International Journal of Anesthetics and Anesthesiology is an open access peer reviewed journal that publishes discoveries in wide variety of drugs which are used in modern anesthetic practice and fundamental understandings in anesthesiology. The main objective of the journal is to act as a forum for publication, education, and exchange of opinions, and to promote research and publications globally. Through open access it expands knowledge across doctors, providing free, immediate availability of the published work online.
International Journal of Anesthetics and Anesthesiology is a bimonthly journal which accelerates the pace of research updates, discovery and innovation in various aspects of anesthetics and clinical anesthesiology. It publishes original articles, reviews, case reports, commentaries, etc. It addresses all aspects of anesthesia practice, including airway management, anesthetic administration, pharmacokinetics, preoperative, postoperative considerations, pain management etc. All articles published in the journal are subject to a stringent peer review process. It encourage authors to publish their experimental and theoretical results in detail.
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Open Access DOI:10.23937/2377-4630/1410113
Enrico Giustiniano, MD and Maurizio Cecconi, MD, FRCA, FFICM, MD(Res)
Article Type: Case Report | First Published: November 19, 2020
Veno-Arterial Extra-Corporeal Membrane Oxygenation (VA-ECMO) in adults has grown over the last decades as a life-saving procedure. Trans-thoracic (TTE) and trans-esophageal (TEE) echocardiography are recommended tool to manage such cases. A 35-years-old female patient suffering from myocarditis after bone marrow transplant for lymphoblastic leukemia underwent V-A ECMO due to a severe Left Ventricle disfunction which developed abruptly. Given the rapid clinical worsening we opted for the extracor...
Open Access DOI:10.23937/2377-4630/1410112
Jaclyn R. Altshuler, MD and Stephanie Ibekwe, MD
Article Type: Case Report | First Published: November 02, 2020
Perioperative opioid sparing techniques are paramount given the current opioid epidemic. A 54-year-old woman presented with medical history of acute cholecystitis for laparoscopic cholecystectomy. Our goal was adequate pain control while limiting opioid administration and opioid-related adverse effects. Pain was managed with preoperative acetaminophen, tramadol, and gabapentin, and intraoperatively with lidocaine, ketamine, and esmolol. Post-operative Visual Analog Score (VAS) was 0/10 immediate...
Open Access DOI:10.23937/2377-4630/1410111
Pernille Ursin Rein, Dag Jacobsen, Vidar Ormaasen, Vera Djordjilović and Oona Dunlop
Article Type: Original Article | First Published: August 10, 2020
In 2016 quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) was presented as a simple bedside screening tool in identifying sepsis and is now replacing the Systemic Inflammatory Response Syndrome (SIRS) criteria in many Emergency Departments. We wanted to study whether these diagnostic criteria were sensitive enough to identify sepsis on the initial hospital admission in a cohort of patients who rapidly developed pneumococcal septic shock....
Open Access DOI:10.23937/2377-4630/1410110
Fabian Rings, Sven Gottschling and Patric Bialas
Article Type: Original Article | First Published: July 18, 2020
Dyspnea is a distressing symptom of many terminal ill patients that has to be treated. Despite recent guideline recommendations there is still great restraint in using opioids for the treatment of dyspnea. In this report, we investigated, whether transdermal application of buprenorphine (TD BUP) is a safe and efficient way to treat dyspnea. Before applying BUP, dyspnea was scored on numerical analog scales and the patients were examined (assessment of vital parameters, questionnaires). Than trea...
Open Access DOI:10.23937/2377-4630/1410109
Yuvaraj Kotteeswaran, MD, Varuna Manoo, MD, Alexander McLaren-Blades, MD, Michael Kahn, MD, Alexander Huang, MD and Hance Clarke, MD, PhD
Article Type: Case Report | First Published: June 26, 2020
Intense, refractory neuropathic pain is an unfortunate complication following a Herpes Zoster (HZ) infection/ rash and is regarded as post-herpetic neuralgia (PHN). The risk of PHN increases with age. The erector spinae plane (ESP) block has been demonstrated to block transmission through the thoracic and lumbar spinal nerves. This report describes two patients that were able to significantly reduce their chronic pain medications following a series of ESP blocks....
Open Access DOI:10.23937/2377-4630/1410108
Michael W Lew, MD and Joseph Chang, MD
Article Type: Letter to the Editor | First Published: June 04, 2020
Residual muscle paralysis is an important safety issue, with multiple studies demonstrating an association with increased postoperative complications. The pathophysiology of these complications isn’t difficult to explain. One can only imagine the signs and symptoms in an awake patient (i.e. the panic from not having the strength to take a deep breath or move at full strength; the anxiety of not controlling one’s body movement). A study by the Cleveland Clinic demonstrated that major complica...
Open Access DOI:10.23937/2377-4630/1410107
Abhishek Singh, Apala Roy Chowdhury, Ameya Pappu and Puneet khanna
Article Type: Case Report | First Published: May 06, 2020
Transanal endoscopic microsurgery (TEMS) is minimally invasive, safe and highly effective treatment modality for resecting small rectal lesion like adenomas, early stage carcinoma and strictures. We describe an unusual case of massive subcutaneous emphysema and hypercarbia secondary to TEMS leading to ventilatory difficulty and post-operative mechanical ventilation. Extra peritoneal insufflation of CO2 at high pressure, for prolonged duration and extent of tissue dissection are some of the predi...
Open Access DOI:10.23937/2377-4630/1410104
Tatiana Basto and Humberto S Machado
Article Type: Review Article | First Published: April 20, 2020
Balanced anaesthesia relies on the administration of opioids in the perioperative period as antinociceptive agents. There is no clear evidence that intraoperative opioids result in reduction of postoperative pain scores. Opioid-free anaesthesia (OFA), combination of various opioids- sparing techniques leading to no administration of intraoperative systemic, neuraxial or intracavitary opioids, arises from the attempt to develop anti-hyperalgesic techniques to improve postoperative pain control. T...
Open Access DOI:10.23937/2377-4630/1410106
Xianzeng Chen, Weilan Wu and Xiaodan Wu
Article Type: Short Article | First Published: April 24, 2020
Since December 2019, the outbreaks of COVID-19 global pandemic has occurred, currently considered, first on Wuhan, and appeared successively on many other countries in China. As an acute respiratory infectious disease, it has been defined as a class B infectious disease, according to the regulations of the People’s Republic of China on the prevention and control of infectious diseases, and managed as a top class infectious disease....
Open Access DOI:10.23937/2377-4630/1410103
Jacquelin Peck, MD, Nicholas Suraci, MD, Frederick Hasty, MD and Jayanard D'Mello, MD
Article Type: Case Report | First Published: April 06, 2020
Cor Triatriatum (CT) is a seldom-reported cardiac anomaly defined by the presence of an abnormal septation within the right or left atrium. Cor triatriatum usually remain asymptomatic until late adulthood, but depending on the severity of septation and location within the atrium the manifestations can vary in presentation. We present a case of cardioembolic cerebrovascular accident in a patient with cor triatriatum dexter and a patent foramen ovale. To our knowledge, no existing case report desc...
Open Access DOI:10.23937/2377-4630/1410105
Saurin J Shah, MD, Juan C Mora, MD, Shashank S Shettar, MD and John P Pirris, MD
Article Type: Case Report | First Published: April 22, 2020
Cold agglutinin disease is a rare form of autoimmune hemolytic anemia mediated mainly by IgM antibodies reacting to surface antigens of the red blood cells at low temperatures causing agglutination and posterior hemolysis on rewarming. Patients with this condition might never be symptomatic, but when they are exposed to hypothermia during cardiovascular procedures, these reactions can be triggered leading to serious organ damage. We describe/discuss a case of a patient with a wide range cold agg...
Open Access DOI:10.23937/2377-4630/1410102
Mafdy Basta, MD
Article Type: Case Report | First Published: March 26, 2020
Infectious (bacterial) sacroiliitis, though rare, yet needs to be considered at the differential diagnosis of back/leg pain in parturients. The following is a case of infectious sacroiliitis in a postpartum patient that presented four days after delivery with hip and leg pain. Interestingly, the patient’s labor analgesia was conducted with a continuous lumbar epidural analgesia; however, a causal relationship remains to be determined....
Open Access DOI:10.23937/2377-4630/1410101
Xinyue Liu, MD, Jing Ji, MD and Guo-Qing Zhao, MD, PhD
Article Type: Review Article | First Published: January 04, 2020
As the recent update of General Anaesthesia compared to Spinal anaesthesia (GAS) studies has been published in 2019, together with other clinical evidence, the human studies provided an overwhelming mixed evidence of an association between anaesthesia exposure in early childhood and later neurodevelopment changes in children. Pre-clinical studies in animals provided strong evidence on how anaesthetic and sedative agents (ASAs) causing neurotoxicity in developing brain and deficits in long-term c...
