Antifibrinolytics as a Patient Blood Management Modality in Craniosynostosis Surgery: Current Concepts and a View to the Future
AbstractPurpose of ReviewThe use of antifibrinolytics to reduce blood loss and blood transfusion in craniosynostosis surgery has become a standard of care for pediatric anesthesia. The purpose of this review is to summarize contemporary aspects of surgical and anesthesia care and to review current blood management evidence and best practices with a focus on antifibrinolytics.Recent FindingsThe literature was reviewed to assess the evolving role of antifibrinolytics in perioperative hemostatic management. The paper focuses on current concepts regarding the safety, efficacy, and appropriate dosing regimen of tranexamic acid ...
Source: Current Anesthesiology Reports - June 24, 2023 Category: Anesthesiology Source Type: research
Updates from the Pediatric Difficult Airway Registry
AbstractPurpose of ReviewThe goal of this paper is to review the salient clinical research generated by the Pediatric Difficult Intubation Registry (PediR) in the management of the pediatric difficult airway.Recent FindingsPediatric difficult airway management is associated with a high rate of complications. It is important that clinicians understand the latest evidence and best practices for pediatric difficult airway management.SummaryThis review will highlight key current concepts in the management of the difficult pediatric airway from the PediR. (Source: Current Anesthesiology Reports)
Source: Current Anesthesiology Reports - June 22, 2023 Category: Anesthesiology Source Type: research
The Effect of Intraoperative Hypotension on Postoperative Renal Function
AbstractPurpose of ReviewThis review summarizes the most recent literature on the association between intraoperative hypotension (IOH) and the occurrence of postoperative acute kidney injury (AKI). It provides recommendations for the management of intraoperative blood pressure to reduce the incidence of postoperative AKI. Fluid management strategies, administration of vasopressor medications, and other methods for reducing the incidence of AKI are also briefly discussed.Recent FindingsRecent retrospective studies have demonstrated a solid association of IOH with postoperative AKI. IOH is associated not only with AKI but al...
Source: Current Anesthesiology Reports - June 14, 2023 Category: Anesthesiology Source Type: research
Perioperative Anterior Knee Pain Management and Ultrasound-Guided Genicular Nerve Block: a Narrative Review
AbstractPurpose of ReviewThe comprehensive management of acute anterior knee pain is still challenging despite all the ongoing research and debate. With the goal of providing adequate motor-sparing analgesia after knee surgery, ultrasound-guided genicular nerve blocks, which directly target articular branches of the nerves that innervate the capsule of the knee, have now emerged as a promising new regional anesthesia technique. A literature search was conducted to describe anatomical considerations of the innervation to the anterior knee capsule, the ultrasound techniques to view this innervation, and a summation of the cu...
Source: Current Anesthesiology Reports - June 1, 2023 Category: Anesthesiology Source Type: research
Evidence-Based Acupuncture in Anesthesia
AbstractPurpose of ReviewThis narrative review explores the use of acupuncture in pediatric patients in the acute perioperative period and chronic pain management. It provides a summary of the existing literature evaluating acupuncture for common perioperative concerns including preoperative anxiety, acute postoperative pain, and postoperative nausea/vomiting (PONV) in addition to common conditions encountered in chronic pain syndromes including chronic pain, sleep disturbances, and generalized anxiety.Recent FindingsAcupuncture in adults is well studied while the pediatric literature is much more limited. Acupuncture is b...
Source: Current Anesthesiology Reports - May 4, 2023 Category: Anesthesiology Source Type: research
Intraoperative EEG Monitoring in Pediatric Anesthesia
AbstractPurpose of ReviewThis
review summarizes the literature on intraoperative electroencephalography (EEG) monitoring in pediatric anesthesia from 2017 to 2022.Recent FindingsNew developments to our understanding of EEG changes in the anesthetized brain, developing brain, emergence delirium, epileptiform activity, and EEG changes during spinal anesthesia will be discussed. Low voltage EEG (i.e., discontinuous or isoelectric EEG) and its association with changes in the alpha frequency (8 –12 Hz) band, non-proprietary EEG to guide anesthetic dosing in young children, EEG-guided propofol anesthesia, and a summary of...
Source: Current Anesthesiology Reports - May 4, 2023 Category: Anesthesiology Source Type: research
Neonatal Resuscitation in Delivery Room: Current Trends and Guidelines in 2022
AbstractPurpose of ReviewThis review article summarizes current trends and provides an updated overview of the 2020 guidelines on neonatal resuscitation in the delivery room. Neonatal respiratory depression, which accounts for one-third of all neonatal mortality, results in approximately 1 million newborn deaths each year worldwide due to asphyxia at birth.Recent FindingsAround 10% of all newborns will require some intervention, while less than 1% of all newborns necessitate intensive resuscitation at birth. An increase in heart rate during the first few minutes is the key sign of the newborn's smooth transition from intra...
Source: Current Anesthesiology Reports - May 3, 2023 Category: Anesthesiology Source Type: research
Racial Inequity in Pediatric Anesthesia
AbstractPurpose of ReviewMinority health disparities have received
renewed attention in the USA following several highly publicized racial injustices in 2020. Though the focus has been largely on adults, children are not immune to these inequities. By reviewing racial disparities in pediatric perioperative care, we aim to engage the anesthesia community in the fight against systemic racism.Recent FindingsMinority children have higher rates of anesthetic and surgical morbidity compared to White children, including respiratory events, length of stay, hospital costs, and even death. These inequities occur across surgical ...
