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Publisher: Elsevier   (Total: 3030 journals)

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Showing 1 - 200 of 3030 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: 16, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 79, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 22, 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: 303, 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: 196, 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: 21, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 5, 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: 3, 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: 4)
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: 120, 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: 8, 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: 24, 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: 21, 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: 26, 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: 8, 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: 39, 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: 38, 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: 41, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 14)
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: 11)
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: 18, 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: 22)
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: 33, 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: 7, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 8)
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: 5, 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: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 6, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
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: 20, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 14)
Advances in Pharmacology     Full-text available via subscription   (Followers: 13, 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: 17, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 56)
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: 1, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 332, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 7)
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: 28, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 14)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 12)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 42, 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: 304, 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: 4, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 7, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 390, 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: 29, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 36, 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: 48, 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: 3, 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: 5)
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: 7, 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: 5, 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: 6, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 45, 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: 45, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 34, 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: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 32, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 25, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 31, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 48, 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: 174, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 51, 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: 22, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 23, 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: 32, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 13, 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: 52, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 3)
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: 154, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 7, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 10)
Anesthésie & Réanimation     Full-text available via subscription  
Anesthesiology Clinics     Full-text available via subscription   (Followers: 21, 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: 143, 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]   [21 followers]  Follow
    
   Full-text available via subscription Subscription journal  (Not entitled to full-text)
   ISSN (Print) 1932-2275
   Published by Elsevier Homepage  [3030 journals]
  • 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
       
  • Embracing the Next Phase in Obstetric Anesthesiology
    • 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/j.anclin.2016.12.001
       
  • Identification and Management of Obstetric Hemorrhage
    • Authors: Emily J. Baird
      Pages: 15 - 34
      Abstract: Publication date: March 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 1
      Author(s): Emily J. Baird
      Teaser Obstetric hemorrhage remains the leading cause of maternal death and severe morbidity worldwide. Although uterine atony is the most common cause of peripartum bleeding, abnormal placentation, coagulation disorders, and genital tract trauma contribute to adverse maternal outcomes. Given the inability to reliably predict patients at high risk for obstetric hemorrhage, all parturients should be considered susceptible, and extreme vigilance must be exercised in the assessment of blood loss and hemodynamic stability during the peripartum period. Obstetric-specific hemorrhage protocols, facilitating the integration and timely escalation of pharmacologic, radiological, surgical, and transfusion interventions, are critical to the successful management of peripartum bleeding.

      PubDate: 2017-01-30T04:05:26Z
      DOI: 10.1016/j.anclin.2016.09.004
       
  • The Use of Ultrasonography in Obstetric Anesthesia
    • Authors: Chiraag Talati; Cristian Arzola; Jose C.A. Carvalho
      Pages: 35 - 58
      Abstract: Publication date: March 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 1
      Author(s): Chiraag Talati, Cristian Arzola, Jose C.A. Carvalho
      Teaser This article provides an overview of the use of ultrasonography in obstetric anesthesia. It discusses the indications, benefits, and techniques of using ultrasonography to optimize the delivery of anesthesia and provide safe and efficacious clinical care. More specifically, it discusses the use of ultrasonography to facilitate neuraxial anesthesia, abdominal field blocks, central and peripheral vascular access, as well as the assessment of the lung fields and gastric contents, and identification of the cricothyroid membrane.

      PubDate: 2017-01-30T04:05:26Z
      DOI: 10.1016/j.anclin.2016.09.005
       
  • Obstetric and Anesthetic Approaches to External Cephalic Version
    • Authors: Stephanie Lim; Jennifer Lucero
      Pages: 81 - 94
      Abstract: Publication date: March 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 1
      Author(s): Stephanie Lim, Jennifer Lucero
      Teaser Breech presentation is the most common abnormal fetal presentation and complicates approximately 3% to 4% of all pregnancies. External cephalic version (ECV) should be recommended to women with a breech singleton pregnancy, if there is no maternal or fetal contraindication. ECV increases the chance of cephalic presentation at the onset of labor and decreases the rate of cesarean delivery by almost 40%. The success rate of ECV is approximately 60%. Review of the risks and benefits for performing an ECV and for both the timing of ECV and the number of attempts should be should be discussed with the patient.

