Subjects -> MEDICAL SCIENCES (Total: 8442 journals)
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ANAESTHESIOLOGY (119 journals)                     

Showing 1 - 119 of 119 Journals sorted alphabetically
Acta Anaesthesiologica Scandinavica     Hybrid Journal   (Followers: 60)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 6)
Acute Pain     Full-text available via subscription   (Followers: 15)
Advances in Anesthesia     Full-text available via subscription   (Followers: 30)
African Journal of Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 8)
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: 219)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 67)
Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 59)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 26)
Anaesthesia Reports     Hybrid Journal  
Anaesthesia, Pain & Intensive Care     Open Access  
Anaesthesiology Intensive Therapy     Open Access   (Followers: 9)
Analgesia & Resuscitation : Current Research     Hybrid Journal   (Followers: 6)
Anestesia Analgesia Reanimación     Open Access   (Followers: 1)
Anestesia en México     Open Access   (Followers: 1)
Anesthesia & Analgesia     Hybrid Journal   (Followers: 235)
Anesthesia : Essays and Researches     Open Access   (Followers: 10)
Anesthesia Progress     Hybrid Journal   (Followers: 5)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 2)
Anesthesiology     Hybrid Journal   (Followers: 214)
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: 14)
BDJ Team     Open Access   (Followers: 1)
Best Practice & Research Clinical Anaesthesiology     Hybrid Journal   (Followers: 15)
BJA : British Journal of Anaesthesia     Hybrid Journal   (Followers: 211)
BJA Education     Hybrid Journal   (Followers: 67)
BMC Anesthesiology     Open Access   (Followers: 17)
BMJ Supportive & Palliative Care     Hybrid Journal   (Followers: 44)
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: 26)
Canadian Journal of Anesthesia/Journal canadien d'anesthésie     Hybrid Journal   (Followers: 46)
Case Reports in Anesthesiology     Open Access   (Followers: 11)
Clinical Journal of Pain     Hybrid Journal   (Followers: 18)
Colombian Journal of Anesthesiology : Revista Colombiana de Anestesiología     Hybrid Journal  
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: 58)
Current Pain and Headache Reports     Hybrid Journal   (Followers: 2)
Der Anaesthesist     Hybrid Journal   (Followers: 8)
Der Schmerz     Hybrid Journal   (Followers: 4)
Der Schmerzpatient     Hybrid Journal  
Douleur et Analgésie     Hybrid Journal  
Egyptian Journal of Anaesthesia     Open Access   (Followers: 2)
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: 28)
European Journal of Pain     Full-text available via subscription   (Followers: 26)
European Journal of Pain Supplements     Full-text available via subscription   (Followers: 5)
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: 7)
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: 12)
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: 40)
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: 18)
Journal of Pain and Symptom Management     Hybrid Journal   (Followers: 45)
Journal of Pain Research     Open Access   (Followers: 10)
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: 56)
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: 8)
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 Opinion in Anaesthesiology
Journal Prestige (SJR): 0.792
Citation Impact (citeScore): 3
Number of Followers: 58  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0952-7907 - ISSN (Online) 1473-6500
Published by LWW Wolters Kluwer Homepage  [299 journals]
  • Editorial introductions
    • Abstract: imageNo abstract available
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • Fascial plane blocks in thoracic surgery: a new era or plain painful'
    • Authors: Marciniak; Donn; Kelava, Marta; Hargrave, Jennifer
      Abstract: imagePurpose of review The demand for well-tolerated, effective, and opioid reducing pain management has become imperative in thoracic surgery. With the recent movement away from neuraxial analgesia for thoracic surgical patients, great interest in alternative analgesic techniques of the chest wall has developed. Multiple fascial plane blocks have been developed for pain management of the lateral chest wall and we present an up-to-date review of these popular new interventions.Recent findings The pectoralis and serratus anterior plane blocks may offer effective analgesia of the lateral chest wall for thoracic surgical patients. The erector spinae plane block may offer more extensive analgesic coverage but requires further investigation.Summary Fascial plane blocks hold the potential for well-tolerated and effective analgesia for thoracic surgical patients as part of a multimodal regimen of pain relief. However, many questions remain regarding block characteristics. As the literature matures, more formal recommendations will be made but quality trials are needed to provide this guidance.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • Effect of left ventricular diastolic dysfunction on development of primary
           graft dysfunction after lung transplant
    • Authors: Yoon; Jeongae; Salamanca-Padilla, Yuliana
