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.

In search of the holy grail: poisons and extended release local anesthetics
Publication date: Available online 30 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Steve J.R. Coppens, Zoriana Zawodny, Geertrui Dewinter, Arne Neyrinck, Angela Lucia Balocco, Steffen RexAbstractRegional anesthesia has been advocated as adjunct to a multimodal analgesia regimen. The limited duration of action of available local anesthetics limits their application. Catheters, perineural or IV adjuvants or repetition of blocks are modalities available to prolong the analgesic benefit of LRA. All of these approaches have their shortcomings. New extended release local anesthetic formulations m...
Source: Best Practice and Research Clinical Anaesthesiology - May 1, 2019 Category: Anesthesiology Source Type: research

Closed-Loop Hemodynamic Management
Publication date: Available online 27 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Brenton Alexander, Joseph Rinehart, Maxime Cannesson, Jacques Duranteau, Alexandre JoostenAbstractAs the operating room and intensive care settings become increasingly complex the required vigilance practitioners must dedicate to a wide array of clinical systems has increased concordantly. The resulting shortage of available attention to these various clinical tasks creates a vacuum for the introduction of systems that can administer well established goal-directed therapies without significant provider feedba...
Source: Best Practice and Research Clinical Anaesthesiology - April 28, 2019 Category: Anesthesiology Source Type: research

Novel nerve imaging and regional anesthesia, bio-impedance and the future
Publication date: Available online 23 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Brian D. O’Donnell, Frank LoughnaneAbstractUltrasound technology has transformed the practice of regional anaesthesia. Anaesthesiologists routinely use real-time images to guide needle and local anaesthetic placement adjacent to nerves. It is widely accepted that the era of ultrasonography has improved peripheral nerve block success rates and lessened the dose of local anaesthetic required to achieve success. Contemporary reports of harm in relation to nerve injury or local anaesthetic systemic toxicity are...
Source: Best Practice and Research Clinical Anaesthesiology - April 24, 2019 Category: Anesthesiology Source Type: research

Perioperative Hemodynamic Management 4.0
Publication date: Available online 24 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Frederic Michard, Matthieu Biais, Suzana M. Lobo, Emmanuel FutierSummaryPostoperative complications within 30 days represent the third leading cause of death in the world. Multiple solutions have been proposed to tackle the clinical and economic burden of postoperative complications. They include the optimal fluid and hemodynamic management of patients undergoing major surgery. A better understanding of cardiovascular physiology and technological improvements are responsible for the evolution of perioperative...
Source: Best Practice and Research Clinical Anaesthesiology - April 24, 2019 Category: Anesthesiology Source Type: research

Fascia iliaca compartment blocks: different techniques and review of the literature
Publication date: Available online 17 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Matthias Desmet, Angela Lucia Balocco, Vincent Van BelleghemAbstractThe fascia iliaca compartment block has been promoted as a valuable regional anesthesia and analgesia technique for lower limb surgery. Numerous studies have been performed but the evidence on the true benefits of the fascia iliaca compartment block is still limited. Recent anatomical, radiological and clinical research have demonstrated the limitations of the landmark infra-inguinal technique. Nevertheless, this technique is still valuable i...
Source: Best Practice and Research Clinical Anaesthesiology - April 18, 2019 Category: Anesthesiology Source Type: research

Predicting hypotension in perioperative and intensive care medicine
Publication date: Available online 16 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Bernd Saugel, Karim Kouz, Phillip Hoppe, Kamal Maheshwari, Thomas W.L. ScheerenAbstractBlood pressure is the main determinant of organ perfusion. Hypotension is common in patients having surgery and in critically ill patients. The severity and duration of hypotension is associated with hypoperfusion and organ dysfunction. Hypotension is mostly treated reactively after low blood pressure values have already occurred. However, prediction of hypotension before it becomes clinically apparent would allow the clini...
Source: Best Practice and Research Clinical Anaesthesiology - April 16, 2019 Category: Anesthesiology Source Type: research

Percutaneous Peripheral Nerve Stimulation and Other Alternatives for Perineural Catheters for Postoperative Analgesia
Publication date: Available online 5 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Rodney A. Gabriel, Brian M. IlfeldAbstractA perineural catheter with a continuous infusion of local anesthetic is an excellent option for postoperative analgesia; however, its limitations include limited duration of action (i.e. 3 – 7 days) as well as a risk of infection and dislodgement. Furthermore, these blocks may cause dense sensory and motor blockade that under certain circumstances may not be ideal. There is novel evidence that ultrasound-guided percutaneous peripheral nerve stimulation (pPNS) may ser...
Source: Best Practice and Research Clinical Anaesthesiology - April 6, 2019 Category: Anesthesiology Source Type: research

