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    24044 results match your criteria Anesthesia and analgesia[Journal]

    1 OF 481

    Intraoperative Esmolol as an Adjunct for Perioperative Opioid and Postoperative Pain Reduction: A Systematic Review, Meta-analysis, and Meta-regression.
    Anesth Analg 2017 Oct 11. Epub 2017 Oct 11.
    From the *Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts; †Department of Pediatric Anesthesiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago, Illinois; and ‡Department of Anesthesia, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
    Background: Esmolol is an ultrashort β-1 receptor antagonist. Recent studies suggest a role for esmolol in pain response modulation. The authors performed a meta-analysis to determine if the intraoperative use of esmolol reduces opioid consumption or pain scores. Read More

    Fundamental Epidemiology Terminology and Measures: It Really Is All in the Name.
    Anesth Analg 2017 Oct 11. Epub 2017 Oct 11.
    From the *Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, Texas; and †Research Enterprise, Seton Healthcare Family, Austin, Texas.
    Epidemiology is the study of how disease is distributed in populations and the factors that influence or determine this distribution. Clinical epidemiology denotes the application of epidemiologic methods to questions relevant to patient care and provides a highly useful set of principles and methods for the design and conduct of quantitative clinical research. Validly analyzing, correctly reporting, and successfully interpreting the findings of a clinical research study often require an understanding of the epidemiologic terms and measures that describe the patterns of association between the exposure of interest (treatment or intervention) and a health outcome (disease). Read More

    In Response.
    Anesth Analg 2017 Oct 4. Epub 2017 Oct 4.
    Central University Hospital of Defence "Gómez Ulla", Madrid, Spain Department of Anesthesiology and Reanimation, Alcalá de Henares University, Madrid, Spain, Research Institute on Higher Education and Science (INAECU) UC3M-UAM, Madrid, Spain Central University Hospital of Defence "Gómez Ulla", Madrid, Spain Department of Anesthesiology and Reanimation, Alcalá de Henares University, Madrid, Spain Joint Institute for Biomedical Research of Defence (IMIDEF), Madrid, Spain Department of History of Science and Documentation, University of Valencia, Valencia, Spain University Hospital "12 de Octubre", Madrid, Spain Department of Respiratory Medicine, Complutense University, Madrid, Spain Historical Sample of the Netherlands, Internationaal Instituut boot Sociale Geschiedenis, Amsterdam, the Netherlands Department of Anesthesiology and Reanimation, University Hospital "Madrid Montepríncipe", Madrid, Spain.

    Peripheral Nerve Blocks for Hip Fractures: A Cochrane Review.
    Anesth Analg 2017 Oct 4. Epub 2017 Oct 4.
    From the *Department of Anesthesiology, University of Sherbrooke, Sherbrooke, Quebec, Canada; †Teaching and Research Unit, Health Sciences, University of Quebec in Abitibi-Temiscamingue, Rouyn-Noranda, Quebec, Canada; ‡Department of Orthopaedics, Peterborough and Stamford Hospitals, NHS Foundation Trust, Peterborough, UK; §Department of Anaesthesia, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, UK; ‖Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota.
    Background: This review focuses on the use of peripheral nerve blocks as preoperative analgesia, as postoperative analgesia, or as a supplement to general anesthesia for hip fracture surgery and tries to determine if they offer any benefit in terms of pain on movement at 30 minutes after block placement, acute confusional state, myocardial infarction/ischemia, pneumonia, mortality, time to first mobilization, and cost of analgesic.

    Methods: Trials were identified by computerized searches of Cochrane Central Register of Controlled Trials (2016, Issue 8), MEDLINE (Ovid SP, 1966 to 2016 August week 1), Embase (Ovid SP, 1988 to 2016 August week 1), and the Cumulative Index to Nursing and Allied Health Literature (EBSCO, 1982 to 2016 August week 1), trials registers, and reference lists of relevant articles. Randomized controlled trials involving the use of nerve blocks as part of the care for hip fractures in adults aged 16 years and older were included. Read More

    Comparative Effectiveness Research in Health Services.
    Anesth Analg 2017 Oct 4. Epub 2017 Oct 4.
    Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania,

