Most Popular Videos : Anesthesia & Analgesia

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Creator: Marta Kelava
Duration: 1:16
Anesthesia & Analgesia
A 12-15 MHz linear ultrasound probe is placed at a midclavicular line below the clavicle. The probe is moved inferolaterally to the level of the 3rd rib. With a slight medial tilt, the three layers of muscles are identified: pectoralis major, pectoralis minor and serratus anterior. When performing both blocks simultaneously, single puncture site can be used to preserve near-field imaging with deposition of the LA between the layers of the serratus anterior and pectoralis minor (PECS II), followed by needle withdrawal and injection between the pectoralis minor and pectoralis major (PECS I)
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Creator: Hongye Zhang
Duration: 0:43
The subparaneural upper trunk block is performed in the supraclavicular fossa, at the site where the upper trunk has trifurcated into anterior and posterior divisions and the suprascapular nerve. Local anesthetic is injected inside the paraneural sheath between either anterior and posterior divisions or posterior division and the suprascapular nerve.
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Creator: Marta Kelava
Duration: 0:41
Anesthesia & Analgesia
The PIF block is performed under ultrasound guidance, with either cranio-caudal or latero-medial needle advancement. The latter has been proposed to avoid inadvertent puncture of the perforating branch of the internal thoracic artery or the anterior perforating veins joining the internal thoracic vein, with the goal to deposit LA between the pectoralis major and intercostal muscles. The craniocaudal in-plane needle approach and injection is usually performed 1 cm lateral to the sternum at the midsternal level with LA deposition between the pectoralis major and intercostal muscles.
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Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:08
The right ventricle is under the transducer. There is normal excursion and coaptation of the aortic and mitral valves. The chambers are normal in size. There is brisk excursion of the aortic root, brisk opening of the mitral valve, a normal descent of the base of the MV, and normal thickening of the left ventricular segments.
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Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:08
The RVOT, LA, and LV are all dilated and appear proportionally large compared to the aortic annulus and root. Compare the relative sizes with Video 1 (normal PLAX.) There is evidence of decreased LV systolic function, with decreased motion of the aortic root, decreased excursion of the anterior mitral leaflet, decreased mitral annular excursion, and decreased thickening of the left ventricular segments. There is also a left pleural effusion.
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Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:06
The aortic valve is heavily calcified and does not open well. The degree of stenosis cannot be quantified from this view, but with excursion this limited the assumption should be that the patient has severe stenosis until it is proven otherwise. In addition to aortic valve calcification, the mitral annulus is heavily calcified, there is left ventricular hypertrophy, and the left atrium is enlarged.
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Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:07
Multiple beats are shown in this clip and the image does not remain still because the patient was severely dyspneic. The patient has significant hypertrophy of the anterioseptal wall of the left ventricle. In multiple cardiac cycles the anterior mitral leaflet can be seen to impinge on the left ventricular outflow tract.
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Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:05
Left ventricular and aortic valve function appear normal. There is thickening of the tips of the mitral leaflets, with diastolic bowing seen particularly in the anterior mitral leaflet (the “hockey stick” appearance). The left atrium appears enlarged as well, consistent with elevated left atrial pressure from mitral stenosis.
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Creator: A. Y. Denault
Duration: 1:02
Animated description on the technique to obtain splenic vein Doppler interrogation using the Vimedix Simulator from CAE Healthcare.
With permission of Denault et al. for the international study on the clinical significance of portal hypertension after cardiac surgery (NCT03656263).
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Creator: Chris W. Fields & Jon G. Dean
Duration: 6:30
Anesthesia & Analgesia
The video in left panel shows behavioral arousal after bilateral electrical stimulation of basal forebrain (200 Hz, 30 s ON, 30 s OFF, 60 – 100 µA) in a female Sprague Dawley rat (session 1). Note that the behavioral arousal after electrical stimulation occurred under continuous sevoflurane exposure; the rat was breathing 1.7% sevoflurane before, during, and after recovery of the righting reflex. The right panel shows the effect of bilateral electrical stimulation in the same rat (session 2;~1 week later) after inactivation of prefrontal cortex with bilateral infusion of 156 µM tetrodotoxin. The inactivation of prefrontal cortex attenuated the arousal-promoting effects of basal forebrain stimulation. The traces on top of the video show the electroencephalographic activation induced by electrical stimulation. The lightning bolt in the upper right-hand corner indicates when the electrical stimuli were being delivered.
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Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:10
At the top of the image is the liver. The right atrium and right ventricle are seen well, as is the left ventricle. There is normal global biventricular systolic function. It is important to remember that, while this view often shows all four cardiac chambers, the cross section is not exactly the same as the apical four chamber.
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Creator: Dr. Josh Zimmerman, MD, FASE
Duration: 0:11
Subcostal four chamber in a patient with pericardial effusion and tamponade. The effusion is seen as a large echolucent space around the heart. The right atrium appears collapsed in ventricular systole and the right ventricle appears compressed in ventricular diastole. These findings are both consistent with tamponade physiology.
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Creator:
Duration: 0:15
Anesthesia & Analgesia
First part: Superior view. 3D data was acquired with a 4-beat gated full volume mode, based on a modified ME 5ch view. The superior wall of the RA is partially cropped. Second part: The RA view was obtained after rotating the data set of the first part with a 90º up-down rotation to locate the SVC at the 12 o’clock position and a 90º rotation around the vertical axis on the screen. The echogenicity of the distal mass is lower than that of the proximal mass. ‘#’ indicates intra-tumor calcification in the distal mass.
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