Open Access DOI:10.23937/2377-4630/1410100
Matthew B Ellison, MD, Jeremy Hensley, MD, Roy E Henrickson, MD, Jeffrey Puette, MD, Jason Shepherd, MD, Daniel Sloyer, MD and Pavithra R Ellison, MD
Article Type: Case Rep ort | First Published: January 04, 2020
A 51-year-old male presented to the emergency department with four self-inflicted nail gun wounds. Computed tomography angiography demonstrated three nails penetrating the frontal bone toward the falx cerebri causing small subdural hematomas. The fourth nail penetrated the parietal bone posteriorly, ending very close to the vein of Galen. Despite the ominous-appearing imaging, the patient was neurologically intact and cooperative to the point that consideration was given to the possibility of re...
Open Access DOI:10.23937/2377-4630/1410099
Ali Dogan Dursun, Faruk Metin Comu, Aysegul Kucuk, Ulku Sabuncu, Nevriye Salman, Timucin Sabuncu, Gulay Kip, Omer Kurtipek and Mustafa Arslan
Article Type: Original Article | First Published: December 20, 2019
Ischemia reperfusion (I/R) injury is a common problem in vascular surgery. We aimed to investigate the effects of esmolol on erythrocyte deformability in rat lower limb I/R injury. Following Ethics Commitee approval 24 rats were randomly divided into 4 groups, Control (Group C), Esmolol (Group E), Ischemia-reperfusion (Group I/R), I/R-Esmolol (Group I/R-E). In I/R group, atraumatic microvascular clamp was placed to infrarenal abdominal aorta. After 120 minutes from ischemia, the clamp was remove...
Open Access DOI:10.23937/2377-4630/1410098
Harry Mc Grath, Colin Flanagan, Liaoyuan Zeng and Yiming Lei
Article Type: Original Article | First Published: December 07, 2019
Artificial Intelligence (AI) will change our lives beyond recognition, it will have a far bigger impact than the internet or mobile technology. We are now at the threshold where machine intelligence is comparable with human intelligence, in certain limited aspects, for the first time in history. Enhancements in technology, both software and hardware, have resulted in some human decision-making being inferior to, and more erratic than, AI in many fields, including medicine. However, it is widely ...
Open Access DOI:10.23937/2377-4630/1410097
Thiruselvi Subramaniam and Tan Ann Jee
Article Type: Original Article | First Published: October 26, 2019
Pain in the immediate postoperative period is found to be less after laparoscopic than after conventional surgical techniques. Ropivacaine is often in favour of Bupivacaine to avoid the risks of toxicity. Levo-bupivacaine, a safer version of bupivacaine is a contender to Ropivacaine. We compare the pain relief provided by Ropivacaine and Levo-bupivacaine instilled intra-abdominally during laparoscopic surgery for acute appendicitis. This is a double blinded randomized placebo- controlled study c...
Open Access DOI:10.23937/2377-4630/1410096
Incidence of Residual Neuromuscular Blocking in Oncological Patients in the Anesthetic Rescue Room: Importance of Objective Monitoring in the Foundation Center of Control of Oncology of the State of Amazonas - Fcecon
Fernanda Rondon Fonseca Pirangy, Mirlane Guimaraes de Melo Cardoso, Ivandete Pereira Coelho Pimentel, e Mewryane Camara Brandao Ramos and Jamilly Reboucas Demosthenes Marques
Article Type: Research Article | First Published: September 23, 2019
The present research project aims to evaluate the incidence of residual neuromuscular block in the post-anesthetic recovery room in patients who underwent general anesthesia with mechanical ventilation. It is known that neuromuscular blockers are drugs that interrupt the transmission of nerve impulses at the neuromuscular junction causing muscle paralysis. In addition, they facilitate endotracheal intubation during anesthetic induction and allow for adequate surgical management....
Open Access DOI:10.23937/2377-4630/1410095
Bastian J, Bauer A, Kern C and Robertson-Baeriswyl M
Article Type: Case Report | First Published: August 23, 2019
A 32-year-old primigravida woman received an epidural anesthetic at 38 weeks of gestation for an elective caesarean delivery. She had for the past 10 years an intrathecal baclofen infusion pump to relieve spastic tetraparesis secondary to perinatal cerebral anoxia. She otherwise also suffered from sickle cell disease complicated by several vaso-occlusive crisis during pregnancy and a recent history of thromboembolic disease. A recent CT scan showed the intrathecal catheter entering the L3-L4 int...
Open Access DOI:10.23937/2377-4630/1410094
Emily Pallister and Thogulava Kannan
Article Type: Case Report | First Published: August 21, 2019
A 79-year-old patient with type 2 diabetes mellitus was admitted to the Intensive Care Unit for management of Acute Kidney Injury refractory to fluid resuscitation. She had felt unwell for three days with poor oral intake. Admission bloods showed severe lactic acidosis and Acute Kidney Injury (AKI). The patient was initially managed with fluid resuscitation in A&E, but there was no improvement in her acid/base balance or AKI. The Intensive Care team were asked to review the patient and she was s...
Open Access DOI:10.23937/2377-4630/1410093
Hazem El Sayed Moawad Weheba, MD, Tamer Abdelsalam, MSc, Sameh Ghareeb, MD and Mohamed Younis Makharita, MD
Article Type: Research Article | First Published: August 08, 2019
Effective perioperative analgesia with laparoscopic cholecystectomy enhances early recovery, ambulation, and discharge. Subcostal TAP block has been shown to reduce perioperative opioid use and provide effective perioperative analgesia. Currently, the QLB is performed as one of the perioperative pain management procedures for patients undergoing abdominal surgery. In the current study, we hypothesized that posterior QLB would be equal to or better than the subcostal TAP block with regard to pain...
Open Access DOI:10.23937/2377-4630/1410092
Christopher F Tirotta, Richard G Lagueruela, Danielle Madril, Marysory Irizarry, John McBride, Davinder Ramsingh and Jonathan Ho
Article Type: Clinical Study Summary | First Published: August 08, 2019
An observational prospective trial was conducted in operating room settings across multiple study sites. A total of 120 surgical patients undergoing a variety of interventional and surgical procedures were included, representing multiple patient populations, case types and anesthesia setups. The ClearLine IV, a device that detects and removes air from IV tubing, was inserted into the IV circuit. Clinicians followed standard protocols. Blood warmers were used at the practitioner's discretion. IV ...
Open Access DOI:10.23937/2377-4630/1410091
Valentini Pogiatzi, Dimosthenis Petsas, Evripidis Efthymiou, Maria Drogouti, Athanasios Ntonas, and Georgios Ntonas
Article Type: Case Report | First Published: July 27, 2019
The dual nature of CPSP -both nociceptive and neuropathic- can cause confusion regarding comparisons of pain in the literature. Treating this condition can be complicated and difficult. There is a variety of modalities, ranging from medication in pain clinic, revision surgery or invasive procedures (neurolysis, nerve blocks). A feasible and reproducible solution seems to be ultrasound guided nerve block. Nerve blocks might work in multiple ways. First of all providing a temporary break of the vi...
Open Access DOI:10.23937/2377-4630/1410090
Sohel MG Ahmed, Amna Mustafa Ali, Tayseer Salih Mohamed, Mohamed Sayed M Hajnour, Hayat O Elfil, et al.
Article Type: Original Article | First Published: May 27, 2019
Medical services in general, and anaesthetic services in particular, in Sudan have been vulnerable to changes secondary to socio-economic factors over the last few decades. This cross-state survey aims to identify the current set up of obstetric anaesthesia services in 19 hospitals - representing all public hospitals in Khartoum State with maternity units- and audit them against internationally set standards....
Open Access DOI:10.23937/2377-4630/1410089
Kerem Erkalp, MD, Nuran Kalekoglu Erkalp, MD, Veysel Erden, MD, Arzu Yasemin Korkut, MD, and Yesim Cokay Abut, MD
Article Type: Original Article | First Published: May 10, 2019
Inhalation induction (II) of anesthesia is a commonly used method in difficult airway management, pediatric anesthesia and also tracheostomized patients' surgical practices. Sevoflurane and desflurane are the most common inhalation agents for II in these procedures of patients. We demonstrated that II with sevoflurane or desflurane in tracheostomized patients who are not studied up until now and their outcomes. Cardiorespiratory changes in II should be the same in tracheostomized patients with d...
