Mostrando entradas con la etiqueta Anesthesia. Mostrar todas las entradas
Mostrando entradas con la etiqueta Anesthesia. Mostrar todas las entradas

jueves, 11 de enero de 2018

Neurotoxicidad y anestesia / Anesthesia neurotoxicity

Enero 11, 2018. No. 2960
Neurotoxicidad anestésica en pacientes pediátricos
Anesthetic Neurotoxicity in Pediatric Patients
Ayse B. Ozer and Sibel Ozcan
Current Topics in Anesthesiology
book edited by Riza Hakan Erbay, ISBN 978-953-51-2918-9, Print ISBN 978-953-51-2917-2, Published: February 8, 2017 under CC BY 3.0 license. © The Author(s).
Abstract In recent years, an increasing number of publications have shown the negative effects of anesthetics on the developing brain and have made inquiries about anesthesia for pediatric patients in practice. Anesthesia is applied to millions of children for surgery, imaging, and other invasive procedures; the issue is very serious and concerns. In this chapter, experimental and clinical studies about the issue have been summarized. As a result, anesthetic drugs except alpha-2 adrenergic agonist anesthetic (NMDA antagonist or a GABA agonist) used in pediatric patients (especially if there is no painful situation) have potential neurotoxicity. Particularly, if anesthesia exposure was applied in the fragile period (the first 4 years) and if used at higher concentrations or repeated anesthesia application, adverse effects of anesthesia exposure on the developing brain have been claimed. But, the issue is not fully clarified yet. Keywords: anesthesia, neurotoxicity, neonatal, developing brain
Un mecanismo celular reversible por presión de anestésicos generales capaz de alterar un posible mecanismo para la conciencia
A pressure-reversible cellular mechanism of general anesthetics capable of altering a possible mechanism for consciousness
Kunjumon I. Vadakkan
Springerplus. 2015; 4: 485. Published online 2015 Sep 7. doi: 10.1186/s40064-015-1283-1
ASbstract
Different anesthetics are known to modulate different types of membrane-bound receptors. Their common mechanism of action is expected to alter the mechanism for consciousness. Consciousness is hypothesized as the integral of all the units of internal sensations induced by reactivation of inter-postsynaptic membrane functional LINKs during mechanisms that lead to oscillating potentials. The thermodynamics of the spontaneous lateral curvature of lipid membranes induced by lipophilic anesthetics can lead to the formation of non-specific inter-postsynaptic membrane functional LINKs by different mechanisms. These include direct membrane contact by excluding the inter-membrane hydrophilic region and readily reversible partial membrane hemifusion. The constant reorganization of the lipid membranes at the lateral edges of the postsynaptic terminals (dendritic spines) resulting from AMPA receptor-subunit vesicle exocytosis and endocytosis can favor the effect of anesthetic molecules on lipid membranes at this location. Induction of a large number of non-specific LINKs can alter the conformation of the integral of the units of internal sensations that maintain consciousness. Anesthetic requirement is reduced in the presence of dopamine that causes enlargement of dendritic spines. Externally applied pressure can transduce from the middle ear through the perilymph, cerebrospinal fluid, and the recently discovered glymphatic pathway to the extracellular matrix space, and finally to the paravenular space. The pressure gradient reduce solubility and displace anesthetic molecules from the membranes into the paravenular space, explaining the pressure reversal of anesthesia. Changes in membrane composition and the conversion of membrane hemifusion to fusion due to defects in the checkpoint mechanisms can lead to cytoplasmic content mixing between neurons and cause neurodegenerative changes. The common mechanism of anesthetics presented here can operate along with the known specific actions of different anesthetics.
Keywords: Consciousness, General anesthetics, Pressure reversal, Semblance hypothesis, Inter-membrane contact, Membrane hemifusion, Partial hemifusion, Complete hemifusion, Membrane fusion, Neurodegeneration
Una espada de doble filo: efectos anestésicos volátiles en el cerebro neonatal
A Double-Edged Sword: Volatile Anesthetic Effects on the Neonatal Brain
Sunny Chiao, Zhiyi Zuo
Brain Sci. 2014 Jun; 4(2): 273-294. Published online 2014 Apr 16. doi: 10.3390/brainsci4020273
Abstract
The use of volatile anesthetics, a group of general anesthetics, is an exceedingly common practice. These anesthetics may have neuroprotective effects. Over the last decade, anesthetic induced neurotoxicity in pediatric populations has gained a certain notoriety based on pre-clinical cell and animal studies demonstrating that general anesthetics may induce neurotoxicity, including neuroapoptosis, neurodegeneration, and long-term neurocognitive and behavioral deficits. With hundreds of millions of people having surgery under general anesthesia worldwide, and roughly six million children annually in the U.S. alone, the importance of clearly defining toxic or protective effects of general anesthetics cannot be overstated. Yet, with our expanding body of knowledge, we have come to learn that perhaps not all volatile anesthetics have the same pharmacological profiles; certain ones may have a more favorable neurotoxic profile and may actually exhibit neuroprotection in specific populations and situations. Thus far, very few clinical studies exist, and have not yet been convincing enough to alter our practice. This review will provide an update on current data regarding volatile anesthetic induced neurotoxicity and neuroprotection in neonatal and infant populations. In addition, this paper will discuss ongoing studies and the trajectory of further research over the coming years.
Keywords: anesthesia, anesthetics, neuroprotection, neurotoxicity, pediatrics, volatile anesthetics, preconditioning, postconditioning, ischemic conditioning

