Compications of regional anesthesia
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I were in my final year of residency. I took a presentation on the complications of regional anesthesia. It is a very tough subject. There is so much that can go wrong with this topic. I had to show that I had learnt and could bear the burden the pressure of cross questioning just to be able to probe learn this magnificent field.
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The document discusses various special routes of drug administration and potential adverse reactions and toxicity from drugs. It describes several routes of administration including intrathecal, intra-articular, intra-osseous, intracardiac, intraperitoneal, intravesical, intravaginal, intracerebroventricular, epidural, intracavernous, and extra-amniotic administration. It also discusses different types of potential drug reactions like side effects, toxicity, intolerance, idiosyncrasy, allergy, and dependency. Factors affecting drug toxicity and mechanisms of toxicity are also summarized.
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Chronic pain management
This document discusses chronic pain management and treatment options. It notes that chronic pain is influenced by many physical and psychological factors, requiring multimodal interventions. Common drug classes used include antidepressants, anticonvulsants, opioids, and local anesthetics. Antidepressants are effective for neuropathic pain and may enhance inhibitory pathways and act on other receptors. Anticonvulsants are commonly used for neuropathic pain by reducing neuronal excitability. Opioids can be effective but have side effects like nausea and constipation. Non-pharmacological therapies and more advanced interventions are also discussed.
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The document discusses various reasons for delayed recovery from anesthesia, including pharmacological factors related to specific drugs, surgery-related issues, and patient-specific factors. It provides case examples of delayed recovery and recommends having a generalized protocol as well as understanding specific situations to properly manage patients and prevent complications. Vigilance and careful balancing of many variables by an experienced anesthesiologist are important to avoid morbidity and mortality from delayed recovery.
Concious sedation ppt nat
Conscious sedation is a type of sedation that minimizes pain and discomfort through sedatives and analgesics while maintaining an altered state of consciousness. It allows for quick recovery and is safe and effective for minor procedures. The American Society of Anesthesiologists provides guidelines for four levels of sedation. Common medications used include midazolam, fentanyl, and propofol which are carefully titrated based on the individual patient. Close monitoring of vital signs is required during and after a procedure, and complications like respiratory depression require reversal agents such as naloxone or flumazenil.
Acute pain - dr. ike
Conclusions:
74% of patients discharge home with moderate to severe pain --> with or without treatment before
ED patients should receive proper pain management, avoiding delays such as those related to diagnostic testing or consultation
In order to further improve patient care we must now apply our knowledge regarding acute and chronic pain treatment base on pharmacology of the drugs
Ongoing research in the area of ED patient pain management conducted and an algorythm or clinical guidelines in this area should be developed
Effective physician and patient educational strategies should be developed regarding pain management, including the use of pain therapy adjuncts and how to minimize pain after disposition from the ED
Systemic complications of la
This document discusses systemic complications that can arise from local anesthesia. It begins by outlining three principles: 1) no drug exerts a single action, 2) no clinically useful drug is devoid of toxicity, and 3) a drug's potential toxicity depends on how it is used by the healthcare provider. It then discusses factors that can lead to overdose, including patient characteristics, drug properties, and inadvertent intravascular injection. Signs and symptoms of overdose are described, as well as ways to prevent overdose through careful administration and use of aspiration.
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The document discusses the importance of preoperative assessment in neurosurgery patients. It outlines the goals of assessment which include optimizing the patient's health, determining perioperative risk, obtaining informed consent, and creating a care plan. The assessment involves a thorough medical history, physical exam, and documentation of the patient's neurological status. Areas examined include cardiopulmonary, gastrointestinal, endocrine, and medication histories. The assessment helps minimize risk and ensure patient safety during surgery and anesthesia.
Introduction to Regional
Regional anesthesia involves administering local anesthetics near nerves to block pain signals from specific parts of the body. There are several types including neuraxial blocks like epidurals and spinals that involve the spinal canal, and peripheral nerve blocks that target individual nerves. Regional anesthesia has advantages like reduced blood loss and postoperative complications compared to general anesthesia, though placement can be difficult and side effects like hypotension are possible. Proper technique and monitoring are needed to avoid complications.
