Apneic Oxygenation: Let’s All Just Take a Deep Breath
(Abstracted from Can J Anaesth, 64(4):358–360, 2017)
The diffusion of oxygen into the lungs without ventilation is known as apneic oxygenation and was first highlighted in 1959. The article by Wong et al1 assessed the effectiveness of apneic oxygenation with a narrative review examining 19 studies of apneic oxygenation in varied cohorts. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Miscellaneous Source Type: research
Standardized Care Versus Precision Medicine in the Perioperative Setting: Can Point-of-Care Testing Help Bridge the Gap?
(Abstracted from Anesth Analg, 124(4):1347–1353, 2017)
In perioperative setting, precision medicine targets the patient's inherent genetic and environmental variability to achieve an individualized approach to health care, whereas standardized care pathways and protocols aim at decreasing variability of care at the systemic and practitioner level. The current article aims at understanding precision medicine and outlining an implementation procedure in the perioperative setting. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Techniques and Monitoring Source Type: research
Cricoid Pressure Controversies: Narrative Review
(Abstracted from Anesthesiology, 126(4):738–752, 2017)
This narrative review summarizes and addresses the effectiveness, controversies, and potential complications associated with the use of cricoid pressure (CP) in clinical practice. B. A. Sellick, who devised this maneuver in 1961, demonstrated that firm CP on a cadaver prevented stomach contents being regurgitated to the pharynx even with prior stomach distension (with water) and maintaining the steep Trendelenburg tilt. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Techniques and Monitoring Source Type: research
Determination of Perioperative Blood Loss: Accuracy or Approximation?
(Abstracted from Anesth Analg, 125(1):280–286, 2017)
The purpose of this research was to evaluate the accuracy of different perioperative blood loss calculation methods from previous clinical trials with new formulas. With more complex surgeries happening, blood loss is a major cause for adverse events; hence, a criterion standard to estimate blood loss and manage it becomes crucial to optimize patient outcomes. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Techniques and Monitoring Source Type: research
Safe Performance of Peripheral Regional Anaesthesia: The Significance of Ultrasound Guidance
(Abstracted from Anaesthesia, 72(4):431–434, 2017)
Ultrasound guidance has contributed toward making regional anaesthesia safer. Sermeus et al1 (“Ultrasound-Guided Approach to Nerves [Direct vs. Tangential] and the Incidence of Intraneural Injection: A Cadaveric Study”) evaluated the safety of ultrasound guidance in regional anaesthesia by comparing tangential and direct needle-to-nerve approach in nerve puncture and intraneural injection. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Regional Anesthesia and Pain Control Source Type: research
Preoperative Fasting Guidelines: Why Are We Not Following Them?: The Time to Act Is Now
(Abstracted from Anesth Analg, 124(4):1041–1043, 2017)
This editorial accompanies the study by Shiraishi et al1 (“Gastric Fluid Volume Change After Oral Rehydration Solution Intake in Morbidly Obese and Normal Controls: A Magnetic Resonance Imaging–Based Analysis”) that tests gastric volumes preoperatively using magnetic resonance imaging in order to validate the American Society of Anesthesiologists (ASA) guidelines allowing patients to consume clear liquids until 2 hours before surgery involving anesthesia. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Preoperative and Postoperative Care Source Type: research
Remifentanil Patient-Controlled Intravenous Analgesia for Labor Pain Relief: Is It Really an Option to Consider?
