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    24347 results match your criteria Anesthesia and analgesia[Journal]

    1 OF 487

    Neuraxial Anesthesia in Children With Ventriculoperitoneal Shunts.
    Anesth Analg 2018 Feb 14. Epub 2018 Feb 14.
    From the Departments of Anesthesiology and Neurosurgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
    Neuraxial anesthesia has been demonstrated to be safe and effective for children undergoing subumbilical surgery. There is limited evidence regarding the safety of neuraxial anesthesia in pediatric patients with a ventriculoperitoneal shunt. We evaluated a series of 25 patients with indwelling ventriculoperitoneal shunts for complications within 30 days of any procedure performed with a neuraxial technique. Read More

    Combined Colloid Preload and Crystalloid Coload Versus Crystalloid Coload During Spinal Anesthesia for Cesarean Delivery: A Randomized Controlled Trial.
    Anesth Analg 2018 Feb 14. Epub 2018 Feb 14.
    From the Department of Anesthesia and Surgical Intensive Care, Mansoura University Hospital, Mansoura, Egypt.
    Background: The optimal strategy of fluid administration during spinal anesthesia for cesarean delivery is still unclear. Ultrasonography of the inferior vena cava (IVC) has been recently used to assess the volume status and predict fluid responsiveness. In this double-blind, randomized controlled study, we compared maternal hemodynamics using a combination of 500-mL colloid preload and 500-mL crystalloid coload versus 1000-mL crystalloid coload. Read More

    Bivalirudin for Pediatric Procedural Anticoagulation: A Narrative Review.
    Anesth Analg 2018 Feb 14. Epub 2018 Feb 14.
    From the Department of Anesthesiology, Perioperative, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.
    Bivalirudin (Angiomax; The Medicines Company, Parsippany, NJ), a direct thrombin inhibitor, has found increasing utilization as a heparin alternative in the pediatric population, most commonly for the treatment of thrombosis secondary to heparin-induced thrombocytopenia. Due to the relative rarity of heparin-induced thrombocytopenia as well as the lack of Food and Drug Administration-approved indications in this age group, much of what is known regarding the pharmacokinetics and pharmacodynamics of bivalirudin in this population has been extrapolated from adult data. This narrative review will present recommendations regarding the use of bivalirudin for procedural anticoagulation in the pediatric population based on the published literature. Read More

    Approaches to Patient Counseling Regarding Effectiveness of Oral Contraceptives.
    Anesth Analg 2018 Feb 14. Epub 2018 Feb 14.
    Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Michigan Medicine, Ann Arbor, Michigan, University of Michigan College of Pharmacy, Ann Arbor, Michigan Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania,

    Intensive Care Unit Enhanced Recovery Pathway for Patients Undergoing Orthotopic Liver Transplants Recipients: A Prospective, Observational Study.
    Anesth Analg 2018 Feb 9. Epub 2018 Feb 9.
    Background: Liver transplant recipients continue to have high perioperative resource utilization and prolonged length of stay despite improvements in perioperative care. Enhanced recovery pathways have been shown in other surgical populations to produce reductions in hospital resource utilization.

    Methods: A prospective, observational study was performed to examine the effect of an enhanced recovery pathway for postoperative care after liver transplantation. Read More

    The Effect of Intermittent Oxytocin Pretreatment on Oxytocin-Induced Contractility of Human Myometrium In Vitro.
    Anesth Analg 2018 Feb 2. Epub 2018 Feb 2.
    Background: Prolonged continuous oxytocin administration during labor may induce oxytocin receptor desensitization, which attenuates the response of the myometrium to further oxytocin, increasing the risk of postpartum hemorrhage. The literature comparing pulsatile (intermittent) versus continuous oxytocin administration for induction and augmentation of labor is inconsistent with regard to maternal outcomes. We aimed to determine the effect of intermittent versus continuous oxytocin preexposure on myometrial responsiveness to subsequent oxytocin. Read More

    Effect-Site Target-Controlled Infusion in the Obese: Model Derivation and Performance Assessment.
    Anesth Analg 2018 Feb 2. Epub 2018 Feb 2.
    Background: The aim of this study is to derive a propofol pharmacokinetic (PK) pharmacodynamic (PD) model to perform effect-site target-controlled infusion (TCI) in obese patients, and to analyze its performance along with that of other available PK models.

