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ANAESTHESIOLOGY (121 journals)                     

Showing 1 - 121 of 121 Journals sorted alphabetically
Acta Anaesthesiologica Scandinavica     Hybrid Journal   (Followers: 62)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 6)
Acute Pain     Full-text available via subscription   (Followers: 16)
Advances in Anesthesia     Full-text available via subscription   (Followers: 31)
African Journal of Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 9)
Ain-Shams Journal of Anaesthesiology     Open Access   (Followers: 2)
Ain-Shams Journal of Anesthesiology     Open Access   (Followers: 1)
Ambulatory Anesthesia     Open Access   (Followers: 9)
Anaesthesia     Hybrid Journal   (Followers: 242)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 72)
Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 62)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 28)
Anaesthesia Reports     Hybrid Journal  
Anaesthesia, Pain & Intensive Care     Open Access  
Anaesthesiology Intensive Therapy     Open Access   (Followers: 9)
Analgesia & Resuscitation : Current Research     Hybrid Journal   (Followers: 7)
Anestesia Analgesia Reanimación     Open Access   (Followers: 1)
Anestesia en México     Open Access   (Followers: 1)
Anesthesia & Analgesia     Hybrid Journal   (Followers: 276)
Anesthesia : Essays and Researches     Open Access   (Followers: 10)
Anesthesia Progress     Hybrid Journal   (Followers: 6)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 2)
Anesthesiology     Hybrid Journal   (Followers: 233)
Anesthesiology and Pain Medicine     Open Access   (Followers: 23)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 25)
Anesthesiology Research and Practice     Open Access   (Followers: 15)
Angewandte Schmerztherapie und Palliativmedizin     Hybrid Journal  
Annales Françaises d'Anesthésie et de Réanimation     Full-text available via subscription   (Followers: 4)
Annals of Cardiac Anaesthesia     Open Access   (Followers: 15)
BDJ Team     Open Access   (Followers: 1)
Best Practice & Research Clinical Anaesthesiology     Hybrid Journal   (Followers: 15)
BJA : British Journal of Anaesthesia     Hybrid Journal   (Followers: 245)
BJA Education     Hybrid Journal   (Followers: 70)
BMC Anesthesiology     Open Access   (Followers: 18)
BMJ Supportive & Palliative Care     Hybrid Journal   (Followers: 47)
Brazilian Journal of Anesthesiology     Open Access   (Followers: 5)
Brazilian Journal of Anesthesiology (Edicion en espanol)     Open Access  
Brazilian Journal of Anesthesiology (English edition)     Open Access   (Followers: 1)
Brazilian Journal of Pain (BrJP)     Open Access  
British Journal of Pain     Hybrid Journal   (Followers: 28)
Canadian Journal of Anesthesia/Journal canadien d'anesthésie     Hybrid Journal   (Followers: 48)
Case Reports in Anesthesiology     Open Access   (Followers: 11)
Clinical Journal of Pain     Hybrid Journal   (Followers: 19)
Colombian Journal of Anesthesiology : Revista Colombiana de Anestesiología     Hybrid Journal   (Followers: 1)
Current Anaesthesia & Critical Care     Full-text available via subscription   (Followers: 36)
Current Anesthesiology Reports     Hybrid Journal   (Followers: 4)
Current Opinion in Anaesthesiology     Hybrid Journal   (Followers: 61)
Current Pain and Headache Reports     Hybrid Journal   (Followers: 2)
Der Anaesthesist     Hybrid Journal   (Followers: 9)
Der Schmerz     Hybrid Journal   (Followers: 4)
Der Schmerzpatient     Hybrid Journal  
Douleur et Analgésie     Hybrid Journal  
Egyptian Journal of Anaesthesia     Open Access   (Followers: 3)
Egyptian Journal of Cardiothoracic Anesthesia     Open Access  
EMC - Anestesia-Reanimación     Hybrid Journal  
EMC - Anestesia-Rianimazione     Hybrid Journal  
EMC - Urgenze     Full-text available via subscription  
European Journal of Anaesthesiology     Hybrid Journal   (Followers: 30)
European Journal of Pain     Full-text available via subscription   (Followers: 27)
European Journal of Pain Supplements     Full-text available via subscription   (Followers: 5)
Global Journal of Anesthesiology     Open Access   (Followers: 2)
