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1.
Neurourol Urodyn ; 43(3): 574-578, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38238985

RESUMEN

INTRODUCTION: Staged sacral neuromodulation (SNM) testing has been shown to have a high rate of progression to permanent implantation for the management of voiding dysfunction. Stage 1 lead placement (SNM-I) can be performed under monitored anesthesia care (MAC) or general anesthesia (GA). MAC allows for interpretation of sensory and motor responses to optimize lead placement while GA only permits for motor assessment. However, patient discomfort and movement can make lead placement challenging during MAC. Herein we evaluate whether the anesthesia type impacts the progression rate to permanent implantation (SNM-II). MATERIALS AND METHODS: A retrospective chart review was performed for patients who underwent SNM-I in the operating room for wet overactive bladder between 2005 and 2023. Patients were divided into two groups based on the type of anesthesia used, MAC or GA. Clinical variables and progression to SNM-II were compared between cohorts. Progression to SNM-II was based on ≥50% symptomatic improvement during a 1-2 week trial period following SNM-I. RESULTS: Of 121 patients included in the study, 95 (79%) underwent MAC and 26 (21%) GA for SNM-I. No difference in the progression rate to SNM-II was noted between groups (MAC, 68/95 patients, 72%; GA, 19/26, 73%; p = 0.39). We also found no difference when comparing the GA group to the 26 most recent MAC patients (MAC, 20/26 patients, 77%; GA, 19/26, 73%; p = 0.48). CONCLUSION: Types of anesthesia for SNM-I did not affect rate of progression to SNM-II. The result lends support to the reliance on motor responses alone for lead placement during SNM-I.


Asunto(s)
Anestesia , Terapia por Estimulación Eléctrica , Vejiga Urinaria Hiperactiva , Humanos , Estudios Retrospectivos , Vejiga Urinaria Hiperactiva/diagnóstico , Vejiga Urinaria Hiperactiva/terapia , Sacro , Resultado del Tratamiento
2.
AANA J ; 92(1): 27-34, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38289684

RESUMEN

We present an overview of best practices for integrating emotional intelligence into a nurse anesthesia educational program. We first cover a brief history of the importance of emotional intelligence to the healthcare, nursing, and nurse anesthesia fields and then present the processes we undertook to integrate emotional intelligence holistically into our curriculum.


Asunto(s)
Anestesia , Anestesiología , Educación de Postgrado en Enfermería , Humanos , Curriculum , Inteligencia Emocional
3.
Medicine (Baltimore) ; 103(1): e36317, 2024 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-38181270

RESUMEN

The severity of severe pneumonia in children depends on the degree of local inflammation, spread of lung inflammation and systemic inflammatory response. Appropriate care can effectively reduce the mortality of children with severe pneumonia. This study was designed to explore the nursing effect of targeted sedation nursing and comprehensive nursing intervention in children with severe pneumonia. Eighty children with severe pneumonia who complained of the main complaint were selected, and they were evenly distributed to receive comprehensive care (control group) and targeted sedation care and comprehensive care (observation group). In each group, different degrees of sedation, pain scores, and changes in adverse reactions were evaluated. Before nursing, the sedation and pain scores of the 2 groups of children were not statistically significant; after nursing, the sedation and pain scores of the 2 groups of children improved with time, and the sedation effect of the observation group was significantly lower than that of the control. In the group, the pain score was lower than that of the control group, indicating improvement. The SAS and SDS of the observation group were lower than those of the control group, while the social support score was significantly higher than that of the control group. The difference was statistically significant (P < .05). The accidental extubation, delirium, respiratory depression, and laryngospasm of the 2 groups of children were significantly improved, and the observation group was significantly less than the control group. This difference was statistically significant (P < .05). Targeted sedation nursing and comprehensive nursing intervention can effectively reduce the incidence of adverse reactions in children with severe pneumonia, reduce the pain and discomfort of children with severe pneumonia, and significantly improve the degree of sedation, which has certain reference value for the care of children with severe pneumonia.


