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Latest & greatest articles for anesthesia
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Clinical anesthesia is used to induce a temporary medical state of controlled unconsciousness, inducing a loss of sensation or awareness. There are three main types of anesthesia:
Local and Regional
Anesthesia is primarily used during surgical procedures to block pain. While unconscious, blood flow and heart rate is monitored.
Research and development in the use of anesthesia has helped anesthesiologists in the progression of patient safety before and after surgery and medical procedures. The developments and research of anesthesia through the years has massively influences medicine and surgery today.
Case studies and clinical trials help aid researchers in the development of aftercare during postoperative recovery. Research is a vital part in the field of anesthesia, it allows anesthesiologists to improve the delivery of patient safety while unconscious.
Learn more on the emerging technology in anesthesia and the advancements in anesthesia practise by searching Trip.
Effect of local anesthetic volume (20 mL vs 30 mL ropivacaine) on electromyography of the diaphragm and pulmonary function after ultrasound-guided supraclavicular brachial plexus block: a randomized controlled trial Diaphragmatic paralysis following supraclavicular brachial plexus block (SCBPB) is ascribed to phrenic nerve palsy. This study investigated the effect of 2 volumes of 0.375% ropivacaine on efficacy of block as a surgical anesthetic and as an analgesic and examined diaphragm compound (...) muscle action potentials (CMAPs) and pulmonary function before and after SCBPB.Eighty patients scheduled for removal of hardware for internal fixation after healing of an upper limb fracture distal to the shoulder were randomized to receive ultrasound-guided SCBPC for surgical anesthesia with 20 mL (Group A) or 30 mL (Group B) 0.375% ropivacaine. The latency and amplitude of diaphragm CMAPs and forced vital capacity (FVC), FVC% predicted, and forced expiratory volume in 1 s (FEV1) were measured
Onset Time of Local Anesthesia After Single Injection in Toe Nerve Blocks: A Randomized Double-Blind Trial. The study was conducted to investigate the onset time and safety profile of four different local anesthetic solutions.Randomized controlled clinical trial study.One hundred twelve healthy volunteers were assigned to receive digital block on their second toe. Individuals were randomly assigned to one of the following groups: lidocaine 2%, lidocaine 2% with epinephrine, bupivacaine 0.5 (...) %, or bupivacaine 0.5% with epinephrine. Onset time was measured until detecting the absence of pinprick sensation. Oxygen saturation was measured in the infiltrated toe up to 60 minutes.The subjects in the groups of anesthetics with epinephrine had a significantly lower mean onset time. There were no significant differences regarding oxygen saturation between the groups and no adverse effects were recorded.The use of anesthetics with epinephrine can be an effective form of local anesthetic for digital blocks
Preoperative Blindfold Training Prevents Pediatric Psychological Behavior Disorders During the Anesthesia Recovery Period: A Randomized Controlled Trial. To identify the effectiveness and feasibility of blindfold training on preventing pediatric psychological behavior disorders during the anesthesia recovery period.This study investigated the effect of blindfold training through the assessment of anxiety, delirium, and pain in children during the anesthesia recovery period.This study (...) was a prospective, randomized, controlled trial. Pediatric patients were randomized into either a control (routine practice) or blindfold training group (routine practice + blindfold training). Anxiety, delirium, and pain levels of children were assessed by the modified Yale Preoperative Anxiety Scale, Pediatric Anesthesia Emergence Delirium scale, and the Face, Legs, Activity, Cry, Consolability scale.The blindfold training group had significantly lower scores for emergence delirium, anxiety, and pain during
Effect of Benson Relaxation on the Intensity of Spinal Anesthesia-Induced Pain After Elective General and Urologic Surgery. The present study aimed to evaluate the effect of Benson's muscle relaxation on postoperative spinal anesthesia-induced pain.Randomized clinical trial.Sixty-four patients were randomly assigned to intervention and control groups. Benson's muscle relaxation was performed on the intervention group for 10 to 20 minutes based on the patients' tolerance. Before and after (...) the intervention, the two groups were assessed using the visual analog scale and compared. SPSS version 23 was used to analyze data.The mean pain score in the control group before and after the intervention was 5.34 and 5.62, respectively (P < .003), and in the intervention group, 5.28 and 4.03, respectively (P < .001).Benson's relaxation technique effectively influenced the intensity of postoperative spinal anesthesia-induced pain. Therefore, it can be used by nurses as a safe, simple, and inexpensive
