Use of Simulation in Performance Improvement
This article explores the use of simulation for performance improvement. Educational theories that underlie effective simulation programs are described as driving forces behind the advancement of simulation in performance improvement. (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - March 2, 2018 Category: Anesthesiology Source Type: research

Emergency Manuals
This article examines how the principles of implementation science and quality improvement were applied by multiple teams in the development, testing, and systematic implementations of emergency manuals in perioperative care. The core principles of implementation have relevance for future patient safety innovations perioperatively and beyond, and the concepts of emergency manuals and interprofessional teamwork are applicable for diverse fields throughout health care. (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - March 2, 2018 Category: Anesthesiology Source Type: research

Quality Improvement in Anesthesiology — Leveraging Data and Analytics to Optimize Outcomes
Publication date: March 2018 Source:Anesthesiology Clinics, Volume 36, Issue 1 Author(s): Elizabeth A. Valentine, Scott A. FalkTeaser Quality improvement is at the heart of practice of anesthesiology. Objective data are critical for any quality improvement initiative; when possible, a combination of process, outcome, and balancing metrics should be evaluated to gauge the value of an intervention. Quality improvement is an ongoing process; iterative reevaluation of data is required to maintain interventions, ensure continued effectiveness, and continually improve. Dashboards can facilitate rapid analysis of data and drive ...
Source: Anesthesiology Clinics - March 2, 2018 Category: Anesthesiology Source Type: research

Human Factors Applied to Perioperative Process Improvement
This article discusses some of the major theories of the science of human factors/ergonomics (HF/E) in relation to perioperative medicine, with a focus on safety and errors within these systems. The discussion begins with human limitations based in cognition, decision making, stress, and fatigue. Given these limitations, the importance of measuring human performance is discussed. Finally, using the HF/E perspective on safety, high-level recommendations are provided for increasing safety within the perioperative environment. (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - March 2, 2018 Category: Anesthesiology Source Type: research

Implementation Science in Perioperative Care
We describe opportunities for additional training and discuss strategies for funding and publishing IS work. The objective is to demonstrate how IS can improve perioperative patient care, while highlighting perioperative IS studies and identifying areas in need of additional investigation. (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - March 2, 2018 Category: Anesthesiology Source Type: research

Quality Improvement and Implementation Science: Different Fields with Aligned Goals
Publication date: March 2018 Source:Anesthesiology Clinics, Volume 36, Issue 1 Author(s): Meghan B. Lane-Fall, Lee A. Fleisher (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - March 2, 2018 Category: Anesthesiology Source Type: research

Improving Perioperative Care: What Are the Tools That Lead to  Sustainable Change?
Publication date: March 2018 Source:Anesthesiology Clinics, Volume 36, Issue 1 Author(s): Lee A. Fleisher (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - March 2, 2018 Category: Anesthesiology Source Type: research

Quality Improvement and Implementation Science
Publication date: March 2018 Source:Anesthesiology Clinics, Volume 36, Issue 1 Author(s): Meghan B. Lane-Fall, Lee A. Fleisher (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - March 2, 2018 Category: Anesthesiology Source Type: research