    Higher Operating Table for Optimal Needle-Entry Angle and Less Discomfort During Spinal Anesthesia.
    Anesth Analg 2017 Oct 4. Epub 2017 Oct 4.
    From the *Department of Anesthesiology and Pain Medicine and †Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
    The aim of this study was to find the optimal table height to facilitate insertion of the spinal needle at a 90° angle and to reduce the anesthesiologist's discomfort. Sixty patients were randomly allocated according to landmarks on the anesthesiologist's body: umbilicus (group U), lowest rib margin (R), xiphoid process (X), and nipple (N). The coronal insertion angle between the patient's skin and the spinal needle was obtuse in groups U and R, and 90° in group X. Read More

    Truncated μ-Opioid Receptors With 6 Transmembrane Domains Are Essential for Opioid Analgesia.
    Anesth Analg 2017 Oct 4. Epub 2017 Oct 4.
    From the *The Affiliated Hospital of Nanjing University of Chinese Medicine, First College of Clinical Medicine, and †Key Laboratory of Acupuncture and Medicine Research of Ministry of Education Nanjing University of Chinese Medicine, Nanjing, China; ‡Department of Neurology and the Molecular Pharmacology Program, Memorial Sloan-Kettering Cancer Center, New York, New York; and §Department of Psychology, Long Island University, Post Campus, Brookville, New York.
    Background: Most clinical opioids act through μ-opioid receptors. They effectively relieve pain but are limited by side effects, such as constipation, respiratory depression, dependence, and addiction. Many efforts have been made toward developing potent analgesics that lack side effects. Read More

    Thermal A-δ Nociceptors, Identified by Transcriptomics, Express Higher Levels of Anesthesia-Sensitive Receptors Than Thermal C-Fibers and Are More Suppressible by Low-Dose Isoflurane.
    Anesth Analg 2017 Oct 4. Epub 2017 Oct 4.
    From the *Department of Perioperative Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland; and †Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
    We investigated the effect of isoflurane on 2 main types of thermal nociceptors: A-δ and C-fibers. Surprisingly, 1% inhaled isoflurane led to a hyperalgesic response to C-fiber thermal stimulation, whereas responses to A-δ thermal stimulation were blunted. We explored the hypothesis that differences in withdrawal behavior are mediated by differential expression of isoflurane-sensitive proteins between these types of thermal nociceptors. Read More

    Incidence and Operative Factors Associated With Discretional Postoperative Mechanical Ventilation After General Surgery.
    Anesth Analg 2017 Oct 4. Epub 2017 Oct 4.
    From the *DeWitt Daughtry Family Department of Surgery and †Department of Anesthesiology, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, Florida; and ‡US Anesthesia Partners, Dallas, Texas.
    Background: Mechanical ventilation after general surgery is associated with worse outcomes, prolonged hospital stay, and increased health care cost. Postoperatively, patients admitted to the intensive care unit (ICU) may be categorized into 1 of 3 groups: extubated patients (EXT), patients with objective medical indications to remain ventilated (MED), and patients not meeting these criteria, called "discretional postoperative mechanical ventilation" (DPMV). The objectives of this study were to determine the incidence of DPMV in general surgery patients and identify the associated operative factors. Read More

    Preventing Adverse Events in Cataract Surgery: Recommendations From a Massachusetts Expert Panel.
    Anesth Analg 2017 Oct 4. Epub 2017 Oct 4.
    From the *Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard University, Boston, Massachusetts; †Betsy Lehman Center for Patient Safety, Boston, Massachusetts; ‡Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; and §Department of Anesthesia, Massachusetts Eye & Ear, Harvard Medical School, Boston, Massachusetts.
    Massachusetts health care facilities reported a series of cataract surgery-related adverse events (AEs) to the state in recent years, including 5 globe perforations during eye blocks performed by 1 anesthesiologist in a single day. The Betsy Lehman Center for Patient Safety, a nonregulatory Massachusetts state agency, responded by convening an expert panel of frontline providers, patient safety experts, and patients to recommend strategies for mitigating patient harm during cataract surgery. The purpose of this article is to identify contributing factors to the cataract surgery AEs reported in Massachusetts and present the panel's recommended strategies to prevent them. Read More