    Methods: In the first step of the study, a 3-compartment PK model linked to a sigmoidal inhibitory Emax PD model by a first-order rate constant (keo) was used to fit propofol concentration-bispectral index (BIS) data. Population modeling analysis was performed by nonlinear mixed effects regression in NONMEM (ICON, Dublin, Ireland). Read More

    Teaching Medical Students Clinical Anesthesia.
    Anesth Analg 2018 Feb 2. Epub 2018 Feb 2.
    From the Department of Anesthesiology, Columbia University, New York, New York.
    There are many reasons for evaluating our approach and improving our teaching of America's future doctors, whether they become anesthesiologists (recruitment) or participate in patient management in the perioperative period (general patient care). Teaching medical students the seminal aspects of any medical specialty is a continual challenge. Although no definitive curricula or single clinical approach has been defined, certain key features can be ascertained from clinical experience and the literature. Read More

    SmartTots Update Regarding Anesthetic Neurotoxicity in the Developing Brain.
    Anesth Analg 2018 Feb 2. Epub 2018 Feb 2.
    SmartTots (http://smarttots.org/) represents a public-private partnership between the International Anesthesia Research Society and the US Food and Drug Administration. Over the past 7 years, SmartTots has worked in collaboration with various stakeholders to determine whether anesthetic drugs have detrimental effects on the developing brain. Read More

    Comparison of Nasal Intubations by GlideScope With and Without a Bougie Guide in Patients Who Underwent Maxillofacial Surgeries: Randomized Clinical Trial.
    Anesth Analg 2018 Feb 2. Epub 2018 Feb 2.
    Background: Nasotracheal intubation is commonly performed to provide a secure airway for the maintenance of general anesthesia in maxillofacial surgeries. Routine nasotracheal intubation is performed under general anesthesia by direct laryngoscopy, frequently with the aid of Magill forceps. This method can be time-consuming and may cause bleeding in the field of view. Read More

    Summative Objective Structured Clinical Examination Assessment at the End of Anesthesia Residency for Perioperative Ultrasound.
    Anesth Analg 2018 Jan 29. Epub 2018 Jan 29.
    While standardized examinations and data from simulators and phantom models can assess knowledge and manual skills for ultrasound, an Objective Structured Clinical Examination (OSCE) could assess workflow understanding. We recruited 8 experts to develop an OSCE to assess workflow understanding in perioperative ultrasound. The experts used a binary grading system to score 19 graduating anesthesia residents at 6 stations. Read More

    Activation of Melatonin Receptors by Ramelteon Induces Cardioprotection by Postconditioning in the Rat Heart.
    Anesth Analg 2018 Jan 29. Epub 2018 Jan 29.
    Activation of melatonin receptors protects the heart against ischemia-reperfusion injury. Ramelteon, a clinically used drug for insomnia, acts via activation of melatonin receptors. We investigated whether ramelteon induces acute infarct size reduction by postconditioning. Read More

    A Systematic Review of Outcomes Associated With Withholding or Continuing Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Before Noncardiac Surgery.
    Anesth Analg 2018 Jan 29. Epub 2018 Jan 29.
    From the Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
    Background: The global rate of major noncardiac surgical procedures is increasing annually, and of those patients presenting for surgery, increasing numbers are taking either an angiotensin-converting enzyme inhibitor (ACE-I) or an angiotensin receptor blocker (ARB). The current recommendations of whether to continue or withhold ACE-I and ARB in the perioperative period are conflicting. Previous meta-analyses have linked preoperative ACE-I/ARB therapy to the increased incidence of postinduction hypotension; however, they have failed to correlate this with adverse patient outcomes. Read More

    Sex Difference of Angiotensin IV-, LVV-Hemorphin 7-, and Oxytocin-Induced Antiallodynia at the Spinal Level in Mice With Neuropathic Pain.
    Anesth Analg 2018 Jan 29. Epub 2018 Jan 29.
    Background: We demonstrated previously that angiotensin IV (Ang IV) and LVV-hemorphin 7 (LVV-H7) act through the blockade of insulin-regulated aminopeptidase to decrease oxytocin degradation, thereby causing antihyperalgesia at the spinal level in rats. We determined that intrathecal oxytocin can induce significant antihyperalgesia in male rats with inflammation but not in female rats. Thus, we speculate that Ang IV, LVV-H7, and oxytocin can induce antiallodynia, which could be of great therapeutic potential. Read More

    The Evolving Dilemma of Factor XI in Pregnancy: Suggestions for Management.
    Anesth Analg 2018 Jan 29. Epub 2018 Jan 29.
    A case of a patient with severe factor XI (FXI) deficiency who presented for her seventh labor and delivery is presented. The nature of FXI deficiency, its prevalence, and issues related to genetic screening are discussed. Published literature on the topic is reviewed, including criteria that were developed to assess bleeding, laboratory tools used to estimate bleeding risk, and available treatments. Read More

    Adding Dopamine to Proxymetacaine or Oxybuprocaine Solutions Potentiates and Prolongs the Cutaneous Antinociception in Rats.
    Anesth Analg 2018 Jan 29. Epub 2018 Jan 29.
    Background: We evaluated the interaction of dopamine-proxymetacaine and dopamine- oxybuprocaine antinociception using isobolograms.

