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
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
