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Pediatric anesthesiology: thoughts on the future.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article outlines a multidimensional strategy for pediatric anesthesiology to sustain its progress as a profession and contribute to the health of our children. PMID: 16310667 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: Costarino AT, Deshpande JK Source Type: journals

Palliative care in pediatrics.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Palliative care for children is not about dying; rather, it is about helping children and families to live to their fullest and to restore wholeness while facing complex medical conditions. Family centered pediatric palliative care is the art and science of improving quality of life and attending to suffering for children with life-threatening conditions; the basic principles are presented and discussed in this article. PMID: 16310666 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: Himelstein BP Source Type: journals

Regional anesthesia in children.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The future of regional anesthesia in children is to continue to use current techniques, but also to search for ways to make them easier to employ. The potential development of safe local anesthetic agents with much longer durations, will serve to facilitate improvements in the techniques and styles of practice. The advances in minimally invasive surgical techniques do not mean that regional techniques will not be necessary, but will result in an adaptation of techniques. Peripheral nerve blockade and local wound infiltration can still be used and in some instances, may be very appropriate. PMID: 16310665 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: Zwass MS Source Type: journals

Pediatric acute pain management.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Children are benefiting from the advances made in developmental neurobiology and analgesic pharmacology over the past few decades. Heightened public awareness and increased political pressure from external regulatory agencies are helping to maintain the momentum in improving pediatric pain management. As a result, methods of assessing and managing children's pain are being refined, and new modalities of pain relief are being explored. This review summarizes selected current topics in pediatric acute pain management, with the major emphasis on acute postoperative pain management. PMID: 16310664 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: Brislin RP, Rose JB Source Type: journals

Anesthetic management for pediatric spinal fusion: implications of advances in spinal cord monitoring.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Currently, the detection of emerging injury through intraoperative neurologic monitoring is the best way to prevent neurologic injury. This requires a team approach that includes the anesthesiologist, neurophysiologist, and surgeon. The monitoring modalities available for the patient must be considered in planning the anesthetic management. In addition, intraoperative care for the patient requires an ongoing attention to how the anesthetic drugs affect spinal cord monitoring. PMID: 16310663 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: DiCindio S, Schwartz DM Source Type: journals

Anesthesia for pediatric obesity.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses the unique anesthetic implications of obesity, with an emphasis on children and adolescents. It also touches on the issues surrounding bariatric surgery in the morbidly obese adolescent population. Adolescent bariatric surgery is moving to the forefront as a treatment modality because weight-loss programs alone are not keeping pace with the growth of the problem. Bariatric surgery offers the potential to achieve the weight reductions necessary to reverse the debilitating and costly comorbidities of obesity. PMID: 16310662 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: Brenn BR Source Type: journals

Surgery and anesthesia for children who have cerebral palsy.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Cerebral palsy is a spectrum of signs and symptoms resulting from an injury to the brain during its developmental stage. Children with cerebral palsy have disorders that impact their anesthetic management. In particular, abnormalities of the respiratory system, gastrointestinal system, and neuromuscular system must be considered. There is emerging evidence for abnormalities in their neuromuscular junction that potentially increase their anesthetic risk. In addition, there are recent data explaining possible reasons for increased bleeding in these children. PMID: 16310661 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: Theroux MC, Akins RE Source Type: journals

Anesthesia considerations for pediatric thoracic solid organ transplant.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses the indications, perioperative management, postoperative complications, and patient outcome of pediatric heart transplantation and pediatric lung transplantation. Special emphasis is placed on the anesthetic considerations relevant for children who are undergoing or have received a solid thoracic organ transplant. PMID: 16310660 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: Williams GD, Ramamoorthy C Source Type: journals

Single-lung ventilation in pediatric anesthesia.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article focuses on various devices available for single-lung ventilation in the pediatric age group, the relevant respiratory physiology, and the strategies that optimize oxygenation during one-lung anesthesia. PMID: 16310659 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: Choudhry DK Source Type: journals