      Abstract: imagePurpose of review Primary graft dysfunction (PGD) is one of the most common complications after lung transplant and is associated with significant early and late morbidity and mortality. The cause of primary graft dysfunction is often multifactorial involving patient, donor, and operational factors. Diastolic dysfunction is increasingly recognized as an important risk factor for development of PGD after lung transplant and here we examine recent evidence on the topic.Recent findings Patients with end-stage lung disease are more likely to suffer from cardiovascular disease including diastolic dysfunction. PGD as result of ischemia–reperfusion injury after lung transplant is exacerbated by increased left atrial pressure and pulmonary venous congestion impacted by diastolic dysfunction. Recent studies on relationship between diastolic dysfunction and PGD after lung transplant show that patients with diastolic dysfunction are more likely to develop PGD with worse survival outcome and complicated hospital course.Summary Patients with diastolic dysfunction is more likely to suffer from PGD after lung transplant. From the lung transplant candidate selection to perioperative and posttransplant care, thorough evaluation and documentation diastolic dysfunction to guide patient care are imperative.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • Patients with left ventricle assist devices presenting for thoracic
           surgery and lung resection: tips, tricks and evidence
    • Authors: Hayes; Tim; Charlesworth, Mike; Garcia, Miguel
      Abstract: imagePurpose of review Over a thousand left ventricular-assist device (LVAD) implants were performed for heart failure destination therapy in 2017. With increasing survival, we are seeing increasing numbers of patients present for noncardiac surgery, including resections for cancer. This article will review the relevant literature and guidelines for patients with LVADs undergoing thoracic surgery, including lung resection.Recent findings The International Society for Heart and Lung Transplant Mechanically Assisted Circulatory Support Registry has received data on more than 16 000 patients with LVADs. Four-year survival is more than 60% for centrifugal devices. There are increasing case reports, summaries and recommendations for patients with LVADs undergoing noncardiac surgery. However, data on thoracic surgery is restricted to case reports.Summary Successful thoracic surgery requires understanding of the LVAD physiology. Modern devices are preload dependent and afterload sensitive. The effects of one-lung ventilation, including hypoxia and hypercapnia, may increase pulmonary vascular resistance and impair the right ventricle. Successful surgery necessitates a multidisciplinary approach, including thorough preoperative assessment; optimization and planning of intraoperative management strategies; and approaches to anticoagulation, right ventricular failure and LVAD flow optimization. This article discusses recent evidence on these topics.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • Right ventricular function during and after thoracic surgery
    • Authors: Gelzinis; Theresa; Assaad, Sherif; Perrino, Albert C. Jr
      Abstract: imagePurpose of review Right ventricular (RV) dysfunction following thoracotomy and pulmonary resection is a known phenomenon but questions remain about its mechanism, risk factors, and clinical significance. Acute RV dysfunction can present intraoperatively and postoperatively, persisting for 2 months after surgery.Recent findings Recently, the pulmonology literature has emphasized pulmonary arterial capacitance, rather than pulmonary vascular resistance, as a marker to predict disease progression and outcome in patients with pulmonary hypertension and heart failure. Diagnostic focus has emerged on the use of cardiac MRI and new echocardiographic parameters to better quantify the presence of RV dysfunction and the role of pulmonary capacitance in its development.Summary In this review, we examine the most recent literature on RV dysfunction following lung resection, including possible mechanisms, time span of RV dysfunction, and available diagnostic modalities. The clinical relevance of these factors on preoperative assessment and risk stratification are presented.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • Circulatory support during lung transplantation
    • Authors: Kiziltug; Hannah; Falter, Florian
      Abstract: imagePurpose of review Lung transplantation can be performed off-pump, with sequential one-lung ventilation, or using mechanical circulatory support (MCS). MCS can either be in the form of cardiopulmonary bypass (CPB) or veno-arterial or veno-venous extracorporeal membrane oxygenation (VA ECMO or VV ECMO).This article reviews the indications, benefits and limitations of these different techniques and evaluates their effect on outcomes.Recent findings Recently, there has been a shift toward intraoperative ECMO support and away from CPB. The first results of this strategy are promising. The use of intraoperative ECMO with the possibility of prolongation of MCS into the postoperative period has been shown to lead to improved survival when compared with lung transplants not receiving ECMO. Recipients of organs from extended criteria donors show encouraging survival rates when the lungs are reperfused using MCS. A recent metaanalysis comparing ECMO versus CPB showed favourable outcomes supporting the use of ECMO despite not finding a difference in mortality between the two methods.Summary The trend toward ECMO and away from cardiopulmonary bypass is backed up with good survival rates. However, to date, there has not been a randomized controlled trial to further guide the choice of MCS strategy for lung transplantation.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • Anesthetic management of lung transplantation: impact of presenting
           disease
    • Authors: Martin; Archer Kilbourne; Fritz, Ashley V.; Wilkey, Barbara J.
