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Items 1 - 27 of 27 |
One page. |
New onset Lambert-Eaton myasthenic syndrome as an unexpected cause of delayed recovery from general anesthesia after thyroidectomy.
Bui PK, Kuczkowski KM, Moeller-Bertram T, Sanchez RA.
Departments of Anesthesiology and Reproductive Medicine, University of California San Diego, San Diego, CA, USA.
Publication Types:
PMID: 15471643 [PubMed - in process]
Density of spinal anaesthetic solutions.
Pitkanen M, McLeod G.
Helsinki, Finland.
PMID: 15472147 [PubMed - in process]
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Nausea and vomiting after fast-track cardiac anaesthesia.
Morton G, Lim M, Stacey S, Kogan A.
London, UK.
PMID: 15472146 [PubMed - in process]
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Editorial I: Tiny wonders of tiny impurities of nitrous oxide during anaesthesia.
Marczin N.
Department of Anaesthesia, Division of Surgery and Anaesthetics, Faculty of Medicine, Imperial College London, Department of Anaesthetics, Royal Brompton and Harefield NHS Trust, Harefield Hospital, Middlesex UB9 6JH, UK. n.marczin@imperial.ac.uk.
PMID: 15472140 [PubMed - in process]
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Effects of xenon anaesthesia on intestinal oxygenation in acutely instrumented pigs{dagger}
Vagts DA, Hecker K, Iber T, Roesner JP, Spee A, Otto B, Rossaint R, Noldge-Schomburg GF.
Klinik und Poliklinik fur Anasthesiologie und Intensivtherapie, Universitat Rostock, Schillingallee 35, D-18055 Rostock, Germany.
BACKGROUND: Xenon is a narcotic gas that might be able to replace volatile anaesthetics or nitrous oxide due to its favourable pharmacological properties, such as providing haemodynamic stability. Intestinal oxygenation is affected by most volatile anaesthetics as a result of cardiodepressive effects. Reducing oxygenation of the gut might be a factor leading to perioperative organ dysfunction. This animal study was designed to assess the effects of xenon on intestinal oxygenation. METHODS: After ethical approval, 24 anaesthetized, acutely instrumented pigs were randomly assigned to three groups: nine animals received xenon anaesthesia with inspiratory concentrations of 0, 20, 50 and 65% in addition to their basic i.v. anaesthesia, nine animals served as a study control group, and five animals were used to assess model stability. Measurement of systemic and regional haemodynamic and oxygenation parameters was made 30 min after changing the xenon concentration. RESULTS: Xenon elicited dose-dependent systemic haemodynamic changes: heart rate and cardiac output decreased by 30%, while mean arterial pressure was stable. Superior mesenteric artery blood flow was lower in the xenon group. Vascular resistance of the superior mesenteric artery increased. The small intestinal oxygen supply decreased with increasing xenon concentration; the mucosal tissue oxygen partial pressure decreased but did not reach hypoxic (<5 mm Hg) values. Serosal tissue oxygen partial pressure was maintained. CONCLUSIONS: Xenon, in addition to basic i.v. anaesthesia, elicited a decrease in cardiac output and maintained mean arterial pressure. Intestinal oxygenation was maintained, although regional macrohaemodynamic perfusion decreased. Xenon does not impair intestinal oxygenation under physiological conditions.
PMID: 15465844 [PubMed - as supplied by publisher]
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Intravenous anaesthesia and repetitive transcranial magnetic stimulation monitoring in spinal column surgery.
Hargreaves SJ, Watt JW.
Spinal Injuries Unit, Southport and Ormskirk Hospital NHS Trust, Town Lane, Southport PR8 6PN, UK.
