Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 45.971
Filtrar
1.
Eur Rev Med Pharmacol Sci ; 26(14): 5053-5062, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-35916801

RESUMEN

OBJECTIVE: To explore whether anesthesiologists' efficiency can be increased via the use of intelligent equipment, thereby improving the quality of surgical anesthesia. SUBJECTS AND METHODS: This paper first introduces the intelligent management system and work flow of drugs and consumables in the department of anesthesiology in our hospital, and then compares the time before and after the use of intelligent equipment, the time for anesthesiologists and nurses to manage drugs and consumables, the misdistribution rate of drugs distributed by anesthetic nurses, and the inventory time and accuracy of narcotic drugs. RESULTS: For the intelligent management with intelligent drug cabinets and logistics robots as the terminal, compared with traditional management, the anesthesiologist saves an average of 24±1 (min) per day in acquisition of drugs and consumables, and the total error rate in drugs and consumables distribution by anesthesia nurses is reduced from 4% to 1%, the inventory time of anesthetic drugs is 12±5 (min) earlier than before, and inventory accuracy has been increased from 94.6% to 98.6%. The anesthesia nurses save an average of 53.1±10 (min) per day from taking medicines to operating anesthesia billing than before. CONCLUSIONS: The intelligent management of drugs and consumables in the Anesthesiology Department improves management efficiency, ensures medication safety for surgical patients, increases anesthesia management time for anesthesiologists, and improves the quality of surgical anesthesia.


Asunto(s)
Anestesia , Anestesiología , Anestesiólogos , Hospitales , Humanos
2.
Anaesthesiologie ; 71(6): 417-425, 2022 Jun.
Artículo en Alemán | MEDLINE | ID: mdl-35925144

RESUMEN

Perioperative mortality and morbidity in childhood essentially depend on the quality of the anesthesia. The Safe Anesthesia for every Tot (SafeTots) initiative takes this into account and has defined normotension, normovolemia and normal heart rate as quality criteria in pediatric anesthesia. Appropriate monitoring of pediatric hemodynamics is necessary to fulfil these criteria. This article provides an overview of currently used methods and techniques for instrumental and non-instrumental cardiovascular monitoring in children. The current study situation, recommendations and guidelines on the application as well as practical aspects of the measurement methods are explained as far as possible. For a better understanding, procedures not routinely used in clinical practice are described in more detail.


Asunto(s)
Anestesia , Monitorización Hemodinámica , Anestesia/efectos adversos , Presión Sanguínea , Niño , Hemodinámica/fisiología , Humanos , Monitoreo Fisiológico
4.
A A Pract ; 16(8): e01613, 2022 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-35952341

RESUMEN

Trauma is associated with debilitating acute and posttraumatic stress disorders, which have limited treatment options. We report on a patient undergoing surgical hand repair after a recent knife attack who experienced vivid dreaming and subsequent remission of acute stress disorder. After local anesthesia with propofol sedation she recalled a dream wherein she relived the attack, sought medical care, completed surgery, and returned home with a healed hand. While intraoperative dreaming is common, this case details potential associations between anesthetic state, dreaming, intraoperative electroencephalography, and remission of a psychiatric disorder. Our experience suggests a novel intervention for stress disorders.


Asunto(s)
Anestesia , Anestésicos , Trastornos Mentales , Propofol , Sueños , Femenino , Humanos
5.
Artículo en Inglés | MEDLINE | ID: mdl-35955074