APS chapter 5.pptx
The document discusses the management of acute pain, including the introduction of Acute Pain Services in hospitals in Malaysia starting in the 1990s. It describes techniques like patient-controlled analgesia, epidural analgesia, and multimodal analgesia that have improved acute pain management. Factors in choosing a pain management technique include the patient, surgery, nursing needs, costs, and side effects. Common techniques discussed in more depth include patient-controlled analgesia, its programming and problems that can occur. Central neuraxial blocks like epidural and intrathecal analgesia are also covered.
Tues 11am wrobel new antiseizure meds
This document discusses the treatment of epilepsy through antiepileptic medications and new treatments. It provides a history of antiepileptic medications from 1912 to the present, describing key medications introduced over time. It discusses factors that influence drug selection and compliance, side effects of medications, and newer antiepileptic medications that have been approved. It also briefly discusses non-medication treatments for epilepsy including neurostimulators, deep brain stimulation, and magnetoencephalography.
managing_surgical_pain.ppt
This document discusses pain management for surgical patients. It covers preoperative, intraoperative, and postoperative pain assessment and treatment. Preoperatively, a thorough pain history is important. Intraoperatively, adequate pain management can reduce postoperative complications. Postoperatively, a multimodal approach including opioids, non-opioids, and adjuvant therapies is recommended. Special populations like pediatrics and elderly patients require extra care with pain treatment.
managing_surgical_pain.ppt
This document discusses pain management for surgical patients. It covers preoperative, intraoperative, and postoperative pain assessment and treatment. Preoperatively, a thorough pain history is important. Intraoperatively, adequate pain management can reduce postoperative complications. Postoperatively, the focus is on treating acute pain from the incision and immobilization through multimodal means including opioids, NSAIDs, and adjunct therapies according to the WHO 3-step ladder approach. Special populations like pediatrics and elderly require tailored plans.
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This document discusses pain management for surgical patients. It covers preoperative, intraoperative, and postoperative pain assessment and treatment. The key points are: conducting a thorough preoperative pain assessment; providing pain education and setting expectations for patients; adequately treating pain during and after surgery to reduce complications and speed recovery; and assessing pain regularly while managing it according to the World Health Organization's 3-step ladder approach. Special populations like elderly patients require extra care due to medical issues and medication sensitivities.
Surgical pain.ppt
This document discusses pain management for surgical patients from pre-operative assessment through post-operative care. It outlines the importance of thorough pre-op evaluation, educating patients on the pain plan, and using a multi-modal approach during surgery and recovery. The World Health Organization's 3-step ladder is recommended for treating mild to severe pain with non-opioids, opioid combinations, and opioids with adjuvants as needed. Close monitoring and re-assessment of pain is key.
Pain management
A 32-year-old pregnant woman at 29 weeks gestation presents to the ER with sudden onset of severe right flank pain radiating to her back and groin, associated with nausea and increased urination.
On examination, her vital signs are stable. The fetal heart sound is normal and there is no vaginal bleeding. Preliminary tests have been ordered.
The document discusses evaluating and treating pain using analgesics like paracetamol, NSAIDs, opioids, and adjuvants depending on the intensity of pain. Regional anesthesia techniques are also described.
For this pregnant patient, the document recommends treating her pain with paracetamol, NSAIDs initially given her gestational age and pain description. Close monitoring
Postoperative pain management
This document discusses postoperative pain management. It begins by stating that pain is commonly experienced after surgery and has historically been under treated. It then discusses pain assessment and various methods for treating pain, including acetaminophen, NSAIDs, opioids, local anesthetics, and patient-controlled analgesia. The document emphasizes the importance of treating pain for patient wellbeing and recovery, and the need for a multimodal approach using different drug classes to provide effective pain relief with fewer side effects.
Pain management
This document summarizes interventional pain procedures for chronic pain. It describes common origins of lumbar back pain such as degenerative discs and discusses invasive treatment options like surgery, injections, and radiofrequency ablation. Facet joint injections are described as effective for pain originating from facet joints. Epidural injections can provide temporary relief for nerve root compression or spinal stenosis. Medial branch blocks are used diagnostically prior to potential radiofrequency ablation to denervate medial branch nerves controlling facet joint sensation. Psychological assessment and management strategies are also outlined to optimize pain treatment.