    A Survey Evaluating Burnout, Health Status, Depression, Reported Alcohol and Substance Use, and Social Support of Anesthesiologists.
    Anesth Analg 2017 Oct 5. Epub 2017 Oct 5.
    From the Departments of *Anesthesiology and †Biostatistics, Vanderbilt University School of Medicine and Vanderbilt University Medical Center, Nashville, Tennessee; ‡Statistical Center for HIV/AIDS Research and Prevention, Fred Hutchinson Cancer Research Center, Seattle, Washington; §Department of Nursing Research, Vanderbilt Nursing, Vanderbilt University Medical Center, Nashville, Tennessee; Departments of ‖Biomedical Informatics and ¶Medical Education, Vanderbilt University School of Medicine and Vanderbilt University Medical Center, Nashville, Tennessee; and #Geriatric Research Education and Clinical Center, VA Tennessee Valley Healthcare System, Nashville, Tennessee.
    Background: Burnout affects all medical specialists, and concern about it has become common in today's health care environment. The gold standard of burnout measurement in health care professionals is the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), which measures emotional exhaustion, depersonalization (DP), and personal accomplishment. Besides affecting work quality, burnout is thought to affect health problems, mental health issues, and substance use negatively, although confirmatory data are lacking. Read More

    Pearls of Wisdom for High-Risk Laser Lead Extractions: A Focused Review.
    Anesth Analg 2017 Oct 5. Epub 2017 Oct 5.
    From the *Department of Anesthesiology, Cleveland Clinic Florida, Weston, Florida; and †Department of Anesthesiology, Perioperative Medicine and Pain Management and ‡Division of Cardiothoracic Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.
    Due to new indications and improved technology, the incidence of laser lead extraction (LLE) has significantly increased over the past years. While LLE has been well studied and proven to be safe and effective, only few studies are geared toward the anesthesiologist's role during high-risk LLEs. This article utilized both a focused review and authors' experience to investigate anesthetic protocols during LLEs. Read More

    The Influence of Age on Sensitivity to Dexmedetomidine Sedation During Spinal Anesthesia in Lower Limb Orthopedic Surgery.
    Anesth Analg 2017 Oct 5. Epub 2017 Oct 5.
    From the *Department of Anesthesiology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China; †Department of Anesthesiology, Peking University Shenzhen Hospital, Shenzhen, China; ‡Department of Anesthesiology, Xiangyang Central Hospital, Xiangyang, China; and §Department of Arthrosteopedics, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China.
    To investigate the influence of age on sensitivity to dexmedetomidine sedation in adult patients, we selected 79 patients scheduled for lower limb orthopedic surgery under spinal anesthesia to identify the dexmedetomidine ED50 for adequate sedation among different age groups. After a spinal anesthetic was placed, a dose of dexmedetomidine determined by the Dixon up-and-down method was administered over 15 minutes. The ED50 in the elderly group was lower than in the other 2 groups (elderly: 0. Read More

    An Intraplantar Hypertonic Saline Assay in Mice for Rapid Screening of Analgesics.
    Anesth Analg 2017 Oct 5. Epub 2017 Oct 5.
    From the *Hugill Anesthesia Research Centre, Department of Anesthesiology, Pharmacology & Therapeutics, the University of British Columbia, Vancouver, British Columbia, Canada; †Department of Anesthesia, St Paul's Hospital/Providence Health Care, Vancouver, British Columbia, Canada; ‡Department of Animal Care Services, the University of British Columbia, Vancouver, British Columbia, Canada; §Faculty of Land and Food Systems, the University of British Columbia, Vancouver, British Columbia, Canada; and ‖BC Children's Hospital Research Institute, the University of British Columbia, Vancouver, British Columbia, Canada.
    Background: Development of new analgesics is limited by shortcomings of existing preclinical screening assays such as wide variations in response, suitability for a narrow range of analgesics, and propensity to induce tissue damage. Our aim was to determine the feasibility of a new in vivo animal assay as an analgesic screen based on nociceptive responses (licking and biting) after intraplantar (i.pl. Read More

    Photoplethysmography and Heart Rate Variability for the Diagnosis of Preeclampsia.
    Anesth Analg 2017 Oct 5. Epub 2017 Oct 5.
    From the *Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida; †Convergent Engineering, Newberry, Florida; and Departments of ‡Obstetrics and Gynecology and §Orthopedics and Rehabilitation, University of Florida College of Medicine, Gainesville, Florida.
    Background: The goal of this study was to determine a set of timing, shape, and statistical features available through noninvasive monitoring of maternal electrocardiogram and photoplethysmography that identifies preeclamptic patients.

