Anesthetic challenges posed by generalised Medical Adhesive Related Skin Injury (MARSI)
Medical Adhesive Related Skin Injury (MARSI) is a dermatological disorder in which erythema and/or other cutaneous abnormalities including, but not limited to, vesicles, bullae, erosions or tears, appear and persist for 30 min or more after removal of an adhesive [1]. MARSI is well recognised in the medical literature, but there is limited awareness of the anesthetic management of patients with MARSI. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 23, 2018 Category: Anesthesiology Authors: Janice Nam, Rosie Earle, Himat Vaghadia Tags: Correspondence Source Type: research
The importance of appropriate control groups in perioperative analgesic studies: One size does not fit all
Postoperative pain remains poorly treated [1]. Specifically in the United States, opioids continue to be the main weapon used by clinicians to optimize postoperative analgesia [2]. Nonetheless, opioids can worsen patient reported quality of postoperative recovery [3,4]. In addition, the current national focus in the US to reduce the prescription of opioid analgesics and, subsequently, opioid diversion makes the use of multimodal analgesic strategies a very important topic in the perioperative care of surgical patients [5]. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 23, 2018 Category: Anesthesiology Authors: Gildasio S. De Oliveira Tags: Editorial Source Type: research
We need more studies to guide the perioperative management of high risk seniors undergoing surgery
The number of surgical procedures in the ambulatory care setting in the United States has increased by over 300% during the past decade with over 30 million ambulatory surgeries (AS) being performed yearly [1]. Of these, 6 million are done in seniors ( ≥65years of age) and, with the aging of the US population, the number of seniors undergoing surgery will expand exponentially. In addition, more complex surgeries (e.g. hysterectomy, thyroidectomy, spine surgery) are also now conducted in the ambulatory setting [2–4]. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 22, 2018 Category: Anesthesiology Authors: Gildasio S. De Oliveira Tags: Editorial Source Type: research
Postoperative outcomes in patients with a do-not-resuscitate (DNR) order undergoing elective procedures
Do-not-resuscitate (DNR) status has been shown to be an independent risk factor for mortality in the post-operative period. Patients with DNR orders often undergo elective surgeries to alleviate symptoms and improve quality of life, but there are limited data on outcomes for informed decision making. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 19, 2018 Category: Anesthesiology Authors: Ethan Y. Brovman, Elisa C. Walsh, Brittany N. Burton, Christine E. Kuo, Charlotta Lindvall, Rodney A. Gabriel, Richard D. Urman Tags: Original contribution Source Type: research
Atypical distribution of local anesthetic solution in a patient with distal adductor canal catheter
Distal adductor canal block is performed under ultrasound guidance by administering high volume of local anesthetic close to the distal hiatus, which leads to distribution down to the popliteal fossa [1 –3]. Although rarely used up to date, a catheter placement is possible within the adductor canal close to distal hiatus. A distal adductor canal catheter is expected to provide sufficient continuous analgesia for treatment of chronic pain at lower part of leg by blocking both the sciatic and saphe nous nerve. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 18, 2018 Category: Anesthesiology Authors: Onur Balaban, Tayfun Aydin, Merve Yaman Tags: Correspondence Source Type: research
Hypnotic agents for induction of general anesthesia in cesarean section patients: A systematic review and meta-analysis of randomized controlled trials
An ideal induction drug for cesarean section (CS) must have quick action, with minimum side effects such as awareness, hemodynamic compromise, and neonatal depression. Thiopentone is frequently used; however, no reliable evidence is available to support its use as a dedicated hypnotic agent in this setting. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 17, 2018 Category: Anesthesiology Authors: Kavita Houthoff Khemlani, Stephanie Weibel, Peter Kranke, Jan-Uwe Schreiber Tags: Original Contribution Source Type: research
Infraclavicular and supraclavicular approaches to brachial plexus for ambulatory elbow surgery: A randomized controlled observer-blinded trial
To compare the effectiveness of supraclavicular and infraclavicular approaches to brachial plexus block for elbow surgery. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 17, 2018 Category: Anesthesiology Authors: Shalini Dhir, Brigid Brown, Peter Mack, Yves Bureau, Janice Yu, Douglas Ross Tags: Original contribution Source Type: research
Interchangeability of counts of cases and hours of cases for quantifying a hospital's change in workload among four-week periods of 1 year
Recent studies have made longitudinal assessments of case counts using State (e.g., United States) and Provincial (e.g., Canada) databases. Such databases rarely include either operating room (OR) or anesthesia times and, even when duration data are available, there are major statistical limitations to their use. We evaluated how to forecast short-term changes in OR caseload and workload (hours) and how to decide whether changes are outliers (e.g., significant, abrupt decline in anesthetics). (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 17, 2018 Category: Anesthesiology Authors: Franklin Dexter, Richard H. Epstein, Johannes Ledolter, Jonathan P. Wanderer Tags: Original Contribution Source Type: research
Successful directional thoracic erector spinae plane block after failed lumbar plexus block in hip joint and proximal femur surgery
We read with great interest the clinical experiences using the erector spinae plane blocks (ESPB) for hip and proximal femur surgeries by Tulgar et al. [1]. We are grateful for their work in the identification of contrast spread to lumbar plexus with ESPB as it confirms our experiences with this technique at our institution. With patient assent and parental written consent, we report a case of an 11-year-old female with a history of right hip dysplasia undergoing surgical dislocation of the hip and proximal femoral osteotomy, successfully managed with a caudally-oriented thoracic ESPB following inability to place a nerve-s...
