Co-administration of dexmedetomidine with total intravenous anaesthesia in carotid endarterectomy reduces requirements for propofol and improves haemodynamic stability: A single-centre, prospective, randomised controlled trial.

Background: Total intravenous anaesthesia guided by electroencephalography and neurophysiological monitoring may be used for carotid endarterectomy. Reduction of brain metabolic demand during cross-clamping of the internal carotid artery with propofol titrated to burst suppression requires effect-site concentrations that may delay emergence and interfere with intraoperative neurophysiological monitoring.

Objective: To test the hypothesis that dexmedetomidine decreases the effect-site concentration of propofol required for burst-suppression in patients undergoing carotid endarterectomy.

Using Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) as a Rescue Strategy in Severe Postpartum Hemorrhage: A Case Report.

Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality. Routine treatment of PPH includes uterotonics, tranexamic acid, curettage, uterine (balloon) tamponade, compression sutures, uterine artery ligation, and, if available, transcatheter arterial embolization (TAE). In cases of severe PPH refractory to standard medical and surgical management, hysterectomy is usually the ultima ratio, and is equally associated with a higher rate of complications.

Coma After Droperidol Administration: A Case Report.

In Switzerland, approximately 32,000 patients are hospitalized annually due to adverse drug reactions (ADRs), representing 2.3% of all hospitalizations. During the perioperative period, the administration of a variety of drugs from different classes over a relatively short period of time increases the risk of ADR.

Characterization of the electrical properties of mammalian peripheral nerve laminae.

Background And Objective: The intrinsic electrical material properties of the laminar components of the mammalian peripheral nerve bundle are important parameters necessary for the accurate simulation of the electrical interaction between nerve fibers and neural interfaces. Improvements in the accuracy of these parameters improve the realism of the simulation and enables realistic screening of novel devices used for extracellular recording and stimulation of mammalian peripheral nerves. This work aims to characterize these properties for mammalian peripheral nerves to build upon the resistive parameter set established by Weerasuriya et al.

Durable scalable 3D SLA-printed cuff electrodes with high performance carbon + PEDOT:PSS-based contacts.

Background: The stimulation and recording performance of implanted neural interfaces are functions of the physical and electrical characteristics of the neural interface, its electrode material and structure. Therefore, rapid optimization of such characteristics is becoming critical in most clinical and research studies. This paper describes the development of an upgraded 3D printed cuff electrode shell design containing a novel intrinsically conductive polymer (ICP) for stimulation and recording of peripheral nerve fibers.

In vivo peripheral nerve activation using sinusoidal low-frequency alternating currents.

Background: The sinusoidal low-frequency alternating current (LFAC) waveform was explored recently as a novel means to evoke nerve conduction block. In the present work, we explored whether increasing the amplitude of the LFAC waveform results in nerve fiber activation in autonomic nerves. In-silico methods and preliminary work in somatic nerves indicated a potential frequency dependency on the threshold of activation.

High Aspect Ratio Structuring of Glass with Ultrafast Bessel Beams.

Controlling the formation of high aspect ratio void channels inside glass is important for applications like the high-speed dicing of glass. Here, we investigate void formation using ultrafast Bessel beams in the single shot illumination regime. We characterize the morphology of the damages as a function of pulse energy, pulse duration, and position of the beam inside fused silica, Corning Eagle XG, and Corning Gorilla glass.

Postoperative Pain Is Driven by Preoperative Pain, Not by Endometriosis.

(1) Background: The aim of this study was to evaluate the impact of endometriosis on postoperative pain following laparoscopic hysterectomy; (2) Methods: A total of 214 women who underwent a laparoscopic hysterectomy between January 2013 and October 2017 were divided into four subgroups as follows: (1) endometriosis with chronic pain before the surgery ( = 57); (2) pain-free endometriosis ( = 50); (3) pain before the surgery without endometriosis ( = 40); (4) absence of both preoperative pain and endometriosis ( = 67). Postoperative pain was compared by using Visual Analog Scale (VAS) scores and by tracking the use of painkillers during the day of surgery and the first two postoperative days; (3) Results: Women with chronic pain before the surgery reported higher VAS scores during the first postoperative days, while the use of analgesics was similar across the groups. There was no difference in the postoperative pain when comparing endometriosis patients to non-endometriosis patients; (4) Conclusions: Women with chronic pelvic pain demonstrated increased postoperative pain after laparoscopic hysterectomy, which was independent of the presence or severity of endometriosis.

