Context Is King—Obstetric Anaesthesia Management Strategies in Limited Resource Settings
(Abstracted from Int J Obstet Anesth, 31:1–4, 2017)
Developing nations account for 99% of all global maternal deaths, with two-thirds of these occurring in sub-Saharan Africa. Anesthesia contributes disproportionately to maternal mortality in this context, confirming the need for provision of obstetric anesthesia in underdeveloped countries. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Obstetric Anesthesia Source Type: research
Transthoracic Echocardiography and Electrical Cardiometry Elucidate the Hemodynamics of Autotransfusion During Labor Under Epidural Analgesia
(Abstracted from Int J Obstet Anesth, 31:113–115, 2017)
Electrical cardiometry (EC) is a safe technique for continuous, hands-free trending of stroke volume and cardiac output. Periodic changes in hemodynamic parameters occur in patients in active labor because of autotransfusion from uterine contractions. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Obstetric Anesthesia Source Type: research
Anesthetic Neuroprotection? It’s Complicated
(Abstracted from Anesthesiology, 126(4):579–581, 2017)
Research has been unable to replicate a neuroprotective effect of anesthetics in the clinical setting in contrast to reliable demonstrations of neuroprotection in laboratory animals. The research in this issue by Archer et al1 (“Anesthetic Neuroprotection in Experimental Stroke in Rodents: A Systematic Review and Meta-analysis”) seeks to explain this dichotomy by reviewing 80 laboratory investigations. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Neuroanesthesia Source Type: research
Anesthetic Neuroprotection in Experimental Stroke in Rodents: A Systematic Review and Meta-analysis
(Abstracted from Anesthesiology, 126(4):653–665, 2017)
The primary aim of the meta-analysis undertaken here was to assess the impact (if any) of study quality, publication bias, and the timing of anesthetic administration on neurologic outcomes of the middle cerebral artery filament occlusion model of focal ischemia in rodents. The filament model in rats and mice is usually utilized to study the effects and mechanisms of potential neuroprotective agents. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Neuroanesthesia Source Type: research
Cerebral Autoregulation-Oriented Therapy at the Bedside: A Comprehensive Review
(Abstracted from Anesthesiology, 126(6):1187–1199, 2017)
This comprehensive review by Rivera-Lara et al1 aims to provide an overview of cerebral autoregulation-directed therapy use at the point of care in order to manage cerebral perfusion pressure, and this study also aims to assess whether this therapy can optimize functional outcomes. The article summarizes the physiology and measurement methods of cerebral autoregulation before going on to deliberate on the validation of different cerebral autoregulation indices. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Neuroanesthesia Source Type: research
The Protective Effects of Dexmedetomidine on Ischemic Brain Injury: A Meta-analysis
(Abstracted from J Clin Anesth, 40:25–32, 2017)
The inflammatory cascade mediated by neuroendocrine hormones and proinflammatory mediators, caused by disordered hemodynamics or adverse stress, has been implicated in the pathophysiology of ischemic brain injury. The α2-adrenoceptor agonist dexmedetomidine (DEX) inhibits inflammatory and neuroendocrine responses, but comprehensive meta-analysis to estimate neuroprotection of α2-agonists is still lacking and could guide clinical treatment and prognosis. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Neuroanesthesia Source Type: research
Into the Wilderness?: The Growing Importance of Nonoperating Room Anesthesia Care in the United States
(Abstracted from Anesth Analg, 124(4):1044–1046, 2017)
This editorial reviews the article by Nagrebetsky et al1 (“Growth of Nonoperating Room Anesthesia Care in the United States: A Contemporary Trends Analysis”), which highlights the fact that the need for anesthesia care is moving beyond the operating room (OR). (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Growth of Nonoperating Room Anesthesia Care in the United States: A Contemporary Trends Analysis
(Abstracted from Anesth Analg, 124(4):1261–1267, 2017)
The purpose of this retrospective analysis was to assess the available data from the National Anesthesia Clinical Outcomes Registry (NACOR) to distinguish and compare non–operating room anesthesia (NORA) and traditional operating room (OR) cases as well as to examine the evolution and variations in annual frequency and characteristics of NORA and OR cases. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
What Can Population Data Tell Us About Anesthesia and Cognition in the (Vulnerable) Older Patient?
