“Perioperative management of anti-thrombotic treatment”
Publication date: Available online 29 January 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Alberto Zanetto, Marco Senzolo, Annabel BlasiAbstractEnd stage liver disease is characterized by multiple and complex alterations of hemostasis that are associated with an increased risk of both bleeding and thrombosis. Liver transplantation further challenges the feeble hemostatic balance of patients with decompensated cirrhosis, and the management of anti-thrombotic treatment during and after transplant surgery is particularly difficult. Bleeding was traditionally considered the major concern during a...
Source: Best Practice and Research Clinical Anaesthesiology - January 29, 2020 Category: Anesthesiology Source Type: research

Anesthesia for combined liver-thoracic transplantation
Publication date: Available online 25 January 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Miriam Zeillemaker - Hoekstra, Carlijn I. Buis, Vlado Cernak, Koen MEM. ReyntjensAbstractThe combined transplantation of a thoracic organ and the liver is performed in patients with dual-organ failure in whom survival is not expected with single-organ transplantation alone. Although uncommonly performed, the number of combined liver-lung and liver-heart transplants is increasing. Anesthetic management of this complex procedure is challenging. Major blood loss, prolonged operation time, difficult weaning...
Source: Best Practice and Research Clinical Anaesthesiology - January 25, 2020 Category: Anesthesiology Source Type: research

Critical Care Management in Patients with Acute Liver Failure
Publication date: Available online 23 January 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Nadja Rifaie, Fuat H. SanerAbstractAcute liver failure is defined as severe hepatic dysfunction (marked transaminases elevation, detoxification disorder (jaundice and coagulopathy with INR> 1.5)Presence of hepatic encephalopathy and exclusion of underlying chronic liver disease and a secondary cause like sepsis or cardiogenic shock.Reasons for acute liver failure includes paracetamol -and warfarin toxicity, autoimmune – and viral (mainly hepatitis B and E) hepatitis, herbal and dietary suppleme...
Source: Best Practice and Research Clinical Anaesthesiology - January 23, 2020 Category: Anesthesiology Source Type: research

Economic considerations in abdominal transplantation
Publication date: Available online 22 January 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Evan E. Lebovitz, Anh Vinh T. Nguyen, Tetsuro SakaiAbstractCare for end-stage organ failure through transplant is one of the landmark accomplishments of the modern medicine. At the same time, organ transplant is a resource-intensive service that has been under increasing scrutiny in this era of cost containment. A detailed understanding of the economic implications of organ quality, recipient characteristics, and allocation policy is vital for the transplant professionals. Prior studies of kidney transp...
Source: Best Practice and Research Clinical Anaesthesiology - January 22, 2020 Category: Anesthesiology Source Type: research

Perioperative considerations for kidney and pancreas-kidney transplantation
Publication date: Available online 22 January 2020Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Beatriz Tena, Marina VendrellSummaryKidney transplantation is the treatment of choice in patients with end-stage renal disease, as it improves survival and quality of life. Living donor kidney transplant prior to pancreas transplantation, or simultaneous pancreas and kidney transplantation are also discussed.Patients usually present comorbidities, and extensive preoperative workups are recommended, especially cardiac assessment, though type and frequency of surveillance is not established.Nefroprotectiv...
Source: Best Practice and Research Clinical Anaesthesiology - January 22, 2020 Category: Anesthesiology Source Type: research

Splanchnic and systemic circulation cross talks: Implications for hemodynamic management of liver transplant recipients
Publication date: Available online 17 December 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ahmed Mukhtar, Ahmed Lotfy, Amr Hussein, Eman FouadThe interaction between splanchnic and systemic circulation has many hemodynamic and renal consequences during liver transplant. In a patient with liver cirrhosis, splanchnic vasodilatation causes arterial steal from the systemic circulation into the splanchnic bed, which decreases the effective blood volume. Moreover, rapid volume loading in these patients has less impact on the cardiac output because a higher proportion of infused fluid is shifted to...
Source: Best Practice and Research Clinical Anaesthesiology - January 13, 2020 Category: Anesthesiology Source Type: research

