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Publisher: Elsevier   (Total: 3042 journals)

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Showing 1 - 200 of 3042 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 20, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 17, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 82, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 23, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 27, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 327, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription  
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 204, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 9, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 23, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 3)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 127, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 25, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 20, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 25, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 24, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 10, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 4)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 41, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 40, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 47, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 15)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 12)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 21, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 25)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 35, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 4)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 22)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 7, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 19, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 59)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 2, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 339, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 6, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 30, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 15)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 43, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 308, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 5, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 8, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 402, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 38, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 50, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 5, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 9, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 6)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 8, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 4, SJR: 0.776, h-index: 35)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 7, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 48, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 3)
American Heart J.     Hybrid Journal   (Followers: 48, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 44, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 37, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 6, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 16, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 31, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 24, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 34, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 46, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 179, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 55, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 2)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 23, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 25, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 34, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 55, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 10)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 38, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 158, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 11)
Anesthésie & Réanimation     Full-text available via subscription  
Anesthesiology Clinics     Full-text available via subscription   (Followers: 22, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 152, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

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Journal Cover Anesthesiology Clinics
  [SJR: 0.421]   [H-I: 40]   [22 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 1932-2275
   Published by Elsevier Homepage  [3042 journals]
  • Pharmacology
    • Authors: Alan D. Kaye
      Abstract: Publication date: June 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 2
      Author(s): Alan D. Kaye


      PubDate: 2017-05-17T18:16:24Z
      DOI: 10.1016/s1932-2275(17)30033-2
       
  • Pharmacology
    • Authors: Lee A. Fleisher
      Abstract: Publication date: June 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 2
      Author(s): Lee A. Fleisher


      PubDate: 2017-05-17T18:16:24Z
      DOI: 10.1016/j.anclin.2017.03.002
       
  • The Future of Pharmacology in Anesthesia Practice
    • Authors: Alan D. Kaye
      Abstract: Publication date: June 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 2
      Author(s): Alan D. Kaye


      PubDate: 2017-05-17T18:16:24Z
      DOI: 10.1016/j.anclin.2017.03.001
       
  • Anticoagulation and Neuraxial/Peripheral Anesthesia
    • Authors: Mudit Kaushal; Ryan E. Rubin; Alan D. Kaye; Karina Gritsenko
      Abstract: Publication date: June 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 2
      Author(s): Mudit Kaushal, Ryan E. Rubin, Alan D. Kaye, Karina Gritsenko
      Teaser Novel anticoagulants (NAGs) have emerged as the preferred alternatives to vitamin K antagonists. In patients being considered for regional anesthesia, these drugs present a layer of complexity in the preprocedure evaluation. There are no established tests to monitor anticoagulant activity and our experience is short with these drugs. These authors believe it is important to review the relevant hematology, orthopedics, and anesthesiology literature to provide a valuable reference for the clinician who is met with these challenges. In addition to discussing NAGs, we also review the existing American Society of Regional Anesthesia guidelines for heparin, low-molecular-weight heparin, and antiplatelet agents.

      PubDate: 2017-05-17T18:16:24Z
      DOI: 10.1016/j.anclin.2017.01.002
       
  • Pharmacology of Antiemetics
    • Authors: Alan D. Kaye; Elyse M. Cornett; John Chalabi; Natale Z. Naim; Matthew B. Novitch; Justin B. Creel; Preya Jhita; Thomas N. Trang; Jacquelyn R. Paetzold; Nicholas Darensburg; Burton D. Beakley; Richard D. Urman
      Abstract: Publication date: June 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 2
      Author(s): Alan D. Kaye, Elyse M. Cornett, John Chalabi, Natale Z. Naim, Matthew B. Novitch, Justin B. Creel, Preya Jhita, Thomas N. Trang, Jacquelyn R. Paetzold, Nicholas Darensburg, Burton D. Beakley, Richard D. Urman
      Teaser Postoperative nausea and vomiting (PONV) is associated with delayed recovery and dissatisfaction after surgical procedures. A key component to management is identifying risk factors and high-risk populations. Advances in pharmacologic therapeutics have resulted in agents targeting different pathways associated with the mediation of nausea and vomiting. This review focuses on these agents and the clinical aspects of their use in patients postoperatively. Combination therapies are reviewed, and studies demonstrate that when 2 or more antiemetic agents acting on different receptors are used, an overall improved efficacy is demonstrated when compared with a single agent alone in patients.