      PubDate: 2017-01-30T04:05:26Z
      DOI: 10.1016/j.anclin.2016.09.008
       
  • Should Nitrous Oxide Be Used for Laboring Patients?
    • Authors: Michael G. Richardson; Brandon M. Lopez; Curtis L. Baysinger
      Pages: 125 - 143
      Abstract: Publication date: March 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 1
      Author(s): Michael G. Richardson, Brandon M. Lopez, Curtis L. Baysinger
      Teaser Nitrous oxide, long used during labor in Europe, is gaining popularity in the United States. It offers many beneficial attributes, with few drawbacks. Cost, safety, and side effect profiles are favorable. Analgesic effectiveness is highly variable, yet maternal satisfaction is often high among the women who choose to use it. Despite being less effective in treating labor pain than neuraxial analgesic modalities, nitrous oxide serves the needs and preferences of a subset of laboring parturients. Nitrous oxide should, therefore, be considered for inclusion in the repertoire of modalities used to alleviate pain and facilitate effective coping during labor.

      PubDate: 2017-01-30T04:05:26Z
      DOI: 10.1016/j.anclin.2016.09.011
       
  • Postdural Puncture Headache
    • Authors: Robert R. Gaiser
      Pages: 157 - 167
      Abstract: Publication date: March 2017
      Source:Anesthesiology Clinics, Volume 35, Issue 1
      Author(s): Robert R. Gaiser
      Teaser Headache after dural puncture is a common complication accompanying neuraxial anesthesia. The proposed cause is loss of cerebrospinal fluid through the puncture into the epidural space. Although obstetric patients are at risk for the development of this headache because of female gender and young age, there is a difference in the obstetric population. Women who deliver by cesarean delivery have a lower incidence of headache after dural puncture compared with those who deliver vaginally. Treatment of postdural puncture headache is an epidural blood patch. Departments should develop protocols for management of accidental dural puncture, including appropriate follow-up and indications for further management.

      PubDate: 2017-01-30T04:05:26Z
      DOI: 10.1016/j.anclin.2016.09.013
       
  • 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
       
  • Medically Complex Patients
    • Authors: Robert B. Schonberger; Stanley H. Rosenbaum
      Abstract: Publication date: December 2016
      Source:Anesthesiology Clinics, Volume 34, Issue 4
      Author(s): Robert B. Schonberger, Stanley H. Rosenbaum


      PubDate: 2016-11-10T10:01:45Z
      DOI: 10.1016/s1932-2275(16)30086-6
       
  • The Patient with Multimorbidities: Does 1 + 1 Always Simply Equal 2?
    • Authors: Lee A. Fleisher
      Abstract: Publication date: December 2016
      Source:Anesthesiology Clinics, Volume 34, Issue 4
      Author(s): Lee A. Fleisher


      PubDate: 2016-11-10T10:01:45Z
      DOI: 10.1016/j.anclin.2016.09.002
       
  • Medically Complex Patients
    • Authors: Robert B. Schonberger; Stanley H. Rosenbaum
      Abstract: Publication date: December 2016
      Source:Anesthesiology Clinics, Volume 34, Issue 4
      Author(s): Robert B. Schonberger, Stanley H. Rosenbaum


      PubDate: 2016-11-10T10:01:45Z
      DOI: 10.1016/s1932-2275(16)30086-6
       
  • Anesthetic Management of the Adult Patient with Concomitant Cardiac and
           Pulmonary Disease
    • Authors: Misty A. Radosevich; Daniel R. Brown
      Pages: 633 - 643
      Abstract: Publication date: December 2016
      Source:Anesthesiology Clinics, Volume 34, Issue 4
      Author(s): Misty A. Radosevich, Daniel R. Brown
      Teaser Several common diseases of the cardiac and pulmonary systems and the interactions of the two in disease and anesthetic management are discussed. Management of these disease processes in isolation is reviewed and how the management of one organ system impacts another is then explored. For example, in a patient with acute lung injury and right heart failure, lung-protective ventilation may directly conflict with strategies to minimize right heart afterload. Such challenging clinical scenarios require appreciation of each disease entity, their appropriate management, and the balance between competing priorities.

