journal
https://read.qxmd.com/read/37756499/the-physician-anesthesia-workforce-in-canada-from-1996-to-2018-a-longitudinal-analysis-of-health-administrative-data
#1
JOURNAL ARTICLE
Sarah Simkin, Beverley A Orser, C Ruth Wilson, Jason A McVicar, Mitchell Crozier, Ivy Lynn Bourgeault
BACKGROUND: A robust anesthesia workforce is essential to the provision of safe surgical, obstetrical, and critical care but information describing the physician anesthesia workforce and volume of clinical services delivered in Canada is limited. This study examines the Canadian physician anesthesia workforce, exploring trends in physician characteristics and activity levels over time. Practice patterns of specialist anesthesiologists and family physician anesthetists (FPAs) working in urban and rural communities were of particular interest...
September 27, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37756246/the-influence-of-electromyographic-on-electroencephalogram-based-monitoring-putting-the-forearm-on-the-forehead
#2
JOURNAL ARTICLE
Felicitas Lichtenfeld, Stephan Kratzer, Dominik Hinzmann, Paul S García, Gerhard Schneider, Matthias Kreuzer
BACKGROUND: Monitoring the electroencephalogram (EEG) during general anesthesia can help to safely navigate the patient through the procedure by avoiding too deep or light anesthetic levels. In daily clinical practice, the EEG is recorded from the forehead and available neuromonitoring systems translate the EEG information into an index inversely correlating with the anesthetic level. Electrode placement on the forehead can lead to an influence of electromyographic (EMG) activity on the recorded signal in patients without neuromuscular blockade (NMB)...
September 27, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37756245/occupational-factors-associated-with-time-to-breastfeeding-discontinuation-after-return-to-work-among-female-anesthesiologists-in-china-a-nationwide-survey
#3
JOURNAL ARTICLE
Xiaohan Xu, Ruiqi Wang, Yuelun Zhang, Juan Li, Hange Li, Xuerong Yu, Jiao Zhang, Xu Li, Yuguang Huang
BACKGROUND: Breast milk is of great benefit to both infants and mothers. Due to occupational barriers, female physicians are at high risk of unintentionally discontinuing breastfeeding. However, evidence among anesthesiologists was limited. The purpose of this study was to investigate occupational factors associated with time to breastfeeding discontinuation among female anesthesiologists following maternity leave in China. METHODS: We conducted a nationwide survey of female anesthesiologists who had given birth since January 1, 2015...
September 27, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37733945/influence-of-intravenous-s-ketamine-on-the-pharmacokinetics-of-oral-morphine-in-healthy-volunteers
#4
JOURNAL ARTICLE
Terhi J Lohela, Satu Poikola, Daniel Backmansson, Outi Lapatto-Reiniluoto, Janne T Backman, Klaus T Olkkola, Tuomas O Lilius
BACKGROUND: Subanesthetic ketamine may reduce perioperative consumption of opioids. We studied whether intravenous S-ketamine alters the pharmacokinetics of oral morphine in healthy volunteers. METHODS: In this paired, randomized, double-blind, crossover trial, 12 participants under a 2-hour intravenous S-ketamine (0.57 mg/kg/h) or placebo infusion received oral morphine (0.2 mg/kg) at 30 minutes. Plasma concentrations of ketamine, morphine, and their major metabolites were quantified for 24 hours...
September 21, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37733944/administration-of-milrinone-following-tetralogy-of-fallot-repair-increases-postoperative-volume-administration-without-improving-cardiac-output
#5
JOURNAL ARTICLE
Kwannapas Saengsin, Francesca Sperotto, Minmin Lu, Julia Garcia Mancebo, Elizabeth Sacco, Manasee Godsay, James A DiNardo, John N Kheir
BACKGROUND: Phosphodiesterase inhibitors are known to relieve symptoms in the setting of heart failure, although their effects in restrictive ventricular physiology have been poorly characterized. We explored the association between the use of milrinone and volume administration during the first 72 hours following surgical repair of tetralogy of Fallot (TOF). METHODS: We reviewed all cases of primary surgical repair of TOF with pulmonary stenosis or atresia at Boston Children's Hospital between 2011 and 2020...