Manuscript submission to Best Practice & Research: Clinical Anesthesiology Acute Kidney Injury: A Critical Care Perspective for Orthotopic Liver Transplantation
Publication date: Available online 17 December 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Andrew J. MacDonald, Constantine J. KarvellasAbstractAcute kidney injury is associated with high perioperative mortality in patients undergoing liver transplantation. In the era of Model of End-stage Liver Disease score-based allocation, more patients with impaired renal function are receiving liver transplantation. The majority of preoperative acute kidney injury is secondary to azotemia, including hepatorenal syndrome—a progressive form of renal impairment unique to liver failure. Prompt recogn...
Source: Best Practice and Research Clinical Anaesthesiology - December 18, 2019 Category: Anesthesiology Source Type: research

Splanchnic and systemic circulation cross talks: Implication for hemodynamic management of liver transplant recipient
Publication date: Available online 17 December 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ahmed Mukhtar, Ahmed Lotfy, Amr Hussein, Eman FouadAbstractThe interaction between splanchnic and systemic circulation has many hemodynamic and renal consequences during liver transplant. In patient with liver cirrhosis, splanchnic vasodilatation causes arterial steal from systemic circulation into splanchnic bed which decreases effective blood volume. Moreover, rapid volume loading in these patients has little impact on cardiac output because higher proportion of infused fluid is shifted to splanchnic...
Source: Best Practice and Research Clinical Anaesthesiology - December 18, 2019 Category: Anesthesiology Source Type: research

Liver Transplantation For Acute-On-Chronic Liver Failure
Publication date: Available online 16 December 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Dana Tomescu, Mihai Popescu, Gianni BiancofioreAbstractAcute-on-chronic liver failure represents a newly defined entity in patients with liver disease leading to multiple organs failures and increased mortality. To date, no universally accepted definition exists, and different academic societies developed guidelines on the early diagnosis and classification of Acute-on-chronic liver failure. Recently published trials focused on factors associated with a poor outcome and on the development of severity s...
Source: Best Practice and Research Clinical Anaesthesiology - December 18, 2019 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: December 2019Source: Best Practice & Research Clinical Anaesthesiology, Volume 33, Issue 4Author(s): (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - November 30, 2019 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: September 2019Source: Best Practice & Research Clinical Anaesthesiology, Volume 33, Issue 3Author(s): (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - November 29, 2019 Category: Anesthesiology Source Type: research

Ultrasound for peripheral and arterial access
Publication date: Available online 25 October 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Lori-Ann Oliver, Jodi-Ann Oliver, Sargis Ohanyan, William Park, Aharon Benelyahoo, Nalini VadiveluPeripheral venous access is perhaps the most commonly performed procedure in hospitals, urgent care, or surgical centers across the country. The ability to obtain peripheral intravenous (IV) access, and in a timely manner, is arguably one of the most important skill sets to be mastered by health care professionals. While skill and experience play a role in successful and timely vascular access, numerous pat...
Source: Best Practice and Research Clinical Anaesthesiology - November 16, 2019 Category: Anesthesiology Source Type: research

A Survey of postoperative pain treatments and unmet needs
Publication date: Available online 31 October 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Winfried Meissner, Ruth ZaslanskyAbstractMore than 300 million patients undergo surgery worldwide each year. Pain associated with these procedures is associated with short-and long term negative sequelae for patients, healthcare providers and healthcare systems. The following chapter is a review of the reality of postoperative pain management in everyday clinical routine, based on survey- and registry-derived data with a focus on care in adults.Between thirty and up to 80% of patients report moderate to...
Source: Best Practice and Research Clinical Anaesthesiology - October 31, 2019 Category: Anesthesiology Source Type: research

Ultrasound for peripheral and arterial access Lori-Ann Oliver, MD Assistant Professor Department of Anesthesiology
Publication date: Available online 25 October 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Jodi-Ann Oliver, Sargis Ohanyan, William Park, Aharon Benelyahoo, Nalini VadiveluAbstractPeripheral venous access is perhaps the most commonly performed procedure in hospitals, urgent care, or surgical centers across the country. Thus, arguably the ability to obtain peripheral intravenous access in a timely manner is one of the most important skill sets to be mastered by health care professionals. While the skill and experience of a health care professional is an important factor in determining successf...
Source: Best Practice and Research Clinical Anaesthesiology - October 27, 2019 Category: Anesthesiology Source Type: research

Preface
Publication date: Available online 21 October 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Girish P. Joshi, Francis Bonnet (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - October 22, 2019 Category: Anesthesiology Source Type: research