(Abstracted from Anesth Analg, 124(4):1036–1038, 2017)
Postoperative cognitive dysfunction has been observed in patients following anesthesia and surgery. Recent evidence of preoperative cognitive impairment has made identifying preoperative cognitive trajectory of an individual very important in understanding and interpreting postoperative change in the short and long term. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Mild Cognitive Impairment and Exposure to General Anesthesia for Surgeries and Procedures: A Population-Based Case-Control Study
(Abstracted from Anesth Analg, 124(4):1277–1290, 2017)
The purpose of this article was to use a case-control design to prove or disprove the hypothesis that exposure to general anesthesia for surgery and procedures in patients 40 years or older is associated with prevalent mild cognitive impairment (MCI) and analysis to find the connection between general anesthesia in the “aged” (defined here as ≥40 years) and cognitive impairment (eg, MCI, dementia). Preclinical studies indicate that some general anesthesia drugs may cause neurohistologic changes consistent with Alzheimer dementia. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Deep Neuromuscular Block to Optimize Surgical Space Conditions During Laparoscopic Surgery: A Systematic Review and Meta-analysis
(Abstracted from Br J Anaesth, 118(6):834–842, 2017)
Lowering the elevated intra-abdominal pressure during pneumoperitoneum created in laparoscopic procedures can impair the quality of the surgical field and increase the risk of intraoperative complications. Deep neuromuscular block (NMB) has been known to improve surgical conditions in laparoscopic procedures; however, the routine use of NMB is still debatable. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Sugammadex Efficacy for Reversal of Rocuronium- and Vecuronium-Induced Neuromuscular Blockade: A Pooled Analysis of 26 Studies
(Abstracted from J Clin Anesth, 41:84–91, 2017)
The Food and Drug Administration–approved pharmaceutical product, sugammadex, rapidly and effectively reverses moderate and deep levels of rocuronium- or vecuronium-induced neuromuscular blockade (NMB) through a unique mechanism and is currently approved for use in more than 80 countries. This pooled analysis aimed to compare the efficacy of sugammadex with neostigmine or placebo for reversal of the effects of rocuronium- or vecuronium-induced blockade and to illustrate consistency of results with sugammadex across the various patient populations. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Sensorimotor and Executive Function Slowing in Anesthesiology Residents After Overnight Shifts
(Abstracted from J Clin Anesth, 40:110–116, 2017)
Physicians and medical residents working overnight shifts suffer from sleep deprivation, cognitive dysfunction, and decreased sensorimotor performance due to disturbances in circadian rhythms. This can lead to medical errors and work-related injuries and accidents. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Educational Issues Source Type: research
Pain Measurement in Mechanically Ventilated Patients After Cardiac Surgery: Comparison of the Behavioral Pain Scale (BPS) and the Critical-Care Pain Observation Tool (CPOT)
(Abstracted from J Cardiothorac Vasc Anesth, 31:1227–1234, 2017)
Postsurgical pain is common in critically ill patients, such as cardiac surgery patients, and can have a negative effect on recovery. The experience of severe pain during intensive care unit (ICU) stays has been linked to the development of posttraumatic stress disorder–related symptoms. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Critical Care Source Type: research
Little Black Boxes: Noncardiac Implantable Electronic Medical Devices and Their Anesthetic and Surgical Implications
This report provides an overview of their perioperative functioning in electromagnetic environments, such as operating room, gastrointestinal procedure suite, and imaging suite, where electromagnetic interference with the devices can lead to adverse patient outcomes. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Coexisting Disease Source Type: research