      PubDate: 2017-05-17T18:16:24Z
      DOI: 10.1016/j.anclin.2017.01.003
       
  • Essential Elements of Multimodal Analgesia in Enhanced Recovery After
           Surgery (ERAS) Guidelines
    • Authors: Anair Beverly; Alan D. Kaye; Olle Ljungqvist; Richard D. Urman
      Abstract: Publication date: June 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 2
      Author(s): Anair Beverly, Alan D. Kaye, Olle Ljungqvist, Richard D. Urman
      Teaser Perioperative multimodal analgesia uses combinations of analgesic medications that act on different sites and pathways in an additive or synergistic manner to achieve pain relief with minimal or no opiate consumption. Although all medications have side effects, opiates have particularly concerning, multisystemic, long-term, and short-term side effects, which increase morbidity and prolong admissions. Enhanced recovery is a systematic process addressing each aspect affecting recovery. This article outlines the evidence base forming the current multimodal analgesia recommendations made by the Enhanced Recovery After Surgery Society (ERAS). We describe current evidence and important future directions for effective perioperative multimodal analgesia in enhanced recovery pathways.

      PubDate: 2017-05-17T18:16:24Z
      DOI: 10.1016/j.anclin.2017.01.018
       
  • Perioperative Pharmacologic Considerations in Obesity
    • Authors: Simon Willis; Gregory J. Bordelon; Maunak V. Rana
      Pages: 247 - 257
      Abstract: Publication date: June 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 2
      Author(s): Simon Willis, Gregory J. Bordelon, Maunak V. Rana
      Teaser Obesity has increased in incidence worldwide. Along with the increased number of obese patients, comorbid conditions are also more prevalent in this population. Obesity leads to changes in the physiology of patients along with an altered response to pharmacologic therapy. Vigilant perioperative physicians must be aware of the unique characteristics of administered agents in order to appropriately provide anesthetic care for obese patients. Because of the variability in tissue content in obese patients and changes in pharmacokinetic modeling, a one-size-fits-all approach is not justified and a more sophisticated and prudent approach is indicated.

      PubDate: 2017-05-17T18:16:24Z
      DOI: 10.1016/j.anclin.2017.01.010
       
  • Pharmacogenomics in Anesthesia
    • Authors: Ramsey Saba; Alan D. Kaye; Richard D. Urman
      Pages: 285 - 294
      Abstract: Publication date: June 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 2
      Author(s): Ramsey Saba, Alan D. Kaye, Richard D. Urman
      Teaser A significant number of commonly administered medications in anesthesia show wide clinical interpatient variability. Some of these include neuromuscular blockers, opioids, local anesthetics, and inhalation anesthetics. Individual genetic makeup may account for and predict cardiovascular outcomes after cardiac surgery. These interactions can manifest at any point in the perioperative period and may also only affect a specific system. A better understanding of pharmacogenomics will allow for more individually tailored anesthetics and may ultimately lead to better outcomes, decreased hospital stays, and improved patient satisfaction.

      PubDate: 2017-05-17T18:16:24Z
      DOI: 10.1016/j.anclin.2017.01.014
       
  • Pharmacogenomics in Pain Management
    • Authors: Ramsey Saba; Alan D. Kaye; Richard D. Urman
      Pages: 295 - 304
      Abstract: Publication date: June 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 2
      Author(s): Ramsey Saba, Alan D. Kaye, Richard D. Urman
      Teaser There is interpatient variability to analgesic administration. Much can be traced to pharmacogenomics variations between individuals. Certain ethnicities are more prone to reduced function of CYP2D6. Weak opioids are subject to interpatient variation based on their CYP2D6 type. Strong opioids have variations based on their transport and individual metabolism. Several cytochrome enzymes have been found to be involved with ketamine but there is no strong evidence of individual polymorphisms manifesting in clinical outcomes. Nonsteroidal anti-inflammatory drugs have adverse outcomes that certain CYP variants are more prone toward. There are now recommendations for dosing based on specific genomic makeup.

      PubDate: 2017-05-17T18:16:24Z
      DOI: 10.1016/j.anclin.2017.01.015
       
  • Pharmacology of Octreotide
    • Authors: Reza M. Borna; Jonathan S. Jahr; Susanna Kmiecik; Ken F. Mancuso; Alan D. Kaye
      Pages: 327 - 339
      Abstract: Publication date: June 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 2
      Author(s): Reza M. Borna, Jonathan S. Jahr, Susanna Kmiecik, Ken F. Mancuso, Alan D. Kaye
      Teaser Many patients presenting with a history of foregut, midgut neuroendocrine tumors (NETs) or carcinoid syndrome can experience life-threatening carcinoid crises during anesthesia or surgery. Clinicians should understand the pharmacology of octreotide and appreciate the use of continuous infusions of high-dose octreotide, which can minimize intraoperative carcinoid crises. We administer a prophylactic 500-μg bolus of octreotide intravenously (IV) and begin a continuous infusion of 500 μg/h for all NET patients. Advantages include low cost and excellent safety profile. High-dose octreotide for midgut and foregut NETs requires an appreciation of the pathophysiology involved in the disease, pharmacology, drug–drug interactions, and side effects.