RESUMEN

PURPOSE: To investigate the efficacy of manipulation under anesthesia (MUA) compared to other non-surgical therapeutic strategies for patients with frozen shoulder contracture syndrome (FSCS). METHODS: A systematic review of literature was conducted. A literature search was performed in MEDLINE, EMBASE, PEDro, Cochrane Central Library and Scopus. Only randomized controlled trials were included and assessed for critical appraisal through the Cochrane Collaborations tools. RESULTS: Five randomized controlled trials were included. The overall risk of bias (RoB) was high in 4 out of 5 of the included studies. MUA was found to be not superior in terms of reduction of pain and improvement of function when compared to cortisone injections with hydrodilatation (mean regression coefficient MUA -2.77 vs. injection -2.75; 95% CI (-1.11 to 1.15)) and home exercise (mean difference 95% CI: 0.2 (-0.64 to 1.02)) in the short term (3 months), and cortisone injections with hydrodilatation (mean regression coefficient MUA 3.13 vs. injection 3.23; 95% CI (-0.90 to 1.11)) in the long term (>6 months). Moreover, if compared to structured physiotherapy, MUA highlighted a higher Oxford Shoulder Score at final 1-year follow up (mean difference 95% CI: 1.05 (-1.28 to 3.39); p = 0.38). Similar results were obtained for disability, with statistically no significant long-term (>12 months) differences between MUA and home exercise (mean difference 95% CI: 0 (-3.2 to 3.2)) or structured physiotherapy (mean difference 95% CI: -0.50 (-5.70 to 4.70); p = 0.85)). Only two trials reported adverse events. CONCLUSIONS: This review suggested that limited and inconsistent evidence currently exists on the efficacy of MUA compared to other non-surgical strategies in the management of patients with FSCS. Future research should focus on clinical trials with higher methodological quality.


Asunto(s)
Anestesia , Bursitis , Contractura , Cortisona , Bursitis/terapia , Contractura/terapia , Humanos , Modalidades de Fisioterapia
6.
Int J Mol Sci ; 23(15)2022 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-35955662

RESUMEN

Memories are lasting representations over time of associations between stimuli or events. In general, the relatively slow consolidation of memories requires protein synthesis with a known exception being the so-called Anesthesia Resistant Memory (ARM) in Drosophila. This protein synthesis-independent memory type survives amnestic shocks after a short, sensitive window post training, and can also emerge after repeated cycles of training in a negatively reinforced olfactory conditioning task, without rest between cycles (massed conditioning-MC). We discussed operational and molecular mechanisms that mediate ARM and differentiate it from protein synthesis-dependent long-term memory (LTM) in Drosophila. Based on the notion that ARM is unlikely to specifically characterize Drosophila, we examined protein synthesis and MC-elicited memories in other species and based on intraspecies shared molecular components and proposed potential relationships of ARM with established memory types in Drosophila and vertebrates.


Asunto(s)
Anestesia , Proteínas de Drosophila , Animales , Drosophila/metabolismo , Proteínas de Drosophila/genética , Proteínas de Drosophila/metabolismo , Drosophila melanogaster/metabolismo , Memoria , Memoria a Largo Plazo
7.
AANA J ; 90(4): 253-262, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35943750

RESUMEN

According to a joint statement by the US National Academy of Sciences and the UK Royal Society, it is now more certain than ever that human activity is a leading cause of rapid, accelerated climate change. Our volatile anesthetics have up to 2,000 times more greenhouse gas contributing potential than the same amount of carbon dioxide, yet no emission regulations have been imposed. The carbon footprint of volatile agents exists in all anesthesia practices, indirectly affecting all humans. It manifests daily in the clinical practice of over 30,000 certified registered nurse anesthetists in the United States, as their anesthetic choices directly impact the environment. However, education about anesthetic choice and its impact has been overlooked, making many anesthesia providers unaware of meaningful ways to reduce ecological and economic costs. Decreasing the use of volatile agents by low-flow techniques and the use of a total intravenous anesthetic could dramatically reduce carbon footprint produced by anesthesia. The authors review other advantages of limiting or avoiding volatile agents beyond green anesthesia such as decreased costs, reduced postoperative nausea and vomiting, and lowering the risk of malignant hyperthermia.