September 21, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37733625/meeting-report-11th-and-12th-annual-meetings-of-the-society-of-anesthesia-and-sleep-medicine-taking-sleep-health-into-the-next-decade
#6
JOURNAL ARTICLE
Ameya Pappu, Satya Krishna Ramachandran, Dennis Auckley, Christine Won, Bhargavi Gali, Mary Hargett, Olubukola Nafiu, Jennifer Dominguez, Mandeep Singh
No abstract text is available yet for this article.
September 21, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37733624/arterial-hyperoxemia-during-cardiopulmonary-bypass-was-not-associated-with-worse-postoperative-pulmonary-function-a-retrospective-cohort-study
#7
JOURNAL ARTICLE
Marta Kelava, Adam J Milam, Junhui Mi, Andrej Alfirevic, Patrick Grady, Shinya Unai, Haytham Elgharably, Kenneth McCurry, Marijan Koprivanac, Andra Duncan
BACKGROUND: Arterial hyperoxemia may cause end-organ damage secondary to the increased formation of free oxygen radicals. The clinical evidence on postoperative lung toxicity from arterial hyperoxemia during cardiopulmonary bypass (CPB) is scarce, and the effect of arterial partial pressure of oxygen (Pao2) during cardiac surgery on lung injury has been underinvestigated. Thus, we aimed to examine the relationship between Pao2 during CPB and postoperative lung injury. Secondarily, we examined the relationship between Pao2 and global (lactate), and regional tissue malperfusion (acute kidney injury)...
September 21, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37713332/associations-between-fresh-gas-flow-and-duration-of-anesthetic-on-the-maximum-potential-benefit-of-anesthetic-gas-capture-in-operating-rooms-and-in-postanesthesia-care-units-to-capture-waste-anesthetic-gas
#8
JOURNAL ARTICLE
Franklin Dexter, Richard H Epstein
BACKGROUND: Sevoflurane and desflurane are halogenated hydrocarbons with global warming potential. We examined the maximum potential benefit assuming 100% efficiency of waste gas capture technology used in operating rooms and recovery locations. METHODS: We performed computer simulations of adult patients using the default settings of the Gas Man software program, including the desflurane vaporizer setting of 9% and the sevoflurane vaporizer setting of 3.7%. We performed 21 simulations with desflurane and 21 simulations with sevoflurane, the count of 21 = 1 simulation with 0-hour maintenance + (1, 2, 3, 4, or 5 hours of maintenance) × (0...
September 15, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37713329/postanesthesia-care-unit-recovery-time-according-to-volatile-anesthetic-used-in-clinical-practice
#9
JOURNAL ARTICLE
Juraj Sprung, Atousa Deljou, David O Warner, Darrell R Schroeder, Toby N Weingarten
BACKGROUND: Whether volatile anesthetic solubility affects postanesthesia recovery time in clinical practice is unclear. We investigated the association among 3 volatile agents and 2 clinically relevant outcomes-postanesthesia care unit (PACU) recovery time (time from PACU admission to fulfillment of discharge criteria) and oversedation (Richmond Agitation-Sedation Scale score ≤-3)-as a potential contributor to delaying PACU discharge. The volatile agents studied were isoflurane, desflurane, and sevoflurane...
September 15, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37713328/sex-specific-associations-between-preoperative-hemoglobin-and-outcomes-after-major-noncardiac-surgery-a-retrospective-cohort-study
#10
JOURNAL ARTICLE
Bing-Cheng Zhao, Shao-Hui Lei, Jia-Ming Liu, Shi-Da Qiu, Zhi-Wen Yao, Jian Liu, Fan Deng, Zhi-Hao Li, Ke-Xuan Liu
BACKGROUND: Preoperative anemia is an established risk factor for morbidity and mortality after surgery. Men and women have different hemoglobin concentrations and are at different risks of postoperative complications. However, sex-stratified analysis on the association between preoperative hemoglobin and outcomes after noncardiac surgery has been limited in previous studies. METHODS: This was a retrospective cohort study of adult patients undergoing elective major noncardiac surgery in a large academic hospital...