Headache The Journal of Head and Face Pain     Hybrid Journal   (Followers: 5)
Indian Journal of Anaesthesia     Open Access   (Followers: 7)
Indian Journal of Pain     Open Access   (Followers: 2)
Indian Journal of Palliative Care     Open Access   (Followers: 8)
International Anesthesiology Clinics     Hybrid Journal   (Followers: 9)
International Journal of Clinical Anesthesia and Research     Open Access  
Itch & Pain     Open Access   (Followers: 2)
JA Clinical Reports     Open Access  
Journal Club Schmerzmedizin     Hybrid Journal  
Journal of Anesthesia & Clinical Research     Open Access   (Followers: 10)
Journal of Anaesthesiology Clinical Pharmacology     Open Access   (Followers: 8)
Journal of Anesthesia     Hybrid Journal   (Followers: 13)
Journal of Anesthesia History     Full-text available via subscription   (Followers: 1)
Journal of Anesthesiology and Clinical Science     Open Access   (Followers: 1)
Journal of Cellular and Molecular Anesthesia     Open Access  
Journal of Clinical Anesthesia     Hybrid Journal   (Followers: 13)
Journal of Critical Care     Hybrid Journal   (Followers: 42)
Journal of Headache and Pain     Open Access   (Followers: 3)
Journal of Neuroanaesthesiology and Critical Care     Open Access   (Followers: 3)
Journal of Neurosurgical Anesthesiology     Hybrid Journal   (Followers: 8)
Journal of Obstetric Anaesthesia and Critical Care     Open Access   (Followers: 22)
Journal of Pain     Hybrid Journal   (Followers: 19)
Journal of Pain and Symptom Management     Hybrid Journal   (Followers: 45)
Journal of Pain Research     Open Access   (Followers: 10)
Journal of Palliative Care     Full-text available via subscription   (Followers: 20)
Journal of Society of Anesthesiologists of Nepal     Open Access   (Followers: 2)
Journal of the Bangladesh Society of Anaesthesiologists     Open Access  
Jurnal Anestesi Perioperatif     Open Access  
Jurnal Anestesiologi Indonesia     Open Access  
Karnataka Anaesthesia Journal     Open Access   (Followers: 2)
Le Praticien en Anesthésie Réanimation     Full-text available via subscription   (Followers: 2)
Local and Regional Anesthesia     Open Access   (Followers: 8)
Medical Gas Research     Open Access   (Followers: 3)
Medycyna Paliatywna w Praktyce     Open Access   (Followers: 1)
OA Anaesthetics     Open Access   (Followers: 3)
Open Anesthesia Journal     Open Access  
Open Journal of Anesthesiology     Open Access   (Followers: 10)
Pain     Hybrid Journal   (Followers: 61)
Pain Clinic     Hybrid Journal   (Followers: 1)
Pain Management     Hybrid Journal   (Followers: 18)
Pain Medicine     Hybrid Journal   (Followers: 13)
Pain Research and Management     Open Access   (Followers: 7)
Pain Research and Treatment     Open Access   (Followers: 2)
Pain Studies and Treatment     Open Access   (Followers: 2)
Research and Opinion in Anesthesia and Intensive Care     Open Access   (Followers: 3)
Revista Chilena de Anestesia     Open Access   (Followers: 1)
Revista Colombiana de Anestesiología     Open Access   (Followers: 1)
Revista Cubana de Anestesiología y Reanimación     Open Access   (Followers: 1)
Revista da Sociedade Portuguesa de Anestesiologia     Open Access  
Revista Española de Anestesiología y Reanimación     Hybrid Journal  
Revista Española de Anestesiología y Reanimación (English Edition)     Full-text available via subscription   (Followers: 2)
Romanian Journal of Anaesthesia and Intensive Care     Open Access   (Followers: 1)
Saudi Journal of Anaesthesia     Open Access   (Followers: 7)
Scandinavian Journal of Pain     Hybrid Journal   (Followers: 1)
Southern African Journal of Anaesthesia and Analgesia     Open Access   (Followers: 8)
Sri Lankan Journal of Anaesthesiology     Open Access   (Followers: 2)
Survey of Anesthesiology     Full-text available via subscription   (Followers: 12)
Techniques in Regional Anesthesia and Pain Management     Hybrid Journal   (Followers: 11)
Topics in Pain Management     Full-text available via subscription   (Followers: 2)
Trends in Anaesthesia and Critical Care     Full-text available via subscription   (Followers: 23)

           

