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current opinion in anesthesiology

B Zwissler
Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery, and may help to optimize the patient's preoperative medical condition and guide perioperative management. Whether performance of additional technical tests (e. g., blood chemistry, electrocardiography, spirometry, chest x‑ray) can contribute to reduction of the perioperative risk is often not well known or controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists, and surgeons with respect to perioperative management of the patient's long-term medication...
November 2, 2017: Der Anaesthesist
Ryan M Chadha, Cara Crouch, Jeron Zerillo, Ernesto A Pretto, Raymond Planinsic, Sang Kim, Ramona Nicolau-Raducu, Dieter Adelmann, Elia Elia, Christopher L Wray, Coimbatore Srinivas, M Susan Mandell
The anesthesia community has openly debated if the care of transplant patients was generalist or specialist care ever since the publication of an opinion paper in 1999 recommended subspecialty training in the field of liver transplantation anesthesia. In the past decade, liver transplant anesthesia has become more complex with a sicker patient population and evolving evidence-based practices. Transplant training is currently not required for accreditation or certification in anesthesiology, and not all anesthesia residency programs are associated with transplant centers...
December 2017: Seminars in Cardiothoracic and Vascular Anesthesia
Manfred Weiss, Andrej Michalsen, Anke Toenjes, Franz Porzsolt, Thomas Bein, Marc Theisen, Alexander Brinkmann, Heinrich Groesdonk, Christian Putensen, Friedhelm Bach, Dietrich Henzler
BACKGROUND: Structural aspects and current practice about end-of-life (EOL) decisions in German intensive care units (ICUs) managed by anesthesiologists are unknown. A survey among intensive care anesthesiologists has been conducted to explore current practice, barriers and opinions on EOL decisions in ICU. METHODS: In November 2015, all members of the German Society of Anesthesiology and Intensive Care Medicine (DGAI) and the Association of German Anesthesiologists (BDA) were asked to participate in an online survey to rate the presence or absence and the importance of 50 items...
July 11, 2017: BMC Anesthesiology
B Zwissler
Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery and may help to optimize the patient's preoperative medical condition and to guide perioperative management. Whether the performance of additional technical tests (e. g. blood chemistry, ECG, spirometry, chest x‑ray) can contribute to a reduction of perioperative risk is often not very well known or is controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists and surgeons with respect to the perioperative management of the patient's long-term medication...
June 2017: Der Anaesthesist
Frederick Conlin, Neil R Connelly, Michael P Eaton, Patrick J Broderick, Jennifer Friderici, Adam C Adler
BACKGROUND: The advent of portable ultrasound machines in recent years has led to greater availability of focused cardiac ultrasound (FoCUS) in the perioperative and critical care setting. To our knowledge, its use in the perioperative setting among anesthesiologists remains undefined. We sought to assess the use of FoCUS by members of the Society of Cardiovascular Anesthesiologists (SCA) in clinical practice, to identify variations in its application, to outline limits to its use, and to understand the level of training of physicians using this technology...
December 2017: Anesthesia and Analgesia
Brenda Griffin, Philip A Bushby, Emily McCobb, Sara C White, Y Karla Rigdon-Brestle, Leslie D Appel, Kathleen V Makolinski, Christine L Wilford, Mark W Bohling, Susan M Eddlestone, Kelly A Farrell, Nancy Ferguson, Kelly Harrison, Lisa M Howe, Natalie M Isaza, Julie K Levy, Andrea Looney, Michael R Moyer, Sheilah Ann Robertson, Kathy Tyson
As community efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs have increased, many veterinarians have increasingly focused their clinical efforts on the provision of spay-neuter services. Because of the wide range of geographic and demographic needs, a wide variety of spay-neuter programs have been developed to increase delivery of services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, community cat programs, and services provided through private practitioners...
July 15, 2016: Journal of the American Veterinary Medical Association
Khaled Mahmoud-Tawfik, Ellie Heidari, David Craig, Abdel Rahman Tawfik
OBJECTIVE: This research explores the attitudes of medical professionals towards fasting patients prior to the use of conscious sedation. MATERIALS AND METHODS: Questionnaires were completed by a total of 113 dentists, anaesthetists and dental nurses in order to identify current practices and opinions concerning the employment of pre-operative fasting in the context of conscious sedation in dentistry. RESULTS: Seventy-eight (69%) respondents did not recommend fasting, compared with 35 (31%) who did...
