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MedWorm: Anesthesiology



MedWorm.com provides a medical RSS filtering service. Over 7000 RSS medical sources are combined and output via different filters. This feed contains the latest news and research in Anesthesiology



Last Build Date: Mon, 28 Mar 2016 14:23:27 +0100

 



Science, Sex and Society – why maternal mortality is still a global health issue

Mon, 28 Mar 2016 12:22:18 +0100

(Source: Anaesthesia)

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Postoperative sore throat: a systematic review

Sun, 27 Mar 2016 22:00:00 +0100

Summary Postoperative sore throat has a reported incidence of up to 62% following general anaesthesia. In adults undergoing tracheal intubation, female sex, younger age, pre‐existing lung disease, prolonged duration of anaesthesia and the presence of a blood‐stained tracheal tube on extubation are associated with the greatest risk. Tracheal intubation without neuromuscular blockade, use of double‐lumen tubes, as well as high tracheal tube cuff pressures may also increase the risk of postoperative sore throat. The expertise of the anaesthetist performing tracheal intubation appears to have no influence on the incidence in adults, although it may in children. In adults, the i‐gel™ supraglottic airway device results in a lower incidence of postoperative sore throat. Cuffed supraglot...



Controversies in the peripartum management of diabetes

Sun, 27 Mar 2016 22:00:00 +0100

(Source: Anaesthesia)



One minute to assess frailty, but what should we do next?

Sun, 27 Mar 2016 22:00:00 +0100

(Source: Anaesthesia)



Do first impressions count? Frailty judged by initial clinical impression predicts medium‐term mortality in vascular surgical patients

Sun, 27 Mar 2016 22:00:00 +0100

Summary Recognising frailty during pre‐operative assessment is important. Frail patients experience higher mortality rates and are less likely to return to baseline functional status following the physiological insult of surgery. We evaluated the association between an initial clinical impression of frailty and all‐cause mortality in 392 patients attending our vascular pre‐operative assessment clinic. Prevalence of frailty assessed by the initial clinical impression was 30.6% (95% CI 26.0–35.2%). There were 133 deaths in 392 patients over a median follow‐up period of 4 years. Using Cox regression, adjusted for age, sex, revised cardiac risk index and surgery (yes/no), the hazard ratio for mortality for frail vs. not‐frail was 2.14 (95% CI 1.51–3.05). The time to 20% mortalit...



Psychosocial risks in Psychiatry and Anaesthesiology residents in a Portuguese General and University Hospital.

Sun, 27 Mar 2016 15:04:02 +0100

CONCLUSIONS: These results suggest that residents have a health risk which derives from the cognitive demands of their work and that it increases with the workload.  This implicates the need for occupational health measures to be taken to manage and reduce these psychological risks. PMID: 27015028 [PubMed - as supplied by publisher] (Source: Medicina del Lavoro)

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Complications of Cardiac Catheterization in Structural Heart Disease.

Sun, 27 Mar 2016 13:03:02 +0100

CONCLUSION: Currently, the use of cardiac catheterization in SHD is increasing and becoming more complex; this could cause complications despite the preventive efforts. Careful patient selection for therapeutic catheterization and improved technique and management during the peri-procedural period are required to reduce complications. PMID: 27014356 [PubMed] (Source: Korean Circulation Journal)



[Effects of lidocaine and magnesium sulfate in attenuating hemodynamic response to tracheal intubation: single-center, prospective, double-blind, randomized study].

Sun, 27 Mar 2016 08:45:02 +0100

CONCLUSION: We concluded that the magnesium sulfate and lidocaine have good efficacy and safety for hemodynamic management in laryngoscopy and intubation. PMID: 27013150 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Anestesiologia)



Pain-reducing anesthesia prevents oxidative stress in human term placenta.

Sun, 27 Mar 2016 07:01:02 +0100

In this study, we immunohistochemically analyzed two markers for oxidative stress, namely 8-hydroxy-2'-deoxyguanosine (8-OHdG) and 4-hydroxy-2-nonenal-modified proteins (HNE), using placentas from 21 cases of normal tansvaginal delivery (V group), 20 Caesarean sections (C group), and 17 normal transvaginal deliveries with epidural anesthesia (E group). 8-OHdG staining in the nuclei of trophoblasts lining the chorionic villi was significantly stronger in the V group either compared with the C or E group (p<0.001), without significant differences in the C and E groups (p = 0.792). Moderate to intense staining by HNE of the intravascular serum of chorionic villi vasculature was frequently observed in the placentas from the V group, but less frequently of those in either C or E groups (p&...



Association of OHVIRA syndrome with aortic stenosis and block vertebra: A case report and anaesthetic management.

Sun, 27 Mar 2016 03:07:01 +0100

Authors: Goswami D, Sharma A, Vyas V, Vasudevan B PMID: 27013360 [PubMed - as supplied by publisher] (Source: Journal of Obstetrics and Gynaecology)

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Nonintubated uniportal thoracoscopic surgery for resection of lung lesions.

Sat, 26 Mar 2016 22:10:02 +0100

CONCLUSIONS: Nonintubated uniportal VATS is technically feasible, effective, and safe for diagnosis and treatment of various lung lesions in selected patients. PMID: 27014470 [PubMed] (Source: Journal of Thoracic Disease)






Occupational exposure to volatile anaesthetics: a systematic review

Fri, 25 Mar 2016 23:00:00 +0100

Conclusions Evidence for adverse effects of volatile anaesthetics on exposed personnel is scarce and inconsistent, but there is no evidence of adverse effects when environmental levels are kept within legal threshold values. Further studies are needed to improve our knowledge of the effects of occupational exposure to volatile anaesthetics. New surveillance methods that include systematic data collection, clinical signs and biomarkers of exposure are required to formulate consistent and reproducible surveillance criteria for exposed personnel. (Source: Occupational Medicine)



Insertion of a chest drain for pneumothorax

Fri, 25 Mar 2016 23:00:00 +0100

This article examines the indications for chest drain insertion for pneumothorax and the choice of drain. The equipment required is outlined and the positioning and preparation for the procedure described, including the choice of pre-medication. Techniques for insertion of both Seldinger-style and wide-bore chest drain are also described, including safe administration of local anaesthesia for intercostal block. The procedures outlined include how to place securing sutures and the preferred alternative to the old ‘purse-string’ technique for later closure of a tract following wide-bore chest drain. Troubleshooting for potential complications is also briefly covered. (Source: Anaesthesia and intensive care medicine)

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Basic airway equipments in pediatric cardiac arrest management

Fri, 25 Mar 2016 23:00:00 +0100

Publication date: Available online 26 March 2016 Source:Trends in Anaesthesia and Critical Care Author(s): Kemal Tolga Saracoglu, Ayten Saracoglu, Haluk Kafali In both in-hospital and out-of-hospital settings, pediatric cardiac arrest cases are common. Performing rescue breathing within a shorter time and achieving safe airway as early as possible during resuscitation is important for reducing interruptions. After a thorough review of the literature we concluded that the number of available randomized clinical studies is not enough to prove the superiority of different airway equipments in pediatric cardiac arrests. It is clear that the steps to be taken in this field will help determine the superior methods and create a tremendous impression. There is no data supporting the routine u...



