Anesthesia and Analgesia

Weiyun Chen, Yuguang Huang
The Coronavirus Disease 2019 (COVID-19) pandemic has thus far caused a total of 81,747 confirmed cases with 3,283 deaths in China, and more than 370,000 confirmed cases including over 16,000 deaths around the world by March 24, 2020. This issue has received extensive attention from the international community and has become a major public health priority. As the pandemic progresses, it is regrettable to know the healthcare workers, including anesthesiologists, being infected constantly. Therefore, we would like to share our firsthand practical experience and perspective in China, focusing on the personal protection of healthcare workers and the risk factors related to their infection, based on the different stages of the COVID-19 epidemic in China...
March 30, 2020: Anesthesia and Analgesia
Olubukola O Nafiu, Aleda M Leis, Wendy Wang, Matthew Wixson, Lara Zisblatt
BACKGROUND: The critical question of racial and gender diversity in pediatric anesthesia training programs has not been previously explored. The primary objective of this study was to evaluate trends by race/ethnicity and gender in pediatric anesthesiology fellowship training programs in the United States for the years 2000 to 2018. METHODS: Demographic data on pediatric anesthesiology fellows and anesthesiology residents were obtained from the self-reported data collected for the Journal of the American Medical Association's annual report on Graduate Medical Education for the years 2000 to 2018...
March 27, 2020: Anesthesia and Analgesia
Laurent Zieleskiewicz, Mickael Papinko, Alexandre Lopez, Alice Baldovini, David Fiocchi, Zoe Meresse, Alain Boussuges, Pascal Alexandre Thomas, Stephane Berdah, Ben Creagh-Brown, Belaid Bouhemad, Emmanuel Futier, Noémie Resseguier, François Antonini, Gary Duclos, Marc Leone
BACKGROUND: Postoperative pulmonary complications are associated with increased morbidity. Identifying patients at higher risk for such complications may allow preemptive treatment. METHODS: Patients with an American Society of Anesthesiologists (ASA) score >1 and who were scheduled for major surgery of >2 hours were enrolled in a single-center prospective study. After extubation, lung ultrasound was performed after a median time of 60 minutes by 2 certified anesthesiologists in the postanesthesia care unit after a standardized tracheal extubation...
March 27, 2020: Anesthesia and Analgesia
Hanae Tokita, Rebecca Twersky, Vincent Laudone, Marcia Levine, Daniel Stein, Peter Scardino, Brett A Simon
Minimally invasive operative techniques and enhanced recovery after surgery (ERAS) protocols have transformed clinical practice and made it possible to perform increasingly complex oncologic procedures in the ambulatory setting, with recovery at home after a single overnight stay. Capitalizing on these changes, Memorial Sloan Kettering Cancer Center's Josie Robertson Surgery Center (JRSC), a freestanding ambulatory surgery facility, was established to provide both outpatient procedures and several surgeries that had previously been performed in the inpatient setting, newly transitioned to this ambulatory extended recovery (AXR) model...
March 27, 2020: Anesthesia and Analgesia
Yi Sun, Fan Ye, Jing Wang, Pan Ai, Changwei Wei, Anshi Wu, Wuxiang Xie
BACKGROUND: Postoperative delirium is a major debilitating complication for patients and is associated with poor outcomes. Previous studies have suggested that excessive general anesthesia may lead to postoperative delirium. Electroencephalography (EEG)-based monitors have been administered in clinical practice in an attempt to deliver appropriate anesthesia. The aim of this updated meta-analysis was to evaluate the current body of research concerning the effects of EEG-based monitor on postoperative delirium...
March 27, 2020: Anesthesia and Analgesia
Melissa E Bauer, Ruth Chiware, Carlo Pancaro
No abstract text is available yet for this article.
March 26, 2020: Anesthesia and Analgesia
Franklin Dexter, Michelle C Parra, Jeremiah R Brown, Randy W Loftus
We describe an evidence-based approach for optimization of infection control and operating room management during the COVID-19 pandemic. Confirmed modes of viral transmission are primarily but not exclusively contact with contaminated environmental surfaces and aerosolization. Evidence-based improvement strategies for attenuation of residual environmental contamination involve a combination of deep cleaning with surface disinfectants and ultraviolet light (UV-C). (1) Place alcohol-based hand rubs on the IV pole to the left of the provider...
March 26, 2020: Anesthesia and Analgesia
Phillip Sommer, Elvedin Lukovic, Eliot Fagley, Dustin Long, Julia Sobol, Katherine Heller, Vivek Moitra, Ronald Pauldine, Michael O'Connor, Sajid Shahul, Mark Nunnally, Avery Tung
Since the first recognition of a cluster of novel respiratory viral infections in China in late December, 2019, intensivists in the United States have watched with growing concern as infections with the SARS-CoV-2 virus-now named Coronavirus disease of 2019 (COVID-19) -have spread to hospitals in the United States (US). Because COVID-19 is extremely transmissible and can progress to a severe form of respiratory failure, the potential to overwhelm available critical care resources is high and critical care management of COVID-19 patients has been thrust into the spotlight...