Asunto(s)
Anestesia , Neumonía , Niño , Humanos , Inflamación , Dolor , Atención Integral de Salud
4.
Artículo en Alemán | MEDLINE | ID: mdl-38190827

RESUMEN

Patients undergoing challenging medical procedures often suffer from high levels of anxiety and stress. Their most important need is a feeling of control and safety. Hypnotic communication provides a means of addressing these feelings without medication. The core technique is to use the perceived stimuli, like beeping sounds or the pressure of the ventilation mask and re-evaluate them as helpful signs. For example, the beeping sounds can be an indicator of the optimal treatment with the highest level of medical equipment in the intensive care unit and the pressure of the ventilation mask might feel like a tight hug of a friend that wants to help. Positive suggestions work even better when patients are in a trance state. In the intensive care unit, you can use the natural trance state instead of inducing a formal hypnotic trance. Positive suggestions can even help to prevent negative emotions before the challenging medical procedure starts. It greatly improves patients' well-being to replace common phrases in the everyday medical practice. This article gives examples of better phrasings and elaborates the scientific evidence of positive suggestions that can even stop bleeding. The goal is to show simple ways to improve communication with patients and induce feelings of control and safety.


Asunto(s)
Anestesia , Anestesiología , Hipnosis , Humanos , Ansiedad , Hipnóticos y Sedantes
5.
Artículo en Inglés | MEDLINE | ID: mdl-38218568

RESUMEN

Nile tilapia, Oreochromis niloticus, is the most cultivated fish species in the world, due to its low cost, high growth rate, environmental adaptability, and resistance to disease and stress. Anesthetics for fish become necessary in management because they minimize mortality during transport and maintenance of ponds, one of the most used anesthetics is clove oil, which has eugenol as the major substance, representing 90-95 % of clove oil. The present study evaluates the effect of eugenol on cardiac activity in Oreochromis niloticus specimens and relates it to behavioral data to determine a concentration window for safe anesthesia. For the comportamental analysis, was used five treatments (50, 75, 100, 125, and 150 µL·L-1) were evaluated and for the eletrocardiographic test was used seven groups (Control, Vehicle, 50, 75, 100, 125, and 150 µL·L-1), n = 9/treatment, totaling 108 animals. Behavioral and electrocardiographic tests were performed on all treatments during induction and recovery. The results of the behavioral tests demonstrated the reversibility of the effects with recovery of the posture reflex, varying according to the concentration. The ECG results showed a slow recovery because, at concentrations above 100 µL·L-1, there was no full reversibility of the cardiac effects in the observed experiment time, which could cause greater changes in the tilapia hemodynamics, which led us to identify a window for safe anesthesia. Eugenol is an effective anesthetic in Nile tilapia juveniles when used in concentrations ranging from 50 to 100 µL·L-1, if there is a need for anesthetic deepening, doses above 100 µL·L-1, however, the animals must be monitored due to hemodynamic changes.


Asunto(s)
Anestesia , Anestésicos , Cíclidos , Animales , Eugenol/toxicidad , Aceite de Clavo , Baños , Inmersión , Anestésicos/toxicidad , Anestesia/veterinaria
6.
Theranostics ; 14(2): 480-495, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38169536

RESUMEN

Background: The neurobiological basis of gaining consciousness from unconscious state induced by anesthetics remains unknown. This study was designed to investigate the involvement of the cerebello-thalamus-motor cortical loop mediating consciousness transitions from the loss of consciousness (LOC) induced by an inhalational anesthetic sevoflurane in mice. Methods: The neural tracing and fMRI together with opto-chemogenetic manipulation were used to investigate the potential link among cerebello-thalamus-motor cortical brain regions. The fiber photometry of calcium and neurotransmitters, including glutamate (Glu), γ-aminobutyric acid (GABA) and norepinephrine (NE), were monitored from the motor cortex (M1) and the 5th lobule of the cerebellar vermis (5Cb) during unconsciousness induced by sevoflurane and gaining consciousness after sevoflurane exposure. Cerebellar Purkinje cells were optogenetically manipulated to investigate their influence on consciousness transitions during and after sevoflurane exposure. Results: Activation of 5Cb Purkinje cells increased the Ca2+ flux in the M1 CaMKIIα+ neurons, but this increment was significantly reduced by inactivation of posterior and parafascicular thalamic nucleus. The 5Cb and M1 exhibited concerted calcium flux, and glutamate and GABA release during transitions from wakefulness, loss of consciousness, burst suppression to conscious recovery. Ca2+ flux and Glu release in the M1, but not in the 5Cb, showed a strong synchronization with the EEG burst suppression, particularly, in the gamma-band range. In contrast, the Glu, GABA and NE release and Ca2+ oscillations were coherent with the EEG gamma band activity only in the 5Cb during the pre-recovery of consciousness period. The optogenetic activation of Purkinje cells during burst suppression significantly facilitated emergence from anesthesia while the optogenetic inhibition prolonged the time to gaining consciousness. Conclusions: Our data indicate that cerebellar neuronal communication integrated with motor cortex through thalamus promotes consciousness recovery from anesthesia which may likely serve as arousal regulation.


