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181. Propofol sparing effect of dexmedetomidine and magnesium sulfate during BIS targeted anesthesia: A prospective, randomized, placebo controlled trial. (Abstract)

Propofol sparing effect of dexmedetomidine and magnesium sulfate during BIS targeted anesthesia: A prospective, randomized, placebo controlled trial. Maintenance of adequate depth of anesthetic is crucial to prevent awareness and to reduce stress response associated with surgery. Goals of balanced general anesthetic are met by use of adjuvants to facilitate use of lower anesthetic dose, while ensuring adequate anesthetic depth. This study employed BIS monitoring to compare the anesthetic

2019 Journal of anaesthesiology, clinical pharmacology Controlled trial quality: uncertain

182. Intraoperative hypotension is a risk factor for postoperative acute kidney injury after femoral neck fracture surgery: a retrospective study. Full Text available with Trip Pro

disease, preoperative blood urea nitrogen (BUN), preoperative estimated glomerular filtration rate (eGFR), preoperative haemoglobin (Hb) level, type of operation, postoperative creatinine level and intraoperative hypotension (P <  0.05). After controlling for confounding variables, intraoperative hypotension was only the independent risk factor for acute kidney injury (P = 0.012).Acute kidney injury was found to occur frequently after surgery for femur neck fracture. Surgeons should be aware of acute

2019 BMC Musculoskeletal Disorders

183. An unusual delayed onset of systemic toxicity after fluoroscopy-guided cervical epidural steroid injection with levobupivacaine: A case report. (Abstract)

was administrated. After 50 minutes of injection, the patient showed CNS toxicity (unconsciousness, seizure) with normal blood pressure and tachycardia; therefore, she was immediately sedated with intravenous midazolam (3 mg), and 15 L/min of oxygen was administered. The patient fully recovered after 30 minutes of sedation without any sequelae.Delayed onset of LAST is a rare complication of a common procedure in CESI, so it is important to be aware of this complication and the presentation of toxicity.© 2019

2019 Pain Practice

184. Post-traumatic stress in the postoperative period: current status and future directions. (Abstract)

, with additionally elevated rates in specific surgical groups. Potential risk factors include the perceived uncontrollable nature of high-risk surgery, psychiatric history, intraoperative awareness, dissociation, surgical complications, medication administration, delirium, and pain. PTSD after surgery may manifest in ways that are distinct from traditional conceptualizations of PTSD. Identification of perioperative risk factors and stress symptoms in the early postoperative period may provide opportunities

2019 Canadian Journal Of Anaesthesia

185. Pediatric Intraocular Pressure Measurements: Tonometers, Central Corneal Thickness, and Anesthesia. Full Text available with Trip Pro

Pediatric Intraocular Pressure Measurements: Tonometers, Central Corneal Thickness, and Anesthesia. Measuring intraocular pressure (IOP) is the cornerstone of a comprehensive glaucoma examination. In babies or small children, however, IOP measurements are problematic, cannot often be performed at the slit lamp, and sometimes require general anesthesia. Therefore, it is essential for an ophthalmologist who examines a pediatric patient to be aware of the different tonometers used in children (...) and thinner corneas having artifactually lower IOP readings. Although various machines can be used to compensate for corneal factors (e.g., the dynamic contour tonometer and ocular response analyzer), it is important to be aware that certain ocular diseases can be associated with abnormal central corneal thickness values and that their IOP readings need to be interpreted accordingly. Because induction and anesthetics can affect IOP, office IOPs taken in awake patients are always the most

2019 Survey of Ophthalmology

186. Upper Cervical Epidural Abscess Resulting in Respiratory Compromise After Lumbar Steroid Injection. (Abstract)

and respiratory distress secondary to the space-occupying lesion near his spinal cord. His hospital course included surgical decompression and antibiotics. He was eventually discharged to rehabilitation, but never regained full strength in his arms or legs. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Patients who present with back or neck pain, fever, and neurologic deficits may have epidural abscess. In some patients, neurologic deficits may include respiratory distress if the upper cervical region

2019 Journal of Emergency Medicine

187. A Spontaneous Cervical Epidural Hematoma Mimicking a Stroke: A Challenging Case. (Abstract)

present a case where an SCEH mimicked the much more frequent condition of a stroke, and discuss the importance of diagnostics procedures that help differentiate SCEH from acute cerebral infarction. The patient's history of neck pain and spondylosis render this case more challenging. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Considering that the emergency tissue plasminogen activator treatment for acute cerebral infarction can worsen the state of an SCEH patient, or even lead to permanent

2019 Journal of Emergency Medicine

188. Dilution and microfiltration of particulate corticosteroids for spinal epidural injections: impact on drug concentration and agglomerate formation. (Abstract)

interferes with drug dosage. The choice of diluents must also be considered to reduce large agglomerate formation. Clinicians should be aware of the consequences of filtering particulate suspensions and carefully consider the selection of diluent when considering treatment plans.© 2019 Association of Anaesthetists.

2019 Anaesthesia

189. Intraoperative parathyroid hormone (PTH) testing in patients with primary hyperparathyroidism and PTH levels in the normal range. Full Text available with Trip Pro

with normal PTH is rare but physicians should be aware of this possibility in patients with hypercalcaemia. Patients with normal PTH levels are younger and more frequently symptomatic. Intraoperative PTH testing plays an important role in the operative management even in such patients.

2019 BMC Surgery

190. Intraoperative tumor lysis syndrome in a giant teratoma: a case report. Full Text available with Trip Pro

failure due to unrecognized intraoperative tumor lysis syndrome developed.Surgeons, anesthesiologists and oncologists should be aware of this complication in order to be prepared for such an emergency.