Bupivacaine vs. Pethidine in Spinal Anesthesia of Old Patients: Haemodynamic Changes and Complications. Organ changes during the aging are one of the signifi cant events in old patients. rthopedic surgeries are common operations in these patients that accompany with hemodynamic changes as blood pressure decrease, heart rate, and respiratory rate change. On the other hand, pain management of the ancient patients due to negative consequences as tachycardia, blood pressure increase, and myocardial (...) posture by Quincke spinal needle 24 gauge, 12.5 mg of bupivacaine 0.5% (2.5 mL) injected in the subarachnoid space between L2-L3 or L3-L4. In the second group, in a same posture by applying the same spinal needle 24 gauge, 1 mg/kg of preservative-free pethidine injected in the subarachnoid space between L2-L3 or L3-L4. The patients evaluated for duration of anesthesia and analgesia, hemodynamic changes and complications such as headache, pruritus, shivering, urinary retention, and respiratory
no. SC040697). Association of Anaesthetists | The Anaesthesia Team 3 Contents 1. Recommendations 4 2. Introduction 4 3. Organisation and management 5 4. Pre-operative assessment 6 5. The operating department 7 6. The role of ‘anaesthetic assistant’ 8 7. Recovery in the post-anaesthetic care unit (PACU) 10 8. Postoperative pain management 10 9. References 11 To be reviewed by 2023 This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivs 4.0 International License CC BY-NC-ND4 (...) Association of Anaesthetists | The Anaesthesia Team Association of Anaesthetists | The Anaesthesia Team 5 1. Recommendations • Anaesthetic care within the peri-operative pathway can only be provided by an anaesthesia team led by consultant anaesthetists. All members of the team should be trained to nationally agreed standards. • Effective pre-operative assessment of patients for anaesthesia and surgery is vital. It improves safety, reduces cancellations, promotes efficient bed usage and can allay patients
Transversus abdominis plane block under laparoscopic guide versus port-site local anaesthetic infiltration in laparoscopic excision of endometriosis: a double-blind randomised placebo-controlled trial To compare the efficiency of laparoscopically guided transversus abdominis plane block (LTAP) versus port-site local anaesthetic infiltration (LAI) in reducing postoperative pain following laparoscopic excision of endometriosis.A prospective, double-blind randomised controlled trial.A tertiary
Liposomal Bupivacaine Versus Standard Periarticular Injection in Total Knee Arthroplasty With Regional Anesthesia: A Prospective Randomized Controlled Trial Liposomal bupivacaine (Exparel) is a long-acting local anesthetic preparation with demonstrated efficacy over placebo in reducing postoperative pain and opioid requirement. Limited comparative efficacy and cost-effectiveness data exist for its use in total knee arthroplasty (TKA) when used in a multimodal, opioid-sparing analgesic (...) and anesthetic approach. We hypothesized that liposomal bupivacaine offers no clinical advantage over our standard of care but carries significant economic impact.This is a prospective, randomized, single-blinded, controlled trial comparing liposomal bupivacaine periarticular injection (PAI) to our current approach including conventional bupivacaine PAI, in the setting of regional anesthesia. All adult unilateral TKA patients of the collaborating surgeon were eligible to participate in the study. Patients
Effects of fascia iliaca compartment block combined with general laryngeal mask airway anesthesia in children undergoing femoral fracture surgery: a randomized trial Postoperative agitation after general anesthesia is a common complication in children; however, pain or uncomfortable feeling is the main reason of emergence agitation. Here, we have investigated the effects of fascia iliaca compartment block (FICB) combined with general laryngeal mask airway (LMA) anesthesia in children undergoing (...) femoral surgery.Eighty children undergoing femoral surgery were randomly divided into two groups: FICB + LMA group and control group (n=40). The FICB + LMA group received FICB combined with general LMA anesthesia, and the control group received tracheal intubation general anesthesia alone. Anesthesia was maintained with nitrous oxide and sevoflurane. Hemodynamic parameters were monitored, and pain was assessed by verbal numeric score within 24 hours postoperatively. Time to extubation, time