Similar Journals
Journal Cover
Current Anesthesiology Reports
Number of Followers: 4  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Online) 2167-6275
Published by Springer-Verlag Homepage  [2626 journals]
  • Septic Shock and the Heart
    • Abstract: Purpose of Review The aim of this review is to analyze the cardiovascular pathophysiology of septic shock. Using visual representations of a left ventricular cycle in the pressure/volume plane, we describe hemodynamic derangement occurring in septic shock and subsequent changes at each step of treatment allowing a rapid understanding of complex alterations. Recent Findings Acute circulatory failure during sepsis has to be counterbalanced rapidly and appropriately. The most recent guidelines rely on volume expansion, vasoactive, and inotropic support but underlining patients’ pathophysiology is often undetermined. Summary Diagnosis of the hemodynamic substrate needs to be carried out thoroughly, using echocardiography, now commonplace for the intensivist. A pathophysiological approach as we describe might help to understand complicated patterns allowing updates during resuscitation steps. Finally, in our beliefs, clinicians should address septic shock resuscitation using a tailored approach and specific protocols, but their applicability needs to be investigated.
      PubDate: 2019-03-21
       
  • Renal Replacement Therapy in Critical Care: When to Start'
    • Abstract: Purpose of Review Aside from absolute indications, the optimal timing of renal replacement therapy (RRT) in critical care is unknown. In this review, we discuss initiation of RRT in relation to both severity of acute kidney injury (AKI) and fluid accumulation. Recent Findings Results from studies of early vs. late RRT are conflicting, and no definitive conclusions have been made. Observational data points to fluid accumulation as a detrimental factor in critical illness and recent studies have shown that early fluid removal with RRT is feasible and could potentially improve survival. Summary There is a gap in the knowledge regarding when to initiate RRT in the absence of acute life-threatening complications. Recent studies of fluid accumulation in critically ill patients indicate the importance of avoiding fluid overload, and RRT might play an increasing role in the management of fluid balance in critical care.
      PubDate: 2019-03-19
       
  • Pediatric Post-anesthesia Care Unit Challenges Update
    • Abstract: Purpose of Review The purpose of this review is to discuss the current management of various challenges the health care provider faces in the pediatric post-anesthesia care unit (PACU). Recent Findings Efforts to ameliorate and manage PACU issues in the pediatric patient continue to evolve as new medications and methods of anesthesia delivery are introduced and incorporated into the perioperative period. In this review, emergence delirium (ED), postoperative nausea and vomiting (PONV), residual neuromuscular blockade, and tracheal extubation in the operating room versus the PACU are addressed. As ED may be self-limited, pharmacologic treatment may only be indicated if there is a concern for patient harm. Midazolam, fentanyl, and propofol have all been shown to be effective in the treatment of emergence delirium. Dexmedetomidine has been shown to decrease the incidence of ED when administered preoperatively or intraoperatively. This has led practitioners to use dexmedetomidine to treat ED in the PACU, though this has not been studied. Postoperative nausea is difficult to assess in the pediatric patient leading to under treatment. In order to capture these children, the BARF score, initially validated for use in oncologic pediatric patients, is validated for use in postoperative pediatric patients 6 years and older. The approach to treating breakthrough PONV in the PACU is guided by the medications administered intraoperatively for prophylactic treatment. Rescue medications from a different class should be selected if fewer than 6 h have passed since the administration of prophylactic antiemetics. Inadequate reversal of neuromuscular blockade intraoperatively results in adverse respiratory events in the PACU. In the past, when maximum doses of reversal agents are administered, the only recourse in the PACU is to provide assisted ventilation. With the introduction of sugammadex, assisted ventilation can be avoided since sugammadex is capable of reversing dense neuromuscular blockade by vecuronium or rocuronium. In the current environment of achieving greater OR efficiency and cost savings, some institutions are moving tracheal extubation from the operating room by trained anesthesiologists to the PACU by trained nurses with physicians immediately available. This practice in two different children’s hospitals is shown to be safe with no greater incidence of adverse respiratory events and with the added benefit of decreasing operating room time. Summary PACU challenges in the pediatric patient continue to occur despite changes in anesthetic practice and introduction of newer medications. It is important to keep abreast of these newer modalities to best manage these PACU conditions.
      PubDate: 2019-03-02
       