Adjuvants in clinical regional anesthesia practice: A comprehensive review
Publication date: Available online 2 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Amit Prabhakar, Todd Lambert, Rachel J. Kaye, Scott M. Gaignard, Joseph Ragusa, Shannon Wheat, Vanessa Moll, Elyse M. Cornett, Richard D. Urman, Alan David KayeAdjuvants are medications that work synergistically with local anesthetics to help enhance the duration and quality of analgesia in regional techniques. Regional anesthesia has become more prevalent as evidence continues to show efficacy, enhancement of patient care, increased patient satisfaction, and improved patient safety. Practitioners in the pe...
Source: Best Practice and Research Clinical Anaesthesiology - October 10, 2019 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: June 2019Source: Best Practice & Research Clinical Anaesthesiology, Volume 33, Issue 2Author(s): (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - October 2, 2019 Category: Anesthesiology Source Type: research

Preface on advances in hemodynamic monitoring in perioperative medicine
Publication date: June 2019Source: Best Practice & Research Clinical Anaesthesiology, Volume 33, Issue 2Author(s): Thomas W.L. Scheeren, Bernd Saugel (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - October 2, 2019 Category: Anesthesiology Source Type: research

Opioid-free anesthesia
Publication date: Available online 26 September 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Helene BeloeilAbstractOpioid Free Anesthesia (OFA) is emerging as a new stimulating research perspective. The rationale to propose OFA is based on the aim to avoid the negative impact of intraoperative opioid on patient’s postoperative outcomes and also on the physiology of pathways involved in intraoperative nociception. It is based on the concept of multimodal anesthesia. OFA has been shown to be feasible but the literature is still scarce on the clinically meaningful benefits for patients as ...
Source: Best Practice and Research Clinical Anaesthesiology - September 28, 2019 Category: Anesthesiology Source Type: research

Newer Nerve Blocks in Pediatric Surgery
Publication date: Available online 20 September 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Jeremy Green, Kelly S. Davidson, Sonja Gennuso, Morgan Brown, Allison Pinner, Jordan Renschler, Kelsey Cramer, Rachel J. Kaye, Elyse M. Cornett, Alan D. Kaye, Ira W. Padnos, Richard D. Urman, Charles J. FoxAbstractPurposeof review: The purpose of this manuscript is to provide a brief discussion of the current direction in pediatric regional anesthesia, highlighting both newer nerve blocks and techniques, as well as traditional blocks.Recent findingsThe number of nerve blocks performed in pediatric pat...
Source: Best Practice and Research Clinical Anaesthesiology - September 20, 2019 Category: Anesthesiology Source Type: research

Pain measurement and critical review of analgesic trials: pain scores, functional pain measurements, limits and bias of clinical trials
Publication date: Available online 12 August 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Adrien Lemoine, Valeria Martinez, Francis BonnetRandomized clinical trials designed to assess analgesic agents and/or techniques used for postoperative pain control have several limitations, which are addressed in this article. Efficacy of analgesics cannot be limited to the evaluation of pain intensity or the amount of opioid rescue medication, but it also means to evaluate parameters such as the delay and duration of the effect, the number of patients with satisfactory pain control, and side effects. B...
Source: Best Practice and Research Clinical Anaesthesiology - September 12, 2019 Category: Anesthesiology Source Type: research

Incidence of vocal cord paresis following ultrasound-guided interscalene nerve block: An observational cohort study
ConclusionsAlthough larger studies are required to determine the true incidence of vocal cord paresis following US-guided IBPB, our results suggest that incidence of unwanted nerve blockade other than brachial plexus is much lower than that previously described. (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - August 30, 2019 Category: Anesthesiology Source Type: research

Postoperative acute pain challenges in patients with cancer
In conclusion, the management of acute postoperative pain in patients with cancer can be challenging. (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - August 30, 2019 Category: Anesthesiology Source Type: research

Perioperative hemodynamic monitoring: Still a place for cardiac filling pressures?
Publication date: Available online 22 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Christian Schmidt, Astrid Ellen Berggreen, Matthias HeringlakeThe clinical usefulness of the so-called “static” cardiac filling pressures - central (CVP) and pulmonary-artery-occlusion-pressure (PAOP) – has come into question for guiding hemodynamic therapy due to their poor ability to predict fluid responsiveness in comparison with other monitoring modalities such as transpulmonary thermodilution-derived volumetric measurements, dynamic variables for assessing fluid responsiveness, and t...
Source: Best Practice and Research Clinical Anaesthesiology - August 21, 2019 Category: Anesthesiology Source Type: research

