Practice Advisory for the Prevention, Diagnosis, and Management of Infectious Complications Associated With Neuraxial Techniques: An Updated Report by the American Society of Anesthesiologists Task Force on Infectious Complications Associated With Neuraxial Techniques and the American Society of Regional Anesthesia and Pain Medicine
This article is an update to the 2009 (published 2010) American Society of Anesthesiologists' (ASA's) “Practice Advisory for the Prevention, Diagnosis, and Management of Infectious Complications Associated With Neuraxial Techniques by the ASA Task Force on Infectious Complications Associated With Neuraxial Techniques.” In this context “infectious complications” are serious infections that result from the use of neuraxial techniques, which range from spinal, epidural, or combined spinal-epidural administration of analgesics, anesthetics, or steroids; lumbar puncture/spinal tap; epidural blood patch; intrathecal chem...
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Regional Anesthesia and Pain Control Source Type: research
Prospective Double Blind Randomized Placebo-Controlled Clinical Trial of the Pectoral Nerves (Pecs) Block Type II
(Abstracted from J Clin Anesth, 40:46–50, 2017)
Regional anesthesia techniques are used for acute and persistent postsurgical pain in breast surgery, with pectoral nerves block type II (Pecs) being an easy-to-perform, superficial block technique in which local anesthetic is deposited between the pectoralis major and the pectoralis minor muscle. This distribution of local anesthetics blocks the pectoral, intercostobrachial, III–VI intercostal, and the long thoracic nerves. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Regional Anesthesia and Pain Control Source Type: research
Preoperative Fasting Guidelines: Why Are We Not Following Them? The Time to Act Is Now
(Abstracted from Anesth Analg, 124(4):1041–1043, 2017)
This editorial accompanies the study by Shiraishi et al1 (“Gastric Fluid Volume Change After Oral Rehydration Solution Intake in Morbidly Obese and Normal Controls: A Magnetic Resonance Imaging–Based Analysis”) that tests gastric volumes preoperatively using magnetic resonance imaging in order to validate the American Society of Anesthesiologists (ASA) guidelines allowing patients to consume clear liquids until 2 hours before surgery involving anesthesia. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Preoperative and Postoperative Care Source Type: research
Gastric Fluid Volume Change After Oral Rehydration Solution Intake in Morbidly Obese and Normal Controls: A Magnetic Resonance Imaging–Based Analysis
(Abstracted from Anesth Analg, 124(4):1174–1178, 2017)
The purpose of this magnetic resonance imaging–based analysis was to examine the gastric emptying of the oral rehydration solution formulation used commonly in Japan (OS-1) in morbidly obese subjects (body mass index [BMI]>35 kg/m2) after standard overnight fasting compared with nonobese subjects as control subjects. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Preoperative and Postoperative Care Source Type: research
Three Wise Men (×2) and the ASA–Physical Status Classification System
(Abstracted from Anesthesiology, 126(4):577–578, 2017)
The American Society of Anesthesiologists (ASA) Physical Status score is a simple, subjective, nonspecific, and the most commonly applied classification system in perioperative medicine and is used worldwide. The decision makers weigh multiple and conflicting criteria and assign an ASA Physical Status on the basis of tacit knowledge and intuition, acquired through experience. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Preoperative and Postoperative Care Source Type: research
Adding Examples to the ASA–Physical Status Classification Improves Correct Assignment to Patients
(Abstracted from Anesthesiology, 126(4):614–622, 2017)
The main objective of this study was to examine whether including publicly available American Society of Anesthesiologists (ASA)–approved examples for the ASA Physical Status classification system improves correct assignment both by non–anesthesia-trained and anesthesia-trained clinicians. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Preoperative and Postoperative Care Source Type: research
Postoperative Atrial Fibrillation
(Abstracted from Anesth Analg, 125(1):10–12, 2017)
As the population ages, atrial fibrillation (AF) has emerged as a major public health issue that is making health care more expensive. This editorial reviews the research presented by Alonso-Coello et al,1 who attempt to develop a clinical prediction model to evaluate the diagnosis of what they call “new clinically important AF” in the POISE I (PeriOperative ISchemic Evaluation I) trial’s noncardiac surgery patients. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Preoperative and Postoperative Care Source Type: research
