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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.
Intraoperative Completion Studies, Local Anesthesia, and Antiplatelet Medication Are Associated With Lower Risk in Carotid Endarterectomy In Germany, all surgical and endovascular procedures on the carotid bifurcation must be documented in a statutory nationwide quality assurance database. We aimed to analyze the association between procedural and perioperative variables and in-hospital stroke or death rates after carotid endarterectomy.Between 2009 and 2014, overall 142 074 elective carotid (...) . In the multivariable analysis, lower risks of stroke or death were independently associated with local anesthesia (versus general anesthesia: RR, 0.85; 95% confidence interval [CI], 0.75-0.95), carotid endarterectomy with patch plasty compared with primary closure (RR, 0.71; 95% CI, 0.52-0.97), intraoperative completion studies by duplex ultrasound (RR, 0.74; 95% CI, 0.63-0.88) or angiography (RR, 0.80; 95% CI, 0.71-0.90), and perioperative antiplatelet medication (RR, 0.83; 95% CI, 0.71-0.97). No shunting
performance in adolescence. There may be vulnerable groups that are at higher risk. Conflicts of interest: the authors had no conflicts of interest. Funding source: various grants from Swedish institutions. Critical Commentary Justification: data from animal model studies suggest that exposure to anaesthetic agents at early ages causes neuronal apoptosis and long-term learning and memory impairment. 1 Since millions of children require anaesthesia for surgical interventions every year, these findings have (...) anestésicos versus retrasos en los procedimientos indicados que podrían ser perjudiciales para los pacientes. Referencias 1 Andropoulos DB, Greene MF. Anesthesia and developing brains – Implications of the FDA warning. NEJM. 2017. DOI: 10.1056/NEJMp1700196 2 Davidson AJ, Disma N, de Graaff JC, Withington DE, Dorris L, Bell G, et al . Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled
patients requiring bilateral local anesthetic injections. Randomized Controlled Trial Key results The split-mouth study evaluated anticipated and actual pain for inferior-alveolar, palatal, long buccal, and infraorbital injections given via an intraoral vibration device. Actual pain upon injection was significantly less than anticipated pain for inferior alveolar (P Evidence Search ("pain"[MeSH Terms] OR "pain"[All Fields]) AND ("local anaesthesia"[All Fields] OR "anesthesia, local"[MeSH Terms (...) Research indicates Reduction of Pain upon Inferior Alveolar and Infraorbatial injection Using Vibrating Intraoral Local Anesthetic Devices UTCAT3207, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Research indicates Reduction of Pain upon Inferior Alveolar and Infraorbatial injection Using Vibrating Intraoral Local Anesthetic Devices Clinical Question In patients with fear of dental injections, do vibrating intraoral
Liposomal Bupivacaine May Prove to Provide Adequate Long-Term Local Anesthesia UTCAT3208, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Liposomal Bupivacaine May Prove to Provide Adequate Long-Term Local Anesthesia Clinical Question Is liposomal bupivacaine (Exparel) effective in providing extended local anesthesia and reducing post-operative opioid use in a variety of dental procedures? Clinical Bottom Line (...) For patients receiving endodontic care or third molar extractions, there is not enough evidence to support the conclusion that liposomal bupivacaine is any more effective than other anesthesia medications. This is supported by a randomized double-blinded study in which buccal infiltration of liposomal bupivacaine was shown to not achieve clinically relevant levels of anesthesia for prolonged periods of time. A systematic review of liposomal bupivacaine showed inconclusive evidence to support that liposomal
local anesthesia infiltration, does the warming of the cartridge pre-injection reduce the anticipated injection pain compared to using cartridges at room temperature? Clinical Bottom Line Warming of local anesthetic cartridges does not reduce pain and discomfort during intraoral infiltration injections. This is supported by a randomized controlled clinical trial that showed that children's objective and subjective reactions to warmed and room temperature injections were not statistically different (...) between the children’s reactions to the warm (W) and room temperature (RT) injections on any of the three parameters. Evidence Search ("review"[All Fields] OR "review literature as topic"[MeSH Terms] OR "systematic review"[All Fields]) AND warming[All Fields] AND ("local anaesthesia"[All Fields] OR "anesthesia, local"[MeSH Terms] OR ("anesthesia"[All Fields] AND "local"[All Fields]) OR "local anesthesia"[All Fields] OR ("local"[All Fields] AND "anesthesia"[All Fields])) Comments on The Evidence