Best practice & research clinical anaesthesiology: Advances in haemodynamic monitoring for the perioperative patient: Perioperative cardiac output monitoring
Publication date: Available online 22 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Berthold Bein, Jochen RennerLess invasive or even completely non-invasive haemodynamic monitoring technologies have evolved during the last decades. Even established, invasive devices such as the pulmonary artery catheter and transpulmonary thermodilution have still an evidence-based place in the perioperative setting, albeit only in special patient populations. Accumulating evidence suggests to use continuous haemodynamic monitoring, especially flow-based variables such as stroke volume or cardiac output ...
Source: Best Practice and Research Clinical Anaesthesiology - August 18, 2019 Category: Anesthesiology Source Type: research

Postoperative ward monitoring – Why and what now?
Publication date: Available online 23 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ashish K. Khanna, Sanchit Ahuja, Robert S. Weller, Timothy N. HarwoodThe postoperative ward is considered an ideal nursing environment for stable patients transitioning out of the hospital. However, approximately half of all in-hospital cardiorespiratory arrests occur here and are associated with poor outcomes. Current monitoring practices on the hospital ward mandate intermittent vital sign checks. Subtle changes in vital signs often occur at least 8–12 h before an acute event, and continuous m...
Source: Best Practice and Research Clinical Anaesthesiology - August 15, 2019 Category: Anesthesiology Source Type: research

Pain measurement and critical review of analgesic trials
Publication date: Available online 12 August 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Adrien Lemoine, Valeria Martinez, Francis BonnetAbstractRandomized clinical trials designed to assess analgesic agents and/or techniques used for postoperative pain control, have several limitations, which are addressed in this article. Efficacy of analgesics cannot be limited to the evaluation of pain intensity or the amount of opioid rescue medication, but also means to evaluate parameters such as the delay and duration of the effect, the number of patients with satisfactory pain control, and side effe...
Source: Best Practice and Research Clinical Anaesthesiology - August 13, 2019 Category: Anesthesiology Source Type: research

Novel utilization of fascial layer blocks in hip and knee procedures
Publication date: Available online 17 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Jinlei Li, Shuai Tang, David Lam, Anja Hergrueter, Jeremy Dennis, Henry LiuPurposeof review: Novel motor-sparing peripheral nerve blocks in hip and knee procedures are desirable.Recent findingsThe application of ultrasound (US) in fascial plane blocks has improved the efficacy and effectiveness of obturator nerve block, lateral femoral cutaneous nerve block, and quadratus lumborum block. The improved performance of these fascial plane blocks has led to additional clinical applications to the hip and knee p...
Source: Best Practice and Research Clinical Anaesthesiology - August 11, 2019 Category: Anesthesiology Source Type: research

PECS, serratus plane, erector spinae, and paravertebral blocks: A comprehensive review
Publication date: Available online 17 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Erik M. Helander, Michael P. Webb, Julia Kendrick, Tim Montet, Aaron J. Kaye, Elyse M. Cornett, Alan David KayeThoracic planar blocks represent a novel and rapidly expanding facet of regional anesthesia. These recently described techniques represent the potential for excellent analgesia, enhanced technical safety profiles, and reduced physiological side effects versus traditional techniques in thoracic anesthesia. Regional techniques, particularly those described in this review, have potential implications...
Source: Best Practice and Research Clinical Anaesthesiology - August 9, 2019 Category: Anesthesiology Source Type: research

Interfascial plane blocks
This article will define interfascial plane blocks, discuss the potential benefits, review the most common techniques and the evidence supporting their indication, and guide clinicians in selecting an appropriate interfascial plane block for different types of surgical procedures. (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - August 9, 2019 Category: Anesthesiology Source Type: research

