Delirium in Intensive Care
AbstractPurpose of ReviewDelirium in the intensive care unit (ICU) has become increasingly acknowledged as a significant problem for critically ill patients affecting both the actual course of illness as well as outcomes. In this review, we focus on the current evidence and the gaps in knowledge.Recent FindingsThis review highlights several areas in which the evidence is weak and further research is needed in both pharmacological and non-pharmacological treatment. A better understanding of subtypes and their different response to therapy is needed and further studies in aetiology are warranted. Larger studies are needed to...
Source: Current Anesthesiology Reports - September 3, 2021 Category: Anesthesiology Source Type: research
What ’s New in Neuraxial Labor Analgesia
This article provides an update of recent practice trends in neuraxial labor analgesia. It reviews available evidence regarding management of labor pain in obstetric patients with COVID-19, serious adverse events in obstetric anesthesia to help inform risk/benefit decisions, and increasingly popular neuraxial labor analgesia techniques and adjuvants. State-of-the-art modes of epidural drug delivery are also discussed.Recent FindingsThere has recently been a focus on several considerations specific to obstetric anesthesia, such as anesthetic management of obstetric patients with COVID-19, platelet thresholds for the safe pe...
Source: Current Anesthesiology Reports - August 27, 2021 Category: Anesthesiology Source Type: research
Patient Blood Management in Pediatric Anesthesiology
This study reviews important evidence regarding PMB strategies in pediatric patients. (Source: Current Anesthesiology Reports)
Source: Current Anesthesiology Reports - August 26, 2021 Category: Anesthesiology Source Type: research
Enhanced Recovery After Neurosurgery
AbstractPurpose of ReviewEnhanced Recovery After Surgery (ERAS) protocols have shown significant success in improving pain scores and postoperative recovery and reducing hospital length of stay. Since the initial application in the colorectal patient population in the late 1990s, ERAS pathways have expanded to include many surgical subspecialties. This review explores the applicability of ERAS and its components in the field of cranial and spinal surgery.Recent FindingsOnly recently have researchers begun to study how to apply ERAS principles to intracranial or spine procedures. To date, robust evidence is lacking. Spine s...
Source: Current Anesthesiology Reports - August 20, 2021 Category: Anesthesiology Source Type: research
Update on Non-neuraxial Labor Analgesia
AbstractPurpose of ReviewThis review will present recent updates for the use of non-neuraxial analgesia for laboring women.Recent FindingsNon-neuraxial labor analgesia by nitrous oxide and intravenous opioids are described, and safety concerns with regard to remifentanil administration have been a major focus of recent studies. Fentanyl and nitrous oxide offer some efficacy, albeit less than remifentanil, however with a greater safety margin.SummaryWomen may request or require alternatives to neuraxial labor analgesia, in some cases due to concurrent comorbidities. Remifentanil offers the most efficacious alternative analg...
Source: Current Anesthesiology Reports - August 18, 2021 Category: Anesthesiology Source Type: research
Anesthesia for the Pediatric Patient With Epilepsy and Minimally Invasive Surgery for Epilepsy
AbstractPurpose of ReviewThis review outlines a perioperative approach to the pediatric patient with a seizure disorder and anesthesia for minimally invasive epilepsy surgical treatment.Recent FindingsSurgical interventions for epilepsy have undergone dramatic progression. Minimally invasive treatments and high-tech imaging, such as intraoperative magnetic resonance imaging (iMRI), are recent advances. Many anesthetics have epileptogenic activity and must be adjusted for an effective anesthetic. The needs for imaging techniques, moving patients in and out of computer tomography (CT) and magnetic resonance imaging (MRI) loc...
Source: Current Anesthesiology Reports - August 16, 2021 Category: Anesthesiology Source Type: research
Application of Continuous Positive Airway Pressure During Video-Assisted Thoracoscopic Surgery
AbstractPurpose of ReviewVideo-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracoscopic surgery (RATS) are used for anatomic resection of early stage cancer. These surgical techniques require the use of one-lung ventilation (OLV). During OLV, an obligatory intrapulmonary shunt may produce hypoxemia. One method to correct hypoxemia is with the use of continuous positive airway pressure (CPAP). This review focuses on 1) the lung physiology of OLV; 2) application of CPAP in VATS or RATS during supine and lateral position; and 3) the application of CPAP in COVID-19 patients during OLV.Recent FindingsStudies hav...
Source: Current Anesthesiology Reports - August 10, 2021 Category: Anesthesiology Source Type: research
The Use of Corticosteroids for Cardiopulmonary Bypass in Adults
AbstractPurpose of ReviewCardiopulmonary bypass for on-pump cardiac surgery induces a systemic inflammation that may contribute to postoperative major complications. To reduce this inflammatory response in patients undergoing heart surgery, the perioperative use of anti-inflammatory corticosteroids has long been recommended to improve clinical outcomes. However, the efficacy and safety of steroids remain still unclear.Recent FindingsWe reviewed recent published literature, including the large clinical trials DECS and SIRS and the two meta-analysis by Dvirnik et al. (2018) and Ng et al. (2020), on mortality and major postop...
