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.

Journal Information

Title: International Journal of Anesthetics and Anesthesiology

ISSN: 2377-4630

Editor-in-chief: Prof. Ike Eriator

NLM title abbreviation: Int J Anesthetic Anesthesiol

ICV: 87.18

ISO abbreviation: Int J Anesthetic Anesthesiol

Other titles: IJAA

Category: Medicine

DOI: 10.23937/2377-4630

Peer review: Double blind

Review speed: 3 weeks

Fast-track review: 10 days

Publication format (s): Electronic and print

Publication policy: Open Access; COPE guide

Publication type(s): Periodicals

Publisher: ClinMed International Library

Country of publication: USA

Language: English

Contact email:

Articles Search by   Keyword   |   Journal title   |   Author name   |   DOI


 Open Access DOI:10.23937/2377-4630/1410175

Implementation of Hemodynamic Management with the Hypotension Prediction Index during Elective Open Abdominal Aortic Surgery: A Pilot Observational Report

Enrico Giustiniano, MD, Fulvio Nisi, MD1, Francesco Gambino, MD, Romina Aceto, MSc, Manuel Ignacio Garcia Monge, MD and Maurizio Cecconi, FRCA, FFICM, MD

Article Type: Clinical Observational Study | First Published: 2024/03/22

Intra-operative hypotension (IOH) is associated with a poor post-operative outcome. Consequently, it seems important to reduce the incidence of hypotensive events during anesthesia. The HemosphereTM (Edwards Lifescience Co., Irwin, CA, USA) platform provides the Hypotension Prediction Index (HPI), a predictive marker for a drop in blood pressure within a few minutes. We report the results of one year of application of a simple HPI-algorithm aiming at reducing the incidence of IOH in open abdomin...

 Open Access DOI:10.23937/2377-4630/1410174

How an Anesthesiologist Can Increase Interventional Testing 200% in A Whiplash Case?

Nelson Hendler, MD, MS and William Gallagher, DC

Article Type: Review Article | First Published: 2024/03/07

The answer to this title question is simple. Get a correct diagnosis. In order to improve your recovery from any whiplash case, soft tissue injury with no objective medical findings, or a cervical sprain, there are several easy steps a trial attorney can follow. First and foremost is to obtain an accurate diagnosis....

 Open Access DOI:10.23937/2377-4630/1410173

Anaesthetic Management in Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency Patient Posted for Total Knee Replacement: A Case Report

Medha Bhardwaj, MD, DNB, DM, Saurabh Mittal, MD, DNB, DM, Harsimran Kaur Buttar, MD and Gurjeet Khurana

Article Type: Case Report | First Published: 2024/03/01

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a most common hereditary genetic, X-linked defect of red blood cells (RBC) enzyme disorder in humans. Clinical manifestations commonly seen are neonatal jaundice, acute hemolytic or chronic non-spherocytic anemia. Acute hemolysis poses a perioperative challenge in management for anesthesiologists and the surgeons. Peripheral nerve block as well as general anaesthesia is a popular and safe anesthesia technique....

 Open Access DOI:10.23937/2377-4630/1410172

The Trapezius Plane Block: Extended Use in Perioperative Pain Management in Nerve Transfer Surgeries

Chandini Kukanti, MBBS, MD, Sravani Jakkireddy, MBBS, MD and Prateek Arora, MD, PDCC

Article Type: Case Report | First Published: 2024/02/29

Nerve transfer surgery has emerged as a promising approach to restoring function in paralyzed muscles. The Trapezius Plane Block (TPB) blocks the thoracic branches of the posterior primary rami, providing extended analgesia in nerve transfer surgeries....

 Open Access DOI:10.23937/2377-4630/1410171

A Questionnaire-Based Survey of Perioperative Utilisation of Ultrasound among Anaesthesiology Residents

Pharanitharan Natarajan and Chandini Kukanti

Article Type: Original Article | First Published: 2024/02/29

Ultrasonography (USG) is a resourceful tool in the perioperative period. A structured training curriculum during residency can enhance the utilisation of USG among residents. This cross-sectional online survey was conducted to evaluate the utilisation of USG in the perioperative period and to assess the adequacy of current training. It was found that although the availability of USG has increased, its use in the perioperative period is limited due to various factors such as time constraints. The...

 Open Access DOI:10.23937/2377-4630/1410170

May Numbers be the Voice of Gods? - May Artificial Intelligence Replace Human Intelligence and Bring Man Back to the Future?

Enrico Giustiniano, MD and Fulvio Nisi, MD

Article Type: Editorial | First Published: 2024/01/19

Knowing the future has been a challenge for humans since the dawn of time. Divination or Mantics is an ancient practice based on the idea that humans could ask gods about the future, and it was practiced in two ways. First, a priest, directly in contact with the divinity, interpreted its objective signs. Second, the 'gods’ will manifest themselves in a more immediate way, through the words uttered by a human figure directly inspired by the god. In both cases, it was a leap of faith, with only ...

 Open Access DOI:10.23937/2377-4630/1410169

Posterior Reversible Encephalopathy Syndrome (PRES): An Unusual Presentation

Geetika Duggal, Ruchika Kathuria and Vibha Mehta

Article Type: Editorial | First Published: 2024/01/19

The first patient, a 20-year-old woman who underwent a caesarean section under spinal anaesthesia complained of a headache immediately after surgery and experienced a generalised tonic-clonic seizure 4 hours later. Vitals remained stable. Supplemental oxygen, midazolam, magnesium sulphate, levetiracetam, mannitol, furosemide, and steroids were used to treat the patient. The results of a brain MRI showed subcortical vasogenic edoema suggestive with PRES and bilaterally symmetrical areas of altere...

 Open Access DOI:10.23937/2377-4630/1410168

Anaesthetic Management of Rigid Bronchoscopic Guided Removal of Endobronchial Tumour: A Case Series

Harishwar M, Karthik Jain M and Arpana Kedlaya

Article Type: CASE SERIES | First Published: 2023/12/01

Anaesthetic challenges involving removal of endobronchial growths are numerous. Use of rigid bronchoscopy, electrocautery, cryoprobe apart from the need of continuous communication and monitoring are essential part of this unique anesthetic care. We report two cases of endobronchial tumors which were removed under general anesthesia....

 Open Access DOI:10.23937/2377-4630/1410167

Evaluating the Utilization of Nalbuphine as an Adjuvant to 0.5% Bupivacaine for Ultrasound-Guided Supraclavicular Brachial Plexus Blockade: A Study in a Tertiary Care Hospital, Dhaka, Bangladesh

Mir Masud Royhan, Nazmul Ahsan Siddiqi Rubel, Abul Ishrat, Md Anisur Rahman and Nazem Ahmed

Article Type: Original Article | First Published: 2023/11/24

Supraclavicular block (SCB) has demonstrated remarkable post-operative patient outcomes in upper limb surgeries. Bupivacaine, a long-acting regional anesthetic, exhibits efficacy that can be influenced by the concomitant administration of additives....

