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Journal Cover Anesthesiology
  [SJR: 2.162]   [H-I: 181]   [141 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 0003-3022 - ISSN (Online) 1528-1175
   Published by LWW Wolters Kluwer Homepage  [290 journals]
  • Artificial Intelligence for Everyone.
    • Abstract: Anesthesiology, No Available

      PubDate: Wed, 22 Nov 2017 00:00:00 -050
       
  • Recovery Room.
    • Abstract: Anesthesiology, No Available

      PubDate: Wed, 22 Nov 2017 00:00:00 -050
       
  • Science, Medicine, and the Anesthesiologist: Erratum.
    • Abstract: Anesthesiology, No Available

      PubDate: Wed, 15 Nov 2017 00:00:00 -050
       
  • Chad Brummett, M.D., Recipient of the 2017 James C. Cottrell, M.D.,
           Presidential Scholar Award: Erratum.
    • Abstract: Anesthesiology, No Available

      PubDate: Wed, 15 Nov 2017 00:00:00 -050
       
  • Using Activity Trackers to Quantify Postpartum Ambulation: A Prospective
           Observational Study of Ambulation after Regional Anesthesia and Analgesia
           Interventions.
    • Abstract: Anesthesiology, BACKGROUND: Early postoperative ambulation is associated with enhanced functional recovery, particularly in the postpartum population, but ambulation questionnaires are limited by recall bias. This observational study aims to objectively quantify ambulation after neuraxial anesthesia and analgesia for cesarean delivery and vaginal delivery, respectively, by using activity tracker technology. The hypothesis was that vaginal delivery is associated with greater ambulation during the first 24 h postdelivery, compared to cesarean delivery.METHODS: Parturients having first/second cesarean delivery under spinal anesthesia or first/second vaginal delivery under epidural analgesia between July 2015 and December 2016 were recruited. Patients with significant comorbidities or postpartum complications were excluded, and participants received standard multimodal analgesia. Mothers were fitted with wrist-worn activity trackers immediately postdelivery, and the trackers were recollected 24 h later. Rest and dynamic postpartum pain scores at 2, 6, 12, 18, and 24 h and quality of recovery (QoR-15) at 12 and 24 h were assessed.RESULTS: The study analyzed 173 patients (cesarean delivery: 76; vaginal delivery: 97). Vaginal delivery was associated with greater postpartum ambulation (44%) compared to cesarean delivery, with means ± SD of 1,205 ± 422 and 835 ± 381 steps, respectively, and mean difference (95% CI) of 370 steps (250, 490; P < 0.0001). Although both groups had similar pain scores and opioid consumption (less than 1.0 mg of morphine), vaginal delivery was associated with superior QoR-15 scores, with 9.2 (0.6, 17.8; P = 0.02) and 8.2 (0.1, 16.3; P = 0.045) differences at 12 and 24 h, respectively.CONCLUSIONS: This study objectively demonstrates that vaginal delivery is associated with greater early ambulation and functional recovery compared to cesarean delivery. It also establishes the feasibility of using activity trackers to evaluate early postoperative ambulation after neuraxial anesthesia and analgesia.

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • Pressor vs. Pressor: A Comparison of Phenylephrine & Norepinephrine.
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • Brown Describes Bolivian Coca-Leaf Chewing: A Remedy Gathered versus
           Altitude and Attitude'
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • Christmas Suspense about Hosting the Columbian Exposition‚Ķand,
           Indirectly, the "Post-Graduate School of Anaesthesia".
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • Racing Around: "Albany Dentist" G. E. Hill and "Vitalized
           Air".
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • From Brooklyn's Master Laughing Gasser: "Dr. Colton's Dentifrice‚Ķ for
           Rigg's Disease".
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • A "Dopeless" Diamond Belied Koca Nola's Cocaine-laced Content.
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • Transfusion-associated Circulatory Overload or Degassing'
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • In Reply.
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • Situations Where Intravenous Lidocaine Should Not Be Used as an Analgesic
           Adjunct'
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • In Reply.
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • Pain as a Predictor of Disability in Elderly Population.
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • In Reply.
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • Can Remote Ischemic Preconditioning Really Improve Long-term Kidney
           Outcomes after Cardiac Surgery'
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • In Reply.
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • What Is the Role of Cytokines during Ventilator-induced Lung Injury'
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • In Reply.
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • Anesthesia, Consciousness, and Language.
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • Ideal Body Weight Is Not Really Ideal.
    • Abstract: Anesthesiology, No Available