Source: Journal of Clinical Anesthesia - May 15, 2018 Category: Anesthesiology Authors: Curtis E. Darling, Stephanie Y. Pun, Thomas J. Caruso, Ban C.H. Tsui Tags: Correspondence Source Type: research
Incorporation of point-of-care ultrasound into morning round is associated with improvement in clinical outcomes in critically ill patients with sepsis
Point-of-care ultrasound (POCUS) has been widely used in the intensive care unit (ICU). However, it is largely unknown whether the use of POCUS is associated with improved patient-important outcomes. The study aimed to investigate whether incorporation of POCUS during morning round on a routine basis was able to improve clinical outcomes in critically ill patients with sepsis. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 12, 2018 Category: Anesthesiology Authors: Zhonghua Chen, Yucai Hong, Junru Dai, Lifeng Xing Tags: Original contribution Source Type: research
Local anesthetic spread during erector spinae plane block
Dear editor, (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 10, 2018 Category: Anesthesiology Authors: Alessandro De Cassai, Tommaso Tonetti Tags: Correspondence Source Type: research
Perineural dexamethasone successfully prolongs adductor canal block when assessed by objective pinprick sensory testing: A prospective, randomized, dose-dependent, placebo-controlled equivalency trial
To determine whether perineural dexamethasone prolongs peripheral nerve blockade (PNB) when measured objectively; and to determine if a 1 mg and 4 mg dose provide equivalent PNB prolongation compared to PNB without dexamethasone. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 9, 2018 Category: Anesthesiology Authors: James D. Turner, Daryl S. Henshaw, Robert S. Weller, J. Douglas Jaffe, Christopher J. Edwards, J. Wells Reynolds, Gregory B. Russell, Sean W. Dobson Tags: Original contribution Source Type: research
Low flow vascular malformations of cervico facial area: An airway challenge
Sir, (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 9, 2018 Category: Anesthesiology Authors: Manpreet Kaur, Anjum Goth, Rajeshwari Subramaniam Tags: Correspondence Source Type: research
Anesthetic management of a patient with Freeman-Sheldon syndrome in thoracic surgery
We present the anesthetic management of a forty-year old male patient affected by FSS undergoing elective wedge pulmonary left resection via muscle-sparing mini-thoracotomy. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 8, 2018 Category: Anesthesiology Authors: Silvia Fiorelli, Giulio Leopizzi, Domenico Massullo, Antonio D'Andrilli, Anna Maria Ciccone, Monica Rocco Tags: Correspondence Source Type: research
Sphenopalatine ganglion block by transnasal approach in post-dural puncture headache
Post-dural puncture headache (PDPH) is a common complication in neuraxial anesthesia, particularly epidural anesthesia, possibly related with loss of cerebrospinal fluid through the puncture site, exceeding its production rate [1]. Common PDPH symptoms include severe frontal and occipital headache, nausea, vomiting, hearing and visual disturbances, and dizziness [2]. Epidural blood patch is the standard therapy for PDPH, with efficacy rates ranging from 61 to 98% [1]. However, this is an invasive technique susceptible to risks, such as accidental additional dural puncture, bleeding, infection, and neurological complication...
Source: Journal of Clinical Anesthesia - May 8, 2018 Category: Anesthesiology Authors: L úcia M. Gonçalves, Pedro M. Godinho, Francisco J. Durán, Elisabete C. Valente Tags: Correspondence Source Type: research