Ethnobotany, phytochemistry and neuropharmacological effects of Petiveria alliacea L. (Phytolaccaceae): A review

Fri, 25 Mar 2016 23:00:00 +0100

Conclusions Many traditional uses of P. alliacea have now been validated by modern pharmacology research. The available data reviewed here support the emergence of P. alliacea as a potential source for the treatment of different CNS disorders including anxiety, depression, pain, epilepsy and memory impairments. However, further studies are certainly required to improve the knowledge about the mechanisms of action, toxicity and efficacy of the plant as well as about its bioactive compounds before it can be approved in terms of its safety for therapeutic applications. Graphical abstract (Source: Journal of Ethnopharmacology)



Are Anesthesia Providers Ready for Hypnosis? Anesthesia Providers' Attitudes Toward Hypnotherapy.

Fri, 25 Mar 2016 21:04:02 +0100

This study sought to measure current attitudes toward hypnosis among anesthesia providers using an in-person survey distributed at a single grand rounds at a single academic teaching hospital. One hundred twenty-six anesthesia providers (anesthesiologists and nurse anesthetists) were included in this study. A 10-question Institutional Review Board (IRB)-approved questionnaire was developed. One hundred twenty-six (73% of providers at the meeting) anesthesia providers completed the survey. Of the respondents, 54 (43%) were anesthesiologists, 42 (33%) were trainees (interns/residents/fellows) in anesthesia, and 30 (24%) were nurse anesthetists. Over 70% of providers, at each level of training, rated their knowledge of hypnosis as either below average or having no knowledge. Fifty-two (42%) p...

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[Hyperglycemia assessment in the post-anesthesia care unit].

Fri, 25 Mar 2016 20:50:01 +0100

CONCLUSION: The prevalence of hyperglycemia was high in the PACU, and factors such as age, BMI, corticosteroids, blood pressure, and duration of surgery are strongly related to this complication. PMID: 27005828 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Anestesiologia)



[Chronic hepatothorax due to right diaphragmatic rupture: an anesthetic challenge in a rare case].

Fri, 25 Mar 2016 20:50:01 +0100

CONCLUSIONS: Hepatothorax is a rare condition and its repair may represent an anesthetic challenge. After liver replacement in the abdominal cavity during corrective surgery under general anesthesia complications may occur, particularly associated with pulmonary re-expansion. Effective teamwork and careful planning of surgery, between the surgical and anesthetic teams, are the key to success. PMID: 27005827 [PubMed - as supplied by publisher] (Source: Revista Brasileira de Anestesiologia)



Dynamics of the melatonin MT1 receptor in the rat parotid gland upon melatonin administration.

Fri, 25 Mar 2016 19:51:02 +0100

Authors: Isola M, Ekstrom J, Lilliu MA, Isola R, Loy F Abstract Our recent ultrastructural study of human parotid glands revealed that the melatonin receptors, MT1 and MT2, are localised in the plasma cell membranes of acinar and ductal cells but also, and intriguingly, predominantly in acinar secretory granules, giving rise to the working hypothesis that secretory granules are a part of a transcytotic transport system for melatonin. To put this hypothesis to the test in rat parotid glands, anaesthetised animals were exposed to a high melatonin dose (3 mg/kg per hour), infused intravenously over two hours and aiming to stimulate a glandular melatonin-receptor-dependent intracellular transport system, if any. Thirty minutes later, the right parotids were removed. Pre-stimulation, le...

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Transverse myelitis associated with heroin and cannabis abuse: a new issue from the past.

Fri, 25 Mar 2016 17:21:02 +0100

Authors: Marturano F, Galzerano A, Nisi F, Sabatini A, Liberti A, Peduto VA PMID: 27003705 [PubMed - as supplied by publisher] (Source: Minerva Anestesiologica)



Mortality as an endpoint in studies in critically ill patients: a reappraisal of definitions.

Fri, 25 Mar 2016 17:21:02 +0100

Authors: Groeneveld JA Abstract The recent literature was critically reviewed reporting heterogeneous mortality endpoints in studies involving critically ill patients. Both location- and duration-dependent definitions are used, more or less arbitrarily and sometimes with contradictory results. Location-dependent mortality refers to intensive care or in-hospital mortality whereas duration-dependent mortality concerns 7-180 day mortality after admission or intervention. There is no consensus on how mortality should be evaluated in the critically ill. It is argued that trialists should aim at uniformity in outcome evaluation of critical care, in order to allow comparison of studies, and that 28-day mortality should remain the primary endpoint for intervention studies. PMID: 270037...



Antepartum surgical management of Pott’s paraplegia along with maintenance of pregnancy during second trimester

Fri, 25 Mar 2016 13:25:05 +0100

Conclusion Although this is only a single case but being the first to our knowledge, the good results highlight the point that both surgical management and maintenance of pregnancy during second trimester complicated by Pott’s paraplegia are possible, involving a multi-disciplinary team approach for optimal maternal and fetal outcome. (Source: European Spine Journal)



Decompression of the gluteus medius muscle as a new treatment for buttock pain: technical note

Fri, 25 Mar 2016 13:25:05 +0100

Conclusion In patients with buttock pain, pain around the GMeM should be considered as a causative factor. Less invasive surgery with cutting and opening of the tight gluteal aponeurosis over the GMeM under local anesthesia yielded excellent clinical outcomes. (Source: European Spine Journal)



Anaesthetic Implications for Liver Disease in PregnancyAnaesthetic Implications for Liver Disease in Pregnancy

Fri, 25 Mar 2016 12:34:28 +0100

What does the anesthetist need to consider when caring for pregnant women with liver disease? BJA Education (Source: Medscape Today Headlines)

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Are Graduating Residents Comfortable Performing Oral-Maxillofacial Surgery?

Fri, 25 Mar 2016 11:07:41 +0100

Many members of our specialty, including me, have voiced concerns about the ongoing trend of a large proportion of young oral-maxillofacial surgeons focusing their clinical practices on dentoalveolar surgery including site preparation and placement of dental implants. One reason given for this phenomenon is that this area of practice tends to be more lucrative, particularly when combined with income derived from in-office imaging and surgeon-provided advanced forms of anesthesia. Other drivers pushing surgeons toward an office-based practice include post-training student loan indebtedness, hospital staff membership requirements mandating trauma call participation, and inappropriately low insurance company compensation for the time and complexity of surgeries performed in the hospital setti...



Compatibility of common drugs with acetate‐containing balanced electrolyte solutions in pediatric anesthesia

Fri, 25 Mar 2016 08:43:07 +0100

ConclusionsMost of the tested drugs did not show any signs or evidence of incompatibility reactions. However, phenytoin and diazepam should not be in contact with the three tested solutions, including NS. Thiopental should be used with caution because it can precipitate in solutions with a low pH (e.g., BS). (Source: Pediatric Anesthesia)



FDA Wants Generic Narcotic Painkillers to Be Abuse-Deterrent

Fri, 25 Mar 2016 07:00:00 +0100

Title: FDA Wants Generic Narcotic Painkillers to Be Abuse-DeterrentCategory: Health NewsCreated: 3/24/2016 12:00:00 AMLast Editorial Review: 3/25/2016 12:00:00 AM (Source: MedicineNet Chronic Pain General)



Procedures of cervical conization: a national survey among Italian colposcopy units.