BACKGROUND: Transcranial magnetic stimulation with motor evoked potential monitoring is a non-invasive method for monitoring motor tracts during surgery. However, anaesthetic agents such as propofol and volatile agents reduce responses to single transcranial magnetic stimulation. We assessed an intravenous technique for anaesthesia to allow motor evoked potentials (MEPs) to be monitored using repetitive transcranial magnetic stimulation (rTMS). METHODS: We applied three-pulse rTMS (TriStim) in 11 patients undergoing spinal column surgery after spinal column injury and recorded the latency and peak-to-peak amplitude of MEPs. Anaesthesia was maintained with propofol and remifentanil. RESULTS: MEPs were monitored successfully intraoperatively in all patients. CONCLUSIONS: It is possible to monitor intraoperative MEP using rTMS during anaesthesia with propofol and remifentanil.
PMID: 15465838 [PubMed - as supplied by publisher]
Narcotrend(R) depth of anesthesia monitoring in infants and children.
Weber F, Hollnberger H, Gruber M, Frank B, Taeger K.
PMID: 15470185 [PubMed - in process]
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Le bloc paravertebral n'est pas une technique anesthesique de choix pour la chirurgie mammaire mineure en court sejour [Paravertebral blockade is not a suitable anesthetic technique for ambulatory minor breast surgery].
Lemay E, Guay J, Cote C, Leclerc YE.
PMID: 15470182 [PubMed - in process]
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Total airway obstruction during local anesthesia in a non-sedated patient with a compromised airway: [Une obstruction totale des voies aeriennes pendant une anesthesie locale chez un patient eveille qui presentait deja une obstruction respiratoire partielle].
Ho AM, Chung DC, To EW, Karmakar MK.
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR, PRC., hoamh@cuhk.edu.hk.
PURPOSE: To report a case of complete upper airway obstruction after topicalization with lidocaine in a completely conscious patient with partial upper airway obstruction. CLINICAL FEATURES: A 69-yr-old man with a history of neck cancer and radiation presented for resection of recurrent neck tumour. No preoperative sedation was given. He had inspiratory and expiratory stridor but had no history of aspiration or swallowing problem. Phonation was distorted but effective. The surgeon was reluctant to perform an awake tracheostomy under local anesthesia. In preparation for a fibrescope-assisted orotracheal intubation, the non-sedated patient was given topical upper airway lidocaine during which he developed total airway obstruction and hypoxemia. He was immediately intubated with a fibrescope. His vocal cords were not edematous although the supraglottic structures appeared to be. The vocal cords were abducted and their movement was limited and not paradoxical. Tumour resection was uneventful upon successful tracheal intubation and general anesthesia. Tracheostomy at the end of the case was difficult, as expected. The patient tolerated the procedures and regained consciousness with no neurologic sequelae. CONCLUSION: Dynamic airflow limitation associated with local anesthesia of the upper airway may lead to complete upper airway obstruction in a compromised airway. The main cause may be the loss of upper airway muscle tone, exacerbated by deep inspiration during panic.
PMID: 15470176 [PubMed - in process]
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Decreased heart rate and blood pressure in a recent cardiac transplant patient after spinal anesthesia: [Baisse de la frequence cardiaque et de la tension arterielle apres rachianesthesie chez un patient qui a recemment recu une greffe cardiaque].
Allard R, Hatzakorzian R, Deschamps A, Backman SB.
Department of Anaesthesia, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, Quebec H3A 1A1, Canada. steven.backman@muhc.mcgill.ca.
