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This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 20.

Ultrasound-guided haemodynamic state assessmentemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
The haemodynamic state refers to the integration of myocardial and vascular systems, and involves both left and right hearts, and systolic and diastolic phases. The assessment of the haemodynamic state can be performed with echocardiography, and provides a higher level of diagnosis than conventional pressure- and flow-based monitoring. Whilst hypotension alerts the practitioner about the existence of haemodynamic abnormality, it does not provide sufficient information to identify the cause or the underlying haemodynamic state. The premise of haemodynamic state monitoring is that better diagnosis will lead to more rational ...
Source: Best Practice and Research. Clinical Anaesthesiology - August 31, 2009 Category: Anesthesiology Authors: Colin Forbes Royse Source Type: journals

Limited transthoracic echocardiography assessment in anaesthesia and critical careemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
The use of echocardiography in anaesthesia and critical care started with transoesophageal echocardiography, whereas transthoracic echocardiography was largely the domain of the cardiologist. In recent times, there has been a change in focus towards transthoracic echocardiography owing to the development of small and portable, yet high-fidelity, echocardiography machines. The cost has reduced, thereby increasing the availability of equipment. A parallel development has been the concept of limited transthoracic echocardiography that can be performed by practitioners with limited experience. The basis of these examinations i...
Source: Best Practice and Research. Clinical Anaesthesiology - August 31, 2009 Category: Anesthesiology Authors: John G. Faris, Michael G. Veltman, Colin F. Royse Source Type: journals

Ultrasound guided vascular access: efficacy and safetyemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This article summarises the literature on complication rates, efficacy and safety of ultrasound-guided vascular access procedures and describes a practical method of ultrasound-guided central venous access and arterial catheterisation.
Source: Best Practice and Research. Clinical Anaesthesiology - August 31, 2009 Category: Anesthesiology Authors: Ajay Kumar, Alwin Chuan Source Type: journals

Ultrasound-guided nerve blocks: efficacy and safetyemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This article focusses on the recent growing evidence to support the benefits of its use in nerve and plexus blocks. Common complications of nerve blocks can be avoided with ultrasound but have still been reported. Anatomical variants have been demonstrated by ultrasound and it has proved to be useful in performing regional anaesthesia in difficult situations or where peripheral nerve stimulation is unsuccessful or inappropriate.
Source: Best Practice and Research. Clinical Anaesthesiology - August 31, 2009 Category: Anesthesiology Authors: Paul Warman, Barry Nicholls Source Type: journals

Goal-directed fluid management with trans-oesophageal Doppleremail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Major surgery is associated with significant trauma and is a potential cause of multiple system organ failure and death. Measurement of cardiac output using a variety of techniques during the perioperative period has enabled practitioners to proactively optimise stroke volume and cardiac output in an attempt to reduce postoperative complications. Although pulmonary artery catheter has been widely used and considered as the gold standard for measuring cardiac output, recent advancement of technology has seen the development of a number of less-invasive haemodynamic monitors. Oesophageal Doppler ultrasonography is a minimall...
Source: Best Practice and Research. Clinical Anaesthesiology - August 31, 2009 Category: Anesthesiology Authors: Anthony M. Roche, Timothy E. Miller, Tong J. Gan Source Type: journals

Epiaortic ultrasound assessment of the aorta in cardiac surgeryemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
The dislodgement of atheroma from the ascending aorta and proximal arch is a major cause of stroke and neurological injury following cardiac surgery. The accurate detection of atheroma prior to aortic manipulation is necessary to facilitate surgical strategies to reduce the risk of embolisation.The traditional method for atheroma detection is manual palpation by the surgeon. This technique misses about half the number of the atheroma lesions, as the soft (non-calcified) lesions offer little resistance to the surgeon's fingers. Trans-oesophageal echocardiography (TOE) is commonly used in cardiac surgery, but the interpositi...
Source: Best Practice and Research. Clinical Anaesthesiology - August 31, 2009 Category: Anesthesiology Authors: Alistair George Royse, Colin Forbes Royse Source Type: journals