 Open Access DOI:10.23937/2377-4630/1410166

Anesthetic Management of the Case of Removal of Tracheobronchial Foreign Body in a Whistling Child: A Case Report

Renu Sinha, MD, Ruma Thakuria, MD, Hitesh Verma, MD and Abhishek Singh, MD

Article Type: Case Report | First Published: 2023/11/22

Tracheobronchial foreign body pose an anesthetic challenge due to their propensity to cause partial or complete airway obstruction resulting in a need for urgent bronchoscopy and removal. Diagnosis mainly depends on taking proper history and radiological investigation which should demonstrate the time, type and location of the foreign body. The most suitable type of anesthesia and ventilation should be chosen that reduces the risk of complications, morbidity and mortality. ...

 Open Access DOI:10.23937/2377-4630/1410165

Successful Airway Management in a Comorbid Patient with Retrosternal Goiter: A Case Study on Lipoma Excision and Biopsy

Chenal Shah and Rahul Gupta

Article Type: Case Study | First Published: 2023/09/29

This case study presents the management of a 54-year-old British male patient suffering from retrosternal goiter with a BMI of 46.11, who was scheduled for lipoma excision and biopsy with adjacent tissue transfer or rearrangement on the back. The patient had a complex medical history, including type 2 diabetes mellitus, hypertension, hyperlipidemia, and obstructive sleep apnea. Preoperative assessments revealed difficulties...

 Open Access DOI:10.23937/2377-4630/1410164

Pseudo Hypoxic Brain Swelling - An Unanticipated Life-Threatening Complication in Neurosurgery - Report of Two Cases with Review of Literature

Juneja Sarika, MD, Agarwal Himanshu, DM and Sandhu Kavita, MD

Article Type: Case Report | First Published: 2023/09/28

Pseudo Hypoxic Brain Swelling (PHBS) is an under diagnosed and seldom reported fatal complication of seemingly uneventful neurosurgery. Diagnosis may be confused with acute ischemic injury. Early recognition and institution of corrective measures can lead to complete reversal of symptoms and prevent mortality. In this paper, we want to highlight two cases of PHBS, which we came across and present their management and outcome, with review of literature....

 Open Access DOI:10.23937/2377-4630/1410162

Effectiveness of Transtracheal Lignocaine in Relieving Post Extubation Laryngospasm: A Case Report

Ratul Kundu, Anindita Saha, Ananya Sukul and Suman Samanta

Article Type: Case Report | First Published: 2023/09/09

Laryngospasm is reversible spasm of vocal cords that is common in patients who are undergoing upper airway related surgeries under general anaesthesia. It occurs mostly following extubation; requires immediate management and if these patients are left untreated rapid decrease in saturation with bradycardia may take place. Lignocaine is considered effective in prevention of laryngospasm by both topical and intravenous route....

 Open Access DOI:10.23937/2377-4630/1410161

The Use of the Liposomal Bupivacaine in the Quadratus Lumborum Block and Early Surgery Are Key Elements in Facilitating Ambulatory Robotic-Assisted Laparoscopic Radical Prostatectomy

Yehoshua Feierman, Piyush M Gupta, MD, Daniel Escobar, MD, Akram Hossain, MD, Logan Fairchild, DO, David Silver, MD, Ervin Teper, MD, and Dennis Feierman, MD, PhD

Article Type: Original Article | First Published: 2023/08/27

To show that the addition of Quadratus Lumborum Block (QLB) to multimodal perioperative pain management decreases perioperative opioid use, decreases pain scores, and facilitates same day discharge after robotic assisted laparoscopic radical prostatectomies (RALP)....

 Open Access DOI:10.23937/2377-4630/1410160

The Unusual Migration of Right Subclavian Vein Triple Lumen Venous Catheter into Left Subclavian Vein: A Rare Presentation

Parul Raina, MD, Monica Yadav, MD and Abhishek Singh, MD

Article Type: Letter to Editor | First Published: 2023/06/10

Central venous catheter placement is associated with known risks and complications [1]. Its proper placement is necessary for long-term use. However, their mispositioning is not uncommon. But mispositioning of the catheter tip into the contralateral subclavian vein is extremely rare. After obtaining the informed written consent, we present an image of a 48-year-old female who presented to emergency with traumatic right above elbow amputation and blunt chest trauma. ...

 Open Access DOI:10.23937/2377-4630/1410159

Impact of mHealth on Informed Consent for General Anaesthesia in a Low to Middle-Income Country: A Double-Blind Randomized Control Trial

Sakina Bhaloo, MBChB, Vitalis Mung'ayi, MBChB, MMed, Wangari-Waweru Siika, MBChB, MMed, David Nekyon, MBChB, MMed and Jasmit Shah, MBChB, MMed

Article Type: Review Article | First Published: 2023/06/05

To establish whether patients who access a mobile health (mHealth) application following a pre-anaesthesia review have better knowledge of the anaesthetic process and higher satisfaction overall than those who receive a patient information leaflet....

 Open Access DOI:10.23937/2377-4630/1410158

A Near-Fatal Anaphylactic Shock: Differential Diagnosis and Management

Ryan Kaplevatsky, BA and Sabry Ayad, MD

Article Type: Case Report | First Published: 2023/05/24

Severe anaphylactic reactions to midazolam and Clindamycin are exceedingly rare. Thorough surveillance, early recognition, and prompt intervention for these reactions are imperative due to the widespread use of both of these medications in the surgical setting....

 Open Access DOI:10.23937/2377-4630/1410157

Cardiac Anesthesia Management of an Acquired Methemoglobinemia Patient

E Kesimci, E Bihorac and A Sezgin

Article Type: Mini Review | First Published: 2023/04/27

Acquired methemoglobinemia occurs most commonly from the ingestion of medications or toxins that oxidize the ferrous iron of hemoglobin. Anesthetizing patients with methemoglobinemia is a highly specialized task. Nevertheless, cardiac anesthesia for these patients requires high attention on maintenance of precise O2 delivery to tissues. We herein, describe an uneventful course of an acquired methemoglobinemia patient having on pump mitral valve replacement and two coronary vessel bypass grafting...

 Open Access DOI:10.23937/2377-4630/1410156

Changing Trends in the Management of Accidental Dural Puncture during Labor Epidural Analgesia: A Narrative Review and Recent Updates

Surjya Prasad Upadhyay and Ajit Kanbur

Article Type: Review Article | First Published: March 31, 2023

Inadvertent or accidental dural puncture while attempting epidural for labor analgesia is a known anaesthetist complication with potential for post dural puncture headache, increased morbidity, prolonged hospitalisation and overall medical cost. Historically, following accidental dural puncture- resitation of the epidural catheter at another level was the norm. Over the last 2-3 decades, there is a paradigm shift in the management of dural puncture while attempting epidural....