    Methods: Pregnant women admitted to Labor and Delivery were monitored with pulse oximetry and electrocardiogram for 30 minutes. Photoplethysmogram features and heart rate variability were extracted from each data set and applied to a sequential feature selection algorithm to discriminate women with preeclampsia with severe features, from normotensive and hypertensive controls. Read More

    Patient Blood Management in Pediatric Cardiac Surgery: A Review.
    Anesth Analg 2017 Oct 5. Epub 2017 Oct 5.
    From the *Department of Pediatrics, Golisano Children's Hospital, University of Rochester, Rochester, New York; †Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; ‡Department of Anesthesiology, Perioperative and Pain Medicine, Boston, Massachusetts; §Children's Hospital, Harvard Medical School, Boston, Massachusetts; ‖Department of Surgery, University of Kentucky Chandler Medical Center & Lexington Veterans Affairs Medical Center, Lexington, Kentucky; and ¶Division of Pediatric Critical Care, Children's Hospital of Illinois At OSF St Frances, University of Illinois at Peoria, Peoria, Illinois.
    Efforts to reduce blood product transfusions and adopt blood conservation strategies for infants and children undergoing cardiac surgical procedures are ongoing. Children typically receive red blood cell and coagulant blood products perioperatively for many reasons, including developmental alterations of their hemostatic system, and hemodilution and hypothermia with cardiopulmonary bypass that incites inflammation and coagulopathy and requires systemic anticoagulation. The complexity of their surgical procedures, complex cardiopulmonary interactions, and risk for inadequate oxygen delivery and postoperative bleeding further contribute to blood product utilization in this vulnerable population. Read More

    Patient Harm in Cataract Surgery: A Series of Adverse Events in Massachusetts.
    Anesth Analg 2017 Oct 5. Epub 2017 Oct 5.
    From the *Betsy Lehman Center for Patient Safety, Boston, Massachusetts; †Department of Anesthesia, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; ‡Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; and §Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard University, Boston, Massachusetts.
    Massachusetts state agencies received reports of 37 adverse events (AEs) involving cataract surgery from 2011 to 2015. Fifteen were anesthesia related, including 5 wrong eye blocks, 3 cases of hemodynamic instability, 2 retrobulbar hematoma/hemorrhages, and 5 globe perforations resulting in permanent loss of vision. While Massachusetts' reported AEs likely underrepresent the true number of AEs that occur during cataract surgery, they do offer useful signal data to indicate the types of patient harm occurring during these procedures. Read More

    Monte Carlo Simulations Comparing Fisher Exact Test and Unequal Variances t Test for Analysis of Differences Between Groups in Brief Hospital Lengths of Stay.
    Anesth Analg 2017 Sep 28. Epub 2017 Sep 28.
    From the *Division of Management Consulting, Department of Anesthesia, and †Departments of Anesthesia and Biostatistics, University of Iowa, Iowa City, Iowa; and ‡Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York.
    Background: We examined type I and II error rates for analysis of (1) mean hospital length of stay (LOS) versus (2) percentage of hospital LOS that are overnight. These 2 end points are suitable for when LOS is treated as a secondary economic end point.

    Methods: We repeatedly resampled LOS for 5052 discharges of thoracoscopic wedge resections and lung lobectomy at 26 hospitals. Read More

    Maternal Death Due to Amniotic Fluid Embolism: A National Study in France.
    Anesth Analg 2017 Sep 28. Epub 2017 Sep 28.
    From the *Inserm UMR 1153 Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France; †Anesthesia and Intensive Care Department, Cochin Hospital, University Hospitals Paris Centre, Assistance Publique-Hôpitaux de Paris, Paris V University, Paris, France; and ‡University of Lyon, Claude Bernard Lyon 1 University, and Department of Anesthesia and Intensive Care, Femme Mère Enfant Hospital, Hospices Civiles de Lyon, Lyon, France.
    Background: A structured definition of amniotic fluid embolism (AFE) based on 4 criteria was recently proposed for use in research by the Society for Maternal-Fetal Medicine (SMFM) and the Amniotic Fluid Embolism Foundation. The main objective of this study was to review all AFE-related maternal deaths in France during 2007-2011 according to the presence or not of all these 4 diagnostic criteria.