Asunto(s)
Anestesia , Corteza Motora , Ratones , Animales , Estado de Conciencia/fisiología , Sevoflurano/efectos adversos , Células de Purkinje/fisiología , Calcio , Inconsciencia/inducido químicamente , Neuronas , Glutamatos/efectos adversos , Ácido gamma-Aminobutírico
7.
Altern Ther Health Med ; 30(1): 18-23, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37773657

RESUMEN

Objective: To investigate the effect of esketamine combined with propofol on patient hemodynamics and its safety in hysteroscopy anesthesia. Methods: A total of 186 hysteroscopic patients admitted to our hospital from January 2021 to January 2022 were selected, and the patients were divided into group K and Group P according to a completely random number table, with 93 cases each. In short, all patients are uniformly numbered and adequately intermixed, according to the prescribed sampling starting point and order, the sample unit numbers were successively drawn from the random number table, until the extraction to the required sample size. Group K was given esketamine combined with propofol intravenously, and group P was given sufentanil combined with propofol intravenously. The changes in respiratory circulation [heart rate (HR), mean arterial pressure (MAP) and oxygen saturation (SpO2)] at the time of entering the operating room (T0), at the beginning of surgery (T1), 10 minutes after surgery(T2), and 10 minutes after the end of surgery (T3) were compared between the two groups, as well as the total time of surgery, the time to wake up after surgery, the amount of propofol used intraoperatively and the proportion of additional propofol were compared. The numerical rating scale (NRS) was used to assess the pain level of patients in both groups at different times after awakening and the occurrence of intraoperative and postoperative adverse reactions such as body movement, respiratory depression, bradycardia, injection site pain, nausea and vomiting, and dizziness were counted in both groups. Results: There were no significant changes in MAP, HR, and SpO2 in Group K at all moments compared with T0 (P > .05), MAP, HR and SpO2 in Group P at T1 and T2 were lower than those at T0 (P < .05). MAP, HR, and SpO2 were significantly lower in Group P at T1 and T2 moments compared with Group K, suggesting that circulatory depression was more pronounced in Group P at T1 and T2 moments (P < .05) and was not conducive to postoperative recovery. Compared with group P, the postoperative recovery time of group K was significantly shorter, and the dosage of propofol and the proportion of additional propofol were significantly lower (P < .05) which was beneficial to the health of patients. The pain level was significantly lower in Group K at 5, 15, and 30 minutes after awakening than in Group P (P < .05). The incidence of adverse reactions such as intraoperative motion, respiratory depression, bradycardia, injection site pain, and dizziness was significantly lower in group K than in group P (P < .05), and there was no significant difference in the incidence of nausea and vomiting between the two groups (P > .05), and prove that esketamine combined with propofol used for anesthesia which have high safety as well as more effective. Conclusion: The use of esketamine compounded with propofol in hysteroscopy anesthesia has less effect on the patient's circulatory and respiratory systems. This protocol can improve the postoperative analgesic effect of anesthesia in patients, reduce the amount of propofol during surgery, have fewer adverse effects and mild symptoms, is safe and effective, and can be used in clinical practice.


Asunto(s)
Anestesia , Ketamina , Propofol , Insuficiencia Respiratoria , Femenino , Embarazo , Humanos , Propofol/efectos adversos , Histeroscopía/efectos adversos , Bradicardia , Mareo , Hemodinámica , Dolor , Vómitos , Náusea
8.
J Biophotonics ; 17(2): e202300401, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38031986

RESUMEN

The objective of this split-mouth case report is to evaluate the effect of photobiomodulation (PBM, 880 nm) on pain control during pterygomandibular puncture. A patient received anesthesia on both sides of the mouth in a randomized manner. On the right side, an 880-nm infrared laser was applied immediately before local anesthesia. On the left side, a sham laser was applied using the same technique. There was a 50% reduction in pain levels on the PBM-treated side compared to the PBM-sham side, as measured by the visual analog scale. Sensitivity tests revealed that anesthesia was more effective on the PBM side. There was no difference in blood pressure. This case report suggests that PBM (880 nm) before anesthesia may alleviate puncture pain associated with pterygomandibular anesthesia. Although these findings are based on a single case report, they can serve as the initial stepping stone for further randomized clinical trials.


