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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.
Recent Trends in the Practice of Procedural Sedation Under Local Anesthesia for Catheter Ablation, Gastrointestinal Endoscopy, and Endoscopic Surgery in Japan: A Retrospective Database Study in Clinical Practice from 2012 to 2015 To investigate changes in sedation practice during 2012-2015, using a large health claims database, for catheter ablation (CA), gastrointestinal endoscopic examination (EE), and surgery (ES) after dexmedetomidine (DEX) was approved for procedural sedation in 2013. We (...) assessed the trends of sedative utilization, sedative-analgesic combinations, and, additionally, incidence of complications from 2012 to 2015.Using the database provided by Medical Data Vision Co., Ltd. (Tokyo, Japan), annual utilization proportions of the sedatives and sedative-analgesic combinations and occurrence of complications were calculated in patients with a record of local anesthesia and CA, EE, and/or ES but without general anesthesia used on the same day. The sedatives studied were DEX
The Efficacy of Vibration Anesthesia on Reducing Pain Levels During Lip Augmentation: Worth the Buzz? Lip augmentation procedures have increased drastically in the last years as patients seek to enhance the shape and size of their lips with dermal fillers. One of the main concerns faced with these procedures is the pain inflicted through injections. On the other hand, many different techniques have been introduced for the reduction of pain while performing office-based minimal invasive (...) procedures.This study aims to determine the analgesic effect of vibration anesthesia during lip augmentation procedures and to evaluate its overall effect on the comfort of patients.A split-lip study was designed in a randomized fashion for 25 lip augmentation patients who received hyaluronic acid fillers with or without with a concurrent vibration stimulus on either half of their lips. Patients were asked to score the pain that they felt during lip injections on a scale from 0 to 10 (0 being no pain and 10
. Islocalanesthesiaeffectiveforpaincontrolinsurgicalabortion? Women receiving local cervical anesthesia alone for ?rst- trimestersurgicalabortionreport,onaverage,experiencing moderatepainrangingfrom4to7outof10[19,42–46]com- paredto8to9outof10withshamlocalcervicalanesthesia . The PCB anesthetizes the nervebundles lateral to the cervixat3o'clockand9o'clockaswellasthosewithinthe uterosacral ligaments. In a randomized controlled trial of 120 women undergoing surgical abortion at less than 11 weeks , a PCB with 20 mL of 1% buffered lidocaine (...) Pain control in surgical abortion part 1 ? local anesthesia and minimal sedation Reviewarticle SocietyofFamilyPlanningclinicalguidelinespaincontrolinsurgical abortionpart1 —localanesthesiaandminimalsedation RebeccaH.Allen a, ?,RameetSingh b a ObstetricsandGynecology,WarrenAlpertMedicalSchoolofBrownUniversity,WomenandInfantsHospital,101DudleyStreet,Providence,RI02905 b DivisionofFamilyPlanning,DepartmentofObstetricsandGynecology,UniversityofNewMexicoSchoolofMedicine,Albuquerque,NM87131 abstract
Ketamine-based anesthesia improves electroconvulsive therapy outcomes: a randomized-controlled study Major depressive disorder (MDD) is a common and debilitating condition that can be challenging to treat. Electroconvulsive therapy (ECT) is currently the therapeutic gold standard for treatment-resistant MDD. We tested our hypothesis that ketamine-based anesthesia for ECT results in superior improvement in treatment-resistant MDD outcomes compared with propofol-based anesthesia.Patients (...) with treatment-resistant MDD were enrolled in a randomized clinical trial with assignment to ketamine- or propofol-based anesthesia arms. Using a modified intention-to-treat analysis, we compared the median number of ECT treatments required to achieve a 50% reduction (primary outcome) and a score ≤ 10 (secondary outcome) on the Montgomery-Asberg depression rating scale (MADRS) between anesthesia groups.The study was terminated as significant results were found after the first planned interim analysis with 12
Psoas Compartment Block vs Periarticular Local Anesthetic Infiltration for Pain Management After Anterior Total Hip Arthroplasty: A Prospective, Randomized Study The psoas compartment block (PCB) or periarticular soft-tissue local anesthetic injection are forms of regional anesthesia often used as one of the components in multimodal anesthesia applied during total hip arthroplasty (THA). The most efficacious form of regional anesthesia for THA has yet to be determined.In a single-surgeon (...) , prospective, clinical trial, patients undergoing THA via direct anterior approach were randomized to receive an intraoperative periarticular local anesthetic infiltration (periarticular injection) or a PCB. Postoperative pain scores, narcotic consumption, and complications were recorded.Forty-nine patients were randomized to the PCB and 50 were randomized to the periarticular injection. The resting pain score 3 hours postoperatively was statistically significantly lower in the periarticular injection
Use of platelet transfusions prior to lumbar punctures or epidural anaesthesia for the prevention of complications in people with thrombocytopenia. People with a low platelet count (thrombocytopenia) often require lumbar punctures or an epidural anaesthetic. Lumbar punctures can be diagnostic (haematological malignancies, subarachnoid haematoma, meningitis) or therapeutic (spinal anaesthetic, administration of chemotherapy). Epidural catheters are placed for administration of epidural (...) anaesthetic. Current practice in many countries is to correct thrombocytopenia with platelet transfusions prior to lumbar punctures and epidural anaesthesia, in order to mitigate the risk of serious procedure-related bleeding. However, the platelet count threshold recommended prior to these procedures varies significantly from country to country. This indicates significant uncertainty among clinicians regarding the correct management of these patients. The risk of bleeding appears to be low