Local anesthetic toxicity: acute and chronic management Local anesthetics are commonly used medicines in clinical settings. They are used for pain management during minor interventional treatments, and for postoperative care after major surgeries. Cocaine is the well-known origin of local anesthetics, and the drug and related derivatives have long history of clinical usage for more than several centuries. Although illegal use of cocaine and its abuse are social problem in some countries, other (...) local anesthetics are safely and effectively used in clinics and hospitals all over the world. However, still this drug category has several side-effects and possibilities of rare but serious complications. Acute neurotoxicity and cardiac toxicity are derived from unexpected high serum concentration. Allergic reactions are observed in some cases, especially following the use of ester structure drugs. Chronic toxicity is provoked when nerve fibers are exposed to local anesthetics at a high
The Influence of Oral Ginger before Operation on Nausea and Vomiting after Cataract Surgery under General Anesthesia: A double-blind placebo-controlled randomized clinical trial. According to Iranian traditional medicine, using safe ginger may contribute to taking less chemical medicines and result in fewer side effects.To determine the influence of using ginger before operation on nausea and vomiting, after cataract surgery under general anesthesia.This study was a double-blind placebo
Topical anaesthesia for needle-related pain in newborn infants. Hospitalised newborn neonates frequently undergo painful invasive procedures that involve penetration of the skin and other tissues by a needle. One intervention that can be used prior to a needle insertion procedure is application of a topical local anaesthetic.To evaluate the efficacy and safety of topical anaesthetics such as amethocaine and EMLA in newborn term or preterm infants requiring an invasive procedure involving (...) anaesthetics amethocaine and eutectic mixture of local anaesthetics (EMLA) in terms of anaesthetic efficacy and safety in newborn term or preterm infants requiring an invasive procedure involving puncture of skin and other tissues with a needle DATA COLLECTION AND ANALYSIS: From the reports of the clinical trials we extracted data regarding clinical outcomes including pain, number of infants with methaemoglobin level 5% and above, number of needle prick attempts prior to successful needle-related procedure
Comparison of Regional vs. General Anesthesia for Surgical Repair of Open-Globe Injuries at a University Referral Center This study compares the clinical features and physician selection of either Regional Anesthesia (peribulbar or retrobulbar block) with Monitored Anesthesia Care (RA-MAC) or General Anesthesia (GA) for open globe injury repair.A non-randomized, comparative, retrospective case series at a University Referral Center.All adult repairable open globe injuries receiving primary (...) repair between January 1st, 2004 and December 31st, 2014 (11 years). Exclusion criteria were patients less than 18 years of age and those treated with primary enucleation.Data was gathered via retrospective chart review.Data collected from each patient was age, gender, injury type, location, length of wound, presenting visual acuity, classification of anesthesia used, duration of the procedure performed, months of clinical follow-up, and final visual acuity.During the 11 years study period, 448
Palliative radiation therapy for superior vena cava syndrome in metastatic Wilms tumor using 10XFFF and 3D surface imaging to avoid anesthesia in a pediatric patientâ€”a teaching case 28740919 2018 11 13 2452-1094 2 1 2017 Jan-Mar Advances in radiation oncology Adv Radiat Oncol Palliative radiation therapy for superior vena cava syndrome in metastatic Wilms tumor using 10XFFF and 3D surface imaging to avoid anesthesia in a pediatric patient-a teaching case. 101-104 10.1016/j.adro.2016.12.007