Value-Based Care and Strategic Priorities
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): Wendy L. Gross, Lebron Cooper, Steven Boggs, Barbara GoldTeaser The anesthesia market continues to undergo disruption. Financial margins are shrinking, and buyers are demanding that anesthesia services be provided in an efficient, low-cost manner. To help anesthesiologists analyze their market, Drucker and Porter’s framework of buyers, suppliers, quality, barriers to entry, substitution, and strategic priorities allows for a structured analysis. Once this analysis is completed, anesthesiologists must articulate their value t...
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Market Evaluation
This article discusses health care financing and delivery models in the context of procedures and surgeries that happen outside of the operating room. It describes the history of health insurance, trends in ambulatory surgery centers, and new payment models that have emerged from the Affordable Care Act and the Medicare Access and Children's Health Insurance Program Reauthorization Act. (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Pediatric Anesthesia Considerations for Interventional Radiology
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): Olivia Nelson, Philip D. BaileyTeaser Anesthesiologists are increasingly called on to care for pediatric patients undergoing diagnostic imaging and invasive procedures in interventional radiology. These procedures are typically classified as either nonvascular or vascular, and can range from short diagnostic imaging studies or biopsies to significantly longer and more invasive intravascular procedures. Anesthesia providers must consider each child’s ability to cooperate reliably during the procedure, their age, and any cogni...
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Interventional Pulmonology
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): David M. DiBardino, Andrew R. Haas, Richard C. MonthTeaser Bronchoscopy presents a unique challenge and need for collaboration between anesthesia providers and bronchoscopists. The approach to topical anesthesia, analgesia, and sedation must be customized based on complexity, duration, and setting. The bronchoscopy team must work together in each phase of the procedure to ensure patient safety and allow completion of a quality bronchoscopy. Airway access may change depending on the type of procedure planned and must be discussed b...
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Anesthesia for Colonoscopy and Lower Endoscopic Procedures
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): John Michael Trummel, Vinay Chandrasekhara, Michael L. KochmanTeaser Demand for anesthesiologist-assisted sedation is expanding for gastrointestinal lower endoscopic procedures and may add to the cost of these procedures. Most lower endoscopy can be accomplished with either no, moderate, or deep sedation; general anesthesia and active airway management are rarely needed. Propofol-based sedation has advantages in terms of satisfaction and recovery over other modalities, but moderate sedation using benzodiazepines and opiates work w...
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Anesthesia for Routine and Advanced Upper Gastrointestinal Endoscopic Procedures
This article aims to detail the breadth and depth of advanced upper gastrointestinal endoscopic procedures. It will focus on sedation and airway management concerns pertaining to this emerged and emerging class of minimally invasive interventions. The article will also cover endoscopic hemostasis, endoscopic resection, stenting and Barrett eradication therapy plus endoscopic ultrasound. It additionally will address the nuances of endoscopic retrograde cholangiopancreatography and new natural orifice transluminal endoscopic surgery procedures including endoscopic cystgastrostomy and the per-oral endoscopic myotomy procedure...
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Cardioversions and Transthoracic Echocardiography
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): Ronak Shah, Elizabeth ZhouTeaser Patients with atrial fibrillation and flutter routinely require transesophageal echocardiography with cardioversion. It is not uncommon to encounter patients with reduced ejection fractions, coronary artery disease, prior cardiac surgery, or obstructive sleep apnea. The anesthesiologist must carefully evaluate the patient and any available laboratory and study findings to assess for potential complications after anesthesia. Appropriate anesthetics must be chosen based on the preoperative evaluation...
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Anesthesia in the Electrophysiology Laboratory
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): Jeff E. Mandel, William G. Stevenson, David S. FrankelTeaser The electrophysiology suite is a foreign location to many anesthesiologists. The initial experience was with shorter procedures under conscious sedation, and the value of greater tailoring of the sedation/anesthesia by anesthesiologists was not perceived until practice patterns had already been established. Although better control of ventilation with general anesthesia may be expected, suppression of arrhythmias, blunting of the hemodynamic adaptation to induced arrhythm...
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Catheterization Laboratory
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): Paul N. Fiorilli, Saif Anwaruddin, Elizabeth Zhou, Ronak ShahTeaser The cardiac catheterization laboratory is advancing medicine by performing procedures on patients who would usually require sternotomy and cardiopulmonary bypass. These procedures are done percutaneously, allowing them to be performed on patients considered inoperable. Patients have compromised cardiovascular function or advanced age. An anesthesiologist is essential for these procedures in case of hemodynamic compromise. Interventionalists are becoming more famil...
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

A Radiologist ’s View of Tumor Ablation in the Radiology Suite
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): Sharath K. Bhagavatula, Jason Lane, Paul ShynTeaser Image-guided percutaneous, minimally invasive ablation techniques offer a wide variety of new modalities to treat tumors in some of the most medically complicated patients coming to our hospitals. The use of computed tomography, PET, ultrasound imaging, and MRI to guide radiofrequency ablation, microwave ablation, and cryoablation techniques now makes it possible to treat patients on a short stay or outpatient basis with very good immediate outcomes. This rapid expansion of new t...
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