September 15, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37703209/the-infinite-game-one-possible-future-of-anesthesia-in-the-united-states
#11
JOURNAL ARTICLE
D Matthew Sherrer, Richard P Dutton, Nirav Kamdar, Lynn Reede, Mitchell H Tsai, Dan E Berkowitz, Thomas R Vetter
No abstract text is available yet for this article.
September 13, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37678264/hyperoxia-increases-kidney-injury-during-renal-ischemia-and-reperfusion-in-mice
#12
JOURNAL ARTICLE
Melissa J Kimlinger, Tom J No, Eric H Mace, Rachel D Delgado, Marcos G Lopez, Mark P de Caestecker, Frederic T Billings
BACKGROUND: Renal ischemia and reperfusion (IR) contribute to perioperative acute kidney injury, and oxygen is a key regulator of this process. We hypothesized that oxygen administration during surgery and renal IR would impact postoperative kidney function and injury in mice. METHODS: Mice were anesthetized, intubated, and mechanically ventilated with a fraction of inspired oxygen (Fio2) 0.10 (hypoxia), 0.21 (normoxia), 0.60 (moderate hyperoxia), or 1.00 (severe hyperoxia) during 67 minutes of renal IR or sham IR surgery...
September 4, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37678254/does-anesthesia-quality-improvement-participation-lead-to-incremental-savings-in-a-surgical-quality-collaborative-population-a-retrospective-observational-study
#13
JOURNAL ARTICLE
Allison M Janda, Michelle T Vaughn, Douglas A Colquhoun, Graciela Mentz, Kathryn Buehler, Hari Nathan, Scott E Regenbogen, John Syrjamaki, Sachin Kheterpal, Nirav Shah
BACKGROUND: The Anesthesiology Performance Improvement and Reporting Exchange (ASPIRE) Collaborative Quality Initiative (CQI) was launched as a partnership among hospitals to measure quality, review evidence-based practices, and improve anesthesia-related outcomes. Cost savings and improved patient outcomes have been associated with surgical CQI participation, but the impact of an anesthesia CQI on health care cost has not been thoroughly assessed. In this study, we evaluated whether participation in an anesthesia CQI led to health care savings...
September 4, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37678233/virtual-reality-distraction-for-reducing-acute-postoperative-pain-after-hip-arthroplasty-a-randomized-trial
#14
JOURNAL ARTICLE
Jorge Araujo-Duran, Orkun Kopac, Mateo Montalvo Campana, Omer Bakal, Daniel I Sessler, Richard L Hofstra, Karan Shah, Alparslan Turan, Sabry Ayad
BACKGROUND: Relaxation and distraction provided by virtual reality presentations might be analgesic and reduce the need for opioid analgesia. We tested the hypothesis that a virtual reality program (AppliedVR) decreases acute postoperative pain and opioid requirements in patients recovering from hip arthroplasty. We also evaluated whether virtual reality distraction improves patient mobility and reduces the need for antiemetics. METHODS: We evaluated 106 adults who were recovering from elective primary total hip arthroplasty...
September 4, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37678224/mechanism-based-modeling-of-perioperative-variations-in-hemoglobin-concentration-in-patients-undergoing-laparoscopic-surgery
#15
JOURNAL ARTICLE
Sebastian Jaramillo, Nicolás Marco-Ariño, Mar Montane-Muntane, Annabel Blasi, Ricard Navarro-Ripoll, Claudia de Peray-Bruel, Isabel Vila-Cullell, Pedro L Gambús, Iñaki F Troconiz
BACKGROUND: Hemoglobin concentration ([Hb]) in the perioperative setting should be interpreted in the context of the variables and processes that may affect it to differentiate the dilution effects caused by changes in intravascular volume. However, it is unclear what variables and processes affect [Hb]. Here, we modeled the perioperative variations in [Hb] to identify the variables and processes that govern [Hb] and to describe their effects. METHODS: We first constructed a mechanistic framework based on the main variables and processes related to the perioperative [Hb] variations...