    Methods: Maternal deaths due to AFE were identified by the national experts committee of the French Confidential Enquiry into Maternal Deaths during 2007-2011 (n = 39). Read More

    General Anesthesia Imposes Negative Effects on Heart Rate and Blood Pressure Regulation in Patients With a History of Head and Neck Radiation Therapy.
    Anesth Analg 2017 Sep 28. Epub 2017 Sep 28.
    From the Departments of *Anesthesiology and Perioperative Medicine, †Biostatistics, and ‡Head and Neck Surgery, the University of Texas MD Anderson Cancer Center, Houston, Texas.
    Background: Head and neck radiation therapy (HNRT) impairs baroreflex sensitivity, and it may potentiate the effects of anesthetics on heart rate (HR) and blood pressure (BP) regulation. Currently, the impacts of HNRT on HR and BP under anesthesia remain unclear.

    Methods: In this study, 472 patients with primary oral cavity or oropharyngeal cancer at all stages were examined. Read More

    The Technology of Video Laryngoscopy.
    Anesth Analg 2017 Sep 28. Epub 2017 Sep 28.
    From the Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida.
    Tracheal intubation via laryngeal exposure has evolved over the past 150 years and has greatly expanded in the last decade with the introduction and development of newer, more sophisticated optical airway devices. The introduction of indirect and video-assisted laryngoscopes has significantly impacted airway management as evidenced by the presence of these devices in the majority of published difficult airway algorithms. However, it is quite possible that many airway managers do not have a thorough comprehension of how these devices actually function, an understanding that is vital not only for their use but also for assessing the devices' limitations. Read More

    Research Productivity and Rankings of Anesthesiology Departments in Canada and the United States: The Relationship Between the h-Index and Other Common Metrics.
    Anesth Analg 2017 Sep 28. Epub 2017 Sep 28.
    From the *Faculty of Medicine, the University of Ottawa, Ottawa, Ontario, Canada; †Obstetrics and Maternal Neonatal Investigations Research Group, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; ‡Department of Anesthesiology and Pain Medicine, the Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada; and §Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
    Background: To evaluate the relative research productivity and ranking of anesthesiology departments in Canada and the United States, using the Hirsch index (h-index) and 4 other previously validated metrics.

    Methods: We identified 150 anesthesiology departments in Canada and the United States with an accredited residency program. Publications for each of the 150 departments were identified using Thomson's Institute for Scientific Information Web of Science, and the citation report for each department was exported. Read More

    In Response.
    Anesth Analg 2017 Sep 25. Epub 2017 Sep 25.
    Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada Department of Medicine, Division of Critical Care, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada,

    The Effect of Prophylactic Phenylephrine and Ephedrine Infusions on Umbilical Artery Blood pH in Women With Preeclampsia Undergoing Cesarean Delivery With Spinal Anesthesia: A Randomized, Double-Blind Trial.
    Anesth Analg 2017 Sep 25. Epub 2017 Sep 25.
    From the *Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; and †Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa.
    Background: Spinal anesthesia for cesarean delivery is associated with a high incidence of hypotension. Phenylephrine results in higher umbilical artery pH than ephedrine when used to prevent or treat hypotension in healthy women. We hypothesized that phenylephrine compared to ephedrine would result in higher umbilical artery pH in women with preeclampsia undergoing cesarean delivery with spinal anesthesia. Read More

    The Effect of Zinc Lozenge on Postoperative Sore Throat: A Prospective Randomized, Double-Blinded, Placebo-Controlled Study.
    Anesth Analg 2017 Sep 25. Epub 2017 Sep 25.
    From the Department of Anesthesiology, University of Vermont College of Medicine, Burlington, Vermont.
    Background: Postoperative sore throat (POST) is commonly seen after endotracheal intubation, and oral zinc prevents oral mucositis associated with chemotherapy. This study is designed to evaluate the effects of administration of zinc lozenges on POST.