  • Development of Intensive Care in Low-Resource Regions
    • Abstract: Purpose of review Since their introduction almost a century ago, intensive care units have become an essential part of the health care system. Although the majority are found in the high-income countries, access to intensive care in the low-income countries has improved. The purpose of this review is to report on the current state of intensive care in resource-limited settings. Recent Findings Lack of basic health care resources still poses a specific challenge to the development and sustainability of health care. In addition, adequate funding, human resource training, and equipment specific to the specialty of critical care pose an even larger setback to the development of critical care in low-resource-limited settings. Summary Deaths potentially preventable with access to critical care as presented by data from the global disease burden analysis in 2004 are approximately 70% of all recorded deaths in low-income countries. This reflects the large burden of critical illness in low-income countries. Efforts to increase access to hospitals and intensive care for all critically ill patients should grow to match these needs.
      PubDate: 2019-03-01
       
  • Update on Vasopressors for Cesarean Delivery
    • Abstract: Purpose of Review The aim of this article is to provide an overview of the current strategies for managing spinal-induced hypotension during cesarean delivery with a particular focus on the evidence guiding the use of vasopressors. Recent Findings Phenylephrine is currently regarded as the first-line vasopressor in the prevention and treatment of spinal-induced hypotension following evidence that supports a favorable effect on neonatal acid-base status as well as reduced incidences of nausea and vomiting when compared with ephedrine. Norepinephrine and metaraminol are also effective in the prevention and treatment of hypotension. Summary The current consensus for vasopressor use in the treatment of spinal-induced hypotension has been shaped by data gathered from studies involving healthy parturients undergoing elective cesarean deliveries. While these results cannot necessarily be extrapolated to high-risk patients with impaired cardiovascular function or evidence of fetal compromise, these studies may help inform vasopressor choice and establish recommendations for clinical practice.
      PubDate: 2019-03-01
       
  • Maternal Sepsis: Recognition, Treatment, and Escalation of Care
    • Abstract: Purpose of Review The purpose of this article is to provide a brief review of maternal sepsis and the supporting literature for recognition and management. Recent Findings Recent findings suggest that there is significant room for improvement in identifying patients at risk, expeditiously providing appropriate intervention, and developing action plans to best care for these patients and prevent morbidity and mortality. Summary Improved education and understanding of the unique presentation of sepsis during pregnancy may help to improve detection, timely treatment, and expedite appropriate transfer to higher levels of care.
      PubDate: 2019-03-01
       
  • Hurdles to the Development of the “Surgical Home” in the
           Low-Resource World
    • Abstract: Purpose of Review This chapter assesses the current state of practice of anesthesia in a low-resourced hospital and the hurdles envisaged in the development of perioperative surgical home, PSH, at the Komfo Anokye Teaching Hospital, KATH in Ghana. Recent Findings In the PSH model, the patient’s experience of care is coordinated by a Director of Perioperative Services, additional Surgical Home Leadership, and supportive personnel, which constitute an interdisciplinary team. KATH is yet to establish working structures that provide a solid foundation that would make implementation of this model possible. Foundational tenets of the PSH being operating room (OR) managers or directors, interdisciplinary teamwork, well-oriented and motivated staff, appreciation of the key roles of the anesthetist by both patients and surgeons among others are either not well established or nonexistent currently at KATH. Summary While KATH has the basic infrastructure and personnel compared to other low-resourced countries for delivery of safe anesthesia, there exist several important limitations to the successful establishment of the PSH practice. Besides having to operate currently on limited funding, the necessary interdepartmental cohesion and acceptance of the anesthetist to lead any such model present an important hurdle to be surmounted.
      PubDate: 2019-03-01
       
  • Inhaled Nitrous Oxide Analgesia for Labor
    • Abstract: Purpose of Review This paper reviews the history, efficacy, safety, and administrative concerns for nitrous oxide analgesia during labor. Recent Findings While pain relief is inferior to that provided by neuraxial analgesia, maternal satisfaction is equivalent to that of neuraxial techniques, and better if analgesia is reported to be poor. A recent systematic review reports good safety for mother and child, that some women report excellent pain relief and others not, and that minor side effects are infrequent. Qualitative research summarizing patient comments on their experience suggests that numerous factors other than pain relief affect maternal satisfaction with their analgesia for labor. Only one study has examined patient factors that predict conversion from nitrous oxide to neuraxial analgesia for labor. Summary Inhaled nitrous oxide offers a safe and effective means for labor analgesia for many women. Maternal satisfaction is not as dependent on effective pain relief as with neuraxial analgesia.
      PubDate: 2019-03-01
       