Asunto(s)
Anestesia , Anestésicos por Inhalación , Dióxido de Carbono , Huella de Carbono , Humanos , Enfermeras Anestesistas , Estados Unidos
8.
AANA J ; 90(4): 271-277, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35943752

RESUMEN

Intravenous dantrolene is the first-line treatment of malignant hyperthermia (MH), however, it is not always accessible in lower-middle income countries (LMICs). Facilities in the United States are in a transition period where dantrolene is being replaced with Ryanodex, therefore, there is an opportunity for excess dantrolene to be utilized in LMICs where neither dantrolene nor Ryanodex exist. Thirty-six vials of recently expired, unused dantrolene were obtained for a hospital in a LMIC and an MH program was developed in conjunction with the Lao Friends Hospital for Children (LFHC) anesthesia providers, LFHC liaison, LFHC leadership team, and an expert in the field of MH. Components of the MH program included developing a facility-specific protocol, treatment guidelines, supply list, and educational tools. A designated MH drawer was also created in preparation for an MH event. By procuring dantrolene and implementing an MH program in a facility where no MH protocol, treatment guidelines, supply list, or educational tools existed, LFHC is better equipped to handle a potentially lethal scenario.


Asunto(s)
Anestesia , Hipertermia Maligna , Niño , Dantroleno/uso terapéutico , Humanos , Hipertermia Maligna/tratamiento farmacológico , Estados Unidos
9.
AANA J ; 90(4): 288-292, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35943755

RESUMEN

Student registered nurse anesthetists (SRNAs) are required by the Council on Accreditation to provide anesthetics to a minimum of 30 patients ages 2-12 years and 10 patients younger than 2 years. Pediatric anesthesia can prove to be stressful because children are at higher risk for morbidity and mortality during the perioperative period compared with adults. Simulation allows SRNAs the opportunity to review and develop skills in a safe and supportive environment. The purpose of this project was to provide a high-fidelity pediatric simulation for SRNAs prior to their pediatric rotation to improve skills, knowledge, and self-confidence in the recognition and management/treatment of common pediatric anesthesia complications (airway obstruction, laryngospasm, bronchospasm, and bradycardia). Twenty SRNAs enrolled in a nurse anesthesia program participated in the pediatric anesthesia simulation prior to the start of their pediatric anesthesia rotation. Participants completed surveys at three intervals; presimulation, postsimulation, and at the end of their pediatric rotation that addressed the trainee's perceived self-confidence level and ability to identify and manage/treat common pediatric anesthesia complications. Statistical significance (P < .05) was achieved in the participants overall self-confidence levels in their ability to recognize, treat, and manage common pediatric complications (P = .00) after completion of simulation experience.


Asunto(s)
Anestesia , Estudiantes de Enfermería , Adulto , Niño , Preescolar , Competencia Clínica , Simulación por Computador , Humanos , Enfermeras Anestesistas
10.
BMC Med Imaging ; 22(1): 136, 2022 08 04.
Artículo en Inglés | MEDLINE | ID: mdl-35927630

RESUMEN

BACKGROUND: Altered neural activity based on the fractional amplitude of low-frequency fluctuations (fALFF) has been reported in patients with diabetes. However, whether fALFF can differentiate healthy controls from diabetic animals under anesthesia remains unclear. The study aimed to elucidate the changes in fALFF in a rat model of diabetes under isoflurane anesthesia. METHODS: The first group of rats (n = 5) received a single intraperitoneal injection of 70 mg/kg streptozotocin (STZ) to cause the development of diabetes. The second group of rats (n = 7) received a single intraperitoneal injection of the same volume of solvent. Resting-state functional magnetic resonance imaging was used to assess brain activity at 4 weeks after STZ or solvent administration. RESULTS: Compared to the healthy control animals, rats with diabetes showed significantly decreased fALFF in various brain regions, including the cingulate cortex, somatosensory cortex, insula, and striatum (all P < 0.05). The decreased fALFF suggests the aberrant neural activities in the diabetic rats. No regions were detected in which the control group had a lower fALFF than that in the diabetes group. CONCLUSIONS: The results of this study demonstrated that the fALFF could be used to differentiate healthy controls from diabetic animals, providing meaningful information regarding the neurological pathophysiology of diabetes in animal models.