    Methods: Seventy-nine patients undergoing low- or moderate-risk surgery with endotracheal intubation were randomly assigned into 2 groups: Control group received placebo and zinc group received 40-mg zinc lozenges 30 minutes preoperatively. Read More

    Repeated Administration of Amitriptyline in Neuropathic Pain: Modulation of the Noradrenergic Descending Inhibitory System.
    Anesth Analg 2017 Aug 4. Epub 2017 Aug 4.
    From the *Department of Anesthesiology, Gunma University Graduate School of Medicine, Gunma, Japan; †Center of Pain Management, Fukushima Medical University Hospital, Fukushima, Japan; and ‡Department of Anesthesiology, Fukushima Medical University, Fukushima, Japan.
    Background: The tricyclic antidepressant amitriptyline, the serotonin and noradrenaline reuptake inhibitor duloxetine, and gabapentinoids are first-line drugs for treatment of neuropathic pain. The analgesic effect of these drugs relates to brainstem-spinal descending noradrenergic systems. However, amitriptyline utilizes a variety of mechanisms for analgesia in neuropathic pain, and it is unclear which mechanism is most important. Read More

    Fundamentals of Research Data and Variables: The Devil Is in the Details.
    Anesth Analg 2017 Aug 4. Epub 2017 Aug 4.
    From the Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, Texas.
    Designing, conducting, analyzing, reporting, and interpreting the findings of a research study require an understanding of the types and characteristics of data and variables. Descriptive statistics are typically used simply to calculate, describe, and summarize the collected research data in a logical, meaningful, and efficient way. Inferential statistics allow researchers to make a valid estimate of the association between an intervention and the treatment effect in a specific population, based upon their randomly collected, representative sample data. Read More

    Optimization of Endotracheal Tube Cuff Pressure by Monitoring CO2 Levels in the Subglottic Space in Mechanically Ventilated Patients: A Randomized Controlled Trial.
    Anesth Analg 2017 Aug 4. Epub 2017 Aug 4.
    From the *Assaf-Harofeh Medical Center, Zerifin, Israel; †Sackler School of Medicine and Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel; ‡Cardiac Surgery, Rambam Health Care Campus, Haifa, Israel; §Technion-Institute of Technology, Faculty of Medicine, Haifa, Israel; ‖Mayanei HaYeshua Medical Center, B'nai Brak, Israel; ¶Laniado Medical Center, Netanya, Israel; #Wolfson Medical Center, Holon, Israel; **Massachusetts General Hospital, Boston, Massachusetts; ††Harvard Medical School, Boston, Massachusetts; and ‡‡Ben-Gurion University of the Negev, Beer Sheva, Israel.
    Background: Many of the complications of mechanical ventilation are related to inappropriate endotracheal tube (ETT) cuff pressure. The aim of the current study was to evaluate the effectiveness of automatic cuff pressure closed-loop control in patients under prolonged intubation, where presence of carbon dioxide (CO2) in the subglottic space is used as an indicator for leaks. The primary outcome of the study is leakage around the cuff quantified using the area under the curve (AUC) of CO2 leakage over time. Read More

    Perioperative Acute Kidney Injury: An Under-recognized Problem.
    Anesth Analg 2017 Aug 4. Epub 2017 Aug 4.
    From the Department of Anesthesiology, Intensive Care and Pain Medicine, University of Münster, Münster, Germany.
    The incidence of perioperative acute kidney injury (AKI) is more common than previously recognized, especially in high-risk patients undergoing higher risk procedures. The growing number of patients who develop perioperative AKI is related, in part, to the aging population and increase in the number of individuals with chronic comorbidities, particularly those with premorbid chronic kidney disease. Despite the acceptance of standardization in the definition of AKI, clinicians routinely underdiagnose it and fail to appreciate that it is associated with considerable morbidity and mortality. Read More