Fri, 25 Mar 2016 05:38:02 +0100

CONCLUSIONS: The administrative regimen in which conizations are performed is an expression of behaviors of different health authorities and hospitals in relation to the costs that this procedure entails. PMID: 27008241 [PubMed - in process] (Source: Minerva Ginecologica)

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Falsely low values of oxygen saturation measured by pulse oximetry in a boy treated with Chinese herb tea

Thu, 24 Mar 2016 23:00:00 +0100

Abstract An 8-year-old boy suffering from progressive glioblastoma was scheduled for neurosurgery. Prior to induction of anaesthesia pulse oximetry measured 64 % saturation of oxygen (SpO2). Arterial blood gas analysis revealed normal oxygen saturation and normal oxygen partial pressure. After having ruled out technical problems of pulse oximetry the neurosurgical procedure was halted. Meticulous examination of the child’s history and medication did not explain a possible interaction of drugs with pulse oximetry. A Chinese herb tea had been given to the child, but was then stopped on the day of admission. The surgical procedure took place the next day without any complications. During the subsequent inpatient stay, repeated blood gas analyses showed normal oxygenation, but puls...



Stimulating forebrain communications: Slow sinusoidal electric fields over frontal cortices dynamically modulate hippocampal activity and cortico-hippocampal interplay during slow-wave states

Thu, 24 Mar 2016 23:00:00 +0100

Publication date: June 2016 Source:NeuroImage, Volume 133 Author(s): Anastasia Greenberg, Tara A. Whitten, Clayton T. Dickson Slow-wave states are characterized by the most global physiological phenomenon in the mammalian brain, the large-amplitude slow oscillation (SO; ~1Hz) composed of alternating states of activity (ON/UP states) and silence (OFF/DOWN states) at the network and single cell levels. The SO is cortically generated and appears as a traveling wave that can propagate across the cortical surface and can invade the hippocampus. This cortical rhythm is thought to be imperative for sleep-dependent memory consolidation, potentially through increased interactions with the hippocampus. The SO is correlated with learning and its presumed enhancement via slow rhythmic electrical ...



Millisecond Coupling of Local Field Potentials to Synaptic Currents in the Awake Visual Cortex

Thu, 24 Mar 2016 23:00:00 +0100

Publication date: Available online 24 March 2016 Source:Neuron Author(s): Bilal Haider, David P.A. Schulz, Michael Häusser, Matteo Carandini The cortical local field potential (LFP) is a common measure of population activity, but its relationship to synaptic activity in individual neurons is not fully established. This relationship has been typically studied during anesthesia and is obscured by shared slow fluctuations. Here, we used patch-clamp recordings in visual cortex of anesthetized and awake mice to measure intracellular activity; we then applied a simple method to reveal its coupling to the simultaneously recorded LFP. LFP predicted membrane potential as accurately as synaptic currents, indicating a major role for synaptic currents in the relationship between cortical LFP a...



Anticonvulsant drug–induced cell death in the developing white matter of the rodent brain

Thu, 24 Mar 2016 23:00:00 +0100

Summary ObjectiveDuring critical periods of brain development, both seizures and anticonvulsant medications can affect neurodevelopmental outcomes. In rodent models, many anticonvulsants trigger neuronal apoptosis. However, white matter apoptosis (WMA) has not been examined after anticonvulsant drug treatment. Herein, we sought to determine if anticonvulsant drugs induced apoptosis in the developing white matter (WM) in a rodent model. MethodsPostnatal day (P)7 rats were treated with phenobarbital (PB‐75), MK‐801 (dizocilpine, 0.5), lamotrigine (LTG‐20), carbamazepine (CBZ‐100), phenytoin (PHT‐50), levetiracetam (LEV‐250), or saline; all doses are mg/kg. Brain tissue collected 24 h after treatment was stained using the terminal deoxynucleotidyl transferase dUTP nick end labelin...



High-Dose Ketamine Sedation of an Agitated Patient During Air Medical Transport

Thu, 24 Mar 2016 23:00:00 +0100

We report a case in which a high-dose ketamine infusion was used to sedate an agitated patient for air medical transport, avoiding the risks of general anesthesia and causing no exacerbation of psychiatric symptoms. (Source: Air Medical Journal)

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Unidirectional left-to-right interatrial shunting for treatment of patients with heart failure with reduced ejection fraction: a safety and proof-of-principle cohort study

Thu, 24 Mar 2016 23:00:00 +0100

Publication date: 26 March–1 April 2016 Source:The Lancet, Volume 387, Issue 10025 Author(s): Maria Del Trigo, Sebastien Bergeron, Mathieu Bernier, Ignacio J Amat-Santos, Rishi Puri, Francisco Campelo-Parada, Omar Abdul-Jawad Altisent, Ander Regueiro, Neal Eigler, Erez Rozenfeld, Philippe Pibarot, William T Abraham, Josep Rodés-Cabau Background In patients with heart failure, interventions to reduce elevated left atrial pressure improve symptoms and reduce the risk of hospital admission. We aimed to assess the safety and potential efficacy of therapeutic left-to-right interatrial shunting in patients with heart failure with reduced ejection fraction. Methods We did this proof-of-principle cohort study at one centre in Canada. Patients (aged ≥18 years) with New York Hea...



Recording and labeling at a site along the cochlea shows alignment of medial olivocochlear and auditory nerve tonotopic mappings

Thu, 24 Mar 2016 23:00:00 +0100

Medial olivocochlear (MOC) neurons provide an efferent innervation to outer hair cells (OHCs) of the cochlea, but their tonotopic mapping is incompletely known. In the present study of anesthetized guinea pigs, the MOC mapping was investigated using in vivo, extracellular recording, and labeling at a site along the cochlear course of the axons. The MOC axons enter the cochlea at its base and spiral apically, successively turning out to innervate OHCs according to their characteristic frequencies (CFs). Recordings made at a site in the cochlear basal turn yielded a distribution of MOC CFs with an upper limit, or "edge," due to usually absent higher-CF axons that presumably innervate more basal locations. The CFs at the edge, normalized across preparations, were equal to the CFs of the audit...



Excitatory amino acid transporters tonically restrain nTS synaptic and neuronal activity to modulate cardiorespiratory function

Thu, 24 Mar 2016 23:00:00 +0100

The nucleus tractus solitarii (nTS) is the initial central termination site for visceral afferents and is important for modulation and integration of multiple reflexes including cardiorespiratory reflexes. Glutamate is the primary excitatory neurotransmitter in the nTS and is removed from the extracellular milieu by excitatory amino acid transporters (EAATs). The goal of this study was to elucidate the role of EAATs in the nTS on basal synaptic and neuronal function and cardiorespiratory regulation. The majority of glutamate clearance in the central nervous system is believed to be mediated by astrocytic EAAT 1 and 2. We confirmed the presence of EAAT 1 and 2 within the nTS and their colocalization with astrocytic markers. EAAT blockade with dl-threo-β-benzyloxyaspartic acid (TBOA) pr...