Source: Current Anesthesiology Reports - May 1, 2023 Category: Anesthesiology Source Type: research
Teaching and Learning Obstetric Anaesthesia in Low- and Middle-Income Countries: Current Situation and Perspectives
AbstractPurpose of ReviewOur goal in this review is to describe the current context and peculiarities of obstetric anaesthesia in low- and middle-income countries (LMIC) and the ongoing actions and perspectives in terms of teaching and learning, focusing on improving maternal outcomes.Recent FindingsCorrect identification of barriers and lack of infrastructures and anaesthesia providers are still major problems despite efforts of different stakeholders. International consensus and commitment for 2030 goals are trying to be achieved.SummaryStructured training courses look a good option as short- and long-term evaluations sh...
Source: Current Anesthesiology Reports - April 19, 2023 Category: Anesthesiology Source Type: research
Computer-Assisted Fluid Therapy
AbstractPurpose of ReviewThis review provides an overview of the rapidly evolving field of computer-assisted fluid management systems, aimed at familiarizing clinicians with its key concepts and advancements.Recent FindingsOver the past two decades, several attempts have been made to develop computerized systems to support clinicians with the complicated task of patient fluid management. These systems vary in their purpose, logic, evaluation methods, and more, but they share the principle of utilizing closed-loop control mechanisms.SummaryComputer-assisted fluid management systems (CAFMs) provide automated tools to support...
Source: Current Anesthesiology Reports - April 13, 2023 Category: Anesthesiology Source Type: research
Perioperative Considerations for Gender-Affirming Surgery
AbstractPurpose of ReviewAs perioperative patient advocates, anesthesiology providers should be well prepared to deliver compassionate gender-affirming care to their transgender patients. The purpose of this paper is to identify areas where there is a lack of knowledge and to review this standard of care and to highlight high-yield topics that are directly applicable to the perioperative care of transgender patients.Recent FindingsA wide range of anatomical, physiological, psychological, and anatomical changes exist within the transgender and gender-diverse community who seek gender-affirming care. Resources such as the Wo...
Source: Current Anesthesiology Reports - April 11, 2023 Category: Anesthesiology Source Type: research
Nitrous Oxide — Application in Modern Anesthesia
AbstractPurpose of ReviewThis review paper shows the controversies of using nitrous oxide in anesthesia of different patient populations. It provides information on nitrous oxide ’s potential side effects when used in modern anesthesia during surgery.Recent FindingsThe ENIGMA I and ENIGMA II studies showed a significantly increased risk of postoperative nausea and vomiting after nitrous oxide administration. The theory is that nitrous oxide administered at pediatric age may accelerate neuronal apoptosis and lead to cerebral toxicity and behavioral and learning disorders later in life. The side effects associated with the...
Source: Current Anesthesiology Reports - April 6, 2023 Category: Anesthesiology Source Type: research
On the Horizon: Specific Applications of Automation and Artificial Intelligence in Anesthesiology
AbstractPurpose of ReviewThe purpose of this review is to summarize the current research and critically examine artificial intelligence (AI) technologies and their applicability to the daily practice of anesthesiologists.Recent FindingsNovel AI tools are developed using data from electronic health records, imaging, waveforms, clinical notes, and wearables. These tools can accurately predict the perioperative risk for adverse outcomes, the need for blood transfusion, and the risk of difficult intubation. Intraoperatively, AI models can assist with technical skill augmentation, patient monitoring, and management. Postoperati...
Source: Current Anesthesiology Reports - April 6, 2023 Category: Anesthesiology Source Type: research
Airway Management in Pregnancy
AbstractPurpose of ReviewThis review highlights the current evidence on airway management in obstetric patients, with a focus on clinical strategies to minimize the use of general anesthesia when possible.Recent FindingsDifficult intubation in the obstetric population remains an ongoing concern, with an incidence of 1:50. Risk factors for difficult intubation include obesity and abnormal airway anatomy. An obstetric specific difficult airway algorithm was created to help mitigate associated morbidity. Successful conversion of labor epidural analgesia into surgical anesthesia for cesarean delivery involves careful managemen...
Source: Current Anesthesiology Reports - March 30, 2023 Category: Anesthesiology Source Type: research
What Is the Current Status of Global Health Training for US Postgraduate Trainees in Anesthesiology? What Are Possible Visions for the Future?
AbstractPurpose of ReviewThere is a great deal of interest in global health at all levels of educational attainment. Many residency programs wish to offer a global health opportunity (GHO) but lack the resources to create one de novo. This review will look at the prevalence of global health education in residency and consider the fellowships available. It will summarize the existing recommendations about a curriculum in global health and how best to prepare trainees for a GHO.Recent FindingsWhile approximately 45% of residency programs make GHOs available to their residents, there is a lack of standardization of curriculum...
Source: Current Anesthesiology Reports - March 24, 2023 Category: Anesthesiology Source Type: research
