Perioperative Point of Care Ultrasound (POCUS) for Anesthesiologists: an Overview

This article provides a brief overview of the indications, techniques for image acquisition, and general principles in interpreting basic images.Recent FindingsWhole-body POCUS can provide quick diagnoses and impact clinical management across relevant pre-, intra-, and post-operative settings. Anesthesia providers need to understand different applications for POCUS, including focused cardiac ultrasound (FoCUS), lung ultrasound (LUS), gastric ultrasound, abdominopelvic ultrasound, and the use of ultrasound for airway management. Currently, there is no standard ultrasound curriculum for anesthesiology residents, and teaching methods include informal bedside teaching, structured expert demonstration, didactic lectures, and simulations. Model/simulation-based lecture series may be effective in teaching ultrasound to anesthesiology residents, and e-learning and traditional didactics are both equally effective in teaching POCUS applications such as LUS and focused assessment with sonography in trauma (FAST). Creating protocol-guided frameworks for POCUS, such as I-AIM (indication, acquisition, interpretation, medical decision making), can also ensure more consistent and reliable diagnoses and interpretations of findings.SummaryApplications of POCUS should be focused, goal-oriented, easily learned, rapidly performable at bedside, accurate, and reliable. A variety of studies have shown this potential for POCUS in assessing cardiac, pulmonary, and intraabdominal pathologies, making it...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research

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AbstractMigraine is a common brain disorder with a large genetic component. Of the two main migraine types, migraine with aura and migraine without aura, the genetic underpinning in the former is least understood. Given the evidence from epidemiological studies in cohorts and families that the genetic contribution is highest in migraine with aura, this seems paradoxical. Various genetic approaches have been applied to identify genetic factors that confer risk for migraine. Initially, so-called candidate gene associations studies (CGAS) have been performed that test DNA variants in genes prioritized based on presumed a prio...
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research
elletti Post-traumatic headache (PTH) may be considered a secondary headache, which is linked to severe disability and psychosocial impairment. Interestingly, nearly 30% of subjects with persistent post-traumatic headache (PPTH) also suffer from post-traumatic stress disorder (PTSD). Although existing studies demonstrated the existence of common pathophysiological characteristics in subjects with migraine and PPTH, the differences and similarities between these complex diseases are currently poorly understood and are yet to be comprehensively elucidated. Thus, the present review aimed to systematically investigate the ...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Review Source Type: research
AbstractBackgroundSeveral previous studies have reported a cross-sectional association between elevated high sensitivity C-reactive protein (hs-CRP) and migraine. The aim of this population-based follow-up study was to investigate the influence of hs-CRP at baseline on the risk of developing migraine 11  years later.MethodsData from the Nord-Tr øndelag Health Study performed in 2006–2008 (baseline) and 2017–2019 were used. A total of 19,574 participants without migraine at baseline were divided into three groups based on hs-CRP levels (
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research
ConclusionsThis meta-analysis suggests that lasmiditan is effective for the acute treatment of migraine with a higher incidence of CNS-related adverse reactions compared with placebo. Long-term, open-label, multi-dose trials are required to verify the current findings.
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research
AbstractThe fifth cranial nerve is the common denominator for many headaches and facial pain pathologies currently known. Projecting from the trigeminal ganglion, in a bipolar manner, it connects to the brainstem and supplies various parts of the head and face with sensory innervation. In this review, we describe the neuroanatomical structures and pathways implicated in the sensation of the trigeminal system. Furthermore, we present the current understanding of several primary headaches, painful neuropathies and their pharmacological treatments. We hope that this overview can elucidate the complex field of headache patholo...
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research
Authors: Ondriska F, Boldiš V, Stanislavová M, Antolová D, Miterpáková M, Hanáček A, Vešperová S, Jančovič I Abstract Dirofilaria repens is the causative agent of human subcutaneous or, less often, ocular dirofilariasis. The work presents a rare case of ocular dirofilariasis manifested by previous subcutaneous migration accompanied by severe headache symptoms. In February 2017, a 58-yr-old man from Trnava region, western Slovakia, noticed red and itchy stripes on his left leg. Inflamed but painless stripes disappeared and showed up again every 5-7 days, mig...
Source: Iranian Journal of Parasitology - Category: Parasitology Tags: Iran J Parasitol Source Type: research
Conclusions: CT-guided low-temperature plasma radiofrequency ablation is an effective and safe strategy for refractory cluster headache. For patients who have not responded to conservative treatment, this minimally invasive intervention is a reliable alternative. PMID: 32489492 [PubMed]
Source: Videosurgery and Other Miniinvasive Techniques - Category: Surgery Tags: Wideochir Inne Tech Maloinwazyjne Source Type: research
ConclusionsAmong patients with persistent PTH, erenumab resulted in a lower frequency of moderate to severe headache days in this 12-week open-label trial. In addition, erenumab was well-tolerated as discontinuations due to adverse events were low. Placebo-controlled randomized clinical trials are needed to adequately evaluate the efficacy and safety of erenumab in patients with  persistent PTH.Trial registrationClinicalTrials.Gov,NCT03974360. Registered on April 17, 2019 - Retrospectively registered
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research
This study demonstrates the sensit ivity of the TMT in detecting cognitive alterations in migraine. This test should be considered for inclusion in cognitive batteries assessing patients with migraine.
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research
Conclusions Given that a high frequency of families endorsed that they were worried about the headache when presenting to the ED, clinicians should strive to make a diagnosis of migraine in the ED setting and to educate families about this diagnosis. Because of divergent parent and patient perspectives, health care providers should inquire about family expectations, especially in relation to expectations for investigations and concerns surrounding intravenous interventions, and ensure that both the patient's and parent's perspectives are considered when developing a management plan for pediatric migraine.
Source: Pediatric Emergency Care - Category: Emergency Medicine Tags: Original Articles Source Type: research
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