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Anesthesia and Analgesia

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https://www.readbyqxmd.com/read/29787414/perioperative-peripheral-nerve-injury-after-general-anesthesia-a-qualitative-systematic-review
#1
Jason Chui, John M Murkin, Karen L Posner, Karen B Domino
Perioperative peripheral nerve injury (PNI) is a well-recognized complication of general anesthesia that continues to result in patient disability and malpractice claims. However, the multifactorial etiology of PNI is often not appreciated in malpractice claims given that most PNI is alleged to be due to errors in patient positioning. New advances in monitoring may aid anesthesiologists in the early detection of PNI. This article reviews recent studies of perioperative PNI after general anesthesia and discusses the epidemiology and potential mechanisms of injury and preventive measures...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29787413/halving-the-volume-of-anaconda-evaluation-of-a-new-small-volume-anesthetic-reflector-in-a-test-lung-model
#2
Hagen Bomberg, Franziska Meiser, Philipp Daume, Martin Bellgardt, Thomas Volk, Daniel I Sessler, Heinrich V Groesdonk, Andreas Meiser
BACKGROUND: Volatile anesthetics are increasingly used for sedation in intensive care units. The most common administration system is AnaConDa-100 mL (ACD-100; Sedana Medical, Uppsala, Sweden), which reflects volatile anesthetics in open ventilation circuits. AnaConDa-50 mL (ACD-50) is a new device with half the volumetric dead space. Carbon dioxide (CO2) can be retained with both devices. We therefore compared the CO2 elimination and isoflurane reflection efficiency of both devices. METHODS: A test lung constantly insufflated with CO2 was ventilated with a tidal volume of 500 mL at 10 breaths/min...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29787412/does-respiratory-variation-in-inferior-vena-cava-diameter-predict-fluid-responsiveness-in-mechanically-ventilated-patients-a-systematic-review-and-meta-analysis
#3
Xiang Si, Hailin Xu, Zimeng Liu, Jianfeng Wu, Daiyin Cao, Juan Chen, Minying Chen, Yongjun Liu, Xiangdong Guan
BACKGROUND: We performed a systematic review and meta-analysis of studies investigating the diagnostic accuracy of respiratory variation in inferior vena cava diameter (ΔIVC) for predicting fluid responsiveness in patients receiving mechanical ventilation. METHODS: MEDLINE, EMBASE, the Cochrane Library, and Web of Science were screened from inception to February 2017. The meta-analysis assessed the pooled sensitivity, specificity, diagnostic odds ratio, and area under the receiver operating characteristic curve...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29787411/perianesthetic-and-anesthesia-related-mortality-in-a-southeastern-united-states-population-a-longitudinal-review-of-a-prospectively-collected-quality-assurance-data-base
#4
Richard J Pollard, Thomas Hopkins, C Tyler Smith, Bryan V May, James Doyle, C Labron Chambers, Reese Clark, William Buhrman
BACKGROUND: Perianesthetic mortality (death occurring within 48 hours of an anesthetic) continues to vary widely depending on the study population examined. The authors study in a private practice physician group that covers multiple anesthetizing locations in the Southeastern United States. This group has in place a robust quality assurance (QA) database to follow all patients undergoing anesthesia. With this study, we estimate the incidence of anesthesia-related and perianesthetic mortality in this QA database...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29787410/the-effect-of-dexmedetomidine-on-propofol-requirements-during-anesthesia-administered-by-bispectral-index-guided-closed-loop-anesthesia-delivery-system-a-randomized-controlled-study
#5
Amitabh Dutta, Nitin Sethi, Jayashree Sood, Bhuwan C Panday, Manish Gupta, Prabhat Choudhary, Goverdhan D Puri
BACKGROUND: Dexmedetomidine, a selective α2-adrenergic agonist currently approved for continuous intensive care unit sedation, is being widely evaluated for its role as a potential anesthetic. The closed-loop anesthesia delivery system (CLADS) is a method to automatically administer propofol total intravenous anesthesia using bi-spectral index (BIS) feedback and attain general anesthesia (GA) steady state with greater consistency. This study assessed whether dexmedetomidine is effective in further lowering the propofol requirements for total intravenous anesthesia facilitated by CLADS...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29787409/-modified-dynamic-needle-tip-positioning-short-axis-out-of-plane-ultrasound-guided-radial-artery-cannulation-in-neonates-a-randomized-controlled-trial
#6
Lifei Liu, Yanzhe Tan, Shangyingying Li, Jie Tian
BACKGROUND: Radial artery cannulation is extremely challenging in neonatal patients. Herein, we compared the success rate of the modified dynamic needle tip positioning short-axis, out-of-plane, ultrasound-guided technique with that of the traditional palpation technique in neonatal radial artery cannulation. METHODS: Sixty term neonates undergoing major abdominal surgery were randomized into the ultrasound or palpation group via the sealed-envelope method. The ultrasound group underwent radial artery cannulation using an ultrasonic apparatus, while traditional palpation of arterial pulsation was used in the palpation group...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29787408/organ-donation-after-circulatory-death-ethical-issues-and-international-practices
