Thoracic Epidural Analgesia Is Not Associated With Improved Survival After Pancreatic Surgery: Long-Term Follow-Up of the Randomized Controlled PAKMAN Trial
CONCLUSIONS: Results from this long-term follow-up of the PAKMAN randomized controlled trial do not support favoring EDA over PCIA in pancreatic surgery. Until further evidence is available, EDA and PCIA should be considered similar regarding long-term survival.PMID:38335141 | DOI:10.1213/ANE.0000000000006812 (Source: Anesthesia and Analgesia)
Source: Anesthesia and Analgesia - February 9, 2024 Category: Anesthesiology Authors: Rosa Klotz Azaz Ahmed Anja Tremmel Christopher B üsch Solveig Tenckhoff Colette Doerr-Harim Johan F Lock Elmar-Marc Brede J örg Köninger Jan-Henrik Schiff Uwe A Wittel Alexander H ötzel Tobias Keck Carla Nau Anca-Laura Amati Christian Koch Markus K Di Source Type: research
Association of Early Dexmedetomidine Utilization With Clinical Outcomes After Moderate-Severe Traumatic Brain Injury: A Retrospective Cohort Study
CONCLUSIONS: Dexmedetomidine is being utilized increasingly as a sedative for mechanically ventilated patients with msTBI. Early dexmedetomidine exposure may lead to improved patient outcomes in this population.PMID:38335145 | DOI:10.1213/ANE.0000000000006869 (Source: Anesthesia and Analgesia)
Source: Anesthesia and Analgesia - February 9, 2024 Category: Anesthesiology Authors: Sunny Yang Liu Margot Kelly-Hedrick Jordan Komisarow Jordan Hatfield Tetsu Ohnuma Miriam M Treggiari Katharine Colton Evangeline Arulraja Monica S Vavilala Daniel T Laskowitz Joseph P Mathew Adrian Hernandez Michael L James Karthik Raghunathan Vijay Krish Source Type: research
The Association of Preoperative Diabetes With Postoperative Delirium in Older Patients Undergoing Major Orthopedic Surgery: A Prospective Matched Cohort Study
CONCLUSIONS: This study suggests that preoperative diabetes is associated with an increased risk of POD in older patients undergoing major orthopedic surgery, and that low intraoperative alpha power partially mediates such association.PMID:38335150 | DOI:10.1213/ANE.0000000000006893 (Source: Anesthesia and Analgesia)
Source: Anesthesia and Analgesia - February 9, 2024 Category: Anesthesiology Authors: Zixiang Shang Yu Jiang Panpan Fang Wenjie Zhu Jiaxin Guo Lili Li Yongjie Liang Sichen Zhang Shenglan Ma Bin Mei Yinguang Fan Zhongcong Xie Qiying Shen Xuesheng Liu Source Type: research
Sepsis-Induced Coagulopathy: A Comprehensive Narrative Review of Pathophysiology, Clinical Presentation, Diagnosis, and Management Strategies
Anesth Analg. 2024 Feb 7. doi: 10.1213/ANE.0000000000006888. Online ahead of print.ABSTRACTPhysiological hemostasis is a balance between pro- and anticoagulant pathways, and in sepsis, this equilibrium is disturbed, resulting in systemic thrombin generation, impaired anticoagulant activity, and suppression of fibrinolysis, a condition termed sepsis-induced coagulopathy (SIC). SIC is a common complication, being present in 24% of patients with sepsis and 66% of patients with septic shock, and is often associated with poor clinical outcomes and high mortality.1,2 Recent preclinical and clinical studies have generated new ins...
Source: Anesthesia and Analgesia - February 7, 2024 Category: Anesthesiology Authors: Brittney Williams Lin Zou Jean-Francois Pittet Wei Chao Source Type: research
A Prospective Observational Cohort Study of Language Preference and Preoperative Cognitive Screening in Older Adults: Do Language Disparities Exist in Cognitive Screening and Does the Association Between Test Results and Postoperative Delirium Differ Based on Language Preference?
