Publications by authors named "Kenneth Mancuso"

7 Publications

  • Page 1 of 1

Comparing Video and Direct Laryngoscopy for Nasotracheal Intubation.

Anesth Prog 2020 12;67(4):193-199

Assistant Professor, Department of Oral & Maxillofacial Surgery, School of Dentistry, Louisiana State University Health Sciences Center, New Orleans, Louisiana.

This parallel group randomized controlled clinical trial compared intubation duration and success using video laryngoscopy (VL) versus direct laryngoscopy (DL) during routine nasotracheal intubation. Fifty patients undergoing oral and maxillofacial surgery under general anesthesia were randomly assigned into 2 groups receiving either VL or DL to facilitate nasotracheal intubation. The primary outcome was the amount of time required to complete nasotracheal intubation. The secondary outcomes included the success of first attempt at intubation and the use of Magill forceps. Results demonstrated a mean time to intubation of 142 seconds in the DL group and 94 seconds in the VL group (p = .011). First attempt intubation success was 92.0% in the VL group and 84.0% in the DL group (p = .34). The use of Magill forceps was significantly increased in the DL group (p = .007). VL for routine nasotracheal intubation in oral and maxillofacial surgery procedures results in significantly faster intubation times and decreased use of Magill forceps compared with traditional DL.
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http://dx.doi.org/10.2344/anpr-67-02-08DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7780258PMC
December 2020

Novel Pharmacological Nonopioid Therapies in Chronic Pain.

Curr Pain Headache Rep 2018 Apr 3;22(4):31. Epub 2018 Apr 3.

Department of Anesthesiology, LSU School of Medicine, LSUHSC, 1542 Tulane Ave, New Orleans, LA, 70112, USA.

Purpose Of Review: Opioid use and abuse has led to a worldwide opioid epidemic. And while opioids are clinically useful when appropriately indicated, they are associated with a wide range of dangerous side effects and whether they are effective at treating or eliminating chronic pain is controversial. There has long been a need for the development of nonopioid alternative treatments for patients that live in pain, and until recently, only a few effective treatments were available. Today, there are a wide range of nonopioid treatments available including NSAIDs, acetaminophen, corticosteroids, nerve blocks, SSRIs, neurostimulators, and anticonvulsants. However, these treatments are still not entirely effective at treating pain, which has sparked a new exploration of novel nonopioid pharmacotherapies.

Recent Findings: This manuscript will outline the most recent trends in novel nonopioid pharmacotherapy development including tramadol/dexketoprofen, TrkA inhibitors, tapentadol, opioid agonists, Nektar 181, TRV 130, ßarrestin2, bisphosphonates, antibodies, sodium channel blockers, NMDA antagonists, TRP receptors, transdermal vitamin D, AAK1 kinase inhibition, calcitonin gene-related peptide (CGRP), TRPV4 antagonists, cholecystokinin, delta opioid receptor, neurokinin, and gene therapy. The pharmacotherapies discussed in this manuscript outline promising opioid alternatives which can change the future of chronic pain treatment.
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http://dx.doi.org/10.1007/s11916-018-0674-8DOI Listing
April 2018

Novel drug development for neuromuscular blockade.

J Anaesthesiol Clin Pharmacol 2016 Jul-Sep;32(3):376-8

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Pharmacological advances in anesthesia in recent decades have resulted in safer practice and better outcomes. These advances include improvement in anesthesia drugs with regard to efficacy and safety profiles. Although neuromuscular blockers were first introduced over a half century ago, few new neuromuscular blockers and reversal agents have come to market and even fewer have remained as common clinically employed medications. In recent years, newer agents have been studied and are presented in this review. With regard to nondepolarizer neuromuscular blocker agents, the enantiomers Gantacurium and CW002, which are olefinic isoquinolinium diester fumarates, have shown potential for clinical application. Advantages include ultra rapid reversal of neuromuscular blockade via cysteine adduction and minimal systemic hemodynamic effects with administration.
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http://dx.doi.org/10.4103/0970-9185.188833DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5009847PMC
September 2016

Evolution of the transversus abdominis plane block and its role in postoperative analgesia.

Best Pract Res Clin Anaesthesiol 2014 Jun 9;28(2):117-26. Epub 2014 May 9.

Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:

Since it was first described by Rafi in 2001, the transversus abdominis plane (TAP) block can be best described as a peripheral nerve block to the anterior abdominal wall (T6 to L1). The TAP block is specifically a local anesthetic injection into the fascial plane superficial to the transversus abdominis muscle and deep to the internal oblique muscle. The TAP block has been a subject of controversy with regard to utility, to indications, and more fundamentally, how best to place the block and its precise mechanism of action. The evolution of thinking with regard to this block, or more correctly family of interrelated blocks, includes knowledge of underlying anatomy, as well as an appreciation of its varied approaches. The TAP block affords excellent analgesia for abdominal procedures. In summary, the TAP block affords effective analgesia with opioid sparing effects, technical simplicity, and long duration of action. Some disadvantages include the need for bilateral block for midline incisions and absence of effectiveness for visceral pain.
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http://dx.doi.org/10.1016/j.bpa.2014.04.001DOI Listing
June 2014

Perioperative analgesia outcomes and strategies.

Best Pract Res Clin Anaesthesiol 2014 Jun 22;28(2):105-15. Epub 2014 May 22.

Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, LA, USA. Electronic address:

Despite an appreciation for many unwanted physiological effects from inadequate pain postoperative relief, moderate to severe postoperative pain remains commonplace. Though treatment options have evolved in recent years, including improvement in medications, multimodal regimens, and regional anesthetic techniques, including ultrasound and continuous catheters, outcomes data indicate that many of these strategies are associated with varying degrees of morbidity and mortality. This review focuses on the importance of effective postoperative analgesia and both short- and long-term effects associated with inadequate management. A careful literature review of emphasizing treatment options and potential pathogenesis associated with these strategies is emphasized in this review.
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http://dx.doi.org/10.1016/j.bpa.2014.04.005DOI Listing
June 2014

Peripheral nerve catheters and local anesthetic infiltration in perioperative analgesia.

Best Pract Res Clin Anaesthesiol 2014 Mar 18;28(1):41-57. Epub 2014 Mar 18.

Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, USA. Electronic address:

Peripheral nerve catheters (PNCs) and local infiltration analgesia (LIA) represent valuable options for controlling perioperative pain. PNCs have been increasingly utilized to provide both surgical anesthesia and prolonged postoperative analgesia for a wide variety of procedures. PNCs can be more technically challenging to place than typical single-injection nerve blocks (SINB), and familiarity with the indications, contraindications, relevant anatomy, and appropriate technical skills is a prerequisite for the placement of any PNC. PNCs include risks of peripheral nerve injury, damage to adjacent anatomic structures, local anesthetic toxicity, intravascular injection, risks associated with motor block, risks of unnoticed injury to the insensate limb, and risks of sedation associated with PNC placement. In addition to these common risks, there are specific risks unique to each PNC insertion site. LIA strategies have emerged that seek to provide the benefit of targeted local anesthesia while minimizing collateral motor block and increasing the applicability of durable local anesthesia beyond the extremities. LIA involves the injection and/or infusion of a local anesthetic near the site of surgical incision to provide targeted analgesia. A wide variety of techniques have been described, including single-injection intraoperative wound infiltration, indwelling wound infusion catheters, and the recent high-volume LIA technique associated with joint replacement surgery. The efficacy of these techniques varies depending on specific procedures and anatomic locations. The recent incorporation of ultra-long-acting liposomal bupivacaine preparations has the potential to dramatically increase the utility of single-injection LIA. LIA represents a promising yet under-investigated method of postoperative pain control.
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http://dx.doi.org/10.1016/j.bpa.2014.02.002DOI Listing
March 2014

Carcinoid syndrome and perioperative anesthetic considerations.

J Clin Anesth 2011 Jun;23(4):329-41

Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.

Carcinoid tumors are uncommon, slow-growing neoplasms. These tumors are capable of secreting numerous bioactive substances, which results in significant potential challenges in the management of patients afflicted with carcinoid syndrome. Over the past two decades, both surgical and medical therapeutic options have broadened, resulting in improved outcomes. The pathophysiology, clinical signs and symptoms, diagnosis, treatment options, and perioperative management, including anesthetic considerations, of carcinoid syndrome are presented.
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http://dx.doi.org/10.1016/j.jclinane.2010.12.009DOI Listing
June 2011