Bypassing the Bypass

Thu, 24 Mar 2016 23:00:00 +0100

A 59-year-male presented with a painful pulsatile left leg swelling 4 years after a below-knee femoropopliteal bypass for a popliteal artery aneurysm. Computed tomography angiography revealed a proximal 29-mm vein graft aneurysm (1) and a 56-mm distal pseudoaneurysm (2) with generalised vein graft ectasia (A). These were successfully excluded under local anaesthetic by an endobypass from the superficial femoral artery to the distal anastomosis using heparin-bonded endoprostheses (Viabahn, W. L. Gore & Associates Inc., Flagstaff, AZ, USA; 11 × 100 mm, n = 2, 13 × 100 mm, n = 3) avoiding the need for complex redo lower limb surgery (B). (Source: European Journal of Vascular and Endovascular Surgery)



Teaching surgery takes time: the impact of surgical education on time in the operating room.

Thu, 24 Mar 2016 21:51:02 +0100

CONCLUSION: Our results show that a wide range of surgical procedures require significantly more time to perform in teaching than nonteaching hospitals. Given the magnitude of this difference, the impact of surgical training on health care costs and clinical outcomes should be a priority for future studies. PMID: 27007088 [PubMed - as supplied by publisher] (Source: Canadian Journal of Surgery)

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Characterization and Activation of NLRP3 Inflammasomes in the Renal Medulla in Mice

Thu, 24 Mar 2016 21:22:21 +0100

Conclusion: Our results indicate that renal medullary Nlrp3 inflammasomes represent a new regulatory mechanism of renal MBF and sodium excretion which may not depend on classical inflammatory response.Kidney Blood Press Res 2016;41:208-221 (Source: Kidney and Blood Pressure Research)



Perioperative Surgical Home—An Innovative Concept

Thu, 24 Mar 2016 17:45:15 +0100

The Perioperative Surgical Home (PSH) is a concept that was developed by the American Society of Anesthesiologists (ASA) in answer to the typical disjointed care received by perioperative/perianesthesia patients.1 The PSH is a patient-centered, multi-disciplinary, team-based model of care that streamlines and coordinates care of the patient from the moment the decision is made to have surgery until at least 30 days after surgery. The PSH is designed to emphasize value, patient satisfaction, and reduced costs. (Source: Journal of PeriAnesthesia Nursing)



Ischemic conditioning protects the microcirculation, preserves organ function, and prolongs survival in sepsis

Thu, 24 Mar 2016 15:34:08 +0100

ABSTRACT: Ischemic conditioning induces a series of cellular modifications that may prevent injury from further hypoxic episodes, but there are few data in sepsis. In this randomized controlled study, we evaluated the effects of ischemic conditioning on the microcirculation, organ function, and survival time in an ovine model of septic shock. Sepsis was induced in 14 anesthetized, mechanically ventilated adult sheep by injecting autologous feces into the abdominal cavity. Animals were then randomized to ischemic pre- and post-conditioning or no conditioning (both n = 7). Remote ischemic conditioning was performed by inflating the balloon of a catheter in the aortic bifurcation for 2 min, followed by a 4-min deflation period. The procedure was performed four times before sepsis inducti...



Intrathecal amantadine for prolonged spinal blockade of sensory and motor functions in rats

Thu, 24 Mar 2016 15:25:15 +0100

This article is protected by copyright. All rights reserved. (Source: Fundamental and Clinical Pharmacology)



End-tidal sevoflurane concentration for ProSeal™ versus Classic™ laryngeal mask airway insertion in unpremedicated anaesthetised adult females

Thu, 24 Mar 2016 14:08:04 +0100

The optimal end-tidal sevoflurane concentration for successful ProSeal™ (Teleflex, Morrisville, NC, USA) laryngeal mask airway (PLMA) versus Classic™ (Teleflex, Morrisville, NC, USA) laryngeal mask airway (CLMA) insertion in unpremedicated anaesthetised adults is unknown. We determined end-tidal sevoflurane concentrations for successful insertion in fifty percent of anaesthetised adults. This randomised, prospective, double-blind study was conducted in the operating theatre of a government tertiary care hospital. Forty-four unpremedicated American Society of Anesthesiologists physical status I and II women with cervical carcinoma (aged 30 to 60 years), scheduled for intracavity caesium implantation under general anaesthesia with a laryngeal mask airway (LMA) were included in the study....

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Implementation of a new dantrolene formulation across a multifacility health system.

Thu, 24 Mar 2016 13:25:02 +0100

CONCLUSION: A multifacility health system was successful in converting an existing stock of dantrolene to a newly available formulation. PMID: 27001988 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)



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Thu, 24 Mar 2016 12:13:07 +0100

Incorrect information was published in Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, Carter T, Cassidy CL, Chittenden EH, Degenhardt E, Griffith S, Manworren R, McCarberg B, Montgomery R, Murphy J, Perkal MF, Suresh S, Sluka K, Strassels S, Thirlby R, Viscusi E, Walco GA, Warner L, Weisman SJ, Wu CL: Management of postoperative pain: A clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. (Source: The Journal of Pain)



Target Controlled Infusion versus Sevoflurane/Desflurane Anesthesia for Laparoscopic Cholecystectomy: Comparison Postoperative Nausea/Vomiting and Extubation Time.

Thu, 24 Mar 2016 11:39:02 +0100

CONCLUSION: Laparoscopic cholecystectomy under propofol with TCI is one option of anesthetic technique with a significantly lower incidence of PONV compared with both sevoflurane and desflurane otherwise there is no statistical difference in the extubation time. Propofol-TCI technique is suggested for laparoscopic and ambulatory surgery. PMID: 27004303 [PubMed - in process] (Source: Journal of the Medical Association of Thailand = Chotmaihet thangphaet)



Discussion

Thu, 24 Mar 2016 01:35:37 +0100

DR TIMOTHY M PAWLIK (Baltimore, MD): Our group at Johns Hopkins recently introduced an enhanced recovery after surgery (ERAS) pathway for open hepatic surgery that includes the same elements as the pathway proposed here such as preoperative carbohydrate loading, minimization of IV fluids, and increased use of regional anesthesia. Similar to your presented data, we showed that among patients undergoing an open hepatectomy, the introduction of ERAS was associated with a reduction in opioid use, shorter hospital stay, and decreased hospital costs. (Source: Journal of the American College of Surgeons)

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The mitochondrial division inhibitor Mdivi-1 rescues mammalian neurons from anesthetic-induced cytotoxicity

Thu, 24 Mar 2016 00:00:00 +0100

Concerns have risen regarding the potential side effects of clinical exposure of the pediatric population to inhalational anesthetics, and how they might impact cognitive, learning, and memory functions. Howev... (Source: Molecular Brain)



Abdominal girth and vertebral column length can adjust spinal anesthesia for lower limb surgery, a prospective, observational study

Thu, 24 Mar 2016 00:00:00 +0100

Studies have shown that abdominal girth and vertebral column length have high predictive value for spinal spread after administering a dose of plain bupivacaine. we designed a study to identify the specific co... (Source: BMC Anesthesiology)



