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Dynamic Arterial Elastance Obtained Using Arterial Signal Does Not Predict An Increase In Arterial Pressure After A Volume Expansion in the Operating Room
Conclusion In the present study performed in the OR and in hypotensive patients, Eadyn obtained using arterial signal was unable to predict an increase in MAP after volume expansion.
Source: Anaesthesia, Critical Care and Pain Medicine - July 8, 2017 Category: Anesthesiology Source Type: research

Sickle Cell Disease Subjects Have a Distinct Abnormal Autonomic Phenotype Characterized by Peripheral Vasoconstriction With Blunted Cardiac Response to Head-Up Tilt
Conclusion We have shown that SCD subjects are much more likely than non-SCD subjects to have impaired cardiac, but intact peripheral responses to orthostatic stress induced by HUT. These abnormal responses are associated with low baseline cardiac parasympathetic activity, independent of hemoglobin level. The classification of autonomic phenotypes based on HUT response may have potential use for predicting disease severity, guiding and targeting treatments/interventions to alleviate the risk of adverse outcomes in SCD. Ethics Statement All experiments were conducted at Children’s Hospital Los Angeles (CHLA). The ...
Source: Frontiers in Physiology - April 10, 2019 Category: Physiology Source Type: research

Combination of Dexmedetomidine and Ketamine for Magnetic Resonance Imaging Sedation
Conclusions: The efficacy of DEX–KET sedation was comparable to that of midazolam for MRI examination. DEX–KET was related to shorter scan time and lower occurrence of complications compared to midazolam. Introduction Neurocritically ill patients often require brain magnetic resonance imaging (MRI) in addition to conventional neurological evaluations. Brain MRI can reveal structural lesions with a high sensitivity due to its excellent spatial resolution and enhanced soft tissue contrast (1–3). To acquire MRI images, patients' cooperation is imperative. However, keeping patients with ...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

How Virtual Reality Is Expanding Health Care
Clinicians can help patients recover from strokes while they’re anywhere in the world—even states or countries far away from each other—by using a combination of robotics and virtual-reality devices. It’s happening at Georgia Institute of Technology, where Nick Housley runs the Sensorimotor Integration Lab. There, patients undergoing neurorehabilitation, including those recovering from a stroke, are outfitted with robotic devices called Motus, which are strapped to their arms and legs. The goal: to speed up recovery and assist with rehabilitation exercises. Patients and practitioners using the syste...
Source: TIME: Health - March 4, 2022 Category: Consumer Health News Authors: Sascha Brodsky Tags: Uncategorized healthscienceclimate Source Type: news

A Novel Approach to New-Onset Hemiplegic Shoulder Pain With Decreased Range of Motion Using Targeted Diagnostic Nerve Blocks: The ViVe Algorithm
Introduction: Hemiplegic shoulder pain (HSP) is the most common pain disorder after stroke with incidence estimates of 30–70% and associated with reductions in function, interference with rehabilitation, and a reduced quality of life. Onset may occur as soon as a week after stroke in 17% of patients. Management of HSP represents a complex treatment pathway with a lack of evidence to support one treatment. The pain has heterogeneous causes. In the acute setting, decreased range of motion in the shoulder can be due to early-onset spasticity, capsular pattern stiffness, glenohumeral pathology, or complex regional pain syndr...
Source: Frontiers in Neurology - May 28, 2021 Category: Neurology Source Type: research

Outcomes of Dexmedetomidine with Local Regional Anesthesia in Carotid Endarterectomy
CONCLUSIONS: The use of dexmedetomidine in addition to LRA is a safe and acceptable alternative to conventional GETA or LRA alone in CEA with shorter length of hospital stay when compared with GETA, improved patient tolerance based on physician observation and similar rates of immediate and short-term complications, as well as post-operative pain scores.PMID:36229003 | DOI:10.1016/j.avsg.2022.08.009
Source: Pain Physician - October 13, 2022 Category: Anesthesiology Authors: Samik H Patel Vikram L Sundararaghavan Amber M Pawlikowski Jeremy Albright Jason M Adams Michael J Heidenreich Robert J Beaulieu Abdulhameed Aziz Source Type: research

Postoperative dissection of the vertebral artery in two steps.
We report a case revealed by a tegmento-thalamic stroke after an abdominal second surgical look. The interest of this observation is related to a particular evolution in two steps separated by a 2-month-interval and an intercurrent cervical manipulation. After the second anesthesia, neck pain associated with a third cranial nerve palsy and a supranuclear ophtalmoplegia revealed a tegmento-thalamic ischemic stroke due to vertebral artery dissection. We discuss here the different factors possibly involved in the pathophysiology of postoperative vertebral artery dissection: positioning, cervical manipulation, subclavian centr...
Source: Annales Francaises d'Anesthesie et de Reanimation - October 28, 2014 Category: Anesthesiology Authors: Bien JY, Morel J, Demasles S, Abboud K, Molliex S Tags: Ann Fr Anesth Reanim Source Type: research