      PubDate: Tue, 14 Nov 2017 00:00:00 -050
       
  • A Comparison of Red Cell Rejuvenation versus Mechanical Washing for the
           Prevention of Transfusion-Associated Organ Injury in Swine.
    • Abstract: Anesthesiology, BACKGROUND: We evaluated the effects of two interventions that modify the red cell storage lesion on kidney and lung injury in experimental models of transfusion.METHODS: White-landrace pigs (n = 32) were allocated to receive sham transfusion (crystalloid), 14-day stored allogeneic red cells, 14-day red cells washed using the red cells washing/salvage system (CATS; Fresenius, Germany), or 14-day red cells rejuvenated using the inosine solution (Rejuvesol solution; Zimmer Biomet, USA) and washed using the CATS device. Functional, biochemical, and histologic markers of organ injury were assessed for up to 24 h posttransfusion.RESULTS: Transfusion of 14 day red cells resulted in lung injury (lung injury score vs. sham, mean difference -0.3 (95% CIs -0.6, -0.1; P = 0.02), pulmonary endothelial dysfunction, and tissue leukocyte sequestration. Mechanical washing reduced red cell-derived microvesicles but increased cell-free hemoglobin in 14-day red cell units. Transfusion of washed red cells reduced leukocyte sequestration but did not reduce the lung injury score (mean difference -0.2; 95% CI -0.5, 0.1; P = 0.19) relative to 14-day cells. Transfusion of washed red cells also increased endothelial activation and kidney injury. Rejuvenation restored adenosine triphosphate to that of fresh red cells and reduced microvesicle concentrations without increasing cell-free hemoglobin release. Transfusion of rejuvenated red cells reduced plasma cell-free hemoglobin, leukocyte sequestration, and endothelial dysfunction in recipients and reduced lung and kidney injury relative to 14-day or washed 14-day cells.CONCLUSIONS: Reversal of the red cell storage lesion by rejuvenation reduces transfusion-associated organ injury in swine.

      PubDate: Thu, 9 Nov 2017 00:00:00 -0500
       
  • Targeted Genotyping Identifies Susceptibility Locus in Brain-derived
           Neurotrophic Factor Gene for Chronic Postsurgical Pain.
    • Abstract: Anesthesiology, BACKGROUND: The purpose of this study was to evaluate the association between single-nucleotide polymorphisms and chronic postsurgical pain.METHODS: Using GoldenGate genotyping assays, we genotyped 638 polymorphisms within 54 pain-related genes in 1,152 surgical patients who were enrolled in our Persistent Pain after Surgery Study. Patients were contacted by phone to determine whether they had chronic postsurgical pain at 12 months. Polymorphisms identified were validated in a matched cohort of 103 patients with chronic postsurgical pain and 103 patients who were pain free. The functions of targeted polymorphisms were tested in an experimental plantar incisional nociception model using knock-in mice.RESULTS: At 12 months after surgery, 246 (21.4%) patients reported chronic postsurgical pain. Forty-two polymorphisms were found to be associated with chronic postsurgical pain, 19 decreased the risk of pain, and 23 increased the risk of pain. Patients carrying allele A of rs6265 polymorphism in brain-derived neurotrophic factor (BDNF) had a lower risk of chronic postsurgical pain in the discovery and validation cohorts, with an adjusted odds ratio (95% CI) of 0.62 (0.43 to 0.90) and 0.57 (0.39 to 0.85), respectively. Age less than 65 yr, male sex, and prior history of pain syndrome were associated with an increased risk of pain. Genetic polymorphisms had higher population attributable risk (7.36 to 11.7%) compared with clinical risk factors (2.90 to 5.93%). Importantly, rs6265 is a substitution of valine by methionine at amino acid residue 66 (Val66Met) and was associated with less mechanical allodynia in BDNF mice compared with BDNF group after plantar incision.CONCLUSIONS: This study demonstrated that genetic variation of BDNF is associated with an increased risk of chronic postsurgical pain.

      PubDate: Thu, 9 Nov 2017 00:00:00 -0500
       
  • Practice Advisory for the Prevention of Perioperative Peripheral
           Neuropathies 2018: An Updated Report by the American Society of
           Anesthesiologists Task Force on Prevention of Perioperative Peripheral
           Neuropathies.
    • Abstract: Anesthesiology, No Available

      PubDate: Wed, 8 Nov 2017 00:00:00 -0500
       
  • An Anesthesiologist's Perspective on the History of Basic Airway
           Management: The "Progressive" Era, 1904 to 1960.
    • Abstract: Anesthesiology, This third installment of the history of basic airway management discusses the transitional-"progressive"-years of anesthesia from 1904 to 1960. During these 56 yr, airway management was provided primarily by basic techniques with or without the use of a face mask. Airway maneuvers were inherited from the artisanal era: head extension and mandibular advancement. The most common maneuver was head extension, also used in bronchoscopy and laryngoscopy. Basic airway management success was essential for traditional inhalation anesthesia (ether, chloroform) and for the use of the new anesthetic agents (cyclopropane, halothane) and intravenous drugs (thiopental, curare, succinylcholine). By the end of the era, the superiority of intermittent positive pressure ventilation to spontaneous ventilation in anesthesia and negative pressure ventilation in resuscitation had been demonstrated and accepted, and the implementation of endotracheal intubation as a routine technique was underway.