AND DEPOLARIZING MUSCLE RELAXANTS Background Potent volatile anesthetic agents are widely used and generally safe agents for inducing general anesthesia. The mechanism of action of these agents is unknown in spite of many hypotheses and inves- tigations. The agents include sevoflurane, halothane, enflurane, isoflurane, methoxyflurane, and desflurane; all of the currently available potent inhalation anesthetics are presumed to be equiva- lent triggers of malignant hyperthermia (MH). Depolarizing muscle (...) . If succinylcholine was administered, masseter muscle rigidity is often the first sign of MH. 5 If left untreated, an MH reaction can re- sult in cardiac arrest and death. 4 Any of the potent volatile anes- thetics, and the depolarizing muscle relaxant succinylcholine, can trigger an MH reaction in susceptible individuals. 5 Potent volatile anesthetics and succinylcholine are contraindicated in individu- als with MHS. MH episodes have an estimated incidence of be- tween 1/10,000 and 1/250,000 anesthesias
serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. Background T hereislittlerigorousinformationinthescienti?c literature about anesthesia or procedural sedation in breastfeeding mothers. Recommendations in this area typi- cally focus on pharmacologic properties of anesthetic agents, limited (...) , single doses of meperidine/pethidine or diazepam are unlikely to affect the breastfeeding infant. 15 (III) Local anesthetics given by injection or topical application are considered safe for breastfeeding mothers. 2,3 (IV) Regional anesthesia. Regional anesthesia, including spinal, epidural, or peripheral nerve block, should be con- sidered whenever possible, whether for intraoperative anes- thesia or postoperative analgesia. 3 (IV) Regional anesthesia reduces the need for intraoperative medications
Pre-procedural fasting for inpatients undergoing interventional radiology or cardiac procedures not requiring general anesthesia Pre-procedural fasting for inpatients undergoing interventional radiology or cardiac procedures not requiring general anesthesia Pre-procedural fasting for inpatients undergoing interventional radiology or cardiac procedures not requiring general anesthesia Lavenberg JG, Holland S, Solano L, Stoudt G, Mitchell MD, Mull, N. Record Status This is a bibliographic record (...) of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Lavenberg JG, Holland S, Solano L, Stoudt G, Mitchell MD, Mull, N.. Pre-procedural fasting for inpatients undergoing interventional radiology or cardiac procedures not requiring general anesthesia. Philadelphia: Center for Evidence-based Practice (CEP). 2017 Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Anesthesia
of booking, but the duty remains on the anaesthetist to ensure that the information is understood. 2 Immediately before induction of anaesthesia, for example in the anaesthetic room, is not an accept- able time to provide elective patients with new information other than in exceptional circum- stances. 3 The amount and the nature of information that should be provided to the patient should be deter- mined by the question: ‘What would this particu- lar patient regard as relevant when coming to a decision (...) ‘treatment’ is used in this document to indicate both treatment in the usual sense, that is, something used to ‘treat’ (alleviate) something, and also an anaesthetic intervention such as general/regional anaesthesia, etc). The importance of consent Ethical aspects Clinicians have an ethical obligation to respect patients’ autonomy – that is, their right to be involved in decisions that affect them. In medicine, this is re?ected in the requirement to obtain consent for treatment, which can only be valid
minutes and for a maximum of 45 minutes. Timing of cuff times and inflation pressure reading should be clearly documented. 8. Effectiveness of this guideline should be continuously monitored by means of audit, clinical incident review, clinician feedback, and patient complaints. 9. Clinical staff using local anaesthetics should have ready access to intra-lipid. Intravenous Regional Anaesthesia for Distal Forearm Fractures (Bier’s Block) (revised Nov 2017) 3 Scope To assist emergency physician using (...) of these fractures require manipulation within the Emergency Department using the two commonest methods either Haematoma block or Bier’s block (IVRA). There is evidence to state that haematoma block provides less analgesia and can compromise reduction. Due to reported toxicity of different local anaesthetic agents, Bupivacaine and more rarely lignocaine, Prilocaine is the recommended agent for use in intravenous regional anaesthesia. Indication: Reduction of wrist fractures, most commonly Colles’ fracture