      Abstract: imagePurpose of review Recent literature has described the emerging role of anesthesiologists as key members of the lung transplantation team and the impact of anesthetic management on outcomes. This review examines the impact of presenting cause of end-stage lung disease (ESLD) on anesthetic management.Recent findings The four primary causes of ESLD are suppurative, obstructive, or restrictive processes, and pulmonary hypertension. Our recent review of perioperative literature revealed new data regarding preoperative risk stratification, intraoperative management, and postoperative use of extracorporeal membrane oxygenation (ECMO) support. Major studies specifically about anesthetic management are lacking; however, the principles studied are readily applicable to the design of a perioperative care plan. The most compelling data have resulted in a revolutionary change in terms of intraoperative support and postoperative planning for pulmonary hypertension patients. Historically treated with cardiopulmonary bypass, significant data have been reported describing the successful use of ECMO both as an intraoperative support with superior outcomes, as well as postoperative support for improved stability during biventricular remodeling post graft implantation.Summary The application of these updated findings should assist anesthesiologists as they develop internal protocols and external guidelines to integrate within multidisciplinary teams caring for the lung transplant patient.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • Ex-vivo lung perfusion
    • Authors: Moreno Garijo; Jacobo; Roscoe, Andrew
      Abstract: imagePurpose of review Ex-vivo lung perfusion (EVLP) has been developed to expand the donor pool for lung transplantation recipients. The role of EVLP in organ preservation, evaluation and potential reconditioning is reviewed.Recent findings EVLP has been shown to significantly increase the utilization of donor lungs for transplantation. Evidence suggests that patient outcomes from EVLP lungs are comparable to standard procurement technique. Novel strategies are being developed to treat and recondition injured donor lungs. EVLP may also prove to be a tool for translational research of lung diseases.Summary EVLP has been shown to be an effective system to expand donor pool for lung transplantation without detriment to recipients. Future potential ex-vivo developments may further improve patient outcomes as well as increasing availability of donor organs.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • Anesthetic considerations for tracheobronchial resection in oncologic
           surgery
    • Authors: Stoica; Radu T.; Cordos, Ioan; Popescu, Wanda M.
      Abstract: imagePurpose of review Anesthesia for the resection and reconstruction of the tracheobronchial tree for neoplastic disease is challenging, both from surgical as well as anesthetic points of view. There are no published recommendations or guidelines addressing anesthetic and airway management dilemmas that arise during these surgical interventions. This review presents key aspects of preoperative imaging evaluation, surgical planning, as well as anesthesia and airway management during these complex cases.Recent findings Newly published articles highlight both the surgical and anesthetic challenges encountered during tracheobronchial resections and emphasize the importance of creating specialized, high-volume centers for good patient outcomes. Of great importance is the development of a preoperative joint anesthetic-surgical plan which includes a patient-specific airway management strategy. This review presents newer and less commonly employed anesthetic management strategies which have been recently described in the literature to allow expansion of care to patients who were previously deemed too high risk for surgery.Summary With advances in technology, the use of classical ventilation methods in conjunction with newer alternatives, such as extracorporeal membrane oxygenation, creates the premise for a more individualized, safer and controlled approach to tracheobronchial resections for oncologic purposes.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • Ultrasound-guided blocks for cardiovascular surgery: which block for which
           patient'
    • Authors: Smith; Lauren M.; Barrington, Michael J.; St Vincent's Hospital, Melbourne
      Abstract: imagePurpose of review Regional anesthesia blocks may benefit patients undergoing cardiovascular surgery. This review coincides with the evolution of ultrasound-guided fascial plane blocks, societal concerns regarding opioid misuse and changing expectations regarding surgical recovery.Recent findings Paravertebral block and thoracic epidural analgesia have comparable postoperative analgesic profiles following thoracotomy; however, the former has a more favorable complication profile. Limited trials have compared these modalities in cardiac surgery. The mechanism of action of continuous paravertebral blockade may be systemic. Bilateral continuous paravertebral (and other continuous peripheral nerve blocks) should be used with caution in adult patients having cardiac surgery because of the risk of systemic local anesthetic toxicity and bleeding. Novel ultrasound-guided blocks: erector spinae, serratus anterior, pectoral, transversus thoracic muscle and pecto-intercostal fascial plane blocks potentially reduce postoperative opioid requirements; however, they require further investigation before their routine use can be recommended in adult cardiovascular surgical practice. The mechanism of action of erector spinae block is not fully elucidated.Summary Ultrasound-guided fascial plane blocks may reduce postoperative opioid requirements. Investigation into the safety and efficacy of bilateral continuous ultrasound-guided blockade for cardiac surgery is required. Trial protocols should be embedded into enhanced recovery after surgery programs. Patient-reported and long-term outcomes are recommended.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • Antibiotic dosing during extracorporeal membrane oxygenation: does the
           system matter'
    • Authors: Abdul-Aziz; Mohd H.; Roberts, Jason A.
