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Anesthetic Management of Mitochondrial Encephalopathy With Lactic Acidosis and Stroke-Like Episodes (MELAS Syndrome) in a High-Risk Pregnancy: A Case Report
We present the in-hospital course of a 36-year-old gravida 2, para 0 with MELAS syndrome and severe preeclampsia, complicated by hyponatremia, hyperkalemia, and diabetes. A retained placenta with postpartum hemorrhage required urgent instrumental delivery under spinal anesthesia, transfusion, and intensive care unit admission for pulmonary edema, effusions, and atelectasis. Postpartum endometritis and sepsis also were encountered. This is to our knowledge the first case report of obstetric complications in MELAS syndrome and highlights the salient metabolic sequelae of this syndrome.
Source: A&A Case Reports - July 14, 2017 Category: Anesthesiology Tags: Case Reports: Case Report Source Type: research

Ischemic Optic Neuropathy in Cardiac Surgery Incidence and Risk Factors in the United States from the National Inpatient Sample 1998 to 2013
Conclusions The incidence of ischemic optic neuropathy in cardiac surgery did not change during the study period. Development of ischemic optic neuropathy after cardiac surgery is associated with carotid artery stenosis, stroke, and degenerative eye conditions.
Source: Anesthesiology - April 18, 2017 Category: Anesthesiology Source Type: research

Perioperative medicine and Taiwan National Health Insurance Research Database.
Abstract "Big data", characterized by 'volume', 'velocity', 'variety', and 'veracity', being routinely collected in huge amounts of clinical and administrative healthcare-related data are becoming common and generating promising viewpoints for a better understanding of the complexity for medical situations. Taiwan National Health Insurance Research Database (NHIRD), one of large and comprehensive nationwide population reimbursement databases in the world, provides the strength of sample size avoiding selection and participation bias. Abundant with the demographics, clinical diagnoses, and capable of linking divers...
Source: Acta Anaesthesiologica Taiwanica - November 17, 2016 Category: Anesthesiology Authors: Chang CC, Liao CC, Chen TL Tags: Acta Anaesthesiol Taiwan Source Type: research

The Genetics of Pain
This article aims to review some human pain conditions, both common and rare, and their possible association with ion channels, receptors and the genes involved. Current and ongoing research evidence of the involvement of multiple cellular and molecular pathways in pain, advances in gene therapy and new medications are mentioned, as well as their limitations due to the complexity of pain.
Source: Current Anesthesiology Reports - November 16, 2016 Category: Anesthesiology Source Type: research

Complex neuropathic pain states
Publication date: Available online 23 September 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Rhian P. Lewis, Indre Kriukelyte In this article we discuss complex neuropathic pain states: diabetic peripheral neuropathic pain (DPNP), phantom limb pain (PLP), central post-stroke pain (CPSP), and complex regional pain syndrome (CRPS). Pain in these conditions can often be severe, significantly affect quality of life and be resistant to current treatment options. Multidisciplinary assessment and treatment is essential.
Source: Anaesthesia and intensive care medicine - September 23, 2016 Category: Anesthesiology Source Type: research

Interest of cervical epidural anesthesia in perioperative management of thyroidectomy with the high-risk anesthetic patient.
We report the case of a patient of 49years old with hypertension, diabetes mellitus, epilepsy, left hemiparesis sequelae of stroke and congestive left ventricular failure. The patient underwent total thyroidectomy under cervical epidural anesthesia. No difficulty breathing or decompensation of chronic underlying diseases were noted in the postoperative. PMID: 24525284 [PubMed - as supplied by publisher]
Source: Annales Francaises d'Anesthesie et de Reanimation - February 10, 2014 Category: Anesthesiology Authors: Mahoungou Guimbi KC, Itiere Odzili FA, Soussa GR Tags: Ann Fr Anesth Reanim Source Type: research

Increased Glycemic Variability in Patients with Elevated Preoperative HbA1C Predicts Adverse Outcomes Following Coronary Artery Bypass Grafting Surgery.
CONCLUSIONS: Postoperative glycemic variability is associated with MAEs after cardiac surgery. Glycemic variability is only measured when the patient leaves the intensive care unit, and there is no opportunity to intervene earlier. Preoperative HbA1C identifies risk for postoperative glycemic variability and may provide a more rational guide for targeting measures to reduce variability. PMID: 24445629 [PubMed - in process]
Source: Anesthesia and Analgesia - January 24, 2014 Category: Anesthesiology Authors: Subramaniam B, Lerner A, Novack V, Khabbaz K, Paryente-Wiesmann M, Hess P, Talmor D Tags: Anesth Analg Source Type: research

Perioperative stroke arising from the interplay of patent foramen ovale, atrial septal aneurysm, and right diaphragm paralysis during endoscopic surgery
A number of risk factors and mechanisms have been associated with vulnerability to perioperative stroke, yet there remains the need to increase awareness of this potential complication, its risks, and consequences. A case of a 59 year old man who underwent a prolonged laparoscopic-thoracoscopic diaphragmatic plication procedure for paralyzed right hemidiaphragm is reported. His past medical history included coronary artery disease, diabetes mellitus type II, hypertension, and hyperlipidemia. Routine transthoracic echocardiogram performed 6 months prior to surgery was unremarkable, noting normal ejection fraction, no valvul...
Source: Journal of Clinical Anesthesia - September 25, 2013 Category: Anesthesiology Authors: Ioanna Apostolidou, Kamini Sundarbose, Sarah L. Richards, Mojca R. Konia Tags: Correspondence Source Type: research

High Thoracic Epidural Analgesia as an Adjunct to General Anesthesia is Associated With Better Outcome in Low-to-Moderate Risk Cardiac Surgery Patients
Conclusion: This large, uniquely matched single-center cohort was generated, and, subject to the listed limitations the authors concluded that supplemental HTEA to general anesthesia had a better outcome in low-risk cardiac surgery patients, with a significantly lower 6-month mortality rate compared with the control group. However, regression analysis revealed that HTEA only had an independently positive effect on the frequency of postoperative dialysis.
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 31, 2013 Category: Anesthesiology Authors: Michael Stenger, Anja Fabrin, Henrik Schmidt, Jacob Greisen, Poul Erik Mortensen, Carl-Johan Jakobsen Tags: Original Article Source Type: research

HbA1c: A Prognostic Biomarker in the Surgical and Critically Ill Patient Population
HYPERGLYCEMIA CAN OCCUR as part of the catabolic response to stress. Acute hyperglycemia is associated with a poor outcome and increased mortality under a variety of clinical conditions, most notably myocardial infarction, stroke, and major surgical tissue trauma. Data from hospital admissions indicate that nondiabetic patients with newly diagnosed hyperglycemia have an increased risk of death. However, the evidence supporting a link between diabetes mellitus (DM) and increased mortality in critically ill and surgical patients is not as strong. This may be caused partly by the underdiagnosis of DM and, thereby, falsely lab...
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 3, 2012 Category: Anesthesiology Authors: Justin Letourneau, Helen Bui, Thomas Schricker, Roupen Hatzakorzian Tags: Review Articles Source Type: research

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