Hacking The Nervous System
(Photo: © Job Boot) One nerve connects your vital organs, sensing and shaping your health. If we learn to control it, the future of medicine will be electric.When Maria Vrind, a former gymnast from Volendam in the Netherlands, found that the only way she could put her socks on in the morning was to lie on her back with her feet in the air, she had to accept that things had reached a crisis point. “I had become so stiff I couldn’t stand up,” she says. “It was a great shock because I’m such an active person.”It was 1993. Vrind was in her late 40s and working two jobs, athletics coach and a carer for disabled ...
Source: Science - The Huffington Post - May 30, 2015 Category: Science Source Type: news

Safety and efficiency of ultrasound-guided intermediate cervical plexus block for carotid surgery
Conclusions The present work reports our first 50 cases of intermediate CPB using ultrasound guidance. The results underline that this technique is easy to perform, safe and reliable, provided good surgical conditions with continuous intraoperative neurologic monitoring and stable haemodynamics are respected.
Source: Anaesthesia, Critical Care and Pain Medicine - December 6, 2015 Category: Anesthesiology Source Type: research

Combined carotid endarterectomy and retrograde stenting of the supra-aortic trunk: Does cervical block offers advantages?
Atherosclerosis of the carotid artery is a major source of stroke. In some cases atherosclerosis occurs at several positions within the carotid artery. Carotid endarterectomy (CEA) in combination with retrograde balloon angioplasty and stenting of a brachiocephalic or common carotid artery stenosis has been described as efficacious and save procedure to prevent stroke in these cases. The aim of this study was to analyse the impact of anaesthetic techniques on hemodynamic factors, operation time, duration of clamping and post-operative pain.
Source: Annals of Vascular Surgery - May 9, 2016 Category: Surgery Authors: Jens Heyn, Franziska Rosch, Marcus Treitl, Alexander Klose, Benjamin Luchting, Mojtaba Sadeghi-Azandaryani Source Type: research

Combined Carotid Endarterectomy and Retrograde Stenting of the Supra-Aortic Trunk: Does Cervical Block Offer Advantages?
Atherosclerosis of the carotid artery is a major source of stroke. In some cases, atherosclerosis occurs at several positions within the carotid artery. Carotid endarterectomy (CEA) in combination with retrograde balloon angioplasty and stenting of a brachiocephalic or common carotid artery stenosis has been described as efficacious and safe procedure to prevent stroke in these cases. The aim of this study was to analyze the impact of anesthetic techniques on hemodynamic factors, operation time, duration of clamping, and postoperative pain.
Source: Annals of Vascular Surgery - May 9, 2016 Category: Surgery Authors: Jens Heyn, Franziska Rosch, Marcus Treitl, Alexander Klose, Benjamin Luchting, Mojtaba Sadeghi-Azandaryani Tags: Clinical Research Source Type: research

Epidural therapy for the treatment of severe pre-eclampsia in non labouring women.
CONCLUSIONS: Currently, there is insufficient evidence from randomised controlled trials to evaluate the effectiveness, safety or cost of using epidural therapy for treating severe pre-eclampsia in non-labouring women.High-quality randomised controlled trials are needed to evaluate the use of epidural agents as therapy for treatment of severe pre-eclampsia. The rationale for the use of epidural is well-founded. However there is insufficient evidence from randomised controlled trials to show that the effect of epidural translates into improved maternal and fetal outcomes. Thus, there is a need for larger, well-designed stud...
Source: Cochrane Database of Systematic Reviews - November 28, 2017 Category: General Medicine Authors: Ray A, Ray S Tags: Cochrane Database Syst Rev Source Type: research

NIH scientists identify spasm in women with endometriosis-associated chronic pelvic pain
(NIH/National Institute of Neurological Disorders and Stroke) Pelvic pain associated with endometriosis often becomes chronic and can persist (or recur) following surgical and hormonal interventions. According to results published in Regional Anesthesia& Pain Medicine, treating pelvic floor muscle spasm with botulinum toxin may relieve pain and improve quality of life. The study was conducted by scientists at the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health.
Source: EurekAlert! - Biology - July 11, 2019 Category: Biology Source Type: news

Suprascapular nerve block in hemiplegic shoulder pain: comparison of the effectiveness of placebo, local anesthetic, and corticosteroid injections —a randomized controlled study
ConclusionsThe findings of this study support the use of an SSNB with or without CS, to increase the range of motion in the affected shoulder, especially during the rehabilitation period.
Source: Neurological Sciences - May 9, 2020 Category: Neurology Source Type: research

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