• The decision to use a particular anesthetic technique for cesarean delivery (i.e., neuraxial versus general anesthe- sia) should be individualized based on anesthetic, obstet- ric, maternal, and fetal risk factors. There is a preference for neuraxial anesthesia over general anesthesia for most cesarean deliveries, but general anesthesia may be most appropriate in certain circumstances such as profound fetal bradycardia, ruptured uterus, severe maternal hemorrhage, and severe placental abruption 22 (IB-IV (...) effects, such as a transverse abdominis plane block, particularly if the cesarean delivery required general anesthesia, or the use of wound infiltration with a local anesthetic, may decrease systemic opioid consumption, provide better comfort during breastfeeding, and de- crease time to first breastfeed 50,51 (IIA). Postpartum pain management In addition to evaluating the effects of analgesia used during labor—or in the subset of women who may have had an intrapartum cesarean delivery after neuraxial
Obstetric Analgesia and Anesthesia Obstetric Analgesia and Anesthesia | ACOG Clinical Guidance Journals & Publications Patient Education Topics Featured Clinical Topics Hi, Featured Clinical Topics Clinical Guidance Obstetric Analgesia and Anesthesia Practice Bulletin Number 209 March 2019 Jump to Resources Share By reading this page you agree to ACOG's Terms and Conditions. . Although the availability of different methods of labor analgesia will vary from hospital to hospital, the methods (...) to participate in the management of epidural infusions. The purpose of this document is to review medical options for analgesia during labor and anesthesia for surgical procedures that are common at the time of delivery. Nonpharmacologic options such as massage, immersion in water during the first stage of labor, acupuncture, relaxation, and hypnotherapy are not covered in this document, although they may be useful as adjuncts or alternatives in many cases. Log in to read more This content is only available
Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia: The IRIS Randomized Clinical Trial The use of cricoid pressure (Sellick maneuver) during rapid sequence induction (RSI) of anesthesia remains controversial in the absence of a large randomized trial.To test the hypothesis that the incidence of pulmonary aspiration is not increased when cricoid pressure is not performed.Randomized, double-blind, noninferiority trial conducted in 10 academic (...) centers. Patients undergoing anesthesia with RSI were enrolled from February 2014 until February 2017 and followed up for 28 days or until hospital discharge (last follow-up, February 8, 2017).Patients were assigned to a cricoid pressure (Sellick group) or a sham procedure group.Primary end point was the incidence of pulmonary aspiration (at the glottis level during laryngoscopy or by tracheal aspiration after intubation). It was hypothesized that the sham procedure would not be inferior
Norepinephrine Infusion for Preventing Postspinal Anesthesia Hypotension during Cesarean Delivery: A Randomized Dose-finding Trial Norepinephrine has been recently introduced for prophylaxis against postspinal hypotension during cesarean delivery; however, no data are available regarding its optimum dose. The objective of this study is to compare three infusion rates of norepinephrine for prophylaxis against postspinal hypotension during cesarean delivery.The authors conducted a double-blinded
and special needs populations. Advanced training in recognition and manage- ment of pediatric emergencies is critical in providing safe sedation and anesthetic care. 1 Close collaboration between the dentist and the anesthesia providers can provide access to care, establish an enhanced level of patient cooperation, improve surgical quality, and offer an elevated level of patient safety during the delivery of dental care. Federal, state, and local credentialing and licensure laws, regulations, and codes (...) dental office, noting any that may be unique to these clinical circumstances? DS/GA= Deep sedation/General anesthesia. SHCN= Special health care needs. OMFS= Oral and maxillofacial surgery. * During the oral and maxillofacial surgery training program, a resident’s assignment to the department of anesthesiology “must be for a minimum of five months, should be consecutive and one of these months should be dedicated to pediatric anesthesia”. 11 This anesthesia experience is supplemented throughout