PURPOSE: To describe the cardiovascular effects of neuraxial blockade in a heart transplant patient. CLINICAL FEATURES: A 69-yr-old 70-kg male underwent orthotopic heart transplant (bicaval anastomosis technique) for ischemic cardiomyopathy. Five months after transplantation, the patient underwent a transurethral bladder tumour resection under spinal anesthesia. Two millilitres of bupivacaine 0.75% (15 mg) were injected intrathecally at L(3-4) and the patient remained seated for approximately 20 sec prior to assuming the lithotomy position. Subsequently, both blood pressure (BP) and heart rate (HR) diminished gradually (BP and HR immediately pre-spinal: 113 mmHg (mean arterial pressure) and 92 beats.min(-1), respectively; nadir BP and HR: 94 mmHg (16.8% decrease) 30 min postspinal and 73 beats.min(-1) (20.7% decrease) 40 min postspinal, respectively). HR and mean BP were highly correlated (r = 0.9410, P < 0.0001, R(2) = 0.8854). The dermatome level of neuraxial anesthesia, determined by sensitivity to pin prick, was T(8) (five minutes) and T(6) (ten minutes) postinjection of spinal anesthetic. Control patients (n = 10) undergoing elective urological procedures with identical anesthesia management demonstrated very similar cardiovascular responses. CONCLUSIONS: Although cardiac transplant patients may tolerate neuraxial anesthesia admirably, a fall in HR may ensue which theoretically could have important physiological consequences. It is argued that the change in HR in the transplanted patient was mediated by mechanisms intrinsic to the transplanted heart and/or by reduced catecholamine secretion from the adrenal medulla. It is emphasized that HR changes observed in cardiac transplant patients do not necessarily imply reinnervation of the transplanted organ.
PMID: 15470174 [PubMed - in process]
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Desflurane increases cerebral blood flow velocity when used for rapid emergence from propofol anesthesia in children: [Le desflurane augmente la vitesse circulatoire cerebrale quand il est utilise pour un reveil rapide apres l'anesthesie au propofol chez des enfants].
Barlow R, Karsli C, Luginbuehl I, Bissonnette B.
Department of Anaesthesia, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G IX8, Canada. ross.barlow@sickkids.ca.
PURPOSE: Desflurane may be used to replace propofol at the end of anesthesia to facilitate rapid emergence. This study determined the effect of administering desflurane during emergence of anesthesia on middle cerebral artery blood flow velocity (Vmca) in children anesthetized with propofol. METHODS: Thirty healthy chilren aged one to six years scheduled for orchidopexy or hypospadias repair under general anesthesia were enrolled. Anesthesia was maintained with a propofol infusion targeting an estimated serum level of 3 μg.mL(-1), remifentanil 0.2 μg.kg(-1).min(-1) and a caudal epidural block. Transcranial Doppler sonography was used to measure Vmca at five-minute intervals. In half the patients, propofol was substituted with desflurane 1 MAC, 30 min prior to the end of the surgical procedure. Once steady-state had been achieved recordings of Vmca, heart rate, and mean arterial pressure were resumed. Upon termination of the surgical procedure, the maintenance agent was discontinued and recordings continued at one-minute intervals during emergence of anesthesia. RESULTS: There were no demographic differences between the two groups. Vmca increased from 37.2 +/- 3.1 cm.sec(-1) to 57.7 +/- 4.1 cm.sec(-1) when propofol was changed to desflurane (P < 0.01). Upon emergence of anesthesia, Vmca decreased from 57.8 +/- 4.2 cm.sec(-1) to 37.8 +/- 3.2 cm.sec(-1) in the desflurane group (P < 0.01) but remained unchanged in the propofol group. CONCLUSION: Desflurane is associated with an increase in cerebral blood flow velocity when used to facilitate rapid emergence following a propofol infusion in children. This may be of clinical significance in patients with intracranial pathology.
PMID: 15470173 [PubMed - as supplied by publisher]
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Patient satisfaction with anesthesia care: information alone does not lead to improvement: [La satisfaction du patient face a l'anesthesie : l'information ne suffit pas a l'amelioration].
Heidegger T, Nuebling M, Germann R, Borg H, Fluckiger K, Coi T, Husemann Y.
Department of Anaesthesiology, Cantonal Hospital, St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland. thomas.heidegger@kssg.ch.
