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Anesthesia and Analgesia

Daniel C Schroeder, Alexandra C Maul, Maria Guschlbauer, Simon-Richard Finke, David de la Puente Bethencourt, Ingrid Becker, Stephan A Padosch, Andreas Hohn, Thorsten Annecke, Bernd W Böttiger, Anja Sterner-Kock, Holger Herff
BACKGROUND: Targeted temperature management is a standard therapy for unconscious survivors of cardiac arrest. To date, multiple cooling methods are available including invasive intravascular cooling devices (IVDs), which are widely used in the clinical setting. Recently, esophageal heat exchangers (EHEs) have been developed providing cooling via the esophagus that is located close to the aorta and inferior vena cava. The objective was to compare mean cooling rates, as well as differences, to target temperature during maintenance and the rewarming period of IVD and EHE...
November 9, 2018: Anesthesia and Analgesia
Yu Yung Lai, Chia Ming Chang
No abstract text is available yet for this article.
November 9, 2018: Anesthesia and Analgesia
Rishi Vashishta, Samir M Kendale
BACKGROUND: Patients on antidepressant or antianxiety medications often have complex perioperative courses due to difficult pain management, altered coping mechanisms, or medication-related issues. This study examined the relationship between preoperative antidepressants and antianxiety medications on postoperative hospital length of stay while controlling for confounding variables. METHODS: From an administrative database of 48,435 adult patients who underwent noncardiac surgery from 2011 to 2014 at a single, large urban academic institution, multivariable zero-truncated negative binomial regression analyses controlling for age, sex, medical comorbidities, and surgical type were performed to assess whether preoperative exposure to antidepressant or antianxiety medication use was associated with postoperative hospital length of stay...
November 9, 2018: Anesthesia and Analgesia
Roi Gat, Eran Hadar, Sharon Orbach-Zinger, Tzippy Shochat, Shiri Kushnir, Sharon Einav
BACKGROUND: The impact of physiological adjustments throughout pregnancy on maternal vital signs and laboratory values has yet to be fully defined. The present study was designed to determine the normal range of these parameters among healthy pregnant women during the peripartum period. METHODS: This is a retrospective analysis of data collected during real-time deliveries in a single medical center. Vital signs and laboratory results from the 24 hours preceding delivery room admission and up to 72 hours postpartum were collected...
November 9, 2018: Anesthesia and Analgesia
Joanna Miller, Emuejevoke Chuba, Stacie Deiner, Samuel DeMaria, Daniel Katz
Despite increasing representation in medicine, women continue to be a minority in academic practice and leadership, especially in male-dominated fields like anesthesiology. Differences in compensation and participation in leadership may represent barriers to career advancement for women in anesthesiology. Key factors for promotion in academic anesthesiology are research, funding, and publication. As such, designation as a first or senior author on a publication in a professional journal may act as currency for promotion...
November 9, 2018: Anesthesia and Analgesia
Anna Maria Bombardieri, James Beckman, Michael Urban, George Go, A Raffaele De Gaudio, Federico P Girardi, Yan Ma, Stavros G Memtsoudis
BACKGROUND: Prone positioning (PP) is necessary for surgical access during posterior spine procedure. However, physiological changes occur in the PP. Typical findings are a decrease in arterial blood pressure and in cardiac output that could potentially lead to an alteration in cerebral perfusion. Therefore, we decided to study cerebral blood flow velocity (CBFV) with transcranial Doppler ultrasonography to evaluate the effect of the PP on cerebral hemodynamics. METHODS: Twenty-two patients undergoing spine surgery in the PP were studied...
November 9, 2018: Anesthesia and Analgesia
Tomasz Rechberger, Randall J Mack, Stewart W McCallum, Wei Du, Alex Freyer
BACKGROUND: An intravenous (IV) formulation of meloxicam was developed for moderate-to-severe pain management. This study evaluated the safety and efficacy of meloxicam IV after open abdominal hysterectomy. Meloxicam IV is an investigational product not yet approved by the US Food and Drug Administration. METHODS: Women (N = 486) with moderate-to-severe pain after open abdominal hysterectomy were enrolled in this multicenter, randomized, double-blind, placebo- and active-controlled trial...
November 9, 2018: Anesthesia and Analgesia
Hanns-Christian Dinges, Stephan Otto, David K Stay, Synke Bäumlein, Susanne Waldmann, Peter Kranke, Hinnerk F Wulf, Leopold H Eberhart
BACKGROUND: Side effects of opioids used for the treatment of acute pain frequently limit their analgesic quality. Many studies have compared opioid side effects in patient-controlled analgesia (PCA), but it remains unclear whether there are specific side effect profiles that can be exploited when choosing an opioid for a patient. In this review, we wanted to determine the risk ratios (RRs) for the most common side effects when using different opioids for intravenous PCA in equianalgesic doses and rank the substances accordingly...