A Randomized Controlled Trial Comparing Epidural Analgesia Versus Continuous Local Anesthetic Infiltration Via Abdominal Wound Catheter in Open Liver Resection To compare outcomes following open liver resection (OLR) between patients receiving thoracic epidural (EP) versus abdominal wound catheters plus patient-controlled analgesia (AWC-PCA).Patients were randomized 1:1 to either EP or AWC-PCA within an enhanced recovery protocol. Primary outcome was length of stay (LOS), other variables (...) included functional recovery, pain scores, peak flow, vasopressor and fluid requirements, and postoperative complications.Between April 2015 and November 2017, 83 patients were randomized to EP (n = 41) or AWC-PCA (n = 42). Baseline demographics were comparable. No difference was noted in LOS (EP 6 d (3-27) vs AWC-PCA 6 d (3-66), P = 0.886). Treatment failure was 20% in the EP group versus 7% in the AWC-PCA (P = 0.09). Preoperative anesthetic time was shorter in the AWC-PCA group, 49 minutes versus 62
Effects of Combined Lower Thoracic Epidural/General Anesthesia on Pain Control in Patients Undergoing Elective Lumbar Spine Surgery: A Randomized Controlled Trial Randomized controlled trial.Our objective was to compare postoperative pain relief and operating field condition of single-shot, low-thoracic epidural anesthesia combined with general anesthesia versus general anesthesia alone.Prior studies have suggested that continuous epidural analgesia provides better postoperative pain relief (...) and less intraoperative blood loss, but with the risk of the epidural catheter contaminating the surgical field.A total of 22 patients scheduled for elective lumbar spine surgery were enrolled and randomly allocated into two groups. Group B (block) received a single-shot epidural block with 0.25% bupivacaine plus 4 mg of morphine with a total volume of 10 mL before receiving general anesthesia with desflurane, and cisatracurium. Group G (general) received general anesthesia alone with desflurane
APA Consensus Statement on updated fluid fasting guidelines for children prior to elective general anaesthesia ‘We the undersigned representatives of our respective national societies agree that, based on the current convincing evidence base, unless there is a clear contra-indication, it is safe and recommended for all children able to take clear fluids*, to be allowed and encouraged to have them up to one hour before elective general anaesthesia’ Charles Stack, President, Association
Evidence Basis for Regional Anesthesia in Ambulatory Anterior Cruciate Ligament Reconstruction: Part I-Femoral Nerve Block The optimal management of pain after ambulatory anterior cruciate ligament reconstruction (ACLR) is unclear. Femoral nerve block (FNB) is purported to enhance postoperative analgesia, but its effectiveness in the setting of modern multimodal analgesia is unclear. This systematic review examines the effect of adding FNB to multimodal analgesia on analgesic outcomes after
patients and frequently used dental anesthetic techniques. Recommendations: 1. Dry mucosa. 2. Topical anesthetic. 3. Initial infiltration along long axis of dental tooth. 4. Local anesthesia of the adjacent segment may be needed; therefore change needle direction at initial puncture site towards pre-maxilla, crossing cleft towards other side. Evidence Search Search (((cleft lip and palate)) AND local anesthetic) AND dental treatment Comments on The Evidence Validity: Limited articles with low level (...) Dentists Treating Cleft Lip and/or Palate Patients Will Need to Consider Anatomical Variations when Delivering Local Anesthetic UTCAT3331, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Dentists Treating Cleft Lip and/or Palate Patients Will Need to Consider Anatomical Variations when Delivering Local Anesthetic Clinical Question In cleft lip and palate patients, will altered anesthetic techniques be more effective
dentistry. IANB is commonly used but can induce higher post-operative trauma due to residual numbing affect to lip and tongue, risk of trismus, and facial nerve palsy. PDL injection is a simpler technique that provides adequate pain control, shorter post-operative anesthesia and overall, and uses less anesthetic solution. Specialty/Discipline (Endodontics) (General Dentistry) (Pediatric Dentistry) (Restorative Dentistry) Keywords anesthesia, inferior alveolar nerve block, intraligamental injection (...) The Periodontal Ligament (PDL) Injection for Anesthesia of Primary Mandibular Teeth is Less Traumatic and as Effective as the Inferior Alveolar Nerve Block (IANB) Injection UTCAT3326, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title The Periodontal Ligament (PDL) Injection for Anesthesia of Primary Mandibular Teeth is Less Traumatic and as Effective as the Inferior Alveolar Nerve Block (IANB) Injection Clinical Question