Asunto(s)
Anestesia , Terapia por Luz de Baja Intensidad , Humanos , Boca , Punciones , Dolor/radioterapia
9.
J Vis Exp ; (202)2023 Dec 08.
Artículo en Inglés | MEDLINE | ID: mdl-38145382

RESUMEN

The treatment of central nervous disorders has consistently posed significant challenges to the medical field. Acupuncture, a non-pharmacological practice rooted in traditional Chinese medicine, entails the insertion of fine needles into precise points on the body and is commonly employed for the management of diverse conditions. Recently, acupuncture has emerged as a promising therapeutic intervention for a range of neurological diseases, including anxiety and respiratory disorders. However, the potential of acupuncture in treating cognitive dysfunction induced by chronic hypoxia has not yet been explored. This paper presents a comprehensive protocol for establishing a mouse model of chronic hypoxia-induced cognitive impairment, administering mild anesthesia, performing acupuncture treatment, and assessing behavioral changes and memory abilities using open field tests and water mazes. The step-by-step protocol provides detailed instructions on accurately locating and positioning acupoints and needles for cognitive improvement. By employing this protocol, researchers can conduct systematic studies to thoroughly evaluate the therapeutic potential of acupuncture for cognitive dysfunction.


Asunto(s)
Terapia por Acupuntura , Anestesia , Disfunción Cognitiva , Ratones , Animales , Terapia por Acupuntura/métodos , Disfunción Cognitiva/etiología , Disfunción Cognitiva/terapia , Medicina Tradicional China/métodos , Hipoxia/terapia , Modelos Animales de Enfermedad , Puntos de Acupuntura
10.
Trials ; 24(1): 765, 2023 Nov 27.
Artículo en Inglés | MEDLINE | ID: mdl-38012777

RESUMEN

BACKGROUND: Frozen shoulder (FS) is a common condition that can cause severe pain and limited range of motion in the shoulder joint. While intra-articular steroid injection has been shown to be an effective treatment for FS, manipulation under anesthesia (MUA) is an alternative treatment that has gained popularity in recent years. However, there is a lack of evidence regarding the effectiveness of MUA on FS patients with concomitant rotator cuff injury or tear. Though a few studies have shown that MUA is not associated with rotator cuff tears, and will not exacerbate the injury, more high-quality studies with bigger sample sizes are needed. Therefore, the aim of this multi-center, single-blinded, randomized, parallel-group, superiority study is to compare the efficacy of MUA versus intra-articular steroid injection in the treatment of FS patients with a diagnosis of rotator cuff injury or tear by MRI. METHODS: A parallel, single-blinded, multi-center randomized controlled trial of 320 patients will be conducted at three hospitals of China. Eligible patients with frozen shoulder and rotator cuff injury or tear diagnosed by MRI will be randomly assigned to, in equal proportions, the manipulation under anesthesia group and the intra-articular steroid injection group via a central randomization system, undergoing a corresponding operation on day one and a sequent physical exercise for 14 days. The primary outcome is the comprehensive efficacy evaluation (total effective rate) and the change of Constant-Murley Score. Outcome assessors and data analysts will be blinded, and participants will be asked not to reveal their allocation to assessors. DISCUSSION: This study aims to explore the superiority of manipulation under anesthesia in reducing pain and improving shoulder function in frozen shoulder patients accompanied with rotator cuff injury. To provide a scientific basis for the dissemination and application of manipulation under anesthesia, and a better knowledge for the role of MUA in the treatment of frozen shoulder accompanied with rotator cuff injury. TRIAL REGISTRATION: Chictr.org.cn ChiCTR2200067122 . Registered on 27 December 2022. ChiCTR is a primary registry of the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) network and includes all items from the WHO Trial Registration data set in Trial registration.