Safe Anaesthesia Worldwide
Delivering safe anaesthesia to the world's poorest people
World Congress on Regional Anesthesia & Pain Medicine
April 19-21, 2018, New York City, USA
International Anesthesia Research Society Annuals Meetings
USA
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Anestesiología y Medicina del Dolor

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lunes, 30 de octubre de 2017

Revisiones sistemáticas en anestesia /Systematic reviews in anesthesia

Octubre 30, 2017. No. 2897

  


Heterogeneidad de los estudios en revisiones sistemáticas de anestesiología: revisión metaepidemiológica y propuesta de mapeo de evidencia.
Heterogeneity of studies in anesthesiology systematic reviews: a meta-epidemiological reviewand proposal for evidence mapping.
Br J Anaesth. 2017 Nov 1;119(5):874-884. doi: 10.1093/bja/aex251.
Abstract
Heterogeneity among the primary studies included in a systematic review (SR) is one of the most challenging considerations for systematic reviewers. Current practices in anaesthesiology SRs have not been evaluated, but traditional methods may not provide sufficient information to evaluate the true nature of these differences. We address these issues by examining the practices for evaluating heterogeneity in anesthesiology reviews. Also, we propose a mapping method for presenting heterogeneous aspects of the primary studies in SRs.We evaluated heterogeneity practices reported in SRs published in highly ranked anesthesiology journals and Cochrane reviews. Elements extracted from the SRs included heterogeneity tests, models used, analyses conducted, plots used, and I2 values. Additionally, we selected a SR to develop an evidence map in order to display clinical heterogeneity.Our statistical analysis showed 150/207 SRs reporting a test for statistical heterogeneity. Plots were used in 138 reviews to display heterogeneity. Subgroup analyses were the most commonly reported analysis (54%). Meta-regression and sensitivity analyses were used sparingly (25%; 23% respectively). A random effects model was most commonly reported (33%). Heterogeneity statistics across meta-analyses suggested that, in our sample, the majority (55%) did not present sufficient heterogeneity to be of great concern. Cochrane reviews (n=58) were also analysed. Plots were used in 88% of Cochrane reviews. Subgroup analysis was used in 59% Cochrane reviews, while sensitivity analysis was used in 62%.Many reviews did not provide sufficient detail regarding heterogeneity. We are calling for improvement to reporting practices.

XXVII Congreso Peruano de Anestesiología
Lima, Noviembre 2-4, 2017
LI Congreso Mexicano de Anestesiología
Mérida Yucatán, Noviembre 21-25, 2017
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Anestesiología y Medicina del Dolor

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jueves, 26 de octubre de 2017

Alergia y anestesia / Allergy and anesthesia

Octubre 25, 2017. No. 2892

  