Asunto(s)
Anestesia , Diabetes Mellitus Experimental , Isoflurano , Animales , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Diabetes Mellitus Experimental/inducido químicamente , Diabetes Mellitus Experimental/diagnóstico por imagen , Diabetes Mellitus Experimental/patología , Isoflurano/farmacología , Imagen por Resonancia Magnética/métodos , Ratas , Solventes
11.
Contrast Media Mol Imaging ; 2022: 9541060, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35935320

RESUMEN

Objective: To investigate the comparison and clinical value of ciprofol and propofol for painless gastroenteroscopy anesthesia in terms of intraoperative adverse reactions, operation, resuscitation, and satisfaction of patients. Methods: A total of 96 patients who underwent painless gastroenteroscopy anesthesia in our hospital from June 2021 to January 2022 were enrolled. The cases were randomly assigned into research group and control group. The control group received propofol anesthesia (n = 49), and the research group received ciprofol anesthesia (n = 47). The patients, physician satisfaction, vital signs, incidence of adverse reactions, anesthetic first dose, additional time, additional dose, total dose, induction time, insertion time, operation time, awake time, orientation recovery time, leaving room time, and injection pain score were compared. Results: The overall satisfaction of the study group was higher than that of the control group (p < 0.05). After taking medicine, the score of 1 min and MAP in the study group were higher than those in the control group. The incidence of adverse reactions in the study group was lower than that in the control group (p < 0.05). The satisfaction of doctors in the study group was higher than that in the control group (p < 0.05). The anesthesia induction time, intubation time, operation time, awake time, orientation recovery time, and leaving room time in the study group were significantly longer than those in the control group (p < 0.05). The incidence and degree of injection pain in the propofol group were significantly lower than those in the propofol group (p < 0.05). Conclusion: In painless gastroenteroscopy, compared with propofol, ciprofol is equally safe and effective for patients and will not cause early cognitive dysfunction after operation, which is a good choice in painless gastroenteroscopy anesthesia. In addition, ciprofol has significant advantages in patient and physician satisfaction, especially in injection pain. This trial is registered with ChiCTR2100045400.


Asunto(s)
Anestesia , Propofol , Anestésicos Intravenosos/efectos adversos , Humanos , Dolor/inducido químicamente , Dolor/etiología , Satisfacción del Paciente , Satisfacción Personal , Propofol/efectos adversos
12.
Beijing Da Xue Xue Bao Yi Xue Ban ; 54(4): 770-773, 2022 Aug 18.
Artículo en Chino | MEDLINE | ID: mdl-35950407

RESUMEN

According to literature reports, the injury rate of the athletes in Olympic Winter Games recent years was as high as 10%-14%. Combined with the background of corona virus disease 2019 (COVID-19), the medical insurance work of the 24th Olympic Winter Games held in Beijing had put forward more complicated requirements and more severe challenges. In order to better optimize anesthesia management, this article summarized the perioperative treatment of athletes in Olympic Winter Games, the safety protection strategy of medical staff under general anesthesia, and the potential impact of peri-operative drugs on athletes. Anesthesiologists, as the core members of the rescue team, should be familiar with the particularity of operative anesthesia of athletes, sum up relevant experience to ensure the safety of perioperative patients. So all kinds of technical measures should be taken in the process of operation to minimize the indoor pollution caused by the patient's cough. For example, all the patients should wear N95 masks from the ward to the operating room, and after the operation, wear the N95 masks back to the ward. Although the International Olympic Committee had banned more than 200 drugs for participants and athletes who had to strictly follow International Olympic Committee requirements during anesthesia, the athletes were no longer participating in this Olympic Winter Games, so opioids (sufentanil and remifentanil) and glucocorticoid (dexamethasone) could be used according to the actual needs of surgery and anesthesia. Five athletes in Yanqing competition area underwent surgical anesthesia in Peking University Third Hospital Yanqing Hospital. All the five patients received general anesthesia, of whom four underwent orthopaedic surgery and one underwent laparoscopic cholecystectomy. General anesthesia with laryngeal mask airway was the first choice in the five patients. And the pain after orthopaedic surgery was severe and nerve block technique could effectively relieve the pain after surgery. Three patients received ultrasound-guided nerve block analgesia, the postoperative analgesia lasted 36 h. After the operation, non-steroidal anti-inflammatory drug (NSAID) was infused intravenously in the ward and all the patients recovered uneventfully. As the core member of the trauma rescue team, anesthesiologists should be familiar with the particularity of the athletes' surgical anesthesia, do a good job in medical security, and summarize relevant experience to ensure the life safety of the perioperative patients.


