Drug Shortages in Obstetrics
AbstractPurpose of ReviewThis review highlights the patient safety and practice management concerns surrounding drug shortages in obstetric anesthesiology. Given the lack of evidence-based strategies for managing shortages, this review was created to provide societal consensus suggestions and practical guidance to assist clinicians in creating safe systems for medication administration in the obstetric unit.Recent FindingsDrug shortages occur for a variety of reasons but may pose significant risk to patients as they may be more likely to receive suboptimal therapy or even experience harm due to medication errors.SummaryMin...
Source: Current Anesthesiology Reports - January 28, 2021 Category: Anesthesiology Source Type: research
Distance-Learning Initiatives Targeting Non-physician Anesthesia Providers in Low-Resource Environments
AbstractPurpose of Review“Distance-learning” encompasses a variety of didactics, from self-directed online learning to focused courses and programs. Despite increasing internet availability, focused distance-learning courses are rarely practiced in low- or middle-income countries, particularly among non-physician anesth etists. This review aims to discuss the availability, significance, and challenges of distance-learning programs for non-physician anesthesia providers in low-resource settings.Recent FindingsTask shifting and sharing in anesthesia remains essential in low-resource settings to meet the demand of surgica...
Source: Current Anesthesiology Reports - January 26, 2021 Category: Anesthesiology Source Type: research
The Comparability and Utility of Perioperative Mortality Rates in Global Health
AbstractPurpose of ReviewTo examine the comparability and utility of perioperative mortality rate (POMR) as a key global surgery metric and the added potential for mortality review to drive continuous quality improvement.Recent FindingsThere is a wide variation in the perioperative mortality rate (POMR) reported between countries, even for the three Bellwether procedures (emergency laparotomy, emergency caesarean section, management of an open fracture) and other common procedures. Clinical registries such as the National Emergency Laparotomy Audit target high-mortality procedures. Nationally, administrative databases may ...
Source: Current Anesthesiology Reports - January 21, 2021 Category: Anesthesiology Source Type: research
Task Sharing in Global Anesthesia and Surgery: Workforce Concerns
AbstractPurpose of ReviewThis review highlights the role of task sharing in temporarily solving the human resource crisis in anesthesia and surgery in low- and middle-income countries (LMICs) while emphasizing the need for these countries to increase the workforce of anesthesiologists and surgeons as a permanent solution.Recent FindingsDespite the obvious need for specialists to provide safe anesthesia and surgery in the LMICs, there is still a critical shortage of skilled personnel to fill this gap. Task sharing and task shifting are temporary solutions to this crisis but continue to be a challenge. Even with such measure...
Source: Current Anesthesiology Reports - January 8, 2021 Category: Anesthesiology Source Type: research
Unique Pain Management Needs for Pregnant Women with Pre-existing PTSD and Other Mental Health Disorders
AbstractPurpose of ReviewThis review describes how the presence of maternal mental health disorders influences peripartum pain. It provides practical guidance for tailored anesthetic plans that address the unique needs of pregnant women with such disorders.Recent FindingsThe role of maternal mental health conditions in the peripartum experience and postpartum course for the mother-baby dyad is an evolving area of interest in the current psychiatric and obstetric literature. It is only recently, however, that providers are beginning to understand how pre-existing maternal posttraumatic stress disorder (PTSD), anxiety, or de...
Source: Current Anesthesiology Reports - January 7, 2021 Category: Anesthesiology Source Type: research
Point-of-Care Ultrasound: Applications in Low- and Middle-Income Countries
AbstractPurpose of ReviewThis review highlights the applications of point-of-care ultrasound in low- and middle-income countries and shows the diversity of ultrasound in the diagnosis and management of patients.Recent FindingsThere is a paucity of data on point-of-care ultrasound in anesthesiology in low- and middle-income countries. However, research has shown that point-of-care ultrasound can effectively help manage infectious diseases, as well as abdominal and pulmonary pathologies.SummaryPoint-of-care ultrasound is a low-cost imaging modality that can be used for the diagnosis and management of diseases that affect low...
Source: Current Anesthesiology Reports - January 6, 2021 Category: Anesthesiology Source Type: research
Prescribing Opioids: Universal Education on Opioid Use, Storage, and Disposal
This article highlights the challenges in opioid prescribing and provides guidance on patient education for opioid safety, storage, and disposal as well as recommendations for cautious prescribing for a patient with cancer.Recent FindingsAmid the opioid crises, multiple groups have reported that there is a gap in knowledge among patients and prescriber on proper opioid use, storage, and disposal that contributes to unsafe opioid practices.SummaryOpioids are important in the treatment of pain in majority of patients with advanced cancer. Clinicians managing cancer-related pain have faced significant challenges in safely pre...
