Best Practice and Research. Clinical Anaesthesiology This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Surgical Site Infiltration: A Neuroanatomical Approach
Publication date: Available online 25 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Girish P. Joshi, Anthony MachiAbsractLocal anaesthetic administration into a surgical wound blocks the noxious stimuli that result from surgical insult at the site of origin. Surgical site infiltration (also known as local infiltration analgesia) is easy to perform, safe, and inexpensive. In addition, it avoids motor blockade, which is particularly relevant for lower limb surgery. The best approach to surgical site infiltration includes meticulous, systematic and extensive surgical site local anaesthetic infil...
Source: Best Practice and Research Clinical Anaesthesiology - July 26, 2019 Category: Anesthesiology Source Type: research

Best Practice & Research Clinical Anaesthesiology: Advances in haemodynamic monitoring for the peri-operative patient Perioperative cardiac output monitoring
Publication date: Available online 22 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Berthold Bein, Jochen RennerAbstractLess invasive or even completely non-invasive haemodynamic monitoring technologies have evolved during the last decades. But even established, invasive devices such as the pulmonary artery catheter and transpulmonary thermodilution have still an evidence-based place in the perioperative setting, albeit only in special patient populations. Accumulating evidence suggests to use continuous haemodynamic monitoring, specifically flow-based variables such as stroke volume or cardi...
Source: Best Practice and Research Clinical Anaesthesiology - July 24, 2019 Category: Anesthesiology Source Type: research

Why and how to assess cerebral autoregulation?
Publication date: Available online 22 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Annelies Moerman, Stefan De HertAbstractAround the turn of the century, a better understanding of the complex physiology of cerebral blood flow regulation has emerged. It is now acknowledged that cerebral autoregulation is much more complicated than we previously thought it was, with the shape of the autoregulation curve and limits of autoregulation that may vary enormously and unpredictably, both within and between patients. The consequence is that in order to safeguard the cerebral circulation, the dogma tha...
Source: Best Practice and Research Clinical Anaesthesiology - July 24, 2019 Category: Anesthesiology Source Type: research

Perioperative hemodynamic monitoring: still a place for cardiac filling pressures ?
Publication date: Available online 22 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Christian Schmidt, Astrid Ellen Berggreen, Matthias HeringlakeAbstractThe clinical usefulness of the so-called “static” cardiac filling pressures - central (CVP) and pulmonary-artery-occlusion-pressure (PAOP) – has come into question for guiding hemodynamic therapy due to their poor ability to predict fluid responsiveness in comparison with other monitoring modalities like transpulmonary thermodilution derived volumetric measurements, dynamic variables for assessing fluid responsiveness, and the potentia...
Source: Best Practice and Research Clinical Anaesthesiology - July 24, 2019 Category: Anesthesiology Source Type: research

Peripheral nerve catheters: A critical review of the efficacy
Publication date: Available online 22 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Rasmus W. Hauritz, Kjartan E. Hannig, Angela Lucia Balocco, Gwendolyne Peeters, Admir Hadzic, Jens Børglum, Thomas F. BendtsenAbstractContinuous peripheral nerve blocks are commonly used for postoperative analgesia after surgery. However, catheter failure may occur due to either primary (incorrect insertion) or secondary reasons (displacement, obstruction, disconnection). Catheter failure results in unanticipated pain, need for opioid use, and risk of readmission or delay in hospital discharge. This review ai...
Source: Best Practice and Research Clinical Anaesthesiology - July 24, 2019 Category: Anesthesiology Source Type: research

Post-Operative Ward Monitoring – Why & What Now?
Publication date: Available online 23 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ashish K. Khanna, Sanchit Ahuja, Robert Weller, Timothy N. HarwoodAbstractThe postoperative ward is considered an ideal nursing environment for stable patients transitioning out of the hospital. However, about half of all in-hospital cardiorespiratory arrests occur here and are associated with poor outcomes. Current monitoring practices on the hospital ward mandate intermittent vital signs checks. Subtle changes in vital signs often occur at least 8-12 hours prior to an acute event, and continuous monitoring o...
Source: Best Practice and Research Clinical Anaesthesiology - July 24, 2019 Category: Anesthesiology Source Type: research

Upper Extremity Regional Anesthesia Techniques: A Comprehensive Review for Clinical Anesthesiologists
Publication date: Available online 20 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Mark R. Jones, Matthew B. Novitch, Sudipta Sen, Nadia Hernandez, Johanna Blair De Haan, Rebecca A. Budish, Christopher Bailey, Joseph Ragusa, Pankaj Thakur, Vwaire Orhurhu, Ivan Urits, Elyse M. Cornett, Alan David KayeAbstractSurgeries and chronic pain states of the upper extremity are quite common and pose unique challenges for the clinical anesthesiology and pain specialists. Most innervation of the upper extremity involves the brachial plexus. The four most common brachial plexus blocks performed in clinica...
Source: Best Practice and Research Clinical Anaesthesiology - July 21, 2019 Category: Anesthesiology Source Type: research