Asunto(s)
Anestesia , Traumatismos en Atletas , Anestesia/métodos , Aniversarios y Eventos Especiales , Traumatismos en Atletas/cirugía , Beijing/epidemiología , COVID-19/epidemiología , COVID-19/prevención & control , Humanos , Manejo del Dolor/métodos , Deportes
14.
Glob Health Action ; 15(1): 2104301, 2022 Dec 31.
Artículo en Inglés | MEDLINE | ID: mdl-35960190

RESUMEN

BACKGROUND: Conditions amenable to surgical, obstetric, trauma, and anaesthesia (SOTA) care are a major contributor to death and disability in Ghana. SOTA care is an essential component of a well-functioning health system, and better understanding of the state of SOTA care in Ghana is necessary to design policies to address gaps in SOTA care delivery. OBJECTIVE: The aim of this study is to assess the current situation of SOTA care in Ghana. METHODS: A situation analysis was conducted as a narrative review of published scientific literature. Information was extracted from studies according to five health system domains related to SOTA care: service delivery, workforce, infrastructure, finance, and information management. RESULTS: Ghanaians face numerous barriers to accessing quality SOTA care, primarily due to health system inadequacies. Over 77% of surgical operations performed in Ghana are essential procedures, most of which are performed at district-level hospitals that do not have consistent access to imaging and operative room fundamentals. Tertiary facilities have consistent access to these modalities but lack consistent access to oxygen and/or oxygen concentrators on-site as well as surgical supplies and anaesthetic medicines. Ghanaian patients cover up to 91% of direct SOTA costs out-of-pocket, while health insurance only covers up to 14% of the costs. The Ghanaian surgical system also faces severe workforce inadequacies especially in district-level facilities. Most specialty surgeons are concentrated in urban areas. Ghana's health system lacks a solid information management foundation as it does not have centralized SOTA databases, leading to incomplete, poorly coded, and illegible patient information. CONCLUSION: This review establishes that surgical services provided in Ghana are focused primarily on district-level facilities that lack adequate infrastructure and face workforce shortages, among other challenges. A comprehensive scale-up of Ghana's surgical infrastructure, workforce, national insurance plan, and information systems is warranted to improve Ghana's surgical system.


Asunto(s)
Anestesia , Atención a la Salud , Femenino , Ghana , Humanos , Procedimientos Quirúrgicos Obstétricos , Oxígeno , Embarazo
15.
Thorac Surg Clin ; 32(3): 307-315, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35961739

RESUMEN

Anesthesia in low-to-middle income countries (LMICs) is often provided by nonphysician anesthetists. The training and resources for anesthesia in LMICs are limited, and this must be evaluated when starting or expanding a thoracic surgery program in LMICs. The ability to access a patient's baseline pulmonary and cardiovascular status is often based on rudimentary studies and a thorough history and physical. Advance studies, such as echocardiograms, cardiovascular stress test, cardiac catherizations, pulmonary function tests, and MRIs, are often not available. Careful assessment of both preoperative patient selection, intraoperative ability to provide one-lung ventilation, and postoperative critical care management must be considered when surgical planning is occurring.