The Role of Regional Anesthesia in the Propagation of Cancer: A Comprehensive Review
Publication date: Available online 31 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Sudipta Sen, Veerandra Koyyalamudi, Darwin D. Smith, Ricardo A. Weis, Michael Molloy, Allyson L. Spence, Aaron J. Kaye, Carmen C. Labrie-Brown, O. Morgan Hall, Elyse M. Cornett, Alan David KayeAbstractCancer incidence worldwide will eclipse 18 million in 2019 with nearly 10 million cancer related deaths. It is estimated that in the United States, almost 40% of all individuals alive today will be diagnosed with cancer in their lifetimes. Surgical resection of primary tumors remains a cornerstone of cancer t...
Source: Best Practice and Research Clinical Anaesthesiology - August 1, 2019 Category: Anesthesiology Source Type: research

Postoperative acute pain challenges in the cancer patient
In conclusion, the management of acute postoperative pain in patients with cancer can be challenging. (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - July 27, 2019 Category: Anesthesiology Source Type: research

Postoperative pain management in the era of ERAS: an overview
This article presents an improved approach to developing pain management guidelines, as well as pragmatic approach to procedure-specific perioperative pain management that could be incorporated in an ERAS pathway. (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - July 27, 2019 Category: Anesthesiology Source Type: research

Fascia Iliaca Block, History, Technique, and Efficacy in Clinical Practice
Publication date: Available online 26 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Mark R. Jones, Matthew B. Novitch, O. Morgan Hall, Andrew P. Bourgeois, George M. Jeha, Rachel J. Kaye, Vwaire Orhurhu, Mariam Salisu Orhurhu, Matthew Eng, Elyse M. Cornett, Alan David KayeAbstractThe facsia iliaca block (FIB) is a relatively new regional technique where local anesthetic is delivered within the fascia iliaca region. Indications for a FIB include surgical anesthesia to the lower extremity after knee, femoral shaft, hip surgery, management of cancer pain or pain secondary to inflammatory con...
Source: Best Practice and Research Clinical Anaesthesiology - July 27, 2019 Category: Anesthesiology Source Type: research

Recent Technological Advancements in Regional Anesthesia
Publication date: Available online 25 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Sudipta Sen, Michelle Ge, Amit Prabhakar, Vanessa Moll, Rachel J. Kaye, Elyse M. Cornett, O.Morgan Hall, Ira.W. Padnos, Richard D. Urman, Alan David KayeAbstractJust two decades ago, regional anesthesia was performed blindly with dubious outcomes and little support from surgeons and patients. Technological advances in regional anesthesia have revolutionized techniques and greatly improved outcomes. Ultrasound technology continues to advance and has become more affordable. Improvements have come in the form...
Source: Best Practice and Research Clinical Anaesthesiology - July 26, 2019 Category: Anesthesiology Source Type: research

Surgical Site Infiltration: A Neuroanatomical Approach
Publication date: Available online 25 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Girish P. Joshi, Anthony MachiAbsractLocal anaesthetic administration into a surgical wound blocks the noxious stimuli that result from surgical insult at the site of origin. Surgical site infiltration (also known as local infiltration analgesia) is easy to perform, safe, and inexpensive. In addition, it avoids motor blockade, which is particularly relevant for lower limb surgery. The best approach to surgical site infiltration includes meticulous, systematic and extensive surgical site local anaesthetic i...
Source: Best Practice and Research Clinical Anaesthesiology - July 26, 2019 Category: Anesthesiology Source Type: research

Best Practice & Research Clinical Anaesthesiology: Advances in haemodynamic monitoring for the peri-operative patient Perioperative cardiac output monitoring
Publication date: Available online 22 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Berthold Bein, Jochen RennerAbstractLess invasive or even completely non-invasive haemodynamic monitoring technologies have evolved during the last decades. But even established, invasive devices such as the pulmonary artery catheter and transpulmonary thermodilution have still an evidence-based place in the perioperative setting, albeit only in special patient populations. Accumulating evidence suggests to use continuous haemodynamic monitoring, specifically flow-based variables such as stroke volume or c...
Source: Best Practice and Research Clinical Anaesthesiology - July 24, 2019 Category: Anesthesiology Source Type: research

Why and how to assess cerebral autoregulation?
Publication date: Available online 22 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Annelies Moerman, Stefan De HertAbstractAround the turn of the century, a better understanding of the complex physiology of cerebral blood flow regulation has emerged. It is now acknowledged that cerebral autoregulation is much more complicated than we previously thought it was, with the shape of the autoregulation curve and limits of autoregulation that may vary enormously and unpredictably, both within and between patients. The consequence is that in order to safeguard the cerebral circulation, the dogma...
Source: Best Practice and Research Clinical Anaesthesiology - July 24, 2019 Category: Anesthesiology Source Type: research