Asunto(s)
Anestesia , Bursitis , Lesiones del Manguito de los Rotadores , Humanos , Lesiones del Manguito de los Rotadores/diagnóstico por imagen , Lesiones del Manguito de los Rotadores/tratamiento farmacológico , Bursitis/diagnóstico por imagen , Bursitis/tratamiento farmacológico , Resultado del Tratamiento , Esteroides , Dolor , Imagen por Resonancia Magnética , Rango del Movimiento Articular , Artroscopía , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios Multicéntricos como Asunto
11.
Am J Emerg Med ; 74: 196.e5-196.e7, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37833202

RESUMEN

Treating shoulder dislocations is common in the emergency department and often requires procedural sedation. The use of acupuncture for treatment of chronic pain has been shown to be successful in various outpatient settings, and some EDs have recently incorporated acupuncture as an analgesia adjunct for chronic painful conditions to avoid opioid therapy. Limited data describe acupuncture to facilitate ED procedures. Here we present two cases of acute shoulder dislocation that were successfully treated with acupuncture as an alternative to parenteral pharmacologic procedural sedation. A 50 year old male sustained an anterior shoulder dislocation after an altercation, and a 59 year old female sustained an anterior dislocation after a fall. Instead of using conventional pharmacologic sedation and analgesia during shoulder reduction, both were treated with acupuncture in the ED. Reduction in both cases was rapid, safe, and avoided use of any parenteral medications, procedural sedation monitoring, or prolonged nurse observation. Using acupuncture as alternative to opioids for ED procedures deserves future study for orthopedic and other common ED procedures.


Asunto(s)
Terapia por Acupuntura , Anestesia , Luxación del Hombro , Masculino , Femenino , Humanos , Persona de Mediana Edad , Luxación del Hombro/terapia , Hombro , Dolor , Analgésicos Opioides , Servicio de Urgencia en Hospital , Sedación Consciente/métodos
12.
Zhen Ci Yan Jiu ; 48(9): 946-50, 2023 Sep 25.
Artículo en Chino | MEDLINE | ID: mdl-37730266

RESUMEN

OBJECTIVE: To compare the clinical effect of "initial scheme" and "improved scheme" of acupuncture-aided anesthesia for patients undergoing thoracoscopic lobectomy. METHODS: A retrospective analysis about 2 groups ("initial scheme" and "improved scheme") of patients (40 cases in each group) who underwent thoracoscopic lobectomy was conducted in the present paper. Patients of the "initial scheme" group received thoracoscopic operation with three incisions under acupuncture-aided anesthesia i.e., electroacupuncture (EA) stimulation of bilateral Hegu (LI4), Neiguan (PC6), Houxi (SI3) and Zhigou (SJ6), combined with Lidocaine and ropivacaine epidural anesthesia and propofol intravenous anesthesia from January of 2013 to December of 2017. Patients of the "improved scheme" group received thoracoscopic operation with single incision under acupuncture-aided anesthesia by EA, combined with ropivacaine paravertevinal block and lidocaine and remifentanil intravenous anesthesia from August 2018 to August 2021. The incidence of intraoperative deep breathing, resuscitation time, ambulatory rate on day after surgery and postoperative incision pain of the two schemes were compared. RESULTS: The incidence of intraoperative deep breathing and the degree of postoperative incision pain were significantly lower (P<0.05), the postoperative resuscitation time was obviously shorter (P<0.05), and the ambulatory rate on day after surgery was higher (P<0.05) in the "improved scheme" group than in the "initial scheme" group. CONCLUSION: The "improved scheme" is better than the "initial scheme" in stabilizing the patient's breathing during thoracoscopic lobectomy operation, shortening the resuscitation time, and ameliorating the postoperative recovery state and pain reaction, thus being a better technical solution in clinical practice.