Anesthesia ventilators: better options for children.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses unique aspects of pediatric ventilation in the operating room, limitations of traditional anesthesia machine technology, the features of modern anesthesia ventilators that circumvent these limitations, and presents several comparison studies. PMID: 16310658 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: Stayer S, Olutoye O Source Type: journals

New developments in pediatric cardiac anesthesia.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews anesthetic agents, bleeding and coagulation, neurological monitoring, and mechanical circulatory support in the treatment of infants and children. PMID: 16310657 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: Diaz LK, Andropoulos DB Source Type: journals

Procedural sedation in the pediatric patient.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The demand for safe and effective procedural sedation for children is rapidly increasing because of the increased awareness about procedure-related anxiety even in young infants and children. The development of short-acting sedatives, improved monitoring, and new regulatory requirements have led to the evolution of new paradigms of safe, effective, and resource-efficient systems for providing procedural sedation outside the operating rooms by anesthesiologists and nonanesthesiologists. PMID: 16310656 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: Shankar V, Deshpande JK Source Type: journals

Opioids in pediatric anesthesia.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article addresses the developmental pharmacologic changes that occur with opioids as well as their most common clinical uses. PMID: 16310655 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: Jablonka DH, Davis PJ Source Type: journals

The genetics of malignant hyperthermia.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The genetic evaluation of the ryanodine type one receptor (RYR1) gene is unlikely to be a useful screening test of malignant hyperthermia susceptibility. But when significant suspicion of malignant hyperthermia has been raised by well-documented clinical events or strong family history, the genetic evaluation of RYR1 could secure a diagnosis and indicate appropriate treatment for both the index patient and many relatives of all ages, including the youngest. PMID: 16310654 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: Brandom BW Source Type: journals

Preoperative psychological preparation of the child for surgery: an update.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses the psychologic preparation of children for surgery. PMID: 16310653 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: Kain ZN, Caldwell-Andrews AA Source Type: journals

Pediatric anesthesia historical perspective.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article examines how anesthesia evolved to serve the needs of children. Discussion includes milestones in technologic advancement related to pediatric anesthetic care and how collaboration among pediatric surgeons, neonatologists, and pediatric anesthesiologists has helped our specialty to progress. Conversely, the significant contributions of pediatric anesthesiology to pediatric critical care medicine, pain management, and pediatric public health care are also presented. PMID: 16310652 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - December 14, 2005 Category: Anesthesiology Authors: Costarino AT, Downes JJ Source Type: journals

The rapid sequence induction revisited: obesity and sleep apnea syndrome.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Pulmonary aspiration is a cause of anesthesia-related morbidity and mortality, with little change in incidence over the past 20 years. Rapid sequence induction is a common procedure in obese patients, who appear to be more at risk for both pulmonary gastric aspiration and difficult airways, and is required in obese and sleep apnea syndrome patients with symptomatic gastroesophageal reflux or other predisposing conditions. In the elective obese or sleep apnea patient with no other risk factors for pulmonary aspiration, the risks and benefits of rapid sequence induction and cricoid pressure should be weighed. If rapid se...
Source: Anesthesiology Clinics of North America - September 14, 2005 Category: Anesthesiology Authors: Freid EB Source Type: journals

Obstructive sleep apnea syndrome in children.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Obstructive sleep apnea syndrome is characterized by recurrent episodes of partial or complete obstruction of the upper airway during sleep. This results in the disruption of normal ventilation and sleep patterns. The symptoms, polysomnographic findings, pathophysiology, and treatment of obstructive sleep apnea syndrome are significantly different in children from those seen in adults. PMID: 16005829 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - September 14, 2005 Category: Anesthesiology Authors: Bandla P, Brooks LJ, Trimarchi T, Helfaer M Source Type: journals

Nonsurgical and surgical treatments for sleep apnea.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the various treatments currently available for obstructive sleep apnea and discusses some newer and more controversial therapies. Decisions regarding the best treatment should be aimed at relieving the unique levels of obstruction in each patient. Increased controlled outcome trials will be needed to assess the success of each therapy in certain subpopulations in comparison with CPAP. As these data become available, the roles of each therapy will become clearer in treating this major health problem. PMID: 16005828 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - September 14, 2005 Category: Anesthesiology Authors: Couch ME, Senior B Source Type: journals

