Stephen J Gleich, Ashley V Wong, Kathryn S Handlogten, Daniel E Thum, Michael E Nemergut
BACKGROUND: Perioperative arterial cannulation in children is routinely performed. Based on clinical observation of several complications related to femoral arterial lines, the authors performed a larger study to further examine complications. The authors aimed to (1) describe the use patterns and incidence of major short-term complications associated with arterial cannulation for perioperative monitoring in children, and (2) describe the rates of major complications by anatomical site and age category of the patient...
October 19, 2020: Anesthesiology
Beatrijs I Valk, Douglas J Eleveld, Peter Meyer, Sascha Meier, Izaak den Daas, Kai van Amsterdam, Jason A Campagna, Steven P Sweeney, Anthony R Absalom, Michel M R F Struys
BACKGROUND: γ-Aminobutyric acid type A (GABAA) receptor agonists are known to cause involuntary muscle movements. The mechanism of these movements is not known, and its relationship to depth of anesthesia monitoring is unclear. We have explored the effect of involuntary muscle movement on the pharmacokinetic-pharmacodynamic model for the GABAA receptor agonist ABP-700 and its effects on the Bispectral Index (BIS) as well as the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scores...
October 16, 2020: Anesthesiology
Alexander J Butwick, Cynthia A Wong, Henry C Lee, Yair J Blumenfeld, Nan Guo
BACKGROUND: Up to 84% of women who undergo operative vaginal delivery receive neuraxial analgesia. However, little is known about the association between neuraxial analgesia and neonatal morbidity in women who undergo operative vaginal delivery. The authors hypothesized that neuraxial analgesia is associated with a reduced risk of neonatal morbidity among women undergoing operative vaginal delivery. METHODS: Using United States birth certificate data, the study identified women with singleton pregnancies who underwent operative vaginal (forceps- or vacuum-assisted delivery) in 2017...
October 12, 2020: Anesthesiology
Gen Li, Jonathan P Wanderer, Robert E Freundlich
No abstract text is available yet for this article.
October 9, 2020: Anesthesiology
Giacomo Deferrari, Alessio Signori, Alice Bonanni
No abstract text is available yet for this article.
October 9, 2020: Anesthesiology
Sachin Kheterpal, Michelle T Vaughn
No abstract text is available yet for this article.
October 9, 2020: Anesthesiology
Hiroshi Yonekura, Miho Sumiyoshi, Yasunori Matsunari, Michihiro Sakai, Masataka Kamei
No abstract text is available yet for this article.
October 9, 2020: Anesthesiology
George W Williams, Nathaniel K Berg, Alexander Reskallah, Xiaoyi Yuan, Holger K Eltzschig
No abstract text is available yet for this article.
October 5, 2020: Anesthesiology
Alan Walter Grogono, Iván Solarte
No abstract text is available yet for this article.
October 5, 2020: Anesthesiology
Shubham Chamadia, Lauren Hobbs, Sophia Marota, Reine Ibala, Eunice Hahm, Jacob Gitlin, Jennifer Mekonnen, Breanna Ethridge, Katia M Colon, Kimberly S Sheppard, Dara S Manoach, Alan DiBiasio, Sarah Nguyen, Juan C Pedemonte, Oluwaseun Akeju
BACKGROUND: The administration of dexmedetomidine is limited to highly monitored care settings because it is only available for use in humans as intravenous medication. An oral formulation of dexmedetomidine may broaden its use to all care settings. The authors investigated the effect of a capsule-based solid oral dosage formulation of dexmedetomidine on sleep polysomnography. METHODS: The authors performed a single-site, placebo-controlled, randomized, crossover, double-blind phase II study of a solid oral dosage formulation of dexmedetomidine (700 mcg; n = 15)...
October 1, 2020: Anesthesiology
Hao Li, Huiping Li, Jing Cheng, Xicheng Liu, Zhongjun Zhang, Chaoran Wu
BACKGROUND: Acid-sensing ion channel 3 (ASIC3) upregulation has been reported in dorsal root ganglion neurons after incision and contributes to postoperative nociception. This study hypothesized that upregulation of ASIC3 in incised tissues is induced by nerve growth factor through the phosphoinositide 3-kinase/protein kinase B signaling pathway. METHODS: A plantar incision model was established in adult male and female Sprague-Dawley rats. ASIC3 was inhibited by APETx2 treatment, small interfering RNA treatment, or ASIC3 knockout...