November 9, 2018: Anesthesia and Analgesia
Toshiyuki Mizota, Li Dong, Chikashi Takeda, Atsuko Shiraki, Shino Matsukawa, Satoshi Shimizu, Shinichi Kai
BACKGROUND: There is a need for a clinically relevant and feasible outcome measure to facilitate clinical studies in perioperative care medicine. This large-scale retrospective cohort study proposed a novel composite outcome measure comprising invasive respiratory or vasopressor support (IRVS) and death. We described the prevalence of IRVS in patients undergoing major abdominal surgery and assessed the validity of combining IRVS and death to form a composite outcome measure. METHODS: We retrospectively collected perioperative data for 2776 patients undergoing major abdominal surgery (liver, colorectal, gastric, pancreatic, or esophageal resection) at Kyoto University Hospital...
November 9, 2018: Anesthesia and Analgesia
Hannan Chaudery, Neil MacDonald, Tahania Ahmad, Susilo Chandra, Aida Tantri, Velayuthapillai Sivasakthi, Marzida Mansor, Ricardo Matos, Rupert M Pearse, John R Prowle
BACKGROUND: Postoperative acute kidney injury (AKI) is associated with a high mortality rate. However, the relationship among AKI, its associations, and mortality is not well understood. METHODS: Planned analysis of data was collected during an international 7-day cohort study of adults undergoing elective in-patient surgery. AKI was defined using Kidney Disease Improving Global Outcomes criteria. Patients missing preoperative creatinine data were excluded. We used multivariable logistic regression to examine the relationships among preoperative creatinine-based estimated glomerular filtration rate (eGFR), postoperative AKI, and hospital mortality, accounting for the effects of age, major comorbid diseases, and nature and severity of surgical intervention on outcomes...
November 9, 2018: Anesthesia and Analgesia
Kamal Maheshwari, Natalya Makarova, Daniel I Sessler
No abstract text is available yet for this article.
November 1, 2018: Anesthesia and Analgesia
Lauren E Gibson, Teresa S Henriques, Madalena D Costa, Roger B Davis, Murray A Mittleman, Pooja Mathur, Balachundhar Subramaniam
BACKGROUND: Continuous arterial blood pressure (ABP) is typically recorded by placement of an intraarterial catheter. Recently, noninvasive ABP monitors have been shown to be comparable in accuracy to invasive measurements. In a previous study, we showed that the fluctuations in beat-to-beat ABP measurements were not random variations but had a complex dynamical structure, and that ABP dynamical complexity was inversely associated with surgical risk estimated using the Society of Thoracic Surgeons (STS) index...
November 1, 2018: Anesthesia and Analgesia
Jean-François Carabalona, Benjamin Delwarde, Antoine Duclos, Mary-Charlotte Le Goff, Mustapha Moulsma, Antony Citterio-Quentin, Yves Bouffard, Thomas Rimmelé
Lidocaine has been shown to be clinically beneficial during bariatric surgery. However, information about lidocaine serum concentrations in this setting is scarce. This prospective clinical trial included 42 obese patients undergoing laparoscopic bariatric surgery. They received lidocaine based on adjusted body weight. Administration began with a 1.5 mg·kg bolus of intravenous lidocaine followed by a continuous infusion of 2 mg·kg·hour. After skin closure, administration was decreased to 1 mg·kg·hour until discharge from the recovery room...
November 1, 2018: Anesthesia and Analgesia
Karim Lakhal
No abstract text is available yet for this article.
November 1, 2018: Anesthesia and Analgesia
Matthew A Warner, Daryl J Kor
No abstract text is available yet for this article.
October 30, 2018: Anesthesia and Analgesia
Elena Bignami, Valentina Bellini
No abstract text is available yet for this article.
October 30, 2018: Anesthesia and Analgesia
James A Bradley, Richard D Urman, Dongdong Yao
No abstract text is available yet for this article.
October 30, 2018: Anesthesia and Analgesia
Faraj Massouh, Rachel Martin, Bokman Chan, Julia Ma, Vikita Patel, Michael P Geary, John G Laffey, Duminda N Wijeysundera, Faraj W Abdallah
BACKGROUND: Quality of recovery (QOR) instruments measure patients' ability to return to baseline health status after surgery. Whether, and the extent to which, postoperative ambulation contributes to QOR is unclear, in part due to the lack of valid tools to measure ambulation in clinical settings. This cohort study of the cesarean delivery surgical model examines the accuracy and reliability of activity trackers in quantifying early postoperative ambulation and investigates the correlation between ambulation and QOR...
October 30, 2018: Anesthesia and Analgesia
Hiroshi Yonekura, Kazuki Ide, Yoshika Onishi, Isao Nahara, Chikashi Takeda, Koji Kawakami
BACKGROUND: The effect of preoperative transthoracic echocardiography on the clinical outcomes of patients with hip fractures undergoing surgical treatment remains controversial. We hypothesized that preoperative echocardiography is associated with reduced postoperative morbidity and improved patient survival after surgical repair of hip fractures. METHODS: Drawing from a nationwide administrative database, patients undergoing hip fracture surgeries between April 1, 2008 and December 31, 2016 were included...
October 30, 2018: Anesthesia and Analgesia
Evan G Pivalizza, Johanna B De Haan
No abstract text is available yet for this article.
October 30, 2018: Anesthesia and Analgesia
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