CONCLUSIONS: We observed a disparity in the rates LOE patients were cognitively screened before surgery, despite the Mini-Cog being associated with POD in both English-speaking and LOE patients. Efforts should be made to identify barriers to cognitive screening in limited English-proficient older adults.PMID:38324340 | DOI:10.1213/ANE.0000000000006780 (Source: Anesthesia and Analgesia)
Source: Anesthesia and Analgesia - February 7, 2024 Category: Anesthesiology Authors: Cecilia Canales Cecilia M Ramirez Shangyang C Yang Sharon A Feinberg Tristan R Grogan Robert A Whittington Catherine Sarkisian Maxime Cannesson Source Type: research
Scoping Review: Anesthesiologist Involvement in Alternative Payment Models, Value Measurement, and Nonclinical Capabilities for Success in the United States of America
Anesth Analg. 2024 Feb 7. doi: 10.1213/ANE.0000000000006763. Online ahead of print.ABSTRACTThe US healthcare sector is undergoing significant payment reforms, leading to the emergence of Alternative Payment Models (APMs) aimed at improving clinical outcomes and patient experiences while reducing costs. This scoping review provides an overview of the involvement of anesthesiologists in APMs as found in published literature. It specifically aims to categorize and understand the breadth and depth of their participation, revolving around 3 main axes or "Aims": (1) shaping APMs through design and implementation, (2) gauging the...
Source: Anesthesia and Analgesia - February 7, 2024 Category: Anesthesiology Authors: Jay Sanghvi Daniel Qian Ezekiel Olumuyide Deborah C Mokuolu Aakash Keswani Gordon H Morewood Garrett Burnett Chang H Park Jonathan S Gal Source Type: research
Efficacy of Single-Bolus Administration of Remimazolam During Induction of Anesthesia in Patients Undergoing Cardiac Surgery: A Prospective, Single-Center, Randomized Controlled Study
CONCLUSIONS: A single-bolus injection of remimazolam provided efficient anesthetic induction in patients undergoing cardiac surgery. A 0.2 mg/kg bolus injection of remimazolam resulted in the shortest time to loss of responsiveness among the 3 groups, without significantly altering the hemodynamic parameters. Therefore, this dosing can be considered a favorable anesthetic induction method for patients undergoing cardiac surgery.PMID:38315621 | DOI:10.1213/ANE.0000000000006861 (Source: Anesthesia and Analgesia)
Source: Anesthesia and Analgesia - February 5, 2024 Category: Anesthesiology Authors: Sou-Hyun Lee Jae-Sik Nam Dae-Kee Choi Ji-Hyun Chin In-Cheol Choi Kyungmi Kim Source Type: research
Decision Curve Analysis of In-Hospital Mortality Prediction Models: The Relative Value of Pre- and Intraoperative Data For Decision-Making
CONCLUSIONS: When it comes to predicting in-hospital mortality and subsequent decision-making, preoperative demographics, comorbidities, and surgery-related data provide the largest benefit for clinicians with risk-averse preferences, whereas preoperative laboratory values provide the largest benefit for decision-makers with more moderate risk preferences. Our decision-analytic investigation of different predictor categories moves beyond the question of whether certain predictors provide a benefit in traditional performance metrics (eg, AUROC). It offers a nuanced perspective on for whom these predictors might be beneficia...
Source: Anesthesia and Analgesia - February 5, 2024 Category: Anesthesiology Authors: Markus Huber Corina Bello Patrick Schober Mark G Filipovic Markus M Luedi Source Type: research
Effects of Oxygenation Targets on Mortality in Critically Ill Patients in Intensive Care Units: A Systematic Review and Meta-Analysis
CONCLUSIONS: Critically ill ICU patients ≥18 years of age managed with lower and higher oxygenation targets did not differ in terms of mortality, RRT need, mechanical ventilation-free days through day 28, or ICU length of stay. However, due to considerable heterogeneity between specific targets in individual studies, no conclusion can be drawn regarding the effect of oxygenation targets on ICU outcomes.PMID:38315626 | DOI:10.1213/ANE.0000000000006859 (Source: Anesthesia and Analgesia)
Source: Anesthesia and Analgesia - February 5, 2024 Category: Anesthesiology Authors: Lei Cao Qi Chen Ying-Ying Xiang Cheng Xiao Yu-Ting Tan Hong Li Source Type: research
A Mixed-Methods Cohort Study Evaluating the Impact of a One-Day Well-Being Course for Anesthesia Providers Working in Low-Resource Settings
CONCLUSIONS: Causes of burnout are complex and multidimensional. VAST Wellbeing did not change measures of burnout and fulfillment 2 months postcourse but did have a meaningful impact by raising awareness, reducing stigma, fostering connection, providing skills to prioritize personal well-being, and empowering people to seek workplace change.PMID:38306670 | DOI:10.1213/ANE.0000000000006870 (Source: Anesthesia and Analgesia)
