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...
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...
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...
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...
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...
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 ...
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...
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...
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...