      PubDate: 2017-05-17T18:16:24Z
      DOI: 10.1016/j.anclin.2017.01.021
       
  • Obstetric Anesthesia
    • Authors: Onyi C. Onuoha; Robert R. Gaiser
      Abstract: Publication date: March 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 1
      Author(s): Onyi C. Onuoha, Robert R. Gaiser


      PubDate: 2017-01-30T04:05:26Z
      DOI: 10.1016/s1932-2275(16)30102-1
       
  • Anesthesiologists in Obstetric Care: Beyond Labor Epidurals and C-Section
           Care
    • Authors: Lee A. Fleisher
      Abstract: Publication date: March 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 1
      Author(s): Lee A. Fleisher


      PubDate: 2017-01-30T04:05:26Z
      DOI: 10.1016/j.anclin.2016.12.002
       
  • Organ Transplantation: A Systematic Review
    • Authors: Aman Mahajan; Christopher Wray
      Abstract: Publication date: Available online 10 July 2017
      Source:Anesthesiology Clinics
      Author(s): Aman Mahajan, Christopher Wray


      PubDate: 2017-07-21T22:52:39Z
      DOI: 10.1016/j.anclin.2017.06.001
       
  • Anesthesia for Kidney and Pancreas Transplantation
    • Authors: Aaron M. Mittel; Gebhard Wagener
      Abstract: Publication date: Available online 10 July 2017
      Source:Anesthesiology Clinics
      Author(s): Aaron M. Mittel, Gebhard Wagener
      Teaser Kidney transplants are the most common solid organ abdominal transplant and are occasionally performed simultaneously with pancreas transplants in diabetic patients. Preoperative evaluation of potential transplant recipients should focus on the potential for occult cardiovascular disease while also screening for other signs of end-organ dysfunction. Intraoperatively, it is of utmost importance to ensure adequate graft perfusion to limit the risk of postoperative graft dysfunction or rejection. Postoperative care of the kidney or pancreas transplant patient should focus on ensuring normalization of volume status, electrolyte concentrations, and glycemic control.

      PubDate: 2017-07-21T22:52:39Z
      DOI: 10.1016/j.anclin.2017.04.005
       
  • Anesthetic Management of Pediatric Liver and Kidney Transplantation
    • Authors: Nicholas R. Wasson; Jeremy D. Deer; Santhanam Suresh
      Abstract: Publication date: Available online 10 July 2017
      Source:Anesthesiology Clinics
      Author(s): Nicholas R. Wasson, Jeremy D. Deer, Santhanam Suresh
      Teaser Pediatric patients with liver dysfunction and renal failure may exhibit many comorbidities. There are often associated congenital syndromes to be taken into account. Liver and renal transplantation offer a solution and substantial improvement in quality of life. Anesthetic management of pediatric liver and renal transplantation has not been well-described. There are key differences between adults and children undergoing these procedures, and acknowledgment of some key principles provide a solid foundation to optimize perioperative outcomes. This article provides an overview of the perioperative management and considerations in pediatric patients undergoing liver and renal transplantation.

      PubDate: 2017-07-21T22:52:39Z
      DOI: 10.1016/j.anclin.2017.05.001
       
  • Anesthesia for Liver Transplantation
    • Authors: Dieter Adelmann; Kate Kronish; Michael A. Ramsay
      Abstract: Publication date: Available online 10 July 2017
      Source:Anesthesiology Clinics
      Author(s): Dieter Adelmann, Kate Kronish, Michael A. Ramsay
      Teaser The provision of anesthesia for a liver transplant program requires a dedicated team of anesthesiologists. Liver transplant anesthesiologists must have an understanding of liver physiology and anatomy; the spectrum of clinical disease associated with liver dysfunction; the impact of warm and cold ischemia times, surgical techniques in liver transplantation, the impact of ischemia–reperfusion syndrome; and optimal practices to protect the liver. The team must provide a 24-hour service, be actively involved in the selection committee process, and stay current with advances in the subspecialty.

      PubDate: 2017-07-21T22:52:39Z
      DOI: 10.1016/j.anclin.2017.04.006
       
  • Transfusion Medicine and Coagulation Management in Organ Transplantation
    • Authors: Jaswanth Madisetty; Cynthia Wang
      Abstract: Publication date: Available online 10 July 2017
      Source:Anesthesiology Clinics
      Author(s): Jaswanth Madisetty, Cynthia Wang
      Teaser Organ transplantation recipients present unusual challenges with regard to blood transfusion. Although this patient population requires a larger proportion of blood product resources, liberal transfusion of allogeneic blood products can lead to a plethora of complications. Recent trends suggest that efforts to minimize bleeding, conserve products, and target transfusion to specific deficits and needs are increasingly becoming the standard practice. This must all occur with optimization of graft function and preservation in mind. With newer monitoring modalities and factor concentrates, the approach toward transfusion and bleeding in organ transplantation has rapidly improved in recent years.