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Ventilation test for icu
This document contains 5 multiple choice questions regarding patients on ventilators in the ICU. Each question provides details about a patient's condition and medical history, and asks how the respondent would diagnose, manage ventilation settings, or address challenges for that specific clinical case. The questions cover a range of respiratory conditions and post-operative patients, assessing knowledge of appropriate ventilation goals and strategies.
Sepsis
It is the first kind of cases that I had to learn to manage. The cases ere so abundant and management so rapid that it took me a while to wrap my head around it. I did not sepsis from septic shiock, I did not know the signs and symptoms and I definitely did not how it all came together. Sepsis bundles included in the presentation need to be updated.
Oxygen delivery devices
It is the bread and butter of the anesthesia specialist. We have to learn so much about the things that go into the delivery of the oxygen from the sources to the patients, their set up, their construct, things that can go wrong and troubleshooting the, quality check and maintenance. I have summarized it all in this presentation.
Labor analgesia
What can be said about the importance of labor analgesia. I did not understand it in the beginning. Because the physiology of obstetrics not only changes but is dynamic. It keeps on changing depending upon the gestational month of the mother. Hence the difficulty faced by me are summarized in this presentation. It is very different and difficult but extremely rewarding.
Emergency craniotomy
One of the hardest specialties is neuro anesthesia. When I initially started, I were so dumb founded. The things in brain did not only change, they become instantly harder. The drugs which were supposed to work now did not because the brain had developed edema or there was no blood supply. I worked real hard on this presentation. Took help from the textbooks and my teachers and has helped me. I hope you will found it somewhat helpful. Some of the answers are beyond the scope of this presentation due to the diversity of the field.
Cvs pharma
It is one of the hardest subjects to grasp initially. I have read this thoroughly during the initial years of my anesthesia training. This presentation on the pharmacology of anesthesia addresses the key concepts any anesthetist should have on his fingertips.
Critical events report
Working in operation theaters, sometimes things do not go as planned. As such we have to write something about the sequence of events. I have just made a template of how I presented my critical incidence in the department.
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The Electrocardiogram - Physiologic Principles
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Cell Therapy Expansion and Challenges in Autoimmune Disease
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Efficacy of Avartana Sneha in Ayurveda
Avartana Sneha is a unique method of Preparation of Sneha Kalpana in Ayurveda, mainly it is indicated for the Vataja rogas.
Osteoporosis - Definition , Evaluation and Management .pdf
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Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
A Classical Text Review on Basavarajeeyam
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Adhd Medication Shortage Uk - trinexpharmacy.com
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
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We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.Best Ayurvedic medicine for Gas and Indigestion
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Compications of regional anesthesia
- 1. Complications of Regional Anesthesia Dr. Muhammad Muneeb Riaz PGR Anesthesia/ICU, JHL
- 2. Regional Anesthesia • Neuraxial Anesthesia • Peripheral Nerve Blocks • Scalp • Upper limb • Trunk • Lower limb
- 3. Drugs Used • Local Anesthetics • Adjuvants
- 4. Complications • Related to procedure • Related to drugs
- 5. Complications related to procedure • Ineffective/ partial, incomplete block • Hematoma • Nerve damage • Positioning complications • Surrounding visceral damage like pneumothorax • Expected side effects, like Horners' syndrome after stellate ganglion block • Dissatisfaction of the patient
- 6. What is neuraxial anesthesia? • Spinal • Epidural • Caudal
- 7. Complications related to Drugs • Local Anesthesia Systemic Toxicity • Factors contributing • Drug properties • Site of block • Dose and concentration • Speed of injection • Adjuvants used or not like adrenaline
- 8. • Patient factors: • Age • Weight • Pregnancy in females • Volume status
- 9. Complications of Neuraxial Anesthesia • Failure/ incomplete block • Hypotension • Bradycardia • Nausea and vomiting • High spinal • Total spinal • Infection • Spinal abscess • Blood vessel injury • Back ache
- 10. Local Anesthesia Systemic Toxicity • Occurs due to high concentration of local anesthetic in blood.