Perioperative hemodynamic monitoring: still a place for cardiac filling pressures ?
Publication date: Available online 22 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Christian Schmidt, Astrid Ellen Berggreen, Matthias HeringlakeAbstractThe clinical usefulness of the so-called “static” cardiac filling pressures - central (CVP) and pulmonary-artery-occlusion-pressure (PAOP) – has come into question for guiding hemodynamic therapy due to their poor ability to predict fluid responsiveness in comparison with other monitoring modalities like transpulmonary thermodilution derived volumetric measurements, dynamic variables for assessing fluid responsiveness, ...
Source: Best Practice and Research Clinical Anaesthesiology - July 24, 2019 Category: Anesthesiology Source Type: research

Peripheral nerve catheters: A critical review of the efficacy
Publication date: Available online 22 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Rasmus W. Hauritz, Kjartan E. Hannig, Angela Lucia Balocco, Gwendolyne Peeters, Admir Hadzic, Jens Børglum, Thomas F. BendtsenAbstractContinuous peripheral nerve blocks are commonly used for postoperative analgesia after surgery. However, catheter failure may occur due to either primary (incorrect insertion) or secondary reasons (displacement, obstruction, disconnection). Catheter failure results in unanticipated pain, need for opioid use, and risk of readmission or delay in hospital discharge. This...
Source: Best Practice and Research Clinical Anaesthesiology - July 24, 2019 Category: Anesthesiology Source Type: research

Post-Operative Ward Monitoring – Why & What Now?
Publication date: Available online 23 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ashish K. Khanna, Sanchit Ahuja, Robert Weller, Timothy N. HarwoodAbstractThe postoperative ward is considered an ideal nursing environment for stable patients transitioning out of the hospital. However, about half of all in-hospital cardiorespiratory arrests occur here and are associated with poor outcomes. Current monitoring practices on the hospital ward mandate intermittent vital signs checks. Subtle changes in vital signs often occur at least 8-12 hours prior to an acute event, and continuous monitori...
Source: Best Practice and Research Clinical Anaesthesiology - July 24, 2019 Category: Anesthesiology Source Type: research

Upper Extremity Regional Anesthesia Techniques: A Comprehensive Review for Clinical Anesthesiologists
Publication date: Available online 20 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Mark R. Jones, Matthew B. Novitch, Sudipta Sen, Nadia Hernandez, Johanna Blair De Haan, Rebecca A. Budish, Christopher Bailey, Joseph Ragusa, Pankaj Thakur, Vwaire Orhurhu, Ivan Urits, Elyse M. Cornett, Alan David KayeAbstractSurgeries and chronic pain states of the upper extremity are quite common and pose unique challenges for the clinical anesthesiology and pain specialists. Most innervation of the upper extremity involves the brachial plexus. The four most common brachial plexus blocks performed in cli...
Source: Best Practice and Research Clinical Anaesthesiology - July 21, 2019 Category: Anesthesiology Source Type: research

Truncal Regional Nerve Blocks in Clinical Anesthesia Practice
Publication date: Available online 19 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Ivan Urits, Peter S. Ostling, Matthew B. Novitch, James C. Burns, Karina Charipova, Kyle L. Gress, Rachel J. Kaye, Matthew R. Eng, Elyse M. Cornett, Alan David KayeAbstractRegional anesthetic techniques are important components of successful multimodal analgesic strategies. When used successfully, truncal nerve blocks of the chest wall, abdomen, and, paraneuraxial nerves, in combination with other analgesic modalities, may offer similar analgesic efficacy as neuraxial techniques, which are associated with ...
Source: Best Practice and Research Clinical Anaesthesiology - July 20, 2019 Category: Anesthesiology Source Type: research

Liposomal Bupivacaine and Novel Local Anesthetic Formulations
Publication date: Available online 19 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Amit Prabhakar, Ceressa T. Ward, Matthew Watson, Jay Sanford, Babar Fiza, Vanessa Moll, Rachel J. Kaye, O. Morgan Hall, Elyse M. Cornett, Richard D. Urman, Alan David KayeAbstractNovel preparations allowing for extending duration of action of local anesthetics have many clinically relevant benefits. In this regard, the development of liposomal bupivacaine has the potential to significantly impact patient care by improving perioperative pain control. The unique liposomal bilayer that encapsulates bupivacain...
Source: Best Practice and Research Clinical Anaesthesiology - July 20, 2019 Category: Anesthesiology Source Type: research

