journal
https://read.qxmd.com/read/38842001/environmental-impact-of-anesthetic-drugs
#1
JOURNAL ARTICLE
Diane W Gordon
PURPOSE OF REVIEW: The environmental impact of anesthesia far exceeds that of other medical specialties due to our use of inhaled anesthetic agents (which are potent greenhouse gases) and many intravenous medications. RECENT FINDINGS: Calls for reducing the carbon footprint of anesthesia are ubiquitous in the anesthesia societies of developed nations and are appearing in proposed changes for hospital accreditation and funding in the United States. The body of research on atmospheric, land and water impacts of anesthetic pharmaceuticals is growing and generally reinforces existing recommendations to reduce the greenhouse gas emissions of anesthesia care...
June 5, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38841986/remifentanil-induced-hyperalgesia-the-current-state-of-affairs
#2
JOURNAL ARTICLE
Alexander A Vitin, Talmage D Egan
Remifentanil-induced hyperalgesia (RIH) is a part of a general opioid-induced hyperalgesia (OIH) syndrome, seemingly resulting from abrupt cessation of continuous remifentanil infusion at rates equal or exceeding 0.3 mcg/kg/min. The intricate mechanisms of its development are still not completely understood. However, hyperactivation of the N-methyl d-aspartate receptor system, descending spinal facilitation and increased concentration of dynorphin (a κ-opioid ligand) are commonly proposed as possible mechanisms...
June 4, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38841922/the-way-towards-ethical-anesthesia-care-no-aim-no-game-no-fame-or-blame
#3
JOURNAL ARTICLE
Basak Ceyda Meco, Cigdem Yildirim Guclu, Joana Berger-Estilita, Finn M Radtke
PURPOSE OF REVIEW: This review explores the intricacies of ethical anesthesia, exploring the necessity for precision anesthesia and its impact on patient-reported outcomes. The primary objective is to advocate for a defined aim, promoting the implementation of rules and feedback systems. The ultimate goal is to enhance precision anesthesia care, ensuring patient safety through the implementation of a teamwork and the integration of feedback mechanisms. RECENT FINDINGS: Recent strategies in the field of anesthesia have evolved from intraoperative monitorization to a wider perioperative patient-centered precision care...
June 4, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38841921/sugammadex-and-oral-contraceptives
#4
JOURNAL ARTICLE
Tamblyn Devoy, Natalie Smith
PURPOSE OF REVIEW: This review article explores the evidence regarding sugammadex (MSD Australia) and its potential interaction with hormonal contraceptives. The impact of recent clinical trials and review articles is examined. RECENT FINDINGS: Recent clinical data suggest that the interaction between sugammadex and estrogen and progesterone concentrations may not be clinically significant and may confer some protection against ovulation. There are no clinical trials reporting interactions between sugammadex and the exogenous hormonal compounds found in oral contraceptive pills...
June 4, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38841991/the-drug-titration-paradox-a-control-engineering-perspective
#5
JOURNAL ARTICLE
Elie Sarraf
PURPOSE OF REVIEW: The drug titration paradox describes that, from a population standpoint, drug doses appear to have a negative correlation with its clinical effect. This paradox is a relatively modern discovery in anesthetic pharmacology derived from large clinical data sets. This review will interpret the paradox using a control engineering perspective. RECENT FINDINGS: Drug titration is a challenging endeavor, and the medication delivery systems used in everyday clinical practice, including infusion pumps and vaporizers, typically do not allow for rapid or robust titration of medication being delivered...
May 30, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38841919/progress-in-the-validation-of-nociception-monitoring-in-guiding-intraoperative-analgesic-therapy
#6
JOURNAL ARTICLE
Hendrik Van Santvliet, Hugo E M Vereecke
PURPOSE OF REVIEW: This article summarizes the current level of validation for several nociception monitors using a categorized validation process to facilitate the comparison of performance. RECENT FINDINGS: Nociception monitors improve the detection of a shift in the nociception and antinociception balance during anesthesia, guiding perioperative analgesic therapy. A clear overview and comparison of the validation process for these monitors is missing. RESULTS: Within a 2-year time-frame, we identified validation studies for four monitors [analgesia nociception index (ANI), nociception level monitor (NOL), surgical pleth index (SPI), and pupillometry]...