      PubDate: 2017-07-21T22:52:39Z
      DOI: 10.1016/j.anclin.2017.04.004
       
  • Anesthesia for Lung Transplantation
    • Authors: Alina Nicoara; John Anderson- Dam
      Abstract: Publication date: Available online 5 July 2017
      Source:Anesthesiology Clinics
      Author(s): Alina Nicoara, John Anderson- Dam
      Teaser Perioperative management of patients undergoing lung transplantation is challenging and requires constant communication among the surgical, anesthesia, perfusion, and nursing teams. Although all aspects of anesthetic management are important, certain intraoperative strategies (mechanical ventilation, fluid management, extracorporeal mechanical support deployment) have tremendous impact on the subsequent evolution of the lung transplant recipient, especially with respect to allograft function and should be carefully considered. This review highlights some of the intraoperative anesthetic challenges and opportunities during lung transplantation.

      PubDate: 2017-07-10T22:25:24Z
      DOI: 10.1016/j.anclin.2017.05.003
       
  • Anesthesia for Heart Transplantation
    • Authors: Davinder Ramsingh; Reed Harvey; Alec Runyon; Michael Benggon
      Abstract: Publication date: Available online 5 July 2017
      Source:Anesthesiology Clinics
      Author(s): Davinder Ramsingh, Reed Harvey, Alec Runyon, Michael Benggon
      Teaser This review seeks to evaluate current practices in heart transplantation. The goals of this article were to review current practices for heart transplantation and its anesthesia management. The article reviews current demographics and discusses the current criteria for candidacy for heart transplantation. The process for donor and receipt selection is reviewed. This is followed by a review of mechanical circulatory support devices as they pertain to heart transplantation. The pre-anesthesia and intraoperative considerations are also discussed. Finally, management after transplantation also is reviewed.

      PubDate: 2017-07-10T22:25:24Z
      DOI: 10.1016/j.anclin.2017.05.002
       
  • Anesthesia for Intestinal Transplantation
    • Authors: Christine Nguyen-Buckley; Melissa Wong
      Abstract: Publication date: Available online 5 July 2017
      Source:Anesthesiology Clinics
      Author(s): Christine Nguyen-Buckley, Melissa Wong
      Teaser The diagnosis of irreversible intestinal failure confers significant morbidity, mortality, and decreased quality of life. Patients with irreversible intestinal failure may be treated with intestinal transplantation. Intestinal transplantation may include intestine only, liver–intestine, or other visceral elements. Intestinal transplantation candidates present with systemic manifestations of intestinal failure requiring multidisciplinary evaluation at an intestinal transplantation center. Central access may be difficult in intestinal transplantation candidates. Intestinal transplantation is a complex operation with potential for hemodynamic and metabolic instability. Patient and graft survival are improving, but graft failure remains the most common postoperative complication.

      PubDate: 2017-07-10T22:25:24Z
      DOI: 10.1016/j.anclin.2017.04.007
       
  • Transplantation Anesthesia: The Role of the Anesthesiologist
    • Authors: Lee A. Fleisher
      Abstract: Publication date: Available online 5 July 2017
      Source:Anesthesiology Clinics
      Author(s): Lee A. Fleisher


      PubDate: 2017-07-10T22:25:24Z
      DOI: 10.1016/j.anclin.2017.06.002
       
  • Anesthetic Considerations in Transplant Recipients for Nontransplant
           Surgery
    • Authors: Joshua Herborn; Suraj Parulkar
      Abstract: Publication date: Available online 5 July 2017
      Source:Anesthesiology Clinics
      Author(s): Joshua Herborn, Suraj Parulkar
      Teaser As solid organ transplantation increases and patient survival improves, it will become more common for these patients to present for nontransplant surgery. Recipients may present with medical problems unique to the transplant and important considerations are necessary to keep the transplanted organ functioning. A comprehensive preoperative examination with specific focus on graft functioning is required, and the anesthesiologist needs pay close attention to considerations of immunosuppressive regimens, blood product administration, and the risk benefits of invasive monitoring in these immunosuppressed patients. This article reviews the posttransplant physiology and anesthetic considerations for patients after solid organ transplantation.

      PubDate: 2017-07-10T22:25:24Z
      DOI: 10.1016/j.anclin.2017.04.009
       
  • Anesthesia and Perioperative Care in Reconstructive Transplantation
    • Authors: Raymond M. Planinsic; Jay S. Raval; Vijay S. Gorantla
      Abstract: Publication date: Available online 5 July 2017
      Source:Anesthesiology Clinics
      Author(s): Raymond M. Planinsic, Jay S. Raval, Vijay S. Gorantla
      Teaser Reconstructive transplantation of vascularized composite allografts (VCAs), such as upper extremity, craniofacial, abdominal, lower extremity, or genitourinary transplants, has emerged as a cutting-edge specialty with more than 50 programs in the United States and 30 programs across the world performing these procedures. Most VCAs involve complicated technical planning and preparation, protracted surgery, and complex immunosuppressive or immunomodulatory protocols, each associated with unique anesthesiology challenges. This article outlines key procedural, patient, and protocol-related aspects of VCA relevant to anesthesiology management with the goal of ensuring patient safety and optimizing surgical, immunologic, and functional outcomes.

