Current Issue : January - March Volume : 2021 Issue Number : 1 Articles : 7 Articles
Background: Arteriovenous fistulae (AVF) are the hemodialysis access modality of choice for patients with endstage\nrenal disease. However, they have a high early failure rate. Good vascular access is essential to manage longterm\nhemodialytic treatment, but some anesthesia techniques directly affect venous diameter as well as intra- and\npost-operative blood flow. The main purpose of this meta-analysis was to compare the results of regional and local\nanesthesia (RA and LA) for arteriovenous fistula creation in end-stage renal disease.\nMethods: We conducted a systematic review and meta-analysis to synthesize evidence from 7 randomized\ncontrolled trials (565 patients) and 1 observational study (408 patients) with the aim of evaluating the safety and\nefficacy of RA versus LA in surgical construction of AVF.\nResults: Pooled data showed that RA was associated with higher primary patency rates than LA (odds ratio [OR],\n1.88; 95% confidence interval.......................
Background: Inadvertent intravascular injection has been suggested as the most probable mechanism behind serious\nneurological complications during transforaminal epidural steroid injections. Authors believe a smaller gauge needle may\nlead to less intravascular uptake and less pain. Theoretically, there is less chance for a smaller gauge needle to encounter\na blood vessel during an injection compared to a larger gauge needle. Studies have also shown smaller gauge needle to\ncause less pain. The aim of the study was to quantify the difference between a 22-gauge needle and 25-gauge needle\nduring lumbosacral transforaminal epidural steroid injection in regards to intravascular uptake and pain perception.\nMethods: This was a prospective single blind randomized clinical trial performed at outpatient spine practice locations of\ntwo academic institutions. One hundred sixty-two consecutive patients undergoing lumbosacral transforaminal epidural\ninjections from February 2018 to June 2019 were recruited and randomized to each arm of the study â?? 84 patients were\nrandomized to the 22-gauge needle arm and 78 patients to 25-gauge arm. Each transforaminal injection level was\nconsidered a separate incidence, hence total number of incidence was 249 (136 in 22-gauge arm and 113 in 25-gauge\narm). The primary outcome measure was intravascular uptake during live fluoroscopy and/or blood aspiration. The\nsecondary outcome measure was patient reported pain during the procedure on the numerical rating scale.\nResults: Fisher exact test was used to detect differences between 2 groups in regards to intravascular uptake and paired\nt-tests were used to detect differences in pain scores...............................
Background: Dexmedetomidine has advantages during colonoscopy as it allows the patient to cooperate during\nthe procedure. Few studies examined the dexmedetomidine-remifentanil combination. This study was to evaluate\nthe effects of different doses of the dexmedetomidine-remifentanil combination in colonoscopy.\nMethods: This was a prospective trial carried out at the Fourth Hospital of Hebei Medical University between 02/\n2018 and 10/2018. ........................
Background: To observe the effect of pretreatment with ketorolac tromethamine on sufentanil-induced cough in\ngeneral anesthesia patients.\nMethods: A total of 102 patients were screened, and 90 patients were scheduled for elective surgery under general\nanesthesia. The 90 patients were randomly divided into two groups: the control group (C group) and the\nobservation group (KT group). Five minutes before anesthesia induction, the observation group was given ketorolac\ntromethamine 0.5 mg/kg intravenously within 3 s, while the control group was given the same amount of normal\nsaline intravenously....................................
Background: Postoperative pain in ambulatory surgery is a multifactorial issue affecting patient satisfaction, time of\ndischarge, and rehospitalization. This study evaluated the efficacy and safety of nalbuphine for the treatment of\npostoperative pain after ambulatory surgery, relative to tramadol.\nMethods: This multi-center, randomized, double blind, and controlled study was conducted at 10 centers. In\naccordance with the inclusion criteria, 492 ambulatory surgery patients were recruited. These patients had\nmoderate to severe pain after ambulatory surgery, with a visual analogue scale (VAS) score > 3 cm. They were\nrandomly divided into an experimental (n = 248) or control (n = 244) group and treated for analgesia with 0.2 mg/\nkg of nalbuphine or 2 mg/kg of tramadol, respectively. VAS scores, adverse events, and vital signs of the patients\nwere recorded before administration............................................
Background: Based on the previous investigation in our institution, the incidence of intraoperative hypothermia in\nneonates was high. Since September 1st, 2019, the recommendation had been launched to utilize less than equal to 1 L/min fresh\ngas flow during the neonatesâ?? surgical procedure. We therefore intended to evaluate the association between low\nfresh gas flow anesthesia and the occurrence of hypothermia in neonates undergoing digestive surgeries.\nMethods: A retrospective chart review, before-after study was conducted for neonates who underwent digestive\nsurgeries. The primary outcomes were the incidence of hypothermia. The secondary outcomes included hospital\nmortality, the value of lowest temperature, blood loss, mean body temperature during the surgery, the length of\nhypothermia during the surgery and postoperative hospital length-of- stay (PLOS).\nResults: 249 neonates fulfilled the eligibility criteria. The overall incidence of intraoperative hypothermia was 81.9%.\nThe low fresh gas flow anesthesia significantly reduced the odds of hypothermia [routine group: 149 (87.6%) versus\nlow flow group.................................
Background: Hydranencephaly is a rare and debilitating congenital condition in which most anesthesiologists are\nunfamiliar. Primary surgical treatment involves CSF diversion, though other palliative procedures requiring\nanesthesia are often required. With medical advancements and a resulting prolonged life expectancy, caring for\nthese patients is becoming more routine.\nCase presentation: We follow an infant with hydranencephaly over three different procedures requiring anesthesia\nfrom 5 months of age to 2 years, highlighting the various anesthetic considerations.\nConclusions: Anticipation of difficult positioning, deliberate airway management, and attention to anesthetic\nrecovery were all necessary to safely care for this patient. An understanding of the challenges this particular\ncondition poses will help anesthesiologists provide the most safe and effective care when encountering these\npatients....
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