January 2015: SAAD Digest
Bassem O Asaad, Ruth A Reinsel, Eric DeVeaux, Hadi Moten, Brian Durkin
BACKGROUND: Over the last decade ultrasound guidance (USG) has been utilized very successfully in acute pain procedures to confirm nerves' anatomic location and obtain live images. Not only the utilization, but the teaching, of USG has become an essential part of anesthesiology residency training. Prior to the introduction of USG, chronic pain procedures were always done either under fluoroscopy or blindly. USG offers advantages over fluoroscopy for completion of chronic pain procedures...
November 2014: Pain Physician
François Montastruc, Guillaume Moulis, Aurore Palmaro, Virginie Gardette, Geneviève Durrieu, Jean-Louis Montastruc
BACKGROUND: The present study aimed to describe exposure and attitudes of French medical residents towards pharmaceutical industry. The study was performed shortly after the Mediator affair which revealed several serious conflicts of interest inside the French health system. METHODS AND FINDINGS: A cross-sectional study was implemented among residents from 6 French medical faculties. Independent education in pharmacology, attitudes towards the practices of pharmaceutical sales representatives, opinions concerning the pharmaceutical industry, quality of information provided by the pharmaceutical industry, and opinions about pharmaceutical company sponsorship were investigated through a web-based questionnaire...
2014: PloS One
James S Tweddell, Nancy S Ghanayem, George M Hoffman
The goal of perioperative monitoring is to aid the clinician in optimizing care to achieve the best possible survival with the lowest possible morbidity. Ideally, we would like to have monitoring that can rapidly and accurately identify perturbations in circulatory well-being that would permit timely intervention and allow for restoration before the patient is damaged. The evidence to support the use of our standard monitoring strategies (continuous electrocardiography, blood pressure, central venous pressure, oxygen saturation and capnography) is based on expert opinion, case series, or at best observational studies...
2014: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
Shaheen E Lakhan, Mitchel Schwindt, Bashar N Alshareef, Deborah Tepper, Maryann Mays
As per the Centers for Medicare and Medicaid Services (CMS) current proposal, many specialties including neurology are not eligible for the increase in Medicare reimbursements that will be allocated to other cognitive specialties, such as the 7% increase for family physicians, 5% for internists, and 4% for geriatric specialists.(1,2) Other specialties such as anesthesiology, radiology, and cardiology are scheduled for a 3%-4% decrease in reimbursement in order to pay for the increases outlined above. Current estimates show that neurologists provide a significant amount of primary care for complex patients and yet these services are not eligible for increased payments...
July 2, 2013: Neurology
J M Sistac Ballarín, E Gredilla Díaz, A Sáez Fernández
OBJECTIVES: To determine the current situation of the tutors in our specialty as regards resident/tutor ratios, times they have available to develop their work, the training that they have received to perform their function, and whether this is recognised by official bodies, other than by their own hospital. Furthermore, to determine the teaching and research work taught to the residents through the sessions, as well as their participation in publications per year. To find out their opinion of the tutors as regards unifying training contents, whether or not they have objective tests on finishing their residency, and their willingness to take part in the project promoted by the Teaching Section of SEDAR to carry out a common minimum theoretical-practical programme throughout the whole of Spain...
March 2012: Revista Española de Anestesiología y Reanimación
Claire F la Chapelle, Willem A Bemelman, Bart M P Rademaker, Teus A van Barneveld, Frank Willem Jansen
The Dutch Society for Endoscopic Surgery together with the Dutch Society of Obstetrics and Gynecology initiated a multidisciplinary working group to develop a guideline on minimally invasive surgery to formulate multidisciplinary agreements for minimally invasive surgery aiming towards better patient care and safety. The guideline development group consisted of general surgeons, gynecologists, an anesthesiologist, and urologist authorized by their scientific professional association. Two advisors in evidence-based guideline development supported the group...