 Open Access DOI:10.23937/2377-4630/1410155

A Survey of the Factors Affecting Theatre Turnaround Time in Kenyatta National Hospital Main Theatres

Belinda Adda Namisi, Caroline H karugu and Vernon Mark Gacii

Article Type: Research Article | First Published: March 22, 2023

Operating theatres are heavily budgeted departments in health facilities. Theatre turnaround time (TAT) is used as one modality in determining the efficiency of health service delivery. Factors that correlate with TAT in the Kenyan setting are largely unknown. The main objective of this study was to determine the factors affecting turnaround time in Kenyatta National Hospital’s main theatres. This was a descriptive observational study done in September and October 2021. Data on personnel, surg...

 Open Access DOI:10.23937/2377-4630/1410154

Risk Factors Associated with Somato-Visceral Pain Investigation, in Scheduled Cesarean Section under Epidural Anesthesia with Lidocaine 2% and Adrenaline

BIZIMANA Prudence and Bin Wang

Article Type: Research Article | First Published: March 12, 2023

Epidural anaesthesia with 2% lidocaine has been reported to be more effective in caesarean section, but somato-visceral pain remains a potential complication, and can generate many dire effects including mother psychological impairment and burden. Pain during caesarean deliveries is a challenge, but any study was performed to identify risk factors associated to it. We conducted this study to identify pain risk factors, investigate whether surgical anaesthesia length is sufficient, and discover p...

 Open Access DOI:10.23937/2377-4630/1410153

Gender Equality in High-Quality Anesthesiology Research – A Descriptive Bibliometric Study on Scientific Authorships

Malte L Zipper, Doris Klingelhöfer, David A Groneberg and Michael HK Bendels

Article Type: Original Article | First Published: December 29, 2022

As in other scientific disciplines, medicine has undergone a huge movement in sex distribution due to an increasing number of women entering the field. The effects of this shift on gender equality in anesthesiology research are discussed in this study. Authorships in medical publications provide information of the grade of the author within the medical discipline. As a result, they can be used as indicators for integration within medical research....

 Open Access DOI:10.23937/2377-4630/1410152

A Comparison Study of Anesthetic Techniques in Elderly Patients between General and Regional Anesthesia in a Day Surgery Center: A Retrospective Cohort Study

Janvier Nibaruta, Lyu Xingjiao, Han Xiaoxia, Hou Xiaoyu, Cao Xuefen and Leng Yufang

Article Type: Original Article | First Published: December 21, 2022

The prevalence of geriatric surgery is rapidly increasing and, concomitantly, the procedure of anesthesia in the aging population. As a result, the goal of this research was to compare the efficacy of various anesthetic methods used in an ambulatory elderly population....

 Open Access DOI:10.23937/2377-4630/1410151

Is Peritonsillar Infiltration of Tramadol an Effective Method of Analgesia Following Tonsillectomy? A Systematic Review and Meta Analysis

Dilsher Randhawa, Emma Carnuccio, Fraser Nott, Suzannah Read, Anindya Banerjee and Arnab Banerjee

Article Type: Meta Analysis | First Published: December 15, 2022

Post-tonsillectomy pain is a common concern. This study aimed to assess the effectiveness of peritonsillar infiltration of tramadol during tonsillectomy in terms of analgesia requirement, pain scores and time to commencement of liquid diet, as there is heterogeneity in the randomized controlled trials conducted....

 Open Access DOI:10.23937/2377-4630/1410150

Management of Elective Cesarean Section Anesthesia in HIV-Positive Patients

Pinter Hartono and Yusmein Uyun

Article Type: Retrospective Study | First Published: November 11, 2022

A 23-year-old woman with a weight of 50 kg and a height of 150 cm with a diagnosis of primigravida pregnant at term not yet in labor with HIV positive. Consular patients from the Obstetrics and Gynecology section for elective cesarean section. The patient was diagnosed with HIV positive for 2 years. The patient had been on routine antiretroviral treatment for 2. In the preoperative assessment, which included history taking, physical examination, and investigations, the patient was assessed as ha...

 Open Access DOI:10.23937/2377-4630/1410149

Spinal Anesthesia: Position of Puncture, Ultrasound and Local Anesthetics Solution

Luiz Eduardo Imbelloni, MD, PhD

Article Type: Editorial | First Published: October 24, 2022

With the objective of identifying the best position for performing the lumbar puncture and identifying the distance from the skin to the interspinous space, 16 adult volunteers participating in measuring the distance with ultrasound between the lumbar region and the spinous processes in three positions: lateral decubitus, sitting and leaning forward, and sitting with the feet supported....

 Open Access DOI:10.23937/2377-4630/1410148

Thoracic Spinal Anesthesia is Safe and without Neurological Sequelae: Study with 1,406 Patients

Luiz Eduardo Imbelloni, MD, PhD, Marcos Fornasari, MD, Raphael Sant’Anna, MD and Geraldo Borges de Morais Filho, MSc

Article Type: Retrospective Study | First Published: October 06, 2022

Most anesthesiologists use the thoracic epidural, with a 0.75% incidence of accidental perforation. However, they are reluctant to consider higher levels for spinal anesthesia because of the possibility of direct spinal cord injury. The main objective of this retrospective study was to evaluate the incidence of paresthesia and neurological complications, as well as cardiocirculatory changes after thoracic spinal anesthesia....

 Open Access DOI:10.23937/2377-4630/1410147

Automation of Anesthesiology – Will Artificial Intelligence Replace Clinicians

Dmitry Neymark, BSc

Article Type: Commentary | First Published: October 01, 2022

As technology continues to evolve at an exponential rate, conversations about its innovative promise become increasingly prominent in every sphere of life. Medicine and the field of anesthesiology are no exceptions to this trend. Discussions surrounding the topic of artificial intelligence (AI) elicit a mixture of feelings, ranging from excitement about its potential for enhancing patient care to uncertainty about the impact it may have on the future of the profession among current and prospecti...

 Open Access DOI:10.23937/2377-4630/1410146

Anesthetic Management of a Glycogen Storage Disease Type 1a with Air Embolism During Liver Transplantation: A Case Report

Emre Kandemir, Nedim Çekmen and Adnan Torgay

Article Type: Case Report | First Published: September 08, 2022

Glycogen storage disease type 1a is a rare inborn error of metabolism. It causes severe fasting intolerance and lactic acidosis due to the deficiency of glucose-6-phosphatase enzyme. Anesthetic management of these patients is very difficult due to their course with different system involvements....

 Open Access DOI:10.23937/2377-4630/1410145

Multiple Intubation Trials and Body Weight Increase the Risk of Post-Operative Sore Throat after Tracheal Intubation in National Referral Hospitals in Asmara: A Prospective Observational Study

Yafiet M Ghebremeskel, Eyasu H Tesfamariam, Idris M Idris and Ghirmay Ghebreigziabher Beraki

Article Type: Original Manuscript | First Published: August 10, 2022

This study aimed to estimate the incidence rate and determine the possible associated factors for postoperative sore throat following surgery conducted under general anesthesia using endotracheal intubation....