Truncal Regional Nerve Blocks in Clinical Anesthesia Practice
Publication date: Available online 19 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ivan Urits, Peter S. Ostling, Matthew B. Novitch, James C. Burns, Karina Charipova, Kyle L. Gress, Rachel J. Kaye, Matthew R. Eng, Elyse M. Cornett, Alan David KayeAbstractRegional anesthetic techniques are important components of successful multimodal analgesic strategies. When used successfully, truncal nerve blocks of the chest wall, abdomen, and, paraneuraxial nerves, in combination with other analgesic modalities, may offer similar analgesic efficacy as neuraxial techniques, which are associated with a gr...
Source: Best Practice and Research Clinical Anaesthesiology - July 20, 2019 Category: Anesthesiology Source Type: research

Liposomal Bupivacaine and Novel Local Anesthetic Formulations
Publication date: Available online 19 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Amit Prabhakar, Ceressa T. Ward, Matthew Watson, Jay Sanford, Babar Fiza, Vanessa Moll, Rachel J. Kaye, O. Morgan Hall, Elyse M. Cornett, Richard D. Urman, Alan David KayeAbstractNovel preparations allowing for extending duration of action of local anesthetics have many clinically relevant benefits. In this regard, the development of liposomal bupivacaine has the potential to significantly impact patient care by improving perioperative pain control. The unique liposomal bilayer that encapsulates bupivacaine al...
Source: Best Practice and Research Clinical Anaesthesiology - July 20, 2019 Category: Anesthesiology Source Type: research

Complications and Liability Related to Regional and Neuraxial Anesthesia
Publication date: Available online 19 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Henry Liu, Morgan Brown, Lu Sun, Shukan P. Patel, Jinlei Li, Elyse M. Cornett, Richard D. Urman, Charles J. Fox, Alan David KayeAbstractRegional anesthesia is responsible for approximately one-fifth of professional liability claims. The present investigation evaluated common and rare complications related to regional and neuraxial anesthesia, including postdural puncture headache, backache, transient neurological symptoms, inadvertent intrathecal injection, epidural hematoma and abscess, meningitis, arachnoidi...
Source: Best Practice and Research Clinical Anaesthesiology - July 20, 2019 Category: Anesthesiology Source Type: research

Recent Advances in Regional Anesthesia and Ultrasound Techniques
Publication date: Available online 17 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Richard D. Urman, Alan David Kaye (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - July 18, 2019 Category: Anesthesiology Source Type: research

PECS, Serratus Plane, Erector Spinae and Paravertebral Blocks: A Comprehensive Review
Publication date: Available online 17 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Erik M. Helander, Michael P. Webb, Julia Kendrick, Tim Montet, Aaron J. Kaye, Elyse M. Cornett, Alan David KayeAbstractThoracic planar blocks represent a novel and rapidly expanding facet of regional anesthesia. These recently described techniques represent the potential for excellent analgesia, enhanced technical safety profiles, and reduced physiological side effects versus traditional techniques in thoracic anesthesia. Regional techniques, particularly those described in this review, have potential implicat...
Source: Best Practice and Research Clinical Anaesthesiology - July 18, 2019 Category: Anesthesiology Source Type: research

Regional Anesthesia Considerations for Cardiac Surgery
Publication date: Available online 17 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Henry Liu, Patrick I. Emelife, Amit Prabhakar, Vanessa Moll, Julia B. Kendrick, Allan T. Parr, Farees Hyatali, Thakur Pankaj, Jinlei Li, Elyse M. Cornett, Richard D. Urman, Charles J. Fox, Alan D. KayeAbstractPain is a significant consequence of cardiac surgery and newer techniques in cardiac anesthesia have provided an impetus for the development of multimodal techniques to manage acute pain in this setting. In this regard, regional anesthesia techniques have been increasingly used in many cardiac surgical pr...
Source: Best Practice and Research Clinical Anaesthesiology - July 18, 2019 Category: Anesthesiology Source Type: research

Novel Utilization of Fascia Layer Blocks in Hip and Knee Procedures
Publication date: Available online 17 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Jinlei Li, Shuai Tang, David Lam, Anja Hergrueter, Jeremy Dennis, Henry LiuAbstractPurposeof review: Novel motor-sparing peripheral nerve blocks in hip and knee procedures are desirable.Recent findingsThe application of ultrasound in fascial plane blocks have improved the efficacy and effectiveness of obturator nerve block, lateral femoral cutaneous nerve block, and quadratus lumborum block. The improved performance of these fascial plane blocks has led to additional clinical applications to the hip and knee p...
Source: Best Practice and Research Clinical Anaesthesiology - July 18, 2019 Category: Anesthesiology Source Type: research

Perioperative Use of Opioids: Current Controversies and Concerns
Publication date: Available online 17 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): John C. Alexander, Biral Patel, Girish P. JoshiAbstractIn the midst of an epidemic of opioid abuse and overdose related morbidity and mortality, the use of opioids remains the most common means of providing analgesia in the perioperative period. In this article, we review the risks and benefits of opioid use in preoperative, intraoperative, and postoperative phases of care. Furthermore, we describe the role that surgeons and anaesthesiologists can play in reducing perioperative opioid use and mitigate their ad...
Source: Best Practice and Research Clinical Anaesthesiology - July 18, 2019 Category: Anesthesiology Source Type: research