September 4, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37582055/bispectral-index-changes-following-boluses-of-commonly-used-intravenous-medications-during-volatile-anesthesia-identified-from-retrospective-data
#16
JOURNAL ARTICLE
Michael P Schnetz, Brian J Reon, James W Ibinson, Murat Kaynar, Aman Mahajan, Keith M Vogt
BACKGROUND: Although patients are commonly monitored for depth of anesthesia, it is unclear to what extent administration of intravenous anesthetic medications may affect calculated bispectral (BIS) index values under general anesthesia. METHODS: In a retrospective analysis of electronic anesthesia records from an academic medical center, we examined BIS index changes associated with 14 different intravenous medications, as administered in routine practice, during volatile-based anesthesia using a novel screening approach...
August 15, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37678238/perioperative-anesthesia-related-complications-and-risk-factors-in-children-a-cross-sectional-observation-study-in-rwanda
#17
JOURNAL ARTICLE
Francoise Nizeyimana, Teresa Skelton, M Dylan Bould, Michael Beach, Theogene Twagirumugabe
BACKGROUND: Despite an increasing awareness of the unmet burden of surgical conditions, information on perioperative complications in children remains limited especially in low-income countries such as Rwanda. The objective of this study was to estimate the prevalence of perioperative anesthesia-related adverse events and to explore potential risk factors associated with them among pediatric surgical patients in public referral hospitals in Rwanda. METHODS: Data were collected for all patients under 5 years of age undergoing surgery in 3 public referral hospitals in Rwanda from June to December 2015...
August 14, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37553085/data-and-metrics-for-patient-blood-management-a-narrative-review-and-practical-guide
#18
JOURNAL ARTICLE
Kevin M Trentino, Adam Lloyd, Stuart G Swain, Laura Trentino, Irwin Gross
Data collection, analysis, and reporting are fundamental for a successful hospital-based patient blood management program; however, very little has been published on the topic. Our aim was to synthesize evidence from a literature review to provide a detailed, practical list of outcome metrics, and the required data collection(s) to inform implementation. Ovid MEDLINE and PubMed were searched for any full-text original research articles published from inception to the year 2020. We included any studies reporting the implementation of interventions or programs study authors defined as "patient blood management" and extracted information on data collected and metrics reported...
August 8, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37553083/detection-of-postpartum-hemorrhage-using-compensatory-reserve-index-in-patients-undergoing-cesarean-delivery
#19
JOURNAL ARTICLE
Marina L Reppucci, Jonathan Seth Rogerson, Kaci Pickett, Stephanie Kierstead, Margo M Nolan, Steven L Moulton, Cristina L Wood
BACKGROUND: Postpartum hemorrhage (PPH) is the leading cause of maternal death worldwide. Early recognition and management are imperative for improved outcomes. The compensatory reserve index (CRI) is a novel physiological parameter that trends changes in intravascular volume, by continuously comparing extracted photoplethysmogram waveforms to a reference model that was derived from a human model of acute blood loss. This study sought to determine whether the CRI pattern was differential between those who do and do not experience PPH during cesarean delivery and compare these results to the American Society of Anesthesiologists (ASA) standards for noninvasive monitoring...
August 8, 2023: Anesthesia and Analgesia
https://read.qxmd.com/read/37478047/platelet-transfusion-in-cardiac-surgery-an-entropy-balanced-weighted-multicenter-analysis
#20
JOURNAL ARTICLE
Calvin M Fletcher, Jake V Hinton, Zhongyue Xing, Luke A Perry, Noah Greifer, Alexandra Karamesinis, Jenny Shi, Jahan C Penny-Dimri, Dhruvesh Ramson, Zhengyang Liu, Jenni Williams-Spence, Reny Segal, Julian A Smith, Tim G Coulson, Rinaldo Bellomo
BACKGROUND: Platelet transfusion is common in cardiac surgery, but some studies have suggested an association with harm. Accordingly, we investigated the association of perioperative platelet transfusion with morbidity and mortality. METHODS: We conducted a retrospective analysis of prospectively collected data from the Australian Society of Cardiac and Thoracic Surgeons National Cardiac Surgery Database. We included consecutive adults from 2005 to 2018 across 40 centers...
July 21, 2023: Anesthesia and Analgesia
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