Source: Current Anesthesiology Reports - August 10, 2021 Category: Anesthesiology Source Type: research
An Examination of History for Promoting Diversity in Neuroscience
AbstractPurpose of ReviewA review of American history is presented to understand how public policy has contributed to a disproportionate burden of disease in members of underrepresented groups. A review of research conducted in theStroke Belt provides an opportunity to examine more closely traditional and non-traditional risk factors in an effort to consider strategies for change.Recent FindingsA diverse physician workforce has been offered as a way of improving care for our increasingly diverse populace. Given the expected increased prevalence of stroke in communities of color and the impact of stress from discrimination ...
Source: Current Anesthesiology Reports - August 9, 2021 Category: Anesthesiology Source Type: research
Aortic Valve Neocuspidization Using Autologous Pericardium (Ozaki Procedure): an Alternative to Aortic Valve Replacement in Adult Cardiac Surgery?
AbstractPurpose of the ReviewThe aim of this article is to describe the technique of aortic valve neocuspidization using autologous pericardium (AVNeo, “OZAKI procedure”) in adult cardiac surgery, to analyze recent findings, and to discuss benefits and limitations of this technique.Recent FindingsPotential benefits of this technique include excellent hemodynamic performances, minimal use of foreign material, low rates of permanent pacemaker implantation, and omission of oral anticoagulation. However, data regarding the durability of the procedure are hitherto limited, and the procedure is associated with a higher compl...
Source: Current Anesthesiology Reports - August 6, 2021 Category: Anesthesiology Source Type: research
Pediatric Regional Anesthesia: New Techniques, Better Outcomes?
AbstractPurpose of ReviewThe following discussion aims to provide a review of current trends in the subspeciality of pediatric regional anesthesia, highlighting recent evidence-based literature, especially with respect to improved outcomes with newer techniques.Recent FindingsMuch of the recent literature focuses on novel truncal blocks and alternate approaches to regional anesthesia for urologic surgery. In many cases, these newer techniques have been shown to improve postoperative pain scores and lower rescue analgesic requirements.SummaryCurrent trends in pediatric regional anesthesia are focused on providing innovative...
Source: Current Anesthesiology Reports - July 31, 2021 Category: Anesthesiology Source Type: research
Special Anesthesiologic Considerations in Robot-Assisted Thoracic Surgery
AbstractPurpose of ReviewThis review summarizes the key issues for preoperative, peri- and intraoperative, and postoperative patient management for robotic-assisted thoracic surgery (RATS). It provides practical guidance for anesthesiologists and thoracic surgeons starting a RATS program.Recent FindingsRATS is a new technological approach to execute minimal invasive chest operations. In management of RATS patients, the established ERAS principles for video-assisted thoracoscopic surgery (VATS) apply. In addition, RATS imposes additional conditions on anesthesiologists, nurses, and surgeons alike: The spatial constriction i...
Source: Current Anesthesiology Reports - July 28, 2021 Category: Anesthesiology Source Type: research
Pain Management in Children During the COVID-19 Pandemic
AbstractPurpose of ReviewFor many children, the SARS-CoV-2 pandemic has impacted the experience and treatment of their pain. This narrative review draws from the pain literature and emerging findings from COVID-19 research to highlight potentially meaningful directions for clinical consideration and empirical inquiry in the months and years to come.Recent FindingsCOVID-19 has been linked to diffuse acute pains as well as chronic pain sequelae. Contextual factors known to increase vulnerability for pain and associated functional disability have been exacerbated during the pandemic. Beyond these salient concerns has been the...
Source: Current Anesthesiology Reports - July 26, 2021 Category: Anesthesiology Source Type: research
Role of Echocardiography for the Perioperative Assessment of the Right Ventricle
AbstractPurpose of ReviewThis review aims to highlight the perioperative echocardiographic evaluation of right ventricular (RV) function with strengths and limitations of commonly used and evolving techniques. It explains the value of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) and describes the perioperative changes of RV function echocardiographers should be aware of.Recent FindingsRV dysfunction is an entity with strong influence on outcome. However, its definition and assessment in the perioperative interval are not well-defined. Moreover, values assessed by TTE and TEE are not inter...
Source: Current Anesthesiology Reports - July 26, 2021 Category: Anesthesiology Source Type: research
Pediatric Airway Management in Times of COVID-19 —a Review of the Evidence and Controversies
AbstractPurpose of ReviewThis review summarizes and provides a comprehensive narrative synthesis of the current evidence on pediatric airway management during the COVID-19 pandemic.Recent FindingsThe safe care of children undergoing airway management is a primary concern for pediatric anesthesiologists. The COVID-19 pandemic has brought challenges related to airway management and the use of personal protective equipment, aerosol barriers, and the need for simulation and intubation teams. The risk of COVID-19 transmission to the health care worker may be lower in children due to the smaller volume of aerosol dispersal. The ...
Source: Current Anesthesiology Reports - July 24, 2021 Category: Anesthesiology Source Type: research