Asunto(s)
Terapia por Acupuntura , Anestesia , Humanos , Estudios Retrospectivos , Ropivacaína , Lidocaína , Dolor Postoperatorio/terapia
13.
Altern Ther Health Med ; 29(8): 613-617, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37678864

RESUMEN

Objective: To assess the effectiveness of an evidence-based early warning nursing model in reducing postoperative complications and enhancing care satisfaction for gastric cancer (GC) patients undergoing elective surgery. Methods: A retrospective analysis was performed on patients who received laparoscopic assisted radical gastrectomy in Tumor Hospital Affiliated To Nantong University from January 2020 to January 2022 as the research subjects. According to the anesthesia plan, the patients were divided into a comprehensive (intervention plans that received an early warning care model centered on evidence-based concepts) and a conventional group (routine evidence-based nursing plan). The postoperative anesthesia recovery, complications, pain level at 24 hours after surgery, anxiety at different times after surgery, and nursing satisfaction were compared between the two groups. Results: The postoperative spontaneous breathing time, consciousness recovery time, tracheal removal time, and defecation recovery time in the patients who received the early warning nursing based on the evidence-based concept were lower than those receiving only evidence-based care (P < .05). The total incidence of postoperative complications in the patients who received the early warning nursing based on the evidence-based concept were lower than those receiving only evidence-based care (P < .05). The postoperative pain levels of patients receiving the early warning nursing model were significantly lower than those receiving only evidence-based care (Z = -2.199, P = .028). After the intervention of different peri-anesthesia nursing modes, the anxiety scores of the two groups showed a downward trend with time (Ftime = 8.552, Ptime < .05), and the decrease in the comprehensive were greater than that in the routine group (F groups = 135.100, Ptime < .05), and there were no interaction (Finteraction = 2.424, Pinteraction < .05). Patients in the group that received the comprehensive early warning nursing model had significantly higher satisfaction with peri-anesthesia care compared to those receiving only evidence-based care (Z = -1.965, P < .05). Conclusion: Under the evidence-based early warning nursing model, nurses accurately assess patients' conditions during the peri-anesthesia period, leading to improved care plans that reduce complications and postoperative pain while enhancing patient satisfaction.


Asunto(s)
Anestesia , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/cirugía , Estudios Retrospectivos , Anestesia/efectos adversos , Dolor Postoperatorio , Complicaciones Posoperatorias/prevención & control
14.
J Avian Med Surg ; 37(2): 175-179, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37733456

RESUMEN

A 2-year-old female eclectus parrot (Eclectus roratus) was presented for suspected cervical myopathy due to trauma. Severe ventroflexion of the cervical spine and mental depression were identified during the physical examination. The bird was responsive to stimuli but otherwise quiet. Plasma biochemistry results were suggestive of a myopathy, based on marked elevations of both aspartate transaminase (25 652 U/L) and creatine kinase (253 240 U/L). Whole-body radiographic images were unremarkable. Treatment was initiated with supportive therapy for presumptive shock, dehydration, pain, myopathy, and possible spinal swelling. Allopathic therapy included subcutaneous fluids; vitamins A, D, and E; dexamethasone sodium phosphate; hydromorphone; and gavage feeding to treat the acute inflammatory process and provide nutritional support during healing. Supportive care through the Integrative Medicine Department (Louisiana State University, Baton Rouge, LA, USA) was also performed on the patient. Photobiomodulation, acupuncture, Tui-na massage, and rehabilitation exercises were instituted to provide adjunct treatment for relieving pain, promoting muscle healing, improving patient demeanor, and improving cervical mobility. Integrative therapies were well tolerated by the patient, with no sedation required. By day 3, mentation had subjectively improved by 50% despite the persistent cervical ventroflexion. By day 8, the elevated serum enzyme activities had decreased, the patient could eat and drink on its own, and it could readily step up and seek attention during handling. The bird was able to lift its head and could hold it at approximately 50% of normal posture. Integrative therapies were continued throughout hospitalization. The bird was released from the hospital 20 days after initial intake, with head carriage in approximately 80% of the expected normal position and no apparent cervical pain based on palpation. This case demonstrates the benefits of integrative therapies as an adjunct treatment for cervical pain and myopathy in a psittacine species.