In-vivo application of low frequency alternating currents on porcine cervical vagus nerve evokes reversible nerve conduction block.

Background: This paper describes a method to reversibly block nerve conduction through direct application of a 1 Hz sinusoidal current waveform delivered through a bipolar nerve cuff electrode. This low frequency alternating current (LFAC) waveform was previously shown to reversibly block the effects of vagal pulse stimulation evoked bradycardia in-vivo in the anaesthetised rat model (Mintch et al. 2019).

Does the Number of Levels Fused Affect Spinopelvic Parameters and Clinical Outcomes Following Posterolateral Lumbar Fusion for Low-Grade Spondylolisthesis?

Study Design: Retrospective cohort.

Objectives: To determine how the number of fused intervertebral levels affects radiographic parameters and clinical outcomes in patients undergoing open posterolateral lumbar fusion (PLF) for low-grade degenerative spondylolisthesis.

Methods: This was a retrospective cohort study on patients who underwent open PLF for low-grade spondylolisthesis at a single institution from 2011 to 2018.

A case report of several intraoperative convulsions while using the Narcotrend monitor: Significance and predictive use.

Introduction: Intraoperative seizures under general anesthesia are rare and our observation is the first to demonstrate a distinct electroencephalogram (EEG) pattern on the Narcotrend monitor.

Patient Concerns: We present the case of a 30-year-old man undergoing craniotomy for glioblastoma resection under general anesthesia who suffered tonic-clonic seizures captured in a specific pattern by the intraoperative EEG.

Diagnoses: Our depth of anesthesia monitor recorded, before the seizure, a widening of the beta-wave performance in a distinct "triangular-shaped" pattern.

Does increasing age impact clinical and radiographic outcomes following lumbar spinal fusion?

Background Context: Despite the growing senior population within the United States, there is a lack of consensus regarding the safety and efficacy of performing lumbar spinal fusion for this population.

Purpose: To evaluate the clinical and radiographic outcomes in different age cohorts following lumbar spinal fusion.

Study Design: Retrospective cohort analysis.

Implementation and Evaluation of a Web-Based Distribution System For Anesthesia Department Guidelines and Standard Operating Procedures: Qualitative Study and Content Analysis.

Background: Digitization is spreading exponentially in medical care, with improved availability of electronic devices. Guidelines and standard operating procedures (SOPs) form an important part of daily clinical routine, and adherence is associated with improved outcomes.

Objective: This study aimed to evaluate a digital solution for the maintenance and distribution of SOPs and guidelines in 2 different anesthesiology departments in Switzerland.

Real and virtual propagation dynamics of angular accelerating white light beams.

Accelerating waves have received significant attention of late, first in the optical domain and later in the form of electron matter waves, and have found numerous applications in non-linear optics, material processing, microscopy, particle manipulation and laser plasma interactions. Here we create angular accelerating light beams with a potentially unlimited acceleration rate. By employing wavelength independent digital holograms for the creation and propagation of white light beams, we are able to study the resulting propagation in real and virtual space.

Generalized radially self-accelerating helicon beams.

We report, in theory and experiment, on a new class of optical beams that are radially self-accelerating and nondiffracting. These beams continuously evolve on spiraling trajectories while maintaining their amplitude and phase distribution in their rotating rest frame. We provide a detailed insight into the theoretical origin and characteristics of radial self-acceleration and prove our findings experimentally.

Impact of arrhythmias on health-related quality of life in adults with congenital cardiac disease.

Background: Health-related quality of life in adults with congenital cardiac disease appears to be impaired, but the determinants of this alteration remain largely unknown. The aim of our study was to examine the impact of arrhythmias on quality of life in patients late after the atrial redirection operation for transposition, or after complete correction of tetralogy of Fallot.

Patients And Methods: We enrolled 32 patients with transposition, and 35 patients with tetralogy of Fallot, in a prospective study.

Effect of mild endurance exercise training and pravastatin on peripheral vasodilatation of forearm resistance vessels in patients with coronary artery disease.

Background: Improved endothelial function may contribute to the beneficial effects of cholesterol lowering therapy in patients with coronary artery disease (CAD), but results of the effect of statin therapy on endothelial function are disparate in these patients. Exercise training has been reported to improve endothelial function of patients at risk of or with established CAD. The goal of the study was to compare the effect of mild exercise training or statin therapy on forearm endothelial function in CAD patients with average cholesterol levels.