    Methods: This experiment uses subcutaneous drug (proxymetacaine, oxybuprocaine, and dopamine) injections under the skin of the rat's back, thus simulating infiltration blocks. The dose-related antinociceptive curves of proxymetacaine and oxybuprocaine alone and in combination with dopamine were constructed, and then the antinociceptive interactions between the local anesthetic and dopamine were analyzed using isobolograms. Read More

    Electroencephalography and Brain Oxygenation Monitoring in the Perioperative Period.
    Anesth Analg 2018 Jan 23. Epub 2018 Jan 23.
    Maintaining brain function and integrity is a pivotal part of anesthesiological practice. The present overview aims to describe the current role of the 2 most frequently used monitoring methods for evaluation brain function in the perioperative period, ie, electroencephalography (EEG) and brain oxygenation monitoring. Available evidence suggests that EEG-derived parameters give additional information about depth of anesthesia for optimizing anesthetic titration. Read More

    The Effects of Agrin Isoforms on Diabetic Neuropathic Pain in a Rat Streptozotocin Model.
    Anesth Analg 2018 Jan 23. Epub 2018 Jan 23.
    Background: Diabetes mellitus affects 9.3% of the US population and increases risks of surgery and complications. Diabetic neuropathic pain (DNP), one of the main consequences of diabetes mellitus, is extremely difficult to treat. Read More

    Age Does Not Affect Metoprolol's Effect on Perioperative Outcomes (From the POISE Database).
    Anesth Analg 2018 Jan 23. Epub 2018 Jan 23.
    Background: Perioperative β-blockade reduces the incidence of myocardial infarction but increases that of death, stroke, and hypotension. The elderly may experience few benefits but more harms associated with β-blockade due to a normal effect of aging, that of a reduced resting heart rate. The tested hypothesis was that the effect of perioperative β-blockade is more significant with increasing age. Read More

    American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway.
    Anesth Analg 2018 01 23. Epub 2018 Jan 23.
    Perioperative malnutrition has proven to be challenging to define, diagnose, and treat. Despite these challenges, it is well known that suboptimal nutritional status is a strong independent predictor of poor postoperative outcomes. Although perioperative caregivers consistently express recognition of the importance of nutrition screening and optimization in the perioperative period, implementation of evidence-based perioperative nutrition guidelines and pathways in the United States has been quite limited and needs to be addressed in surgery-focused recommendations. Read More

    Comparison of Intranasal Dexmedetomidine and Oral Pentobarbital Sedation for Transthoracic Echocardiography in Infants and Toddlers: A Prospective, Randomized, Double-Blind Trial.
    Anesth Analg 2018 Jan 23. Epub 2018 Jan 23.
    Background: Acquisition of transthoracic echocardiographic (TTEcho) images in children often requires sedation. The optimal sedative for TTEcho has not been determined. Children with congenital heart disease are repeatedly exposed to sedatives and anesthetics that may affect brain development. Read More

    Intratidal Analysis of Intraoperative Respiratory System Mechanics: Keep it Simple.
    Anesth Analg 2018 Feb;126(2):725-726
    Department of Anaesthesiology and Intensive Care Medicine, Pulmonary Engineering Group, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany Department of Anaesthesia and Intensive Care, University of Foggia, Foggia, Italy Departments of Anesthesia and Biomedical Engineering, University of Iowa, Iowa City, Iowa Department of Anaesthesia and Intensive Care, University of Foggia, Foggia, Italy Department of Intensive Care & Laboratory for Experimental Intensive Care and Anesthesiology (L E I C A), Academic Medical Center at the University of Amsterdam, Amsterdam, the Netherlands Department of Surgical Sciences and Integrated Diagnostics, IRCCS AOU San Martino IST, University of Genoa, Genoa, Italy Departments of Anesthesia, Biomedical Engineering, and Radiology, University of Iowa, Iowa City, Iowa Department of Anaesthesia and Intensive Care, University of Foggia, Foggia, Italy Department of Anaesthesiology and Intensive Care Medicine, Pulmonary Engineering Group, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany, For the European Society of Anaesthesiology and the PROtective VEntilation Network.

    Significance, Errors, Power, and Sample Size: The Blocking and Tackling of Statistics.
    Anesth Analg 2018 Feb;126(2):691-698
    Inferential statistics relies heavily on the central limit theorem and the related law of large numbers. According to the central limit theorem, regardless of the distribution of the source population, a sample estimate of that population will have a normal distribution, but only if the sample is large enough. The related law of large numbers holds that the central limit theorem is valid as random samples become large enough, usually defined as an n ≥ 30. Read More

    The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines-Anticoagulation During Cardiopulmonary Bypass.
    Anesth Analg 2018 Feb;126(2):413-424
    Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation therapy for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of Extracorporeal Technology developed an Evidence Based Workgroup. Read More

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