Predictors, Prognosis, and Management of New Clinically Important Atrial Fibrillation After Noncardiac Surgery: A Prospective Cohort Study
(Abstracted from Anesth Analg, 125(1):162–169, 2017)
The purpose of the POISE (PeriOperative ISchemic Evaluation) trial substudy has multiple objectives: it aims to deduce the associations between new clinically important atrial fibrillation (AF) and patient outcomes, as well as patient management strategies, while identifying a valid clinical prediction model for new clinically important AF in patients undergoing noncardiac surgery. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Preoperative and Postoperative Care Source Type: research
A Systematic Review and Meta-analysis Examining the Impact of Incident Postoperative Delirium on Mortality
(Abstracted from Anesthesiology, 127(1):78–88, 2017)
The purpose of this systematic review and meta-analysis was to determine the association between incident postoperative delirium and mortality in noncardiac surgery adult patients. Delirium is a fluctuating and neuropsychiatric geriatric syndrome that is a presentation of decompensation of cerebral function and can be associated with acute and reversible cognitive decline. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Preoperative and Postoperative Care Source Type: research
Preoperative Risk Stratification of Critically Ill Patients
(Abstracted from J Clin Anesth, 39:122–127, 2017)
Preoperative risk assessment is a cornerstone in our practice, and the American Society of Anesthesiologists (ASA) classification has been proven to correlate with a variety of outcomes. Cardiac risk stratification helps guide decision making about further testing and intervention prior to surgery, especially in cardiac patients undergoing noncardiac surgery. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Preoperative and Postoperative Care Source Type: research
Comparative Total and Unbound Pharmacokinetics of Cefazolin Administered by Bolus Versus Continuous Infusion in Patients Undergoing Major Surgery: A Randomized Controlled Trial
(Abstracted from Br J Anaesth, 118(6):876–882, 2017)
Administration of the antibiotic cefazolin before incision can reduce the incidence of surgical site infections, thereby reducing postoperative morbidity rates. Following the initial preincision dose, redosing intervals of cefazolin vary between 2 and 5 hours, depending on patient and procedure variables. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Pharmacology Source Type: research
The Effects of Maternal Presence During Anesthesia Induction on Salivary Cortisol Levels in Children Undergoing Tonsillectomy and/or Adenoidectomy
(Abstracted from J Clin Anesth, 39:64–66, 2017)
Anesthesia induction can cause stress and anxiety in children and their parents. High levels of anxiety are associated with negative outcomes, and several methods have been tested to reduce stress during this period. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Pediatric Anesthesia Source Type: research
Remifentanil Patient-Controlled Intravenous Analgesia for Labor Pain Relief: Is It Really an Option to Consider?
(Abstracted from Anesth Analg, 124(4):1029–1031, 2017)
Patient-controlled intravenous analgesia (PCIA) using remifentanil is a moderately effective nonneuraxial, parenteral opioid analgesic for labor pain relief in patients with contraindications to neuraxial analgesia. A survey of academic teaching centers across the United States by Aaronson et al1 (“A Survey of Intravenous Remifentanil Use for Labor Analgesia at Academic Medical Centers in the United States”) emphasizes the potential risks of respiratory depression associated with the use of intrapartum remifentanil PCIA. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Obstetric Anesthesia Source Type: research
A Survey of Intravenous Remifentanil Use for Labor Analgesia at Academic Medical Centers in the United States
(Abstracted from Anesth Analg, 124(4):1208–1210, 2017)
Currently, there is no standardized protocol regarding the optimal administration, dosing strategy, and maternal monitoring requirements of intravenous (IV) remifentanil for labor analgesia. As this drug has the potential to cause sedation, respiratory depression, oxygen desaturation, and more, it is essential that clear recommendations be established. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Obstetric Anesthesia Source Type: research
Obstetric Interventions and Maternal Morbidity Among Women Who Experience Severe Postpartum Hemorrhage During Caesarean Delivery
(Abstracted from Int J Obstet Anesth, 2017;31, 27–36)
Postpartum hemorrhage (PPH) causes severe maternal morbidity and mortality in women undergoing cesarean delivery (CD) compared to women undergoing vaginal delivery. The planning and management of PPH varies according to whether PPH occurs during prelabor CD or intrapartum CD. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Obstetric Anesthesia Source Type: research