      PubDate: 2017-07-10T22:25:24Z
      DOI: 10.1016/j.anclin.2017.04.008
       
  • Anesthesia Management of Organ Donors
    • Authors: Victor W. Xia; Michelle Braunfeld
      Abstract: Publication date: Available online 5 July 2017
      Source:Anesthesiology Clinics
      Author(s): Victor W. Xia, Michelle Braunfeld
      Teaser The shortage of suitable organs is the biggest obstacle for transplants. At present, most organs for transplant in the United States are from donation after neurologic determination of death (brain death). Potential organs for transplant need to maintain their viability during a series of insults, including the original disease, physiologic derangements during the dying process, ischemia, and reperfusion. Proper donor management before, during, and after procurement has potential to increase the number and quality of organs from donors. Anesthesiologists need to understand the physiologic derangements associated with brain death and the updated donor management during the periprocurement period.

      PubDate: 2017-07-10T22:25:24Z
      DOI: 10.1016/j.anclin.2017.04.003
       
  • Infectious Complications and Malignancies Arising After Liver
           Transplantation
    • Authors: Dame W. Idossa; Douglas Alano Simonetto
      Abstract: Publication date: Available online 5 July 2017
      Source:Anesthesiology Clinics
      Author(s): Dame W. Idossa, Douglas Alano Simonetto
      Teaser Since the first liver transplant was performed in 1963, great advancements have been made in hepatic transplantation. Surgical techniques have been revised and improved, diagnostic methods for identifying and preventing infections have been developed, and more conservative use of immunosuppressive agents have resulted in better long-term posttransplant outcomes. A total of 7841 liver transplantations were performed in the United States in 2016, resulting in greater than 85% survival at 1 year posttransplant. However, technical surgical complications, infections, rejections, and chronic medical conditions persist. In this review, we discuss the infectious complications and malignancies that may arise after liver transplantation.

      PubDate: 2017-07-10T22:25:24Z
      DOI: 10.1016/j.anclin.2017.04.002
       
  • Forthcoming Issues
    • Abstract: Publication date: June 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 2


      PubDate: 2017-05-17T18:16:24Z
       
  • New Hypnotic Drug Development and Pharmacologic Considerations for
           Clinical Anesthesia
    • Authors: Mariah Kincaid Tanious; Sascha S. Beutler; Alan D. Kaye; Richard D. Urman
      Abstract: Publication date: Available online 14 April 2017
      Source:Anesthesiology Clinics
      Author(s): Mariah Kincaid Tanious, Sascha S. Beutler, Alan D. Kaye, Richard D. Urman
      Teaser Since the public demonstration of ether as a novel, viable anesthetic for surgery in 1846, the field of anesthesia has continually sought the ideal anesthetic—rapid onset, potent sedation-hypnosis with a high therapeutic ratio of toxic dose to minimally effective dose, predictable clearance to inactive metabolites, and minimal side effects. This article aims to review current progress of novel induction agent development and provide an update on the most promising drugs poised to enter clinical practice. In addition, the authors describe trends in novel agent development, implications for health care costs, and implications for perioperative care.

      PubDate: 2017-04-19T17:06:52Z
      DOI: 10.1016/j.anclin.2017.01.017
       
  • Pharmacologic Properties of Novel Local Anesthetic Agents in Anesthesia
           Practice
    • Authors: Chih H. King; Sascha S. Beutler; Alan D. Kaye; Richard D. Urman
      Abstract: Publication date: Available online 14 April 2017
      Source:Anesthesiology Clinics
      Author(s): Chih H. King, Sascha S. Beutler, Alan D. Kaye, Richard D. Urman
      Teaser Therapeutic duration of traditional local anesthetics when used in peripheral nerve blocks is normally limited. This article describes novel approaches to extend the duration of peripheral nerve blocks currently available or in development. Three newer approaches on extending the duration of peripheral nerve blocks include site-1 sodium channel blockers, novel local anesthetics delivery systems, and novel adjuvants of local anesthetics. Compared with plain amide-based and ester-based local anesthetics, alternative approaches show significant promise in decreasing postoperative pain, rescue opioid requirement, hospital length-of-stay, and overall health care cost, without compromising the established safety profile of traditional local anesthetics.

      PubDate: 2017-04-19T17:06:52Z
      DOI: 10.1016/j.anclin.2017.01.019
       
  • Ketorolac, Oxymorphone, Tapentadol, and Tramadol
    • Authors: Nalini Vadivelu; Daniel Chang; Erik M. Helander; Gregory J. Bordelon; Alice Kai; Alan D. Kaye; Dora Hsu; Daniel Bang; Inderjeet Julka
      Abstract: Publication date: Available online 14 April 2017
      Source:Anesthesiology Clinics
      Author(s): Nalini Vadivelu, Daniel Chang, Erik M. Helander, Gregory J. Bordelon, Alice Kai, Alan D. Kaye, Dora Hsu, Daniel Bang, Inderjeet Julka
      Teaser Pain remains a tremendous burden on patients and for the health care system, with uncontrolled pain being the leading cause of disability in this country. There are a variety of medications that can be used in the treatment of pain, including ketorolac, oxymorphone, tapentadol, and tramadol. Depending on the clinical situation, these drugs can be used as monotherapy or in conjunction with other types of medications in a multimodal approach. A strong appreciation of pharmacologic properties of these agents and potential side effects is warranted for clinicians.