Nonsurgical and surgical treatment of obesity.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews surgical and nonsurgical options in the management of morbidly obese patients. Overweight and obese individuals should be treated with diet, exercise, and behavioral therapy. The failure of this approach is an indication for pharmacologic therapy. Bariatric surgery reduces obesity-related complications and reduces long-term morbidity, mortality, and health care resources use. PMID: 16005827 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - September 14, 2005 Category: Anesthesiology Authors: Neligan PJ, Williams N Source Type: journals

Postoperative considerations for patients with obesity and sleep apnea.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sleep apnea and obesity are prevalent and often coexisting conditions that challenge medical, anesthetic, and surgical treatment. It is essential to possess knowledge of the magnitude of the sleep disorder as well as concomitant medical comorbidities. Management of obese patients requires a thorough preoperative evaluation and appraisal of anesthetic and operative risks. Postoperatively, these patients can present an additional challenge. PMID: 16005826 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - September 14, 2005 Category: Anesthesiology Authors: Bell RL, Rosenbaum SH Source Type: journals

Anesthetic management of patients with obesity and sleep apnea.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses the intraoperative issues in the care of patients with obesity, including airway management, pharmacokinetics, perioperative positioning, regional anesthesia, the intensity of monitoring required, laparoscopy, and minimizing hypoxia during anesthesia. PMID: 16005825 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - September 14, 2005 Category: Anesthesiology Authors: Passannante AN, Rock P Source Type: journals

Preoperative evaluation of patients with obesity and obstructive sleep apnea.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses the preoperative evaluation of patients with one or both of these conditions. The goals of the preoperative assessment are to identify issues that can adversely affect the patient. This information is critical to forming an effective plan for the perioperative care of the patient. PMID: 16005824 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - September 14, 2005 Category: Anesthesiology Authors: Cartagena R Source Type: journals

The biology and genetics of obesity and obstructive sleep apnea.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews current knowledge about a genetic approach to the causes and risk factors for sleep apnea. Recent evidence suggests that genetic variability may play a significant causal role in the pathogenesis of obstructive sleep apnea. The data supporting a genetic influence on sleep apnea, and the perioperative management of patients with sleep apnea are examined. PMID: 16005823 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - September 14, 2005 Category: Anesthesiology Authors: Tung A Source Type: journals

Pathophysiology of obstructive sleep apnea.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article explores the physiologic basis and symptoms of obstructive sleep apnea--a general term encompassing central sleep apnea and obstructive sleep apnea. The former is relatively uncommon while the latter is much more common. Episodic collapse and blockage of the upper airway occur during sleep despite continuous respiratory effort. Three types of sleep obstructive breathing--apnea, hypopnea, and airway resistance--are associated with respiratory-related arousals from sleep. PMID: 16005822 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - September 14, 2005 Category: Anesthesiology Authors: Pashayan AG, Passannante AN, Rock P Source Type: journals

Pathophysiologic changes of obesity.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article builds on the well-known changes that occur with obesity by drawing from recent advances reported in the literature for an improved understanding of obese patients. The dissemination of information regarding the health risks with being overweight or obese to both the public and the health care community are widespread and effective from a public health perspective. The mechanisms underlying these associated risks must continue to be explored for physicians' knowledge to truly increase, and lead to advances in our understanding of the pathophysiology of obesity. PMID: 16005821 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - September 14, 2005 Category: Anesthesiology Authors: Kuchta KF Source Type: journals

Demographics and diagnosis of obstructive sleep apnea.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the terminology of obstructive sleep apnea and the associated diagnostic tests and provides an overview of the risk factors for this chronic condition. Sleep apnea affects 2% to 4% of middle-aged working adults in the general population, however, a considerable number of affected individuals remain undiagnosed. Patients with the disease may be at a higher risk for adverse perioperative outcomes. Knowledge of factors associated with an increased risk of obstructive sleep apnea is vital to the perioperative assessment and anesthetic plan. PMID: 16005820 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - September 14, 2005 Category: Anesthesiology Authors: Stierer T, Punjabi NM Source Type: journals