Dexmedetomidine: Superiority trials needed? Reply

Wed, 23 Mar 2016 23:00:00 +0100

Publication date: Available online 23 March 2016 Source:Anaesthesia Critical Care & Pain Medicine Author(s): JM. Constantin, S. Perbet (Source: Anaesthesia, Critical Care and Pain Medicine)



Hospital Variation in Anastomotic Leakage After Rectal Cancer Surgery in the Spanish Association of Surgeons Project: The Contribution of Hospital Volume

Wed, 23 Mar 2016 23:00:00 +0100

Conclusion Anastomotic leak varies significantly among hospitals included in the project and this difference cannot be attributed to the annual surgical volume. (Source: Cirugia Espanola)



IJERPH, Vol. 13, Pages 359: Primary Paediatric Bronchial Airway Epithelial Cell in Vitro Responses to Environmental Exposures

Wed, 23 Mar 2016 23:00:00 +0100

The bronchial airway epithelial cell (BAEC) is the site for initial encounters between inhaled environmental factors and the lower respiratory system. Our hypothesis was that release of pro inflammatory interleukins (IL)-6 and IL-8 from primary BAEC cultured from children will be increased after in vitro exposure to common environmental factors. Primary BAEC were obtained from children undergoing clinically indicated routine general anaesthetic procedures. Cells were exposed to three different concentrations of lipopolysaccharide (LPS) or house dust mite allergen (HDM) or particulates extracted from side stream cigarette smoke (SSCS). BAEC were obtained from 24 children (mean age 7.0 years) and exposed to stimuli. Compared with the negative control, there was an increase in IL-6 and IL-8 r...



Team effort behind dog's open-heart surgery

Wed, 23 Mar 2016 23:00:00 +0100

A TEAM at the Royal Veterinary College (RVC) has successfully carried out open-heart surgery to treat a stenotic tricuspid valve in a three-year-old labrador. The dog, called Mabel, was suffering from congenital tricuspid dysplasia; the tricuspid valve in the heart was completely fused in the middle, with just two small openings allowing blood to flow through. RVC students helped with the initial examinations of Mabel, allowing them first-hand insight into the subsequent procedure. Also involved were members of the college's cardiology team. The open-heart surgery was performed by Dan Brockman, professor of small animal surgery at the RVC, assisted by a large team of staff, including a perfusionist, three anaesthetists, two surgery nurses, three surgeons and a cardiology veterinary special...



A randomized comparison of pediatric‐sized Streamlined Liner of Pharyngeal Airway™ and Laryngeal Mask Airway‐Unique™ in paralyzed children

Wed, 23 Mar 2016 23:00:00 +0100

ConclusionsIn conclusion, both the SLIPA and the Laryngeal Mask Airway‐Unique can be used effectively without severe complications in paralyzed children. Additionally, the SLIPA provides a better airway seal and better intraoperative position stability than the Laryngeal Mask Airway‐Unique. (Source: Pediatric Anesthesia)



Relationship between regional cerebral blood volume and oxygenation and blood pressure during spinal anesthesia in women undergoing cesarean section

Wed, 23 Mar 2016 23:00:00 +0100

Conclusions Maternal rCBV and rCBO decrease significantly during spinal anesthesia for cesarean section. Reductions in rCBV and rCBO may be associated with the severity of hypotension induced by subarachnoid sympathetic block with bupivacaine. (Source: Journal of Anesthesia)



Epsilon-Aminocaproic Acid Has No Association With Thromboembolic Complications, Renal Failure, or Mortality after Liver Transplantation

Wed, 23 Mar 2016 23:00:00 +0100

To examine the role of epsilon-aminocaproic acid (EACA) administered after reperfusion of the donor liver in the incidences of thromboembolic events and acute kidney injury within 30 days after orthotopic liver transplantation. One-year survival rates between the EACA-treated and EACA-nontreated groups also were examined. (Source: Journal of Cardiothoracic and Vascular Anesthesia)



Incidental Finding of a Left Atrial Myxoma During Emergency Surgery for Thoracic Aortic Dissection

Wed, 23 Mar 2016 23:00:00 +0100

THE INCREASED USE of perioperative transesophageal echocardiography in cardiac surgery has resulted in the discovery of unexpected and previously undiagnosed findings. It has been reported that the incidence of abnormal findings in patients undergoing transesophageal echocardiography is approximately 11% and includes patent foramen ovale, simultaneous valvular abnormalities, and cardiac masses.1 The authors believe that this was the first case report of the management of incidental finding of a left atrial mass during the transesophageal echocardiography examination of a patient who was undergoing emergency repair of a type-A aortic dissection. (Source: Journal of Cardiothoracic and Vascular Anesthesia)

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The Effect of Quantitative Neuromuscular Monitoring on the Incidence of Residual Neuromuscular Blockade and Clinical Outcomes

Wed, 23 Mar 2016 23:00:00 +0100

Abstract Neuromuscular blocking agents (NMBAs) are useful perioperative medications. Despite this utility, their administration is associated with increased morbidity due to residual neuromuscular blockade. Clinical testing prior to tracheal extubation is subjective, dependent on the patient’s cooperation, and not predictive of adequate respiratory function to prevent the occurrence of postoperative critical respiratory events. The use of peripheral nerve stimulators may improve detection of residual weakness; however, this technique does not reliably detect residual paralysis, as it requires the subjective (and imperfect) assessment of fade in response to train-of-four (TOF) stimulation. Quantitative neuromuscular monitoring can be accomplished through a variety of modalities a...



The Use of Sugammadex in Clinical Practice: Which Patients Are Most Likely to Benefit?

Wed, 23 Mar 2016 23:00:00 +0100

Abstract The main advantage of sugammadex-based reversal compared with the “classical” acetylcholinesterase inhibitor-based concept is that it achieves more rapid and more reliable recovery and has the unique ability to dose-dependently reverse any degree of neuromuscular block. Mainly because of economic reasons, sugammadex is often limited to patient groups or procedures that are most likely to benefit from its unique features. In this context, patients with myasthenia gravis, patients undergoing (abdominal) laparoscopic surgery, patients undergoing short-acting procedures that require neuromuscular blockade, obese, elderly, or patients undergoing rapid sequence induction are most often cited. However, at comparable costs, this arbitrary limitation of sugammadex could be abo...



Case history. “Coral snake” Micrurus mipartitus bite in 1968. A herpetologist's ordeal

Wed, 23 Mar 2016 23:00:00 +0100

Publication date: Available online 24 March 2016 Source:Colombian Journal of Anesthesiology Author(s): Bernardo Ocampo Trujillo Historical clinical case that presented back in 1968 at a time when respiratory support and intensive care techniques were just emerging, with many shortcomings in hospital care areas and monitoring devices. The case is of a 58 year-old patient, outstanding citizen, recent winner in a television contest on snakes, who was bitten accidentally by a coral snake Micrurus mipartitus. The poison of this snake is a macromolecule that induces complete depolarizing muscle blockade which, if not reverted, leads to death from respiratory failure. A group of social leaders in the region managed to obtain the specific anti-venom that was not produced in the country, as well...