Effect of adding dexamethasone to lidocaine on the quality of intravenous regional anesthesia for upper extremity orthopedic operations: A randomized clinical trial Intravenous regional anesthesia (IVRA) is an ideal technique for short surgery on the distal extremities. Different additives have been used to improve lidocaine's block quality.The aim of this study was to determine the effect of adding dexamethasone to lidocaine on improving the quality of IVRA.This study is a prospective, double
Anaesthetizing childrenâ€”From a nurse anaesthetist's perspectiveâ€”A qualitative study The aim of this study was to describe nurse anaesthetists' experiences of encountering and caring for children in connection to anaesthesia.Qualitative design.Sixteen written narratives based on eight nurse anaesthetists' experiences of meeting children was analysed using qualitative content analysis.The overarching theme was: "anaesthetizing children is a complex caring situation, including interactions (...) ' needs are essential for an optimal caring situation. Organizations need to realize that extra time, skills and resources are needed to safely anaesthetize children.
Bilateral corneal denting after surgery under general anesthesia: A case report To report a case of temporary bilateral corneal denting in a patient who underwent cardiovascular surgery under general anesthesia.A 71-year-old male with no history of ophthalmological disease experienced bilateral corneal denting immediately after undergoing surgery for aneurysm of the thoracic aorta under general anesthesia. Anesthesia was induced with propofol and maintained with rocuronium bromide (...) and remifentanil hydrochloride. The initial examination revealed significant denting on the surface of both the corneas and ocular hypotension. Visual evaluation could not be performed due to the patient's low level of consciousness resulting from delayed emergence from anesthesia. After applying tropicamide and phenylephrine ophthalmic solution for fundus examination, the ocular morphology improved. Ocular pressure was normal on the day after surgery, and creasing on the surface of the corneas had
propofol sedation; ECG, electrocardiogram; MAC, monitored anesthesia care; NAAP, non-anesthesiologist–administered propofol sedation; NAPS, nurse-administered propofol sedation; RN, registered nurse. REFERENCES 1. Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336:924-6. 2. Practice guidelines for sedation and analgesia by non-anesthesiolo- gists. Anesthesiology 2002;96:1004-17. 3. Faigel DO, Baron TH, Goldstein (...) population. Clin Gastroenterol Hepatol 2012;10:58-64. 65. Tetzlaff JE, Vargo JJ, Maurer W. Nonoperating room anesthesia for the gastrointestinal endoscopy suite. Anesthesiol Clin 2014;32:387-94. 66. American Society of Anesthesiology. Statement on anesthesia care for endoscopic procedures 2014. Available at https://www.asahq.org/For- Members/Standards-Guidelines-and-Statements.aspx. Accessed June 14, 2015. 67. Practice guidelines for postanesthetic care: a report by the American Society
Inhalational versus IV Induction of Anesthesia in Children with a High Risk of Perioperative Respiratory Adverse Events: A Randomized Controlled Trial Limited evidence suggests that children have a lower incidence of perioperative respiratory adverse events when intravenous propofol is used compared with inhalational sevoflurane for the anesthesia induction. Limiting these events can improve recovery time as well as decreasing surgery waitlists and healthcare costs. This single center open (...) -label randomized controlled trial assessed the impact of the anesthesia induction technique on the occurrence of perioperative respiratory adverse events in children at high risk of those events.Children (N = 300; 0 to 8 yr) with at least two clinically relevant risk factors for perioperative respiratory adverse events and deemed suitable for either technique of anesthesia induction were recruited and randomized to either intravenous propofol or inhalational sevoflurane. The primary outcome
Comparison of Paravertebral Block by Anatomic Landmark Technique to Ultrasound-Guided Paravertebral Block for Breast Surgery Anesthesia: A Randomized Controlled Trial Paravertebral block (PVB) is an established technique for providing anesthesia for breast surgery. The primary objective was to compare anatomical landmark technique (ALT) to the ultrasound-guided (USG) PVB block for providing surgical anesthesia. Secondary objectives included comparison of perioperative analgesia (...) and complications.This randomized, controlled, observer-blinded study included 72 females, aged 18 to 65 years, American Society of Anesthesiologists physical status I or II, undergoing elective unilateral breast surgery. Study participants were randomized to the ALT group or USG group. Ipsilateral PVB was performed with the respective technique from T1 to T6. Five milliliters of local anesthetic mixture (0.5% ropivacaine, 5 μg/mL adrenaline, 1 μg/kg clonidine) was administered at each level. Paravertebral catheter