Definitions and demographics of obesity: diagnosis and risk factors.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The incidence of obesity is increasing yearly among adults and children in the United States and worldwide. Although there is a significant genetic component to obesity, the genome has not changed. The epidemic is caused by an increase in dietary fat and caloric input and a decrease in physical activity. There are significant racial, ethnic, and sociologic differences in all categories of obesity as well as in the disease burden it brings. The effects of the obesity epidemic are considerable, second only to tobacco use in the expenditure of health care dollars and as a cause of premature mortality. PMID: 16005819 [...
Source: Anesthesiology Clinics of North America - September 14, 2005 Category: Anesthesiology Authors: Polk SL Source Type: journals

Current status of artificial O2 carriers.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article describes currently evaluated artificial O2 carriers, summarizes their efficacy, and discusses their side effects, based on and restricted to published data. For compounds in phase III testing, approximately 500 to 1000 patients have been dosed, and similar numbers of control patients have been investigated. For compounds in phase I or II testing, the number of patients dosed is significantly less. Unfortunately, there is a significant amount of nonpublished data, which renders the overall assessment difficult, and the direct comparison among different types of artificial O2 carriers is significantly limited b...
Source: Anesthesiology Clinics of North America - June 14, 2005 Category: Anesthesiology Authors: Thyes C, Spahn DR Source Type: journals

Blood conservation in the critically ill patient.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This review focuses on transfusion practice in the critically ill. PMID: 15922906 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - June 14, 2005 Category: Anesthesiology Authors: Corwin HL Source Type: journals

Blood conservation in pediatric anesthesia.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This review focuses on perioperative blood conservation techniques and the role of transfusion triggers and algorithms, preoperative autologous donation, acute normovolemic hemodilution, intraoperative blood salvage, deliberate hypotension, and preoperative recombinant human erythropoietin in avoiding allogeneic blood transfusion in pediatric patients. PMID: 15922905 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - June 14, 2005 Category: Anesthesiology Authors: Weldon BC Source Type: journals

Clinical outcomes in cardiac surgery: conventional surgery versus bloodless surgery.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Bleeding during and after cardiac operations and the effects of cardiopulmonary bypass hemodilution commonly result in blood transfusions. Excessive microvascular bleeding can result in re-exploration and prolonged hospitalization. Nearly 20% of all blood transfusions in the United States are associated with cardiac surgery. The risks associated with the use of allogeneic blood product transfusion include mistransfusion, immunologic complications, and transmission of infectious diseases. The large demand for blood products places significant pressure on the national blood supply, resulting in frequent shortages. The va...
Source: Anesthesiology Clinics of North America - June 14, 2005 Category: Anesthesiology Authors: Shander A, Rijhwani TS Source Type: journals

Anemia and clinical outcomes.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses the impact of anemia in the context of the perioperative setting. Relevant data from animal and human studies, the adaptive mechanisms in anemia, and current views on transfusion triggers are evaluated. Recommendations are provided for the anesthesiologist for transfusion of red blood cells. PMID: 15922903 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - June 14, 2005 Category: Anesthesiology Authors: Kuriyan M, Carson JL Source Type: journals

Preoperative evaluation and methods to reduce blood use in orthopedic surgery.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Major elective orthopedic surgery may be associated with significant blood loss and allogeneic transfusion risk. Identifying patients at risk for allogeneic transfusion is best accomplished with a thorough preoperative evaluation of the patient's hematopoietic system, which, unfortunately, is not always carried out. An evaluation of the hematopoietic system begins with an evaluation of the patient's hemoglobin level a minimum of 30 days before the scheduled surgical procedure. This allows for expedited diagnosis and treatment of underlying comorbidities. An unexplained low level of hemoglobin or a hemoglobin level low ...
Source: Anesthesiology Clinics of North America - June 14, 2005 Category: Anesthesiology Authors: Keating EM Source Type: journals