PURPOSE: To evaluate if information campaigns and introduction of information leaflets lead to an improvement in patient satisfaction with anesthesia care. METHODS: In 2000, we carried out an assessment of patient satisfaction with anesthesia care. "Information/involvement in decision making" was identified as the worst problem area. The three hospitals involved in this study introduced strategies to improve this dimension of patient satisfaction by launching information campaigns, producing or improving information brochures (particularly in hospitals A and C), and by expanding the preanesthetic care unit (hospital B). In 2002, a second survey was carried out. Each of the hospitals sent questionnaires to 600 elective surgery patients after discharge. We compared the total problem scores (the percentage of patients who responded that a problem was present) and the problem scores for the dimension 'information/involvement in decision making' between 2000 and 2002. RESULTS: The total problem score (mean in %, 95% confidence interval) for all three hospitals together remained unchanged [19% (1)], as well as the problem scores for each hospital [hospital A 16% (1), hospital B 21% (1), hospital C 20% (1)]. The problem score for 'information/involvement in decision making' remained unchanged also: 31% (29-33) in 2000 compared to 28% (26-30) in 2002. CONCLUSION: Information campaigns and the introduction of information leaflets alone do not improve patient satisfaction with anesthesia care.
PMID: 15470168 [PubMed - in process]
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Patient selection in ambulatory anesthesia - An evidence-based review: part II: [La selection des patients en anesthesie ambulatoire - Une revue factuelle : partie II].
Bryson GL, Chung F, Cox RG, Crowe MJ, Fuller J, Henderson C, Finegan BA, Friedman Z, Miller DR, van Vlymen J.
Department of Anesthesiology, Head, Pre-Admission Units, The Ottawa Hospital, 1053 Carling Avenue, Ottawa, Ontario K1Y 4E9, Canada. glbryson@ottawahospital.on.ca.
PURPOSE: This is the second of two reviews evaluating the management of patients with selected medical conditions undergoing ambulatory anesthesia and surgery. Conditions highlighted in this review include: diabetes mellitus; morbid obesity; the ex-premature infant; the child with an upper respiratory infection; malignant hyperthermia; and the use of monoamine oxidase inhibitors. SOURCE: Medline search strategies and the framework for the evaluation of clinical evidence are presented in Part I. PRINCIPAL FINDINGS: Diabetes mellitus has not been linked with adverse events following ambulatory surgery. The morbidly obese patient is at an increased risk for minor respiratory complications in the perioperative period but these events do not increase unanticipated admissions. The ex-premature infant may be considered for ambulatory surgery if post-conceptual age is > 60 weeks and hematocrit is > 30%. The child with a recent upper respiratory tract infection is at an increased risk for perioperative respiratory complications, particularly if endotracheal intubation is required. Patients with malignant hyperthermia may undergo outpatient surgery but require four hours of postoperative temperature monitoring. Sporadic cases of drug interactions have been reported when meperidine and indirect-acting catecholamines are administered in the presence of monamine oxidase inhibitors. Ambulatory anesthesia and surgery is safe if these combinations of drugs are avoided. CONCLUSION: Ambulatory anesthesia can be performed in, and is being offered to, a variety of patients with significant coexistent disease. In many cases there is little evidence documenting the outcomes expected in such patients. Prospective observational and interventional trials are required to better define perioperative management.
PMID: 15470166 [PubMed - in process]
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Patient selection in ambulatory anesthesia - An evidence-based review: part I: [La selection des patients en anesthesie ambulatoire - Une revue factuelle : partie I].
Bryson GL, Chung F, Finegan BA, Friedman Z, Miller DR, van Vlymen J, Cox RG, Crowe MJ, Fuller J, Henderson C.
Department of Anesthesiology, Head, Pre-Admission Units, The Ottawa Hospital, 1053 Carling Avenue, Ottawa, Ontario K1Y 4E9, Canada. glbryson@ottawahospital.on.ca.