The effects of experimental pain and induced optimism on working memory task performance

Wed, 23 Mar 2016 23:00:00 +0100

Conclusions Experimentally induced pain impairs concurrent but not subsequent working memory task performance. Manipulated optimism did not counteract pain-induced deterioration of 2-back performance. Implications It is important to explore factors that may diminish the negative impact of pain on the ability to function in daily life, as pain itself often cannot be remediated. We are planning to conduct future studies that should shed further light on the conditions, contexts and executive operations for which optimism can act as a protective factor. (Source: Scandinavian Journal of Pain)



Low back skin sensitivity has minimal impact on active lumbar spine proprioception and stability in healthy adults.

Wed, 23 Mar 2016 23:00:00 +0100

Authors: Beaudette SM, Larson KJ, Larson DJ, Brown SH Abstract The purpose of the current work was to (1) determine whether low back cutaneous sensitivity could be reduced through the use of a topical lidocaine-prilocaine anesthetic (EMLA(®)) to mirror reductions reported in chronic lower back pain (CLBP) patients, as well as to (2) identify whether reductions in cutaneous sensitivity resulted in decreased lumbar spine proprioception, neuromuscular control and dynamic stability. Twenty-eight healthy participants were divided equally into matched EMLA and PLACEBO treatment groups. Groups completed cutaneous minimum monofilament and two-point discrimination (TPD) threshold tests, as well as tests of sagittal and axial lumbar spine active repositioning error, seated balance and repea...



The initial fall in arterial pressure evoked by endotoxin is mediated by the ventrolateral periaqueductal gray.

Wed, 23 Mar 2016 23:00:00 +0100

This study tested the hypothesis that the initial fall in arterial pressure evoked by lipopolysaccharide (LPS) is mediated by the ventrolateral column of the midbrain periaqueductal gray region (vlPAG). To test this hypothesis, the local anesthetic lidocaine (2%; 0.1 μl, 0.2 μl or 1.0 μl), the delta opioid receptor antagonist naltrindole (2 nmol) or saline was microinjected into the vlPAG of isoflurane-anesthetized rats bilaterally and LPS (1 mg/kg) or saline was administered i.v. 2 min later. Both lidocaine and naltrindole inhibited LPS-evoked hypotension significantly but did not affect arterial pressure in saline-treated control animals. Neither lidocaine nor naltrindole altered heart rate significantly in either LPS-treated or control animals. Microinjection of lidocaine or naltrind...

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The Lungmotor

Wed, 23 Mar 2016 18:44:09 +0100

(Source: Anaesthesia and Intensive Care)



Assessing anaesthesia trainees at work: opportunities and challenges

Wed, 23 Mar 2016 18:44:09 +0100

NA (Source: Anaesthesia and Intensive Care)



Reliability of Numerical scales used for Direct Observation of Procedural Skills

Wed, 23 Mar 2016 18:44:09 +0100

(Source: Anaesthesia and Intensive Care)

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Reliability of the Direct Observation of Procedural Skills assessment tool for ultrasound-guided regional anaesthesia

Wed, 23 Mar 2016 18:44:09 +0100

The objective of this study was to evaluate the reliability of DOPS when used to score trainees performing ultrasound-guided regional anaesthesia. Reliability of an assessment tool is defined as the reproducibility of scores given by different assessors viewing the same trainee. Forty-nine anaesthetists were recruited to score two scripted videos of trainees performing a popliteal sciatic nerve block and an axillary brachial plexus block. Reliability, as measured by intraclass correlation coefficients, was -0.01 to 0.43 for the individual items in DOPS, and 0.15 for the ‘Overall Performance for this Procedure’ item. Assessors demonstrated consistency of scoring within DOPS, with significant correlation of sum of individual item scores with the 'Overall Performance for this Procedure' i...



Learning from defects using a comprehensive management system for incident reports in critical care

Wed, 23 Mar 2016 18:44:09 +0100

Incident reporting systems are often used without a structured review process, limiting their utility to learn from defects and compromising their impact on improving the healthcare system. To describe the experience of implementing a Comprehensive Management System (CMS) for incident reports in the ICU, a physician-led multidisciplinary Incident Report Committee was created to review, analyse and manage the department incident reports. New protocols, policies and procedures, and other patient safety interventions were developed as a result. Information was disseminated to staff through multiple avenues. We compared the pre- and post-intervention periods for the impact on the number of incident reports, level of harm, time needed to close reports and reporting individuals. A total of 1719 ...



End-tidal sevoflurane concentration for ProSeal® versus Classic™ laryngeal mask airway insertion in unpremedicated anaesthetised adult females

Wed, 23 Mar 2016 18:44:09 +0100

The optimal end-tidal sevoflurane concentration for successful ProSeal™ (Teleflex, Morrisville, NC, USA) laryngeal mask airway (PLMA) versus Classic™ (Teleflex, Morrisville, NC, USA) laryngeal mask airway (CLMA) insertion in unpremedicated anaesthetised adults is unknown. We determined end-tidal sevoflurane concentrations for successful insertion in fifty percent of anaesthetised adults. This randomised, prospective, double-blind study was conducted in the operating theatre of a government tertiary care hospital. Forty-four unpremedicated American Society of Anesthesiologists physical status I and II women with cervical carcinoma (aged 30 to 60 years), scheduled for intracavity caesium implantation under general anaesthesia with a laryngeal mask airway (LMA) were included in the study....



Risk factors for bleeding complications after percutaneous dilatational tracheostomy: a ten-year institutional analysis

Wed, 23 Mar 2016 18:44:09 +0100

Bleeding complications after percutaneous dilatational tracheostomy (PDT) are infrequent but may have a tremendous impact on a patient's further clinical course. Therefore, it seems necessary to perform risk stratification for patients scheduled for PDT. We retrospectively reviewed the records of 1001 patients (46% male, mean age 68.1 years) undergoing PDT (using the Ciaglia Blue Rhino® technique with direct bronchoscopic guidance) in our cardiothoracic ICU between January 2003 and February 2013. Patients were stratified into two groups: patients suffering acute moderate, severe, or major bleeding (Group A) and patients who had no or only mild bleeding (Group B). In the majority of patients, no or only mild bleeding during PDT occurred (none: 425 [42.5%], mild: 488 [48.8%]). In 84 pati...



The anaesthetic assessment, management and risk factors of bariatric surgical patients requiring post-operative intensive care support: a state-wide, five-year cohort study.

Wed, 23 Mar 2016 18:44:09 +0100

Bariatric surgery is a rapidly growing and dynamic discipline necessitating a specialised anaesthetic approach coordinating high-risk patients with appropriate post-operative intensive care (ICU) support. The relationship between the anaesthetic and ICU utilisation after bariatric surgery is poorly understood. All adult bariatric surgery patients admitted to any ICU over a five-year period between 2007 and 2011 in Western Australia were identified from hospital admission records and cross-referenced against the Western Australian Department of Health Data Linkage Unit database. During the study period 12,062 patients under went bariatric surgery with 581 (4.8%) patients admitted to ICU immediately following surgery. The mean pre-operative ASA score was 3.3 [standard deviation 1.1] with 76....