      Abstract: imagePurpose of review The aims of this review are to discuss the impact of extracorporeal membrane oxygenation (ECMO) on antibiotic pharmacokinetics and how this phenomenon may influence antibiotic dosing requirements in critically ill adult ECMO patients.Recent findings The body of literature describing antibiotic pharmacokinetic and dosing requirements during ECMO support in critically adult patients is currently scarce. However, significant development has recently been made in this research area and more clinical pharmacokinetic data have emerged to inform antibiotic dosing in these patients. Essentially, these clinical data highlight several important points that clinicians need to consider when dosing antibiotics in critically ill adult patients receiving ECMO: physicochemical properties of antibiotics can influence the degree of drug loss/sequestration in the ECMO circuit; earlier pharmacokinetic data, which were largely derived from the neonatal and paediatric population, are certainly useful but cannot be extrapolated to the critically ill adult population; modern ECMO circuitry has minimal adsorption and impact on the pharmacokinetics of most antibiotics; and pharmacokinetic changes in ECMO patients are more reflective of critical illness rather than the ECMO therapy itself.Summary An advanced understanding of the pharmacokinetic alterations in critically ill patients receiving ECMO is essential to provide optimal antibiotic dosing in these complex patients pending robust dosing guidelines. Antibiotic dosing in this patient population should generally align with the recommended dosing strategies for critically ill patients not on ECMO support. Performing therapeutic drug monitoring (TDM) to guide antibiotic dosing in this patient population appears useful.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • Transesophageal echocardiography in minimally invasive cardiac surgery
    • Authors: Prempeh; Agya B.A.; Scherman, Jacques; Swanevelder, Justiaan L.
      Abstract: imagePurpose of review Transesophageal echocardiography (TEE) has made its way into the cardiac surgery realm and spurred the development of many interventions. In the domain of minimally invasive cardiac surgery (MICS), TEE has become central to reducing cardiovascular complications.Recent findings Real-time three-dimensional TEE is a key contributor to the safe and precise deployment of the PASCAL mitral valve repair system, which is showing great potential in ongoing studies. The current data on outcomes of transcatheter aortic valve replacement show that preprocedural three-dimensional TEE and multidetector computed tomography (CT) perform similarly in aortic root assessment. Three-dimensional color Doppler TEE has been suggested to be more appropriate in quantifying residual mitral regurgitation and evaluating the success of surgical or percutaneous closure. A three-dimensional TEE-derived aortomitral angle may be valuable in predicting and detecting dynamic left ventricular outflow tract obstruction, thereby enhancing the safety of transcatheter mitral valve replacement.Summary Advanced imaging modalities are essential for the sustained growth of MICS, particularly with the evolution of novel transcatheter systems. These techniques rely on exceptional imaging quality at all stages of the perioperative period to modify surgical-risk and improve patient outcomes. TEE has the additional benefit of providing real-time information on intrathoracic structures to guide intraoperative management.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • A narrative review of electroencephalogram-based monitoring during
           cardiovascular surgery
    • Authors: Kaiser; Heiko A.; Hight, Darren; Avidan, Michael S.