PURPOSE: To identify and characterize the evidence supporting decisions made in the care of patients with selected medical conditions undergoing ambulatory anesthesia and surgery. Conditions highlighted in this review include: the elderly, heart transplantation, hyper-reactive airway disease, coronary artery disease, and obstructive sleep apnea. SOURCE: A structured search of MEDLINE (1966-2003) was performed using keywords for ambulatory surgery and patient condition. Selected articles were assigned a level of evidence using Centre for Evidence Based Medicine (CEBM) criteria. Recommendations were also graded using CEBM criteria. PRINCIPAL FINDINGS: The elderly may safely undergo ambulatory surgery but are at increased risk for hemodynamic variation in the operating room. The heart transplant recipient is at increased risk of coronary artery disease and renal insufficiency and should undergo careful preoperative evaluation. The patient with reactive airway disease is at increased risk of minor respiratory complications and should be encouraged to quit smoking. The patient with coronary artery disease and recent myocardial infarction may undergo ambulatory surgery without stress testing if functional capacity is adequate. The patient with obstructive sleep apnea is at increased risk of difficult tracheal intubation but the likelihood of airway obstruction and apnea following ambulatory surgery is unknown. CONCLUSION: Ambulatory anesthesia is infrequently associated with adverse outcomes, however, knowledge regarding specific patient conditions is of generally low quality. Few prospective trials are available to guide management decisions.
PMID: 15470165 [PubMed - in process]
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Anesthesia-related medication error: time to take action/Les erreurs de medication reliees a l'anesthesie : il est temps d'agir.
Orser BA, Byrick R.
Department of Anesthesia, Room 3318, Medical Sciences Building, 1 King's College, University of Toronto, Toronto, Ontario M5S 1A8, Canada. beverley.orser@utoronto.ca.
PMID: 15470163 [PubMed - as supplied by publisher]
Comment on:
Is PDPH from a 25-gauge Whitacre needle always short-lasting and self-resolving?
Wong AY.
Publication Types:
- Case Reports
- Comment
- Letter
PMID: 15197130 [PubMed - indexed for MEDLINE]
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Automated intermittent epidural boluses improve analgesia induced by intrathecal fentanyl during labour.
Chua SM, Sia AT.
Department of Anaesthesia, Singapore General Hospital, Singapore. sebnjess@singnet.com.sg
PURPOSE: We compared the efficacy of epidural continual intermittent boluses (CIB) with a continuous epidural infusion (CEI) in prolonging labour analgesia induced by the combined spinal epidural (CSE) technique. METHODS: CSE was instituted in 42 nulliparous parturients at the L3 to 4 level with intrathecal (IT) fentanyl 25 micro g followed by an epidural test dose of 3 mL of 1.5% lidocaine. These parturients were then randomly assigned to receive either epidural CIB (n = 21) or CEI (n = 21) with 0.1% ropivacaine and fentanyl 2 micro g x mL(-1). For the CIB, 5 mL boluses were given hourly, with the first bolus 30 min postinduction. CEI at the rate of 5 mL.hr(-1) was initiated in the minute after CSE. The duration of analgesia, pain score, degree of sensorimotor block were compared. RESULTS: From Kaplan Meier survival analysis, the duration of analgesia was significantly longer in CIB (mean survival time 239 +/- SD 24 min vs 181 +/- 17, P < 0.05 using log rank test). During the first three hours postblock, the median sensory block to cold was higher in CIB (P < 0.05, Mann U Whitney test) but no difference in blood pressure was detected [P > 0.05, repeated measure analysis of variance (RMANOVA)]. The serial pain scores were lower in the CIB (P < 0.05, RMANOVA). CONCLUSION: CIB prolonged the duration and improved the quality of analgesia. CIB could have resulted in an improved spread of analgesics in the epidural space or encouraged a direct passage of infusate into the IT space. This could have also rendered a higher sensory block to cold in the CIB group. CIB is a good alternative to CEI for the maintenance of epidural analgesia after CSE.
PMID: 15197122 [PubMed - indexed for MEDLINE]
Comment in:
Craniotomy for suprasellar meningioma in a 28-week pregnant woman without fetal heart rate monitoring.
Balki M, Manninen PH.