  • Respiratory and Airway Considerations in Obstetric Patients
    • Abstract: Purpose of Review The purpose of this article is to provide the current evidences on respiratory and airway medicine in the obstetric population. Recent Findings The prevalence of obstructive sleep apnea (OSA) among pregnant women is increasing. Upper body elevation improves respiratory mechanics in parturients and reduces the risk of postpartum OSA. Clinically significant respiratory depression from neuraxial opioid administration, compared to parenteral, is extremely rare. The incidence of failed tracheal intubation in obstetric patients is higher than that in non-obstetric patients and it has been unchanged recently. The first obstetric-specific guidelines for the management of difficult airway were published in 2015. The incidence of serious aspiration in obstetric patients is low and has been decreasing. Interventions to reduce aspiration at cesarean delivery recommended by recently published guidelines and clinical studies will be discussed. Supplemental oxygen during uncomplicated delivery, either cesarean or vaginal, has been controversial. Summary Understanding the changes in airway anatomy and respiratory physiology related to pregnancy, and adherence to evidence-based guidelines are essential in taking care of obstetric patients. Recently published scholarly articles and clinical guidelines relevant to respiratory physiology and airway management in obstetric anesthesia will be presented.
      PubDate: 2019-03-01
       
  • A Philosophical Primer for Your First Global Anesthesia Experience
    • Abstract: Purpose of Review There are few publications regarding practical important philosophical considerations to international anesthesia work. Most of the literature in this realm is aimed at trainees or are logistical recommendations. Recent Findings Clarity of mission can provide guidance and benchmarks for managing challenging situations that may unduly influence the overall experience of a global health trip. Much of that clarity can come from authentic exchanges with your colleagues from the under-resourced region in question. Summary We intend to provide a framework and some core principles for organizing thoughts and interactions before, during, and after your first global anesthesia experience.
      PubDate: 2019-03-01
       
  • Update on Obstetric Hemorrhage
    • Abstract: Purpose of Review Postpartum hemorrhage is increasing in prevalence in the USA and continues to be an important cause of preventable maternal morbidity and mortality. This review provides the most recent epidemiologic data on postpartum hemorrhage in the USA, current nationwide initiatives for prevention, preparedness, and response to postpartum hemorrhage, and recent evidence-based advances in management. Recent Findings The National Partnership for Maternal Safety consensus bundle on obstetric hemorrhage serves as a resource for postpartum hemorrhage–related clinical and research initiatives. Areas of focus include standardizing postpartum hemorrhage management with protocol use, massive transfusion protocols, early and enhanced risk assessment, accurate quantitation of blood loss, and refined transfusion strategies such as early fibrinogen replacement, tranexamic acid therapy, and point of care testing to detect and treat coagulopathy. Summary Continued focus on improving the management of postpartum hemorrhage with available resources is imperative to minimize associated risks of morbidity and mortality.
      PubDate: 2019-03-01
       
  • Anesthetic Management of Nonobstetric Surgery during Pregnancy
    • Abstract: Purpose of Review This article reviews several controversial aspects of management of nonobstetric surgery during pregnancy, including the optimal timing for nonurgent surgery, when to perform intraoperative fetal monitoring, modifications to anesthetic techniques to account for the physiologic changes of pregnancy, and management of maternal cardiac arrest. Recent Findings There have been several advances in the management of nonobstetric surgery during pregnancy, including the increased use of laparoscopic techniques, an improved understanding of the importance of adequate pain management, and new initiatives to improve the maternal cardiac resuscitation algorithm. Traditional dogma regarding aspiration prophylaxis during pregnancy and concerns about abortifacient and teratogenic properties of diagnostic imaging and anesthetic agents have also recently been reevaluated. Summary Urgent and emergent surgeries should proceed without delay during pregnancy in order to ensure optimal outcomes for both the mother and fetus. Anesthetic management may require several modifications to account for physiologic changes of pregnancy. In general, uteroplacental perfusion is best maintained by avoidance of maternal hypoxemia, hypotension, hyper- and hypocapnia, temperature extremes, and stress.
      PubDate: 2019-03-01
       