      PubDate: 2016-11-10T10:01:45Z
      DOI: 10.1016/j.anclin.2016.06.001
       
  • Anesthesia for the Patient with Concomitant Hepatic and Renal Impairment
    • Authors: Tricia E. Brentjens; Ryan Chadha
      Pages: 645 - 658
      Abstract: Publication date: December 2016
      Source:Anesthesiology Clinics, Volume 34, Issue 4
      Author(s): Tricia E. Brentjens, Ryan Chadha
      Teaser Hepatic and renal disease are common comorbidities in patients presenting for intermediate- and high-risk surgery. With the evolution of perioperative medicine, anesthesiologists are encountering more patients who have significant hepatic and renal disease, both acute and chronic in nature. It is important that anesthesiologists have an in-depth understanding of the physiologic derangements seen with hepatic and renal disease to evaluate and manage these patients appropriately. Perioperative management requires an understanding of the physiologic perturbations associated with each disease process. This article elucidates the goals in the management and treatment of this complex patient population.

      PubDate: 2016-11-10T10:01:45Z
      DOI: 10.1016/j.anclin.2016.06.002
       
  • Coexisting Cardiac and Hematologic Disorders
    • Authors: Jordan E. Goldhammer; Benjamin A. Kohl
      Pages: 659 - 668
      Abstract: Publication date: December 2016
      Source:Anesthesiology Clinics, Volume 34, Issue 4
      Author(s): Jordan E. Goldhammer, Benjamin A. Kohl
      Teaser Patients with concomitant cardiac and hematologic disorders presenting for noncardiac surgery are challenging. Anemic patients with cardiac disease should be approached in a methodical fashion. Transfusion triggers and target should be based on underlying symptomatology. The approach to anticoagulation management in patients with artificial heart valves, cardiac devices, or severe heart failure in the operative setting must encompass a complete understanding of the rationale of a patient’s therapy as well as calculate the risk of changing this regimen. This article focuses common disorders and discusses strategies to optimize care in patients with coexisting cardiac and hematologic disease.

      PubDate: 2016-11-10T10:01:45Z
      DOI: 10.1016/j.anclin.2016.06.003
       
  • Surgical Critical Care for the Trauma Patient with Cardiac Disease
    • Authors: Michael M. Woll; Linda L. Maerz
      Pages: 669 - 680
      Abstract: Publication date: December 2016
      Source:Anesthesiology Clinics, Volume 34, Issue 4
      Author(s): Michael M. Woll, Linda L. Maerz
      Teaser The elderly population is rapidly increasing in number. Therefore, geriatric trauma is becoming more prevalent. All practitioners caring for geriatric trauma patients should be familiar with the structural and functional changes naturally occurring in the aging heart, as well as common preexisting cardiac diseases in the geriatric population. Identification of the shock state related to cardiac dysfunction and targeted assessment of perfusion and resuscitation are important when managing elderly patients. Finally, management of cardiac dysfunction in the trauma patient includes an appreciation of the inherent effects of trauma on cardiac function.

      PubDate: 2016-11-10T10:01:45Z
      DOI: 10.1016/j.anclin.2016.06.004
       
  • Surgical Critical Care for the Patient with Sepsis and Multiple Organ
           Dysfunction
    • Authors: Gary J. Kaml; Kimberly A. Davis
      Pages: 681 - 696
      Abstract: Publication date: December 2016
      Source:Anesthesiology Clinics, Volume 34, Issue 4
      Author(s): Gary J. Kaml, Kimberly A. Davis
      Teaser Sepsis and multiple organ dysfunction syndrome (MODS) is common in the surgical intensive care unit. Sepsis involves infection and the patient’s immune response. Timely recognition of sepsis and swift application of evidence-based interventions is critical to the success of therapy. This article reviews the nature of the septic process, existing definitions of sepsis, and current evidence-based treatment strategies for sepsis and MODS. An improved understanding of the process of sepsis and its relation to MODS has resulted in clinical definitions and scoring systems that allow for the quantification of disease severity and guidelines for treatment.

      PubDate: 2016-11-10T10:01:45Z
      DOI: 10.1016/j.anclin.2016.06.005
       
  • Anesthesia for Patients with Concomitant Cardiac and Renal Dysfunction
    • Authors: Radwan Safa; Nicholas Sadovnikoff
      Pages: 697 - 710
      Abstract: Publication date: December 2016
      Source:Anesthesiology Clinics, Volume 34, Issue 4
      Author(s): Radwan Safa, Nicholas Sadovnikoff
      Teaser Renal disease and cardiovascular disease are commonly encountered in the same patient. The dynamic interactions between renal disease and cardiovascular disease have an impact on perioperative management. Renal failure is an independent risk factor for cardiovascular disease and the link between the two disease states remains to be fully elucidated.