Alergia a las benzodiazepinas con administración de anestesia: revisión de la literatura actual.
Benzodiazepine Allergy With Anesthesia Administration: A Review of Current Literature.
Anesth Prog. Fall 2016;63(3):160-7. doi: 10.2344/16-00019.1.
Abstract
The incidence of anaphylactic/anaphylactoid reactions has been reported to vary between 1:3500 and 1:20,000 cases with a mortality rate ranging from 3 to 9%. Clinical signs present as skin rash, urticaria, angioedema, bronchospasm, tachycardia, bradycardia, and hypotension. Rapid identification and treatment are crucial to overall patient prognosis, as delayed intervention is associated with increased mortality. Diagnosis may be confirmed with clinical presentation, serum tryptase levels, and skin test results. While the main causative agents in anesthetic practice are typically neuromuscular blocking agents (NMBs), latex, and antibiotics, this review aims to discuss recognition, management, and preventive measures in perioperative anaphylactic/anaphylactoid reactions from benzodiazepine administration.
KEYWORDS: Anaphylactoid reactions; Anaphylaxis; Benzodiazepine allergy; Diagnosis of anaphylaxis; Management of anaphylaxis
Hipersensibilidad a los anestésicos locales
Hypersensitivity to local anesthetics.
Anaesthesiol Intensive Ther. 2016;48(2):128-34. doi: 10.5603/AIT.a2016.0017. Epub 2016 Mar 15.
Abstract
Using local anaesthetics in daily practice, particularly by anaesthetists and dentists, is connected with the risk of side effects. Therefore, the observation of side effects, carrying out detailed research (according to the chart proposed in this study) and conducting specialist examinations is of the highest importance. There is a variety of side effects that could occur during local anaesthesia procedures, with the intensity ranging from clinically unimportant to life threatening. Clinicians' major concerns are the appearance of various hypersensitivity reactions, including anaphylaxis. Healthcare providers responsible for the administration of local anaesthetics should be able to detect hypersensitivity reactions to implement appropriate treatment and then choose highly selected diagnostic procedures. The final diagnosis should be based on specific medical history; documentation, including a description of the case and measurement of tryptase activity; skin tests; and provocation trials. Screening tests are not recommended in populations without hypersensitivity to local anaesthestics in their medical history.
KEYWORDS: hypersensitivity; local anestehtics; local anesthesia; skin tests

XXVII Congreso Peruano de Anestesiología
Lima, Noviembre 2-4, 2017
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lunes, 16 de octubre de 2017

Día Mundial de la Anestesiología / World Anesthesia Day

Octubre 16, 2017. No. 2843






Sin lugar a duda, la anestesiología es una profesión plena de retos, de incógnitas, de éxitos y de fracasos. Una ciencia milenaria que ha logrado conquistar al dolor, un conocimiento profundo de la fisiopatología, de los fármacos, y de la vida misma. Conocimientos y destrezas son características de esta profesión, actividad que cuando se adereza de amor por nuestros pacientes hace de los anestesiólogos seres humanos especiales.
Es una forma de vivir con plenitud, de satisfacer a nuestros seres más queridos y a nosotros mismos, a la vez que aseguramos que la inmensa mayoría de nuestros enfermos regresen sanos y salvos a su lecho familiar. Cuando nos toca confrontar nuestros errores o la muerte de alguno de nuestros pacientes no podemos dormir satisfechos, la duda nos lleva más allá de la tristeza en búsqueda de una explicación razonable que nos haga superar nuestro fracaso. Es nuestra forma de transitar por la vida, una manera por nosotros elegida, un modus vivendi que en realidad amamos.
Anestesiología y Medicina del Dolor se complace en desearle un feliz inicio de semana celebrando el Día Mundial de la Anestesiología. Disfrútelo con plenitud en compañía de su Familia, amigos, colegas y pacientes.

Undoubtedly, anesthesiology is a profession full of challenges, mysteries, successes and failures. A millenary science that has managed to conquer pain, a deep knowledge of the pathophysiology, drugs, and life itself. Knowledge and skills are characteristics of this profession, an activity that, when it is dressed in love for our patients, makes anesthesiologists special human beings.
It is a way of fully living, of satisfying our loved ones and ourselves, while ensuring that the majority of our patients return safely to their family. When confronting our mistakes or the death of one of our patients we can not sleep satisfied, doubt takes us beyond sadness in search of a reasonable explanation that makes us overcome our failure. It is our way of life, a way chosen by us, a modus vivendi that we really love.
Anestesiología y Medicina del Dolor is pleased to wish you a happy week celebrating World Anesthesiology Day. Enjoy it fully in the company of your Family, friends, colleagues and patients.
Indubitavelmente, a anestesiologia é uma profissão repleta de desafios, incógnitas, sucessos e falhas. Uma ciência milenar que conseguiu conquistar a dor, um profundo conhecimento da fisiopatologia, das drogas e da própria vida. O conhecimento e as habilidades são características desta profissão, uma atividade que, quando está vestida de amor por nossos pacientes, faz anestesiologistas seres humanos especiais.
É uma maneira de viver plenamente, de satisfazer nossos entes queridos e de nós mesmos, assegurando que a grande maioria de nossos pacientes retornem com segurança ao leito da família. Ao enfrentar nossos erros ou a morte de alguns de nossos pacientes, não podemos dormir satisfeitos, a dúvida nos leva além da tristeza em busca de uma explicação razoável que nos faz superar nosso fracasso. É o nosso modo de vida, um caminho escolhido por nós, um modus vivendi que realmente amamos.
Anestesiología y Medicina del Dolor tem o prazer de desejar-lhe um feliz começo da semana comemorando o Dia Mundial da Anestesiologia. Aproveite totalmente na companhia de sua Família, amigos, colegas e pacientes.