      PubDate: 2017-04-19T17:06:52Z
      DOI: 10.1016/j.anclin.2017.01.001
       
  • Pulmonary Vasodilators and Anesthesia Considerations
    • Authors: Jeremy B. Green; Brendon M. Hart; Elyse M. Cornett; Alan D. Kaye; Ali Salehi; Charles J. Fox
      Abstract: Publication date: Available online 14 April 2017
      Source:Anesthesiology Clinics
      Author(s): Jeremy B. Green, Brendon M. Hart, Elyse M. Cornett, Alan D. Kaye, Ali Salehi, Charles J. Fox
      Teaser Pulmonary hypertension (PH) is a complex disease process of the pulmonary vasculature system characterized by elevated pulmonary arterial pressures. Patients with PH are at increased risk for morbidity and mortality, including intraoperatively and postoperatively. Appreciation by the clinical anesthesiologist of the pathophysiology of PH is warranted. Careful and meticulous strategy using appropriate anesthetic medications, pulmonary vasodilator and inotropic agents, and careful fluid management all increase the likelihood of the best possible outcome in this challenging patient population.

      PubDate: 2017-04-19T17:06:52Z
      DOI: 10.1016/j.anclin.2017.01.008
       
  • Cardiovascular Pharmacology
    • Authors: Camellia Asgarian; Henry Liu; Alan D. Kaye
      Abstract: Publication date: Available online 14 April 2017
      Source:Anesthesiology Clinics
      Author(s): Camellia Asgarian, Henry Liu, Alan D. Kaye
      Teaser Cardiovascular disease remains a leading cause of morbidity and mortality worldwide. The development of therapeutic agents for the treatment of cardiovascular diseases has always been a priority because of the huge potential market for these drugs. These medications should be part of the anesthesiologist’s armamentarium because the typical surgical patient is older and has more comorbidities than in the past. This article reviews commonly used cardiovascular medications that are important in managing patients with unstable hemodynamics.

      PubDate: 2017-04-19T17:06:52Z
      DOI: 10.1016/j.anclin.2017.01.013
       
  • Total Parenteral and Enteral Nutrition in the ICU
    • Authors: Amir O. Elhassan; Lien B. Tran; Richard C. Clarke; Sumit Singh; Alan David Kaye
      Abstract: Publication date: Available online 14 April 2017
      Source:Anesthesiology Clinics
      Author(s): Amir O. Elhassan, Lien B. Tran, Richard C. Clarke, Sumit Singh, Alan David Kaye
      Teaser Appropriate nutrition in the hospital setting, particularly in critically ill patients, has long been tied to improving clinical outcomes. During critical illness, inflammatory mediators and cytokines lead to the creation of a catabolic state to facilitate the use of endogenous energy sources to meet increased energy demands. This process results in increasing the likelihood of overfeeding. The literature has revealed exponential advances in understanding the molecular basis of nutritional support and evolution of clinical protocols aimed at treating artificial nutritional support as a therapeutic intervention, preventing loss of lean body mass and metabolic deterioration to improve clinical outcomes in the critically ill.

      PubDate: 2017-04-19T17:06:52Z
      DOI: 10.1016/j.anclin.2017.01.004
       
  • Pharmacologic Considerations of Anesthetic Agents in Pediatric Patients
    • Authors: Alan D. Kaye; Charles J. Fox; Ira W. Padnos; Kenny P. Ehrhardt; James H. Diaz; Elyse Cornett; Debbie Chandler; Sudipta Sen; Shilpadevi Patil
      Abstract: Publication date: Available online 14 April 2017
      Source:Anesthesiology Clinics
      Author(s): Alan D. Kaye, Charles J. Fox, Ira W. Padnos, Kenny P. Ehrhardt, James H. Diaz, Elyse Cornett, Debbie Chandler, Sudipta Sen, Shilpadevi Patil
      Teaser Acute pain in the pediatric population has important differences in terms of biology, intrapopulation variation, and epidemiology. Discussion as to the pharmacologic considerations of anesthetic agents, such as induction agents, neuromuscular blockers, opioids, local anesthetics, and adjuvant agents, is presented in this article. Special considerations and concerns, such as risk for propofol infusion syndrome and adverse potential side effects of anesthesia agents, are discussed. Anesthesiologists managing pediatric patients need to have a firm understanding of physiologic and pharmacologic differences compared with the adult population. Future studies to improve the understanding of pharmacokinetics in the pediatric population are needed.