Open Access DOI:10.23937/2377-4630/1410088
Melike Seyda Dagdelen, Fatma Yesim Abut, Veysel Erden and Seda Seven
Article Type: Original Article | First Published: April 17, 2019
The purpose of this study was to evaluate adding an obturator nerve block to adductor canal block may reduce tramadol consumption (primary endpoint), improve pain relief, enhance early ambulation ability, and reduce side effects (secondary endpoints) after TKA compared with single adductor canal block. This study was carried out retrospectively in order to compare the effect of the single injection adductor nerve block, which was applied to the patients undergoing total knee arthroplasty (TKA) u...
Open Access DOI:10.23937/2377-4630/1410087
Hande Gurbuz Aytuluk and Hulya Topcu
Article Type: Case report | First Published: April 05, 2019
Spinal muscular atrophy (SMA) is one of the most common inherited diseases in children. The clinical symptoms of this neuromuscular disease vary widely from muscle weakness to death according to the onset of symptoms. There is no specific treatment for the disease. There are many risks for anesthesia, as these patients usually have skeletal deformities, increased sensitivity to opioids and neuromuscular blockers, and pulmonary disease secondary to respiratory muscle dysfunction. There is no evid...
Open Access DOI:10.23937/2377-4630/1410086
Antoine Legrand, Remi Bouquerel, Antoine Strzelecki, Benjamin Le Gaillard, Christophe Pelletier, Mireille Houadec and Edmundo Pereira de Souza Neto
Article Type: Case Report | First Published: March 13, 2019
White French female patient, 56-years-old, 76 kg, 170 cm, was scheduled for a Left knee arthroplasty. Vital signs (blood pressure, temperature, oxygen saturation and Glasgow coma score) were normal. His ASA physical status was 2 and she had no treatment. Past medical history found a cervicobrachial neuralgia. Past surgical history consisted of bilateral hallux valgus, left knee arthroscopy, blepharoplasty and an ovarian ectopic pregnancy....
Open Access DOI:10.23937/2377-4630/1410085
Wacharin Sindhvananda, MD, MPH, PhD, Chonlada Bunpeth, MD and Nuthathai Chareonkulnawanun
Article Type: Original Article | First Published: March 09, 2019
An increase of NT-proBNP has been proved to be a predictor for ventilator weaning failure in several medical conditions. However, relation between NT-proBNP and ventilator-weaning outcomes after cardiac surgery has not yet been elucidated. This study was to investigate relationship between blood NT-proBNP and ventilator-weaning outcomes. A prospective analytical study was at Cardiovascular-thoracic intensive care unit. Cardiac-surgery patients (age 18-80 Y, consented and without exclusion criter...
Open Access DOI:10.23937/2377-4630/1410084
K Tollisen, M Bjerva, GT Dahl, NK Meidell, L Sandvik, F Heyerdahl and D Jacobsen
Article Type: Original Article | First Published: February 16, 2019
Intensive care units (ICU) provide advanced health care for seriously injured and ill patients, demanding vast economic resources. The population is aging and the need for intensive care beds is expected to increase considerably over the next decades. This will have serious implications for planning and financing of the health care system. Descriptive studies of intensive care patients are needed to ensure that the health services can meet future needs. Evaluation of ICU services are challenging...
Open Access DOI:10.23937/2377-4630/1410083
Summaira Jan, Tawheed Ahmad and Saima Rashid
Article Type: Research Article | First Published: December 20, 2018
Laparoscopic surgeries involves creation of pneumo-peritoneum with insufflation of gas usually CO2 thereby increasing intra-abdominal pressure. The Intra-abdominal pressure above 10 mmHg causes adverse hemodynamic changes. Various agents have been used to attenuate these adverse effects. Dexmedetomidine alpha-2 agonist has sedative, sympatholytic, analgesic and anxiolytic properties and used in laparoscopic cholecystectomies for attenuation of adverse hemodynamic changes and to maintain hemodyna...
Open Access DOI:10.23937/2377-4630/1410082
Andrea Paoli, Marco Lorenzini, Annalisa Boscolo, Andrea Spagna and Carlo Ori
Article Type: Research Article | First Published: December 06, 2018
Several scientific associations recommend the use of the intraosseous access as a valid alternative to the intravenous route, which is often difficult to find in emergency conditions, as a safe and effective way for drugs and fluids administration and for blood sampling. Rapid intravascular access is of paramount importance in both in and out-of-hospital emergency care. Quick treatment of medical and traumatic situations, along with correct resuscitation maneuvers, can decrease the mortality and...
Open Access DOI:10.23937/2377-4630/1410081
Ayten Saracoglu, Halime Hanim Pence, Mehmet Yilmaz and Kemal Tolga Saracoglu
Article Type: Review Article | First Published: November 16, 2018
Prevention and minimizing serious complications during difficult airway management is an important goal for anesthesia providers. Using the high flow cannula oxygenation systems it is possible to improve the clinical outcomes, increase patient safety and reduce the rate of complications. A possible mechanism of this method can be explain by 'Aventilatory Mass Flow' which is a physilogical phenomenon. Several methods can be used to implement apneic oxygenation such as nasopharyngeal catheter, nas...
Open Access DOI:10.23937/2377-4630/1410080
Ayten Saracoglu and Sermin Tetik
Article Type: Review Article | First Published: November 15, 2018
Trauma is still a leading cause of death in the 21st Century mainly due to uncontrolled hemorrhage. Trauma has also an increasing cost of treatment in patients. Recently we have been aware of the importance of complex hemostatic and immunoinflammatory responses in pathogenesis of "Trauma Induced Coagulopathy". As a result of understanding of changes on coagulation pathway in trauma, different hypotheses put forward explaining the trauma induced coagulopathy. New treatment algorithms also take pl...
Open Access DOI:10.23937/2377-4630/1410079
Budzinski Jessie and Choudhry Dinesh
Article Type: Case Report | First Published: November 05, 2018
A pneumothorax can arise in a variety of clinical settings in the operating room, from bleb rupture to iatrogenic injury. Should it expand in size and cause increase in intrapleural pressures with resultant diminished venous return, it becomes referred to as a tension pneumothorax. We report a case of a premature infant presenting for repair of congenital pulmonary airway malformation who suffered an iatrogenic tension pneumothorax during lung isolation with fogarty embolectomy catheter used for...
Open Access DOI:10.23937/2377-4630/1410078
Stylianos Voulgarelis and Sylvia Y Dolinski
Article Type: Case Report | First Published: November 03, 2018
Congenital diaphragmatic hernias may run undiagnosed for years before a change in symptomatology may lead to the diagnosis and treatment. We present a 63-year-old previously asymptomatic patient that developed progressive symptomatology after a laparoscopic procedure. The increased intraabdominal pressure related to the peritoneal insufflation and Trendelenburg intraoperative positioning in combination with the failure of the surgeon to perform the initial laparoscopic exploration of the whole a...
Open Access DOI:10.23937/2377-4630/1410077
Dustin Hang, Herodotos Ellinas and Sylvia Y Dolinski
Article Type: Case Report | First Published: November 01, 2018
Acute respiratory failure is divided into four categories: hypoxemic (type I), hypercarbic (type II), perioperative (type III) and shock (type IV). We present a case of perioperative respiratory failure in a patient with iatrogenic phrenic nerve injury after mediastinoscopy and the implications for a high index of suspicion as well as appropriate diagnostics. Of the four types of respiratory failure, perioperative (Type III) respiratory failure is often due to hypoxemia or hypercarbia (i.e. Type...
Open Access DOI:10.23937/2377-4630/1410076
Ayten Saracoglu, Fisun Bulutcu, Levent Oklu, Ercument Yentur, Yaman Tokat and Yildiray Yuzer
Article Type: Original Article | First Published: October 31, 2018
Anxiety disorder, which is encountered in surgical patients receiving general anesthesia is a psychological and physical condition, characterized by sudden onset of hazard perception and extensive fear, and may lead to panic disorder. In this study, we aimed to determine anxiety levels of liver transplantation donors via a questionnaire and reveal their quality of life and anxiety status during the 1st postoperative day and month....
Open Access DOI:10.23937/2377-4630/1410075
Abbas Aghabiklooei, Omid Mehrpour, Hossein Hassanian-Moghaddam, Shahin Shadnia and Nasim Zamani
Article Type: Original Article | First Published: October 24, 2018
Respiratory failure is the most common cause of morbidity and mortality in organophosphate (OP)-intoxicated patients. We aimed to assess and compare the need for re-intubation and outcome between patients with self-extubation (SE) and planned extubation (PE). All OP-poisoned endotracheally intubated patients admitted to poisoning ICU were included. The frequency and time of SE, need for re-intubation, and its impact on hospital stay and outcome were assessed....