May 30, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38841992/postoperative-pain-management-after-abdominal-transplantations
#7
JOURNAL ARTICLE
Boris Tufegdzic, Clara Lobo, Arun Kumar
PURPOSE OF REVIEW: The aim of this review article is to present current recommendations as well as knowledge gaps and controversies pertaining to commonly utilized postoperative pain management after solid organ transplantation in the abdominal cavity. RECENT FINDINGS: Postsurgical pain has been identified as one of the major challenges in recovery and treatment after solid organ transplants. Many perioperative interventions and management strategies are available for reducing and managing postoperative pain...
May 22, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38841917/long-term-intravenous-devices-a-narrative-review-of-their-placement
#8
JOURNAL ARTICLE
Sabine Roche
PURPOSE OF REVIEW: This review summarizes the latest findings and recommendations about the characteristics, indications and use of peripheral and central long-term venous access devices.The various complications inherent in these devices are becoming better known, and their contributing factors determined, which could make it possible to reduce their incidence. RECENT FINDINGS: Some measures are integrated into recommendations for good practice, such as appropriate selection of devices, the preferential use of the thinnest catheters, and cyanoacrylate glue and dressings impregnated with chlorhexidine...
May 14, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38841911/opioid-free-general-anesthesia-considerations-techniques-and-limitations
#9
JOURNAL ARTICLE
Harsha Shanthanna, Girish P Joshi
PURPOSE OF REVIEW: To discuss the role of opioids during general anesthesia and examine their advantages and risks in the context of clinical practice. We define opioid-free anesthesia (OFA) as the absolute avoidance of intraoperative opioids. RECENT FINDINGS: In most minimally invasive and short-duration procedures, nonopioid analgesics, analgesic adjuvants, and local/regional analgesia can significantly spare the amount of intraoperative opioid needed. OFA should be considered in the context of tailoring to a specific patient and procedure, not as a universal approach...
May 10, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38841907/remimazolam-its-clinical-pharmacology-and-evolving-role-in-anesthesia-and-sedation-practice
#10
JOURNAL ARTICLE
Kenichi Masui
PURPOSE OF REVIEW: Remimazolam is a novel benzodiazepine anesthetic/sedative, designed as a rapidly metabolized carboxylic acid. Since its recent launch, the role of remimazolam in modern anesthesia and sedation practice is still evolving. This review aims to outline the clinical pharmacology and clinical utility of remimazolam to elucidate its potential advantages and limitations. RECENT FINDINGS: Remimazolam is "short-acting" but not ultra-short-acting compared with propofol based on context-sensitive decrement times...
May 8, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38841982/why-sedative-hypnotics-often-fail-in-development
#11
JOURNAL ARTICLE
J Robert Sneyd
PURPOSE OF REVIEW: Drug development to support anaesthesia and sedation has been slow with few candidates emerging from preclinical discovery and limited innovation beyond attempted reformulation of existing compounds. RECENT FINDINGS: The market is well supported by low-cost generic products and development compounds have not been shown to improve patient outcomes or possess other distinctive characteristics to justify the cost of development. SUMMARY: To make progress in a large-volume, low margin and highly competitive environment requires meaningful advances in relevant basic science...
May 6, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38841978/patient-selection-for-nonoperating-room-anesthesia
#12
JOURNAL ARTICLE
Paige L Georgiadis, Mitchell H Tsai, Justin S Routman
PURPOSE OF REVIEW: Given the rapid growth of nonoperating room anesthesia (NORA) in recent years, it is essential to review its unique challenges as well as strategies for patient selection and care optimization. RECENT FINDINGS: Recent investigations have uncovered an increasing prevalence of older and higher ASA physical status patients in NORA settings. Although closed claim data regarding patient injury demonstrate a lower proportion of NORA cases resulting in a claim than traditional operating room cases, NORA cases have an increased risk of claim for death...
