryngoscopy-vs-fibreoptic-bronchoscopy-for-awake-tracheal-intubation-a-systematic-review-and-meta-analysis
#13
COMPARATIVE STUDY
M Alhomary, E Ramadan, E Curran, S R Walsh
Awake fibreoptic intubation is often considered the technique of choice when a difficult airway is anticipated. However, videolaryngoscopes are being used more commonly. We searched the current literature and performed a meta-analysis to compare the use of videolaryngoscopy and fibreoptic bronchoscopy for awake tracheal intubation. Our primary outcome was the time needed to intubate the patient's trachea. Secondary outcomes included: failed intubation; the rate of successful intubation at the first attempt; patient-reported satisfaction with the technique; and any complications resulting from intubation...
September 2018: Anaesthesia
https://read.qxmd.com/read/30054079/principles-of-urgent-management-of-acute-airway-obstruction
#14
REVIEW
Erkan Yildirim
Recognizing and acting early on airway compromise reduces morbidity and mortality in patients with airway obstruction. Causes include foreign bodies, toxic/hot fumes, difficult intubation, laryngeal spasm, and tumors. Before definitive control of the airway is possible, provide 100% oxygen with a tightly fitting mask to optimize body oxygen stores. Pulse oximetry is a poor indicator of airway compromise; a decreasing arterial hemoglobin oxygen saturation is a late sign of impending hypoxemia. Basic airway maneuvers improve the patency of an obstructed airway...
August 2018: Thoracic Surgery Clinics
https://read.qxmd.com/read/30283785/airway-management-during-anesthetic-induction-of-secondary-laryngectomy-for-recurrent-laryngeal-cancer-three-cases-of-report-and-analysis
#15
Xuezheng Zhang, Omer Cavus, Ying Zhou, Sasima Dusitkasem
Surgery for laryngeal cancer and the following recurrent tumor growth may further change the anatomy of the airway. Airway management during anesthesia induction is challenging for the patients undergoing secondary surgery due to recurrence of laryngeal cancer or its postoperative complication, but it has never been reported. In this report, we described three cases of anesthetic induction which had different process of airway events. The first case was given intravenous general anesthetic for induction and experienced failed intubation, difficult mask ventilation and emergent tracheostomy, eventually were rescued successfully...
2018: Frontiers in Medicine
https://read.qxmd.com/read/30291405/-management-of-the-difficult-airway-overview-of-the-current-guidelines
#16
REVIEW
J C Schäuble, T Heidegger
Several national airway task forces have recently updated their recommendations for the management of the difficult airway in adults. Routinely responding to airway difficulties with an algorithm-based strategy is consistently supported. The focus is increasingly not on tools and devices but more on good planning, preparation and communication. In the case of anticipated airway difficulties the airway should be secured when the patient is awake with maintenance of spontaneous ventilation. Unaltered a flexible bronchoscopic intubation technique is advised as a standard of care in such patients...
October 2018: Der Anaesthesist
https://read.qxmd.com/read/29935584/nociceptive-activation-in-spinal-cord-and-brain-persists-during-deep-general-anaesthesia
#17
JOURNAL ARTICLE
G Lichtner, R Auksztulewicz, H Velten, D Mavrodis, M Scheel, F Blankenburg, F von Dincklage
BACKGROUND: In clinical practice, analgesic drug doses applied during general anaesthesia are considered sufficient when clinical responses (e.g. movement, blood pressure and heart rate elevations) are suppressed during noxious stimulation. We investigated whether absent clinical responses are indicative of suppressed spinal and brain responsiveness to noxious stimulation in anaesthetised subjects. METHODS: Ten healthy volunteers were investigated during deep propofol anaesthesia supplemented with increasing doses of remifentanil in a stepwise manner...
July 2018: British Journal of Anaesthesia
https://read.qxmd.com/read/30500064/pre-operative-fasting-in-adults-and-children-clinical-practice-and-guidelines
#18
REVIEW
W J Fawcett, M Thomas
It is widely recognised that prolonged fasting for elective surgery in both children and adults serves no purpose, adversely affects patient well-being and can be detrimental. Although advised fasting times for solids remain unchanged, there is good evidence to support a 1-h fast for children, with no increase in risk of pulmonary aspiration. In adults, a major focus has been the introduction of carbohydrate loading before anaesthesia, so that patients arrive for surgery not only hydrated but also in a more normal metabolic state...
January 2019: Anaesthesia
https://read.qxmd.com/read/30277931/lung-protective-ventilation-in-the-operating-room-individualized-positive-end-expiratory-pressure-is-needed
#19
COMMENT
Robert M Kacmarek, Jesús Villar
No abstract text is available yet for this article.
December 2018: Anesthesiology
https://read.qxmd.com/read/29704223/low-thoracic-erector-spinae-plane-block-for-perioperative-analgesia-in-lumbosacral-spine-surgery-a-case-series
#20
JOURNAL ARTICLE
Josh P Melvin, Rudolph J Schrot, George M Chu, Ki Jinn Chin
PURPOSE: Severe postoperative pain following spine surgery is a significant cause of morbidity, extended length of facility stay, and marked opioid usage. The erector spinae plane (ESP) block anesthetizes the dorsal rami of spinal nerves that innervate the paraspinal muscles and bony vertebra. We describe the use of low thoracic ESP blocks as part of multimodal analgesia in lumbosacral spine surgery. CLINICAL FEATURES: We performed bilateral ESP blocks at the T10 or T12 level in six cases of lumbosacral spine surgery: three lumbar decompressions, two sacral laminoplasties, and one coccygectomy...
September 2018: Canadian Journal of Anaesthesia
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