Open Access DOI:10.23937/2377-4630/1410074
Luiz Eduardo Imbelloni and Micaela Barbosa L Sales
Article Type: Case Report | First Published: October 17, 2018
The existence of fine gauge needles with a traumatic bevel, pencil tip type; it is possible to increase the indication of spinal anesthesia in young people and to reduce the incidence of post-puncture headache. We present a case of a post-dural puncture headache occurring after perforation dura mater using a 20-gauge needle introducer for spinal anesthesia with Whitacre needle....
Open Access DOI:10.23937/2377-4630/1410073
Veysel Erden, Cihan Guler, Hasan Bulut, Naile Ozsoy Toprak and Nedret Uslu
Article Type: Original Article | First Published: October 12, 2018
This study was registered to Australian New Zealand Clinical Trial Registry with serial number ACTRN12614000286640. After institutional review, board approval and informed consent 50 female patients; ASA (American Society of Anesthesiologists) class 1, ages between 18-45 years old were enrolled in this study. The surgeries performed were septorhinoplasty and tympanoplasty. 25 patients with menstrual cycle days from 1 to 10 (follicular group), 25 patients with menstrual cycle days from 18 to 24 (...
Open Access DOI:10.23937/2377-4630/1410072
Anh Q Dang, Marc Rozner, Nicole Luongo and Shital Vachhani
Article Type: CASE REPORT | First Published: September 07, 2018
The construction of a coaxial circle breathing circuit encloses the inspiratory limb within the expiratory limb to preserve heat, humidity, anesthetic gas, and oxygen. However, the construction also makes kinks or breaks in the enclosed inspiratory limb difficult to detect. With kinking or disconnection of the central inspiratory limb, the patient may rebreathe expiratory gases, leading to a significant increase in dead space and concomitant respiratory acidosis. We describe a clinical case in w...
Open Access DOI:10.23937/2377-4630/1410071
Mohd Nazri A, Nor Hidayah ZA, Suryati MP, Wan Nasrudin WI, Azhar M, Mazelan O, Nurul Ashikin H, Fazilawati Z, Maziah M, Khairul Has H and Puzizer S
Article Type: Case Report | First Published: August 04, 2018
Succinylcholine is a depolarizing, muscle relaxant, that commonly used to facilitate endotracheal intubation, especially in emergency surgery or patient with difficult intubation. However succinylcholine is associated with severe hyperkalaemia, arrhythmia and cardiac arrest especially in severe burn and neuromuscular disease and renal failure. We report a case of young boy with underlying Obstructive Sleep Apnoea (OSA) presented for bleeding post tonsillectomy, who developed cardiac arrest follo...
Open Access DOI:10.23937/2377-4630/1410070
Fadi Farah, Antranig Kalaydjian, Yuen Cheng, Pascal Scemama and Martin Acquadro
Article Type: Case Report | First Published: July 26, 2018
Lower extremities nerves damage is a known complication of prostatectomies. Lumbar sympathetic block is a well-established treatment for sympathetically-mediated lower extremity pain. We report a case of bilateral lower extremity pain in a femoral distribution that developed after a robotic assisted prostatectomy and resolved after a lumbar sympathetic block....
Open Access DOI:10.23937/2377-4630/1410069
Kurt Ruetzler, Till Hauffe, Tobias Piegeler, Alkadhi Hatem and Donat R Spahn
Article Type: Case Report | First Published: July 05, 2018
Central Venous Catheterization is a common procedure in daily clinical practice. The internal jugular, subclavian and the femoral veins are the most frequently catheterized central veins. Pneumothorax, hematothorax, arterial puncture, hematoma, nerve lesions, damage to the left thoracic duct, and air embolism are among the main mechanical complications. Nowadays, there are two techniques in daily clinical use: the traditional technique and the ultrasound guided technique. ...
Open Access DOI:10.23937/2377-4630/1410068
Sonia Veiras, Raquel Rodrguez Gonzalez, Tomas Sobrino, Javier Rodriguez, Aurora Baluja and Julian Alvarez
Article Type: Research Article | First Published: June 25, 2018
Volatile anaesthetics, most of all sevoflurane, have been described as providers of myocardial preconditioning, but few articles are focused on immunomodulatory effects of these agents. We aimed to study the effects of different anaesthetic procotols with sevoflurane and propofol on immunomodulation in patients undergoing cardiopulmonary bypass (CBP)....
Open Access DOI:10.23937/2377-4630/1410067
Smith KL, Sharp C, Smith E, Currie M, Hall KP, Vu T, Lee M and Cooper RL
Article Type: Research Article | First Published: June 14, 2018
Medication errors cause an estimated 100,000 to 400,000 patient deaths in the United States annually (IOM). Previous reviews on this alarming statistic consistently identify human error as the most common etiology. The potential for medication errors is especially high risk in the operating suite, where the provider simultaneously selects, doses and verifies medications to be administered to patients. Additionally, a lack of standardization and error reduction strategies in this setting creates ...
Open Access DOI:10.23937/2377-4630/1410066
Francesco Corazzi, Stefania Brusa, Enrico Giustiniano, Efrem Civilini, Giorgio Luca Poletto and Ferdinando Raimondi
Article Type: Case Report | First Published: May 30, 2018
Anamnesis included cholecystectomy, hypertension and coronary artery by-pass graft (CABG) due to acute myocardial infarction (AMI), dislipidemia, G6PD deficit, allergy to milk proteins, liver steatosis and severe chronic obstructive pulmonary disease (COPD) with FEV1/FVC ratio 0.43 and FEV1 1.12 L (44%)....
Open Access DOI:10.23937/2377-4630/1410065
James L Geiger
Article Type: Review Article | First Published: May 25, 2018
The diagnosis and treatment of Alzheimer's dementia (AD) has gained much attention due to the current and predicted prevalence of the disease. The biomarkers of neural inflammation, oxidative stress, genetics and the multiple medical etiologies of AD coupled with the poly-pharmacy of comorbid conditions and diseases associated with AD are complex....
Open Access DOI:10.23937/2377-4630/1410064
Luis Tollinche, KaySee Tan, Austin Han , Leslie Ojea and Cindy Yeoh
Article Type: Research Article | First Published: April 26, 2018
In a climate of cost containment, it is critical to analyze and optimize all perioperative variable costs. Fresh gas flow is one important variable that determines utilization of inhalational agents and can be tightly controlled by the anesthesia provider. Manufacturers of inhalational agents have recommendations for minimum gas flow for their respective agents. Any gas flow above these recommendations is considered misuse and leads to unnecessary expense. The purpose of this study was to charac...
Open Access DOI:10.23937/2377-4630/1410063
Hertz Laurent, Sola Chrystelle, De La Arena Pablo and Dadure Christophe
Article Type: Case Report | First Published: April 25, 2018
The use of perineural catheter for more than 72 hours is rare in perioperative practice, but was especially reported for chronic pain, oncologic related pain or palliative care. The main concern remains the risk of neurological or infectious complication. No guideline clearly specifies the maximum duration of perineural catheter maintenance and the safety of long-term catheters is discussed....
Open Access DOI:10.23937/2377-4630/1410062
Nwokolo Omonele O and Wegner Robert C
Article Type: Case Report | First Published: April 05, 2018
Heart disease is prevalent in current patient population at an increasing level. Some of these patients have had interventions such as stent placements to improve quality of life and are started on antiplatelet therapy for a definite period of time or indefinitely based on their risk factors, comorbidities or type of stents placed. When these patients present to the hospital with major trauma, the surgical and anesthetic management threads a delicate line between protection of the stents and pre...
Open Access DOI:10.23937/2377-4630/1410061
David J Kopsky and Jan M Keppel Hesselink
Article Type: Case Report | First Published: February 03, 2018
Topical analgesic formulations are gaining interest for the treatment of peripheral neuropathic pain since the beginning of 2000. Advantages of topical analgesics over oral medication are the absence of systemic side effects and drug-drug interactions, higher concentrations of active compound at the pain area, fast onset on action, improvement of compliance, and no risk of abuse. In many peripheral neuropathic pain states the pain area is small and thus topical analgesics are suitable. Most pati...
Open Access DOI:10.23937/2377-4630/1410060
YC Tay and MJ Abrahams
Article Type: Case Report | First Published: November 29, 2017
Epidural catheters that are commonly placed for anaesthesia or analgesia have a serious complication of migration. Besides intravascular local anaesthetic infusion which could lead to systemic toxicity, a subdural migration is often diagnosed late and presents with life-threatening outcomes noted either at post-mortem or requiring intensive care management....
Open Access DOI:10.23937/2377-4630/1410059
Edward M Becerra, Jose L Aguilar, Raquel Pelaez, Jakeline R Jurado and Jordi Ballabriga
Article Type: Case Report | First Published: October 26, 2017
To report a rare case of Pourfour du Petit Syndrome (PDPS), presenting clinically as subdural block (SDB), as a complication of Obstetric Epidural Analgesia (OEA). PDPS is described as reverse Horner´s syndrome. It is characterized by mydriasis, exophthalmos, eye-lid retraction and hyperhidrosis....