  • A Review of Anesthesia Simulation in Low-Income Countries
    • Abstract: Purpose of Review Anesthesia workforce gaps in low- and middle-income countries (LMICs) can hinder safe surgical care. Several countries have fewer than one anesthesiologist per million population and some have fewer than two anesthesiologists nationally. Limited apprenticeship opportunities and inadequate supervision present serious challenges in these locations. Although simulation training could help disseminate expert guidance, the high cost, technical challenges, and varied approaches limit application. We reviewed the literature on cost-efficient and effective simulation training programs for anesthesia workforces in LMICs. Recent Findings Publications relevant to anesthesia simulation in these countries are limited but include anesthesia skill gap identification, technical skill training, and scenario management. Summary High-cost, high-technology simulation available in high-resource countries is often impractical in LMICs. We identified low-cost approaches that are typically used to assess skill deficiencies and develop nontechnical and technical skills. Future studies should evaluate optimal modalities and equipment for greatest impact.
      PubDate: 2019-03-01
       
  • Anesthetic Considerations in the Care of the Parturient with Obesity
    • Abstract: Purpose of Review The goal of this review is to summarize recent findings on the physiologic alterations posed by maternal obesity and implications for the anesthetic care of mother and infant. Recent Findings Obesity is rising nationally and globally. Many studies show associations between excess weight during pregnancy with increased morbidity and mortality. Parturients with obesity are at a higher risk of endocrine, cardiac, pulmonary, and post-operative complications. A neuraxial catheter is recommended given the higher risk of an operative delivery. Consultation by an obstetric anesthesiologist is helpful for patient education and planning. Summary Maternal mortality is the highest in the USA compared to other high-income countries. Understanding the association between obesity and maternal morbidity and mortality is critically important. The obstetric anesthesiologist can improve care by understanding not only the patient's medical needs, but also anticipating complications and having appropriate equipment available. Multi-disciplinary care optimizes outcomes.
      PubDate: 2019-03-01
       
  • How Do We Know' Comparisons of Existing Datasets for Overseas Surgical
           Missions
    • Abstract: Purpose of Review Over five billion people lack access to safe surgery when they need it. Short-term surgical missions from high-resource countries are a popular strategy to try and address this deficit. Each year, thousands of providers spend billions of dollars participating in short-term surgical missions. These missions are poorly characterized in aggregate. In this exercise, we performed reviews of two databases in an attempt to identify and characterize short-term surgical missions to Uganda. The first, a traditional search of the medical literature. The second, an unorthodox search of the internet. We compare the results of each in terms of motive, trip length, operations performed, surgery type, country of origin, evidence of teaching, recurring missions, and year of mission. Recent Findings We found only one article in the academic literature that fits our criteria. We found 43 individual organizations responsible for 129 individual trips in our internet search. These are characterized in this paper. Summary The medical literature contains few traces of short-term surgical trips in Uganda. The internet contains many traces. These traces are rich in both qualitative and quantitative data. It is possible to mine, organize, and evaluate this data to better understand what is happening on the ground in Uganda and potentially the rest of the world.
      PubDate: 2019-03-01
       
  • Pediatric Regional Anesthesia Advances
    • Abstract: Purpose of Review To present recent developments in pediatric regional anesthesia (RA) including safety, complications, special populations, evidence-based trends, and ultrasound guidance. The data presented should be used to improve outcomes of children receiving RA. Recent Findings Current data demonstrates a very low occurrence of serious complications and validates the use of GA for block placement in children. Fewer neuraxial blocks are performed in favor of peripheral blocks as the use of ultrasound guidance has made new blocks possible and old blocks better and safer. Neonates and infants have more RA options. Adjuvant medications and ambulatory catheters increase the duration of RA and facilitate cost-effective, low-risk hospital discharge. The local anesthetic systemic toxicity checklist reinforces new guidelines. Summary Increasing pediatric-specific RA data shows increased analgesic choices and improving patient care. Large well-designed studies to precisely define the risks and benefits and appropriate applications of novel ideas and technologies are needed.
      PubDate: 2019-02-28
       