Source: Anesthesia and Analgesia - February 2, 2024 Category: Anesthesiology Authors: Jonathan G Bailey Adam I Mossenson Sara Whynot Gaston Nyirigira Shelley Gower Patricia Livingston Source Type: research
Women Anesthesiologists in Sub-Saharan Africa in the Pre-COVID Era: A Multinational Demographic Study
CONCLUSIONS: On average, in SSA, female medical graduates (36.9%), female anesthesiologists (24.9%), and female anesthesiology residents projected to graduate between 2018 and 2022 (25.2%) were underrepresented when compared to their male counterparts. Women were underrepresented in SSA, despite evidence that their representation in medicine and anesthesiology in East African countries was rising.PMID:38300845 | DOI:10.1213/ANE.0000000000006868 (Source: Anesthesia and Analgesia)
Source: Anesthesia and Analgesia - February 1, 2024 Category: Anesthesiology Authors: Bertille K Ki Bisola Onajin-Obembe Oyebola Adekola Philippe L Baele Fidele Binam Hadjara Daddy Elizabeth Diouf Lionelle Fanou Zipporah N Gathuya Elizabeth N Igaga Emilia Jeque Peggy Mawandza Mary T Nabukenya Susane M Nabulindo R C Nicole Rakotoarison Anni Source Type: research
High Neuraxial Block in Obstetrics: A 2.5-Year Nationwide Surveillance Approach in the Netherlands
CONCLUSIONS: High neuraxial block requiring tracheal intubation is a rare but impactful complication in obstetric anesthesia, potentially affecting both mother and fetus. Spinal anesthesia after epidural analgesia in labor is a common cause of high neuraxial block. Meticulous follow-up of epidurals in labor facilitates conversion to surgical anesthesia and may therefore reduce the need for spinal anesthesia after epidural analgesia. Large-scale surveillance systems in obstetric anesthesia are needed to identify those at risk, as well as to formulate further strategies to mitigate this burden.PMID:38294948 | DOI:10.1213/ANE...
Source: Anesthesia and Analgesia - January 31, 2024 Category: Anesthesiology Authors: Ingrid C M Beenakkers Timme P Schaap Oscar F C van den Bosch Source Type: research
Analgesic Effect of Exercise on Neuropathic Pain via Regulating the Complement Component 3 of Reactive Astrocytes
CONCLUSIONS: Overall, these results suggest that exercise suppresses neuropathic pain by regulating astroglial C3 expression and function, thereby providing a rationale for the analgesic effect of exercise as an acceptable alternative approach for treating neuropathic pain.PMID:38294950 | DOI:10.1213/ANE.0000000000006884 (Source: Anesthesia and Analgesia)
Source: Anesthesia and Analgesia - January 31, 2024 Category: Anesthesiology Authors: Chenghao Wang Hui He Tianchi Gao Xinzheng Sun Lixia Du Yayue Yang Jianyu Zhu Yachen Yang Yanqing Wang Wenli Mi Source Type: research
The Association of Guideline-Directed Prophylaxis With Postoperative Nausea and Vomiting in Adult Patients: A Single-Center, Retrospective Cohort Study
CONCLUSIONS: Guideline-directed PONV prophylaxis is associated with a modest reduction in PONV, although this effect is small and heterogeneous on the absolute scale. We found evidence for a differential association between adequate prophylaxis and PONV across the guideline-defined risk spectrum, with diminution in patients at very high predicted preoperative risk. While patient-specific benefit was heterogenous, most patients had reasonably high predicted probabilities of absolute benefit from a guideline-directed strategy. Further assessment of these associations in a multicenter setting, with more robust investigation o...
Source: Anesthesia and Analgesia - January 31, 2024 Category: Anesthesiology Authors: Benjamin Y Andrew Romel Holmes Brad M Taicher Ashraf S Habib Source Type: research
Esketamine: Less Drowsiness, More Analgesia
Anesth Analg. 2024 Jan 31. doi: 10.1213/ANE.0000000000006851. Online ahead of print.ABSTRACTRacemic ketamine is a 1:1 mixture of 2 enantiomers that turn light in opposite direction: Dextrorotatory esketamine is approximately 4 times more affine for the N-methyl-D-aspartate (NMDA) receptor than levorotatory arketamine, which may explain why esketamine is about twice as potent as an analgesic and anesthetic as the racemate. Esketamine has attracted renewed interest in view of the opioid crisis, racemic ketamine's abuse, and esketamine's approval for expanded use. We evaluated the anesthesia literature concerning mental, card...
Source: Anesthesia and Analgesia - January 31, 2024 Category: Anesthesiology Authors: Georges Mion Sabine Himmelseher Source Type: research