      PubDate: 2016-11-10T10:01:45Z
      DOI: 10.1016/j.anclin.2016.06.006
       
  • Anesthesia for Patients with Anemia
    • Authors: Aryeh Shander; Gregg P. Lobel; Mazyar Javidroozi
      Pages: 711 - 730
      Abstract: Publication date: December 2016
      Source:Anesthesiology Clinics, Volume 34, Issue 4
      Author(s): Aryeh Shander, Gregg P. Lobel, Mazyar Javidroozi
      Teaser Anemia is a common and often ignored condition in surgical patients. Anemia is usually multifactorial and iron deficiency and inflammation are commonly involved. An exacerbating factor in surgical patients is iatrogenic blood loss. Anemia has been repeatedly shown to be an independent predictor of worse outcomes. Patient blood management (PBM) provides a multimodality framework for prevention and management of anemia and related risk factors. The key strategies in PBM include support of hematopoiesis and improving hemoglobin level, optimizing coagulation and hemostasis, use of interdisciplinary blood conservation modalities, and patient-centered decision making throughout the course of care.

      PubDate: 2016-11-10T10:01:45Z
      DOI: 10.1016/j.anclin.2016.06.007
       
  • Anesthesia Patients with Concomitant Cardiac and Hepatic Dysfunction
    • Authors: Julianne Ahdout; Michael Nurok
      Pages: 731 - 745
      Abstract: Publication date: December 2016
      Source:Anesthesiology Clinics, Volume 34, Issue 4
      Author(s): Julianne Ahdout, Michael Nurok
      Teaser Anesthesia and surgery in patients with hepatic and cardiac dysfunction poses a challenge for anesthesiologists. It is imperative to optimize these patients perioperatively. Cirrhosis is associated with a wide range of cardiovascular abnormalities. Cirrhotic cardiomyopathy is characterized by blunted contractile responsiveness or systolic incompetence, and/or diastolic dysfunction. In liver disease, anesthetic drug distribution, metabolism, and elimination may be altered. Among patients with liver disease, propofol is a reasonable anesthetic choice and cisatracurium is the preferred neuromuscular blocker. Regional anesthesia should be used whenever appropriate if not contraindicated by coagulopathy, because it reduces the need for systemic analgesia.

      PubDate: 2016-11-10T10:01:45Z
      DOI: 10.1016/j.anclin.2016.06.008
       
  • Optimal Pain Management After Cesarean Delivery
    • Authors: Caitlin Dooley Sutton; Brendan Carvalho
      Abstract: Publication date: Available online 12 December 2016
      Source:Anesthesiology Clinics
      Author(s): Caitlin Dooley Sutton, Brendan Carvalho
      Teaser Cesarean delivery rates are increasing worldwide, and effective postoperative pain management is a key priority of women undergoing cesarean delivery. Inadequate pain management in the acute postoperative period is associated with persistent pain, greater opioid use, delayed functional recovery, and increased postpartum depression. In addition to pain relief, optimal management of patients after cesarean delivery should address the goals of unrestricted maternal mobility, minimal maternal and neonatal side effects, rapid recovery to baseline functionality, and early discharge home. Multimodal analgesia should include neuraxial morphine in conjunction with nonopioid adjuncts, with additional oral or intravenous opioids reserved for severe breakthrough pain.

      PubDate: 2016-12-14T19:40:00Z
      DOI: 10.1016/j.anclin.2016.09.010
       
  • Epidural Analgesia for Labor
    • Authors: Onyi C. Onuoha
      Abstract: Publication date: Available online 12 December 2016
      Source:Anesthesiology Clinics
      Author(s): Onyi C. Onuoha
      Teaser Despite the traditional practice to maintain labor analgesia with a combination of continuous epidural infusion and patient-controlled epidural analgesia using an automated epidural pump; compelling data now shows that bolus injection through the epidural catheter may result in better distribution of anesthetic solution in the epidural space. The programmed intermittent epidural bolus technique is proposed as a better maintenance mode and may represent a more effective mode of maintaining epidural analgesia for labor, especially prolonged labor. Additional prospective and adequately powered studies are needed to confirm findings and determine the optimal combination of volume, rate, time, and drug concentration.