Department of Anesthesia, The Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
PURPOSE: To illustrate the anesthetic management of a craniotomy for suprasellar meningioma in a 28-week pregnant woman and to review the considerations for fetal monitoring during surgery. CLINICAL FEATURES: A 33-yr-old woman presented at 28 weeks of gestation with rapidly deteriorating vision in her right eye. Neuroradiological investigations revealed a large suprasellar meningioma extending into the frontal lobe. She underwent a craniotomy for excision of the tumour at 28 weeks gestation because of the risk of irreversible blindness. Anesthetic management was tailored for pregnancy and an intracranial tumour. Intraoperative blood pressure was maintained within 10% of baseline and respiratory variables were stable. No fetal heart rate monitoring was used during the surgery, as there was no plan to perform an emergency Cesarean delivery even in the event of change in fetal monitoring. The aim was to treat the mother aggressively for any untoward events. She made a good neurological recovery after the procedure and had a spontaneous vaginal delivery at 40 weeks of gestation without any neonatal complications. CONCLUSIONS: Anesthetic management of a brain tumour during pregnancy should be tailored to the individual patient according to the circumstances. It is possible to perform this type of procedure without fetal heart rate monitoring. The decision regarding fetal monitoring should be based on the consensus of the multidisciplinary care team and the mother.
Publication Types:
PMID: 15197120 [PubMed - indexed for MEDLINE]
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Encapsulation of mepivacaine prolongs the analgesia provided by sciatic nerve blockade in mice.
de Araujo DR, Cereda CM, Brunetto GB, Pinto LM, Santana MH, de Paula E.
Department of Biochemistry, Institute of Biology, State University of Campinas, Sao Paulo, Brazil.
PURPOSE: Liposomal formulations of local anesthetics (LA) are able to control drug-delivery in biological systems, prolonging their anesthetic effect. This study aimed to prepare, characterize and evaluate in vivo drug-delivery systems, composed of large unilamellar liposomes (LUV), for bupivacaine (BVC) and mepivacaine (MVC). METHODS: BVC and MVC hydrochloride were encapsulated into LUV (0.4 micro m) composed of egg phosphatidylcholine, cholesterol and alpha-tocopherol (4:3:0.07 molar ratio) to final concentrations of 0.125, 0.25, 0.5% for BVC and 0.5, 1, 2% for MVC. Motor function and antinociceptive effects were evaluated by sciatic nerve blockade induced by liposomal and plain formulations in mice. RESULTS: Liposomal formulations modified neither the intensity nor the duration of motor blockade compared to plain solutions. Concerning sensory blockade, liposomal BVC (BVC(LUV)) showed no advantage relatively to the plain BVC injection while liposomal MVC (MVC(LUV)) improved both the intensity (1.4-1.6 times) and the duration of sensory blockade (1.3-1.7 times) in comparison to its plain solution (P < 0.001) suggesting an increased lipid solubility, availability and controlled-release of the drug at the site of injection. CONCLUSION: MVC(LUV) provided a LA effect comparable to that of BVC. We propose MVC(LUV) drug delivery as a potentially new therapeutic option for the treatment of acute pain since the formulation enhances the duration of sensory blockade at lower concentrations than those of plain MVC.
PMID: 15197119 [PubMed - indexed for MEDLINE]
Comment in:
Spontaneous recovery from a spinal epidural hematoma with atypical presentation in a nonagenarian.
Schwarz SK, Wong CL, McDonald WN.