#7
Barbara G Jericho
Donation after circulatory death (DCD) is an increasingly utilized practice that can contribute to reducing the difference between the supply of organs and the demand for organs for transplantation. As the number of transplanted organs from DCD donors continues to increase, there is an essential need to address the ethical aspects of DCD in institutional DCD protocols and clinical practice. Ethical issues of respecting the end-of-life wishes of a potential donor, respecting a recipient's wishes, and addressing potential conflicts of interest are important considerations in developing policies and procedures for DCD programs...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29787407/identifying-barriers-to-implementation-of-the-national-partnership-for-maternal-safety-obstetric-hemorrhage-bundle-at-a-tertiary-center-utilization-of-the-delphi-method
#8
Annemaria De Tina, Anthony Chau, Daniela A Carusi, Julian N Robinson, Lawrence C Tsen, Michaela K Farber
BACKGROUND: In 2015, the National Partnership for Maternal Safety (NPMS) developed an obstetric hemorrhage consensus bundle to provide birthing facilities in the United States with consistent, validated practice guidelines for postpartum hemorrhage management. The process of implementing each bundle element at a large tertiary labor and delivery unit has not been described; we sought to identify practice deficiencies and perceived barriers to bundle implementation among multidisciplinary providers...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782406/population-pharmacokinetics-and-pharmacodynamics-of-dexmedetomidine-in-children-undergoing-ambulatory-surgery
#9
María-Gabriela Pérez-Guillé, Alejandra Toledo-López, Liliana Rivera-Espinosa, Radames Alemon-Medina, Chiharu Murata, Ismael Lares-Asseff, Juan Luis Chávez-Pacheco, Josefina Gómez-Garduño, Ana-Lilia Zamora Gutiérrez, Claudia Orozco-Galicia, Karina Ramírez-Morales, Gustavo Lugo-Goytia
BACKGROUND: Dexmedetomidine (DEX) is an α-2 adrenergic agonist with sedative and analgesic properties. Although not approved for pediatric use by the Food and Drug Administration, DEX is increasingly used in pediatric anesthesia and critical care. However, very limited information is available regarding the pharmacokinetics of DEX in children. The aim of this study was to investigate DEX pharmacokinetics and pharmacodynamics (PK-PD) in Mexican children 2-18 years of age who were undergoing outpatient surgical procedures...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782405/the-impact-of-anesthesia-influenced-process-measure-compliance-on-length-of-stay-results-from-an-enhanced-recovery-after-surgery-for-colorectal-surgery-cohort
#10
Michael C Grant, Claro M Pio Roda, Joseph K Canner, Philip Sommer, Daniel Galante, Deborah Hobson, Susan Gearhart, Christopher L Wu, Elizabeth Wick
BACKGROUND: Process measure compliance has been associated with improved outcomes in enhanced recovery after surgery (ERAS) programs. Herein, we sought to assess the impact of compliance with measures directly influenced by anesthesiology in an ERAS for colorectal surgery cohort. METHODS: From January 2013 to April 2015, data from 1140 consecutive patients were collected for all patients before (pre-ERAS) and after (ERAS) implementation of an ERAS program. Compliance with 9 specific process measures directly influenced by the anesthesiologist or acute pain service was analyzed to determine the impact on hospital length of stay (LOS)...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782404/evaluating-patient-centered-outcomes-in-clinical-trials-of-procedural-sedation-part-2-safety-sedation-consortium-on-endpoints-and-procedures-for-treatment-education-and-research-recommendations
#11
Denham S Ward, Mark R Williams, John W Berkenbosch, Maala Bhatt, Douglas Carlson, Phillip Chappell, Randall M Clark, Isabelle Constant, Aaron Conway, Joseph Cravero, Albert Dahan, Franklin Dexter, Raymond Dionne, Robert H Dworkin, Tong J Gan, David Gozal, Steven Green, Michael G Irwin, Suzanne Karan, Michael Kochman, Jerrold Lerman, Jenifer R Lightdale, Ronald S Litman, Keira P Mason, James Miner, Robert E O'Connor, Pratik Pandharipande, Richard R Riker, Mark G Roback, Daniel I Sessler, Anne Sexton, Joseph R Tobin, Dennis C Turk, Rebecca S Twersky, Richard D Urman, Mark Weiss, Hannah Wunsch, Anna Zhao-Wong
The Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research, established by the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks, a public-private partnership with the US Food and Drug Administration, convened a second meeting of sedation experts from a variety of clinical specialties and research backgrounds to develop recommendations for procedural sedation research. The previous meeting addressed efficacy and patient- and/or family-centered outcomes...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782403/surveying-the-literature-synopsis-of-recent-key-publications
#12
Eugene A Hessel
No abstract text is available yet for this article.