2019 BMC Surgery

191. Incidence, management and outcomes of intraoperative catastrophes during robotic pulmonary resection. (Abstract)

, p<0.001). The most common catastrophic event was intraoperative hemorrhage from the pulmonary artery, followed by injury to the airway, pulmonary vein, and the liver. Detailed management strategies were discussed.The incidence of catastrophic events during robotic anatomical pulmonary resections was low, and the most common complication was pulmonary arterial injury. Awareness of potential intraoperative catastrophes and their management strategies are critical to improving clinical

2019 Annals of Thoracic Surgery

192. Neurocognitive and functional outcomes in patients with diffuse frontal lower-grade gliomas undergoing intraoperative awake brain mapping. (Abstract)

, including working memory and spatial awareness, after tumor removal. The aim of this study was to investigate neurocognitive and functional outcomes of frontal LGGs in both the dominant and nondominant hemispheres after awake brain mapping.METHODSData from 50 consecutive patients with diffuse frontal LGGs in the dominant and nondominant hemispheres who underwent awake brain surgery between December 2012 and September 2018 were retrospectively analyzed. The goal was to map neurocognitive functions

2019 Journal of Neurosurgery

193. Improving the Intraoperative Educational Experience: Understanding the Role of Confidence in the Resident-Attending Relationship. (Abstract)

confidence from attendings in residents' capabilities. Based on these findings, we would propose identifying methods to expand resident's awareness of surgical situations and develop attending's confidence in residents.Copyright © 2019 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

2019 Journal of Surgical Education

194. The Relationship Between Pain-Related Psychological Factors and Postoperative Opioid Use After Ambulatory Hand Surgery. (Abstract)

catastrophizing and mindfulness and postoperative opioid use in patients undergoing ambulatory hand surgery.Patients undergoing ambulatory hand surgery at our institution between May 2017 and January 2018 were prospectively enrolled in an ongoing clinical trial. Patients completed the Pain Catastrophizing Scale (PCS) and Mindfulness Attention Awareness Scale (MAAS) before surgery. Patients completed a pain medication diary for 2 weeks after surgery and were contacted on postoperative days 3, 8, and 15 (...) (representing more mindfulness) were associated with lower average week-1 pain levels but not significantly associated with opioid use or refill rates.Patients demonstrating higher PCSs before surgery used more opioids after surgery after a range of ambulatory hand surgeries. In the setting of the opioid epidemic, hand surgeons should be aware of pain-related psychological factors that can influence postoperative opioid use.Prognostic II.Copyright © 2019 American Society for Surgery of the Hand. Published

2019 Journal of Hand Surgery - American

195. Ipsilateral transient amaurosis, mydriasis and light reflex absence after subconjunctival local anesthesia with mepivacaine in three patients with refractory glaucoma - a case report. Full Text available with Trip Pro

or at a later date without any complication. Overall, our thoroughly elaborated risk management could not determine the causative factor explaining the observed ocular complications just in the current occasion and not at other time points.Doctors should be aware and patients should be informed about such rare complications after subconjunctival local anesthetics administration. Adequate risk management should insure patients' safety.

2019 BMC Ophthalmology

196. Does the choice of intraoperative fluid modify abdominal aneurysm repair outcomes?: A cohort analysis. Full Text available with Trip Pro

; 95% CI, 1.292-2.118; P < .001).We found neither a benefit nor a negative effect of hydroxyethyl starch on the risk of AKI or mortality. Instead, other variables and comorbidities were found to be relevant for the development of postoperative AKI and survival. Nevertheless, clinicians should be aware of the high risk of postoperative AKI, particularly among those undergoing AAA-OR procedures.

2019 Medicine

197. Predicting postoperative fatigue in surgically treated lung cancer patients in Norway: a longitudinal 5-month follow-up study. Full Text available with Trip Pro

treatment variable.Clinicians should pay special attention to lung symptoms and be aware that these may lead to long-term postoperative fatigue. Further research should examine whether interventions reducing lung symptoms, such as shortness of breath and coughing, may prevent development of fatigue in patients undergoing lung cancer surgery.© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

2019 BMJ open

198. Innovation in sedation and analgesia training. (Abstract)

-anesthesiologist sedation practitioners. Less Common Forms of Sedation Training: These include screen-based simulation, high-fidelity manikin-based simulation. Screen-based simulation sedation training is popular, convenient, and relatively inexpensive. Although there are numerous courses available, course content has not been standardized. High-fidelity simulation has been accepted to improve knowledge, self-confidence, awareness of emergency, crisis resource management, and teamwork, but it is costly, time

2019 Current Opinion in Anaesthesiology

199. Moderate and deep sedation training and pharmacology for nonanesthesiologists: recommendations for effective practice. (Abstract)

is explored in moderate sedation. Providers of all sedation types should be aware of hypotension, apnea, hypoventilation, and hypoxia that can develop and they should be able to manage the patient under these circumstances. Preprocedural planning is an integral training expectation to minimize patient risks.

2019 Current Opinion in Anaesthesiology

200. Anesthetic technique and oncological outcomes in urology: A clinical practice review. (Abstract)

Anesthetic technique and oncological outcomes in urology: A clinical practice review. There is increasing awareness that different anesthetic and analgesic techniques may impact outcomes after oncological surgery, generally through modifying effects on the immune system but potentially via other mechanisms including mitigating the surgical stress response. This narrative review aims to summarize the mechanisms underlying the effect of perioperative factors on oncological outcomes

2019 Urologic oncology

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