Open Access DOI:10.23937/2377-4630/1410058
Jens Tan, Javier Lasala, Jose Soliz, Jonathan Wilks, January Tsai, Teresa Moon Calderon, Shital Vachhani, Jagtar Singh Heir and Gabriel Eduardo Mena
Article Type: Review Article | First Published: March 13, 2017
PACU or ICU patients generally require reintubation for two main reasons-inadequate airway patency (extubation failure) and residual need for mechanical support (weaning failure). Such events are relatively common and can be associated with significant morbidity, mortality and costs....
Open Access DOI:10.23937/2377-4630/1410057
Wen-Ming Chuang, Hung-Te Hsu, Shah-Hwa Chou, Chia-Chen Wu, Kuang-Yi Tseng, Kuang-I Cheng and Miao-Pei Su
Article Type: Case Report | First Published: March 13, 2017
Intubation for one lung ventilation in patients with difficult airways can be a challenge. Severely limited mouth opening restricts the use of direct laryngoscopy or video-assisted laryngoscopy. We present two patients with limited mouth opening undergoing video-assisted thoracoscopic decortication, who were successfully intubated with left-sided double-lumen endobronchial tube (DLT) using the Trachway® intubating stylet. This technique provides a safe and reliable method for DLT intubation ...
Open Access DOI:10.23937/2377-4630/1410056
Kiyotaka Nakagawa, Kazuo Arakawa, Tomohide Kamiya, Koichi Kataoka and Katsuhiro Sakai
Article Type: Case Report | First Published: March 02, 2017
The valveless trocar system is a novel insufflator that circulates carbon dioxide in the abdominal cavity. Herein, we report an infant with severe hypothermia due to use of this insufflator. An 83-day-old infant (body weight 3862 g) with gastroesophageal reflux underwent laparoscopic Nissen fundoplication. After insufflation was initiated, his body temperature acutely dropped to 34.4 °C. Standard treatments had no effect on the patient's hypothermia....
Open Access DOI:10.23937/2377-4630/1410055
Chol Kim, Yoshihiko Seino and Atsuhiro Sakamoto
Article Type: Case Report | First Published: January 18, 2017
A 50-year-old male presented to the emergency room at night with complaints of paroxysmal nocturnal dyspnea and worsening shortness of breath on exertion. He was an active tireless estate agent till three months before, when he noticed shortness of breath on climbing the stairs at the station....
Open Access DOI:10.23937/2377-4630/3/4/1054
Quy Tran, Gurpreet Dhaliwal, Christopher Lee and Zohreh Steffens
Article Type: Case Report | First Published: November 28, 2016
Air embolism during gastrointestinal endoscopy procedures is a rare phenomenon but can lead to a catastrophic and fatal event resulting from cardiovascular collapse and neurological injury. Oftentimes, the diagnosis is difficult because the cardiovascular and neurologic symptoms are not specific to systemic air embolism. High index of suspicion with early recognition and treatment is crucial in improving patient outcome....
Open Access DOI:10.23937/2377-4630/3/4/1053
Rispoli Marco, Bizzarri Federico Tommaso, Zani Gianluca, Agnoletti Vanni, Corcione Antonio, Buono Salvatore and Fusari Maurizio
Article Type: Review Article | First Published: October 03, 2016
The Jehovah's Witnesses are best known to outsider for their refusal of blood products, even such a refusal may result in death. In years, a "bloodless surgery" was developed with the aim of avoid blood transfusions and improve patient outcome, shifting from a product-centred to a patient-centred approach. An accurate teamwork is needed to define a perioperative transfusion-alternative program, individualized for patients' characteristics and surgical procedure. The objective of this article is ...
Open Access DOI:10.23937/2377-4630/3/4/1052
Emma Aitken, Richard Stevenson, Faisal Hanif, Diana Raj, Karen Stevenson and David Kingsmore
Article Type: Original Article | First Published: October 01, 2016
Renal transplantation (RTx) is well established as the optimal method of renal replacement therapy (RRT); however the imbalance between organ supply and demand has led to increased numbers of organs coming from marginal donors. This, in conjunction with an increase in the number of 'marginal recipients', necessitates optimisation of other aspects of transplantation including perioperative care to maintain the excellent outcomes and survival benefit previously published in the literature....
Open Access DOI:10.23937/2377-4630/3/3/1051
Article Type: Original Article | First Published: September 08, 2016
On April 2014 the New England Journal of Medicine published the results of the trial ProCESS (Protocolized Care for Early Septic Shock): a multi centers study conducted on 1341 patients of 31 academic hospitals of United States. The trial compared three different way to approach and care the septic shock during the first 6 hs....
Open Access DOI:10.23937/2377-4630/3/3/1050
Esra Ozayar, Handan Gulec, Zehra Baykal Tutal, Munire Babayigit, Mehmet Sirin, Aysun Kurtay and Eyup Horasanli
Article Type: Original Article | First Published: July 20, 2016
Percutaneous tracheotomy is a common procedure in the intensive care units (ICU). Although majority of the complications related to this procedure are considered minor, serious complications secondary to tracheotomies are still being reported. Definition of short neck is not clear in the medical literature, but well known to anesthesiologists since they are flagged for possible difficult airway. Thyromental and sternomental distance, range of neck extension and neck circumference are some of the...
Open Access DOI:10.23937/2377-4630/3/3/1049
Silvana Aparecida Calafatti, Marcelo de Macedo, Juliana Zampoli Boava Papini, Edvaldo Coelho, Cintia Maria Saia Cereda, Jose Pedrazzoli Junior, Eneida de Paula, Daniele Ribeiro de Araujo and Giovana Radomille Tofoli
Article Type: Research Article | First Published: July 18, 2016
Opioids are used for the postoperative period, cancer pain and for moderate to severe chronic noncancer pain. Sufentanil (SUF) is a highly lipophilic opioid that presents rapid and highly effective pain relief, but it presents short duration of action. Due to this short duration of action, SUF is currently used as an intravenous anesthetic agent and analgesic adjuvant for surgery and labor....
Open Access DOI:10.23937/2377-4630/3/2/1048
Nina Maenchen, Christian Kruse Hansen, Mette Dam and Jens Borglum
Article Type: Case Report | First Published: June 28, 2016
The ultrasound-guided transmuscular quadratus lumborum (TQL) block performed in the lumbar paravertebral region exerts its effect by spreading into the thoracic paravertebral space with blockade of both somatosensory and visceral nerves of the abdominal and retroperitoneal region. We discovered an inadequate management of post-operative pain by the conventional analgesic regimen among caesarean section patients in our hospital. In this report we present three cases where the TQL block is demonst...
Open Access DOI:10.23937/2377-4630/3/2/1047
Tugba Karaman, Tamer Kuzucuoglu, Gulten Arslan, Serkan Karaman and Mujge Hatun
Article Type: Original Article | First Published: June 13, 2016
Despite increasing knowledge about pain, postoperative pain management is still a challenge. Opioids are widely used drugs in the treatment, but the side effects of the opioids lead to investigations about the novel pain management strategies. We aimed to compare the effects of preemptive intravenous lornoxicam and paracetamol on postoperative pain scores, opioid consumption, and patient satisfaction during laparoscopic cholecystectomy recovery....
Open Access DOI:10.23937/2377-4630/3/2/1046
SJ Gandhi, A Zavala, U Williams, A Van Meter, P Hsu, DS Gombos and P Owusu-Agyemang
Article Type: Research Article | First Published: May 07, 2016
Corneal abrasions are the single most common ocular injury in the perioperative period. The exact etiology of perioperative corneal abrasions is usually unclear, and several risk factors have been described. The aim of our study was to determine the incidence of known and hypothetical risk factors for corneal abrasion in a cohort of cancer patients who had developed corneal abrasion after oncologic surgery. Our review showed a high incidence of risk factors which were similar to that reported fo...
Open Access DOI:10.23937/2377-4630/3/2/1045
C Hochhold, P Paal, G Luckner, M Rasse and C Velik-Salchner
Article Type: Case Report | First Published: April 11, 2016
Nowadays, children with hypoplastic left heart syndrome (HLHS) survive longer. Thus, the management of such patients undergoing non-cardiac surgery is of increasing relevance. A 12-month-old boy with HLHS following stage II Norwood palliation and Apert syndrome required extended craniosynostosis surgery because of elevated intracerebral pressure. Since extensive blood loss as well as hemodynamic instability were expected, anesthetic and surgical management were carefully planned in a multidiscip...
Open Access DOI:10.23937/2377-4630/3/2/1044
Markus Ritzka, Domagoj Schunk, Susanne Hopf, Diane Bitzinger, Bernhard M. Graf and Benedikt Trabold
Article Type: Research Article | First Published: April 1, 2016
Three groups of health care professionals were given a brief supervised training in using the devices. For each participant the positioning of each device was recorded. Success rate of insertion and time until adequate ventilation was measured. Furthermore, use and handling of a SAD was scored for ease of insertion, clinical and fiber-optic position, and ventilation....
Open Access DOI:10.23937/2377-4630/3/1/1043
Christian Zedler, Alexander Schnabel, Peter Kranke and Leopold Eberhart
Article Type: Original Article | First Published: February 26, 2016
Many medical journals contain advertisements for pharmaceuticals products. While the WHO demands that claims in pharmaceutical advertisements should be based on scientific evidence, past investigations demonstrated that some advertisements fail to fulfill these demands. As there is currently no investigation dealing with advertisements in anaesthetic journals, we aimed to find out whether claims in these journals are accompanied by references to external evidence, and whether these claims are su...
Open Access DOI:10.23937/2377-4630/3/1/1042
Guldem Turan, Yildiz Kuplay, Ceren Karip, Ceren Koksal, Cansu Akin and Nur Akgun
Article Type: Original Article | First Published: February 13, 2016
There are different monitorisation methods for following patients in intensive care units. Monitorisation of respiratory parameters is also important besides monitorisation of hemodynamic parameters. Integrated pulmonary index (IPI) algorithm incorporates four real-time respiratory measurements (end-tidal CO2, respiratory rate, pulse rate and SpO2) into a single value that represents respiratory profile including these parameters. IPI gives an idea to the clinician to determine the need for addi...
Open Access DOI:10.23937/2377-4630/3/1/1041
Steven Boggs, Elizabeth Frost and Jessica Feinleib
Article Type: Research Article | First Published: January 30, 2016
Many ideas have gone into the development of the concept of the Perioperative Surgical Home (PSH) and Enhanced Recovery after Surgery (ERAS). Many anesthesiologists have advocated for an increased role in operating room (OR) management, advancing from OR managers to OR directors with greater decision making and improved means of communication. However, there is little uniformity at present in the running of ORs around the country....
Open Access DOI:10.23937/2377-4630/3/1/1040
Lindsay M Harmon, Anthony J Perkins, Beth Sandford and Christopher S Weaver
Article Type: Original Article | First Published: January 25, 2016
Emergency physicians routinely perform emergency department procedural sedation (EDPS) with propofol and its safety is well established. However, in 2009 the Centers for Medicare and Medicaid Services (CMS) enacted guidelines defining propofol as deep sedation and requiring administration by a physician. Common EDPS practice had been one-physician performing both the sedation and procedure. EDPS has proven safe under this 1-physician practice. However, the 2009 guidelines mandated separate physi...
Open Access DOI:10.23937/2377-4630/3/1/1039
Lavinia Bergesio, Nadia Ruggieri, Orazio Difrancesco, Enrico Giustiniano and Franco Cancellieri
Article Type: Research Article | First Published: January 13, 2016
Airway management is mostly performed in the operating room, and unexpected difficult tracheal intubation may be a life-threatening event which incidence varies in a wide range with estimated pooled frequency of 6.8%. Difficulty at laryngoscopy or intubation, if inability to maintain a patient airway occurs, exposes the patient to the risk of complications basically related to hypoxia. Its incidence has been reported around 1-4% of patients with normal airway and, more recently, in a range of 1....
Open Access DOI:10.23937/2377-4630/2/4/1038
Erden V, Sever E, Dagdelen S, Guler C, Kirgezen T, Toprak N and Yigit O
Article Type: Original Research Article | First Published: December 22, 2015
Postoperative edema and ecchymosis can usually occur after rhinoplasty and can cause disgruntled results which influence the satisfaction of patient and surgeon. Prolonged periorbital ecchymosis and severe edema may cause a delay in healing and affect the result of surgery. Many of agents have been used to reduce the influence of edema and ecchymosis developing around the eyes after rhinoplasty, such as corticosteroids, lidocaine and adrenaline combination, melilotus extract....
Open Access DOI:10.23937/2377-4630/2/4/1037
Christopher F. Tirotta, Richard G. Lagueruela, Danielle Madril, Jorge Ojito, Chelsea Balli, Evelio Velis, Marilyn Torres, Francisco Alonso, Robert Hannan and Redmond P. Burke
Article Type: Original Research Article | First Published: December 21, 2015
Bleeding after cardiac surgery can cause increased morbidity and mortality. This is a particularly serious problem in pediatric patients, especially neonates and infants, who may receive multiple units of blood products intra- and postoperatively. The aim of this study is to demonstrate that the use of human fibrinogen concentrate (HFC) during cardiopulmonary bypass (CPB) decreased operative blood loss and the need for perioperative blood component therapy in neonatal, infant and other high-risk...
Open Access DOI:10.23937/2377-4630/2/4/1036
Mohammed Husam Nafie
Article Type: Original Research Article | First Published: November 19, 2015
Mannitol is one of the most commonly used osmotic diuretics during renal transplant surgery. Two concentrations of mannitol, 10% and 20%, are available, however there is no consensus about which concentration is to be preferred. The purpose of this study was to compare between the efficacy of the two concentrations of mannitol for inducing diuresis during renal transplant surgery and the need for further diuretics (furosemide)....
Open Access DOI:10.23937/2377-4630/2/4/1035
Robert J Farney, Boaz Markewitz, Amanda M McDonald and Jill Rhead
Article Type: Case Report | First Published: November 16, 2015
The optimal therapy of chronic opioid induced sleep disordered breathing (SDB) is unclear. Supplemental oxygen may potentially prolong central apneas and increase respiratory suppression. Continuous positive airway pressure (CPAP) is generally ineffective or may even augment central apneas. Therapy with an Adaptive Servo-Ventilation (ASV) device is the most successful option for most etiologies of central apnea including opioids, but we have observed a subpopulation with OISDB that do not respon...
Open Access DOI:10.23937/2377-4630/2/3/1034
Safinaz Karabayirli, Ismail Uras, Cemile Koca, Merve Ergin, Ruveyda Irem Demircioglu, Bunyamin Muslu
Article Type: Original Research Article | First Published: September 12, 2015
Tourniquets are routinely applied during lower extremity surgery in order to reduce bleeding during surgery, provide better surgical conditions and consequently to shorten the duration of the operation. However, an inflammatory response is often activated by tourniquet application, leading to prolonged ischemia and reperfusion; consequently, organ damage such as acute lung injury may occur. Muscular ischemia causes hypoxic cellular changes and anaerobic glycolysis, and its neutrophil activation ...
Open Access DOI:10.23937/2377-4630/2/3/1033
Jeppe T Jensen, Peter Vilmann, Lars Konge and Moller
Article Type: Review Article | First Published: August 19, 2015
Hospitals and healthcare centers are continuously pushed to deliver a better quality of care with a higher turnover. Hence, there is an increasing demand for shorter procedures and shorter time to discharge. Some of these requirements can be met if sedation is used instead of general anesthesia. Furthermore, sedation, as an alternative to nothing, has its benefits. Two recent studies have shown that sedation for endoscopies increases endoscopist satisfaction, the patient's willingness to undergo...
Open Access DOI:10.23937/2377-4630/2/3/1032
Fusun Bozkirli, Fikriye Dogrul, Faruk Metin Comu, Hande Arpaci, Omer Bayrak, Mustafa Arslan and Yusuf unal
Article Type: Original Article | First Published: August 18, 2015
One of the most common causes of renal insufficiency in children and adults is obstructive nephropathy. Unilateral ureteral obstruction (UUO) is a well-known model to imitate the obstructive nephropathy process in a simple, accelerated and species-independent manner. Previous studies have revealed that morphological lesions in the obstructed kidney are peritubular capillaries rarefaction, tubular atrophy, inflammatory infiltration, widen interstitial space, and progressive tubulointerstitial fib...
Open Access DOI:10.23937/2377-4630/2/3/1031
Ismail Sirit, Ibrahim Ozturk, Dilek Yazicioglu
Article Type: Original Research | First Published: June 20, 2015
We aimed to investigate that whether intraoperative intravenous aminophylline is effective for prevention of postdural puncture headache after caesarean section or not. Materials and method: Records of patients who underwent caesarean section between January, 2013 and November, 2013 with spinal anesthesia were examined retrospectively. Patients older than 18 were included in the study. Failed and conversion to general anesthesia was the exclusion criteria....