    The Relationship Between Women's Intention to Request a Labor Epidural Analgesia, Actually Delivering With Labor Epidural Analgesia, and Postpartum Depression at 6 Weeks: A Prospective Observational Study.
    Anesth Analg 2017 Sep 19. Epub 2017 Sep 19.
    From the *Department of Anesthesia, Rabin Medical Center, Beilinson Hospital, Petach Tikvah, Israel; †Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; ‡Department of Anesthesia, Columbia University College of Physicians and Surgeons, New York, New York; §Department of Obstetrics Gynecology, Rabin Medical Center, Beilinson Hospital, Petach Tikvah, Israel; ‖Department of Anesthesia, Shaare Zedek Medical Center, Jerusalem, Israel; and ¶Clalit Research Institute, Tel Aviv, Israel.
    Background: Postpartum depression (PPD) is associated with pain during and after delivery, with studies showing reduced rates among women delivering with labor epidural analgesia (LEA). We hypothesized that women who intend to deliver with LEA but do not receive it are at higher risk for PPD at 6 weeks due to the combined experience of untreated labor pain and unmatched expectations during labor, and evaluated the interaction between labor plans related to LEA, satisfaction with pain control when actually delivering with LEA, and PPD at 6 weeks after delivery.

    Methods: A total of 1497 women with a vaginal delivery were enrolled into this prospective longitudinal study. Read More

    Preventing Mistransfusions: An Evaluation of Institutional Knowledge and a Response.
    Anesth Analg 2017 Sep 19. Epub 2017 Sep 19.
    From the *Department of Anesthesiology, Arrowhead Regional Medical Center, Colton, California; †Graduate College of Biomedical Sciences, Western University of Health Sciences; and ‡he Patient Safety Program, Arrowhead Regional Medical Center, Colton, California; §Loma Linda University School of Medicine, Loma Linda, California.
    Background: Blood product mistransfusions occur when a process error causes transfusion of incompatible blood products. These events are known sources of negative patient outcomes. One such event demonstrated an institutional knowledge gap and an opportunity to reduce this source of transfusion errors. Read More

    Administration of Hypertonic Solutions for Hemorrhagic Shock: A Systematic Review and Meta-analysis of Clinical Trials.
    Anesth Analg 2017 Sep 19. Epub 2017 Sep 19.
    From the *Department of Emergency Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; †Department of Surgery and ‡Department of Emergency Medicine, Health Economics and Outcome Research Group, National Taiwan University Hospital, Taipei, Taiwan; §Department of Physical Medicine and Rehabilitation, Veterans General Hospital, Kaohsiung, Taiwan; ‖Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee; ¶Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; and #Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; **Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland.
    Background: Several clinical trials on hypertonic fluid administration have been completed, but the results have been inconclusive. The objective of this study is to summarize current evidence for treating hypovolemic patients with hypertonic solutions by performing a systematic review and meta-analysis.

    Methods: Major electronic databases were searched from inception through June 2014. Read More

    Minimizing the Harm of Accidental Awareness Under General Anesthesia: New Perspectives From Patients Misdiagnosed as Being in a Vegetative State.
    Anesth Analg 2017 Sep 14. Epub 2017 Sep 14.
    From the *Rotman Institute of Philosophy, Western University, London, Ontario, Canada; †Brain and Mind Institute, Western University, London, Ontario, Canada; and ‡Department of Anesthesia, Saint Anthony Hospital, Saint Louis University School of Medicine, St. Louis, Missouri.

    Efficacy Outcome Measures for Pediatric Procedural Sedation Clinical Trials: An ACTTION Systematic Review.
    Anesth Analg 2017 Sep 14. Epub 2017 Sep 14.
    From the *Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, New York; †Department of Anesthesiology, Robert Wood Johnson - Saint Barnabas Health System, Livingston, New Jersey; ‡Department of Anesthesiology, University of Florida, Jacksonville, Florida; §Division of Pediatric Hospital Medicine, Washington University, St Louis Children's Hospital, St Louis, Missouri; ‖Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts; ¶Department of Pediatrics, University of Massachusetts Medical School, UMass Memorial Children's Medical Center, Worcester, Massachusetts; #Division of Pediatric Dentistry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; **Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; ††Departments of Anesthesiology, Neurology, and Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York; ‡‡Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, New York; and §§Department of Anesthesiology, Tufts School of Medicine, Boston, Massachusetts.
    Objective evaluations comparing different techniques and approaches to pediatric procedural sedation studies have been limited by a lack of consistency among the outcome measures used in assessment. This study reviewed those existing measures, which have undergone psychometric analysis in a pediatric procedural sedation setting, to determine to what extent and in what circumstances their use is justified across the spectrum of procedures, age groups, and techniques. The results of our study suggest that a wide range of measures has been used to assess the efficacy and effectiveness of pediatric procedural sedation. Read More

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