      PubDate: 2017-04-19T17:06:52Z
      DOI: 10.1016/j.anclin.2017.01.012
       
  • Novel Anticoagulant Agents in the Perioperative Setting
    • Authors: Allyson Lemay; Alan D. Kaye; Richard D. Urman
      Abstract: Publication date: Available online 7 April 2017
      Source:Anesthesiology Clinics
      Author(s): Allyson Lemay, Alan D. Kaye, Richard D. Urman
      Teaser An increasing number of oral anticoagulants have become available over the past decade. Each of these agents has differing implications on both regional and neuraxial anesthetic techniques. This article describes the pharmacology, pharmacokinetics, and pharmacodynamics of the most commonly used novel oral anticoagulants (NOACs). It also outlines recent guidelines for the use of NOACs in the perioperative setting, especially with regard to neuraxial anesthesia.

      PubDate: 2017-04-11T16:49:04Z
      DOI: 10.1016/j.anclin.2017.01.016
       
  • Anticoagulant Reversal and Anesthetic Considerations
    • Authors: Joseph Meltzer; Joseph R. Guenzer
      Abstract: Publication date: Available online 30 March 2017
      Source:Anesthesiology Clinics
      Author(s): Joseph Meltzer, Joseph R. Guenzer
      Teaser Bleeding complications are a common concern with the use of anticoagulant agents. In many situations, reversing of neutralizing their effects may be warranted. Prothrombin complex concentrate replaces coagulation factors lowered by warfarin, as does fresh frozen plasma, but in a more concentrated form. Protamine negates the effect of heparin and combines chemically with heparin molecules to form an inactive salt. It also partially reverses the effects of low-molecular-weight heparin. Recombinant activated factor VII is a nonspecific procoagulant that activates the extrinsic clotting pathway, resulting in thrombin generation, but does not directly neutralize the activity of any of the new oral anticoagulants.

      PubDate: 2017-04-04T16:40:47Z
      DOI: 10.1016/j.anclin.2017.01.005
       
  • An Update on Nonopioids
    • Authors: Alan David Kaye; Elyse Cornett; Erik Helander; Bethany Menard; Eric Hsu; Brendon Hart; Andrew Brunk
      Abstract: Publication date: Available online 30 March 2017
      Source:Anesthesiology Clinics
      Author(s): Alan David Kaye, Elyse Cornett, Erik Helander, Bethany Menard, Eric Hsu, Brendon Hart, Andrew Brunk
      Teaser Despite an appreciation for many unwanted physiologic effects from inadequate postoperative pain relief, moderate to severe postoperative pain remains commonplace. Although treatment options have evolved in recent years, the use of nonopioid analgesics agents can reduce acute pain-associated morbidity and mortality. This review focuses on the importance of effective postoperative nonopioid analgesic agents, such as acetaminophen, nonsteroidal anti-inflammatory agents, gabapentinoid agents, NMDA antagonists, alpha 2 agonists, and steroids, in opioid sparing and enhancing recovery. A careful literature review focusing on these treatment options, potential benefits, and side effects associated with these strategies is emphasized in this review.

      PubDate: 2017-04-04T16:40:47Z
      DOI: 10.1016/j.anclin.2017.01.006
       
  • Alpha-2 Agonists
    • Authors: Viet Nguyen; Dawn Tiemann; Edward Park; Ali Salehi
      Abstract: Publication date: Available online 30 March 2017
      Source:Anesthesiology Clinics
      Author(s): Viet Nguyen, Dawn Tiemann, Edward Park, Ali Salehi
      Teaser Alpha-2 adrenergic receptors are spread throughout the central and peripheral nervous system, specifically in the pontine locus coeruleus, medullospinal tracts, rostral ventrolateral medulla, and the dorsal horn of the spinal cord. Alpha-2 agonist agents cause neuromodulation in these centers, leading to sedation, analgesia, vasodilatation, and bradycardia with little effect on the respiratory drive, which accounts for their good safety profile. The 2 major drugs in this group are clonidine and dexmedetomidine. Their clinical applications in anesthesia practice include providing sedation in the intensive care unit or for minor procedures, adjuvant to general and regional anesthesia, analgesia, and as premedicating agents.

      PubDate: 2017-04-04T16:40:47Z
      DOI: 10.1016/j.anclin.2017.01.009
       
  • Pharmacologic Considerations of Anesthetic Agents in Geriatric Patients
    • Authors: Maunak V. Rana; Lara K. Bonasera; Gregory J. Bordelon
      Abstract: Publication date: Available online 30 March 2017
      Source:Anesthesiology Clinics
      Author(s): Maunak V. Rana, Lara K. Bonasera, Gregory J. Bordelon
      Teaser Aging is a natural process of declining organ function and reserve. Census data show that the geriatric population is expected to grow to nearly 30%. More than half of geriatric patients have 1 or more surgical procedures in their lifetimes. Moreover, this is the population at greatest risk of morbidity and mortality with any given complication. There is remarkable variability in health across the age spectrum, from fit to frail and compromised. This variability requires a unique approach to anesthetic delivery and drug dosing on an individual basis to avoid complications such as postoperative cognitive dysfunction and delirium.