Asunto(s)
Anestesia , Anestesiología , Ventilación Unipulmonar , Cirugía Torácica , Procedimientos Quirúrgicos Torácicos , Anestesia General , Humanos
16.
Comput Math Methods Med ; 2022: 6018037, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35799645

RESUMEN

Background: Propofol (PPF) has been shown in studies to cause cognitive impairment and neuronal cell death in developing animals. PPF has been demonstrated to decrease the expression of microRNA-17-5p (miR-17-5p) in a recent study. Nonetheless, the function of miR-17-5p in PPF-induced neurotoxicity and related mechanisms is uncharacterized. Methods: After the induction of neurotoxicity by treating the SH-SY5Y cells with PPF, qRT-PCR was conducted to evaluate the level of miR-17-5p. Using MTT and flow cytometry, cell viability and apoptosis rate were assessed, respectively. Interaction between miR-17-5p and BCL2 like 11 was (BCL2L11) studied using a Luciferase reporter assay. With the help of western blot analysis, we determined the level of proteins of apoptosis-related genes and autophagy-related markers. Results: In SH-SY5Y cells, PPF treatment induced neurotoxicity and downregulated miR-17-5p expression. In SH-SY5Y cells post-PPF exposure, overexpression of miR-17-5p increased cell viability and decreased apoptosis. Consistently, miR-17-5p mimics mitigated PPF-generated autophagy via inhibition of Atg5, Beclin1, and LC3II/I level and elevation of p62 protein expression. In addition, BCL2L11, which was highly expressed in PPF-treated SH-SY5Y cells, was directly targeted by miR-17-5p. Further, in PPF-treated SH-SY5Y cells, overexpressed BCL2L11 counteracted the suppressing behavior of miR-17-5p elevation on PPF-induced apoptosis. Conclusion: Overexpressed miR-17-5p alleviates PPF exposure-induced neurotoxicity and autophagy in SH-SY5Y cells via binding to BCL2L11, suggesting the possibility that miR-17-5p can serve as a candidate in the treatment of neurotoxicity (caused by PPF).


Asunto(s)
Anestesia , Proteína 11 Similar a Bcl2 , MicroARNs , Neuroblastoma , Propofol , Apoptosis/genética , Autofagia/genética , Proteína 11 Similar a Bcl2/genética , Línea Celular Tumoral , Humanos , MicroARNs/genética , Propofol/farmacología
17.
BMC Anesthesiol ; 22(1): 220, 2022 07 13.
Artículo en Inglés | MEDLINE | ID: mdl-35831790

RESUMEN

BACKGROUND: The neural integrity monitor (NIM) electromyogram (EMG) endotracheal (ET) tube is a widely used device to monitor neural response through muscle activity. It is helpful in surgical procedures with high risk of damaging delicate structures in the head and neck. This case provides a thorough analysis of an adverse event that was encountered in the operating room, which others can hopefully learn from. CASE PRESENTATION: We are reporting a case in which a patient undergoing hemithyroidectomy had experienced an adverse event using the Medtronic NIM™ EMG endotracheal tube. After successful induction and intubation, confirming the proper positioning of the electrode wires was necessary before the incision could be made. Upon reexamination, the patient suddenly became difficult to ventilate with increased peak airway pressure, decreased tidal volume, and end tidal CO2. This episode lasted approximately 15 min and the patient's condition remained stable despite low tidal volumes. The problem was unexpectedly resolved upon deflation of the cuff of the ET tube. CONCLUSIONS: There are several similar reports of these endotracheal tubes causing obstruction, especially those in which overinflation of the cuff caused cuff herniation and blockage of the Murphy eye and the bevel. It is currently believed that the design of this tube allowed for the obstruction to occur. The patient's short body habitus may have also been a small contributing factor. The distance that the electrodes must sit within the vocal cords to the tip of the bevel is longer in this type of ET tube compared with a standard ET tube. The distance from the true vocal cords to where the cuff sits in the trachea is also greater in this model NIM EMG tube. There was no confirmation of the exact obstructive process that took place, however, confirming the tube and cuff positioning would have been optimal.