September 30, 2020: Anesthesiology
Jasper Kamp, Erik Olofsen, Thomas K Henthorn, Monique van Velzen, Marieke Niesters, Albert Dahan
BACKGROUND: Several models describing the pharmacokinetics of ketamine are published with differences in model structure and complexity. A systematic review of the literature was performed, as well as a meta-analysis of pharmacokinetic data and construction of a pharmacokinetic model from raw data sets to qualitatively and quantitatively evaluate existing ketamine pharmacokinetic models and construct a general ketamine pharmacokinetic model. METHODS: Extracted pharmacokinetic parameters from the literature (volume of distribution and clearance) were standardized to allow comparison among studies...
September 30, 2020: Anesthesiology
Carine Zeeni
No abstract text is available yet for this article.
September 29, 2020: Anesthesiology
Harsha Shanthanna, Karim S Ladha, Henrik Kehlet, Girish P Joshi
Opioids form an important component of general anesthesia and perioperative analgesia. Discharge opioid prescriptions are identified as a contributor for persistent opioid use and diversion. In parallel, there is increased enthusiasm to advocate opioid-free strategies, which include a combination of known analgesics and adjuvants, many of which are in the form of continuous infusions. This article critically reviews perioperative opioid use, especially in view of opioid-sparing versus opioid-free strategies...
September 29, 2020: Anesthesiology
Shubham Chamadia, Juan C Pedemonte, Lauren E Hobbs, Hao Deng, Sarah Nguyen, Luis I Cortinez, Oluwaseun Akeju
BACKGROUND: Dexmedetomidine is only approved for use in humans as an intravenous medication. An oral formulation may broaden the use and benefits of dexmedetomidine to numerous care settings. The authors hypothesized that oral dexmedetomidine (300 mcg to 700 mcg) would result in plasma concentrations consistent with sedation while maintaining hemodynamic stability. METHODS: The authors performed a single-site, open-label, phase I dose-escalation study of a solid oral dosage formulation of dexmedetomidine in healthy volunteers (n = 5, 300 mcg; followed by n = 5, 500 mcg; followed by n = 5, 700 mcg)...
September 28, 2020: Anesthesiology
Deepak Sharma
Aneurysmal subarachnoid hemorrhage is an acute neurologic emergency. Prompt definitive treatment of the aneurysm by craniotomy and clipping or endovascular intervention with coils and/or stents is needed to prevent rebleeding. Extracranial manifestations of aneurysmal subarachnoid hemorrhage include cardiac dysfunction, neurogenic pulmonary edema, fluid and electrolyte imbalances, and hyperglycemia. Data on the impact of anesthesia on long-term neurologic outcomes of aneurysmal subarachnoid hemorrhage do not exist...
September 28, 2020: Anesthesiology
Nathaniel J Brown
No abstract text is available yet for this article.
September 28, 2020: Anesthesiology
Philip E Bickler, John R Feiner, Michael S Lipnick, William McKleroy
No abstract text is available yet for this article.
September 24, 2020: Anesthesiology
Marcelo Gama de Abreu, Marcus J Schultz, Ary Serpa Neto, Paolo Pelosi
No abstract text is available yet for this article.
September 24, 2020: Anesthesiology
Kamal Maheshwari, Tetsuya Shimada, Dongsheng Yang, Sandeep Khanna, Jacek B Cywinski, Samuel A Irefin, Sabry Ayad, Alparslan Turan, Kurt Ruetzler, Yuwei Qiu, Partha Saha, Edward J Mascha, Daniel I Sessler
BACKGROUND: The Hypotension Prediction Index is a commercially available algorithm, based on arterial waveform features, that predicts hypotension defined as mean arterial pressure less than 65 mmHg for at least 1 min. We therefore tested the primary hypothesis that index guidance reduces the duration and severity of hypotension during noncardiac surgery. METHODS: We enrolled adults having moderate- or high-risk noncardiac surgery with invasive arterial pressure monitoring...
September 22, 2020: Anesthesiology
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