An Anesthesiologist ’s View of Tumor Ablation in the Radiology Suite
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): Annie Amin, Jason Lane, Thomas CutterTeaser The advent of radiology image–guided tumor ablation procedures has opened up a new era in minimally invasive procedures. Using CT, MRI, ultrasound, and other modalities, radiologists and surgeons can now ablate a tumor through percutaneous entry sites. What traditionally was done in an operating room via large open incisions, with multiple days in the hospital recovering, is now becoming an outpatient procedure via these new techniques. Anesthesiologists play a critical role in opt...
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Use of Anesthesiology Services in Radiology
This article addresses the use of NORA services from the interventional radiologist’s point of view and provides specific examples of preprocedural, intraprocedural, and postprocedural care patients may need for optimal outcome. (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Monitoring for Nonoperating Room Anesthesia
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): Stylianos Voulgarelis, John P. ScottTeaser Procedures requiring nonoperating room anesthesia (NORA) continue to increase in quantity and complexity. The roles of anesthesiologists as members of care teams in nonoperating room locations continue to evolve. The safe provision of NORA requires strict adherence to standardized monitoring guidelines including pulse oximetry, capnography, electrocardiogram, and noninvasive blood pressure ampliflier. Body temperature should also be measured in appropriate scenarios. High-risk anesthetics...
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Implementation and Use of Anesthesia Information Management Systems for Non –operating Room Locations
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): Jason T. Bouhenguel, David A. Preiss, Richard D. UrmanTeaser Non–operating room anesthesia (NORA) encounters comprise a significant fraction of contemporary anesthesia practice. With the implemention of an aneshtesia information management system (AIMS), anesthesia practitioners can better streamline preoperative assessment, intraoperative automated documentation, real-time decision support, and remote surveillance. Despite the large personal and financial commitments involved in adoption and implementation of AIMS and other...
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Safety of Non –Operating Room Anesthesia
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): Zachary G. Woodward, Richard D. Urman, Karen B. DominoTeaser Malpractice claims for non–operating room anesthesia care (NORA) had a higher proportion of claims for death than claims in operating rooms (ORs). NORA claims most frequently involved monitored anesthesia care. Inadequate oxygenation/ventilation was responsible for one-third of NORA claims, often judged probably preventable by better monitoring. Fewer malpractice claims for NORA occurred than for OR anesthesia as assessed by the relative numbers of in NORA versus O...
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Building and Maintaining Organizational Infrastructure to Attain Clinical Excellence
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): Kelly Lebak, Jason Lane, Richard Taus, Hansol Kim, Michael S. Stecker, Michael Hall, Meghan B. Lane-Fall, Mark S. WeissTeaser Active maintenance of highly functional teams is critical to ensuring safe, efficient patient care in the non–operating room anesthesia (NORA) suite. In addition to developing collaborative relationships and patient care protocols, individual and team training is needed. For anesthesiologists, this training must begin during residency. The training should be supplemented with continuing education in t...
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Demands of Integrated Care Delivery in Interventional Medicine and Anesthesiology
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): Wendy L. Gross, Lebron Cooper, Steven BoggsTeaser Evolving financial and medical constraints fueled by the increasing repertoire of nonoperating room cases and widening scope of patient comorbidities are discussed. The need to integrate finances and care approaches is detailed, and strategic suggestions for broader collaborative practice are suggested. (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Anesthesia Outside of the Operating Room: The Wild West or the New Frontier?
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): Lee A. Fleisher (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Anesthesia Outside the Operating Room
Publication date: December 2017 Source:Anesthesiology Clinics, Volume 35, Issue 4 Author(s): Mark S. Weiss, Wendy L. Gross (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - November 2, 2017 Category: Anesthesiology Source Type: research

Overview of Immunosuppressive Therapy in Solid Organ Transplantation
Publication date: September 2017 Source:Anesthesiology Clinics, Volume 35, Issue 3 Author(s): Curtis D. HoltTeaser Mechanisms of rejection, new pharmacologic approaches, and genomic medicine are major foci for current research in transplantation. It is hoped that these new agents and personalized immunosuppression will provide for less toxic regimens that are effective in preventing both acute and chronic allograft rejection. Until new agents are available, practitioners must use various combinations of currently approved agents to find the best regimens for improved long-term outcomes. (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - August 5, 2017 Category: Anesthesiology Source Type: research

Transplantation
Publication date: September 2017 Source:Anesthesiology Clinics, Volume 35, Issue 3 Author(s): Aman Mahajan, Christopher Wray (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - August 5, 2017 Category: Anesthesiology Source Type: research

Transfusion Medicine and Coagulation Management in Organ Transplantation
Publication date: Available online 10 July 2017 Source:Anesthesiology Clinics Author(s): Jaswanth Madisetty, Cynthia WangTeaser Organ transplantation recipients present unusual challenges with regard to blood transfusion. Although this patient population requires a larger proportion of blood product resources, liberal transfusion of allogeneic blood products can lead to a plethora of complications. Recent trends suggest that efforts to minimize bleeding, conserve products, and target transfusion to specific deficits and needs are increasingly becoming the standard practice. This must all occur with optimization of graft f...
Source: Anesthesiology Clinics - July 11, 2017 Category: Anesthesiology Source Type: research

Anesthesia for Liver Transplantation
Publication date: Available online 10 July 2017 Source:Anesthesiology Clinics Author(s): Dieter Adelmann, Kate Kronish, Michael A. RamsayTeaser The provision of anesthesia for a liver transplant program requires a dedicated team of anesthesiologists. Liver transplant anesthesiologists must have an understanding of liver physiology and anatomy; the spectrum of clinical disease associated with liver dysfunction; the impact of warm and cold ischemia times, surgical techniques in liver transplantation, the impact of ischemia–reperfusion syndrome; and optimal practices to protect the liver. The team must provide a 24-hou...
Source: Anesthesiology Clinics - July 11, 2017 Category: Anesthesiology Source Type: research

Anesthetic Management of Pediatric Liver and Kidney Transplantation
This article provides an overview of the perioperative management and considerations in pediatric patients undergoing liver and renal transplantation. (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - July 11, 2017 Category: Anesthesiology Source Type: research

Anesthesia for Kidney and Pancreas Transplantation
Publication date: Available online 10 July 2017 Source:Anesthesiology Clinics Author(s): Aaron M. Mittel, Gebhard WagenerTeaser Kidney transplants are the most common solid organ abdominal transplant and are occasionally performed simultaneously with pancreas transplants in diabetic patients. Preoperative evaluation of potential transplant recipients should focus on the potential for occult cardiovascular disease while also screening for other signs of end-organ dysfunction. Intraoperatively, it is of utmost importance to ensure adequate graft perfusion to limit the risk of postoperative graft dysfunction or rejection. Po...
Source: Anesthesiology Clinics - July 11, 2017 Category: Anesthesiology Source Type: research

Organ Transplantation: A Systematic Review
Publication date: Available online 10 July 2017 Source:Anesthesiology Clinics Author(s): Aman Mahajan, Christopher Wray (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - July 11, 2017 Category: Anesthesiology Source Type: research

Infectious Complications and Malignancies Arising After Liver Transplantation
Publication date: Available online 5 July 2017 Source:Anesthesiology Clinics Author(s): Dame W. Idossa, Douglas Alano SimonettoTeaser Since the first liver transplant was performed in 1963, great advancements have been made in hepatic transplantation. Surgical techniques have been revised and improved, diagnostic methods for identifying and preventing infections have been developed, and more conservative use of immunosuppressive agents have resulted in better long-term posttransplant outcomes. A total of 7841 liver transplantations were performed in the United States in 2016, resulting in greater than 85% survival at 1&nb...
Source: Anesthesiology Clinics - July 5, 2017 Category: Anesthesiology Source Type: research

Anesthesia Management of Organ Donors
Publication date: Available online 5 July 2017 Source:Anesthesiology Clinics Author(s): Victor W. Xia, Michelle BraunfeldTeaser The shortage of suitable organs is the biggest obstacle for transplants. At present, most organs for transplant in the United States are from donation after neurologic determination of death (brain death). Potential organs for transplant need to maintain their viability during a series of insults, including the original disease, physiologic derangements during the dying process, ischemia, and reperfusion. Proper donor management before, during, and after procurement has potential to increase the ...
Source: Anesthesiology Clinics - July 5, 2017 Category: Anesthesiology Source Type: research

