MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Anesthesiology' source. Wed, 08 Feb 2012 07:39:16 +0100 http://www.medworm.com/index.php?rid=5627954&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2012%2F02000%2FPeripartum_Subarachnoid_Hemorrhage__Nationwide.15.aspx Conclusion: SAH during pregnancy results from a range of etiologies, and is less likely to be because of a cerebral aneurysm than SAH occurring in the nonpregnant patient. Peripartum SAH frequently occurs in the setting of hypertensive disorders. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5627954 Tue, 24 Jan 2012 22:05:24 +0100 5627954 http://www.medworm.com/index.php?rid=5627955&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2012%2F02000%2FPractice_Guidelines_for_Acute_Pain_Management_in.10.aspx The American Society of Anesthesiologists Committee on Standards and Practice Parameters presents an updated report of the Practice Guidelines for Acute Pain Management in the Perioperative Setting. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5627955 Tue, 24 Jan 2012 22:04:33 +0100 5627955 http://www.medworm.com/index.php?rid=5627956&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2012%2F02000%2FCase_Scenario___Perianesthetic_Management_of.31.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5627956 Tue, 24 Jan 2012 22:04:07 +0100 5627956 http://www.medworm.com/index.php?rid=5627957&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2012%2F02000%2FA_Mixed__Long__and_Medium_chain__Triglyceride.16.aspx Conclusions: Bupivacaine, ropivacaine, and mepivacaine were sequestered to an extent consistent with their octanol:water partition constants (logP). In contrast with previous studies of extraction of lipids from buffer solutions, an emulsion containing 50% each of medium- and long-chain triglycerides extracted local anesthetics to a greater extent from human serum than one containing exclusively long-chain triglycerides, calling into question recent advanced cardiac life support guidelines for resuscitation from anesthetic toxicity that specify use of a long-chain triglyceride. The current data also do not support recent recommendations to delay administration until pH is normalized. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5627957 Tue, 24 Jan 2012 22:03:34 +0100 5627957 http://www.medworm.com/index.php?rid=5627958&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2012%2F02000%2FAnesthetic_Management_and_Outcome_in_Patients.22.aspx Conclusions: Adjusted for stroke severity, patients who received general anesthesia for treatment are less likely to have a good outcome than those managed with local anesthesia. This may be due to preintervention risk not included in the stroke severity measures. Hypotension, more frequent in the general anesthesia patients, may also contribute. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5627958 Tue, 24 Jan 2012 22:03:02 +0100 5627958 http://www.medworm.com/index.php?rid=5627959&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2012%2F02000%2FPractice_Advisory_for_Perioperative_Visual_Loss.11.aspx The American Society of Anesthesiologists Committee on Standards and Practice Parameters presents an updated report of the Practice Advisory for Perioperative Visual Loss Associated with Spine Surgery. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5627959 Tue, 24 Jan 2012 22:02:21 +0100 5627959 http://www.medworm.com/index.php?rid=5523882&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2012%2F01000%2FVariation_in_the_Practice_of_Preoperative_Medical.12.aspx Conclusions: One-third of surgical patients undergo preoperative medical consultation. Although patient- and surgery-level factors are weak predictors of consultation use, the individual hospital is the major determinant of whether patients undergo consultation. Additional research is needed to better understand the basis for this substantial interhospital variation and to determine which patients benefit most from preoperative consultation. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5523882 Tue, 20 Dec 2011 22:06:30 +0100 5523882 http://www.medworm.com/index.php?rid=5523883&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2012%2F01000%2FRisk_Factors_Associated_with_Ischemic_Optic.11.aspx Conclusions: This is the first study to assess ION risk factors in a large, multicenter case-control fashion with detailed perioperative data. Obesity, male sex, Wilson frame use, longer anesthetic duration, greater estimated blood loss, and decreased percent colloid administration were significantly and independently associated with ION after spinal fusion surgery. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5523883 Tue, 20 Dec 2011 22:05:34 +0100 5523883 http://www.medworm.com/index.php?rid=5523884&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2012%2F01000%2FPredictors_of_Pain_Relieving_Response_to.23.aspx Conclusions: The presence of allodynia and hypoesthesia are negative predictors for treatment success. The selection of sympathetic blockade as treatment for CRPS-1 should be balanced carefully between potential success and side effect ratio. The procedure is as likely to cause a transient increase in pain as a decrease in pain. Patients should be informed accordingly. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5523884 Tue, 20 Dec 2011 22:04:50 +0100 5523884 http://www.medworm.com/index.php?rid=5523885&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2012%2F01000%2FCase_Scenario___Amniotic_Fluid_Embolism.30.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5523885 Tue, 20 Dec 2011 22:04:07 +0100 5523885 http://www.medworm.com/index.php?rid=5523886&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2012%2F01000%2FContinuous_Measurement_of_Glucose__Facts_and.34.aspx Continuous glucose monitors, which will now be appearing in perioperative and intensive care unit patients, are an exciting new tool. Clinicians should understand the benefits and potential pitfalls in using this new technology. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5523886 Tue, 20 Dec 2011 22:03:30 +0100 5523886 http://www.medworm.com/index.php?rid=5523887&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2012%2F01000%2FDysautonomia__Perioperative_Implications.35.aspx Severe autonomic failure occurs in approximately 1 in 1,000 people. Such patients are remarkable for the striking and sometimes paradoxic responses they manifest to a variety of physiologic and pharmacologic stimuli. Orthostatic hypotension is often the finding most commonly noted by physicians, but a myriad of additional and less understood findings also occur. These findings include supine hypertension, altered drug sensitivity, hyperresponsiveness of blood pressure to hypo/hyperventilation, sleep apnea, and other neurologic disturbances. In this article the authors will review the clinical pathophysiology that underlies autonomic failure, with a particular emphasis on those aspects most relevant to the care of such patients in the perioperative setting. Strategies used by clinicians in ... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5523887 Tue, 20 Dec 2011 22:02:55 +0100 5523887 http://www.medworm.com/index.php?rid=5440232&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F12000%2FGenetic_Variation%2C___blockers%2C_and_Perioperative.31.aspx Perioperative myocardial infarction is a common and potentially fatal complication after noncardiac surgery, particular among patients with cardiovascular risk factors. β-blockers have been considered a mainstay in prevention and treatment of perioperative myocardial infarction, yet recent evidence suggests that β-blockers may have an unfavorable risk profile in this setting, and the use has become controversial. What seems conspicuously absent from the current discussion is the appreciation of how much interindividual genetic variation influences the clinical response to β-blocker therapy. Genetic variation in the adrenergic signaling pathway is common, and has a major impact on adrenergic receptor function and β-blocker efficacy in other cardiovascular diseases, such as heart failure... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5440232 Tue, 22 Nov 2011 22:10:02 +0100 5440232 http://www.medworm.com/index.php?rid=5440233&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F12000%2FRelationship_between_Bispectral_Index_Values_and.15.aspx Conclusions: Independent of pharmacokinetic confounding, BIS frequently correlates poorly with ETAC, is often insensitive to clinically significant changes in ETAC, and is vulnerable to interindividual variability. BIS is therefore incapable of finely guiding volatile anesthetic titration during anesthetic maintenance. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5440233 Tue, 22 Nov 2011 22:09:19 +0100 5440233 http://www.medworm.com/index.php?rid=5440234&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F12000%2FBuprenorphine_Metabolites%2C.19.aspx Conclusions: Both glucuronide metabolites of buprenorphine are biologically active at doses relevant to metabolite exposures, which occur after buprenorphine. Activity of the glucuronides may contribute to the overall pharmacology of buprenorphine. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5440234 Tue, 22 Nov 2011 22:08:49 +0100 5440234 http://www.medworm.com/index.php?rid=5440235&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F12000%2FCase_Scenario___Opioid_Association_with_Serotonin.24.aspx Serotonin syndrome is an uncommon but potentially life-threatening drug-induced toxicity, from interaction of opioids to other serotonergic agents. This toxic reaction can either be avoided, through knowing a patient's detailed medicinal history, or be diagnosed early to prevent severe morbidity and mortality. It is even more critical for a practicing anesthesiologist to understand this entity, as the syndrome will be even more difficult to diagnose if secondary to overlapping symptoms from anesthetic. This case scenario focused on serotonin syndrome pathophysiology and management, and its association to routinely used opioids. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5440235 Tue, 22 Nov 2011 22:08:18 +0100 5440235 http://www.medworm.com/index.php?rid=5440236&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F12000%2FSimulation_based_Assessment_of_Pediatric.30.aspx Conclusions: A multiple-scenario, simulation-based assessment of pediatric perioperative care was designed and administered to residents and fellows. The scores obtained from the assessment indicated the content was relevant and that raters could reliably score the scenarios. Participants with more training achieved higher scores, but there was a wide range of ability among subjects. This method has the potential to contribute to pediatric anesthesia performance assessment, but additional measures of validity including correlations with more direct measures of clinical performance are needed to establish the utility of this approach. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5440236 Tue, 22 Nov 2011 22:07:46 +0100 5440236 http://www.medworm.com/index.php?rid=5440237&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F12000%2FAdvances_in_the_Management_of_Sepsis_and_the.35.aspx Anesthesiologists are increasingly confronting the difficult problem of caring for patients with sepsis in the operating room and in the intensive care unit. Sepsis occurs in more than 750,000 patients in the United States annually and is responsible for more than 210,000 deaths. Approximately 40% of all intensive care unit patients have sepsis on admission to the intensive care unit or experience sepsis during their stay in the intensive care unit. There have been significant advances in the understanding of the pathophysiology of the disorder and its treatment. Although deaths attributable to sepsis remain stubbornly high, new treatment algorithms have led to a reduction in overall mortality. Thus, it is important for anesthesiologists and critical care practitioners to be aware of these... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5440237 Tue, 22 Nov 2011 22:07:14 +0100 5440237 http://www.medworm.com/index.php?rid=5346727&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F11000%2FProtective_and_Detrimental_Effects_of_Sodium.23.aspx Conclusions: The data suggest that systemic intravascular treatment with Na2S represents a novel therapeutic strategy to prevent both ventilator-induced lung injury and pulmonary glutathione depletion by activating Nrf2-dependent antioxidant gene transcription. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5346727 Tue, 25 Oct 2011 20:53:31 +0100 5346727 http://www.medworm.com/index.php?rid=5346728&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F11000%2FCase_Scenario___Anesthetic_Considerations_for.32.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5346728 Tue, 25 Oct 2011 20:52:13 +0100 5346728 http://www.medworm.com/index.php?rid=5346729&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F11000%2FEffect_of_Single_Recombinant_Human_Erythropoietin.13.aspx Conclusions: A single intravenous administration of erythropoietin and an iron supplement 1 day before surgery significantly reduced the perioperative transfusion requirement in anemic patients undergoing valvular heart surgery, implicating its potential role as a blood conservation strategy. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5346729 Tue, 25 Oct 2011 20:51:27 +0100 5346729 http://www.medworm.com/index.php?rid=5346730&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F11000%2FIntraoperative_Acceleromyography_Monitoring.16.aspx Conclusion: Acceleromyography monitoring reduces the incidence of residual blockade and associated unpleasant symptoms of muscle weakness in the PACU and improves the overall quality of recovery. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5346730 Tue, 25 Oct 2011 20:50:37 +0100 5346730 http://www.medworm.com/index.php?rid=5346731&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F11000%2FProlonged_Central_Venous_Desaturation_Measured_by.25.aspx Conclusions: We demonstrate that ScvO2 desaturations by continuous oximetry are associated with major adverse events in pediatric patients undergoing cardiac surgery. The most significant associations with major adverse events are seen in patients with greater than 18 min of central venous saturations less than 40%. Our results support the further investigation of ScvO2 as a potential target parameter in high-risk pediatric patients to minimize the risk of major adverse events. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5346731 Tue, 25 Oct 2011 20:49:46 +0100 5346731 http://www.medworm.com/index.php?rid=5346732&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F11000%2FPotential_Adverse_Ultrasound_related_Biological.36.aspx This article reviews ultrasound-related biologic effects, the role of the regulatory agencies in ensuring safety with the use of ultrasound, and the limitations and implications of ultrasound use in humans. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5346732 Tue, 25 Oct 2011 20:49:05 +0100 5346732 http://www.medworm.com/index.php?rid=5236634&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F10000%2FDetermining_Resident_Clinical_Performance__Getting.41.aspx Conclusions: This study demonstrates a reliable and valid clinical performance assessment system for residents at all levels of training. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5236634 Tue, 20 Sep 2011 20:51:48 +0100 5236634 http://www.medworm.com/index.php?rid=5236635&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F10000%2FAutopsy_Utilization_in_Medicolegal_Defense_of.20.aspx Conclusions: Autopsy findings were more often helpful than harmful in the medicolegal defense of anesthesiologists. Autopsy identified a significant nonanesthetic contribution to death in two thirds of claims with evaluable autopsy information. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5236635 Tue, 20 Sep 2011 20:51:20 +0100 5236635 http://www.medworm.com/index.php?rid=5236636&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F10000%2FMethylphenidate_Actively_Induces_Emergence_from.30.aspx Conclusions: Methylphenidate actively induces emergence from isoflurane general anesthesia by increasing arousal and respiratory drive, possibly through activation of dopaminergic and adrenergic arousal circuits. The authors' findings suggest that methylphenidate may be useful clinically as an agent to reverse general anesthetic-induced unconsciousness and respiratory depression at the end of surgery. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5236636 Tue, 20 Sep 2011 20:50:40 +0100 5236636 http://www.medworm.com/index.php?rid=5236637&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F10000%2FStrategy_dependent_Dissociation_of_the_Neural.36.aspx Conclusions: The results of this study suggest that different cognitive behavioral strategies recruit different brain regions to perform the same task: pain modulation. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5236637 Tue, 20 Sep 2011 20:50:00 +0100 5236637 http://www.medworm.com/index.php?rid=5236638&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F10000%2FCase_Scenario___Perioperative_Management_of_a.37.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5236638 Tue, 20 Sep 2011 20:49:29 +0100 5236638 http://www.medworm.com/index.php?rid=5236639&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F10000%2FPerioperative_Stroke_in_Noncardiac%2C.42.aspx Perioperative stroke after noncardiac, nonneurosurgical procedures is more common than generally acknowledged. It is reported to have an incidence of 0.05–7% of patients. Most are thrombotic in origin and are noted after discharge from the postanesthetic care unit. Common predisposing factors include age, a previous stroke, atrial fibrillation, and vascular and metabolic diseases. The mortality is more than two times greater than in strokes occurring outside the hospital. Delayed diagnosis and a synergistic interaction between the inflammatory changes normally associated with stroke, and those normally occurring after surgery, may explain this increase. Intraoperative hypotension is an infrequent direct cause of stroke. Hypotension will augment the injury produced by embolism or other ca... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5236639 Tue, 20 Sep 2011 20:48:55 +0100 5236639 http://www.medworm.com/index.php?rid=5160795&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F09000%2FNo_Clinical_or_Electrophysiologic_Evidence_of.25.aspx Conclusions: Nerve-stimulator–guided sciatic block at the popliteal fossa often results in intraneural injection that may not lead to clinical or electrophysiologic nerve injury. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5160795 Tue, 23 Aug 2011 16:01:01 +0100 5160795 http://www.medworm.com/index.php?rid=5160797&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F09000%2FHigh_Oxygen_Partial_Pressure_Decreases.13.aspx Conclusions: High arterial oxygen partial pressure reverses the heart rate response to anemia, probably because of its usability rather than its effect on total oxygen content. The benefit of high arterial oxygen partial pressure has significant potential clinical implications for the acute treatment of anemia and results of transfusion trials. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5160797 Tue, 23 Aug 2011 16:00:06 +0100 5160797 http://www.medworm.com/index.php?rid=5160798&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F09000%2FInfluence_of_Erythrocyte_Transfusion_on_the_Risk.17.aspx Conclusions: Anemic patients presenting for cardiac surgery are more susceptible to transfusion-related AKI than nonanemic patients. Interventions that reduce perioperative transfusions may protect anemic patients against AKI. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5160798 Tue, 23 Aug 2011 15:59:20 +0100 5160798 http://www.medworm.com/index.php?rid=5160800&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F09000%2FPerioperative_Single_Dose_Systemic_Dexamethasone.24.aspx Conclusion: Dexamethasone at doses more than 0.1 mg/kg is an effective adjunct in multimodal strategies to reduce postoperative pain and opioid consumption after surgery. The preoperative administration of the drug produces less variation of effects on pain outcomes. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5160800 Tue, 23 Aug 2011 15:58:44 +0100 5160800 http://www.medworm.com/index.php?rid=5160799&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F09000%2FReducing_Noninfectious_Risks_of_Blood_Transfusion.32.aspx As screening for transfusion-associated infections has improved, noninfectious complications of transfusion now cause the majority of morbidity and mortality associated with transfusion in the United States. For example, transfusion-related acute lung injury, transfusion-associated circulatory overload, and hemolytic transfusion-reactions are the first, second, and third leading causes of death from transfusion, respectively. These complications and others are reviewed, and several controversial methods for prevention of noninfectious complications of transfusion are discussed, including universal leukoreduction of erythrocyte units, use of male-only plasma, and restriction of erythrocyte storage age. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5160799 Tue, 23 Aug 2011 15:58:07 +0100 5160799 http://www.medworm.com/index.php?rid=5160796&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F09000%2FIntraoperative_Pneumothorax_Identified_with.35.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5160796 Tue, 23 Aug 2011 15:57:37 +0100 5160796 http://www.medworm.com/index.php?rid=5078440&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F08000%2FThe_Absence_of_Adrenal_Gland_Enlargement_during.20.aspx Conclusion: A total adrenal gland volume less than 10 cm3 during septic shock was associated in univariate and multivariate analysis with mortality at day 28 in patients with septic shock. Whether adrenal gland volume can be a surrogate of adrenal gland function and used to guide hydrocortisone therapy in septic shock patients needs to be further investigated. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5078440 Tue, 26 Jul 2011 16:16:32 +0100 5078440 http://www.medworm.com/index.php?rid=5069884&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F08000%2FR2__The_Absence_of_Adrenal_Gland_Enlargement.20.aspx Conclusion: A total adrenal gland volume less than 10 cm3 during septic shock was associated in univariate and multivariate analysis with mortality at day 28 in patients with septic shock. Whether adrenal gland volume can be a surrogate of adrenal gland function and used to guide hydrocortisone therapy in septic shock patients needs to be further investigated. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5069884 Tue, 26 Jul 2011 16:16:32 +0100 5069884 http://www.medworm.com/index.php?rid=5069885&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F08000%2FEstimating_Anesthesia_Time_Using_the_Medicare.19.aspx Conclusion: The anesthesia bill found in Medicare claims provides an excellent source of information for studying surgery time on a vast scale throughout the United States. However, errors in both chart abstraction and anesthesia claims can occur. Care must be taken in the handling of outliers in these data. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5069885 Tue, 26 Jul 2011 16:15:55 +0100 5069885 http://www.medworm.com/index.php?rid=5069886&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F08000%2FA_Cost_Benefit_Analysis_of_the_ENIGMA_Trial.13.aspx Conclusions: Despite N2O reducing the consumption of more expensive potent inhalational agent, there were marked additional costs associated with its use in adult patients undergoing major surgery because of an increased rate of complications. There is no cogent argument to continue using N2O on the basis that it is an inexpensive drug. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5069886 Tue, 26 Jul 2011 16:15:23 +0100 5069886 http://www.medworm.com/index.php?rid=5069887&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F08000%2FEpidural_Analgesia_Is_Associated_with_Improved.18.aspx Conclusion: This study provides evidence that in patients with COPD who are scheduled for major abdominal surgery, epidural analgesia decreases postoperative pulmonary complications. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5069887 Tue, 26 Jul 2011 16:14:49 +0100 5069887 http://www.medworm.com/index.php?rid=5069888&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F08000%2FCase_Scenario__Metastatic_Pediatric_Paraganglioma.28.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5069888 Tue, 26 Jul 2011 16:14:11 +0100 5069888 http://www.medworm.com/index.php?rid=5069889&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F08000%2FA_Review_of_Current_and_Emerging_Approaches_to.33.aspx Failure-to-Rescue, defined as hospital deaths after adverse events, is an established measure of patient safety and hospital quality. Until recently, approaches used to address failure-to-rescue have been focused primarily on improvement of response to a recognized patient crisis, with limited success in terms of patient outcomes. Less attention has been paid to improving the detection of the crisis. A wealth of retrospective data exist to support the observation that adverse events in general ward patients are preceded by a significant period (on the order of hours) of physiologic deterioration. Thus, the lack of early recognition of physiologic decline plays a major role in the failure-to-rescue problem. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=5069889 Tue, 26 Jul 2011 16:13:27 +0100 5069889 http://www.medworm.com/index.php?rid=4954050&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F07000%2FIndependent_Predictors_and_Outcomes_of.15.aspx Conclusions: One half of unanticipated tracheal intubations in a period of 30 days occurred within the first 3 days after nonemergent, noncardiac surgery and were independently associated with a 9-fold increase in mortality. The authors present a validated perioperative risk class index for determining risk of unanticipated early postoperative intubation. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4954050 Tue, 21 Jun 2011 16:15:50 +0100 4954050 http://www.medworm.com/index.php?rid=4954051&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F07000%2FPediatric_Surgery_and_Parental_Smoking_Behavior.11.aspx Conclusions: Parents who smoke were more likely to make a quit attempt within the past 12 months if their children had surgery within this time, but they were not more likely to succeed in maintaining abstinence and thus could benefit from assistance. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4954051 Tue, 21 Jun 2011 16:13:15 +0100 4954051 http://www.medworm.com/index.php?rid=4954052&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F07000%2FGenome_wide_Association_Study_Using_Pooled_DNA_to.16.aspx Conclusions: The authors performed the genome-wide association study for PONV using pooled DNA samples. Through individual genotyping, they confirmed association of at least one SNP that is predictive of PONV susceptibility. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4954052 Tue, 21 Jun 2011 16:12:24 +0100 4954052 http://www.medworm.com/index.php?rid=4954053&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F07000%2FUltrasound_Imaging_Facilitates_Spinal_Anesthesia.20.aspx Conclusion: Preprocedural ultrasound imaging facilitates the performance of spinal anesthesia in the nonobstetric patient population with difficult anatomic landmarks. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4954053 Tue, 21 Jun 2011 16:10:50 +0100 4954053 http://www.medworm.com/index.php?rid=4954054&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F07000%2FDerivation_and_Diagnostic_Accuracy_of_the_Surgical.23.aspx Conclusions: Using readily available preoperative risk factors, we developed the SLIP scoring system to predict risk of early postoperative ALI. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4954054 Tue, 21 Jun 2011 16:09:58 +0100 4954054 http://www.medworm.com/index.php?rid=4954055&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F07000%2FThoracic_Epidural_Analgesia_and_Acute_Pain.34.aspx Thoracic epidural analgesia remains a key tool for acute pain management in selected patients. The indications, placement techniques, solutions administered, potential complications, and evidence-based outcomes for thoracic epidural analgesia in acute pain management are reviewed. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4954055 Tue, 21 Jun 2011 16:08:48 +0100 4954055 http://www.medworm.com/index.php?rid=4863591&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F06000%2FExpansion_of_the_Surgical_Apgar_Score_across_All.16.aspx Conclusion: A previously published methodology for calculating risk among general and vascular surgical patients can be applied across many surgical services to provide an objective means of predicting and communicating patient outcomes in surgery as well as planning potential interventions. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4863591 Tue, 24 May 2011 17:42:31 +0100 4863591 http://www.medworm.com/index.php?rid=4863592&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F06000%2FModerate_dose_Vasopressin_Therapy_May_Impair.30.aspx Conclusions: Vasopressin at a dosage of 0.04 IU · kg−1 · h−1 may impair gastric mucosal perfusion with minimal global hemodynamic effects. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4863592 Tue, 24 May 2011 17:40:53 +0100 4863592 http://www.medworm.com/index.php?rid=4863593&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F06000%2FCase_Scenario__Anesthesia_for_Maternal_Fetal.36.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4863593 Tue, 24 May 2011 17:40:06 +0100 4863593 http://www.medworm.com/index.php?rid=4863594&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F06000%2FPreexisting_Cognitive_Impairment_and_Mild.15.aspx Conclusions: The prevalence of aMCI in subjects scheduled for total hip joint replacement surgery is similar to that in the general community. PreCI and aMCI tend to identify different subjects. Because aMCI is known to progress to Alzheimer disease, future studies that track cognition before and after anesthesia and surgery should document the presence or absence of aMCI so that the rate of conversion to Alzheimer disease after anesthesia and surgery can be compared with the rate in the nonsurgical population. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4863594 Tue, 24 May 2011 17:39:12 +0100 4863594 http://www.medworm.com/index.php?rid=4863595&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F06000%2FPropofol_Enhances_Memory_Formation_via_an.28.aspx Conclusions: These findings indicate that propofol, in contrast to other commonly used sedatives, enhances emotional memory consolidation when administered immediately after a stressful event by enhancing endocannabinoid signaling. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4863595 Tue, 24 May 2011 17:37:53 +0100 4863595 http://www.medworm.com/index.php?rid=4863596&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F06000%2FUltrasonography_of_the_Adult_Thoracic_and_Lumbar.39.aspx The role of ultrasound in central neuraxial blockade has been underappreciated, partly because of the relative efficacy of the landmark-guided technique and partly because of the perceived difficulty in imaging through the narrow acoustic windows produced by the bony framework of the spine. However, this also is the basis for the utility of ultrasound: an interlaminar window that permits passage of sound waves into the vertebral canal also will permit passage of a needle. In addition, ultrasound aids in identification of intervertebral levels, estimation of the depth to epidural and intrathecal spaces, and location of important landmarks, including the midline and interlaminar spaces. This can facilitate neuraxial blockade, particularly in patients with difficult surface anatomic landmarks... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4863596 Tue, 24 May 2011 17:37:06 +0100 4863596 http://www.medworm.com/index.php?rid=4754605&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F05000%2FIntraoperative_Awareness__From_Neurobiology_to.36.aspx Intraoperative awareness is defined by both consciousness and explicit memory of surgical events. Although electroencephalographic techniques to detect and prevent awareness are being investigated, no method has proven uniformly reliable. The lack of a standard intraoperative monitor for the brain likely reflects our insufficient understanding of consciousness and memory. In this review, the authors discuss the neurobiology of consciousness and memory, as well as the incidence, risk factors, sequelae, and prevention of intraoperative awareness. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4754605 Tue, 26 Apr 2011 17:15:15 +0100 4754605 http://www.medworm.com/index.php?rid=4754604&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F05000%2FCase_Scenario__Bronchospasm_during_Anesthetic.32.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4754604 Tue, 26 Apr 2011 17:13:59 +0100 4754604 http://www.medworm.com/index.php?rid=4754603&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F05000%2FInfluence_of_Low_Tidal_Volume_Ventilation_on_Time.20.aspx Conclusions: Although reduction of tidal volume in mechanically ventilated patients undergoing elective cardiac surgery did not significantly shorten time to extubation, several improvements were observed in secondary outcomes. When these data are combined with a lack of observed complications, a strategy of reduced tidal volume could still be beneficial in this patient population. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4754603 Tue, 26 Apr 2011 17:13:13 +0100 4754603 http://www.medworm.com/index.php?rid=4754602&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F05000%2FAcademic_Performance_in_Adolescence_after_Inguinal.17.aspx Conclusion: In the ethnically and socioeconomically homogeneous Danish population, we found no evidence that a single, relatively brief anesthetic exposure in connection with hernia repair in infancy reduced academic performance at age 15 or 16 yr after adjusting for known confounding factors. However, the higher test score nonattainment rate among the hernia group could suggest that a subgroup of these children are developmentally disadvantaged compared with the background population. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4754602 Tue, 26 Apr 2011 17:12:27 +0100 4754602 http://www.medworm.com/index.php?rid=4754601&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F05000%2FExhaled_Breath_Condensate_in_Mechanically.22.aspx Conclusions: In brain-injured, mechanically ventilated patients with neither acute lung injury nor sepsis, EBC markers appear to indicate the presence of subtle pulmonary inflammation that is mostly unaffected by PEEP. There is evidence for a systemic inflammatory response, especially in patients during zero end-expiratory pressure. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4754601 Tue, 26 Apr 2011 17:11:45 +0100 4754601 http://www.medworm.com/index.php?rid=4754600&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F05000%2FClinical_Assessment_of_the_Ultrasonographic.18.aspx Conclusions: The ultrasonographic measurement of antral CSA could be an important help for the anesthesiologist in minimizing the risk of pulmonary aspiration of gastric contents due to general anesthesia. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4754600 Tue, 26 Apr 2011 17:10:55 +0100 4754600 http://www.medworm.com/index.php?rid=4622990&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F04000%2FMagnesium_Essentials_for_Anesthesiologists.37.aspx Magnesium plays a fundamental role in many cellular functions, and thus there is increasing interest in its role in clinical medicine. Although numerous experimental studies indicate positive effects of magnesium in a variety of disease states, large clinical trials often give conflicting results. However, there is clear evidence for magnesium to benefit patients with eclampsia or torsades de pointes arrhythmias. In addition, magnesium seems to have antinociceptive and anesthetic as well as neuroprotective effects, yet well-designed large clinical trials are required to determine its actual efficacy in pain management or in the state of stroke or subarachnoid hemorrhage. The current review aims to provide an overview of current knowledge and available evidence with respect to physiologic a... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4622990 Tue, 22 Mar 2011 16:47:25 +0100 4622990 http://www.medworm.com/index.php?rid=4622989&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F04000%2FCardiopulmonary_Bypass_associated_Acute_Kidney.36.aspx This review addresses the pathophysiology, risk factors, management strategies and emerging concepts in acute kidney injury associated with cardiopulmonary bypass. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4622989 Tue, 22 Mar 2011 16:46:39 +0100 4622989 http://www.medworm.com/index.php?rid=4622988&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F04000%2FChronic___Blockade_Is_Associated_with_a_Better.16.aspx Conclusions: Acute β blockade, initiated within the first 2 days after surgery, was associated with worse cardiac outcome compared with a matched cohort of patients who underwent surgery on chronic β blockade. These results should be validated in a larger prospective trial. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4622988 Tue, 22 Mar 2011 16:45:39 +0100 4622988 http://www.medworm.com/index.php?rid=4622987&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F04000%2FIncreased_Peak_Postoperative_B_type_Natriuretic.15.aspx Background: Increased peak postoperative B-type natriuretic peptide (BNP) is associated with increased major adverse cardiovascular events and all-cause mortality after coronary artery bypass graft (CABG) surgery. Whether increased postoperative BNP predicts worse postdischarge physical function (PF) is unknown. We hypothesized that peak postoperative BNP associates with PF assessed up to 2 yr after CABG surgery, even after adjusting for clinical risk factors. including preoperative PF. Methods: This two-institution prospective cohort study included patients undergoing primary CABG surgery with cardiopulmonary bypass. Short Form-36 questionnaires were administered to subjects preoperatively and 6 months, 1 yr, and 2 yr postoperatively. Short Form-36 PF domain scores were calculated using ... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4622987 Tue, 22 Mar 2011 16:44:55 +0100 4622987 http://www.medworm.com/index.php?rid=4622986&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F04000%2FPractice_Advisory_for_the_Prevention_of.10.aspx The American Society of Anesthesiologists Task Force on Prevention of Perioperative Peripheral Neuropathies presents an updated report of the Practice Advisory for the Prevention of Perioperative Peripheral Neuropathies. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4622986 Tue, 22 Mar 2011 16:42:28 +0100 4622986 http://www.medworm.com/index.php?rid=4622985&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F04000%2FAquaporin_5_Gene_Promoter__1364A_C_Polymorphism.27.aspx Conclusion: The C-allele of the AQP5 −1364A/C polymorphism is associated with increased 30-day survival in patients with severe sepsis. This finding suggests the importance of variations in expression of AQP5 channels in severe sepsis. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4622985 Tue, 22 Mar 2011 16:41:28 +0100 4622985 http://www.medworm.com/index.php?rid=4508007&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F03000%2FHomicides_Using_Muscle_Relaxants%2C_Opioids%2C_and.42.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4508007 Tue, 22 Feb 2011 16:25:06 +0100 4508007 http://www.medworm.com/index.php?rid=4508006&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F03000%2FHepcidin_and_Anemia_of_the_Critically_Ill_Patient_.38.aspx A better comprehension of iron metabolism, linked to the discovery of hepcidin, changes our understanding of anemia in the critically patient and opens new areas for research at the bedside and in the laboratory. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4508006 Tue, 22 Feb 2011 16:24:22 +0100 4508006 http://www.medworm.com/index.php?rid=4508005&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F03000%2FCase_Scenario__Perioperative_Latex_Allergy_in.35.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4508005 Tue, 22 Feb 2011 16:23:36 +0100 4508005 http://www.medworm.com/index.php?rid=4508004&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F03000%2FRadiation_Exposure_of_the_Anesthesiologist_in_the.14.aspx Conclusions: Current guidelines for occupational radiation exposure to the eye are undergoing review and are likely to be lowered below the current 100–150 mSv/yr limit. Anesthesiologists who spend significant time in neurointerventional radiology suites may have ocular radiation exposure approaching that of a radiologist. To ensure parity with safety standards adopted by radiologists, these anesthesiologists should wear protective eyewear. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4508004 Tue, 22 Feb 2011 16:22:37 +0100 4508004 http://www.medworm.com/index.php?rid=4508003&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F03000%2FPractice_Guidelines_for_Preoperative_Fasting_and.13.aspx The American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration presents an updated report of the Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4508003 Tue, 22 Feb 2011 16:21:57 +0100 4508003 http://www.medworm.com/index.php?rid=4508002&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F03000%2FBispectral_Index_Monitoring%2C_Duration_of.18.aspx Background: Postoperative mortality has been associated with cumulative anesthetic duration below an arbitrary processed electroencephalographic threshold (bispectral index [BIS] (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4508002 Tue, 22 Feb 2011 16:21:17 +0100 4508002 http://www.medworm.com/index.php?rid=4400457&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F02000%2FPractice_Advisory_for_the_Perioperative_Management.13.aspx The American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Cardiac Implantable Electronic Devices presents a Practice Advisory for the Perioperative Management of Patients with Cardiac Implantable Electronic Devices: Pacemakers and Implantable Cardioverter-Defibrillators. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4400457 Tue, 25 Jan 2011 16:28:40 +0100 4400457 http://www.medworm.com/index.php?rid=4400461&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F02000%2FPreoperative_Pain_Sensitivity_and_Its_Correlation.35.aspx The objective of this systematic review was to evaluate the correlation between preoperative pain sensitivity and postoperative pain intensity. After a literature search of MEDLINE, EMBASE, and meeting abstracts, we identified 15 studies (n = 948 patients) with univariate and/or multivariate analysis on the topic. In these studies, three types of pain stimuli were applied: thermal, pressure, and electrical pain. The intensity of suprathreshold heat pain (i.e., pain beyond patient threshold) was most consistently shown to correlate with postoperative pain. The most common limitation of the included studies was the method of statistical analysis and lack of multivariate analysis. More research is required to establish the correlation of other pain sensitivity variables with postoperative pai... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4400461 Tue, 25 Jan 2011 16:19:53 +0100 4400461 http://www.medworm.com/index.php?rid=4400460&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F02000%2FGlycemic_Control_in_the_Intensive_Care_Unit_and.34.aspx Maintaining blood glucose levels less than 8.25 mM during surgery and in intensive care units improves the outcome of patients. However, tight glycemic control cannot be implemented regardless of the risk of hypoglycemia and the patient's condition. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4400460 Tue, 25 Jan 2011 16:19:00 +0100 4400460 http://www.medworm.com/index.php?rid=4400459&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F02000%2FCase_Scenario__Self_extraction_of_Intrathecal_Pump.31.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4400459 Tue, 25 Jan 2011 16:18:13 +0100 4400459 http://www.medworm.com/index.php?rid=4400458&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F02000%2FPerioperative_Nerve_Injury_after_Total_Knee.19.aspx Conclusions: Risk for PNI after TKA was unchanged by the use of RA techniques. This finding supports the notion that the known benefits of RA for patients undergoing TKA can be achieved without increasing risk of neurologic injury. However, in rare situations when PNI occurs, complete recovery may be less likely if it develops after peripheral nerve blockade. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4400458 Tue, 25 Jan 2011 16:17:22 +0100 4400458 http://www.medworm.com/index.php?rid=4400456&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F02000%2FAssociation_between_Intraoperative_Blood.16.aspx Conclusions: Intraoperative blood transfusion is associated with a higher risk of mortality and morbidity in surgical patients with severe anemia. It is unknown whether this association is due to the adverse effects of blood transfusion or is, instead, the result of increased blood loss in the patients receiving blood. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4400456 Tue, 25 Jan 2011 16:14:55 +0100 4400456 http://www.medworm.com/index.php?rid=4278149&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F01000%2FPreparation_of_Modern_Anesthesia_Workstations_for.40.aspx Patients with malignant hyperthermia experience an exaggerated metabolic response when exposed to volatile anesthetic gases and succinylcholine. The minimum concentration of anesthetic gas needed to trigger a malignant hyperthermia crisis in humans is unknown and may remain so because of the inherent risks associated with studying the complex nature of this rare and lethal genetic disorder. The Malignant Hyperthermia Association of the United States provides specific instructions on purging anesthesia machines of volatile agents to reduce the risk of exposure. However, these recommendations were developed from studies of older generation machines. Modern anesthesia workstations are more complex and contain more gas absorbing materials. A review of the literature found the current guideline... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4278149 Tue, 21 Dec 2010 16:05:48 +0100 4278149 http://www.medworm.com/index.php?rid=4278148&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F01000%2FRisk_of_Burnout_in_Perioperative_Clinicians__A.39.aspx Conclusions: Physicians (particularly residents) had the largest global burnout scores, implying increased risk of burnout. Improving overall health, increasing personal support, and improving work satisfaction may decrease burnout among perioperative team members. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4278148 Tue, 21 Dec 2010 16:04:55 +0100 4278148 http://www.medworm.com/index.php?rid=4278147&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F01000%2FHigh_Incidence_of_Burnout_in_Academic_Chairpersons.38.aspx Conclusion: Fifty-one percent of academic anesthesiology chairs exhibit a high incidence/risk of burnout. Age, sex, time as a chair, hours worked, and perceived effectiveness were not associated with high burnout; however, low job satisfaction and reduced self-reported spousal/significant other support significantly increased the risk. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4278147 Tue, 21 Dec 2010 16:04:09 +0100 4278147 http://www.medworm.com/index.php?rid=4278146&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F01000%2FCase_Scenario__Management_of_Intraoperative.35.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4278146 Tue, 21 Dec 2010 16:03:21 +0100 4278146 http://www.medworm.com/index.php?rid=4278145&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F01000%2FPreoperative_Cerebral_Oxygen_Saturation_and.20.aspx Conclusions: Preoperative Sco2 levels are reflective of the severity of cardiopulmonary dysfunction, associated with short- and long-term mortality and morbidity, and may add to preoperative risk stratification in patients undergoing cardiac surgery. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4278145 Tue, 21 Dec 2010 16:02:29 +0100 4278145 http://www.medworm.com/index.php?rid=4278144&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2011%2F01000%2FImpact_of_Preoperative_Statin_Therapy_on_Adverse.25.aspx Conclusions: Chronic statin therapy was associated with a reduction in all cardiac and vascular outcomes after major vascular surgery. Furthermore, in major adverse events, such as multiple organ dysfunction syndrome and surgical complications, statins were also associated with decreased mortality. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4278144 Tue, 21 Dec 2010 16:01:39 +0100 4278144 http://www.medworm.com/index.php?rid=4191304&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F12000%2FNitrate_Nitrite_Nitric_Oxide_Pathway__Implications.38.aspx The gaseous radical nitric oxide is involved in numerous physiologic and pathophysiological events important in anesthesiology and intensive care. Nitric oxide is endogenously generated from the amino acid l-arginine and molecular oxygen in reactions catalyzed by complex nitric oxide synthases. Recently, an alternative pathway for nitric oxide generation was discovered, wherein the inorganic anions nitrate (NO ) and nitrite (NO ), most often considered inert end products from nitric oxide generation, can be reduced back to nitric oxide and other bioactive nitrogen oxide species. This nitrate-nitrite-nitric oxide pathway is regulated differently than the classic l-arginine-nitric oxide synthase nitric oxide pathway, and it is greatly enhanced during hypoxia and acidosis. Several lines of ... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4191304 Tue, 23 Nov 2010 16:08:26 +0100 4191304 http://www.medworm.com/index.php?rid=4191303&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F12000%2FCase_Scenario__Tailored_Sedation_to_the_Individual.33.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4191303 Tue, 23 Nov 2010 16:07:22 +0100 4191303 http://www.medworm.com/index.php?rid=4191302&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F12000%2FThe_Human_Carotid_Body__Expression_of_Oxygen.11.aspx Conclusions: In unique samples of the human CB, we here demonstrate presence of critical proteins in the oxygen-sensing and signaling cascade. Our findings demonstrate similarities to, but also important differences from, established animal models. In addition, our work establishes an essential platform for studying the interaction between anesthetic drugs and human CB chemoreception. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4191302 Tue, 23 Nov 2010 16:06:35 +0100 4191302 http://www.medworm.com/index.php?rid=4191301&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F12000%2FMethicillin_resistant_Staphylococcus_Aureus.37.aspx This review discusses the importance of detection (surveillance) and prophylaxis in methicillin-resistant Staphylococcus aureus colonized patients in the surgical and intensive care unit context. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4191301 Tue, 23 Nov 2010 16:05:38 +0100 4191301 http://www.medworm.com/index.php?rid=4191300&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F12000%2FPrediction_of_Postoperative_Pulmonary.20.aspx Conclusion: The risk index based on seven objective, easily assessed factors has excellent discriminative ability. The index can be used to assess individual risk of PPC and focus further research on measures to improve patient care. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4191300 Tue, 23 Nov 2010 16:04:48 +0100 4191300 http://www.medworm.com/index.php?rid=4191299&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F12000%2FImpact_of_a_Comprehensive_Safety_Initiative_on.30.aspx Conclusion: At less than 1%, the incidence of PCA errors is relatively low. Most errors occur during PCA administration. Safety can be improved by addressing equipment, education, and process issues. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4191299 Tue, 23 Nov 2010 16:03:59 +0100 4191299 http://www.medworm.com/index.php?rid=4089120&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F11000%2FMinimally_Invasive_Measurement_of_Cardiac_Output.37.aspx When assessing the accuracy and precision of a new technique for cardiac output measurement, the commonly quoted criterion for acceptability of agreement with a reference standard is that the percentage error (95% limits of agreement/mean cardiac output) should be 30% or less. We reviewed published data on four different minimally invasive methods adapted for use during surgery and critical care: pulse contour techniques, esophageal Doppler, partial carbon dioxide rebreathing, and transthoracic bioimpedance, to assess their bias, precision, and percentage error in agreement with thermodilution. An English language literature search identified published papers since 2000 which examined the agreement in adult patients between bolus thermodilution and each method. For each method a meta-analy... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4089120 Fri, 22 Oct 2010 04:39:21 +0100 4089120 http://www.medworm.com/index.php?rid=4089119&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F11000%2FRegional_Anesthesia_and_Eye_Surgery.38.aspx Changes in surgical techniques and research aimed at improved safety have resulted in the development of alternative, nonakinesia techniques, such as sub-Tenon block or topical anesthesia. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4089119 Fri, 22 Oct 2010 04:38:27 +0100 4089119 http://www.medworm.com/index.php?rid=4089118&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F11000%2FPathophysiology_and_Treatment_of_Coagulopathy_in.36.aspx Fluid resuscitation after massive hemorrhage in major surgery and trauma may result in extensive hemodilution and coagulopathy, which is of a multifactorial nature. Although coagulopathy is often perceived as hemorrhagic, extensive hemodilution affects procoagulants as well as anticoagulant, profibrinolytic, and antifibrinolytic elements, leading to a complex coagulation disorder. Reduced thrombin activation is partially compensated by lower inhibitory activities of antithrombin and other protease inhibitors, whereas plasma fibrinogen is rapidly decreased proportional to the extent of hemodilution. Adequate fibrinogen levels are essential in managing dilutional coagulopathy. After extensive hemodilution, fibrin clots are more prone to fibrinolysis because major antifibrinolytic proteins ar... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4089118 Fri, 22 Oct 2010 04:37:12 +0100 4089118 http://www.medworm.com/index.php?rid=4089117&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F11000%2FCase_Scenario__Emergency_Reversal_of_Oral.33.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4089117 Fri, 22 Oct 2010 04:35:30 +0100 4089117 http://www.medworm.com/index.php?rid=4089116&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F11000%2FBroadly_Applicable_Risk_Stratification_System_for.14.aspx Conclusion: RSI is a broadly applicable and robust system for assessing hospital length of stay and mortality for groups of surgical patients based solely on administrative data. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4089116 Fri, 22 Oct 2010 04:34:33 +0100 4089116 http://www.medworm.com/index.php?rid=4089115&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F11000%2FShort_term_Memory_Impairment_after_Isoflurane_in.18.aspx Conclusions: Memory deficits occurred long after the sedative, analgesic, and anxiolytic effects of isoflurane subsided. L-655,708 prevented memory deficit, suggesting that an isoflurane interaction at α5GABA receptors contributes to memory impairment during the early postanesthesia period. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4089115 Fri, 22 Oct 2010 04:32:28 +0100 4089115 http://www.medworm.com/index.php?rid=4023857&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F10000%2FAssociation_of_the_Pattern_of_Use_of_Perioperative.11.aspx Conclusion: Perioperative β-blockade administered according to the Perioperative Cardiac Risk Reduction protocol is associated with a reduction in 30-day and 1-yr mortality. Perioperative withdrawal of β-blockers is associated with increased mortality. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=4023857 Fri, 24 Sep 2010 01:34:41 +0100 4023857 http://www.medworm.com/index.php?rid=3999413&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F10000%2FAssociation_of_the_Pattern_of_Use_of_Perioperative.11.aspx Conclusion: Perioperative [beta]-blockade administered according to the Perioperative Cardiac Risk Reduction protocol is associated with a reduction in 30-day and 1-yr mortality. Perioperative withdrawal of [beta]-blockers is associated with increased mortality. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3999413 Fri, 24 Sep 2010 01:34:41 +0100 3999413 http://www.medworm.com/index.php?rid=3999418&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F10000%2FDelayed_Time_to_Defibrillation_after.10.aspx Background: Delay in defibrillation (more than 2 min) is associated with worse survival in patients with a cardiac arrest because of ventricular fibrillation or pulseless ventricular tachycardia in intensive care units and inpatient wards. Methods: We tested the relationship between delayed defibrillation and survival from intraoperative or periprocedural cardiac arrest, adjusting for baseline patient characteristics. The analysis was based on data from 865 patients who had intraoperative or periprocedural cardiac arrest caused by ventricular fibrillation or pulseless ventricular tachycardia in 259 hospitals participating in the National Registry of Cardiopulmonary Resuscitation. Results: The median time to defibrillation was less than 1 min (interquartile range, (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3999418 Thu, 23 Sep 2010 23:53:26 +0100 3999418 http://www.medworm.com/index.php?rid=3999416&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F10000%2FEfficacy_and_Safety_of_Melatonin_as_an_Anxiolytic.32.aspx Melatonin possesses sedative, hypnotic, analgesic, antiinflammatory, antioxidative, and chronobiotic properties that distinguish it as an attractive alternative premedicant. A qualitative systematic review of the literature concerning the perioperative use of melatonin as an anxiolytic or analgesic in adult patients was carried out using the recommended guidelines provided by the Cochrane Handbook for Systematic Reviews of Interventions. Nine of the 10 studies showed statistically significant reduction of preoperative anxiety with melatonin premedication compared with placebo. An opioid-sparing effect or reduced pain scores were evident in five studies whereas three studies were contradictory. Thus, melatonin premedication is effective in ameliorating preoperative anxiety in adults, but it... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3999416 Thu, 23 Sep 2010 23:52:43 +0100 3999416 http://www.medworm.com/index.php?rid=3999417&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F10000%2FSmoking_and_Pain__Pathophysiology_and_Clinical.33.aspx Cigarette smoke, which serves as a nicotine delivery vehicle in humans, produces profound changes in physiology. Experimental studies suggest that nicotine has analgesic properties. However, epidemiologic evidence shows that smoking is a risk factor for chronic pain. The complex relationship between smoking and pain not only is of scientific interest, but also has clinical relevance in the practice of anesthesiology and pain medicine. This review will examine current knowledge regarding how acute and chronic exposure to nicotine and cigarette smoke affects acute and chronic painful conditions. It will cover the relevant pharmacology of nicotine and other ligands at the nicotinic acetylcholine receptor as related to pain, explore the association of cigarette smoking with chronic painful con... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3999417 Thu, 23 Sep 2010 23:51:22 +0100 3999417 http://www.medworm.com/index.php?rid=3999415&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F10000%2FDevelopment_and_Feasibility_of_a_Scale_to_Assess.21.aspx Conclusion: The scores on the PQRS demonstrated an improvement over time, consistent with an expected recovery after surgery and anesthesia, and an ability to discriminate between individuals. Many patients had incomplete recovery by the third postoperative day. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3999415 Thu, 23 Sep 2010 23:50:33 +0100 3999415 http://www.medworm.com/index.php?rid=3999414&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F10000%2FPrediction_of_Pediatric_Endotracheal_Tube_Size_by.14.aspx Conclusions: Measuring subglottic airway diameter with ultrasonography facilitates the selection of appropriately sized ETTs in pediatric patients. This selection method better predicted optimal outer ETT diameter than standard age- and height-based formulas. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3999414 Thu, 23 Sep 2010 23:47:08 +0100 3999414 http://www.medworm.com/index.php?rid=3896856&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F09000%2FAn_Update_on_the_Pathophysiology_of_Complex.37.aspx Complex regional pain syndrome (CRPS) is a neuropathic pain disorder with significant autonomic features. Few treatments have proven effective, in part, because of a historically poor understanding of the mechanisms underlying the disorder. CRPS research largely conducted during the past decade has substantially increased knowledge regarding its pathophysiologic mechanisms, indicating that they are multifactorial. Both peripheral and central nervous system mechanisms are involved. These include peripheral and central sensitization, inflammation, altered sympathetic and catecholaminergic function, altered somatosensory representation in the brain, genetic factors, and psychophysiologic interactions. Relative contributions of the mechanisms underlying CRPS may differ across patients and even... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3896856 Tue, 24 Aug 2010 07:47:35 +0100 3896856 http://www.medworm.com/index.php?rid=3896855&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F09000%2FCervical_Epidural_Pressure_Measurement__Comparison.28.aspx Conclusion: CEP was found to be significantly higher in the prone position than in the sitting position. Furthermore, CEPs were not consistently negative even in the sitting position. These results suggest that the hanging drop technique is inappropriate for identifying the cervical epidural space in either the prone or sitting positions. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3896855 Tue, 24 Aug 2010 07:45:53 +0100 3896855 http://www.medworm.com/index.php?rid=3896854&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F09000%2FInhibitors_of_Angiogenesis__New_Hopes_for.35.aspx While potentially improving overall survival, inhibitors of vascular endothelial growth factor are subject to considerable uncertainty concerning potential side effects. For anesthesiologists, this translates into new challenges when assessing perioperative risks in patients undergoing surgery. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3896854 Tue, 24 Aug 2010 07:45:00 +0100 3896854 http://www.medworm.com/index.php?rid=3896853&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F09000%2FSevoflurane_Binds_and_Allosterically_Blocks.21.aspx Conclusions: This study suggests that sevoflurane also blocks the activation-dependent conformational changes of LFA-1 to the high-affinity form. The allosteric mode of action exemplified by sevoflurane and isoflurane via LFA-1 might represent one of the underlying mechanisms of anesthetic-mediated immunomodulation. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3896853 Tue, 24 Aug 2010 07:43:54 +0100 3896853 http://www.medworm.com/index.php?rid=3896852&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F09000%2FNovel_Oral_Anticoagulants__Implications_in_the.38.aspx Patients undergoing surgery receive anticoagulation for perioperative thromboprophylaxis or ischemic cardiovascular disease. Because anticoagulants may also potentiate bleeding, clinicians need to understand the implications of anticoagulation in perioperative and postoperative patient management. Many newer anticoagulants that are now available or are in clinical development do not require routine coagulation monitoring, have more predictable dose responses, and have fewer interactions with other drugs and food. The most advanced oral anticoagulants in clinical development are the direct factor Xa inhibitors rivaroxaban and apixaban, and the direct thrombin inhibitor dabigatran etexilate. These agents have been evaluated in the postoperative setting in patients undergoing total hip- or kn... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3896852 Tue, 24 Aug 2010 07:38:30 +0100 3896852 http://www.medworm.com/index.php?rid=3896851&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F09000%2FQuality_of_Postoperative_Care_after_Major.11.aspx Conclusions: Our postoperative care policy after major orthopedic surgery strongly correlated with both short-term cardiac outcome (i.e., PMI with troponin Ic release) and long-term cardiac outcome. Thus, in a given surgical population, variation of incidence of troponin Ic elevations could be used as a result indicator for postoperative care policy. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3896851 Tue, 24 Aug 2010 07:33:15 +0100 3896851 http://www.medworm.com/index.php?rid=3781525&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F08000%2FAnemia_and_Patient_Blood_Management_in_Hip_and.36.aspx A systematic search was conducted to determine the characteristics of perioperative anemia, its association with clinical outcomes, and the effects of patient blood management interventions on these outcomes in patients undergoing major orthopedic surgery. In patients undergoing total hip or knee arthroplasty and hip fracture surgery, preoperative anemia was highly prevalent, ranging from 24 +/- 9% to 44 +/- 9%, respectively. Postoperative anemia was even more prevalent (51% and 87 +/- 10%, respectively). Perioperative anemia was associated with a blood transfusion rate of 45 +/- 25% and 44 +/- 15%, postoperative infections, poorer physical functioning and recovery, and increased length of hospital stay and mortality. Treatment of preoperative anemia with iron, with or without erythropoiet... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3781525 Sat, 24 Jul 2010 05:05:01 +0100 3781525 http://www.medworm.com/index.php?rid=3781524&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F08000%2FVolume_Kinetics_for_Infusion_Fluids.35.aspx Volume kinetics is a method used for analyzing and simulating the distribution and elimination of infusion fluids. Approximately 50 studies describe the disposition of 0.9% saline, acetated and lactated Ringer's solution, based on repeated measurements of the hemoglobin concentration and (sometimes) the urinary excretion. The slow distribution to the peripheral compartment results in a 50-75% larger plasma dilution during an infusion of crystalloid fluid than would be expected if distribution had been immediate. A drop in the arterial pressure during induction of anesthesia reduces the rate of distribution even further. The renal clearance of the infused fluid during surgery is only 10-20% when compared with that in conscious volunteers. Some of this temporary decrease can be attributed to... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3781524 Sat, 24 Jul 2010 05:05:00 +0100 3781524 http://www.medworm.com/index.php?rid=3781523&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F08000%2FCosyntropin_for_Prophylaxis_against_Postdural.25.aspx Conclusions: Administration of cosyntropin after ADP in parturients was associated with significant reduction in the incidence of PDPH and need for EBP and significant prolongation of the time from ADP to occurrence of PDPH. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3781523 Sat, 24 Jul 2010 05:05:00 +0100 3781523 http://www.medworm.com/index.php?rid=3781522&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F08000%2FMulticenter%2C_Randomized%2C_Comparative.23.aspx Conclusions: Using current reimbursement scales, these findings suggest that proceeding to radiofrequency denervation without a diagnostic block is the most cost-effective treatment paradigm. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3781522 Sat, 24 Jul 2010 05:05:00 +0100 3781522 http://www.medworm.com/index.php?rid=3781521&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F08000%2FAnesthetic_Management_and_Surgical_Site_Infections.10.aspx Conclusions: Total hip or knee replacement under general anesthesia is associated with higher risk of SSI compared with epidural or spinal anesthesia. Our results support the evolving concept of long-term consequences of anesthesia and emphasize the anesthesiologist's role in preventing SSIs. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3781521 Sat, 24 Jul 2010 05:05:00 +0100 3781521 http://www.medworm.com/index.php?rid=3781520&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F08000%2FIncrease_of_Oxygen_Consumption_during_a.21.aspx Conclusions: Patients failing a decremental pressure support trial, in comparison with those who succeed, had an higher baseline oxygen consumption and were not able to increase their oxygen consumption in response to an increased demand. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3781520 Sat, 24 Jul 2010 05:04:59 +0100 3781520 http://www.medworm.com/index.php?rid=3688268&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F07000%2FAssociation_between_Epidural_Analgesia_and_Cancer.8.aspx Conclusion: In contrast to previous retrospective studies in the colon, breast, and prostate cancer surgery, the authors found that the use of epidural analgesia for perioperative pain control during colorectal cancer surgery was not associated with a decreased cancer recurrence; however, a potential benefit was observed in older patients. The benefit of regional anesthesia on cancer recurrence may thus depend on the specific tumor type. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3688268 Thu, 24 Jun 2010 05:04:57 +0100 3688268 http://www.medworm.com/index.php?rid=3688267&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F07000%2FPreconditioning_and_Postinsult_Therapies_for.33.aspx Perinatal hypoxic-ischemic encephalopathy can be a devastating complication of childbirth. Herein, the authors review the pathophysiology of hypoxic-ischemic encephalopathy and the current status of neuroprotective strategies to ameliorate the injury centering on four themes: (1) monitoring in the perinatal period, (2) rapid identification of affected neonates to allow timely institution of therapy, (3) preconditioning therapy (a therapeutic that reduces the brain vulnerability) before hypoxic-ischemic encephalopathy, and (4) prompt institution of postinsult therapies to ameliorate the evolving injury. Recent clinical trials have demonstrated the significant benefit for hypothermic therapy in the postnatal period; furthermore, there is accumulating preclinical evidence that adjunctive ther... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3688267 Thu, 24 Jun 2010 05:04:57 +0100 3688267 http://www.medworm.com/index.php?rid=3688266&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F07000%2FIncidence_of_Epidural_Catheter_associated.32.aspx Clinical observation suggests that the number of serious epidural catheter-associated infections have increased recently in children. This increase is likely attributed to an increase in reporting and in frequency of epidural analgesia usage. Estimates of infection rates are difficult to determine primarily because of insufficient study of large pediatric populations. In this retrospective study, the authors investigated the incidence of epidural catheter-associated soft tissue and epidural infections after use of continuous epidural analgesia spanning 17 yr. A total of 10,653 epidural catheters were used in 7,792 children. The majority of catheters, 10,437 (98%), were placed for the management of postoperative pain, and 216 (2%) were placed for the management of chronic pain. The authors ... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3688266 Thu, 24 Jun 2010 05:04:56 +0100 3688266 http://www.medworm.com/index.php?rid=3688265&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F07000%2FInhaled_Hydrogen_Sulfide_Protects_against.18.aspx Conclusions: Inhalation of hydrogen sulfide during mechanical ventilation protects against VILI by the inhibition of inflammatory and apoptotic responses. Hydrogen sulfide confers lung protection independently of its ability to induce mild hypothermia during ventilation. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3688265 Thu, 24 Jun 2010 05:04:56 +0100 3688265 http://www.medworm.com/index.php?rid=3688264&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F07000%2FRapid_Chemical_Antagonism_of_Neuromuscular.12.aspx Conclusions: l-Cysteine adduction occurs at different rates by design in olefinic isoquinolinium diester neuromuscular blockers, yielding corresponding durations of action. Antagonism by exogenous l-cysteine is superior to anticholinesterases, inducing inactivation of the active molecules to restore function rapidly at any time. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3688264 Thu, 24 Jun 2010 05:04:55 +0100 3688264 http://www.medworm.com/index.php?rid=3688263&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F07000%2FPhase_II_Study_to_Evaluate_the_Safety_and_Efficacy.13.aspx Conclusions: Compared with ondansetron alone, the casopitant and ondansetron combination results in superior emesis prevention during the first 24 h postoperatively in female patients with known risk factors for postoperative nausea and vomiting. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3688263 Thu, 24 Jun 2010 05:04:55 +0100 3688263 http://www.medworm.com/index.php?rid=3596694&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F06000%2FPrediction_of_Postoperative_Pain__A_Systematic.30.aspx Quantitative testing of a patient's basal pain perception before surgery has the potential to be of clinical value if it can accurately predict the magnitude of pain and requirement of analgesics after surgery. This review includes 14 studies that have investigated the correlation between preoperative responses to experimental pain stimuli and clinical postoperative pain and demonstrates that the preoperative pain tests may predict 4-54% of the variance in postoperative pain experience depending on the stimulation methods and the test paradigm used. The predictive strength is much higher than previously reported for single factor analyses of demographics and psychologic factors. In addition, some of these studies indicate that an increase in preoperative pain sensitivity is associated with... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3596694 Wed, 26 May 2010 12:41:36 +0100 3596694 http://www.medworm.com/index.php?rid=3596693&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F06000%2FCase_Scenario__Anesthetic_Implications_of_Restless.32.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3596693 Wed, 26 May 2010 12:41:36 +0100 3596693 http://www.medworm.com/index.php?rid=3596692&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F06000%2FCellular_Effects_of_Helium_in_Different_Organs.31.aspx Experimental research in cardiac and neuronal tissue has shown that besides volatile anesthetics and xenon, the nonanesthetic noble gas helium also reduces ischemia-reperfusion damage. Even though the distinct mechanisms of helium-induced organ protection are not completely unraveled, several signaling pathways have been identified. Beside the protective effects on heart and brain that are mainly obtained by different pre- and postconditioning protocols, helium also exerts effects in the lungs, the immune system, and the blood vessels. Obviously, this noble gas is biochemically not inert and exerts biologic effects, although until today the question remains open on how these changes are mediated. Because of its favorable characteristics and the lack of hemodynamic side effects, helium is s... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3596692 Wed, 26 May 2010 12:41:36 +0100 3596692 http://www.medworm.com/index.php?rid=3596691&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F06000%2FPungent_General_Anesthetics_Activate_Transient.25.aspx Conclusions: General anesthetics induce a reversible loss of consciousness and render the patient unresponsive to painful stimuli. However, they also produce excitatory effects such as airway irritation and they contribute to postoperative pain. Activation of TRPA1 may contribute to these adverse effects, a hypothesis that remains to be tested in the clinical setting. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3596691 Wed, 26 May 2010 12:41:36 +0100 3596691 http://www.medworm.com/index.php?rid=3596690&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F06000%2FIncreased_Genomic_Copy_Number_of_DEFA1_DEFA3_Is.22.aspx Conclusions: DEFA1/DEFA3 is an important genetic component participating in host immune response to severe sepsis. A higher copy number of DEFA1/DEFA3 (>8 copies) is significantly associated with the risk of severe sepsis. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3596690 Wed, 26 May 2010 12:41:36 +0100 3596690 http://www.medworm.com/index.php?rid=3596689&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F06000%2FPrognostic_Implications_of_Asymptomatic_Left.9.aspx Conclusions: This study demonstrated that asymptomatic LV dysfunction is predictive for 30-day and long-term cardiovascular outcome in open vascular surgery patients. These data suggest that preoperative risk stratification should include not only solely heart failure symptoms but also routine preoperative echocardiography to risk stratify open vascular surgery patients. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3596689 Wed, 26 May 2010 12:41:36 +0100 3596689 http://www.medworm.com/index.php?rid=3499823&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F05000%2FA_New_Technique_to_Assist_Epidural_Needle.18.aspx Conclusions: This is the first study to introduce a new optical method to localize epidural space in a porcine model. Epidural space could be identified by the changes in the reflective pattern of light emitted at 650 nm, which were specific for the ligamentum flavum and dural tissue. Real-time optical information successfully guided a modified Tuohy needle into the epidural space. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3499823 Sat, 24 Apr 2010 12:45:47 +0100 3499823 http://www.medworm.com/index.php?rid=3499822&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F05000%2FAssociation_of_Perioperative_Risk_Factors_and.17.aspx Conclusions: This study found an association between cumulative duration of low BIS and mortality in the setting of cardiac surgery. Notably, this association was independent of both volatile anesthetic concentration and duration of anesthesia, suggesting that intermediate-term mortality after cardiac surgery was not causally related to excessive anesthetic dose. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3499822 Sat, 24 Apr 2010 12:45:47 +0100 3499822 http://www.medworm.com/index.php?rid=3499821&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F05000%2FPostoperative_Mortality_in_The_Netherlands__A.16.aspx Conclusions: This population-based study provided a detailed and contemporary overview of postoperative mortality for the entire surgical spectrum, which may act as reference standard for surgical outcome in Western populations. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3499821 Sat, 24 Apr 2010 12:45:46 +0100 3499821 http://www.medworm.com/index.php?rid=3499820&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F05000%2FImplicit_Memory_Formation_during_Routine.14.aspx Conclusion: No implicit memory formation during routine anesthesia was demonstrated in children. It is increasingly likely that the potential clinical implications of implicit memory formation are less of a concern for pediatric anesthetists. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3499820 Sat, 24 Apr 2010 12:45:46 +0100 3499820 http://www.medworm.com/index.php?rid=3499819&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F05000%2FPractice_Guidelines_for_Perioperative.13.aspx The American Society of Anesthesiologists Task Force on Perioperative Transesophageal Echocardiography presents updated Practice Guidelines for perioperative transesophageal echocardiography (TEE). These Guidelines are intended to assist the physician in determining the appropriate application of TEE, and to improve outcomes of surgical patients by defining the utility of perioperative TEE based on the strength of supporting evidence. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3499819 Sat, 24 Apr 2010 12:45:46 +0100 3499819 http://www.medworm.com/index.php?rid=3499818&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F05000%2FLow_Reticulocyte_Hemoglobin_Content_Is_Associated.29.aspx Conclusion: Low CHr is common at ICU admission and is associated with higher transfusion requirements. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3499818 Sat, 24 Apr 2010 12:45:46 +0100 3499818 http://www.medworm.com/index.php?rid=3396279&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F04000%2FPractice_Guidelines_for_Chronic_Pain_Management_.13.aspx The American Society of Anesthesiologists Task Force on Chronic Pain Management presents updated Practice Guidelines for chronic pain management. The Guidelines provide recommendations intended to optimize pain control, recognizing that a pain-free state may not be attainable; enhance functional abilities, physical and psychological well-being; enhance the quality of life for patients; and minimize adverse outcomes. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3396279 Wed, 24 Mar 2010 13:42:22 +0100 3396279 http://www.medworm.com/index.php?rid=3396278&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F04000%2FResidual_Paralysis_after_Emergence_from_Anesthesia.38.aspx Residual paralysis after emergence from anesthesia directly and markedly worsens patient outcome. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3396278 Wed, 24 Mar 2010 13:42:22 +0100 3396278 http://www.medworm.com/index.php?rid=3396277&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F04000%2FMalpractice_Claims_Associated_with_Medication.27.aspx Conclusions: Most anesthesia malpractice claims for medication management problems involved patients with a history of risk behaviors commonly associated with medication misuse. Malpractice claims arising from medication management had a high proportion of deaths with both patient and physician contributions to the outcome. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3396277 Wed, 24 Mar 2010 13:42:22 +0100 3396277 http://www.medworm.com/index.php?rid=3396276&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F04000%2FSimulation_based_Assessment_in_Anesthesiology_.40.aspx Simulations have taken a central role in the education and assessment of medical students, residents, and practicing physicians. The introduction of simulation-based assessments in anesthesiology, especially those used to establish various competencies, has demanded fairly rigorous studies concerning the psychometric properties of the scores. Most important, major efforts have been directed at identifying, and addressing, potential threats to the validity of simulation-based assessment scores. As a result, organizations that wish to incorporate simulation-based assessments into their evaluation practices can access information regarding effective test development practices, the selection of appropriate metrics, the minimization of measurement errors, and test score validation processes. Th... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3396276 Wed, 24 Mar 2010 13:42:22 +0100 3396276 http://www.medworm.com/index.php?rid=3396275&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F04000%2FFrom_Creatine_Kinase_MB_to_Troponin__The_Adoption.37.aspx Cardiac biomarkers evolved from creatine kinase to the more sensitive troponin. To understand how best to interpret elevations in cardiac biomarkers, it is important to understand their prognostic ability both perioperatively and long term. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3396275 Wed, 24 Mar 2010 13:42:22 +0100 3396275 http://www.medworm.com/index.php?rid=3396274&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F04000%2FTemporal_Trends_in_the_Epidemiology_of_Severe.23.aspx Conclusion: During the 10-yr period that we studied, there was a marked increase in the rate of severe postoperative sepsis but a concomitant decrease in the in-hospital mortality rate in severe sepsis. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3396274 Wed, 24 Mar 2010 13:42:22 +0100 3396274 http://www.medworm.com/index.php?rid=3299449&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F03000%2FFamily_centered_Pediatric_Perioperative_Care.42.aspx This article advances the concept of family-centered pediatric perioperative care by providing a practical and clinically relevant model of delivery of care in this manner. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3299449 Wed, 24 Feb 2010 13:41:10 +0100 3299449 http://www.medworm.com/index.php?rid=3299448&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F03000%2FUltrasound_Imaging_for_Regional_Anesthesia_in.35.aspx Complementary to a previous publication related to pediatric extremity and trunk blockade, the authors present a comprehensive narrative review of the literature pertaining to techniques described and outcomes evaluated for ultrasound imaging in pediatric neuraxial anesthesia. The sonoanatomy related to each block is also described and illustrated to serve as a foundation for better understanding the block techniques described. For neuraxial blockade, ultrasound may fairly reliably predict the depth to loss of resistance and can enable a dynamic view of the needle and catheter after entry into the spinal canal. Particularly, in young infants, direct visualization of the needle and catheter tip may be possible, whereas in older children surrogate markers including the displacement of dura m... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3299448 Wed, 24 Feb 2010 13:41:10 +0100 3299448 http://www.medworm.com/index.php?rid=3299447&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F03000%2FPreoperative_C_reactive_Protein_Predicts_Long_term.20.aspx Conclusion: We demonstrate that preoperative CRP levels as low as 3 mg/l are associated with increased long-term mortality and extended hospital length of stay in relatively lower-acuity patients undergoing primary, nonemergent coronary artery bypass graft-only surgery. These important findings may allow for more objective risk stratification of patients who present for uncomplicated surgical coronary revascularization. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3299447 Wed, 24 Feb 2010 13:41:10 +0100 3299447 http://www.medworm.com/index.php?rid=3299446&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F03000%2FEndothelial_Dysfunction_Enhances_Vasoconstriction.17.aspx Conclusions: Reduction in low molecular weight hemoglobin concentrations to less than 1% is insufficient to abrogate the vasoconstrictor effects of HBOC infusion in healthy awake sheep or in mice with reduced vascular nitric oxide levels associated with endothelial dysfunction. These findings suggest that testing HBOCs in animals with endothelial dysfunction can provide a more sensitive indication of their potential vasoconstrictor effects. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3299446 Wed, 24 Feb 2010 13:41:09 +0100 3299446 http://www.medworm.com/index.php?rid=3299445&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F03000%2FPractice_Advisory_for_the_Prevention%2C_Diagnosis%2C.12.aspx The American Society of Anesthesiologists Task Force on Infectious Complications Associated with Neuraxial Techniques presents a Practice Advisory addressing the prevention, diagnosis, and management of infectious complications associated with neuraxial techniques. This Advisory is intended to identify or describe patients at increased risk of infectious complications, describe techniques for reducing infectious risk, and describe interventions to improve outcomes after the occurrence of infectious complications. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3299445 Wed, 24 Feb 2010 13:41:09 +0100 3299445 http://www.medworm.com/index.php?rid=3299444&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F03000%2FBumetanide_Alleviates_Epileptogenic_and_Neurotoxic.15.aspx Conclusion: These results support the possibility that excitatory output of sevoflurane-potentiated [gamma]-aminobutyric acid type A/glycine systems may contribute to epileptogenic and neurotoxic effects in early postnatal rats. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3299444 Wed, 24 Feb 2010 13:41:09 +0100 3299444 http://www.medworm.com/index.php?rid=3198875&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F02000%2FUltrasound_Imaging_for_Regional_Anesthesia_in.36.aspx The use of ultrasound guidance has provided an opportunity to perform many peripheral nerve blocks that would have been difficult to perform in children based on pure landmark techniques due to the potential for injection into contiguous sensitive vascular areas. This review article provides the readers with techniques on ultrasound-guided peripheral nerve blocks of the extremities and trunk with currently available literature to substantiate the available evidence for the use of these techniques. Ultrasound images of the blocks with corresponding line diagrams to demonstrate the placement of the ultrasound probe have been provided for all the relevant nerve blocks in children. The authors hope that this review will stimulate further research into ultrasound-guided regional anesthesia in i... Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3198875 Sat, 23 Jan 2010 13:41:15 +0100 3198875 http://www.medworm.com/index.php?rid=3198874&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F02000%2FPerioperative_Tobacco_Interventions_by_Chinese.18.aspx Conclusions: Given their adequate knowledge of health risks of smoking, strong perception of responsibilities, and willingness to participate in tobacco control, Chinese anesthesiologists are poised to play a significant role in tobacco control in China that could improve perioperative outcomes and promote long-term health. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3198874 Sat, 23 Jan 2010 13:41:15 +0100 3198874 http://www.medworm.com/index.php?rid=3198873&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F02000%2FPostoperative_Noninvasive_Ventilation.34.aspx No abstract available (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3198873 Sat, 23 Jan 2010 13:41:15 +0100 3198873 http://www.medworm.com/index.php?rid=3198872&cid=s_33866_5_f&fid=33866&url=http%3A%2F%2Fjournals.lww.com%2Fanesthesiology%2FFulltext%2F2010%2F02000%2FComparison_of_Single_use_and_Reusable_Metal.16.aspx Conclusions: The single-use metal blade was more efficient than a reusable metal blade in rapid sequence induction of anesthesia. (C) 2010 American Society of Anesthesiologists, Inc. (Source: Anesthesiology) Anesthesiology journals http://www.medworm.com/rss/comments.php?id=3198872 Sat, 23 Jan 2010 13:41:15 +0100 3198872