COVID-19 and Surgery: Getting Back to Business
“It is now considered safe to proceed with most types of elective surgery 2 weeks after COVID-19 infection.” (Source: Anesthesiology)
Source: Anesthesiology - January 16, 2024 Category: Anesthesiology Source Type: research
Science, Medicine, and the Anesthesiologist
Key Papers from the Most Recent Literature Relevant to Anesthesiologists (Source: Anesthesiology)
Source: Anesthesiology - January 16, 2024 Category: Anesthesiology Source Type: research
This Month in Anesthesiology
(Source: Anesthesiology)
Source: Anesthesiology - January 16, 2024 Category: Anesthesiology Source Type: research
COVID Tommy
A modern-day adaptation of Rudyard Kipling ’s “Tommy” through the eyes of an anesthesiologist in the COVID-19 pandemic. (Source: Anesthesiology)
Source: Anesthesiology - November 28, 2023 Category: Anesthesiology Source Type: research
Recruitment-to-inflation Ratio Assessed through Sequential End-expiratory Lung Volume Measurement in Acute Respiratory Distress Syndrome
ConclusionsBoth global and granular recruitment-to-inflation ratio accurately estimate PEEP-induced changes in lung dynamic strain. However, the effect of 10 cm H2O of PEEP on lung strain may be nonuniform. Granular recruitment-to-inflation ratio assessment within narrower PEEP ranges guided by end-expiratory lung volume measurement may aid more precise PEEP selection, especially when the recruitment-to-inflation ratio obtained with the simplified maneuver between PEEP 15 and 5 cm H2O yields intermediate values that are difficult to interpret for a proper choice between a high and low PEEP strategy.Editor ’s Perspe...
Source: Anesthesiology - November 28, 2023 Category: Anesthesiology Source Type: research
Contribution of µ Opioid Receptor–expressing Dorsal Horn Interneurons to Neuropathic Pain–like Behavior in Mice
ConclusionsThe authors conclude that nerve injury sensitizes pronociceptive µ opioid receptor–expressing neurons in mouse dorsal horn. Nonopioid strategies to inhibit these interneurons might yield new treatments for neuropathic pain.Editor ’s PerspectiveWhat We Already Know about This TopicCentral sensitization, resulting from maladaptive changes in the excitation or inhibition balance of neuronal networks in the spinal cord, is widely considered to be a key mechanism leading to chronic neuropathic painThe contribution of spinal µ opioid receptor–expressing interneurons to the development of chronic neuropathic pa...
Source: Anesthesiology - November 28, 2023 Category: Anesthesiology Source Type: research
Electrical Impedance Tomography Identifies Evolution of Regional Perfusion in a Porcine Model of Acute Respiratory Distress Syndrome
ConclusionsElectrical impedance tomography closely approximated computed tomography perfusion measures in experimental acute respiratory distress syndrome, in the supine position, over injury progression and with increased PEEP. Further validation is needed to determine the accuracy of electrical impedance tomography in measuring perfusion redistributions after positional changes.Editor ’s PerspectiveWhat We Already Know about This TopicIn patients with acute respiratory distress syndrome, alterations in regional pulmonary perfusion may markedly alter global oxygenation and have important clinical ramifications for the u...
Source: Anesthesiology - November 28, 2023 Category: Anesthesiology Source Type: research
Association of Labor Neuraxial Analgesia with Maternal Blood Transfusion
ConclusionsLabor neuraxial analgesia may be associated with reduced odds of maternal blood transfusion in intrapartum cesarean deliveries and, to a lesser extent, vaginal deliveries. The specific effect size varies widely by delivery mode and is unclear given the poor sensitivity of the data set for the maternal transfusion primary outcome.Editor ’s PerspectiveWhat We Already Know about This TopicLabor neuraxial analgesia may reduce the risk of postpartum hemorrhageIt is unclear whether labor neuraxial analgesia is associated with a lower risk of maternal transfusion compared to delivery without neuraxial analgesiaWhat T...