Anesthesia and Perioperative Care in Reconstructive Transplantation
This article outlines key procedural, patient, and protocol-related aspects of VCA relevant to anesthesiology management with the goal of ensuring patient safety and optimizing surgical, immunologic, and functional outcomes. (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - July 5, 2017 Category: Anesthesiology Source Type: research

Anesthetic Considerations in Transplant Recipients for Nontransplant Surgery
This article reviews the posttransplant physiology and anesthetic considerations for patients after solid organ transplantation. (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - July 5, 2017 Category: Anesthesiology Source Type: research

Transplantation Anesthesia: The Role of the Anesthesiologist
Publication date: Available online 5 July 2017 Source:Anesthesiology Clinics Author(s): Lee A. Fleisher (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - July 5, 2017 Category: Anesthesiology Source Type: research

Anesthesia for Intestinal Transplantation
Publication date: Available online 5 July 2017 Source:Anesthesiology Clinics Author(s): Christine Nguyen-Buckley, Melissa WongTeaser The diagnosis of irreversible intestinal failure confers significant morbidity, mortality, and decreased quality of life. Patients with irreversible intestinal failure may be treated with intestinal transplantation. Intestinal transplantation may include intestine only, liver–intestine, or other visceral elements. Intestinal transplantation candidates present with systemic manifestations of intestinal failure requiring multidisciplinary evaluation at an intestinal transplantation cente...
Source: Anesthesiology Clinics - July 5, 2017 Category: Anesthesiology Source Type: research

Anesthesia for Heart Transplantation
Publication date: Available online 5 July 2017 Source:Anesthesiology Clinics Author(s): Davinder Ramsingh, Reed Harvey, Alec Runyon, Michael BenggonTeaser This review seeks to evaluate current practices in heart transplantation. The goals of this article were to review current practices for heart transplantation and its anesthesia management. The article reviews current demographics and discusses the current criteria for candidacy for heart transplantation. The process for donor and receipt selection is reviewed. This is followed by a review of mechanical circulatory support devices as they pertain to heart transplantatio...
Source: Anesthesiology Clinics - July 5, 2017 Category: Anesthesiology Source Type: research

Anesthesia for Lung Transplantation
Publication date: Available online 5 July 2017 Source:Anesthesiology Clinics Author(s): Alina Nicoara, John Anderson- DamTeaser Perioperative management of patients undergoing lung transplantation is challenging and requires constant communication among the surgical, anesthesia, perfusion, and nursing teams. Although all aspects of anesthetic management are important, certain intraoperative strategies (mechanical ventilation, fluid management, extracorporeal mechanical support deployment) have tremendous impact on the subsequent evolution of the lung transplant recipient, especially with respect to allograft function and ...
Source: Anesthesiology Clinics - July 5, 2017 Category: Anesthesiology Source Type: research

Pharmacology of Octreotide
Publication date: June 2017 Source:Anesthesiology Clinics, Volume 35, Issue 2 Author(s): Reza M. Borna, Jonathan S. Jahr, Susanna Kmiecik, Ken F. Mancuso, Alan D. KayeTeaser Many patients presenting with a history of foregut, midgut neuroendocrine tumors (NETs) or carcinoid syndrome can experience life-threatening carcinoid crises during anesthesia or surgery. Clinicians should understand the pharmacology of octreotide and appreciate the use of continuous infusions of high-dose octreotide, which can minimize intraoperative carcinoid crises. We administer a prophylactic 500-μg bolus of octreotide intravenously (IV) and ...
Source: Anesthesiology Clinics - May 17, 2017 Category: Anesthesiology Source Type: research

Essential Elements of Multimodal Analgesia in Enhanced Recovery After Surgery (ERAS) Guidelines
This article outlines the evidence base forming the current multimodal analgesia recommendations made by the Enhanced Recovery After Surgery Society (ERAS). We describe current evidence and important future directions for effective perioperative multimodal analgesia in enhanced recovery pathways. (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - May 17, 2017 Category: Anesthesiology Source Type: research