of the patients, which might affect the perception of knee pain, was not evaluated. The follow-up period was 2 months; this period might be insufficient to validate the short-term effects of GNB.Ultrasound-guided GNB, when combined with a local anesthetic and corticosteroid, can provide short-term pain relief. However, the clinical benefit of corticosteroid administration was not clear in comparison with local anesthesia alone. Given the potential adverse effects, corticosteroids might not be appropriate (...) Ultrasound-Guided Genicular Nerve Block for Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial of Local Anesthetic Alone or in Combination with Corticosteroid Recently, several studies suggested that radiofrequency (RF) ablation of the genicular nerves is a safe and effective therapeutic procedure for intractable pain associated with chronic knee osteoarthritis (OA). Diagnostic genicular nerve block (GNB) with local anesthetic has been generally conducted before making decisions
Utility of anesthetic block for endometrial ablation pain: a randomized controlled trial Second-generation endometrial ablation has been demonstrated safe for abnormal uterine bleeding treatment, in premenopausal women who have completed childbearing, in short-stay surgical centers and in physicians' offices. However, no standard regarding anesthesia exists, and practice varies depending on physician or patient preference and hospital policy and setting.The aim of this study was to evaluate (...) whether local anesthetic, in combination with general anesthesia, affects postoperative pain and associated narcotic use following endometrial ablation.This was a single-center single-blind randomized controlled trial conducted in an academic-affiliated community hospital. A total of 84 English-speaking premenopausal women, aged 30 to 55 years, who were undergoing outpatient endometrial ablation for benign disease were randomized to receive standardized paracervical injection of 20 mL 0.25
General versus spinal anaesthesia for caesarean section: a quasi-controlled trial. General anaesthesia and spinal anaesthesia are commonly used for caesarean sections. The aim of this study was to compare the outcomes from caesarean sections with these two types of anaesthesia.In this quasi-controlled trial, we enrolled women undergoing caesarean sections at Al-Helal Al-Emirati Hospital, Rafah, Gaza Strip. Women were assigned either to general anaesthesia (20% intravenous propofol (...) for anaesthesia induction followed by atracurium for muscle relaxation, and nitrous oxide and oxygen for anaesthesia maintenance) or to spinal anaesthesia (0·5% hyperbaric solution bupivacaine with 20 μg fentanyl intrathecally). Outcome measures were length of hospital stay, length of operation, postoperative pain assessment by visual analogue scales (VAS; range 0-10, where 0 is no pain and 10 is very bad pain) 1 hour after the operation, time from anaesthesia to demand for analgesia, amount of analgesics
2018LancetControlled trial quality: predicted high
Anesthesia Assistance in Outpatient Colonoscopy and Risk of Aspiration Pneumonia, Bowel Perforation, and Splenic Injury The increase in use of anesthesia assistance (AA) to achieve deep sedation with propofol during colonoscopy has significantly increased colonoscopy costs without evidence for increased quality and with possible harm. We investigated the effects of AA on colonoscopy complications, specifically bowel perforation, aspiration pneumonia, and splenic injury.In a population-based
Initiation of labor analgesia with injection of local anesthetic through the epidural needle compared to the catheter The rationale for injection of epidural medications through the needle is to promote sooner onset of pain relief relative to dosing through the epidural catheter given that needle injection can be performed immediately after successful location of the epidural space. Some evidence indicates that dosing medications through the epidural needle results in faster onset and improved (...) quality of epidural anesthesia compared to dosing through the catheter, though these dosing techniques have not been compared in laboring women. This investigation was performed to determine whether dosing medication through the epidural needle improves the quality of analgesia, level of sensory blockade, or onset of pain relief measured from the time of epidural medication injection.In this double-blinded prospective investigation, healthy term laboring women (n=60) received labor epidural placement
Efficacy of local dexmedetomidine add-on for spermatic cord block anesthesia in patients undergoing intrascrotal surgeries: randomized controlled multicenter clinical trial The objective of this study was to evaluate the effect of adding dexmedetomidine (DEX) to bupivacaine on the quality of spermatic cord block anesthesia and postoperative analgesia.This is a randomized, double-blind study.This study was performed in an educational and research hospital.One hundred twenty adult males were
underwent surgery with complete handover of anesthesia care. The percentage of patients undergoing surgery with a handover of anesthesiology care progressively increased each year of the study, reaching 2.9% in 2015. In the unweighted sample, the primary outcome occurred in 44% of the complete handover group compared with 29% of the no handover group. After adjustment, complete handovers were statistically significantly associated with an increased risk of the primary outcome (adjusted risk difference (...) Association Between Handover of Anesthesia Care and Adverse Postoperative Outcomes Among Patients Undergoing Major Surgery. Handing over the care of a patient from one anesthesiologist to another occurs during some surgeries and might increase the risk of adverse outcomes.To assess whether complete handover of intraoperative anesthesia care is associated with higher likelihood of mortality or major complications compared with no handover of care.A retrospective population-based cohort study