September 2012: Gynecological Surgery
Anelise Daher, Renata Pinheiro Lima Hanna, Luciane Rezende Costa, Cláudio Rodrigues Leles
BACKGROUND: Relative analgesia (RA), defined as the use of inhalation sedation with nitrous oxide and oxygen, is one of the most common pharmacological behavior management techniques used to provide sedation and analgesia for dental patients. This study aimed to assess RA licensed Brazilian dentists' practices and opinions about nitrous oxide/oxygen sedation in the dental setting. METHODS: A cross sectional national survey was conducted with 281 dentists who were certified to perform RA, using an electronically mailed self-administered questionnaire containing closed questions about their practices and opinions regarding RA...
2012: BMC Oral Health
Alberto J de Armendi, James F Mayhew, Mohanad Shukry, Abhaya Seshachar, Judith Ponder, Marte Martinez, Pratistra Strong, Jorge A Cure
OBJECTIVES: The induction of anesthesia in children is commonly carried out by the administration of inhaled anesthetics via face mask as opposed to an intravenous induction. Thus far, no study has assessed the opinions of anesthesia providers regarding commonly used induction techniques. We surveyed current attitudes among anesthesiologist to understand anesthesia induction techniques in pediatric patients in the community. BACKGROUND: A survey of community anesthesiologists induction of anesthesia methods in children was sent to members of the Oklahoma Society of Anesthesiologists...
March 2012: Journal of the Oklahoma State Medical Association
Fiona E van Gelder, Jurgen C de Graaff, Leo van Wolfswinkel, Wilton A van Klei
CONTEXT: Previous surveys of the current practice of preoperative assessment within different countries have shown that there is much variation between different hospitals. OBJECTIVE: The aim of the present study was to document the current clinical practice of preoperative testing for noncardiac surgery in Europe. We also wanted to assess the opinion of anaesthesiologists on eliminating routine preoperative testing. DESIGN: Cross-sectional study...
October 2012: European Journal of Anaesthesiology
T Hachenberg, J Neu, S Werner, D Wiedemann, W Schaffartzik
Expert opinions have an important place for expert testimony in medical disputes. The report should contain a summary about facts and causality between the damage and the medical treatment in question as well as describe the current medical standard. The fulfillment of scientific criteria was investigated in 179 anesthesiological expert opinions from 150 arbitration cases. Anesthesiological expert reports (2005-2007) of the Arbitration Board of the North German Medical Associations were analyzed in terms of structure, general form of assessment and scientific substantiation of statements...
June 2012: Der Anaesthesist
K Nouette-Gaulain, F Lenfant, D Jacquet-Francillon, A Belbachir, A Bournigault-Nuquet, O Choquet, A Claisse, F Dujarric, D Francon, M Gentili, C Majoufre-Lefebvre, B Marciniack, D Péan, P-G Yavordios, M Leone
INTRODUCTION: Dental injuries represent the most common claims against the anaesthesiologists. Dental lesions are frequent complications of orotracheal intubation and major causal factors are, firstly, preexisting poor dentition, and, secondly, difficult laryngoscopy and tracheal intubation. The aim of this work was to prioritize propositions for prevention in perianaesthetic dental injury and for care in case of dental trauma. METHOD: A GRADE consensus procedure consisting of three rounds was conducted...
March 2012: Annales Françaises D'anesthèsie et de Rèanimation
Abraham J Valkenburg, Sylvia M van der Kreeft, Tom G de Leeuw, Robert J Stolker, Dick Tibboel, Monique van Dijk
BACKGROUND:   Intellectually disabled children are more likely to undergo surgical interventions and almost all have comorbidities that need to be managed. Compared with controls, intellectually disabled children tend to receive less intraoperative analgesia and fewer of them are assessed for postoperative pain. AIM:   To evaluate perceptions and practices of anesthesiologists in the Netherlands concerning pain management in intellectually disabled children...
July 2012: Paediatric Anaesthesia
M E Stone, B Salter, A Fischer
Many anaesthesia practitioners caring for patients with a cardiac implantable electronic device (CIED) lack the knowledge, experience, and requisite programming devices to independently manage these patients perioperatively. A recently updated ASA task force Practice Advisory presents expert opinion regarding the perioperative management of patients with CIEDs, and the Heart Rhythm Society (HRS) recently published a consensus statement on this subject in collaboration with the ASA, American Heart Association (AHA), and Society of Thoracic Surgeons (STS)...
December 2011: British Journal of Anaesthesia
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