Asunto(s)
Anestesia , Intubación Intratraqueal , Electromiografía , Humanos , Intubación Intratraqueal/métodos , Tiroidectomía/efectos adversos , Tráquea
18.
BMC Anesthesiol ; 22(1): 223, 2022 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-35840903

RESUMEN

BACKGROUND: Previous studies examining removal of endotracheal tubes and supraglottic devices under deep anesthesia were underpowered to identify rare complications. This study sought to report all adverse events associated with this practice found in a large national database of pediatric anesthesia adverse events. METHODS: An extract of an adverse events database created by the Wake Up Safe database, a multi-institutional pediatric anesthesia quality improvement initiative, was performed for this study. It was screened to identify anesthetics with variables indicating removal of airway devices under deep anesthesia. Three anesthesiologists screened the data to identify events where this practice possibly contributed to the event. Event data was extracted and collated. RESULTS: One hundred two events met screening criteria and 66 met inclusion criteria. Two cardiac etiology events were identified, one of which resulted in the patient's demise. The remaining 97% of events were respiratory in nature (64 events), including airway obstruction, laryngospasm, bronchospasm and aspiration. Some respiratory events consisted of multiple distinct events in series. Nineteen respiratory events resulted in cardiac arrest (29.7%) of which 15 (78.9%) were deemed preventable by local anesthesiologists performing independent review. Respiratory events resulted in intensive care unit admission (37.5%), prolonged intubation and temporary neurologic injury but no permanent harm. Provider and patient factors were root causes in most events. Upon investigation, areas for improvement identified included improving patient selection, ensuring monitoring, availability of intravenous access, and access to emergency drugs and equipment until emergence. CONCLUSIONS: Serious adverse events have been associated with this practice, but no respiratory events were associated with long-term harm.


Asunto(s)
Anestesia , Anestésicos , Anestesia/efectos adversos , Niño , Bases de Datos Factuales , Humanos , Intubación Intratraqueal/efectos adversos , Mejoramiento de la Calidad
19.
Biosensors (Basel) ; 12(8)2022 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-35892463

RESUMEN

The fluorescence microscope has been widely used to explore dynamic processes in vivo in mouse brains, with advantages of a large field-of-view and high spatiotemporal resolution. However, owing to background light and tissue scattering, the single-photon wide-field microscope fails to record dynamic neural activities in the deep brain. To achieve simultaneous imaging of deep-brain regions and the superficial cortex, we combined the extended-field-of-view microscopy previously proposed with a novel prism-based cranial window to provide a longitudinal view. As well as a right-angle microprism for imaging above 1 mm, we also designed a new rectangular-trapezoidal microprism cranial window to extend the depth of observation to 1.5 mm and to reduce brain injury. We validated our method with structural imaging of microglia cells in the superficial cortex and deep-brain regions. We also recorded neuronal activity from the mouse brains in awake and anesthesitized states. The results highlight the great potential of our methods for simultaneous dynamic imaging in the superficial and deep layers of mouse brains.


Asunto(s)
Anestesia , Corteza Cerebral , Animales , Corteza Cerebral/fisiología , Hipocampo , Ratones , Microscopía Fluorescente , Neuronas/fisiología
20.
Curr Biol ; 32(14): R781-R783, 2022 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-35882199

RESUMEN

One of the greatest unresolved mysteries in medicine relates to the molecular and neuronal mechanisms through which general anesthetics abolish perception. A new study in mice with mutations affecting mitochondrial complex 1 suggests that anesthetic-disruption of cellular energetics impairs endocytosis to alter synaptic function.


Asunto(s)
Anestesia , Anestésicos Generales , Animales , Ratones , Neuronas
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA