Respiratory events with sugammadex vs. neostigmine following laparoscopic sleeve gastrectomy: a prospective pilot study assessing neuromuscular reversal strategies.

Unlabelled: Abdominal surgery in obese patients may be associated with pulmonary morbidity, and mortality. Some patients may arrive in the PACU with residual paralysis. was to find out if there was an association between the type of muscle relaxant reversal agent and the development of postoperative respiratory events in patients undergoing laparoscopic sleeve gastrectomy surgery.

Evaluation of the Temple Touch Pro, a Novel Noninvasive Core-Temperature Monitoring System.

Background: The Temple Touch Pro (TTP) is a novel system that estimates core temperature from skin over the temporal artery. We tested the hypothesis that this noninvasive system estimates core temperature to an accuracy within 0.5°C.

Preconditioning allows engraftment of mouse and human embryonic lung cells, enabling lung repair in mice.

Repair of injured lungs represents a longstanding therapeutic challenge. We show that human and mouse embryonic lung tissue from the canalicular stage of development (20-22 weeks of gestation for humans, and embryonic day 15-16 (E15-E16) for mouse) are enriched with progenitors residing in distinct niches. On the basis of the marked analogy to progenitor niches in bone marrow (BM), we attempted strategies similar to BM transplantation, employing sublethal radiation to vacate lung progenitor niches and to reduce stem cell competition.

Residual Curarization and Postoperative Respiratory Complications Following Laparoscopic Sleeve Gastrectomy. The Effect of Reversal Agents: Sugammadex vs. Neostigmine.

Background: Incomplete muscle relaxant reversal or re-curarization may be associated with postoperative respiratory complications. In this retrospective study we compared the incidence of postoperative residual curarization and respiratory complications in association with the type of muscle relaxant reversal agent, sugammadex or neostigmine, in patients undergoing laparoscopic sleeve gastrectomy.

Material And Methods: We reviewed the charts of all patients (179) undergoing laparoscopic sleeve gastrectomy from July 2012 to July 2013 at Wolfson Medical Center.

Perioperative metabolic alkalemia is more frequent than metabolic acidemia in major elective abdominal surgery.

Objective: To investigate the incidence, type and etiology of perioperative metabolic disturbances associated with major abdominal surgery. We hypothesized that metabolic alkalemia is more frequent than metabolic acidemia.

Methods: This was a prospective, observational study, performed in a university-affiliated hospital.

Prompt correction of endotracheal tube positioning after intubation prevents further inappropriate positions.

Study Objective: To determine whether the timely correction of endotracheal tube (ETT) positioning prevents further inappropriate positions.

Design: Prospective crossover study.

Setting: University-affiliated hospital.

Postoperative analgesia with tramadol and indomethacin for diagnostic curettage and early termination of pregnancy.

Background: The postoperative analgesic effects of rectal indomethacin and tramadol were compared in patients undergoing elective termination of first trimester pregnancy and diagnostic dilatation and curettage.

Methods: Eighty-one American Society of Anesthesiologists class I and II women undergoing first trimester termination of pregnancy or diagnostic dilation and curettage were randomly allocated to receive rectal suppositories of either tramadol 100 mg (n=41) or indomethacin 100 mg (n=40) 90 min before induction of anesthesia. Pain scores and side effects were evaluated until discharge.

Accidental venous and dural puncture during epidural analgesia in obese parturients (BMI > 40 kg/m2): three different body positions during insertion.

Study Objective: To assess the frequency of blood vessel punctures in morbidly obese parturients [body mass index (BMI) > 40 kg/m(2)] during epidural catheterization, in three different body positions.

Design: Prospective, randomized study.

Setting: Delivery room of a university-affiliated hospital.

Obstetric anesthesia units in Israel: a national questionnaire-based survey.

Background: This survey was performed to assess the organization and practice of obstetric anesthesia units in Israel.

Methods: A written questionnaire was mailed at the end of December 2005 to all Israeli anesthesia departments providing labor and delivery services in 2005 (n=25).

Results: A response rate of 100% accounted for 125,340 deliveries.

Organizational prerequisites for anesthesia outside the operating room.

Purpose Of Review: The purpose of this review is to define the responsibility and designation of anesthesia personnel to nonoperating room location anesthesia and their education in this regard. The review will also define the safety standards, guidelines, physical environment, equipment, accreditation, the quality of care and patient and procedural selection.

Recent Findings: Anesthesia outside the operating room continues to be a challenging field.

The effect of intermittent versus continuous bladder catheterization on labor duration and postpartum urinary retention and infection: a randomized trial.

Study Objective: To assess the effect of intermittent versus continuous bladder catheterization on labor duration and local anesthetic consumption.

Design: Randomized, controlled, prospective, single-blind trial.

Setting: University-affiliated hospital.

Gastroesophageal regurgitation during anesthesia and controlled ventilation with six airway devices.

Study Objective: To investigate the frequency of gastroesophageal regurgitation and respiratory mechanics during positive pressure ventilation using 5 supraglottic devices or an endotracheal tube (ETT).

Design: Prospective, randomized study.

Setting: Operating rooms in a university-affiliated hospital.

The effects of remifentanil or acetaminophen with epidural ropivacaine on body temperature during labor.

Purpose: Epidural analgesia is associated with hyperthermia during labor and presumably causes it, although no convincing mechanism has been postulated. It seems likely that fever associated with pyrogenic factors related to labor is suppressed by opioids, whereas it is expressed normally in patients given epidural analgesia. We examined this hypothesis and the possible etiology of temperature elevation in labor.

A brief history of tracheostomy and tracheal intubation, from the Bronze Age to the Space Age.

Objective: To present a concise history of tracheostomy and tracheal intubation for the approximately forty centuries from their earliest description around 2000 BC until the middle of the twentieth century, at which time a proliferation of advances marked the beginning of the modern era of anesthesiology.

Data Sources: Review of the literature.

Conclusions: The colorful and checkered past of tracheostomy and tracheal intubation informs contemporary understanding of these procedures.

Mode of ventilation during cardiopulmonary bypass does not affect immediate postbypass oxygenation in pediatric cardiac patients.

Study Objective: To investigate the impact of different modes of ventilation during cardiopulmonary bypass (CPB) on immediate postbypass oxygenation in pediatric cardiac surgery.

Design: Prospective, randomized clinical trial.

Setting: University hospital.

Transient neurological symptoms after isobaric subarachnoid anesthesia with 2% lidocaine: the impact of needle type.

Background: The reported incidence of transient neurological symptoms (TNS) after subarachnoid lidocaine administration is as high as 40%. We designed this clinical trial to determine the incidence of TNS with two different pencil-point spinal needles: one-orifice (Atraucan) and two-orifice (Eldor) spinal needles.

Methods: Ninety-nine ASA physical status I or II patients undergoing surgical procedures of the urinary bladder or prostate were prospectively allocated to receive spinal anesthesia with 40 mg, 2% isobaric lidocaine plus fentanyl injected through either a 26-gauge Atraucan (n = 52) or a 26-gauge Eldor (n = 47) spinal needle.

Correct depth of insertion of right internal jugular central venous catheters based on external landmarks: avoiding the right atrium.

Objective: Radiographically, a central venous catheter (CVC) tip should lie at the level of the right tracheobronchial angle. Precalculation of length of CVC insertion may avoid unnecessary catheter malposition. The purpose of this study was to assess the accuracy of a method of CVC positioning, based on external topographic landmarks.

Predistention of the epidural space before catheter insertion reduces the incidence of intravascular epidural catheter insertion.

Background: Accidental cannulation of an epidural vein is a common complication associated with epidural anesthesia or analgesia. On the basis of a pilot study and previous reports, we tested the hypothesis that predistention of the epidural space with saline before epidural catheterization would ease catheter insertion and decrease the incidence of this complication.

Methods: Two-hundred-three laboring women were randomly assigned to receive an epidural with loss of resistance technique with 2 mL (nondistention) or 5 mL saline (distention).

Association of ethnicity with the minimum alveolar concentration of sevoflurane.

Background: Selective breeding produces animal strains with varying anesthetic sensitivity. It thus seems unlikely that various human ethnicities have identical anesthetic requirements. Therefore, the authors tested the hypothesis that the minimum alveolar concentration of sevoflurane differs significantly as a function of ethnicity.

Activin betaA in term placenta and its correlation with placental inflammation in parturients having epidural or systemic meperidine analgesia: a randomized study.

Study Objective: To investigate the immunohistochemical localization of betaA subunit of activin A in human term placenta, as a marker for placental infection/inflammation and elevated temperature, in parturients laboring during two analgesic regimens.

Design: Prospective, randomized controlled study.

Setting: Delivery room.

Options for systemic labor analgesia.

Purpose Of Review: This article reviews the challenging practice of systemic analgesia as an alternative to epidural analgesia for labor pain, and places remifentanil within the context of opioid analgesics suitable for managing for labor pain.

Recent Findings: Although systemic opioids have long been used for labor analgesia, they have become less popular because of frequent maternal and neonatal side effects. Recently, their efficacy has been questioned.