  • Pharmacologic Treatment of Insomnia in Children and Adolescents with
           Chronic Pain Conditions
    • Abstract: Purpose of Review The purpose of this chapter is to provide a review and expert opinion supporting pharmacological treatments for insomnia in children and adolescents with chronic pain conditions. Recent Findings Insomnia as an independent disorder is defined as dissatisfaction with sleep quantity or quality, clinically significant distress or impairment in daytime functioning, and a specific time pattern of occurrence. Independent of the pathological context, insomnia is more frequent in adolescents than in children. The impact of insomnia on pediatric patients is quite profound, especially on those affected by chronic pain, where the prevalence of insomnia is significantly greater than in those without pain. Despite the intense effect of insomnia on physical, emotional, and cognitive health, as well as on the efficacy of interdisciplinary therapy, currently, there are no pharmacological guidelines for this population. Thus, the diagnosis and successful treatment of insomnia in children with chronic pain conditions often represent a significant challenge for clinicians. Summary The management of insomnia requires an interdisciplinary team that includes a physician, physiotherapist, and psychologist. Specific therapies for insomnia include sleep hygiene counseling, cognitive behavioral therapy, and pharmacological interventions. This review focuses exclusively on five successful pharmacological treatments for insomnia in children and adolescents with chronic pain conditions, and presents concepts and recommendations based on current medical evidence and the knowledge of medical experts in the field.
      PubDate: 2019-02-22
       
  • Perioperative Stress, Inflammation, and Cancer Progression: Opportunities
           for Intervention in Breast and Colorectal Cancer Surgery Utilizing
           Beta-Adrenergic Blockade and COX-2 Inhibition
    • Abstract: Purpose of review This review explores the blockade of cyclooxygenase (COX)-2/prostaglandin and catecholamine/beta(β)-adrenergic signaling as opportunities to enhance the curative potential of surgical excision of breast and colorectal cancer malignancies. Recent findings Phase-II randomized placebo-controlled biomarker clinical trials, employing perioperative administration of the COX-2 inhibitor etodolac and the β-adrenergic antagonist propranolol, have shown improved biomarkers associated with both breast and colorectal cancer progression. Tumor epithelial-to-mesenchymal transition (EMT) status and tumor transcription activity levels of GATA-1, GATA-2, EGR3, and STAT-3 were reduced, while anti-cancer immune parameters within the tumor microenvironment improved perioperatively. Increased tumor-associated B cells and NK cells and reduced tumor-associated monocytes were noted. Reduced systemic pro-inflammatory markers IL-6 and CRP were indicated, starting before surgery. Summary Improved biomarkers of tumor-associated (i) anti-metastatic transcriptional activity, (ii) anti-metastatic immune function, and (iii) reduced systemic inflammatory indices were observed following the combined administration of etodolac and propranolol. These findings support future investigation with larger clinical trials to test long-term cancer outcomes.
      PubDate: 2018-12-01
       
  • New Cancer Therapies: Implications for the Perioperative Period
    • Abstract: Purpose of Review Cancer is on the rise. Standing on verge of exciting discoveries, research is being translated into therapies that are being widely administered to patients. Providing a hope for cure, where none existed before. This new body of knowledge has come from a better understanding of cancer genetics, molecular and sub molecular behavior, and understanding of cancer-generated cellular environments. These have led to development of immunotherapy and its many sub-genres, improvement and introduction of new radiation technologies, and decreasing toxicities of existing chemotherapies. Recent Findings The purpose of this review is to have a summary look at this huge landscape of cancer therapy. Specially looking at toxicities that an anesthesiologist should be familiar with while providing perioperative care for these patients, complications like tumor lysis syndrome, cytokine release syndromes, Kounis syndrome, myocarditis, encephalopathies, and pituitary failure need to be kept in mind. Summary One should be knowledgeable about these therapies and approach these patients with a high index of suspicion. Anesthesiologists will need to refine preoperative assessment with appropriate testing and intraoperative and postoperative management in collaboration with oncologists, while involving the expertise of internists, cardiologist, and endocrinologists in helping assess and manage these patients in the perioperative period.
      PubDate: 2018-12-01
       
  • Safety in Anesthesia: Latin American Perspective
    • Abstract: Purpose of Review This review intends to broadly illustrate the current anesthesia safety issues in Latin America, discussing the residency training schemes, anesthesia workforce shortages, equipment shortages, and safety initiatives in Latin America that include minimum standards and adverse event reporting systems. Recent Findings Latin America’s distinction is that of a continent of major contrasts which poses major difficulties as quality of anesthesia care ranges between that of high-income countries to that of very low income nations. A major effort to attenuate these is the creation and adoption of mandatory national standards that aim to guarantee that even in the worst conditions, minimal safety strategies are met to safeguard patients. Colombia’s and Brazil’s anesthesia societies have been at the forefront in Latin America in developing strategies to promote anesthesia safety. Summary The creation, promotion, and adoption of Minimal Standards has been key to improve anesthesia safety in the continent.
      PubDate: 2018-12-01
       
 
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