Source: Anesthesiology - November 28, 2023 Category: Anesthesiology Source Type: research
Predictors of Low Risk for Delirium during Anesthesia Emergence
ConclusionsThis study developed an easily applicable exploratory method to analyze a single frontal EEG channel and to identify patterns specific for patients at low risk for delirium.Editor ’s PerspectiveWhat We Already Know about This TopicProcessed electroencephalography has the potential to predict the development of delirium after emergence from anesthesiaDelirium in the postanesthesia care unit is common among older surgical patientsWhat This Article Tells Us That Is NewPatients with total electroencephalography power that diminished the most during emergence may be less likely to develop postanesthesia care unit d...
Source: Anesthesiology - November 28, 2023 Category: Anesthesiology Source Type: research
Evidence-based Perioperative Practice Utilization among Various Racial Populations —A Retrospective Cohort Trending Analysis of Lower Extremity Total Joint Arthroplasty Patients
ConclusionsEvidence-based perioperative practice utilization in lower extremity joint arthroplasty has been increasing during the last decade. However, racial disparities still exist with Black patients consistently having lower odds of evidence-based perioperative practice adherence. Black patients (compared to the White patients) exhibited higher odds of composite major complications, mortality, and prolonged length of stay, independent of evidence-based perioperative practice use, suggesting that evidence-based perioperative practice did not impact racial disparities regarding particularly the Black patients in this sur...
Source: Anesthesiology - November 28, 2023 Category: Anesthesiology Source Type: research
Neurocognitive Effect of Biased µ-Opioid Receptor Agonist Oliceridine, a Utility Function Analysis and Comparison with Morphine
ConclusionsThese data indicate that over the clinical concentration range, oliceridine is an analgesic with a favorable safety profile over morphine when considering analgesia and neurocognitive function.Editor ’s PerspectiveWhat We Already Know about This TopicOliceridine is a μ-opioid receptor agonist that, unlike conventional opioids, preferentially engages the G-protein–coupled signaling pathway, which is associated with analgesia, and has reduced engagement of the β-arrestin pathway, which is associated with adverse effectsOver clinically relevant concentration ranges, oliceridine has a higher probability of pro...
Source: Anesthesiology - November 28, 2023 Category: Anesthesiology Source Type: research
Ropivacaine Promotes Axon Regeneration by Regulating Nav1.8-mediated Macrophage Signaling after Sciatic Nerve Injury in Rats
ConclusionsContinuous nerve block with ropivacaine promotes the structural and functional recovery of injured sciatic nerves, possibly by regulating Nav1.8-mediated macrophage signaling.Editor ’s PerspectiveWhat We Already Know about This TopicNav1.8, a tetrodotoxin-resistant voltage gated sodium channel, is expressed in primary afferent nociceptors and regulates their activity by sensing macrophage-derived cytokinesThe local anesthetic ropivacaine is a blocker of sodium channels and has also been shown to modulate inflammatory responses after surgeryThe mechanistic link between Nav1.8-mediated macrophage responses to in...
Source: Anesthesiology - November 28, 2023 Category: Anesthesiology Source Type: research
Agreement of Posttetanic Count between Monitors: Reply
(Source: Anesthesiology)
Source: Anesthesiology - November 28, 2023 Category: Anesthesiology Source Type: research
Agreement of Posttetanic Count between Monitors: Comment
(Source: Anesthesiology)
Source: Anesthesiology - November 28, 2023 Category: Anesthesiology Source Type: research
Association of Genetic Variants with Postsurgical Pain: A Systematic Review and Meta-analyses
ConclusionsDespite much published data, only two alleles have a small association with postsurgical pain. Small sample sizes, potential confounding variables, and inconsistent findings underscore the need to examine larger cohorts with consistent outcome measures.Editor ’s PerspectiveWhat We Already Know about This TopicMultiple genes and alleles likely influence the complex phenomenon of postsurgical pain, potentially contributing to a wide variation in the degree of postsurgical pain and analgesic usePrevious preclinical and clinical studies have proposed a variety of neurotransmitter- and immune-related candidate gene...
Source: Anesthesiology - November 28, 2023 Category: Anesthesiology Source Type: research