Ultrasound in traumaemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Point-of-care ultrasound is well suited for use in the emergency setting for assessment of the trauma patient. Currently, portable ultrasound machines with high-resolution imaging capability allow trauma patients to be imaged in the pre-hospital setting, emergency departments and operating theatres. In major trauma, ultrasound is used to diagnose life-threatening conditions and to prioritise and guide appropriate interventions. Assessment of the basic haemodynamic state is a very important part of ultrasound use in trauma, but is discussed in more detail elsewhere. Focussed assessment with sonography for Trauma (FAST) rapi...
Source: Best Practice and Research. Clinical Anaesthesiology - August 31, 2009 Category: Anesthesiology Authors: James C.R. Rippey, Alistair G. Royse Source Type: journals

Training guidelines for ultrasound: worldwide trendsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This article covers current provision of training in echocardiography and ultrasound in areas relevant to anaesthetists who are working in critical care (including accident and emergency) and complex surgery (mainly cardiac).
Source: Best Practice and Research. Clinical Anaesthesiology - August 31, 2009 Category: Anesthesiology Authors: Sean Bennett Source Type: journals

Keyword indexemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Source: Best Practice and Research. Clinical Anaesthesiology - August 31, 2009 Category: Anesthesiology Source Type: journals

Introductionemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Source: European Journal of Pain Supplements - August 31, 2009 Category: Anesthesiology Authors: Joan Hester Tags: Pain and Patients – Are We Meeting their Needs? New Concepts in Analgesia for Severe Pain Source Type: journals

Patients' and physicians' needs; defining therapeutic gaps in severe chronic painemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Source: European Journal of Pain Supplements - August 31, 2009 Category: Anesthesiology Authors: Marie Fallon Tags: Pain and Patients – Are We Meeting their Needs? New Concepts in Analgesia for Severe Pain Source Type: journals

Novel concepts for analgesia in severe pain – current strategies and future innovationsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Source: European Journal of Pain Supplements - August 31, 2009 Category: Anesthesiology Authors: Michael Schäfer Tags: Pain and Patients – Are We Meeting their Needs? New Concepts in Analgesia for Severe Pain Source Type: journals

Unmet needs in drug treatment of chronic severe pain – clinical evidence on current and future conceptsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Source: European Journal of Pain Supplements - August 31, 2009 Category: Anesthesiology Authors: Hans G. Kress Tags: Pain and Patients – Are We Meeting their Needs? New Concepts in Analgesia for Severe Pain Source Type: journals

Sub-tenon block and laryngeal mask for anesthesia in a child with isolated pulmonary stenosis undergoing squint surgery.email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
PMID: 19762310 [PubMed - in process]
Source: Acta Anaesthesiologica Taiwanica - August 31, 2009 Category: Anesthesiology Authors: Garg R, Darlong V, Pandey R, Punj J Tags: Acta Anaesthesiol Taiwan Source Type: journals

Rapid Sequence Intubation Using Pentax-AWS Without Muscle Relaxants in Patients With Myasthenia Gravis.email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
PMID: 19762309 [PubMed - in process]
Source: Acta Anaesthesiologica Taiwanica - August 31, 2009 Category: Anesthesiology Authors: Tagawa T, Sakuraba S, Okuda M Tags: Acta Anaesthesiol Taiwan Source Type: journals

Complete atrioventricular block with bradycardia after craniotomy.email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
We report an 82-year-old male patient who developed complete atrioventricular block (CAVB) with severe bradycardia 1 hour after craniotomy. After emergency placement of a transvenous pacemaker, the patient's heart rate was restored. Serial assays of serum cardiac enzymes, echocardiography and serum digoxin concentration did not show evidence of myocardial infarction, myocardial injury, or drug toxicity. Tracing back past history, neither syncope nor arrhythmia of any form was noted. A neurogenic heart disorder, high vagal tone, and aging possibly contributed to this cardiac event in this patient. CAVB, although uncommon, i...
Source: Acta Anaesthesiologica Taiwanica - August 31, 2009 Category: Anesthesiology Authors: Yang SC, Chang WK, Yuan HB, Sung CS, Chan KH Tags: Acta Anaesthesiol Taiwan Source Type: journals