Perioperative assessment of the elective orthopedic surgery patient.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
There are a number of safe and cost-effective therapeutic options for the potential management of all patients without allogeneic blood transfusion. Orthopedic surgeons should consider blood management using these options for all patients to provide them with safe and effective therapy, while minimizing the risks of allogeneic blood and preserving our decreasing blood resources. PMID: 15922901 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - June 14, 2005 Category: Anesthesiology Authors: Spence RK, Parce P Source Type: journals

Red blood cell recovery and reinfusion.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article describes the intraoperative washed cell salvage process and principles of cell salvage technology and addresses the parameters that can maximize the effectiveness of the process. Used appropriately, this technique can be used to recover and readminister several blood volumes of red cells. PMID: 15922900 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - June 14, 2005 Category: Anesthesiology Authors: Waters JH Source Type: journals

Acute normovolemic hemodilution.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article examines the technique of hemodilution and the consequences, benefits, efficacy, cost effectiveness, and future of acute normovolemic hemodilution. PMID: 15922899 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - June 14, 2005 Category: Anesthesiology Authors: Monk TG Source Type: journals

Autologous blood donation.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Preoperative autologous blood donation has become accepted as a standard practice in elective surgery. Subsequent improvements in blood safety and evolving surgical techniques resulting in less blood loss have caused a national decline in preoperative autologous blood donation by approximately 50%. Nevertheless, the continuing emergence of new pathogens and the potential for severe blood inventory shortages continue to give preoperative autologous blood donation an important role in blood conservation strategies. PMID: 15922898 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - June 14, 2005 Category: Anesthesiology Authors: Goodnough LT Source Type: journals

Errors in transfusion medicine.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In the past two decades, health services in the developed world have directed much resource toward improving the safety of the blood supply. Blood is collected, tested, and processed within a carefully controlled environment, and quality is assured by rigorous donor selection procedures and increasingly sensitive and sophisticated testing for transfusion-transmitted pathogens. Additional safety strategies implemented by some blood services include leukocyte reduction, bacterial screening, and pathogen inactivation. Thus, the transfusion chain from the donor to the point of issue from the blood center is highly regulate...
Source: Anesthesiology Clinics of North America - June 14, 2005 Category: Anesthesiology Authors: Stainsby D Source Type: journals

Risks of blood transfusion.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses advances in blood safety during the last 20 years, particularly for prevention of transfusion-transmitted viral infections. Although the most serious known risks from blood transfusion are administrative errors, transfusion-related acute lung injury, and bacterial contamination in platelet products, infection from emerging pathogens such as West Nile virus emphasizes the need for implementing proactive strategies. Pathogen inactivation technologies and reactive strategies such as nucleic acid testing ensure continued advances in blood safety. PMID: 15922896 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - June 14, 2005 Category: Anesthesiology Authors: Goodnough LT Source Type: journals

Organization, function, and implementation of acute pain service.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Undertreatment of postoperative pain continues to be a major problem internationally. The solution does not seem to be the development of new analgesic drugs or technologies but the development of an appropriate organization that utilizes existing expertise. Evidence suggests that the introduction of an Acute Pain Service (APS) reduces patients' pain intensity, but other outcome benefits are modest. Although the number of hospitals with an APS is increasing, the literature is unclear about the optimal structure, staffing, and function. There is a need for the development of well-defined APS criteria with which to asses...
Source: Anesthesiology Clinics of North America - March 14, 2005 Category: Anesthesiology Authors: Rawal N Source Type: journals

Procedure-specific postoperative pain management.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Procedure-specific postoperative pain management guidelines arguably are more helpful to the clinician than general pain guidelines or guidelines based on the use of the Oxford League Tables. Two sources, the United States Veteran's Health Administration and the European Prospect Working Group, offer websites that include surgical procedure-specific postoperative pain management guidelines, which are available and currently updated. PMID: 15763419 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - March 14, 2005 Category: Anesthesiology Authors: Kehlet H Source Type: journals