May 6, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38841990/place-of-high-flow-nasal-oxygen-in-nonoperating-room-anesthesia
#13
JOURNAL ARTICLE
Mai-Anh Nay, Adrien Auvet
PURPOSE OF REVIEW: This article aims to assess the utility of high-flow nasal oxygen (HFNO) therapy in nonoperating room anesthesia (NORA) settings. RECENT FINDINGS: The number of procedural interventions under deep sedation in NORA is still increasing. Administration of oxygen is recommended to prevent hypoxemia and is usually delivered with standard oxygen through nasal cannula or a face mask. HFNO is a simple alternative with a high warmed humidified flow (ranging from 30 to 70 l/min) with a precise fraction inspired of oxygen (ranging from 21 to 100%)...
May 1, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38654545/anesthesia-unveiled-navigating-challenges-posed-by-medical-diseases
#14
EDITORIAL
Omonele Nwokolo
No abstract text is available yet for this article.
June 1, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38654544/strategies-to-increase-patient-safety-in-obstetric-anesthesia
#15
EDITORIAL
Vanessa Neef
No abstract text is available yet for this article.
June 1, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38573191/simulation-in-pediatric-anesthesiology-current-state-and-visions-for-the-future
#16
REVIEW
Rodrigo J Daly Guris, Preeta George, Harshad G Gurnaney
PURPOSE OF REVIEW: Simulation is a well established practice in medicine. This review reflects upon the role of simulation in pediatric anesthesiology in three parts: training anesthesiologists to care for pediatric patients safely and effectively; evaluating and improving systems of care for children; and visions for the future. RECENT FINDINGS: Simulation continues to prove a useful modality to educate both novice and experienced clinicians in the perioperative care of infants and children...
June 1, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38573182/point-of-care-ultrasound-in-pediatric-anesthesiology-considerations-for-training-and-credentialing
#17
REVIEW
Thomas J Lockhart, Elaina E Lin, Adam C Adler
PURPOSE OF REVIEW: To discuss considerations surrounding the use of point-of-care ultrasound (POCUS) in pediatric anesthesiology. RECENT FINDINGS: POCUS is an indispensable tool in various medical specialties, including pediatric anesthesiology. Credentialing for POCUS should be considered to ensure that practitioners are able to acquire images, interpret them correctly, and use ultrasound to guide procedures safely and effectively. In the absence of formal guidelines for anesthesiology, current practice and oversight varies by institution...
June 1, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38573180/obesity-and-anesthesia
#18
REVIEW
Lovkesh Arora, Surangama Sharma, James F Carillo
PURPOSE OF REVIEW: Surgical procedures on obese patients are dramatically increasing worldwide over the past few years. In this review, we discuss the physiopathology of predominantly respiratory system in obese patients, the importance of preoperative evaluation, preoxygenation and intraoperative positive end expiratory pressure (PEEP) titration to prevent pulmonary complications and the optimization of airway management and oxygenation to reduce or prevent postoperative respiratory complications...
June 1, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38573179/perioperative-pain-optimization-in-the-age-of-the-opioid-epidemic
#19
REVIEW
Janki Patel, Kyle Snyder, Amber K Brooks
PURPOSE OF REVIEW: The opioid epidemic remains a constant and increasing threat to our society with overdoses and overdose deaths rising significantly during the COVID-19 pandemic. Growing evidence suggests a link between perioperative opioid use, postoperative opioid prescribing, and the development of opioid use disorder (OUD). As a result, strategies to better optimize pain management during the perioperative period are urgently needed. The purpose of this review is to summarize the most recent multimodal analgesia (MMA) recommendations, summarize evidence for efficacy surrounding the increased utilization of Enhanced Recovery After Surgery (ERAS) protocols, and discuss the implications for rising use of buprenorphine for OUD patients who present for surgery...
June 1, 2024: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/38573178/chronic-pain-in-pediatric-patients-epidemiology-pathophysiology-and-mitigation-strategies
#20
REVIEW
Andrea Rodriguez-Restrepo, Jacob D AuBuchon
PURPOSE OF REVIEW: To provide an updated summary on the epidemiology, pathophysiology, and treatment strategies of chronic pain in pediatric patients and its differences with chronic pain in adults. RECENT FINDINGS: Chronic pain in children is common, can be debilitating and can progress into adulthood, thus it requires an interdisciplinary evaluation and management. Targeting interdisciplinary care, including psychology, physical, and/or occupational therapy, has been shown to improve pain and function...
June 1, 2024: Current Opinion in Anaesthesiology
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