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782402/understanding-conflict-management-styles-in-anesthesiology-residents
#13
Terrie Vasilopoulos, Christopher R Giordano, Jack D Hagan, Brenda G Fahy
BACKGROUND: Successful conflict resolution is vital for effective teamwork and is critical for safe patient care in the operating room. Being able to appreciate the differences in training backgrounds, individual knowledge and opinions, and task interdependency necessitates skilled conflict management styles when addressing various clinical and professional scenarios. The goal of this study was to assess conflict styles in anesthesiology residents via self- and counterpart assessment during participation in simulated conflict scenarios...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782401/is-neuraxial-anesthesia-appropriate-for-cesarean-delivery-in-all-cases-of-morbidly-adherent-placenta
#14
Mohamed Mohamed Tawfik, Mohamed Ahmed Tolba, Sarah Salah Moawad, Khalid Samir Ismail, Mohamed Elsayed Taman
No abstract text is available yet for this article.
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782400/in-response
#15
John C Markley, Michaela K Farber, Nicola C Perlman, Daniela A Carusi
No abstract text is available yet for this article.
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782399/frozen-in-time-a-history-of-the-synthesis-of-nitrous-oxide-and-how-the-process-remained-unchanged-for-over-2-centuries
#16
Alexander Buslov, Matthew Carroll, Manisha S Desai
Three major factors have contributed to the unrivaled popularity of nitrous oxide (N2O) among anesthetists in the 20th century and beyond: its impressive safety profile, its affordability, and its rapid induction and emergence times. These 3 characteristics of N2O have been discussed and written about extensively throughout the medical literature. Nonetheless, the characteristic that contributed most to N2O's initial discovery-the elegance and simplicity of its synthesis-has received substantially less attention...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782398/benefit-and-harm-of-adding-epinephrine-to-a-local-anesthetic-for-neuraxial-and-locoregional-anesthesia-a-meta-analysis-of-randomized-controlled-trials-with-trial-sequential-analyses
#17
Clément Tschopp, Martin R Tramèr, Alexis Schneider, Maroun Zaarour, Nadia Elia
BACKGROUND: This systematic review examines the benefit and harm of adding epinephrine to local anesthetics for epidural, intrathecal, or locoregional anesthesia. METHODS: We searched electronic databases to October 2017 for randomized trials comparing any local anesthetic regimen combined with epinephrine, with the same local anesthetic regimen without epinephrine, reporting on duration of analgesia, time to 2 segments regression, or any adverse effects. Trial quality was assessed using the Cochrane risk of bias tool and a random-effects model was used...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29771716/flupirtine-is-an-effective-analgesic-is-the-associated-rare-liver-injury-a-limiting-factor-to-its-use
#18
Kim Lawson
No abstract text is available yet for this article.
May 15, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29771715/whole-blood-for-resuscitation-in-adult-civilian-trauma-in-2017-a-narrative-review
#19
Evan G Pivalizza, Christopher T Stephens, Srikanth Sridhar, Sam D Gumbert, Susan Rossmann, Marsha F Bertholf, Yu Bai, Bryan A Cotton
After a hiatus of several decades, the concept of cold whole blood (WB) is being reintroduced into acute clinical trauma care in the United States. Initial implementation experience and data grew from military medical applications, followed by more recent development and data acquisition in civilian institutions. Anesthesiologists, especially those who work in acute trauma facilities, are likely to be presented with patients either receiving WB from the emergency department or may have WB as a therapeutic option in massive transfusion situations...
May 15, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29771714/remifentanil-induces-cardio-protection-against-ischemia-reperfusion-injury-by-inhibiting-endoplasmic-reticulum-stress-through-the-maintenance-of-zinc-homeostasis
#20
Mingwei Sheng, Ge Zhang, Jiannan Wang, Qing Yang, Huanhuan Zhao, Xinxin Cheng, Zhelong Xu
BACKGROUND: Although it is well known that remifentanil (Rem) elicits cardiac protection against ischemia/reperfusion (I/R) injury, the underlying mechanism remains unclear. This study tested if Rem can protect the heart from I/R injury by inhibiting endoplasmic reticulum (ER) stress through the maintenance of zinc (Zn) homeostasis. METHODS: Isolated rat hearts were subjected to 30 minutes of regional ischemia followed by 2 hours of reperfusion. Rem was given by 3 consecutive 5-minute infusions, and each infusion was followed by a 5-minute drug-free perfusion before ischemia...
May 15, 2018: Anesthesia and Analgesia
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