March 25, 2020: Anesthesia and Analgesia
Jonathan H Chow, Michael A Mazzeffi, Michael T McCurdy
No abstract text is available yet for this article.
March 23, 2020: Anesthesia and Analgesia
Beverley A Orser
No abstract text is available yet for this article.
March 23, 2020: Anesthesia and Analgesia
Georges Mion, Jean Le Masson, Claire Granier, Clément Hoffmann
No abstract text is available yet for this article.
March 12, 2020: Anesthesia and Analgesia
Duncan Maguire, Douglas Maguire
No abstract text is available yet for this article.
March 12, 2020: Anesthesia and Analgesia
Kurt Ruetzler, Eva Rivas, Barak Cohen, Lauretta Mosteller, Adriana Martin, Allen Keebler, Kamal Maheshwari, Karen Steckner, Mi Wang, Chahar Praveen, Sandeep Khanna, Natalya Makarova, Daniel I Sessler, Alparslan Turan
BACKGROUND: Two-thirds of the US population is considered obese and about 8% morbidly obese. Obese patients may present a unique challenge to anesthesia clinicians in airway management. Videolaryngoscopes may provide better airway visualization, which theoretically improves intubation success. However, previous work in morbidly obese patients was limited. We therefore tested the primary hypothesis that the use of McGrath video laryngoscope improves visualization of the vocal cords versus Macintosh direct laryngoscopy (Teleflex, Morrisville, NC) in morbidly obese patients...
March 12, 2020: Anesthesia and Analgesia
Sebastiano Mercadante
No abstract text is available yet for this article.
March 12, 2020: Anesthesia and Analgesia
Gertrude N Marun, Wayne W Morriss, Jessica S Lim, Jacqueline L Morriss, C Roger Goucke
Papua New Guinea (PNG) is a low-resource country in the South-West Pacific with considerable health care challenges, including a high burden of painful disease. The Essential Pain Management (EPM) educational program was developed to address the challenge of inadequate pain education in PNG and the first workshop was held in 2010. The aims of EPM are to improve pain knowledge, teach a simple system for managing pain, and address local pain management barriers. It is usually delivered as an interactive, multidisciplinary 1-day workshop with an emphasis on developing local solutions to local problems...
March 12, 2020: Anesthesia and Analgesia
Jonathan H Chow, Michael A Mazzeffi, Kenichi A Tanaka
No abstract text is available yet for this article.
March 12, 2020: Anesthesia and Analgesia
Lisa M Stearns
No abstract text is available yet for this article.
March 12, 2020: Anesthesia and Analgesia
Matthew A Warner, Linda Shore-Lesserson, Aryeh Shander, Sephalie Y Patel, Seth I Perelman, Nicole R Guinn
Anemia is common in the perioperative period and is associated with poor patient outcomes. Remarkably, anemia is frequently ignored until hemoglobin levels drop low enough to warrant a red blood cell transfusion. This simplified transfusion-based approach has unfortunately shifted clinical focus away from strategies to adequately prevent, diagnose, and treat anemia through direct management of the underlying cause(s). While recommendations have been published for the treatment of anemia before elective surgery, information regarding the design and implementation of evidence-based anemia management strategies is sparse...
March 9, 2020: Anesthesia and Analgesia
Elina C V Brinck, Kreu Maisniemi, Jyrki Kankare, Laura Tielinen, Pekka Tarkkila, Vesa K Kontinen
BACKGROUND: Severe pain often accompanies major spine surgery. Opioids are the cornerstone of postoperative pain management but their use can be limited by numerous side effects. Several studies claim that adjuvant treatment with intravenous (IV) ketamine reduces opioid consumption and pain after back surgery. However, the exact role of ketamine for this indication is yet to be elucidated. We compared 2 different doses of S-ketamine with placebo on postoperative analgesic consumption, pain, and adverse events in adult, opioid-naïve patients after lumbar fusion surgery...
March 9, 2020: Anesthesia and Analgesia
Natalie K Smith, Jeron Zerillo, Sang Jo Kim, Guy E Efune, Cynthia Wang, Sher-Lu Pai, Ryan Chadha, Todd M Kor, David R Wetzel, Michael A Hall, Kristen K Burton, Kyota Fukazawa, Bryan Hill, Mia-Ashley Spad, David B Wax, Hung-Mo Lin, Xiaoyu Liu, Jaffer Odeh, Laurence Torsher, James D Kindscher, M Susan Mandell, Tetsuro Sakai, Samuel DeMaria
BACKGROUND: Intraoperative cardiac arrest (ICA) has a reported frequency of 1 in 10,000 anesthetics but has a much higher estimated incidence in orthotopic liver transplantation (OLT). Single-center studies of ICA in OLT are limited by small sample size that prohibits multivariable regression analysis of risks. METHODS: Utilizing data from 7 academic medical centers, we performed a retrospective, observational study of 5296 adult liver transplant recipients (18-80 years old) between 2000 and 2017 to identify the rate of ICA, associated risk factors, and outcomes...
March 9, 2020: Anesthesia and Analgesia
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