Source: Current Anesthesiology Reports - November 26, 2020 Category: Anesthesiology Source Type: research
Awareness with Recall After Neuromuscular Blockade —Lessons on Anesthetic Awareness from the UK and Ireland National Audit Project 5 (NAP5)
AbstractPurpose of ReviewThis review will summarize the current understanding of awareness with recall (AWR) after general anesthesia and draw ten lessons on its prevention and management from the largest study of AWR, the UK and Ireland National Audit Project 5 (NAP5).Recent FindingsThe results of NAP5 were published in 2014 and resulted in practice guidance on the prevention and management of AWR, “The NAP5 Handbook” which was published in 2019. NAP5 also led to the Guidelines for the Safe Practice of Total Intravenous Anaesthesia (TIVA) which were produced by the Association of Anaesthetists and the Society for Intr...
Source: Current Anesthesiology Reports - November 23, 2020 Category: Anesthesiology Source Type: research
Perioperative Pain Control in the Opioid-Dependent Patient: Just Bite the Bullet?
AbstractPurpose of ReviewThe opioid crisis in the USA makes it very likely that a large number of patients who are opioid-dependent will require surgical procedures. Perioperative pain control in those patients poses a formidable challenge to the surgical and anesthesia care team. Previously, patients received only additional opioids to cover the postoperative pain and would then be referred back to their primary care physician with often escalation of opioid dosing.Recent FindingsVarious strategies and recommendations to help with postoperative pain control in these challenging situations are available and can be applied ...
Source: Current Anesthesiology Reports - November 3, 2020 Category: Anesthesiology Source Type: research
Airway Management of the Obstetric Patient
AbstractPurpose of ReviewThe purpose of this article is to provide current evidence and review guidelines regarding obstetric airway management.Recent FindingsVideo laryngoscopy (VL) is gaining popularity in obstetric airway management as a primary technique and a rescue technique. Both humidified and high flow nasal cannula (HFNC) are being used for the obstetric difficult airway (DA). Continuing general anesthesia (GA) after successful supraglottic airway (SGA) placement requires awareness and proficiency with different SGAs and SGA-guided flexible bronchoscopic tracheal intubation (SGAFBI). Use of simulation during trai...
Source: Current Anesthesiology Reports - October 28, 2020 Category: Anesthesiology Source Type: research
Non-operating Room Anesthesia: Is It Worth the Risk?
AbstractPurpose of ReviewNon-operating room anesthesia (NORA) has continued to grow. This review provides recent views on the subject and an overview of specific concerns in specialized NORA applications.Recent FindingsRecent literature has reviewed the data from national databases and found no differences in the outcomes of patients undergoing NORA for procedural interventions as opposed to those patients undergoing surgical procedures. Specific areas may have their own challenges and types of patients; however, creation of a system for evaluating, anesthetizing, and recovering these patient from anesthesia results in sig...
Source: Current Anesthesiology Reports - October 27, 2020 Category: Anesthesiology Source Type: research
Use of Processed Electroencephalography in the Clinical Setting
AbstractPurpose of ReviewProcessed electroencephalography (pEEG) is widely used in clinical practice. Few clinicians utilize the full potential of these devices. This brief review will address the improvements in patient management available from the utilization of all pEEG data.Recent FindingsAnesthesiologists easily learn to recognize raw pEEG patterns that are consistent with an appropriate level of hypnotic effect. Power distribution within the waveform can be displayed in a visual format that identifies signatures of the principal anesthetic hypnotics. Opinion on the benefit of pEEG data in the mitigation of postopera...
Source: Current Anesthesiology Reports - October 23, 2020 Category: Anesthesiology Source Type: research
Author Correction: Airway Management in Out of the Operating Room Environments
The original version of this article unfortunately contained a mistake. (Source: Current Anesthesiology Reports)
Source: Current Anesthesiology Reports - October 12, 2020 Category: Anesthesiology Source Type: research
Insights into the Neurobiology of Craving in Opioid Use Disorder
AbstractPurpose of ReviewOpioids remain the most potent form of pain relief currently available yet have a high abuse liability. Here we discuss underlying neurobiological changes in opioid use disorder (OUD) that likely contribute to drug craving, which in turn drives continued drug use and relapse.Recent FindingsCraving has emerged as a strong indicator in drug-seeking and relapse. Studies have demonstrated a number of allostatic changes in circuitry that facilitate learning of drug-stimuli relationships, thereby augmenting cue-triggered drug use and relapse.SummaryThis review will focus on key neurobiological changes in...
Source: Current Anesthesiology Reports - September 28, 2020 Category: Anesthesiology Source Type: research
Opioid Prescribing with Take-Home Naloxone: Rationale and Recommendations
AbstractPurpose of ReviewAlthough take-home naloxone is available for prescribing, recommended for certain high-risk patients, and can prevent overdose-related deaths, access to naloxone remains a challenge. This review describes the high-risk population on opioids that benefit from naloxone co-prescription, guidelines, and the current trends in naloxone prescribing, and the barriers faced by all the stakeholders.Recent FindingsOpioid-related overdoses and deaths still occur at critically high numbers. Short-acting opioid antagonists like naloxone can reverse the effect of an overdose in a few minutes. The US Food and Drug...
Source: Current Anesthesiology Reports - September 22, 2020 Category: Anesthesiology Source Type: research