      PubDate: Tue, 7 Nov 2017 00:00:00 -0500
       
  • Effects of Changes in Arterial Carbon Dioxide and Oxygen Partial Pressures
           on Cerebral Oximeter Performance.
    • Abstract: Anesthesiology, BACKGROUND: Cerebral oximetry (cerebral oxygen saturation; ScO2) is used to noninvasively monitor cerebral oxygenation. ScO2 readings are based on the fraction of reduced and oxidized hemoglobin as an indirect estimate of brain tissue oxygenation and assume a static ratio of arterial to venous intracranial blood. Conditions that alter cerebral blood flow, such as acute changes in PaCO2, may decrease accuracy. We assessed the performance of two commercial cerebral oximeters across a range of oxygen concentrations during normocapnia and hypocapnia.METHODS: Casmed FORE-SIGHT Elite (CAS Medical Systems, Inc., USA) and Covidien INVOS 5100C (Covidien, USA) oximeter sensors were placed on 12 healthy volunteers. The fractional inspired oxygen tension was varied to achieve seven steady-state levels including hypoxic and hyperoxic PaO2 values. ScO2 and simultaneous arterial and jugular venous blood gas measurements were obtained with both normocapnia and hypocapnia. Oximeter bias was calculated as the difference between the ScO2 and reference saturation using manufacturer-specified weighting ratios from the arterial and venous samples.RESULTS: FORE-SIGHT Elite bias was greater during hypocapnia as compared with normocapnia (4 ± 9% vs. 0 ± 6%; P < 0.001). The INVOS 5100C bias was also lower during normocapnia (5 ± 15% vs. 3 ± 12%; P = 0.01). Hypocapnia resulted in a significant decrease in mixed venous oxygen saturation and mixed venous oxygen tension, as well as increased oxygen extraction across fractional inspired oxygen tension levels (P < 0.0001). Bias increased significantly with increasing oxygen extraction (P < 0.0001).CONCLUSIONS: Changes in PaCO2 affect cerebral oximeter accuracy, and increased bias occurs with hypocapnia. Decreased accuracy may represent an incorrect assumption of a static arterial-venous blood fraction. Understanding cerebral oximetry limitations is especially important in patients at risk for hypoxia-induced brain injury, where PaCO2 may be purposefully altered.

      PubDate: Mon, 30 Oct 2017 00:00:00 -050
       
  • Central Venous Catheters in Small Infants.
    • Abstract: Anesthesiology, No Available

      PubDate: Mon, 30 Oct 2017 00:00:00 -050
       
  • Effects of Forced Air Warming on Airflow around the Operating Table.
    • Abstract: Anesthesiology, BACKGROUND: Forced air warming systems are used to maintain body temperature during surgery. Benefits of forced air warming have been established, but the possibility that it may disturb the operating room environment and contribute to surgical site contamination is debated. The direction and speed of forced air warming airflow and the influence of laminar airflow in the operating room have not been reported.METHODS: In one institutional operating room, we examined changes in airflow speed and direction from a lower-body forced air warming device with sterile drapes mimicking abdominal surgery or total knee arthroplasty, and effects of laminar airflow, using a three-dimensional ultrasonic anemometer. Airflow from forced air warming and effects of laminar airflow were visualized using special smoke and laser light.RESULTS: Forced air warming caused upward airflow (39 cm/s) in the patient head area and a unidirectional convection flow (9 to 14 cm/s) along the ceiling from head to foot. No convection flows were observed around the sides of the operating table. Downward laminar airflow of approximately 40 cm/s counteracted the upward airflow caused by forced air warming and formed downward airflow at 36 to 45 cm/s. Downward airflows (34 to 56 cm/s) flowing diagonally away from the operating table were detected at operating table height in both sides.CONCLUSIONS: Airflow caused by forced air warming is well counteracted by downward laminar airflow from the ceiling. Thus it would be less likely to cause surgical field contamination in the presence of sufficient laminar airflow.

      PubDate: Fri, 27 Oct 2017 00:00:00 -050
       
 
 
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