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Authors: Rachael L. Bosma, Ph.D. et al Anesthesiology 11 2018, Vol.129, 1015-1024. What We Already Know about This Topic: Ketamine is an N-methyl-d-aspartate antagonist with growing use in the management of chronic pain Descending pain modulatory circuits are key modulators of chronic pain What This Article Tells Us That Is New: The infusion of ketamine resulted in […]
Read MoreAuthors: Laurent G. Glance, M.D. et al Anesthesiology 11 2018, Vol.129, 889-900. What We Already Know about This Topic: The Revised Cardiac Risk Index, and the risk calculators based on the National Surgical Quality Improvement Program can be used to assess the risk of cardiac adverse events after noncardiac surgery Recent clinical practice guidelines recommend the […]
Read MoreAuthor: Lee A. Fleisher, M.D. Anesthesiology 11 2018, Vol.129, 867-868. “[What are] the implications of advocating different risk algorithms on the decision for further diagnostic evaluation and potential interventional strategies[?]” THE preoperative evaluation of the patient has been a key function of anesthesiologists. The focus of the evaluation has been on identifying baseline comorbidities that will […]
Read MorePostoperative delirium affects a wide range of the general surgical population, with rates reported to be between 9 and 87 percent, depending on patient age and type of operative procedure. This adverse event has been associated with poor outcomes, such as increases in length of hospital stay, likelihood of being discharged to a rehabilitation center […]
Read MoreExtremely challenging situations can develop in the O.R. that affect what happens in the ICU later on. But the more familiar you are with the core tenets of ICU management, the better prepared you’ll be when challenging situations happen. That was the premise of the Sunday session “Intraoperative Critical Care: How to Best Succeed When […]
Read MoreAnesthesiologists have long talked about the transition to perioperative medicine and how this shift will affect the specialty. Leading institutions have already made the move. And the lessons they have learned along the way can help smooth the shift for others. “Perioperative medicine is no longer in the talking phase, it is in the action […]
Read MorePerioperative anesthetic management can have profound effects on patient outcomes for those who are either at risk for stroke during noncardiac surgery or who have had acute ischemic stroke (AIS) and are having endovascular thrombectomy (EVT). Intraprocedural variables, such as blood pressure management, respiratory parameters, medications or time between recognition of AIS and treatment, can […]
Read MoreAn increasing number of patients with coronary stents have a noncardiac operation each year. Approximately 5 to 15 percent of patients will present for a surgical procedure within the first year after stent placement. “The surgical environment is unique, with a complex interplay of multiple factors that predispose patients with coronary stents to a high […]
Read MoreAuthors: Malcolm Lemyze, M.D. et al Anesthesiology October 2018. A PHYSIOLOGICALLY based venti lator strategy using transpulmonary pressure (PL)—the difference between airway pressure (PAW) and pleural pressure or its surrogate, the esophageal pressure (PES)—is especially interesting for morbidly obese patients whose lungs are trapped between excessive chest fat and a massive abdominal wall, as a bag-in-box […]
Read MoreAccidents happen, but they impact some professions more than others. Identifying why accidents happen, evaluating the aftermath and finding solutions to prevent them was part of the Monday session “Understanding Medical Accidents.” Michael F. O’Connor, M.D., FCCM, a Professor in the Department of Anesthesia and Critical Care at the University of Chicago, said learning from […]
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