The effect of hydroalcoholic extract of Achillea eriophora DC. on blood pressure of anaesthetized male rat Achillea eriophora (Asteraceae) is a medicinal plant commonly used in Iran. This study was performed to determine the cardiovascular effects of hydroethanolic extract of A. eriophora (HEAE) and the underlying mechanisms in anaesthetized rats. The acute effects of intravenous (i.v.) administration of different doses of HEAE (40, 50, 60, 80 mg/kg), and its probable interaction
and local preemptive; B, spinal and local preemptive; C, general and placebo; D, spinal and placebo. After general or spinal anesthesia, each patient randomly received an injection of 7 mL of a mixture of local anesthetics or the same amount of normal saline. After 2, 4, 8, 12, 16, 24, 48, and 72 hours following the release of the tourniquet, the pain intensity level was measured with a visual analog scale (VAS). The use of additional analgesics and any adverse effects were also noted.Preemptive local (...) anesthesia (groups A and B) resulted in a significantly lower level of pain intensity during the first 24 hours after surgery. Until 8 hours after the release of the tourniquet, the pain intensity level was statistically lower in the groups A, B, and D in comparison to C. During hospitalization, none of the patients from groups A and B received on-demand ketoprofen intravenously. No side effects of local anesthetic agents were observed. Two patients had transient numbness and paresthesia in the field
Efficacy of Local Anesthetic With Dexamethasone on the Quality of Recovery Following Total Extraperitoneal Bilateral Inguinal Hernia Repair: A Randomized Clinical Trial Quality of recovery (directly associated with patient satisfaction) is an important clinical outcome measurement and a surrogate of anesthetic/surgical care quality.To compare the efficacy of a transversus abdominis plane (TAP) block with dexamethasone sodium phosphate and preperitoneal instillation of local anesthetic (PILA (...) ) with dexamethasone vs control on postoperative quality of recovery following a bilateral total extraperitoneal inguinal hernia repair (TEP-IHR) (>24 hours). Secondary objectives included efficacy of this technique on postoperative opioid use, nausea and vomiting, and pain scores.Conducted from November 2013 to August 2015, this randomized, prospective, single-blinded study compared 2 groups (a TAP block and PILA) with a standard anesthetic technique with no regional technique (control) following bilateral TEP
Opioid use after propofol or sevoflurane anesthesia: a randomized trial The intravenous anesthetic propofol is a gamma-aminobutyric acid A receptor agonist. Propofol promotes analgesia by depressing nociceptive transmission in peripheral neurons, antagonizing N-methyl-D-aspartate receptors, and activating gamma-aminobutyric acid A receptors in dorsal root ganglion receptor cells. Nevertheless, it remains unclear whether intraoperative propofol causes clinically meaningful postoperative (...) analgesia. We therefore tested the hypothesis that patients anesthetized with sevoflurane require a greater quantity of postoperative opioids (from the end of surgery until the next postoperative morning) than those anesthetized with propofol.With Institutional Review Board and EudraCT Number approval (2009-011038-82) and patients' informed consent, ninety patients scheduled for open vein stripping were randomized to either sevoflurane or propofol anesthesia at the Medical University of Vienna General
Moderate hypothermia and its effects in reducing the applied dose of anesthetics for patients with opium dependence in cardiac surgery: A randomized controlled trial. An increasing number of patients addicted to opium are experiencing awareness during coronary artery bypass surgery (CABG) as a result of tolerance to anesthetics.This research was primarily intended to determine the potential diminishing effects of moderate hypothermia on anesthetic dosage and recall of anesthesia during (...) and tear-shedding. To enhance the accuracy of our evaluation of anesthetic depth, we also used two questionnaires to test candidates' recall filled with the assistance of a colleague 24 hours following surgery. Independent-samples t-test and chi-square test were used by SPSS v 18 for data analysis.Eighty patients were studied in two groups of normothermic (N) (n = 40) and hypothermic (H) (n = 40). Given similar demographic data as well as the duration of surgery, we arrived at a propofol dose of 122.52