5 - ULTRASOUND GUIDED SUBCOSTAL TRANSVERSE ABDOMINIS PLANE AND BILATERAL RECTUS SHEATH BLOCK - ADJUNCT TO IV MORPHINE PCA IN LIVE DONOR HEPATECTOMY: DOUBLE BLIND RANDOMIZED TRIAL. PDF Download
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Author: Publisher: ISBN: Category : Languages : en Pages :
Book Description
AbstractBackground and Objectives: Living donor hepatectomy is a major surgery requiring a long upper abdominal incision. Various regional and systemic analgesic approaches have been used to tackle postoperative pain in these patients. The objectives of this study were to evaluate the efficacy and feasibility of subcostal Transverse Abdominis Plane (TAP) block and bilateral rectus sheath blocks as an adjunct to Patient controlled Analgesia (PCA) using Morphine.Methods: The study was planned as a prospective randomized double blind study. 50 consecutive liver donors belonging to age group 18-50 years were randomized into two groups of 25 each. Patients in both the groups received a standard general anesthetic. All patients were given right subcostal TAP block and bilateral rectus sheath blocks under ultrasound guidance at the end of surgery. Group R patients received the blocks with 50 ml of 0.3% Ropivacaine; with 10 ml each for rectus sheath blocks and 30ml for subcostal TAP block using under ultrasound guidance. Group S patients received the same blocks with 50 ml of Normal Saline at the end of surgery. Patients in both the groups had access to morphine PCA.Results: Median morphine consumption was found to be significantly less (28 mg vs. 43 mg, p=0.020) in Group I patients. The Numerical Rating Scores (NRS) were comparable in both the groups. No major block related complications were observed. Conclusions: We found subcostal TAP block in combination with bilateral rectus sheath blocks a safe and effective adjunct for pain management in patients undergoing donor hepatectomy.
Author: Publisher: ISBN: Category : Languages : en Pages :
Book Description
AbstractBackground and Objectives: Living donor hepatectomy is a major surgery requiring a long upper abdominal incision. Various regional and systemic analgesic approaches have been used to tackle postoperative pain in these patients. The objectives of this study were to evaluate the efficacy and feasibility of subcostal Transverse Abdominis Plane (TAP) block and bilateral rectus sheath blocks as an adjunct to Patient controlled Analgesia (PCA) using Morphine.Methods: The study was planned as a prospective randomized double blind study. 50 consecutive liver donors belonging to age group 18-50 years were randomized into two groups of 25 each. Patients in both the groups received a standard general anesthetic. All patients were given right subcostal TAP block and bilateral rectus sheath blocks under ultrasound guidance at the end of surgery. Group R patients received the blocks with 50 ml of 0.3% Ropivacaine; with 10 ml each for rectus sheath blocks and 30ml for subcostal TAP block using under ultrasound guidance. Group S patients received the same blocks with 50 ml of Normal Saline at the end of surgery. Patients in both the groups had access to morphine PCA.Results: Median morphine consumption was found to be significantly less (28 mg vs. 43 mg, p=0.020) in Group I patients. The Numerical Rating Scores (NRS) were comparable in both the groups. No major block related complications were observed. Conclusions: We found subcostal TAP block in combination with bilateral rectus sheath blocks a safe and effective adjunct for pain management in patients undergoing donor hepatectomy.
Author: Zoka Milan Publisher: Springer Nature ISBN: 3030513319 Category : Medical Languages : en Pages : 467
Book Description
This concise, accessible book covers anesthesia for hepatico-pancreatic-biliary (HPB) surgery and transplantation, based on randomized clinical trials, meta-analyses, case series, reports, and hands-on experience. The anatomy, physiology, pathophysiology and clinical consequences are discussed, and the close ties between HPB resection and transplant anesthesia are explored. The content reflects current real-world practice, as liver and pancreatic transplant surgeries have substantially improved in terms of blood-loss reduction, fast tracking and reduced risk. The book also addresses anesthetic aspects in connection with the recently introduced and rapidly expanding practice of laparoscopic surgery; with enhanced recovery; and with pancreatic surgery. Anesthesia for Hepatico-Pancreatic-Biliary Surgery and Transplantation is intended for aspiring HPB and transplant anesthetists, anesthesia trainees, and consultants with experience in HPB anesthesia who want to see whether or not they’re up to date on the current standards.
Author: Charles Vacanti Publisher: Cambridge University Press ISBN: 1139498401 Category : Medical Languages : en Pages : 1191
Book Description
The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.
Author: Ian James Publisher: Cambridge University Press ISBN: 1107244188 Category : Medical Languages : en Pages : 467
Book Description
This book covers all of the important elements of paediatric anaesthesia in a concise and structured manner. From the premature infant to the teenager, readers are guided through the complexities they may encounter, with key points at the end of each chapter to summarise the most important information. The common surgical conditions encountered in daily practice are covered along with comprehensive discussion of consent and the law, safeguarding children, and the complexity of drug dosing in the paediatric population. Other topics covered include trauma, burns, resuscitation, principles of intensive care, and transporting a sick child. Each chapter is written by an acknowledged expert in their field, sharing a wealth of relevant, practical experience. Covering the whole curriculum necessary for advanced training, this is essential reading for trainees, general anaesthetists managing children in non-specialist hospitals and anyone aspiring to become a paediatric anaesthetist, as well as those established in the field.