(Abstracted from Anesth Analg, 124(4):1029–1031, 2017)
Patient-controlled intravenous analgesia (PCIA) using remifentanil is a moderately effective nonneuraxial, parenteral opioid analgesic for labor pain relief in patients with contraindications to neuraxial analgesia. A survey of academic teaching centers across the United States by Aaronson et al1 (“A Survey of Intravenous Remifentanil Use for Labor Analgesia at Academic Medical Centers in the United States”) emphasizes the potential risks of respiratory depression associated with the use of intrapartum remifentanil PCIA. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Obstetric Anesthesia Source Type: research
Anesthetic Neuroprotection in Experimental Stroke in Rodents: A Systematic Review and Meta-analysis
(Abstracted from Anesthesiology, 126(4):653–665, 2017)
The primary aim of the meta-analysis undertaken here was to assess the impact (if any) of study quality, publication bias, and the timing of anesthetic administration on neurologic outcomes of the middle cerebral artery filament occlusion model of focal ischemia in rodents. The filament model in rats and mice is usually utilized to study the effects and mechanisms of potential neuroprotective agents. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Neuroanesthesia Source Type: research
Cerebral Autoregulation-Oriented Therapy at the Bedside: A Comprehensive Review
(Abstracted from Anesthesiology, 126(6):1187–1199, 2017)
This comprehensive review by Rivera-Lara et al1 aims to provide an overview of cerebral autoregulation-directed therapy use at the point of care in order to manage cerebral perfusion pressure, and this study also aims to assess whether this therapy can optimize functional outcomes. The article summarizes the physiology and measurement methods of cerebral autoregulation before going on to deliberate on the validation of different cerebral autoregulation indices. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Neuroanesthesia Source Type: research
The Protective Effects of Dexmedetomidine on Ischemic Brain Injury: A Meta-analysis
(Abstracted from J Clin Anesth, 40:25–32, 2017)
The inflammatory cascade mediated by neuroendocrine hormones and proinflammatory mediators, caused by disordered hemodynamics or adverse stress, has been implicated in the pathophysiology of ischemic brain injury. The α2-adrenoceptor agonist dexmedetomidine (DEX) inhibits inflammatory and neuroendocrine responses, but comprehensive meta-analysis to estimate neuroprotection of α2-agonists is still lacking and could guide clinical treatment and prognosis. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: Neuroanesthesia Source Type: research
Into the Wilderness?: The Growing Importance of Nonoperating Room Anesthesia Care in the United States
(Abstracted from Anesth Analg, 124(4):1044–1046, 2017)
This editorial reviews the article by Nagrebetsky et al1 (“Growth of Nonoperating Room Anesthesia Care in the United States: A Contemporary Trends Analysis”), which highlights the fact that the need for anesthesia care is moving beyond the operating room (OR). (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Growth of Nonoperating Room Anesthesia Care in the United States: A Contemporary Trends Analysis
(Abstracted from Anesth Analg, 124(4):1261–1267, 2017)
The purpose of this retrospective analysis was to assess the available data from the National Anesthesia Clinical Outcomes Registry (NACOR) to distinguish and compare non–operating room anesthesia (NORA) and traditional operating room (OR) cases as well as to examine the evolution and variations in annual frequency and characteristics of NORA and OR cases. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Mild Cognitive Impairment and Exposure to General Anesthesia for Surgeries and Procedures: A Population-Based Case-Control Study
(Abstracted from Anesth Analg, 124(4):1277–1290, 2017)
The purpose of this article was to use a case-control design to prove or disprove the hypothesis that exposure to general anesthesia for surgery and procedures in patients 40 years or older is associated with prevalent mild cognitive impairment (MCI) and analysis to find the connection between general anesthesia in the “aged” (defined here as ≥40 years) and cognitive impairment (eg, MCI, dementia). Preclinical studies indicate that some general anesthesia drugs may cause neurohistologic changes consistent with Alzheimer dementia. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Deep Neuromuscular Block to Optimize Surgical Space Conditions During Laparoscopic Surgery: A Systematic Review and Meta-analysis
(Abstracted from Br J Anaesth, 118(6):834–842, 2017)
Lowering the elevated intra-abdominal pressure during pneumoperitoneum created in laparoscopic procedures can impair the quality of the surgical field and increase the risk of intraoperative complications. Deep neuromuscular block (NMB) has been known to improve surgical conditions in laparoscopic procedures; however, the routine use of NMB is still debatable. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
Sugammadex Efficacy for Reversal of Rocuronium- and Vecuronium-Induced Neuromuscular Blockade: A Pooled Analysis of 26 Studies
(Abstracted from J Clin Anesth, 41:84–91, 2017)
The Food and Drug Administration–approved pharmaceutical product, sugammadex, rapidly and effectively reverses moderate and deep levels of rocuronium- or vecuronium-induced neuromuscular blockade (NMB) through a unique mechanism and is currently approved for use in more than 80 countries. This pooled analysis aimed to compare the efficacy of sugammadex with neostigmine or placebo for reversal of the effects of rocuronium- or vecuronium-induced blockade and to illustrate consistency of results with sugammadex across the various patient populations. (Source: Survey of Anesthesiology)
Source: Survey of Anesthesiology - October 1, 2017 Category: Anesthesiology Tags: General Anesthesia Source Type: research