Acute radial nerve injury associated with an automatic blood pressure monitor.email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Perioperative radial nerve injury is a rare anesthetic complication, and is rarely seen in association with the use of an automatic blood pressure monitor. As far as we know, only one case has been reported. Here, we report a 26-year-old healthy, lean female who sustained acute radial nerve palsy after appendectomy. A dropped wrist improved 5 days later. The cause of the radial neuropathy is discussed. We recommend that when an automatically cycling blood pressure monitor is used on a lean patient, caution should be taken against such a complication. PMID: 19762307 [PubMed - in process]
Source: Acta Anaesthesiologica Taiwanica - August 31, 2009 Category: Anesthesiology Authors: Swei SC, Liou CC, Liu HH, Hung PC Tags: Acta Anaesthesiol Taiwan Source Type: journals

Anesthetic management of a patient with congenital methemoglobinemia.email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Methemoglobinemia occasionally causes cyanosis particularly in congenital methemoglobinemia. Avoidance of exposure to oxidizing agents is important for patients with congenital methemoglobinemia because of their deficient enzymatic pathways and decreased oxygen-carrying capacity. Here, we present a patient with preoperatively undiagnosed congenital methemoglobinemia who underwent uterine myomectomy under general anesthesia. The patient was a 35-year-old woman who displayed a low pulse oximetry reading of 91% prior to induction of anesthesia. Methemoglobinemia was first suspected intraoperatively because of a mismatch o...
Source: Acta Anaesthesiologica Taiwanica - August 31, 2009 Category: Anesthesiology Authors: Lin CY, Yang JM, Chen CT, Hsu YW, Huang CJ, Chen CC, Tsai HJ Tags: Acta Anaesthesiol Taiwan Source Type: journals

Fatal venous air embolism during emergence from anesthesia.email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
We describe a case of the sudden onset of cardiovascular collapse during emergence from anesthesia resulting from a massive venous air embolism, which was detected by transesophageal echocardiography. We present this case to remind anesthesiologists to be aware of the risk of a sudden return of air trapped in the venous system during emergence from anesthesia. The air is freed because the sympathetic tone is increased, muscle-pumping power is regained, ventilation shifts from positive-pressure to negative-pressure spontaneous ventilation, and the patient is repositioned after surgery. PMID: 19762305 [PubMed - in process]
Source: Acta Anaesthesiologica Taiwanica - August 31, 2009 Category: Anesthesiology Authors: Hsieh TK, Hsieh JP, Lin MC, Ho ST, Hsing CH, Wang JJ, Chu CC Tags: Acta Anaesthesiol Taiwan Source Type: journals

Cervicofacial subcutaneous emphysema following tonsillectomy: implications for anesthesiologists.email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
We present a 37-year-old male patient who, after receiving tonsillectomy, developed cervicofacial subcutaneous emphysema immediately following endotracheal extubation. Valsalva maneuvers evidenced by coughing and straining of the patient, and positive pressure ventilation by mask to alleviate laryngospasm in an emergency were believed to induce and exacerbate the emphysema. Fortunately, the patient was re-intubated and protected from further complication of pneumomediastinum or pneumothorax. The emphysema resolved 7 days later with conservative treatment, including broad-spectrum antibiotics and abstention from enteral int...
Source: Acta Anaesthesiologica Taiwanica - August 31, 2009 Category: Anesthesiology Authors: Hung MH, Shih PY, Yang YM, Lan JY, Fan SZ, Jeng CS Tags: Acta Anaesthesiol Taiwan Source Type: journals

Effects of propofol sedation during the early postoperative period in hemorrhagic stroke patients.email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Conclusion: Our results support the use of propofol sedation during the early postoperative period after craniotomy in hemorrhagic stroke patients, because it improved both neurologic and clinical outcomes. However, early postoperative use of propofol sedation at larger dosages warrants special attention. PMID: 19762303 [PubMed - in process]
Source: Acta Anaesthesiologica Taiwanica - August 31, 2009 Category: Anesthesiology Authors: Hung YC, Lee EJ, Chen HY, Ko SW, Shyr MH, Chen TY Tags: Acta Anaesthesiol Taiwan Source Type: journals

Closed-loop Control of Anesthesia Using the Bispectral Index in Open Heart Surgery.email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Conclusion: The closed-loop control of anesthetic delivery adjusted to BIS is feasible and may be useful in open heart surgery under hypothermic CPB. PMID: 19762302 [PubMed - in process]
Source: Acta Anaesthesiologica Taiwanica - August 31, 2009 Category: Anesthesiology Authors: Puri GD, Mathew PJ Tags: Acta Anaesthesiol Taiwan Source Type: journals