Author: Olle Ljungqvist Publisher: Springer Nature ISBN: 3030334430 Category : Medical Languages : en Pages : 654
Book Description
This book is the first comprehensive, authoritative reference that provides a broad and comprehensive overview of Enhanced Recovery After Surgery (ERAS). Written by experts in the field, chapters analyze elements of care that are both generic and specific to various surgeries. It covers the patient journey through such a program, commencing with optimization of the patient’s condition, patient education, and conditioning of their expectations. Organized into nine parts, this book discusses metabolic responses to surgery, anaesthetic contributions, and optimal fluid management after surgery. Chapters are supplemented with examples of ERAS pathways and practical tips on post-operative pain control, feeding, mobilization, and criteria for discharge. Enhanced Recovery After Surgery: A Complete Guide to Optimizing Outcomes is an indispensable manual that thoroughly explores common post-operative barriers and challenges.
Author: Ehab Farag Publisher: Springer Nature ISBN: 3030483746 Category : Medical Languages : en Pages : 582
Book Description
This revised and expanded second edition presents the most recent evidence-based facts on perioperative fluid management and discusses fluid management from basic sciences to clinical applications and the patients’ outcomes. Recent advances in understanding the Revised Starling principle with new concepts in tissue perfusion and the most recent techniques of perioperative goal directed fluid management are described. The endothelial glycocalyx functions and the influence of fluid management on its integrity are covered in detail; moreover, the techniques for its protection are also discussed. The dilemma of perioperative use of hydroxyethyl starch solutions and the resurgence of interest in using human albumin as an alternative colloid is explored. The problems of using unbuffered solutions during the perioperative period and comparison between restrictive versus liberal fluid management are discussed in full. Lastly, case scenarios for every possible clinical situation describe the most up-to-date fluid management for the corresponding clinical problem. Perioperative Fluid Management, Second Edition is of interest to anesthesiologists and also intensivists.
Author: Rebecca A. Fisher Publisher: Springer ISBN: 3319432109 Category : Medical Languages : en Pages : 419
Book Description
Introduction to surgery aims to provide a one-stop guide to the basics of surgery for surgical rotations, as well as providing information for aspiring surgeons on how to explore a surgical career and build your CV for surgical applications. It aims to be the go-to companion for any student shadowing in theatres, and a thorough guide for students wishing to spend more time in a specific specialty, conduct research and plan careers. Introduction to Surgery for Students is an edited collection of 31 chapters from a group of 80 medical students, junior doctors and consultant surgeons. Each chapter has been written by a team made up of at least one student and one senior, and has then been edited and reviewed by a medical student with a special interest in the topic. This near-peer style of writing allows our content to cater to a student’s needs at the right level, whilst having the expert input of surgeons who are leaders in their field.
Author: Iain Au-Yong Publisher: CRC Press ISBN: 1444113585 Category : Medical Languages : en Pages : 573
Book Description
Cracking the MRCS Viva is an outstanding guide to the MRCS Viva examination. Its unique approach recreates the structure and content of each individual viva, allowing the reader to self-test, or two students to recreate mock viva sessions for themselves.Divided into six sections to mirror the exam - applied surgical anatomy, operative surgery, appl
Author: Rakesh Garg Publisher: Springer Nature ISBN: 9811600066 Category : Medical Languages : en Pages : 539
Book Description
This book covers all essential evidence on perioperative care and anesthetic concerns for cancer surgeries, including the evaluation and assessment of patients’ schedule for cancer surgeries, perioperative anesthetic management of various cancers, perioperative analgesia for cancer surgeries, and issues related to inoperable cancers. It reviews anesthetic considerations of all cancer types as there is a wide variation in anesthetic requirements in this subset of patients. Cancer surgeries are on the rise worldwide and healthcare facilities with cancer as a core specialty are emerging quickly around the globe. As cancer is on rise and efficient surgical management is available, more and more patients are being treated surgically. However, cancer surgeries are complicated, have varied concerns and these are not covered sufficiently in presently available textbooks of anesthesiology. This book fulfills the growing need for complete and comprehensive textbook of onco-anesthesia and fills the gap in the current texts that do not exclusively cover anesthesia for cancer surgeries. This textbook serves as a comprehensive but quick guide for trainee residents/fellows and practicing anesthesiologists, clinicians and surgeons.
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Author: Zoka Milan
Author: Charles Vacanti
Author: Ian James
Author: Olle Ljungqvist
Author: Ehab Farag
Author: Rebecca A. Fisher
Author: Iain Au-Yong
Author: Alfred Cuschieri
Author: Rakesh Garg