Asunto(s)
Anestesia , Medicina Integrativa , Loros , Animales , Femenino , Dolor de Cuello/veterinaria , Anestesia/veterinaria , Aspartato Aminotransferasas
15.
BMC Anesthesiol ; 23(1): 287, 2023 08 24.
Artículo en Inglés | MEDLINE | ID: mdl-37620788

RESUMEN

BACKGROUND: Hypnosis can be a beneficial complementary anesthesia technique for a variety of surgical procedures. Despite favorable scientific evidence, hypnosis is still rarely used in the operating room. Obstacles to implementation could be a lack of interest or training, misconceptions, as well as limited knowledge amongst anesthesiology teams. Hence, this study aimed to assess the interest, training, beliefs, and knowledge about hypnosis in the operating room staff. DESIGN: A questionnaire with 21-items, based on a prior survey, was set up on an online platform. The medical and nursing anesthesiology staff of four Swiss academic and large regional hospitals (N = 754) were invited to participate anonymously through e-mails sent by their hierarchy. Results were analyzed quantitatively. RESULTS: Between June, 2020 and August, 2021 353 answers were collected (47% response rate). Most (92%) were aware that hypnosis needs specific training, with 14% trained. A large majority of the untrained staff wished to enroll for conversational hypnosis training. There was a strong agreement for hypnosis playing a role in anesthesia. Nevertheless, many of these professionals believed that hypnosis has a limited field of action (53%) or that it would be too time consuming (33%). The reduction of misconceptions was based more on exposure to hypnosis than on training. CONCLUSION: Overall, anesthesia providers' attitude was in favor of using hypnosis in the operating room. Misconceptions such as a prolongation of the procedure, alteration of consent, lack of acceptability for patients, and limited indications were identified as potential barriers. These deserve to be challenged through proper dissemination of the recent scientific literature and exposure to practice.


Asunto(s)
Anestesia , Anestesiología , Hipnosis , Humanos , Quirófanos , Hospitales
16.
Pediatrics ; 152(3)2023 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-37635689

RESUMEN

OBJECTIVE: The study characterizes cannabis toxicity in relation to tetrahydrocannabinol (THC) dose in pediatric edible cannabis ingestions. METHODS: This is a retrospective review of children aged <6 years presenting with edible cannabis ingestions of known THC dose within a pediatric hospital network (January 1, 2015-October 25, 2022). Cannabis toxicity was characterized as severe if patients exhibited severe cardiovascular (bradycardia, tachycardia/hypotension requiring vasopressors or intravenous fluids, other dysrhythmias), respiratory (respiratory failure, apnea, requiring oxygen supplementation), or neurologic (seizure, myoclonus, unresponsiveness, responsiveness to painful stimulation only, requiring intubation or sedation) effects. Cannabis toxicity was characterized as prolonged if patients required >6 hours to reach baseline. The relationship between THC dose and severe and prolonged toxicity was explored using multivariable logistic regression and receiver operator characteristic curve analyses. RESULTS: Eighty patients met inclusion. The median age was 2.9 years. The median THC ingestion was 2.1 mg/kg. Severe and prolonged toxicity was present in 46% and 74%, respectively. THC dose was a significant predictor of severe (adjusted odds ratio 2.9, 95% confidence interval: 1.8-4.7) and prolonged toxicity (adjusted odds ratio 3.2, 95% confidence interval: 1.6-6.5), whereas age and sex were not. Area under the curve was 92.9% for severe and 87.3% for prolonged toxicity. THC ingestions of ≥1.7 mg/kg can predict severe (sensitivity 97.3%) and prolonged toxicity (sensitivity 75.4%). CONCLUSIONS: The THC dose of edible cannabis correlates to the degree of toxicity in children <6 years old. The threshold of 1.7 mg/kg of THC may guide medical management and preventive regulations.


Asunto(s)
Anestesia , Cannabis , Humanos , Niño , Preescolar , Dronabinol , Bradicardia , Ingestión de Alimentos
17.
J Vis Exp ; (198)2023 08 18.
Artículo en Inglés | MEDLINE | ID: mdl-37607089

RESUMEN

In basic experimental acupuncture research, rats are commonly used as laboratory animals. However, it is difficult for them to maintain a fixed posture. During electroacupuncture procedures, proper immobilization of rats is essential. Various methods of rat fixation are currently used, including anesthesia fixation, high-platform fixation, binding fixation, and fixation with a self-made rat coat. However, these methods have their limitations, which may affect the efficiency and operability of the experiment to some extent. This protocol introduces a method of suspending and fixing rats using rat clothes. Firstly, rats are clothed with rat jackets that match their body shape, taking advantage of their preference for darkness and burrowing. The needling operation can then be carried out after the rats have worn rat clothes. When suspended, the rats are relatively still, as their limbs cannot move. This fixation method offers not only economical and user-friendly benefits but also ensures a stable and reliable fixation of the rats in a comfortably relaxed position. It also effectively minimizes time consumption, experimental space, and manpower resources. Additionally, this method allows for the exposure of most acupoints used for acupuncture in rats. This article primarily concentrates on the device's composition, encompassing a specially designed rat jacket, an elevated fixation rack, and their connecting structures. Additionally, an illustrative example will be presented to demonstrate the application of the rat clothing-based suspension fixation method in rat electroacupuncture procedures.