Accuracy of the Central Landmark for Catheterization of the Right Internal Jugular Vein After Placement of the ProSeal Laryngeal Mask Airway.email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Conclusion: After placement of the ProSeal LMA, the central landmark could not offer a good success rate at the first puncture attempt. When using the central landmark to catheterize the IJV after a ProSeal LMA placement, medial deviation of the central landmark should be considered. Ultrasound guidance may be helpful in difficult cases. PMID: 19762301 [PubMed - in process]
Source: Acta Anaesthesiologica Taiwanica - August 31, 2009 Category: Anesthesiology Authors: Tseng KY, Tsai CJ, Wu SH, Lu DV, Hsu HT, Lu IC, Chu KS Tags: Acta Anaesthesiol Taiwan Source Type: journals

Platelet Function Analyzer (PFA-100) Offers Higher Sensitivity and Specificity than Thromboelastography (TEG) in Detection of Platelet Dysfunction.email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Conclusion: We conclude that PFA-100 offers a higher sensitivity and specificity than TEG in detection of platelet dysfunction. PMID: 19762300 [PubMed - in process]
Source: Acta Anaesthesiologica Taiwanica - August 31, 2009 Category: Anesthesiology Authors: Chang YW, Liao CH, Day YJ Tags: Acta Anaesthesiol Taiwan Source Type: journals

Evaluation of the Platelet Function Analyzer (PFA-100) vs. the Thromboelastogram (TEG) in the Clinical Setting.email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
PMID: 19762299 [PubMed - in process]
Source: Acta Anaesthesiologica Taiwanica - August 31, 2009 Category: Anesthesiology Authors: Tsou MY Tags: Acta Anaesthesiol Taiwan Source Type: journals

Electrical Stimulation Versus Ultrasound Guidance for Popliteal-Sciatic Perineural Catheter Insertion: A Randomized Controlled Trialemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Conclusions: Placement of popliteal-sciatic perineural catheters takes less time and produces less procedure-related discomfort when using US guidance compared with ES. (C)2009 American Society of Regional Anesthesia and Pain Medicine
Source: Regional Anesthesia and Pain Medicine - August 31, 2009 Category: Anesthesiology Tags: Ultrasound Articles Source Type: journals

Ultrasound in Pain Medicine: Advanced Weaponry or Just a Fad?email this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
No abstract available
Source: Regional Anesthesia and Pain Medicine - August 31, 2009 Category: Anesthesiology Tags: Editorials Source Type: journals

Diabetes Mellitus, Independent of Body Mass Index, Is Associated With a "Higher Success" Rate for Supraclavicular Brachial Plexus Blocksemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Conclusions: We speculate that the "higher success" of SCB in patients with diabetes may be explained by: (i) higher sensitivity of diabetic nerve fibers to local anesthetics, (ii) possible unknown intraneural penetration before injection, and/or (iii) preexisting neuropathy with accompanying decreased sensation. In the absence of additional follow-up on these patients, these data should generate outcomes research addressing dose-response curves for patients with diabetes or at risk for diabetes. (C)2009 American Society of Regional Anesthesia and Pain Medicine
Source: Regional Anesthesia and Pain Medicine - August 31, 2009 Category: Anesthesiology Tags: Original Articles Source Type: journals

Parietal Analgesia Decreases Postoperative Diaphragm Dysfunction Induced by Abdominal Surgery: A Physiologic Studyemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Conclusions: Parietal analgesia delivered via a CPWI of ropivacaine reduces PODD induced by open colorectal surgery. (C)2009 American Society of Regional Anesthesia and Pain Medicine
Source: Regional Anesthesia and Pain Medicine - August 31, 2009 Category: Anesthesiology Tags: Original Articles Source Type: journals

Contentsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Source Type: journals

Forthcoming issuesemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Source Type: journals

Forewordemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Anesthesia at the extremes of age has been a topic of interest to anesthesiologists, but much of the focus has been on the very young as opposed to the very old. Anesthesiologists are acquainted with managing patients with multiple comorbidities, which are known to increase with increasing age, but the very old have some unique problems, and the manifestations of the comorbidities have changed. Therefore, there is increasing interest in geriatric patients and their perioperative care, and in this issue of Anesthesiology Clinics, the editor has chosen a different format from the traditional monograph, using a problem-based ...
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: Lee A. Fleisher Source Type: journals

Prefaceemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This issue of Anesthesiology Clinics, focused on problems encountered in geriatric patients, comes at an interesting and exciting time in modern anesthesia practice. The practices of anesthesiologists in North America are becoming progressively populated by aging patients. Longevity seems to be increasing steadily, and the expectations of a vital elderly population include quality medical care. The quality and diversity of information regarding the perioperative care of the elderly has increased significantly, as can be noted at national meetings, in scientific journals, and by the creation of the subspecialty Society for ...
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: Jeffrey H. Silverstein Source Type: journals

Polypharmacy and Perioperative Medications in the Elderlyemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Polypharmacy is a significant and complex problem affecting more than 40% of the geriatric population. Accurate medication histories may be difficult to obtain, but must include over-the-counter remedies as well as prescription. Physiologic changes occur with aging that predispose elderly patients to adverse drug events. At a minimum, medications with significant anticholinergic properties should be recognized and avoided in the perioperative period.
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: Sheila Ryan Barnett Source Type: journals

Parkinson's Disease and Deep Brain Stimulator Placementemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This article examines the role of the anesthesiologist in the pre- and perioperative management of patients undergoing DBS procedures. In terms of the general anesthetic management of PD patients, it is clear that no simple anesthetic regimen exists. Anesthesiologists can provide the best care through preoperative assessment, maintenance of PD drug therapy, and avoidance of known precipitating agents.
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: Stacie Deiner, John Hagen Source Type: journals

Atrial Fibrillation in the Elderlyemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This article provides an overview of the incidence, prevalence, etiology, and pathophysiology of AF in elderly patients, with special emphasis on the perioperative period. The pharmacologic and nonpharmacologic management strategies available to the anesthesiologist are described. The anesthesiologist must be aware of the causes, consequences, and treatment of elderly patients developing AF during the perioperative period, as well as patients presenting to the operating room with chronic AF.
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: Gregory W. Fischer Source Type: journals

Delayed Arousalemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Elderly patients have medical and psychological problems affecting all major organ systems. These problems may alter the pharmacokinetics and/or pharmacodynamics of medications, or expose previous neurologic deficits simply as a result of sedation. Delayed arousal, therefore, may arise from structural problems that are pre-existent or new, or metabolic or functional disorders such as convulsive or nonconvulsive seizures. Determining the cause of delayed arousal may require clinical, chemical, and structural tests. Structural problems that impair consciousness arise from a small number of focal lesions to specific areas of ...
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: Zirka H. Anastasian, Eugene Ornstein, Eric J. Heyer Source Type: journals

Postoperative Delirium in the Elderly Surgical Patientemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Delirium is a common complication in the geriatric population following cardiac and noncardiac procedures. Postoperative delirium is a significant financial burden on the United States health care system and is independently associated with prolonged hospital stay, increased risk of early and long term mortality, increased physical dependence, and an increased rate of nursing home placement. The Confusion Assessment Method (CAM) is a bedside rating scale developed to assist nonpsychiatrically trained clinicians in the rapid and accurate diagnosis of delirium. The CAM has been adapted for use in ventilated intensive care un...
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: Frederick E. Sieber Source Type: journals

Postoperative Urinary Retentionemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Postoperative urinary retention (PUR) is a common complication of surgery and anesthesia. The risk of retention is especially high after anorectal surgery, hernia repair, and orthopedic surgery and increases with advancing age. Certain anesthetic and analgesic modalities, particularly spinal anesthesia with long-acting local anesthetics and epidural analgesia, promote the development of urinary retention. Portable ultrasound provides rapid and accurate assessment of bladder volume and aids in the diagnosis and management of PUR. Catheterization is recommended when bladder volume exceeds 600 mL to prevent the negative seque...
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: Daniela M. Darrah, Tomas L. Griebling, Jeffrey H. Silverstein Source Type: journals