Complications and Liability Related to Regional and Neuraxial Anesthesia
Publication date: Available online 19 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Henry Liu, Morgan Brown, Lu Sun, Shukan P. Patel, Jinlei Li, Elyse M. Cornett, Richard D. Urman, Charles J. Fox, Alan David KayeAbstractRegional anesthesia is responsible for approximately one-fifth of professional liability claims. The present investigation evaluated common and rare complications related to regional and neuraxial anesthesia, including postdural puncture headache, backache, transient neurological symptoms, inadvertent intrathecal injection, epidural hematoma and abscess, meningitis, arachn...
Source: Best Practice and Research Clinical Anaesthesiology - July 20, 2019 Category: Anesthesiology Source Type: research

Recent Advances in Regional Anesthesia and Ultrasound Techniques
Publication date: Available online 17 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Richard D. Urman, Alan David Kaye (Source: Best Practice and Research Clinical Anaesthesiology)
Source: Best Practice and Research Clinical Anaesthesiology - July 18, 2019 Category: Anesthesiology Source Type: research

PECS, Serratus Plane, Erector Spinae and Paravertebral Blocks: A Comprehensive Review
Publication date: Available online 17 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Erik M. Helander, Michael P. Webb, Julia Kendrick, Tim Montet, Aaron J. Kaye, Elyse M. Cornett, Alan David KayeAbstractThoracic planar blocks represent a novel and rapidly expanding facet of regional anesthesia. These recently described techniques represent the potential for excellent analgesia, enhanced technical safety profiles, and reduced physiological side effects versus traditional techniques in thoracic anesthesia. Regional techniques, particularly those described in this review, have potential impl...
Source: Best Practice and Research Clinical Anaesthesiology - July 18, 2019 Category: Anesthesiology Source Type: research

Regional Anesthesia Considerations for Cardiac Surgery
Publication date: Available online 17 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Henry Liu, Patrick I. Emelife, Amit Prabhakar, Vanessa Moll, Julia B. Kendrick, Allan T. Parr, Farees Hyatali, Thakur Pankaj, Jinlei Li, Elyse M. Cornett, Richard D. Urman, Charles J. Fox, Alan D. KayeAbstractPain is a significant consequence of cardiac surgery and newer techniques in cardiac anesthesia have provided an impetus for the development of multimodal techniques to manage acute pain in this setting. In this regard, regional anesthesia techniques have been increasingly used in many cardiac surgica...
Source: Best Practice and Research Clinical Anaesthesiology - July 18, 2019 Category: Anesthesiology Source Type: research

Novel Utilization of Fascia Layer Blocks in Hip and Knee Procedures
Publication date: Available online 17 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Jinlei Li, Shuai Tang, David Lam, Anja Hergrueter, Jeremy Dennis, Henry LiuAbstractPurposeof review: Novel motor-sparing peripheral nerve blocks in hip and knee procedures are desirable.Recent findingsThe application of ultrasound in fascial plane blocks have improved the efficacy and effectiveness of obturator nerve block, lateral femoral cutaneous nerve block, and quadratus lumborum block. The improved performance of these fascial plane blocks has led to additional clinical applications to the hip and kn...
Source: Best Practice and Research Clinical Anaesthesiology - July 18, 2019 Category: Anesthesiology Source Type: research

Perioperative Use of Opioids: Current Controversies and Concerns
Publication date: Available online 17 July 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): John C. Alexander, Biral Patel, Girish P. JoshiAbstractIn the midst of an epidemic of opioid abuse and overdose related morbidity and mortality, the use of opioids remains the most common means of providing analgesia in the perioperative period. In this article, we review the risks and benefits of opioid use in preoperative, intraoperative, and postoperative phases of care. Furthermore, we describe the role that surgeons and anaesthesiologists can play in reducing perioperative opioid use and mitigate thei...
Source: Best Practice and Research Clinical Anaesthesiology - July 18, 2019 Category: Anesthesiology Source Type: research