Sans aucun doute, l'anesthésiologie est une profession pleine de défis, d'inconnus, de réussites et d'échecs. Une science millénaire qui a réussi à vaincre la douleur, une connaissance approfondie de la physiopathologie, de la drogue et de la vie elle-même. Les connaissances et les compétences sont les caractéristiques de cette profession, une activité qui, lorsqu'elle est amoureuse de nos patients, fait des anesthésiologistes des êtres humains spéciaux.
C'est une façon de vivre pleinement, de satisfaire nos proches et nous-mêmes, tout en veillant à ce que la grande majorité de nos patients reviennent en toute sécurité dans leur lit familial. Face à nos erreurs ou à la mort de certains de nos patients, nous ne pouvons pas dormir satisfaits, le doute nous emmène au-delà de la tristesse à la recherche d'une explication raisonnable qui nous fait surmonter notre échec. C'est notre mode de vie, une façon choisie par nous, un modus vivendi que nous aimons vraiment.
Anestesiología y Medicina del Dolor est heureux de vous souhaiter un bon début de la semaine pour célébrer la Journée mondiale de l'anesthésiologie. Profitez-en pleinement en compagnie de votre famille, vos amis, vos collègues et vos patients.
بدون شک، بیهوشی حرفه ای است که از چالش ها، ناشناخته ها، موفقیت ها و شکست ها پر شده است. یک علم هزار ساله است که موفق به تسخیر درد، دانش عمیق از پاتوفیزیولوژی، مواد مخدر و زندگی خود است. دانش و مهارت ها ویژگی های این حرفه است، فعالیت هایی که، زمانی که در عشق به بیماران ما قرار می گیرد، بیهوشی را انسان های خاص می سازد.
این یک روش کامل زندگی است، برای رضایت عزیزان و خودمان، در حالی که اطمینان حاصل کنیم که اکثریت بیماران ما با خیال راحت به تختخواب خانواده خود می روند. در مواجهه با اشتباهات ما و یا مرگ یکی از بیماران ما نمی توانیم راضی نشویم، شكی ما را فراتر از غم و اندوه در جستجوی توضیح معقول می سازد كه ما را از غلبه بر شکست ما جلوگیری می كند. این شیوه زندگی ما است، راهی که ما انتخاب کردیم، مدیسویودی است که ما واقعا دوست داریم.
بیهوشی و درد پزشکی خوشحال است که به شما آرزوی خوشبختی را برای هفته جشن روز جهانی بیهوشی اختصاص
La historia de la anestesiología
The History of Anaesthesia.
J Natl Med Assoc. 1932 Jan;24(1):6-9.
Historia de la anestesia intravenosa con seis años de experiencia con pentotal sódico
History of Intravenous Anæsthesia with Six Years' Experience in the use of Pentothal Sodium.
Postgrad Med J. 1941 May;17(186):70-80.
Historia de la anestesia quirúrgica; una exhibición conmemorativa del centenario de la primera demostración pública de anestesia con éter de William Thomas Green Morton.
History of surgical anaesthesia; an exhibit commemorating the one hundredth anniversary of William Thomas Green Morton's first public demonstration of ether anaesthesia.
Q Bull Northwest Univ Med Sch. 1946;20(4):449-63.
Anestesia con éter, 1842-1900
Ether anaesthesia, 1842-1900.
Postgrad Med J. 1946 Oct;22(252):280-90.
Patrick Black (1813-1879); primer administrador de cloroformo en el Hospital de St. Bartholomew, Londres.
Patrick Black (1813-1879); first administrator of chloroform at St. Bartholomew's Hospital, London.
Anaesthesia. 1955 Jan;10(1):70-3.
Anestesia regional para procedimientos de oficina.
Regional anesthesia for office procedures.
Calif Med. 1953 Mar;78(3):213-5.
Pacientes de la realeza y popularización de la anestesia.
Royal patients and the popularisation of anaesthesia.
Anaesthesia. 1953 Jul;8(3):146-50.
Edward D. Churchill y la anestesia en Harvard
EDWARD D. CHURCHILL AND ANESTHESIA AT HARVARD.
Ann Surg. 1963 Nov;158:872-6.
La conquista del dolor
The conquest of pain.
Ulster Med J. 1959 Nov 1;28:101-17.
Dr. John Snow; 1813-1858
John Snow, M. D.; 1813-1858.
Anaesthesia. 1959 Apr;14(2):113-26.
Breve historia de la anestesia
Mayor M.C. Antonio Moreno-Guzmán
Rev Sanid Milit Mex 2012; 66(4) Jun -Ago: 189-194
17h World Congress of Anaesthesiologists, WFSA
Sep 6-11, 2020
Prague, Czech Republic
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