1,720,961 research outputs found
Cervical Spine: Minimally Invasive and Open Surgery
No full textAnesthesia in cervical spine surgery (CSS) is peculiar and sometimes challenging. Injuries from CSS could be severe and often permanent and disabling. Complications are more frequent in patients with comorbidities such as diabetes, cardiovascular disease and pulmonary diseases. The surgical field is near the airway and the patient’s mouth and the endotracheal tube (ETT) could be not easily accessible. Postoperative edema and/or hematoma could lead to deviation and compression of larynx, trachea or medulla. The patient positioning should be done by expert anesthesiologists in order to avoid eyes, peripheral nerves and skin injuries
Regional anesthesia in a child with sotos syndrome
No full textSotos syndrome is a complex genetic disease first
described by Sotos' in 1964. The four major criteria in the
diagnosis were established in 1994 by Cole and Hughes'.
Basing their findings on the systematic assessment of 41
typical cases they characterized this syndrome by:
1. Advanced bone age.
2. Macrocephaly.
3. Characteristic facial appearance: the face is
round with an abnormal prominence of the forehead and
becomes longer in adolescence.
4. Learning difficulties. This is often associated
with delay in walking that can start after 15 months of age
and speech delay until 2,5 year of age.
Other findings include dolicocephaly, prognatism,
hypertelorism, high-arched palate, early eruption of
teeth, seizures, scoliosis and congenital heart defects 3-4.
Affected patients also show social contact problems and
anxious behavior 5. For forty years the diagnosis of Sotos
syndrome has been based on subjective evaluation of
clinical features. More recently genetic studies showed
mutations of gene NSD 1 in almost all the patients. The
intragenic mutation of NSD 1 gene causes 60-80% of
Sotos syndromes in Europe and USA, whereas 5q35
microdelections encompassing NSD 1 cause 10% of cases
6-7. In contrast, NSDI microdelections are the primary
cause ofSotos syndrome in Japan where the incidence the
incidence of congenital heart defects seems to be higher
8. The gene NSDI encodes a hystone methyltransferase
implicated in chromatin regulation 9.
We present a case ofSotos syndrome which underwent
regional anesthesia with spontaneous breath sedation for
neurological flat foot
Hypobaric versus isobaric spinal levobupivacaine for total hip arthroplasty
No full textSpinal anesthesia (SA) in the lateral decubitus position is often used to perform total hip arthroplasty (THA). Hypobaric local anesthetic ensures enhanced and prolonged sensory and motor block in the involved side. The aim of this study was to compare the intraoperative anesthetic efficacy of hypobaric with isobaric levobupivacaine solutions for THA
The effect of norepinephrine versus epinephrine in irrigation fluid on the incidence of hypotensive/bradycardic events during arthroscopic rotator cuff repair with interscalene block in the sitting position
No full textPurpose: To compare the occurrence rate of hypotensive and bradycardic events (HBEs) during arthroscopic rotator cuff
repair performed with interscalene brachial plexus block anesthesia in the sitting position in 2 groups of patients who
underwent the procedure with norepinephrine or epinephrine added to the irrigation fluid. The secondary objective was
to evaluate the efficacy of norepinephrine in comparison with epinephrine in controlling intraoperative bleeding and
maintaining adequate visualization of the arthroscopic field of view during the procedure. We hypothesized that
norepinephrine added to the irrigation fluid during shoulder arthroscopy in the sitting position would reduce the
occurrence of HBEs, allowing optimal intraoperative bleeding control. Methods: One hundred twenty patients underwent
an arthroscopic rotator cuff repair performed under peripheral anesthesia and in the beach-chair position. Patients
were randomly divided into 2 groups of 60 cases each: Norepinephrine (0.66 mg/L) and epinephrine (0.33 mg/L) were
added to irrigation bags in group N and group E, respectively. The primary outcome was the occurrence rate of HBEs
during surgery. The secondary outcomes were timing of onset of HBEs, accompanying symptoms, and intraoperative
bleeding that impaired arthroscopic visualization. The clarity of the visual field was rated postoperatively by the surgeon
using a visual analog scale. Comparison between groups for all baseline variables and outcome measurements was performed
with the c2 or Fisher exact test, as appropriate, for categorical variables and the Student t test or Mann-Whitney U
test, as appropriate, for continuous variables. Significance was set at P < .05. Results: One patient was excluded from
group E because of block failure; therefore 119 patients were finally included in the study. Comparison between groups
showed no significant differences in baseline characteristics. The occurrence rate of HBEs was significantly greater in group
E (n 1⁄4 15) than in group N (n 1⁄4 5) (P 1⁄4 .02). No differences between groups were found in the average time of onset of
HBEs, accompanying symptoms, and clarity of the visual field. Conclusions: Continuous administration of norepinephrine,
0.66 mg/L, diluted in irrigation fluid during arthroscopic rotator cuff repair with the patient in the beach-chair
position reduces the incidence of HBEs and is as effective as epinephrine in controlling intraoperative bleeding and
maintaining the visual clarity of the surgical field. Level of Evidence: Level I, randomized clinical stud
Anaesthesia for total knee arthroplasty: efficacy of single-injection or continuous lumbar plexus associated with sciatic nerve blocks--a randomized controlled study
No full textTotal knee arthroplasty (TKA) often results in marked postoperative pain. We compared in a randomized controlled study tramadol consumption, postoperative pain and patient satisfaction after primary TKA in patients who received a single injection lumbar plexus and sciatic nerve blocks or a continuous lumbar plexus and sciatic nerve blocks. Forty-four patients scheduled for unilateral total knee arthroplasty were allocated to the single shot group (group A) or to the catheter group (group B). All patients (in both groups) reported being satisfied with their anaesthetic management. Although pain scores and tramadol consumption appeared lower in the active infusion group, the differences did not reach statistical significance. This study confirms that either single injection or continuous infusion of Ropivacaine in lumbar plexus provides reliable and long-acting anaesthesia and analgesia
Intra-articular analgesia following arthroscopic surgery of the shoulder
No full textShoulder surgery is very often followed by severe postoperative pain. Loco-regional anaesthesia has greatly contributed as a solution of this problem. Nevertheless most of surgery is still performed under general anaesthesia. In this case many different methods have been proposed in order to mitigate postoperative pain. Intra-articular administration of local anaesthetics after shoulder surgery is not yet in routinely clinical practice. In this study efficacy of intra-articular administration of Ropivacaine versus Bupivacaine has been evaluated. Analysis of results showed both drugs to share the same effectiveness within four hours postoperatively. In subsequent period (6-24 hours) Ropivacaine demonstrated to provide a statistically significant better postoperative pain relief. Furthermore Ropivacaine group patients needed postoperative analgesics to a lesser extent than Bupivacaine group. The long-losting satisfactory level of analgesia, particularly with Ropivacaine, could recommend the use of intra-articular analgesia even for day-hospital or one-day surgery procedures
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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