 Open Access DOI:10.23937/2377-4630/1410144

Electrical Safety Symbols Used in Medical Equipment and Their Implication

Yilkal Tadesse Desta

Article Type: Expert Review | First Published: July 24, 2022

Electrical shock is dangerous event, which can occasionally happen when we are exposed to any of alive conducting materials. Every year people are died or seriously injured by electrical accidents since electric current is not detected. There are two kinds of danger: one from electrical shock and the other caused indirectly by electrical fires....

 Open Access DOI:10.23937/2377-4630/1410143

Prevention and Management of Post- Dura Puncture Headache (PDPH)

Aynalem Befikadu, Sara Timerga, Fasil Mihretu, Fetene Siyoum and Amare Agmuas

Article Type: Narrative Review | First Published: July 21, 2022

Post-Dural puncture headache (PDPH) is the commonest complications during diagnostic, therapeutic or inadvertent lumbar puncture. It is unavoidable problem during dural puncture and what we can do is decreasing the incidence by taking all precautions and if it occurs, manages appropriately. Despite the existence of wide ranges of popular therapies, there is a continuous controversy about their effectiveness....

 Open Access DOI:10.23937/2377-4630/1410142

Review of Literature: Efficacy of Intraoperative Intravenous Methadone in Reducing Postoperative Opioid Consumption

Praveen Karunanidhi

Article Type: Review Article | First Published: July 08, 2022

This article will review the current literature on the efficacy of intraoperative intravenous methadone in reducing postoperative opioid consumption in bariatric, ambulatory, complex spine, and cardiac surgeries....

 Open Access DOI:10.23937/2377-4630/1410141

Intraoperative Transesophageal Echocardiography Leading to Changes in Surgical Management in the Setting of Infective Endocarditis

Stephanie Opusunju Ibekwe, Noel Shaheen Jeffrey and Shannon Walter Schwenke

Article Type: Case Report | First Published: June 29, 2022

Infective endocarditis (IE) is a potentially lifethreatening disease process that may result in several long-term sequelae. Transthoracic echocardiography (TTE) may be inadequate to diagnose IE in up to 20% of patients secondary to poor image quality or the inability to identify all lesions present....

 Open Access DOI:10.23937/2377-4630/1410140

Opioid Free Anesthesia with Goal-Directed Strategies Based On Monitoring For Spine Surgery in a Patient with Opioid Intolerance: A Case Report

Dornelles Marco and Dornelles Larissa

Article Type: Case Report | First Published: June 29, 2022

This study aimed to report the use of a multimodal anesthetic (MA) regimen by combining panoply of drugs without opioids for posterior spinal fusion surgery in a patient with low-back incapacity and opioid intolerance....

 Open Access DOI:10.23937/2377-4630/1410139

Hemodynamic Effects Ketamine versus Ketamine with Thiopental for Patients Undergoing Abdominal Surgery

Andualem Assefa Andibirku, Zewde Zema Kanche, Birhanu Wondimeneh Demissie, Tsegaye Demeke G/Medihin, Ashebir Debalke Gemechu and Kirubel Eshetu Haile

Article Type: Research Article | First Published: June 29, 2022

Hemodynamic instability of patients during induction of anesthesia and intubation, are very important clinical concern. Hemodynamic change after induction of general anesthesia is a common event and associated with negative result in clinical practice....

 Open Access DOI:10.23937/2377-4630/1410138

Corona Pandemic: Individual Perception Assessment from the Perspective of Anesthesiologist

Ezgi ERKILIC, Cihan DOGER, Yasemin AKCAALAN, M Cem YILMAZ, Tulin GUMUS, Orhan KANBAK, Handan GULEC, Eyup Horasanli, Levent OZTURK3 and Nermin Gogus

Article Type: Research Article | First Published: June 20, 2022

Healthcare workers at the forefront during the COVID-19 pandemic faced increased workload and stress. Young doctors who are training in Anesthesiology and Reanimation residency are one of the groups most exposed to this condition....

 Open Access DOI:10.23937/2377-4630/1410137

Prolonged Recovery of Neuromuscular Transmission during General Anaesthesia after Mivacurium Administration - Case Report

Paweł Radkowski PhD, Katarzyna Podhorodecka and Dr Mariusz Keska

Article Type: Case Report | First Published: June 18, 2022

71 years old woman was admitted for an elective laparotomy surgery with an intraoperative examination. Standard monitoring and TOF Scan (both the adductor pollicis muscle and the orbicularis oculi) were used. 8mg dexamethasone, 0.1mg fentanyl, 150mg propofol, and 18mg mivacurium were administered for induction....

 Open Access DOI:10.23937/2377-4630/1410136

Epidural Anesthesia with Opioids in Open Colorectal Surgeries is not Related to Postoperative Ileum

Marina D Ayres, Luana A Ferreira, Davi B Khouri and Jose L Ubaldo

Article Type: Review Article | First Published: May 18, 2022

This is a short review describing recent data on the use of opioids in epidural anesthesia on abdominal surgery. It is known that postoperative pain has nociceptive, inflammatory and neuropathic components and must be prevented. The period following abdominal surgery is particularly challenging because it has other side effects related to the surgery, in addition to pain....

 Open Access DOI:10.23937/2377-4630/1410135

Effects of Ketamine-Fentanyl and Propofol-Fentanyl Combinations on LMA Insertion Conditions in African Children Undergoing Day- Case Herniotomy

Ajibade Okeyemi, Zakari Aliyu Suleiman, Olanrewaju Olubukola Oyedepo, Benjamin Olusomi Bolaji and Abidemi David Akere

Article Type: Original Article | First Published: May 18, 2022

Propofol is used as an induction agent to facilitate laryngeal mask airway (LMA) insertion but unwanted responses such as drop in blood pressure, cough, laryngospasm, movement and apnoea may occur....

 Open Access DOI:10.23937/2377-4630/1410134

General Anesthesia for the Gravid Patient in the Emergency Operating Room at Sanglah General Hospital

Achmad Munif, Kadek Intan Jelita, I Nyoman Santa Wijaya and Pontisomaya Parami

Article Type: Case Report | First Published: May 18, 2022

General anesthesia and regional anesthesia are the anesthetic techniques of choice for caesarian delivery. Anesthetic technique of choice is determined by several factors such as the safety of the parturient (evaluation of the airway and risk of aspiration), technical problems, the wellbeing of the fetus, and the experience of the anesthesiologist....

 Open Access DOI:10.23937/2377-4630/1410133

Unexplained Intraoperative Hypertension and an Electrocautery Burn: A Case Report

Chaeseong Lim, MD, PhD, Yujin Pak, MD, Hanmi Park, MD, Wonhyung Lee, MD, PhD, Seokhwa Yoon, MD, PhD, and Yongsup Shin, MD, PhD

Article Type: Case Report | First Published: March 31, 2022

Inadvertent electrocautery burns can occur in any patient under general anesthesia. Here we report on a 30-yearold man who underwent arthroscopic surgery on his hip under general anesthesia and experienced a deep second-degree burn from the grounding pad. Our aim is to increase awareness of this avoidable risk associated with electrocautery equipment among surgeons and anesthesiologists. Unexplained hypertension during surgery under general anesthesia may suggest an electrocautery burn. Over the...

 Open Access DOI:10.23937/2377-4630/1410132

Incidence and Risk factors of Postoperative Nausea and Vomiting after ENT Surgery

Petros K Yosief, Ghirmay G Beraki, Susanna Mayer, Michael B Mengistu and Eyasu H Tesfamariam

Article Type: Research Article | First Published: March 31, 2022

Ear Nose Throat (ENT) surgery has been the highest risk of postoperative nausea and vomiting. Despite the advancement of the modern anesthetic techniques in the management and understanding of postoperative nausea and vomiting (PONV), the events of nausea and vomiting in ENT surgery still remains a major problem for participants in the postoperative care unit. Therefore, the aim of this study was to determine the incidence and identify the risk factors of PONV among surgical ENT participants in ...

 Open Access DOI:10.23937/2377-4630/1410131

Anesthetic Immunomodulation and the Tumor Recurrence: A Narrative Literature Review

Gabriele F Silveira, Isadora AC Fraga, Larissa RM Castro, José Lucas UM Gomes, Marina A Delgado

Article Type: Narrative Review | First Published: March 30, 2022

Surgical interventions and the anesthesia chosen for the procedure induce immunosuppression in the perioperative period, triggering the release of pro-inflammatory cytokines, favoring tumor growth and recurrence. However, it must be clarified what actually influences immunomodulation: the surgical technique, the anesthetic used, the type of tumor or a combination of all of them. Both the surgery and anaesthetic technique can exert immunomodulatory effects, and, therefore, they may contribute to ...

 Open Access DOI:10.23937/2377-4630/1410130

Anesthetic Management in a Parturient with Thrombotic Thrombocytopenic Purpura for Cesarean Section: A Case Report and Literature Review

Dimitra Karantoula, Emmanouil Stamatakis, Sofia Hadzilia, Panagiotis Antsaklis and Dimitrios Valsamidis

Article Type: Case Report and Review Article | First Published: December 20, 2021

Thrombotic thrombocytopenic purpura (TTP) is a rare and life-threatening thrombotic microangiopathy (TMA) characterized by microangiopathic hemolytic anemia, severe thrombocytopenia, and organ ischemia linked to disseminated microvascular platelet rich-thrombi. TTP is specifically related to a severe deficiency of ADAMTS13, a cleaving protease for von Willebrand (vWF). TTP is occurring in between 1 and 13 cases per million people depending on geographic location, and 1 in 25,000 pregnancies. We ...

 Open Access DOI:10.23937/2377-4630/1410129

Acute Kidney Injury in the Perioperative Period: Beyond the Obvious

Diego Escarramán Martínez, Manuel Alberto Guerrero Gutiérrez, José Antonio Meade Aguilar, Miguel Ángel Martínez Rojas, Orlando Rubén Pérez Nieto, Bertha M Córdova Sánchez, Eder Ivan Zamarrón Lopez and Jesús Salvador Sánchez Diaz

Article Type: Perioperative Care | First Published: December 18, 2021

Acute kidney injury (AKI) represents a great challenge for the anesthesiologist during the perioperative period, since its presence directly impacts in patients mortality and morbidity, even after its resolution as a result of multiples factors. Furthermore, it is characterized by coexisting with a great variety of systemic alterations, which add special difficulty to its study and understanding. During perioperative period there may be ischemic insult and non-ischemic insult, on the other hand,...

 Open Access DOI:10.23937/2377-4630/1410128

Consensus Reached on How to Recognise and Manage Sepsis and Septic Shock by Intensivists in Northeast Nigeria Held at the University of Maiduguri Teaching Hospital, Borno State Nigeria

Adamu A Sadiq, Ballah Abubakar, Shehu U Panda, Hassan MA, Buma GB, Dakum Longji, Jimoh L Mufutau and Alfa Ndakotsu

Article Type: Case Report | First Published: December 04, 2021

Worldwide, sepsis is a serious health threat and is among the leading cause of death in patients admitted into Intensive Care Units in hospitals across Nigeria and northeastern Nigeria, in particular. Patients of all sexes and ages are affected. However, the vulnerable groups such as extremes of ages (neonates and elderly), pregnant women, the immune-compromised, and those with underlying chronic medical conditions are more at risk. As a low income country, sepsis is a major burden to our health...

 Open Access DOI:10.23937/2377-4630/1410127

Rapid Progression of Neonatal Respiratory Distress from Laryngeal Cleft Type I: A Case Report

Yumi Doi, MD, PhD and Eiji Nishijima, MD

Article Type: Case Report | First Published: December 02, 2021

A one-month-old boy showed cyanosis and severe retraction on crying. He underwent diagnostic rigid bronchoscopy under general anesthesia, maintaining spontaneous ventilation. Rigid bronchoscopy revealed laryngeal cleft type I and excessive mucosa in the interarytenoid space that protruded into the subglottic area, very unusual findings in laryngeal cleft. His clinical condition quickly deteriorated and tracheotomy was performed to prevent complete airway obstruction in the few days until surgica...

 Open Access DOI:10.23937/2377-4630/1410126

Epidural Blood Patch for Spontaneous Intracranial Hypotension

Li Weiling Lydia, MBBS, MMed, Lim Yiqi Ofelia, MBBS, Chan Lijuan Jasmine, BMed/MD and Alex Joseph, MBBS, MD, FRCA

Article Type: Case Report | First Published: September 05, 2021

Spontaneous intracranial hypotension (SIH) is uncommon and postulated to occur due to spontaneous cerebrospinal fluid (CSF) leak. Subdural hemorrhage is a rare but serious complication of intracranial hypotension. With a paucity of high-level evidence to guide treatment, its management remains challenging. We report a case of spontaneous intracranial hypotension which was successfully treated with an epidural blood patch. The patient is a 59-year-old man with poorly controlled diabetes and hyper...

 Open Access DOI:10.23937/2377-4630/1410125

Cardiac Anesthesia Would Be Better With Ultrasound Guided Erector Spinae Plane Block

AHMED Hassan S, MD, MADKHALI Majeed M, MD, SHIHATA Mohammed S, MD and ZABANI Ibramin A, MD

Article Type: Case Report | First Published: August 28, 2021

On July 2020, The International Association for the Study of Pain released the revised definition of pain. Stressing that pain is always a personal experience and should be respected. Candidates of cardiac surgical procedures have significant issues to address regarding outcome of procedure and post-operative pain as well. Cardiac surgical procedures are done either through midline sternotomy or thoracotomy; both are associated with significant pain. Pain can be debilitating and frustrating. It ...

 Open Access DOI:10.23937/2377-4630/1410124

Pseudocholinesterase Deficiency and Patient Perspectives

Jevaughn Davis, MD, Anita Vincent, MD, and Geetha Shanmugam, MD

Article Type: Case Report | First Published: August 25, 2021

Pseudocholinesterase deficiency, commonly referred to as Butyrylcholinesterase deficiency, is a rare, inherited, or acquired condition that results in decreased or absent enzymatic activity. Pseudocholinesterase is a plasma enzyme that is responsible for the breakdown of succinylcholine and mivacurium, which are commonly used paralytic agents. People with this condition are usually unaware they have the disease, and the disease may not manifest until extubation at the end of surgery. These patie...

 Open Access DOI:10.23937/2377-4630/1410121

Minimal Flow Application in Single Lung Ventilation

Fatih Dogu GEYIK, Yucel Yuce, Gulten Arslan and Kemal Tolga Saracoglu

Article Type: Clinical Study | First Published: July 24, 2021

Interest in low fresh gas flow anesthesia methods has gradually increased over the decades. The high standard of anesthesia machines, the presence of monitors that analyze the anesthetic gas composition continuously and in detail, and the increase in knowledge on the pharmacodynamics and pharmacokinetics of inhalation anesthetics have greatly facilitated the safe administration of low-flow anesthesia. The reasons for anxiety about low fresh gas flow techniques are that the anesthesiologist does ...

 Open Access DOI:10.23937/2377-4630/1410123

Comparison of the Effects of Target-Controlled Propofol Infusion and General Anesthesia with Desflurane on Postoperative Cognitive Functions in Controlled Hypotensive Anesthesia

Ayse Altun Gezgel, Fatih Dogu Geyik, Yucel Yuce, Ibrahim Gezgel, Banu Cevik and Kemal Tolga Saracoglu

Article Type: Clinical Study | First Published: August 13, 2021

We evaluated anesthesia depth, cerebral oxygenation and postoperative cognitive functions with NIRS and BIS monitoring and Mini-Mental State Examination (MMSE) score. We studied 60 patients with American Anesthesiologists Association (ASA) I-II, over 18 years of age, with a preoperative MMSE test score of 23 and above. Hemodynamic parameters, BIS and bilateral NIRS values were recorded. The mean arterial pressure (MAP) value was kept between 55-65 mmHg. MMSE test was repeated 1 hour before and 2...

 Open Access DOI:10.23937/2377-4630/1410122

Spinal Anesthesia: Much More Than Single Shot of Hyperbaric Bupivacaine

Luiz Eduardo Imbelloni, MD, PhD, Marildo A Gouveia, MD, Nathália Maluf Ghorayeb, MD, and Sylvio Valença de Lemos Neto, MD, PhD, MBA

Article Type: Research Article | First Published: August 11, 2021

There is significant and renewed attentiveness in the use of regional anesthesia techniques for many common surgeries. The vast majority of anesthesiologists world wide use the routinely the hyperbaric solution of bupivacaine for almost all types of surgery. However, they ignore that spinal anesthesia has more to offer. A different kind of technique for a different kind of patients. The understanding of spinal anesthesia in relation to sensory and motor blocks with hyperbaric and isobaric soluti...

 Open Access DOI:10.23937/2377-4630/1410120

Opioid-Free Anesthesia in Bariatric Surgery: A Retrospective Cohort Study

Judith Aronsohn, MD, Masha Zeltsman, DO, Madina Gerasimov, MD, Greg Palleschi, MD, Patriot Yang, MD and Oonagh Dowling, PhD

Article Type: Brief Report | First Published: March 29, 2021

The objective of this study is to evaluate the analgesic efficacy and patient recovery characteristics when utilizing opioid- free anesthesia (OFA) as part of a multimodal enhanced recovery after surgery pathway (ERAS) for bariatric surgery. Retrospective cohort study. Data was collected from medical records from June 2018 to September 2019 for consecutive patients aged 18 and older undergoing elective laparoscopic sleeve gastrectomy for obesity. A standardized ERAS pathway for bariatric surgery...

 Open Access DOI:10.23937/2377-4630/1410119

Herpes Zoster in an Immunocompetent Adult in the Tropic with Vitamin D Deficiency: A Case Report

Evaristus Chinonye Ezema, Obioma Onah Ezema and Emmanuel Joachim Nebuwa

Article Type: Case Report | First Published: December 31, 2020

Human herpes virus infection induces lifelong latent infection that most likely reactivates when the immune system deteriorates. It usually presents with localized, painful vesicular rash in one or contiguous dermatomal distributions. Although, more serious manifestations like aseptic meningitis, acute retinal necrosis, herpes zoster ophthalmicus and Ramsay Hunt syndrome especially in the immunocompromised. We report a case of 2-dermatomal cutaneous herpes zoster in an adult in the tropic with v...

 Open Access DOI:10.23937/2377-4630/1410118

The Effect of Single-Dose Preemptive Intravenous Ibuprofen on the Intraoperative Hemodynamic Parameters, Recovery Characteristics, and Acute Pain after Laparoscopic Cholecystectomy: A Randomized Double-Blind, Placebo-Controlled Clinical Trial

Ozlem Sezen, MD, Banu Cevik, MD and Kemal Tolga Saracoglu, MD

Article Type: Original Article | First Published: December 31, 2020

The aim of this study was to investigate the effects of the preemptive administration of a single dose of intravenous (IV) ibuprofen on the intraoperative hemodynamic parameters, recovery characteristics, and postoperative pain management in patients undergoing laparoscopic cholecystectomy. The time to first analgesic requirement during postoperative period was the main goal of this study. Following ethical committee approval, sixty patients scheduled for laparoscopic cholecystectomy with Americ...

 Open Access DOI:10.23937/2377-4630/1410116

Meta-Analysis and Evidence Base for the Efficacy of High Frequency Oscillatory Ventilation (HFOV) in ARDS Management: Systematic Review and Quality Assessment

Mohamed E Awad, MD, MBA, Mohamed Gaber, MD, Suhib I Alhusban, MD, Sung Chu, BS, Colville HB Ferdinand, MD, FACS and Mohamed Ben Omran, MD

Article Type: Original Article | First Published: December 30, 2020

To evaluate the efficacy of high frequency oscillatory ventilation (HFOV) in management of acute respiratory distress syndrome and determine whether if there is any superiority over the conventional mechanical ventilation (CMV). A systematic review and meta-analysis were conducted according to PRISMA checklist and the Cochrane Handbook for Systematic Reviews of Interventions. The search of the literature was performed through several search databases: PubMed, MEDLINE via Ovid, and web of science...

 Open Access DOI:10.23937/2377-4630/1410115

Use of Dexmedetomidine in Pediatric Patients for the Decrease of the Postoperative Delirium: Implementation of a Protocol Approved for Premedication

Patricia Catalán Escudero, Adolfo Ramos Luengo, Eva Delgado Encinas and Ernesto Martínez García

Article Type: Original Article | First Published: November 30, 2020

Delirium is a very frequent alteration of postoperative behavior in children. Tonsillectomy surgery is related to severe sleep apnea and does not indicate benzodiazepine premedication. Non-premedication is directly related to the presence of negative behaviors. Dexmedetomidine is a safe option for children with obstructive sleep apnea (OSA) since it does not affect airway tone. The main aim of this retrospective observational study is determining whether intranasal dexmedetomidine premedication ...

 Open Access DOI:10.23937/2377-4630/1410114

Malignant Tracheal Invasion Masked by COVID-19 Symptoms

Chase D Rose, MD, Andrew W Murray, MD, David G Lott, MD, Patrick A Devaleria, MD and Bradford B Smith, MD

Article Type: Case Report | First Published: November 27, 2020

The coronavirus disease 2019 (COVID-19) pandemic has significantly altered the delivery of healthcare, particularly for patients undergoing perioperative surgical care. We present a case of successful airway and surgical management of a patient with substernal tracheal invasion by thyroid cancer whose care was complicated by a diagnosis of COVID-19. We recommend providers exhibit vigilance in addition to multidisciplinary evaluation and planning to limit exposure and avoid potential morbidity an...

 Open Access DOI:10.23937/2377-4630/1410113

Trans-Thoracic Echocardiography during VA-ECMO: May the Supra-Sternal Notch View Detect a Too-Proximally Watershed Area?

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

Multimodal Technique to Maximize Perioperative Pain Control and Minimize Opioid Use in a Patient Undergoing Laparoscopic Cholecystectomy: A Case Report

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

A Comparison of qSOFA and SIRS in the Early Diagnosis of Severe Pneumococcal Sepsis: A Retrospective Cohort Study

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

Palliative Therapy of Refractory Dyspnea with Low Dose Transdermal Applied Buprenorphine: An Observational Study

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

A Series of Erector Spinae Plane Blocks Reduced Pain and Opioid Consumption in Patients with Post Herpetic Neuralgia: Two Patient Cases

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

Sugammadex-Is Cost the Only Drawback?

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

Massive Subcutaneous Emphysema and Intraoperative Hypercarbia after Transanal Endoscopic Microsurgery (TEMS)

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

Effect of Opioid-Free Anaesthesia on Perioperative Period: A Review

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

Protective Measures for Clinical Physicians When Performing Tracheal Intubation for Patients with Acute Respiratory Syndrome of the Coronavirus Disease 2019 (COVID-19)

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

Cor Triatriatum Dexter and Patent Foramen Ovale Discovered Following Cardioembolic Stroke

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

Intraoperative Activation of Very Wide Range Cold Agglutinins during a Cardiac Bypass Case

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

Postpartum Infectious Sacroiliitis Temporally-Related to Continuous Labor Epidural Analgesia: Was the Epidural to Blame? A Case Report and Review of the Literature

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

General Anesthesia Affecting on Developing Brain: Evidence from Animal to Clinical Research

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

Perioperative Management of Multiple Intracranial Nail Gun Injuries

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

Does Esmolol Havean Effect on Erythrocyte Deformability in Rat Lower Limb Ischemia Reperfusion Injury?

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

Anaesthesia Monitoring using Artificial Intelligence Techniques

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

Levo-Bupivacaine vs. Ropivacaine for Post-Operative Pain Relief after Pre-Emptive Intraperitoneal Instillation in Laparoscopic Appendicectomy

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

Epidural Anesthesia for a Caesarean Delivery in a Parturient with an Intrathecal Baclofen Pump and Sickle Cell Disease: A Case Report

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

Persistent Lactic Acidosis - Think beyond Sepsis

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

Posterior Quadratus Lumborum Block versus Subcostal Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy

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

A Prospective Observational Study of Air Burden in Intravenous Tubing: Factors that Increase Patient Exposure

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

Transversus Abdominis Plane (TAP) Block as a Potential Diagnostic and Therapeutic Tool for Treatment of Chronic Post Herniorrhaphy Pain: A Case Report

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

Current Status of Obstetric Anaesthesia Services (Oasis): A Cross-Sectional Survey of Public Hospitals in Khartoum State, Sudan

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

Inhalation Induction in Tracheostomized Patients: Comparison of Desflurane and Sevoflurane

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

Postoperative Analgesia after Combined Obturator Nerve and Adductor Canal Block in Total Knee Arthroplasty

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

Spinal Anesthesia for Emergent Testicular Torsion Surgery in a Pediatric Patient with Spinal Muscular Atrophy Type-II

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

Perioperative Management in Patients with Factor XI Deficiency

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

N-Terminal Pro-Brain Natriuretic Peptide in Post Cardiac Surgery as a Predictor of Ventilator-Weaning Outcomes

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

Acute illness, Co-morbidity and Mortality in a Norwegian Intensive Care Population

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

Dexmedetomidine Infusion an Effective Intra-Operative Medication for Patients Undergoing Laparoscopic Cholecystectomy

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

Efficacy and Safety of the Intraosseous Vascular Access in out-of-Hospital Emergencies: A Prospective Study of the Pre-Hospital Emergency Service (SUEM 118) of Padua from 2012 to Today

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

Apneic Oxygenation and High Flow

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

Hemostatic Coagulation Management in Trauma

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

Occurrence of Tension Pneumothorax following Fogarty Embolectomy Catheter use for Lung Isolation in a Neonate with Congenital Pulmonary Airway Malformation

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

A Rare Case of an Adult Congenital Diaphragmatic Hernia becoming Symptomatic after an Elective Procedure

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

Iatrogenic Nerve Injury Resulting in Respiratory Failure after Mediastinoscopy

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

Quality of Life and Anxiety Status following Donor Liver Transplantation

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

Outcome of Self- and Planned Extubation in Organophosphate-Poisoned Patients

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

Accidental Perforation of Subarachnoid Space with Spinal Introducer

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

Menstrual Cycle Phase May Effect the Thermoregulation during Anesthesia

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

When Equipment Misbehaves: Severe Respiratory Acidosis Resulting from a Compromised Coaxial Circuit

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

Uncommon Complication for Commonly Used Drugs: Cardiac Arrest after Administration of Succinylcholine

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

Lumbar Sympathetic Block for Bilateral Post-Prostatectomy Lower Extremity Pain in the Femoral Nerve Distribution

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

An Accidental Arterial Puncture and Anticoagulation after Internal Jugular Vein Catheterization Resulting in Massive Hematoma and Airway Compromise

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

Sevoflurane but not Propofol Induces Immunomodulatory Effects in Patients Undergoing Aortic Valve Replacement and Cardiopulmonary Bypass

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

Interdisciplinary Anesthesia Tray Revision Project: Reducing the Opportunity for Human Error

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

Transient Unilateral Lower Limb Palsy after Open Surgery Thoraco-Abdominal Aorta Repair

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

Anesthesia Implications of the Use of Essential Oils in Alzheimer's Dementia

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

Analyzing Volatile Anesthetic Consumption by Auditing Fresh Gas Flow: An Observational Study at an Academic Hospital