Asunto(s)
Terapia por Acupuntura , Anestesia , Animales , Ratas , Puntos de Acupuntura , Extremidades , Técnicas Histológicas , Suspensiones
18.
Altern Ther Health Med ; 29(8): 482-488, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37652419

RESUMEN

Objective: To assess the utility of magnetic resonance imaging (MRI) medical technology in the perioperative management of brain gliomas and its impact on anesthesia and prognosis. Methods: An observational, retrospective comparative study was conducted. We selected 60 patients who underwent glioma resection at our hospital from January 2019 to January 2020. Patients were divided into two groups based on admission order: the experimental group (EG) and the control group (CG), with 30 cases each. Patients in the CG underwent conventional intracranial tumor surgery, while those in the EG underwent supratentorial craniotomy for tumor resection with the assistance of MRI medical technology. We compared perioperative parameters, hemodynamic indices, tumor resection outcomes, postoperative complications, and postoperative physical function between the two groups. Results: Compared to the CG, the EG had significantly longer surgery preparation time, anesthesia time, and surgery time (P < .001). However, there were no significant between-group differences in infusion volume and intraoperative blood loss (P > .05). Postoperative hemodynamic indicators were significantly higher in the EG than in the CG (P < .001), and postoperative tumor volume was markedly smaller in the EG (P < .001). The EG also achieved a significantly larger volume of tumor resection and a higher tumor resection rate (P < .001), a significantly lower total incidence of postoperative complications (P < .05), and notably higher Karnofsky Performance Status (KPS) scores (P < .001). Conclusions: Compared to conventional intracranial tumor surgery, the utilization of MRI medical technology in brain glioma surgery, although it prolongs surgery and anesthesia times, enhances the tumor resection rate, and offers significant advantages in improving the prognosis of patients with brain glioma.


Asunto(s)
Anestesia , Neoplasias Encefálicas , Glioma , Humanos , Estudios Retrospectivos , Glioma/diagnóstico por imagen , Glioma/cirugía , Glioma/patología , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/cirugía , Pronóstico , Complicaciones Posoperatorias , Imagen por Resonancia Magnética/métodos , Encéfalo , Tecnología
19.
Complement Ther Med ; 76: 102962, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37406969

RESUMEN

OBJECTIVES: Acupuncture treatment (AT) is commonly utilized for vomiting; however, limited bibliometric analyses exist in this area. Employing a bibliometric approach, we conducted a comprehensive review spanning three decades to assess the research landscape, advancements, and emerging trends in AT for vomiting. METHODS: We collected the related literature data from the Web of Science Core Collection (WOSCC) from 1990 to 2022. VOSviewer and R studio were used to perform the bibliometric analysis of AT on vomiting. The status of authors, countries, affiliations, annual publications, keywords, and journals were analyzed accordingly. RESULTS: The earliest relevant paper was published in 1990. Streitberger, K was the most productive author (7 records) and had significant influence (225 reference times, H-Index = 7). The United States had the highest publication count (224 records) and received the most recognition (9719 reference times, H-Index = 52). MEDICINE had the highest number of outputs (34 records), while ANESTHESIA AND ANALGESIA was the most cited journal (1045 reference times). The institution with the most works was Chengdu University of Traditional Chinese Medicine (CDUTCM) (13 records), and the University of California, Los Angeles received the most citations (1252 reference times). Recent and future research hotspots included AT for postoperative vomiting and post-chemotherapy vomiting. Systematic reviews and meta-analyses were the predominant study types. CONCLUSIONS: The current status and development prospects of AT for vomiting are shown in this study. In addition, this article provides valuable ideas and potential directions for future research activities.


Asunto(s)
Terapia por Acupuntura , Analgesia , Anestesia , Humanos , Náusea y Vómito Posoperatorios , Bibliometría
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