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Intensive Care Management of Children Intubated for Croup: a retrospective analysis

Wed, 23 Mar 2016 18:44:09 +0100

Croup remains the commonest reason for acute upper airway obstruction in children, yet there are scarce contemporary data of airway management in those requiring intubation. We performed a retrospective analysis of the intensive care management of children intubated for croup in two quaternary Paediatric Intensive Care Units: Royal Children’s Hospital Melbourne, Australia and Alberta Children’s Hospital Calgary, Canada. Patients intubated for less than three days were compared with those intubated for greater than three days. Patients less than 10 kg body weight were compared to those greater than 10 kg. Demographic, clinical and microbiological data were recorded. Seventy-seven cases of croup requiring intubation were identified. The median duration of intubation was 60 hours. Parainf...



Acute kidney injury following liver transplantation: a systematic review of published predictive models

Wed, 23 Mar 2016 18:44:09 +0100

Acute kidney injury is a frequent postoperative complication amongst liver transplant recipients and is associated with increased morbidity and mortality. This systematic review analysed the existing predictive models, in order to solidify current understanding. Articles were selected for inclusion if they described the primary development of a clinical prediction model (either an algorithm or risk score) to predict AKI post liver transplantation. The database search yielded a total of seven studies describing the primary development of a prediction model or risk score for the development of AKI following liver transplantation. The models span thirteen years of clinical research and highlight a gradual change in the definitions of AKI, emphasising the need to employ standardised definition...



Characteristics and dying trajectories of adult hospital patients from acute care wards who die following review by the rapid response team

Wed, 23 Mar 2016 18:44:09 +0100

A third of patients reviewed by rapid response teams (RRT) require end-of-life care. However, little is known about the characteristics and management of these patients following RRT review. This paper presents results of a retrospective, descriptive audit that explored the dying trajectory of adult ward inpatients who died outside of intensive care following RRT review. The study setting was a 430-bed tertiary New Zealand hospital during 2013. RRT, inpatient databases and hospital notes were used to identify 100 consecutive adult inpatients who died subsequent to RRT review. Outcome measures included time from RRT review to death, place of death, pre-existing co-morbidities and frequency of medical review. Results demonstrated that patients were old (median 77 years, IQR 63–85years), em...



Intravenous lipid emulsion for levobupivacaine intoxication in acidotic and hypoxaemic pigs

Wed, 23 Mar 2016 18:44:09 +0100

Intravenous lipid emulsion is, in some countries, the recommended treatment for local anaesthetic toxicity. Systemic local anaesthetic toxicity results in hypoxaemia and acidosis, and whether this influences the effects of lipid therapy on drug concentrations and cardiovascular recovery is currently unknown. Twenty anaesthetised pigs were given a 3-mg/kg bolus of levobupivacaine followed by a five minute phase of hypoventilation and 1 mmol/kg of lactic acid in one minute. After lactic acid infusion, pigs were treated, in randomised order, with either 20% lipid emulsion or Ringer’s acetate for 30 min: a 1.5-ml/kg bolus followed by a 0.25-ml/kg/minute infusion. Haemodynamic parameters were recorded and blood samples were collected for pharmacokinetic analysis. There was no difference betwe...



The effect of adjuvant remifentanil with propofol or thiopentone on seizure quality during electroconvulsive therapy

Wed, 23 Mar 2016 18:44:09 +0100

In order to optimise outcome to Electro Convulsive therapy (ECT), there has been a trend to utilise remifentanil as an adjunct to standard intravenous induction agents. This has allowed a reduction in the dose of anaesthetic agent, and usually an improved response to stimulation. However there have been no previous studies to ascertain whether this improvement is simply as a result of the reduced dose of anaesthetic agent or whether remifentanil itself might possess epileptogenic properties. This retrospective case-controlled study examined ECT outcomes, determined by EEG quality analysis, in patients who received ECT with or without remifentanil, where there was no dose reduction in the anaesthetic agent. There were no improvements seen in the measurements of any EEG parameter, including ...

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Chewing gum in the preoperative fasting period: an analysis of de-identified incidents reported to webAIRS

Wed, 23 Mar 2016 18:44:09 +0100

The role of preoperative fasting is well established in current anaesthetic practice with different guidelines for clear fluids and food. However, chewing gum may not be categorised as either food or drink by some patients, and may not always be specified in instructions given to patients about preoperative fasting. The aim of this paper was to review anaesthesia incidents involving gum chewing reported to webAIRS to obtain information on the risks, if any, of gum chewing during the preoperative fasting period. There were nine incidents involving chewing gum reported between late 2009 and early 2015. There were no adverse outcomes from the nine incidents other than postponement of surgery in three cases and cancellation in one. In particular, there were no reports of aspiration or airway o...



Spontaneous ventilation using Propofol TCI for microlaryngoscopy in adults: a retrospective audit

Wed, 23 Mar 2016 18:44:09 +0100

We conducted a retrospective audit of 285 adult elective microlaryngoscopy cases in our institution over a three-and-a-half year period. Conventional anaesthesia with intubation and mechanical ventilation was the most common technique, used in 71% of cases. Tubeless spontaneous ventilation during total intravenous anaesthesia with a target-controlled infusion of propofol (SVTCI) was the most common alternative. Spontaneous ventilation with target-controlled infusion was used for 79 (27.7%) anaesthetic inductions and was continued through the maintenance phase for 60 patients (21.1%). Jet and intermittent ventilation were both used infrequently (1% each). The most common SVTCI technique since 2013 involved adjusting the target-controlled infusion rate during induction using a formula we dev...






Damage to a flexible laryngeal mask by metallic dental braces preventing removal of the mask

Wed, 23 Mar 2016 18:44:09 +0100

(Source: Anaesthesia and Intensive Care)



Ingested dental prosthesis causing significant gastrointestinal bleeding

Wed, 23 Mar 2016 18:44:09 +0100

(Source: Anaesthesia and Intensive Care)

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Anaphylaxis to chlorhexidine in a chlorhexidine-coated central venous catheter during general anaesthesia

Wed, 23 Mar 2016 18:44:09 +0100

(Source: Anaesthesia and Intensive Care)



Septic shock due to Myroides odoratus in a medical intensive care unit patient with severe necrotizing pancreatitis

Wed, 23 Mar 2016 18:44:09 +0100

We present the first case of severe necrotizing pancreatitis and septic shock due to Myroides odoratus. Moreover, our case demonstrates the pathogenicity of Myroides, and the importance given its resistance to multiple antibiotics. (Source: Anaesthesia and Intensive Care)



Erratum

Wed, 23 Mar 2016 18:44:09 +0100

(Source: Anaesthesia and Intensive Care)



ANZICS/ACCCN Annual Scientific Meeting, October 2015, Auckland, New Zealand

Wed, 23 Mar 2016 18:44:09 +0100

(Source: Anaesthesia and Intensive Care)



Medical News Today: Opioids: will the CDC's prescribing guideline help tackle the 'silent epidemic'?

Wed, 23 Mar 2016 15:00:00 +0100

Last week, the CDC issued a new guideline for prescription opioids in a bid to reduce the overdose deaths associated with the drugs. But will it help? We investigate. (Source: Health News from Medical News Today)

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Beneficial effects of intravenous dexmedetomidine on cognitive function and cerebral injury following a carotid endarterectomy.