      PubDate: 2016-12-14T19:40:00Z
      DOI: 10.1016/j.anclin.2016.09.003
       
  • Huddles and Debriefings
    • Authors: Emily McQuaid-Hanson; May C.M. Pian-Smith
      Abstract: Publication date: Available online 12 December 2016
      Source:Anesthesiology Clinics
      Author(s): Emily McQuaid-Hanson, May C.M. Pian-Smith
      Teaser Interprofessional teams work together on the labor and delivery unit, where clinical care is often unscheduled, rapidly evolving, and fast paced. Effective communication is key for coordinated delivery of optimal care and for fostering a culture of community and safety in the workplace. The preoperative huddle allows for information sharing, cross-checking, and preparation before the start of surgery. Postoperative debriefings allow the operative team to engage in ongoing process improvement. Debriefings after adverse events allow for shared understanding, mutual healing, and help mitigating the harm to potential “second victims.”

      PubDate: 2016-12-14T19:40:00Z
      DOI: 10.1016/j.anclin.2016.09.006
       
  • Update in the Management of Patients with Preeclampsia
    • Authors: Nerlyne K. Dhariwal; Grant C. Lynde
      Abstract: Publication date: Available online 12 December 2016
      Source:Anesthesiology Clinics
      Author(s): Nerlyne K. Dhariwal, Grant C. Lynde
      Teaser Hypertensive disorders of pregnancy complicate approximately 10% of all deliveries in the United States and are a leading cause of maternal and fetal morbidity and mortality. Preeclampsia is defined as hypertension in association with proteinuria, thrombocytopenia, impaired liver function, renal insufficiency, pulmonary edema, or new-onset cerebral or visual disturbances. The greatest risk factor for the development of preeclampsia is a history of preeclampsia. There currently is no effective means for the prevention of preeclampsia. Approximately 39% of patients diagnosed with preeclampsia have hypertension and approximately 20% have proteinuria 3 months postpartum. Preeclampsia increases the risk of patients developing hypertension later in life.

      PubDate: 2016-12-14T19:40:00Z
      DOI: 10.1016/j.anclin.2016.09.009
       
  • General Anesthesia During the Third Trimester
    • Authors: Annemaria De Tina; Arvind Palanisamy
      Abstract: Publication date: Available online 12 December 2016
      Source:Anesthesiology Clinics
      Author(s): Annemaria De Tina, Arvind Palanisamy
      Teaser Rodent studies on the effect of general anesthesia during the third trimester on neurocognitive outcomes are mixed, but primate studies suggest that a clinically relevant exposure to anesthetic agents during the third trimester can trigger neuronal and glial cell death. Human studies are conflicting and the evidence is weak. This is an up-to-date review of the literature on the neurodevelopmental effects of anesthetic agents administered during the third trimester. Early brain development and critical periods of neurodevelopment as it relates to neurotoxicity are highlighted. Rodent, nonhuman primate, and population studies are discussed and placed in the context of clinical practice.

      PubDate: 2016-12-14T19:40:00Z
      DOI: 10.1016/j.anclin.2016.09.007
       
  • Awareness and Aortocaval Obstruction in Obstetric Anesthesia
    • Authors: Nathaniel Hsu; Robert Gaiser
      Abstract: Publication date: Available online 12 December 2016
      Source:Anesthesiology Clinics
      Author(s): Nathaniel Hsu, Robert Gaiser
      Teaser Awareness during general anesthesia for cesarean delivery continues to be a major problem. The key to preventing awareness is strict attention to anesthetic technique. The prevalence and implications of aortocaval compression have been firmly established. Compression of the vena cava is a real occurrence when assuming the supine position. Relief of this compression most likely does not occur until the patient is turned 30°, which is not feasible for performing cesarean delivery. Although it is still wise to tilt the patient, the benefit of this tilt may not be as great as once thought.

      PubDate: 2016-12-14T19:40:00Z
      DOI: 10.1016/j.anclin.2016.09.012
       
  • Forthcoming Issues
    • Abstract: Publication date: December 2016
      Source:Anesthesiology Clinics, Volume 34, Issue 4


      PubDate: 2016-11-10T10:01:45Z
       
 
 
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