Centre for Anesthesia and Analgesia, Department of Anesthesia, The University of British Columbia, Canada. Schwarz@neuro.pharmacology.ubc.ca
PURPOSE: Spinal epidural hematoma following epidural anesthesia is extraordinarily rare in association with low-dose sc heparin, and the prognosis for neurologic recovery without rapid surgical decompression poor. We report a case of spinal epidural hematoma in a nonagenarian who received low-dose sc unfractionated heparin postoperatively in accordance with standard guidelines, presented with no back pain, and made full neurologic recovery without surgical intervention. CLINICAL FEATURES: A 90-yr-old female with gastric adenocarcinoma presented for subtotal gastrectomy. Her past medical history and physical examination were largely unremarkable and she had no bleeding diathesis. She took no medications other than preoperative ranitidine, and had a normal coagulation profile. A thoracic epidural catheter was placed uneventfully before induction of general anesthesia. Postoperatively, low-dose sc unfractionated heparin was started 12 hr after the epidural catheter insertion. On postoperative day two, the patient developed flaccid lower extremity paralysis and paresthesia without back pain. Her coagulation profile remained normal. Subsequent magnetic resonance imaging showed a large epidural hematoma extending from T3 to T11. With conservative treatment and no surgery, the patient slowly made full neurologic recovery and was discharged home on postoperative day 56. CONCLUSION: Complete neurologic recovery from flaccid paralysis following spinal epidural hematoma occurred without surgical decompression in a nonagenarian. Low-dose sc heparin may be a greater risk factor for spinal epidural hematoma than previously assumed, and the absence of back pain does not rule out this diagnosis.
Publication Types:
PMID: 15197117 [PubMed - indexed for MEDLINE]
Comment on:
What's a nice patient like you doing with a complication like this? Diagnosis, prognosis and prevention of spinal hematoma.
[Article in English, French]
Horlocker TT.
Publication Types:
PMID: 15197112 [PubMed - indexed for MEDLINE]
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Airway management in acute respiratory distress secondary to tracheal stenosis following one time intubation.
Govindarajan R, Chaudhry R, Babalola O, Nguyen N, Michael R, Sultan S.
Publication Types:
PMID: 15064278 [PubMed - indexed for MEDLINE]
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The Bullard laryngoscope and uvular edema.
Christodoulou C, Friesen J.
Publication Types:
PMID: 15064276 [PubMed - indexed for MEDLINE]
Comment on:
Ischemic optic neuropathy: "whodunit?".
[Article in English, French]
Tempelhoff R.
Publication Types:
PMID: 15064256 [PubMed - indexed for MEDLINE]
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Technique for in-office cranial bone harvesting.
Al-Sebaei MO, Papageorge MB, Woo T.
Department of Oral and Maxillofacial Surgery, Tufts University School of Dental Medicine, Boston, MA 02111, USA.
PURPOSE: This is a report of a technique of cranial bone harvesting suitable for the outpatient setting. MATERIALS AND METHODS: Bone scrapers are used for the harvesting of cranial bone shavings with the patient under intravenous sedation or general anesthesia. RESULTS: Graft volumes larger than that usually obtainable from intraoral sites and the tibia have been harvested utilizing this technique. In a series of 8 first patients, the largest volume of bone obtained was 14 cc with no complications related to the donor sites. These cases include the following types of pre-implant reconstructive procedures: large unilateral sinus grafting, bilateral sinus grafting/guided-bone regeneration of an entire alveolar ridge, inlay grafting of the alveolus, inlay grafting in association with distraction osteogenesis, subnasal grafting, alveolar cleft grafting, closure of large oroantral defects combined with sinus grafting, and grafting of an grossly atrophic mandible with simultaneous placement of dental implants via the submental approach. CONCLUSION: This is a safe bone harvesting technique providing an alternative source of autogenous bone graft.
PMID: 15332189 [PubMed - indexed for MEDLINE]
Cerebral protection.
Bissonnette B.
Department of Anaesthesia, The Hospital for Sick Children, University Avenue, Toronto, Ontario, Canada. bruno@sickkids.ca
Publication Types:
PMID: 15086852 [PubMed - indexed for MEDLINE]
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Update on TIVA.
Eyres R.
Royal Children's Hospital, Parkville, Victoria, Australia. rob.eyres@rch.org.au
Publication Types:
PMID: 15086846 [PubMed - indexed for MEDLINE]
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