Open Access DOI:10.23937/2377-4630/2/3/1030
David D. Nguyen, Daneshvari Solanki, Christopher Babl, Nikolaus Gravenstein and Rene Przkora
Article Type: Commentary | First Published: May 30, 2015
Pain is a global epidemic and in America is considered the fifth vital sign. It causes significant suffering and disability, and pain contributes to massively increased healthcare costs. Effective pain management is an important outcome and quality measure....
Open Access DOI:10.23937/2377-4630/2/2/1029
Mayke E. van der Putten, Viola Christmann, Lucas E. Matthyssens, Arthur R.T. Scheffer and Chris Bleeker
Article Type: Case Report | First Published: May 11, 2015
A preterm boy of 30 weeks and fie days did not breathe spontaneously at birth and despite visualization of the vocal cords, intubation attempts did not succeed, until a tube 2.0 was placed using an Eschmann stylette, mistakenly considered endotracheal. A few hours later, suspicion of tube dislocation arose and renewed intubation attempts failed. The ENT specialist performed a tracheoscopy and found a blind ending of the trachea in the subglottic area....
Open Access DOI:10.23937/2377-4630/2/2/1028
Zachary L. McCormick, Benjamin Marshall, Jeremy Walker, Robert McCarthy and David R. Walega
Article Type: Original Article | First Published: April 06, 2015
Radiofrequency ablation (RFA) of the medial branch nerves for facet-mediated low back pain demonstrates clinical benefit for 6-12 months and possibly up to 2 years. This study investigated function, pain, and medication use outcomes of RFA for lumbar facet syndrome in a cohort with long-term follow-up....
Open Access DOI:10.23937/2377-4630/2/2/1027
Surjya Prasad Upadhyay, Ulka Samant, Sudhakar Seth Tellicherry, Himanshu Chauhan and Piyush N Mallick
Article Type: Review Article | First Published: March 28, 2015
Postoperative pulmonary complications such as Pneumonia, Acute Lung Injury (ALI), Acute Respiratory Distress Syndrome (ARDS) substantially increases the risk of morbidity, mortality, length of hospitalisation and financial burden. Risk factors can be broadly categorized into patient related, procedure related, anaesthesia related and post procedural care related....
Open Access DOI:10.23937/2377-4630/2/2/1026
Muhammed Enes Aydin, Meral Erdal Erbatur, Faruk Metin Comu and Mustafa Arslan
Article Type: Original Article | First Published: March 28, 2015
It is known that blood viscosity and erythrocyte aggregation are increased and erythrocyte deformability is decreased in diabetic patients. Ischemia reperfusion injury (I/R) in lower extremity is a frequent and important clinical phenomenon. Blood rheology is known to be affected by numerous factor including anaesthetic drugs. Accordingly, we aimed to investigate the effects of sevoflurane and desflurane on erythrocyte deformability in infrarenal aorta of diabetic rats undergoing I/R....
Open Access DOI:10.23937/2377-4630/2/2/1025
Toshihiko Nakatani, Tatsuhito Miyamoto, Tatsuya Hashimoto and Yoji Saito
Article Type: Original Article | First Published: March 23, 2015
Increased skin temperature and decreased sweating are used to identify the adequacy of sympathetic block in the upper limb. This, however, requires a thermography device to precisely evaluate skin temperature and a diaphoremeter to measure sweating. Baroreflexes elicited by postural change induce a reduction in peripheral blood flow to sustain systemic blood pressure and cerebral blood flow. We hypothesized that sympathetic blockade in the upper limb results in minimal changes in finger skin blo...
Open Access DOI:10.23937/2377-4630/2/1/1024
Kumiko Tanabe, Shigemi Matsumoto, Mayumi Nakanishi and Hiroki Iida
Article Type: Short Communication | First Published: March 20, 2015
Background: Circadian rhythms influence the pharmacology and effects of anesthetic agents such as local anesthetics, general anesthetics, and muscle relaxants. However, the influences of the circadian rhythm on new anesthetics such as propofol are unknown. Results: Thirty-seven patients underwent induced anesthesia at 8:30. Twenty-eight patients were induced between 14:00 and 16:00.There was no significant difference between the two groups in the predicted blood concentration, the predicted effe...
Open Access DOI:10.23937/2377-4630/2/1/1023
David Neale, Daryl Williams and David Canty
Article Type: Original Research | First Published: March 13, 2015
In a prospective observational study, focused transthoracic echocardiography (TTE) performed in the preoperative clinic on 100 patients with increased cardiac risk resulted in a change in management of 54% and a net reduction in use of hospital resources. The aims of this study are to apply a cost benefit analysis to demonstrate whether or not this translated into saving money for the hospital....
Open Access DOI:10.23937/2377-4630/2/1/1022
Semih Baskan, Dilsen Ornek, Adem Guney, Fahri Acar, Ozlem Sacan and Mustafa Baydar
Article Type: Case Report | First Published: March 09, 2015
Purpose: This report describes the management of anesthesia in a patient with myasthenia gravis, undergoing thymectomy. Clinical features: The patient was a 22-yr-old female. Thoracic computed tomography revealed a thymoma and a right-side paratracheal lymph node 46x44mm in size. A thymectomy operation was required....
Open Access DOI:10.23937/2377-4630/2/1/1021
Jaime Ortiz and Kelly A. Frew
Article Type: Case Report | First Published: February 28, 2015
Airway management of patients following facial trauma poses many challenges to the acute care team. An 80 year old male presented following a pit bull attack with massive trauma to his face, scalp and extremities. After carefully considering the options available, we were able to safely secure his airway by utilizing a WuScope. We confirm that the WuScope is a useful tool for airway management in a case of severe facial trauma....
Open Access DOI:10.23937/2377-4630/2/1/1020
Harikrishnan Kothandan, Lim Michelle Leanne and Shital Kumar Sharad Shah
Article Type: Case Report | First Published: February 06, 2015
Patients with congenital heart diseases are a growing population and noncardiac surgeries will become an important health care issue. Modification of surgical techniques and medical advances has improved the survival of patients with complex congenital cardiac abnormalities, resulting in more adult patients with fontan physiology presenting for non-cardiac surgery. The older fontan patient is at particular risk of thromboembolism, arrhythmias, progressive ventricular dysfunction, protein losing ...
Open Access DOI:10.23937/2377-4630/2/1/1019
Jose M. Belena, Monica Nunez and Alfonso Vidal
Article Type: Opinion | First Published: January 23, 2015
It is a fact that Supraglottic Airway Devices (SAD) are currently present at many clinical scenarios in anesthesia and they are also a good alternative to endotracheal intubation in some routine anesthetic procedures. Nowadays, laparoscopy is one of the most common and widely established surgical techniques. This procedures increase airway pressure due to the peritoneal insufflation and consequently the risk of regurgitation and aspiration. Over the last two decades, many studies have establishe...
Open Access DOI:10.23937/2377-4630/1/3/1018
Trung Du, David Bramley, Justin Nazareth and David T Andrews
Article Type: Research Article | First Published: December 29, 2014
We carried out an observational study using a system of time and motion analysis that was developed to critically evaluate work systems by correlating the number and type of hand and equipment movements that were associated with the time taken to perform the stereotypical anaesthetic technique of rapid sequence intubation (RSI). The number and type of hand movements required to complete RSI exhibited significant correlation with, and were linearly related to, the time taken to carry out the RSI ...
Open Access DOI:10.23937/2377-4630/1/3/1017
Uma Hariharan, Shagun Bhatia Shah and Binod Kumar Naithani
Article Type: Case Report | First Published: December 23, 2014
The introduction of robotic surgery has heralded new challenges for the anesthesiologists. The daVinci TM robotic system provides a three-dimensional view and better work ergonomics for the surgeon, especially in complex and radical cancer surgeries. Innovation of robotic surgery has opened the doors for newer concerns in patient safety for the anesthesia team. This is of greater importance in patients with concurrent serious conditions like hypertrophic cardiomyopathy. The challenge becomes gre...
Open Access DOI:10.23937/2377-4630/1/3/1016
Aparajith Sairam, Jian Feng, Norman I. Badler, Jiabin Liu, Kenneth Richman and Nabil Elkassabany
Article Type: Research Article | First Published: November 24, 2014
We present a system for the interactive simulation of ultrasound guided peripheral nerve blocks using a Microsoft Kinect. The system performs motion tracking of both the ultrasound probe and the nerve block needle. Software generates synthetic ultrasound images from previously captured ultrasound images. Details of the software elements in the system are described. Some of the current challenges and future work in this research are discussed....