      PubDate: 2017-04-04T16:40:47Z
      DOI: 10.1016/j.anclin.2017.01.011
       
  • Uterotonic Medications
    • Authors: Cristianna Vallera; Lynn O. Choi; Catherine M. Cha; Richard W. Hong
      Abstract: Publication date: Available online 30 March 2017
      Source:Anesthesiology Clinics
      Author(s): Cristianna Vallera, Lynn O. Choi, Catherine M. Cha, Richard W. Hong
      Teaser Uterine atony is a common cause of primary postpartum hemorrhage, which remains a major cause of pregnancy-related mortality for women worldwide. Oxytocin, methylergonovine, carboprost, and misoprostol are commonly used to restore uterine tone. Oxytocin is the first-line agent. Methylergonovine and carboprost are both highly effective second-line agents with severe potential side effects. Recent studies have called into question the effectiveness of misoprostol as an adjunct to other uterotonic agents, but it remains a useful therapeutic in resource-limited practice environments. We review the current role these medications play in the prevention and treatment of uterine atony.

      PubDate: 2017-04-04T16:40:47Z
      DOI: 10.1016/j.anclin.2017.01.007
       
  • Pharmacology of Acetaminophen, Nonsteroidal Antiinflammatory Drugs, and
           Steroid Medications: Implications for Anesthesia or Unique Associated
           Risks
    • Authors: Kenneth D. Candido; Oscar J. Perozo; Nebojsa Nick Knezevic
      Abstract: Publication date: Available online 14 March 2017
      Source:Anesthesiology Clinics
      Author(s): Kenneth D. Candido, Oscar J. Perozo, Nebojsa Nick Knezevic
      Teaser Acetaminophen, nonsteroidal antiinflammatory drugs (NSAIDs), and corticosteroids, historically used in perioperative management, are potent analgesic medications. They primarily inhibit the cyclooxygenase (COX) enzyme, decreasing the synthesis of prostaglandins, and modulating pain and temperature. Acetaminophen does not inhibit this synthesis at the inflammatory site. The primary mechanism of action of corticosteroids involves regulation of nuclear expression of genes involved in inflammatory pathways and other systemic effects. Metaanalyses have added purposeful perioperative indications, clarified misconceptions, and established protocols for administering these drugs. Some indications, doses, clinical considerations, and adverse effects need to be further studied.

      PubDate: 2017-03-17T03:16:31Z
      DOI: 10.1016/j.anclin.2017.01.020
       
  • An Analysis of New Approaches and Drug Formulations for Treatment of
           Chronic Low Back Pain
    • Authors: Karishma Patel Bhangare; Alan David Kaye; Nebojsa Nick Knezevic; Kenneth D. Candido; Richard D. Urman
      Abstract: Publication date: Available online 14 March 2017
      Source:Anesthesiology Clinics
      Author(s): Karishma Patel Bhangare, Alan David Kaye, Nebojsa Nick Knezevic, Kenneth D. Candido, Richard D. Urman
      Teaser The prevalence of chronic low back pain (CLBP) is increasing. Treatment is effective in less than 50% of patients after 1 year. This review investigates new treatments for CLBP. An extensive literature focused on new treatments for CLBP. Their safety and efficacy were evaluated and are described in detail in this review. The investigation identified new treatments for CLBP including chemonucleolysis, platelet-rich plasma injections, artemin, tanezumab, and stem cells. Further research and innovation are needed to implement these methods into practice and assess clinical significance. The current evidence suggests that there are promising new agents for the treatment of CLBP.

      PubDate: 2017-03-17T03:16:31Z
      DOI: 10.1016/j.anclin.2017.01.023
       
  • Revisiting Oxycodone Analgesia
    • Authors: Xiulu Ruan; Ken F. Mancuso; Alan David Kaye
      Abstract: Publication date: Available online 14 March 2017
      Source:Anesthesiology Clinics
      Author(s): Xiulu Ruan, Ken F. Mancuso, Alan David Kaye
      Teaser Oxycodone, a semisynthetic opioid analgesic, is widely used in clinical practice. Oxycodone and morphine seem to be equally effective and equipotent; however, morphine is 10 times more potent than oxycodone when given epidurally. This article provides an updated review of the basic pharmacology of oxycodone with a special focus on pharmacokinetic/pharmacodynamics properties. The controversy regarding oxycodone-mediated effects for visceral pain via agonism and the possible role of peripheral opioid analgesia are discussed in the present investigation in an attempt to propose a plausible explanation to the perplexing question of oxycodone analgesia.

      PubDate: 2017-03-17T03:16:31Z
      DOI: 10.1016/j.anclin.2017.01.022
       
  • Forthcoming Issues
    • Abstract: Publication date: March 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 1


      PubDate: 2017-01-30T04:05:26Z
       
 
 
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