Wed, 23 Mar 2016 14:45:02 +0100

Authors: Ge YL, Li X, Gao JU, Zhang X, Fang X, Zhou L, Ji W, Lin S Abstract The present study aimed to investigate the effects of dexmedetomidine (DEX) on cognition following a carotid endarterectomy (CEA). In addition, the neuroprotective effects of DEX against ischemia-reperfusion injury during CEA were analyzed. Patients due to undergo elective CEA under general anesthesia were randomly assigned to either the DEX-treated group (group D; n=25) or the control group (group C; n=25). Patients in group D were treated with 0.3 µg/kg DEX pre-CEA, followed by 0.3 µg/kg/h DEX intraoperatively up to 30 min prior to the completion of surgery, and the patients in group C received an equal volume of normal saline. Cognitive function was assessed prior to CEA (T0), and at 24, 48, and 72 h, ...



Fast-track surgery and exclusive enteral nutrition applied to a rat model of heterotopic intestinal transplantation.

Wed, 23 Mar 2016 14:45:02 +0100

Authors: Xu X, Feng T, Gao X, Zhao X, Liao Y, Ji WU Abstract The present study applied fast-track surgery (FTS) concepts and exclusive enteral nutrition (EEN) to a rat model of heterotopic intestinal transplantation (HIT). A total of 96 pairs of Sprague-Dawley rats were randomly distributed into three groups, as follows: i) The conventional group (group 1); ii) the FTS group (group 2); and iii) the FTS with EEN group (EEN group). FTS alterations to the HIT protocol were as follows: i) The use of sevoflurane as an anesthetic; ii) alterations to the order of the procedure and iii) a modified suturing technique. In addition, the EEN group rats underwent an early EEN gavage. The operation time, success rate, recovery state and morphological characteristics of the grafts were compared a...



Comparison of Nasopharyngeal Airway Device and Nasal Oxygen Tube in Obese Patients Undergoing Intravenous Anesthesia for Gastroscopy: A Prospective and Randomized Study.

Wed, 23 Mar 2016 12:21:02 +0100

Conclusions. Use of the nasopharyngeal airway for obese patients during painless gastroscopy resulted in less SpO2 reduction relative to the nasal oxygen tube. Altogether, it is a safe and effective device for obese patients undergoing painless gastroscopy. PMID: 26997951 [PubMed] (Source: Gastroenterology Research and Practice)



Meditation May Help Ease Chronic Low Back Pain

Wed, 23 Mar 2016 07:00:00 +0100

Title: Meditation May Help Ease Chronic Low Back PainCategory: Health NewsCreated: 3/22/2016 12:00:00 AMLast Editorial Review: 3/23/2016 12:00:00 AM (Source: MedicineNet Chronic Pain General)



FDA Orders Warning Labels on Prescription Narcotic Painkillers

Wed, 23 Mar 2016 07:00:00 +0100

Title: FDA Orders Warning Labels on Prescription Narcotic PainkillersCategory: Health NewsCreated: 3/22/2016 12:00:00 AMLast Editorial Review: 3/23/2016 12:00:00 AM (Source: MedicineNet Chronic Pain General)

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New perineal injection technique for pudendal nerve infiltration in diagnostic and therapeutic procedures

Wed, 23 Mar 2016 04:22:18 +0100

Conclusion Perineal pudendal injection is an effective and safe technique for anesthesia in diagnostic (vulva biopsy) and therapeutic indications (pudendal neuralgia), and regional anesthesia in perinatal settings. (Source: Archives of Gynecology and Obstetrics)



Effect of lateral femoral cutaneous nerve-block on pain after total hip arthroplasty: a randomised, blinded, placebo-controlled trial

Wed, 23 Mar 2016 00:00:00 +0100

Total hip arthroplasty (THA) is a common procedure associated with moderate postoperative pain. No nerve block without loss of motor function has been documented for THA. We hypothesised that an ultrasound-gui... (Source: BMC Anesthesiology)



Progress in pain management to improve small ruminant farm welfare

Tue, 22 Mar 2016 23:00:00 +0100

Publication date: Available online 23 March 2016 Source:Small Ruminant Research Author(s): P.A. Windsor, S. Lomax, P. White Pain management to improve the welfare of livestock during aversive husbandry interventions is increasingly expected of global farming systems, although few products are available for use by farmers to achieve this. An exception is the ‘spray-on’ topical anaesthetic (TS) formulation containing lignocaine and bupivicaine (Tri-Solfen®; Bayer Animal Health, Pymble, NSW, Australia) originally developed for the mulesing operation in sheep in Australia, where breech skin is removed to create a ‘bare area' that significantly decreases the risk of myiasis from Lucilia cuprina. Over 40 million Merino lambs have now received pain management and some flocks have cont...



Propofol postsynaptically suppresses stellate neuron excitability in the entorhinal cortex by influencing the HCN and TREK-2 channels

Tue, 22 Mar 2016 23:00:00 +0100

Publication date: 21 April 2016 Source:Neuroscience Letters, Volume 619 Author(s): Xiaojun Li, Ke Pan, Dan Zhu, Yuping Li, Guocai Tao The entorhinal cortex (EC) provides a majority of the excitatory inputs to the hippocampus and is part of the neural circuitry that is involved in memory formation. Although many studies have investigated the effects of propofol in the hippocampus, the function of propofol in the EC remains unclear. Here, using whole-cell patch clamp recordings, we found that propofol induced a postsynaptic outward current and dramatically suppressed the firing rates in the entorhinal stellate neurons, the axons of which form the perforant pathway and relay the main inputs to hippocampus. Propofol-induced inhibition in the EC was mediated by a dual ionic mechanism, in...

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Interleukin-11 protects mouse liver from warm ischemia/reperfusion (WI/Rp) injury

Tue, 22 Mar 2016 23:00:00 +0100

Conclusions Pre-treatment with IL-11 protects mouse livers from WI/Rp injury by suppressing NF-kB activity. (Source: Clinics and Research in Hepatology and Gastroenterology)



Comparison of effects of intravenous midazolam and ketamine on emergence agitation in children: Randomized controlled trial

Tue, 22 Mar 2016 23:00:00 +0100

Conclusion Premedication with ketamine is more effective than midazolam in preventing EA during the early emergence period after sevoflurane anaesthesia in children. (Source: Journal of International Medical Research)



Comparison of remifentanil with dexmedetomidine for monitored anaesthesia care in elderly patients during vertebroplasty and kyphoplasty

Tue, 22 Mar 2016 23:00:00 +0100

Conclusions During monitored anaesthesia care, dexmedetomidine provides less respiratory depression, lower MAP and HR, but also less analgesic effect than remifentanil in elderly patients undergoing vertebroplasty or kyphoplasty. (Source: Journal of International Medical Research)



Prevalence and risk factors of postoperative delirium in elderly hip fracture patients

Tue, 22 Mar 2016 23:00:00 +0100

Conclusions Correcting the modifiable risk factors might help prevent PD. Strategies might include nutritional support, tight blood glucose control, improvement of liver function, preoperative infection control and minimizing surgical injury or blood loss. (Source: Journal of International Medical Research)