Postoperative Cognitive Dysfunction in the Elderlyemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This article discusses the incidence, assessment, consequences, and prevention of POCD, as well as anesthetic strategies to improve cognitive outcome in elderly patients.
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: Ramesh Ramaiah, Arthur M. Lam Source Type: journals

Diastolic Dysfunction, Cardiovascular Aging, and the Anesthesiologistemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
As the number of persons aged 65 years and older continues to increase, the anesthesiologist will more frequently encounter this demographic. Cardiovascular changes that occur in this patient population present difficult anesthetic challenges and place these patients at high risk of perioperative morbidity and mortality. The anesthesiologist should be knowledgeable about these age-related cardiovascular changes, the pathophysiology underlying them, and the appropriate perioperative management. Whether presenting for cardiac or general surgery, the anesthesiologist must identify patients with altered physiology as a result ...
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: David Sanders, Michael Dudley, Leanne Groban Source Type: journals

Aortic Valve Stenosisemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Calcific aortic stenosis (AS) is primarily a disease of the elderly, possessing features that are biomechanical as well as systemic and inflammatory in nature, with risk factors and histopathology similar to atherosclerosis. To date no medical therapy has been shown to conclusively alter the progression of the disease, and for those with symptomatic AS, aortic valve replacement (AVR) is advocated. Factors that may alert the physician to an accelerated progression of calcific aortic valvular disease toward severe symptomatic AS include moderate aortic valve calcification, chronically dialyzed patients, and patients 80 years...
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: Charles Z. Zigelman, Patti M. Edelstein Source Type: journals

Fat Embolismemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This article reviews the definition, epidemiology, etiology, pathophysiology, clinical presentation, diagnosis, management, and prognosis of FES.
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: Shamsuddin Akhtar Source Type: journals

Anesthetic Management of Acute Mesenteric Ischemia in Elderly Patientsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Ischemic insult to the splanchnic vasculature can jeopardize bowel viability and lead to devastating consequences, including bowel necrosis and gangrene. Although acute mesenteric ischemia (AMI) may occur at any age, the elderly are most commonly affected due to their higher incidence of underlying systemic pathology, most notably atherosclerotic cardiovascular disease. Treatment options include pharmacology-based actions, endovascular, and surgical interventions. AMI remains a life-threatening condition with a mortality rate of 60% to 80%, especially if intestinal infarction has occurred and surgical intervention becomes ...
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: Alexander A. Vitin, Julia I. Metzner Source Type: journals

Informed Consent and the Ethical Management of the Older Patientemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Discussion of do-not-resuscitate orders is part of informed consent, and patients' wishes regarding resuscitation in the operating room should be respected. Surrogate consent for participation in research is not necessarily allowed by IRB approval and research protocols.
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: Yulia Ivashkov, Gail A. Van Norman Source Type: journals

Perioperative Use of β-Blockers in the Elderly Patientemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
This article examines common comorbidities in the elderly who may benefit from the chronic use of β-blockers, prophylactic perioperative use of β-blockers including timing, dosage, and choice of β-blocker, the pharmacologic effects of aging, and recommendations on the use of β-blockers.
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: Stefan A. Lombaard, Reinette Robbertze Source Type: journals

Anesthetic Care for Patients with Skin Breakdownemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Wound patients commonly have multiple comorbidities, which should be optimized before anesthesia. These factors contribute not only to skin breakdown but also other causes of mortality and morbidity. Skin becomes more vulnerable to damage from pressure, friction, shear, and moisture when the skin is dry, less elastic, and less perfused. Careful assessment and implementation of an anesthetic plan using regional or general techniques can improve outcomes. The anesthesiologist plays a vital role in maintaining homeostasis during the surgically stressful perioperative period of the wound patient. Aggressive wound management in...
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Authors: Daniel K. O'Neill, Jason Maggi Source Type: journals

Indexemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Source: Anesthesiology Clinics - August 31, 2009 Category: Anesthesiology Source Type: journals

Editorial Boardemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Source: Journal of Clinical Anesthesia - August 31, 2009 Category: Anesthesiology Source Type: journals

Table of Contentsemail this articleEmail this article to a colleague. save this article to My ClippingsSave this article to My Clippings. discuss this articleDiscuss or comment on this article.
Source: Journal of Clinical Anesthesia - August 31, 2009 Category: Anesthesiology Source Type: journals