Multimodal analgesia techniques and postoperative rehabilitation.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The concept of multimodal analgesia involves the use of different classes of analgesics and different sites of analgesic administration to provide superior dynamic pain relief with reduced analgesic-related side effects. Although multimodal analgesia techniques have assumed increasing importance in the management of perioperative pain, it has become increasingly apparent that postoperative outcome may not be improved. Nevertheless, the integration of multimodal analgesia techniques with a multimodal and multidisciplinary rehabilitation program may enhance recovery, reduce hospital stay, and facilitate early convalescen...
Source: Anesthesiology Clinics of North America - March 14, 2005 Category: Anesthesiology Authors: Joshi GP Source Type: journals

Postoperative pain management in children.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
There is increased awareness of the need for effective postoperative analgesia in infants and young children. A multi-modal approach to preventing and treating pain usually is used. Mild analgesics, local and regional analgesia, and opioids when indicated, frequently are combined to minimize adverse effects of individual drugs or techniques. PMID: 15763417 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - March 14, 2005 Category: Anesthesiology Authors: Verghese ST, Hannallah RS Source Type: journals

Peripheral nerve blocks and continuous catheter techniques.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Peripheral nerve blocks provide intense, site-specific analgesia and are associated with a lower incidence of side effects when compared with many other modalities of postoperative analgesia. Continuous catheter techniques further prolong these benefits. These advantages can facilitate a prompt recovery and discharge and achieve significant perioperative cost savings. This is of tremendous value in a modern health care system that stresses cost-effective use of resources and a continued shift toward shorter hospital stay as well as outpatient surgery. PMID: 15763416 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - March 14, 2005 Category: Anesthesiology Authors: Evans H, Steele SM, Nielsen KC, Tucker MS, Klein SM Source Type: journals

Epidural analgesia for postoperative pain.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Epidural analgesia provides superior analgesia compared with other postoperative analgesic techniques. Additionally, perioperative epidural analgesia confers physiologic benefits, which may potentially decrease perioperative complications and improve postoperative outcome. However, there are many variables (eg, choice of analgesics, catheter-incision congruency, and duration of analgesia) that may influence the efficacy of epidural analgesia. In addition, the use of epidural analgesia should be evaluated on an individual basis because there are risks associated with this technique. PMID: 15763415 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - March 14, 2005 Category: Anesthesiology Authors: Richman JM, Wu CL Source Type: journals

Intravenous patient-controlled analgesia: one size does not fit all.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews some of the factors that could limit the usefulness of intravenous patient-controlled analgesia in the clinical setting and what strategies might allow patient-controlled analgesia to become more effective. PMID: 15763414 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - March 14, 2005 Category: Anesthesiology Authors: Macintyre PE Source Type: journals

Role of analgesic adjuncts in postoperative pain management.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the literature regarding use of analgesic adjuncts in the perioperative period. PMID: 15763413 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - March 14, 2005 Category: Anesthesiology Authors: Habib AS, Gan TJ Source Type: journals

Clinical pharmacology of local anesthetics.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Whereas currently available local anesthetics may be suitable for intraoperative and in-hospital postoperative use, long-acting analgesia after outpatient procedures will require new techniques and drugs. Catheter delivery systems are rapidly gaining clinical acceptance and allow for great flexibility in dosing. Encapsulated local anesthetics can provide the slow release of drugs. Novel, long-acting local anesthetics are being investigated but are not yet ready for clinical use. In addition to the effects on the sodium channel, other actions of these novel compounds need to be explored, because both beneficial and detr...
Source: Anesthesiology Clinics of North America - March 14, 2005 Category: Anesthesiology Authors: White JL, Durieux ME Source Type: journals

Role of cyclooxygenase-2 inhibitors in postoperative pain management.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Cyclooxygenase (COX)-2 inhibitors are as efficacious as nonselective nonsteroidal anti-inflammatory drugs for the treatment of postoperative pain but have the advantages of a better gastrointestinal side-effect profile as well as a lack of antiplatelet effects. There have been recent concerns regarding the cardiovascular side effects of COX-2 inhibitors. Nonetheless, they remain a valuable option for postoperative pain management. The pharmacology of these agents and available studies are reviewed. PMID: 15763411 [PubMed - indexed for MEDLINE]
Source: Anesthesiology Clinics of North America - March 14, 2005 Category: Anesthesiology Authors: Gajraj NM, Joshi GP Source Type: journals