Pressure monitoring: the evidence so far
Publication date: Available online 5 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Milly Rambhia, Jeff GadsdenAbstractNerve injury is a relatively rare, but devastating complication of peripheral nerve blockade (PNB). Monitoring injection pressure during PNB is one method advocated to prevent injury by detecting needle tip placement in a non-compliant position (intraneural or abutting the epineurium). Animal studies show that gross neural damage and clinical injury are associated with injection pressures exceeding 15-20 psi. In contrast, pressures <15 psi are associated with an extraneur...
Source: Best Practice and Research Clinical Anaesthesiology - April 6, 2019 Category: Anesthesiology Source Type: research

Thoracic wall blocks: from paravertebral to retrolaminar to serratus to erector spinae and back again – a review of the evidence
Publication date: Available online 5 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ki Jinn ChinAbstractA multitude of thoracic wall blocks have been described, including parasternal-intercostal plane, Pecs I and II, serratus anterior plane, paraspinal-intercostal plane, erector spinae plane blocks, and retrolaminar blocks. They are almost all fascial plane blocks, relying on passive spread of local anesthetic to target nerves within the plane or in adjacent tissue compartments. They have emerged as attractive alternatives to thoracic paravertebral and epidural blocks, due to their relative s...
Source: Best Practice and Research Clinical Anaesthesiology - April 6, 2019 Category: Anesthesiology Source Type: research

Updates on Multimodal Analgesia and Regional Anesthesia for Total Knee Arthroplasty Patients
Publication date: Available online 6 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Brandon S. Kandarian, Nabil M. Elkassabany, Mallika Tamboli, Edward R. MarianoAbstractThe subspecialty of regional anesthesiology and acute pain medicine (RAAPM) is in a position to lead changes that may impact the current opioid crisis. At the hospital level, RAAPM experts can implement evidence-based multimodal analgesic clinical pathways featuring regional anesthesia. Multimodal analgesia consists of using two or more analgesic modalities targeting pain pathways at various levels to improve pain control, wh...
Source: Best Practice and Research Clinical Anaesthesiology - April 6, 2019 Category: Anesthesiology Source Type: research

Breast surgery and regional anaesthesia
Publication date: Available online 6 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Simon FitzGerald, Peter M. Odor, Ann Barron, Amit PawaAbstractRegional anaesthesia techniques are an important adjunct to perioperative care of breast surgery patients. This chapter focuses on the practical application, evidence base and advantages of peripheral nerve block regional anaesthesia in the anaesthetic management of patients undergoing breast surgery. Functional anatomy and fascial plane blocks are discussed alongside paravertebral and paraspinal techniques. Guidance on the performance the range of ...
Source: Best Practice and Research Clinical Anaesthesiology - April 6, 2019 Category: Anesthesiology Source Type: research

Measuring and Monitoring Cognition in the Postoperative Period
Publication date: Available online 18 January 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Lucy H. Piggin, Stanton P. NewmanAbstractIt is common for patients of all ages to experience some degree of cognitive disturbance following surgery. In most cases, impairment appears mild and is restricted to the acute post-operative period, resolving steadily and speedily. In a small number of cases, however, deficits may be more pronounced and/or endure for longer periods, significantly delaying recovery and increasing the risk of serious clinical complications. The ability to accurately measure postopera...
Source: Best Practice and Research Clinical Anaesthesiology - January 20, 2019 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: September–December 2018Source: Best Practice & Research Clinical Anaesthesiology, Volume 32, Issues 3–4Author(s): (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - December 4, 2018 Category: Anesthesiology Source Type: research

Preface to patient centered clinical anaesthesiology
Publication date: September–December 2018Source: Best Practice & Research Clinical Anaesthesiology, Volume 32, Issues 3–4Author(s): Colin Royse (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - December 4, 2018 Category: Anesthesiology Source Type: research

The future of recovery – Integrated, digitalised and in real time
Publication date: Available online 10 April 2018Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Andrea Bowyer, Colin RoyseTraditional perioperative risk prediction recovery identifies patient populations at risk of suboptimal recovery but not individual patients in whom this actually occurs and in whom timely intervention is beneficial. Patient-focused recovery emphasises a return to a semblance of normality and an ability to perform activities previously undertaken. A patient's sense of self-efficacy and engagement in their own care positively influences functional improvement and emotive recovery.The ...
Source: Best Practice and Research Clinical Anaesthesiology - November 12, 2018 Category: Anesthesiology Source Type: research