Open Access DOI:10.23937/2377-4630/1/3/1015
Stefan Welter, Danjouma Cheufou, Thomas Ehmann, Sandra Kampe and Peter Scharmann
Article Type: Case Report | First Published: November 24, 2014
Tracheal laceration is a rare complication of emergency intubation. The treatment decision depends on severity of accompanying problems, available resources, condition and perspectives of the patient and experience of the responsible intensivist and surgeon. The life saving application of endotracheal suture in a disastrous situation is demonstrated in this report. We present the case of a 83-year-old woman who presented with an acute abdomen and septicaemia. A heavy aspiration occured during in...
Open Access DOI:10.23937/2377-4630/1/3/1014
Prerana N. Shah, Vaishali P Chaskar, Pradeep Rathod, Anand Komawar and Barakha Gadpale
Article Type: Case Report | First Published: November 20, 2014
Acute retention of urine is a medical emergency which needs immediate intervention. Urethral catheterization is a common procedure in the emergency department. Repeated unsuccessful attempts for urethral catheterization demand alternative procedure like suprapubic catheterization. Traditionlly, anatomical landmarks are used to achieve suprapubic catheterization. The confirmation of successful catheterization by ultrasound is recommended. Often due to its unavailability, complications like bowe...
Open Access DOI:10.23937/2377-4630/1/3/1013
Carla Irani, C. Saade, C. Dagher and P.Yazbeck
Article Type: Original Article | First Published: November 02, 2014
8 millions procedures requiring anesthesia are performed yearly in France with 75% of them being general anesthesia. In 45% of those procedures, a NMBA (neuromuscular blocking agents) is used. Th incidence of allergy to general anesthetics ranges between 1/20000 in Australia and 1/350 in Great-Britain. Th incidence of peranesthestic allergic reactions estimated in 1996 in France was 1/9000, all drugs confounded and the incidence of allergic reactions to NMBA was evaluated to be 1/6500 anesthesia...
Open Access DOI:10.23937/2377-4630/1/3/1012
Zeinab Ahmed El Seify and Ahmed Metwally Khattab
Article Type: Original Article | First Published: November 01, 2014
Background: Anesthesia is stressful for children and parents. Although anxiolytics can keep children calm, side effects may exist. No single method shows a clear advantage in keeping the child calm and cooperative. This study aimed to test the effiacy and safety of adding a small dose ketamine to midazolam-based oral premedication on child-parents separation and acceptance of face mask. Methods: Eighty preschool children scheduled for elective surgeries were included. Patients were allocated i...
Open Access DOI:10.23937/2377-4630/1011
Shahla Siddiqui, Lim WoanWui and Koh Kwong Fah
Article Type: Case Report | First Published: October 27, 2014
Introduction: Trauma is a leading cause of mortality and morbidity in Singapore. In our peripheral hospital we have a large trauma load despite being a non level one trauma center. Whilst we have many studies done in the West documenting the quality of life of trauma victims using scoring systems such as the EQ5DTM and GOSE, there is a paucity of literature from this part of the World. Methods: We analyzed the results of 6 months of data collected by our trauma coordinator looking specifially ...
Open Access DOI:10.23937/2377-4630/1010
Alev Oztas, Ezgi Erkilic, Elvin Kesimci, İbrahim Keser and Duran Canatan
Article Type: Case Report | First Published: October 20, 2014
This is the case report of a young man, whose clinical condition has not been identified properly in the preoperative evaluation. A 27-yr-old man presented with complaints of nasal obstruction. His clinical examination was almost unremarkable, except for indistinct cyanosis at the lips. He denied any symptoms related cardiovascular and respiratory systems. A chest radiograph was normal, as were all laboratory investigations. He had received general anesthesia with persistent low pulse oximetry r...
Open Access DOI:10.23937/2377-4630/1009
Siniscalchi A, Gamberini L, Carini A, Laici C, Tassinari S and Faenza S
Article Type: Original Article | First Published: October 15, 2014
Introduction: Since cirrhotic patients undergoing hepatic resection are at increased risk of developing postoperative coagulopathy, epidural catheter placement in this group of patients is still debated. This retrospective study aimed to evaluate postoperative course of coagulation parameters after surgical hepatic resection in cirrhotic patients and their relation to extent of resection and perioperative risk factors. Methods: Perioperative data from 232 hepatic resections performed in cirrho...
Open Access DOI:10.23937/2377-4630/1008
Delgado-Baeza Emilio, Quintana-Villamandos Begona
Article Type: Editorial | First Published: September 30, 2014
It is well established that hypertension is associated with increased cardiovascular morbidity and mortality. Left Ventricular Hypertrophy (LVH) is a relevant problem in patients with hypertension because of its role in long-term severe cardiovascular diseases, including ventricular arrhythmia, congestive heart failure, myocardial infarction, stroke and sudden death. There is a relationship between the regression of LVH and a decreased morbidity and mortality. Treatment to achieve regression of ...
Open Access DOI:10.23937/2377-4630/1007
Joseph G. Werner, Alberto A. Uribe, Karina Castellon-Larios, Sergio D. Bergese and Matthew P. McKierna
Article Type: Case Report | First Published: September 29, 2014
Difficult intubation is a constant concern in surgical and critical care settings due to its direct relationship with morbidity and mortality. The incidence reported in literature varies between 0.1% to 13% and reaches 14% in the obese population. The American Society of Anesthesiologists (ASA) defined difficult airway as a situation in which a trained anesthesiologist experiences difficulty with facemask ventilation of the upper airway, difficulty with tracheal intubation, or both. They also de...
Open Access DOI:10.23937/2377-4630/1006
Karim Omar Elsaeed and Hoda Shokri
Article Type: Case Report | First Published: September 18, 2014
Background: Transversus abdominus plane (TAP) block is suitable for unilateral urologic surgeries. Blind TAP block has many complications and uncertainty of its effects. Use of ultrasonography increases the safety and efficacy. This study was conducted to evaluate the analgesic efficacy of ultrasound (USG) guided TAP block compared with wound infiltration with bupivacaine (0.25%) in patients undergoing urologic surgeries. Methods: In a prospective study, 40 patients undergoing elective unilate...
Open Access DOI:10.23937/2377-4630/1004
Mohamed Hamdy Ellakany
Article Type: Research Article | First Published: September 11, 2014
Background: Shivering occurs frequently during the perioperative period. A prospective, randomized, double-blind study was done to compare between intrathecal dexmedetomidine (5mcg) and intrathecal meperidine (0.2mg/kg) for decreasing the incidence and intensity of shivering after spinal anesthesia for lower abdominal operations. Methods: Seventy five patients scheduled for lower abdominal operations under spinal anesthesia were randomly allocated to three groups. Spinal anesthesia consisted o...
Open Access DOI:10.23937/2377-4630/1005
Monu Yadav, R Gopinath, B Rajesh Kumar, Shibani Padhy, A Anand Ram and Suresh Kumar Chintha
Article Type: Case Report | First Published: September 11, 2014
Anaesthesia has special considerations in any case of intracranial space occupying lesions. Not much of literature is available about anaesthetic considerations in a patient with Glomus jugulare tumour requiring surgery for non neurosurgical procedure. Glomus jugulare tumours arise from the glomus body within the adventitia of the jugular bulb. Glomus bodies are histologically similar to carotid bodies. They are composed of epitheloid cells embedded in capillary net work. Occasionally these tumo...
Open Access DOI:10.23937/2377-4630/1003
Article Type: Editorial | First Published: August 13, 2014
ABA requires re-certification for all Diplomates of the Board who passed oral exam after 1999. This process called MOCA and designed as a 10 years cycle of activities, which results in re-certification. Anesthesiology is not unique in this process - other 23 specialty Boards require maintenance of the certification program. The goal is to assure continuous improvement, so physicians keep up with growing body of medical knowledge and skills....
Open Access DOI:10.23937/2377-4630/1002
Rudin Domi, Myzafer Kaci, Herion Dredha, Artan Bodeci, Hektor Sula, Ilir Ohri, Sokol Paparisto, Gjergj Andrea and Enton Bollano
Article Type: Review | First Published: August 04, 2014
The incidence of postoperative pulmonary complications (PRC) it is recently considered to be up to 5%. In the high-risk group, the incidence may reach or even exceed 20%. The mortality associated with PRC can be ranged 10-25%. Fleischman et al found that the incidence of PRC was higher than perioperative cardiac events, considered to be a common postoperative problem. Other authors reported that PRC is associated with a high morbidity profile....
Open Access DOI:10.23937/2377-4630/1001
Article Type: Editorial | First Published: July 10, 2014
If I ask to a man on the street about Medicine and its progress, only few events came to his mind. Antimicrobial therapy, vaccinations, surgical therapy of cancer and continuous surgical innovations, to cite only some instances, did ameliorate human health. But most of the people forget that many surgical innovations and the care of a lot of infectious disease were due to the birth and upgrading of an often neglected branch of Medicine: Anesthesia and Intensive Care. Furthermore, if I ask to a m...
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