Thromboelastography (TEG) or Rotational Thromboelastometry (ROTEM) to Monitor Haemostatic Treatment in Bleeding Patients: A Systematic Review With Meta-analysis and Trial Sequential Analysis
(Abstracted from Anaesthesia, 72:519–531, 2017)
Impaired hemostasis and bleeding lead to morbidity and mortality. Monitoring dynamic changes of hemostasis with thromboelastography (TEG) or rotational thromboelastometry (ROTEM) reduces bleeding and the use of blood products, hence lowering the risk of hypovolemic shock and mortality. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Techniques and Monitoring Source Type: research
Precision Medicine Versus Procrustean Beds
(Abstracted from Anesth Analg, 124(4):1032–1034, 2017)
This editorial reviews the article by Iravani et al.1 (“Standardized Care Versus Precision Medicine in the Perioperative Setting: Can Point-of-Care Testing Help Bridge the Gap?”) that eschews the “one-size-fits-all” approach to perioperative clinical care instead of going the way of precision medicine. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Techniques and Monitoring Source Type: research
Standardized Care Versus Precision Medicine in the Perioperative Setting: Can Point-of-Care Testing Help Bridge the Gap?
(Abstracted from Anesth Analg, 124(4):1347–1353, 2017)
In perioperative setting, precision medicine targets the patient's inherent genetic and environmental variability to achieve an individualized approach to health care, whereas standardized care pathways and protocols aim at decreasing variability of care at the systemic and practitioner level. The current article aims at understanding precision medicine and outlining an implementation procedure in the perioperative setting. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Techniques and Monitoring Source Type: research
Cricoid Pressure Controversies: Narrative Review
(Abstracted from Anesthesiology, 126(4):738–752, 2017)
This narrative review summarizes and addresses the effectiveness, controversies, and potential complications associated with the use of cricoid pressure (CP) in clinical practice. B. A. Sellick, who devised this maneuver in 1961, demonstrated that firm CP on a cadaver prevented stomach contents being regurgitated to the pharynx even with prior stomach distension (with water) and maintaining the steep Trendelenburg tilt. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Techniques and Monitoring Source Type: research
Determination of Perioperative Blood Loss: Accuracy or Approximation?
(Abstracted from Anesth Analg, 125(1):280–286, 2017)
The purpose of this research was to evaluate the accuracy of different perioperative blood loss calculation methods from previous clinical trials with new formulas. With more complex surgeries happening, blood loss is a major cause for adverse events; hence, a criterion standard to estimate blood loss and manage it becomes crucial to optimize patient outcomes. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Techniques and Monitoring Source Type: research
Intraoperative Ketorolac Dose of 15 mg Versus the Standard 30 mg on Early Postoperative Pain After Spine Surgery: A Randomized, Blinded, Non-inferiority Trial
(Abstracted from J Clin Anesth, 41:11–15, 2017)
Opioids are used for acute postoperative pain management despite significant disadvantages (nausea, vomiting, ileus, urinary retention, excess sedation, and respiratory depression) associated with their use. Nonsedating nonopioid analgesic agents, such as nonsteroidal anti-inflammatory drugs, are a prospective alternative treatment for pain after surgery. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Techniques and Monitoring Source Type: research
Safe Performance of Peripheral Regional Anaesthesia: The Significance of Ultrasound Guidance
(Abstracted from Anaesthesia, 72(4):431–434, 2017)
Ultrasound guidance has contributed toward making regional anaesthesia safer. Sermeus et al1 (“Ultrasound-Guided Approach to Nerves [Direct vs. Tangential] and the Incidence of Intraneural Injection: A Cadaveric Study”) evaluated the safety of ultrasound guidance in regional anaesthesia by comparing tangential and direct needle-to-nerve approach in nerve puncture and intraneural injection. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Regional Anesthesia and Pain Control Source Type: research
Ultrasound-Guided Approach to Nerves (Direct vs. Tangential) and the Incidence of Intraneural Injection: A Cadaveric Study
(Abstracted from Anaesthesia, 72(4):461–469, 2017)
Nerve puncture and/or intraneural injection, resulting from peripheral nerve block, is of major concern for every anesthetist, prevention of which could avoid long-term neurological complications. This cadaveric study evaluated the incidence of intraneural puncture and injection on the basis of direct and tangential approach to the nerves. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Regional Anesthesia and Pain Control Source Type: research
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