      Abstract: imagePurpose of review The current narrative review focuses on depth of hypnosis monitoring with electroencephalography (EEG) during cardiovascular surgery. There have been important findings in recent years regarding the challenges and limitations of EEG-based monitoring during general anesthesia. The purpose of this review is to summarize key EEG-related concepts, as well as to highlight some of the advantages and disadvantages of processed and unprocessed EEG monitoring, especially for older patients with comorbidities undergoing cardiovascular surgery.Recent findings The brain is the target organ of anesthesia. Using the EEG or processed EEG to guide anesthetic administration during cardiovascular surgery conceptually allows precision patient-centered anesthesia. It is suggested that inadequate anesthesia, with the possibility of traumatic intraoperative awareness, can potentially be avoided. Furthermore, excessive anesthesia, with hemodynamic compromise and theoretical risk of delirium, can be minimized. Frail, older patients undergoing major surgery with preexisting neurocognitive disorders might be especially vulnerable to perioperative neurological and other complications. Tailoring anesthetic administration, based on individual patient needs partly guided by certain EEG features, might yield improved perioperative outcomes.Summary Ability to interpret the EEG during surgery might help anesthesia clinicians to individualize anesthetic administration to prevent adverse events, and optimize postoperative recovery.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • Postoperative neurocognitive disorders
    • Authors: Olotu; Cynthia
      Abstract: imagePurpose of review Alterations in cognitive functions are common in the perioperative course. Although often unnoticed by physicians, these alterations might have distinct long-term consequences for the patient with regard to everyday functioning, self-dependency, and quality of life. In recent years, however, perioperative cognition has gained increased interest, both by clinicians and scientists, and knowledge of the preventive measures of postoperative cognitive decline has become mandatory for anesthetists and surgeons.Recent findings This review offers a brief overview of the current state of knowledge concerning perioperative changes in cognition, including its pathophysiology and prevention strategies.Summary Postoperative neurocognitive disorders are frequent complications, especially in elderly patients, with postoperative delirium being its most pronounced and acute postoperative form, predisposing the patient for long-term cognitive impairment. The incidence of postoperative cognitive decline can be reduced by implementing preventive measures during perioperative patient care as recommended by national and international guidelines.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • Pharmacodynamics and pharmacokinetics in older adults
    • Authors: Thürmann; Petra A.
      Abstract: imagePurpose of review With the growing of the aging population, increased and new methods of anesthesia and surgery allow for surgery and other interventions in older adults.Pharmacokinetics and pharmacodynamics of drugs in older adults differ from those in younger and middle-aged adults. However, the geriatric population is frequently neglected in the context of clinical trials. The present review focuses on the consequences of multimorbidity and pharmacokinetic and pharmacodynamic alterations and their implications on anesthesia.Recent findings Physiologically based pharmacokinetic and pharmacodynamic modeling may serve as an option to better understand the influence of age on drugs used for anesthesia. However, difficulties to adequately characterize geriatric patients are described.Summary Further research of drug effects in the aging population may include physiologically based pharmacokinetic and pharmacodynamic complex models and randomized controlled trials with thoroughly conducted geriatric assessments.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • Impact of geriatric co-management programmes on outcomes in older surgical
           patients: update of recent evidence
    • Authors: Van Grootven; Bastiaan; Mendelson, Daniel Ari; Deschodt, Mieke
      Abstract: imagePurpose of review To determine the impact of geriatric co-management programmes on outcomes in older patients undergoing a surgical procedure.Recent findings Twelve programmes were identified. Time to surgery was decreased in two of four studies [pooled mean difference = −0.7 h (95% CI, −3.1 to 4.4)]. The incidence of complications was reduced in two of seven studies (pooled absolute risk reduction = −4% (95% CI −10 to 2%)). Length of stay was reduced in four of eight studies [pooled mean difference = −1.4 days (95% CI −2.7 to −0.1)]. In-hospital mortality was reduced in one of six studies [pooled absolute risk reduction = −2% (95% CI −4 to −0%)]. Unplanned hospital readmissions at 30 days follow-up was reduced in two of three studies [pooled absolute risk reduction = −3% (95% CI −5 to −0%)].Summary There was a shorter length of stay, less mortality and a lower readmission rate. However, there was uncertainty whether the results are clinically relevant and the GRADE of evidence was low. It was uncertain whether the outcomes time to surgery and complications were improved. The evidence is limited to hip fracture patients.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
  • Perioperative blood pressure in the elderly
    • Authors: Kozarek; Katherine; Sanders, Robert D.; Head, Diane
      Abstract: imagePurpose of review Hemodynamic instability is common in the perioperative period because of obligate physiologic changes that occur with surgery. Despite the frequency of such hemodynamic changes and the potential harm associated with them, particularly in the elderly, guidelines to optimize perioperative blood pressure are lacking. The present review examines recent evidence for perioperative blood pressure management in the elderly.Recent findings Hypotension has been associated with poor outcomes, particularly renal injury, myocardial injury, and increased mortality, in the perioperative period. Hypertension, tachycardia, frequency of blood pressure monitoring, and management of chronic antihypertensive medications may also affect patient outcomes. Elderly patients may be especially prone to adverse events associated with perioperative hemodynamic instability.Summary Precise and intentional management of hemodynamic parameters, medication regimens, and blood pressure monitoring may reduce adverse events in elderly patients undergoing surgery. Further investigation is required to identify the exact hemodynamic parameters that mitigate risk.
      PubDate: Sat, 01 Feb 2020 00:00:00 GMT-
       
 
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