Pharmacogenomics in Pain Management
Publication date: June 2017 Source:Anesthesiology Clinics, Volume 35, Issue 2 Author(s): Ramsey Saba, Alan D. Kaye, Richard D. UrmanTeaser There is interpatient variability to analgesic administration. Much can be traced to pharmacogenomics variations between individuals. Certain ethnicities are more prone to reduced function of CYP2D6. Weak opioids are subject to interpatient variation based on their CYP2D6 type. Strong opioids have variations based on their transport and individual metabolism. Several cytochrome enzymes have been found to be involved with ketamine but there is no strong evidence of individual polymorphi...
Source: Anesthesiology Clinics - May 17, 2017 Category: Anesthesiology Source Type: research

Pharmacogenomics in Anesthesia
Publication date: June 2017 Source:Anesthesiology Clinics, Volume 35, Issue 2 Author(s): Ramsey Saba, Alan D. Kaye, Richard D. UrmanTeaser A significant number of commonly administered medications in anesthesia show wide clinical interpatient variability. Some of these include neuromuscular blockers, opioids, local anesthetics, and inhalation anesthetics. Individual genetic makeup may account for and predict cardiovascular outcomes after cardiac surgery. These interactions can manifest at any point in the perioperative period and may also only affect a specific system. A better understanding of pharmacogenomics will allow...
Source: Anesthesiology Clinics - May 17, 2017 Category: Anesthesiology Source Type: research

Perioperative Pharmacologic Considerations in Obesity
Publication date: June 2017 Source:Anesthesiology Clinics, Volume 35, Issue 2 Author(s): Simon Willis, Gregory J. Bordelon, Maunak V. RanaTeaser Obesity has increased in incidence worldwide. Along with the increased number of obese patients, comorbid conditions are also more prevalent in this population. Obesity leads to changes in the physiology of patients along with an altered response to pharmacologic therapy. Vigilant perioperative physicians must be aware of the unique characteristics of administered agents in order to appropriately provide anesthetic care for obese patients. Because of the variability in tissue con...
Source: Anesthesiology Clinics - May 17, 2017 Category: Anesthesiology Source Type: research

Pharmacology of Antiemetics
Publication date: June 2017 Source:Anesthesiology Clinics, Volume 35, Issue 2 Author(s): Alan D. Kaye, Elyse M. Cornett, John Chalabi, Natale Z. Naim, Matthew B. Novitch, Justin B. Creel, Preya Jhita, Thomas N. Trang, Jacquelyn R. Paetzold, Nicholas Darensburg, Burton D. Beakley, Richard D. UrmanTeaser Postoperative nausea and vomiting (PONV) is associated with delayed recovery and dissatisfaction after surgical procedures. A key component to management is identifying risk factors and high-risk populations. Advances in pharmacologic therapeutics have resulted in agents targeting different pathways associated with the medi...
Source: Anesthesiology Clinics - May 17, 2017 Category: Anesthesiology Source Type: research

Anticoagulation and Neuraxial/Peripheral Anesthesia
Publication date: June 2017 Source:Anesthesiology Clinics, Volume 35, Issue 2 Author(s): Mudit Kaushal, Ryan E. Rubin, Alan D. Kaye, Karina GritsenkoTeaser Novel anticoagulants (NAGs) have emerged as the preferred alternatives to vitamin K antagonists. In patients being considered for regional anesthesia, these drugs present a layer of complexity in the preprocedure evaluation. There are no established tests to monitor anticoagulant activity and our experience is short with these drugs. These authors believe it is important to review the relevant hematology, orthopedics, and anesthesiology literature to provide a valuable...
Source: Anesthesiology Clinics - May 17, 2017 Category: Anesthesiology Source Type: research

The Future of Pharmacology in Anesthesia Practice
Publication date: June 2017 Source:Anesthesiology Clinics, Volume 35, Issue 2 Author(s): Alan D. Kaye (Source: Anesthesiology Clinics)
Source: Anesthesiology Clinics - May 17, 2017 Category: Anesthesiology Source Type: research