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

Acute Pain Management in a Child: A Case Report of 46-Days of Popliteal Sciatic Nerve Catheter

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

Perioperative Cardiac Stent Thrombosis Versus Bleeding: A Clinical Dilemma in Trauma Patients

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

Phenytoin in Topical Formulations Augments Pain Reduction of Other Analgesics in the Treatment of Neuropathic Pain

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

Timely Detection of Epidural Catheter Migration: Diagnosis and Management: A Case Report

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

Pourfour Du Petit Syndrome Presenting as Subdural Block. A Rare Complication of Obstetric Epidural Analgesia: A Case Report

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

Extubating Techniques for the Difficult Airway

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

Trachway Intubating Stylet Facilitates the Double-Lumen Endobronchial Tube Placement in Patients with Limited Mouth Opening

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

Treatment-Resistant Severe Hypothermia in an Infant Caused by the AirSeal® Insufflator

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

A Case Report: Adaptive Servo Ventilation for a Patient with Acute Heart Failure and Central Sleep Apnea

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

Systemic Air Embolism during ERCP with Full Recovery

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

Perioperative Management of Patients Refusing Blood Products

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

Renal Transplantation: An Update for Anaesthetists

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

A New Age for Sepsis/Septic Shock Diagnosis and Management?

Enrico Giustiniano

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

Which Guidance Method during Tracheotomy Procedure in Patients with Short Neck in the ICU? A Prospective Randomized Study

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

Pre-Clinical Pharmacokinetics of Sufentanil-2-Hydroxypropyl-Β-Cyclodextrin Inclusion Complex

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

Ultrasound-guided Transmuscular Quadratus Lumborum (TQL) Block for Pain Management after Caesarean Section

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

Comparison of the Analgesic Effects of Preemptive Lornoxicam and Paracetamol after Laparoscopic Cholecystectomy

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

A Retrospective Review of Corneal Abrasions after Oncologic Surgery in a Tertiary Cancer Center

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

Feasibility and Timing of Craniosynostosis Surgery in a Child with Hypoplastic Left Heart Syndrome

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

A Comparison of Three Different Supraglottic Airway Devices in Neonatal Airway Training during Resuscitation Simulation

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

Are Advertisement Claims in Anaesthetic Journals based on High-Quality Evidence?

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

Integrated Pulmonary Index: A New Strategy for Respiratory Patients Evaluation

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

Anesthesiologists as Operating Room Directors: Results of a Survey

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

The Evaluation of 1-Physician Versus 2-Physician Deep Sedation with Propofol

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

Difficult Airway Management in Patients Submitted to General Anesthesia. Is it a Matter of Devices or Predictive Scores?

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

The Effect of Perioperative Restrictive Fluid Therapy on Postoperative Edema and Ecchymosis in Rhinoplasty

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

Use of Human Fibrinogen Concentrate in Pediatric Cardiac Surgery Patients

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

A Comparative study on Efficacy of 10% and 20% Mannitol for Inducing Diuresis During Renal Transplant Surgery

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

Severe Respiratory Suppression Secondary to Buprenorphine Treated with Volume Assured Pressure Support (VAPS)

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

The Effect of Dexmedetomidine and Propofol on Oxidative Stress Parameters during Lower Extremity Surgery: A Prospective Randomized Trial

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

Safety and Efficacy of Remifentanil for Single Agent Procedural Sedation: A Systematic Review

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

The Effects of High-Dose Sugammadex on Erythrocyte Deformability in Rats with Renal Failure Generated by Unilateral Ureteral Obstruction

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

Aminophylline does not Prevent Postdural Puncture Headache in Caesarean Section

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

Perceptions and Attitudes of Anesthesiologists toward Pain Management: A Survey of Pain Categories

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

Early Signs and Perinatal Diagnosis of Tracheal Agenesis

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

Long-Term Function, Pain and Medication Use Outcomes of Radiofrequency Ablation for Lumbar Facet Syndrome

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

Prevention of Postoperative Acute Lung Injury (ALI) - The Anaesthetist Role

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

Effect of Sevoflurane and Desflurane on Erythrocyte Deformability during Ischaemia-Reperfusion Injury of Lower Extremity in Diabetic Rats

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

Retention of Finger Blood Flow against Postural Change Has the Potential to Become a New Indicator of Sympathetic Block in the Upper Limb - A Preliminary Study

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

The Concentration for Loss of Consciousness by Propofol does not differ between Morning and Afternoon

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

Cost - Benefit Analysis of Focused Pre-Operative Transthoracic Echocardiography in the Pre-Operative Clinic in Patients at Increased Cardiac Risk Presenting for Non-Cardiac Surgery - A Pilot Study

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

Management of Anesthesia in A Patient with Myasthenia Gravis

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

Airway Management following Facial Trauma Caused by a Pit Bull Attack

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

Fontan Physiology: Anaesthetic Implications for Non-Cardiac Surgery: A Case Report

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

Proposing a Novel Concept to Evaluate Safety of Supraglottic Devices Regarding Seal Pressure during Laparoscopic Surgery

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

Time and Motion Study Assessment of Simulated Rapid Sequence Intubation

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

Robotic Surgery, Hypertrophic Cardiomyopathy and Difficult Airway - A Challenging Combination for the Anesthesiologist! : A Case Report

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

Ultrasound Guided Regional Anesthesia Training Simulator Using Microsoft Kinect

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

Endotracheal Repair of an Iatrogenic Tracheal Laceration in A 83-Year-Old Critically Ill Woman with Aspiration Pneumonitis and Sepsis

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

Need of Ultrasound in Emergency Department for Suprapubic Catheterization

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

Allergy to General Anesthetics: Evaluation of Patients Profile

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

Supplementary Low - Dose Oral Ketamine Provides Better Parental Separation and Face Mask Acceptance

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

Six Month Quality of Life of Trauma Patients from A Non- Trauma Regional Hospital in Singapore

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

What Happens if The Patient Does Not Tell the Truth to His Anesthesiologist?

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

Platelet Count and INR Profile after Hepatic Resection in Cirrhotic Patients: Implications for Epidural Analgesia

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

Is Left Ventricular Hypertrophy Early Regression Possible?

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

Airway Management in a Patient with Metatropic Dysplasia: Grossly Abnormal Anatomy Combined with a Low Functional Residual Capacity

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

Preemptive Analgesia of Ultrasound - Guided Transversus Abdominis Plane Block Compared with Deep Wound Infiltration in Patients Undergoing Urological Surgery

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

Intrathecal Dexmedetomidine or Meperidine for Post-spinal Shivering

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

Anaesthetic Management in a Patient with Glomus Jugulare Tumour for Ankle Surgery

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

MOCA - 'Improving Home Improvement'

Semyon Fishkin

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

Postoperative Respiratory Complications

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

Anesthesia and Critical Care: Profession or Art?

Giustiniano Enrico

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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