tag:blogger.com,1999:blog-23522881379210319142024-03-12T23:08:39.379-03:00AnesthesioThe Practice and Learning of AnesthesiologyUnknownnoreply@blogger.comBlogger71125tag:blogger.com,1999:blog-2352288137921031914.post-61484765939463320452013-09-19T11:15:00.000-03:002013-09-19T11:15:00.554-03:00Hydroxyethyl Starch
Here Today, Gone Tomorrow
J. P. Nolan, M. G. Mythen
Disclosures
Br J Anaesth. 2013;111(3):321-324.
After a review of the available evidence, on June 14, 2013, the Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicines Agency (EMA) concluded that the benefits of hydroxyethyl starch (HES) solutions no longer outweighed their risks and recommended that the Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-71454703173849640842011-12-20T16:26:00.002-02:002011-12-20T16:29:45.671-02:00Bougie-Aided Cricothyrotomy by Darren BraudeThe bougie can make an open cric much easier. Here is airway Darren Braude, MD demonstrating this technique.
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-23379347221747770852011-12-09T14:29:00.001-02:002011-12-09T14:34:24.662-02:00Reducing the risk of anaphylaxis during anesthesia: 2011 updated guidelines for clinical practice.
These guidelines represent the updated consensus of experts in the field of immediate hypersensitivity reactions occurring during anesthesia.
They provide a series of valid, widely accepted, effective, and easily
teachable guidelines that are the fruit of current knowledge, research,
and experience. The guidelines are based on the findings of
international scientific research and have beenUnknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-23033419146207093072011-12-08T22:46:00.001-02:002011-12-09T14:39:35.145-02:00My patient is allergic to eggs, can i use propofol? A case report and review
an interesting case report by Dr. Jamal Tashkandi
Rather than other drugs, propofol is more likely to be used for induction of anesthesia to cause an allergic reaction. Propofol is becoming the most common intravenous agent used for induction as well as maintenance of anaesthesia. Allergy to propofol is rarely reported. We present a case of 4–year-old boy presented for elective Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-27170654373588850852011-09-21T09:45:00.001-03:002011-09-21T09:45:32.199-03:00Heart rate variability: a diagnostic and prognostic tool in anesthesia and intensive care
The autonomic nervous system (ANS) plays an important role in the human response to various internal and external stimuli, which can modify homeostasis, and exerts a tight control on essential functions such as circulation, respiration, thermoregulation and hormonal secretion. ANS dysfunction may complicate the perioperative course in the surgical patient undergoing anesthesia, increasing Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-11934092310845711532011-08-03T08:47:00.000-03:002011-08-03T08:47:59.728-03:00Laryngeal Mask Airway Devices: Three Manouvers for Any Clinical SituationDuring the past 2 decades, the laryngeal mask airway (LMA; LMA North America) and its variants have proved to be safe, effective, and minimally invasive airways in a wide variety of surgical procedures for patients who have fasted. The 3 maneuvers described below, developed by clinicians with considerable expertise in the use of these products, can help practitioners optimize their skill with Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-4723206658064096552011-07-07T17:15:00.000-03:002011-07-07T17:15:33.440-03:00Effect of patient sex on general anaesthesia and recovery
from BJA:
Background
Numerous studies have shown that women emerge faster from general anaesthesia than men, and differ in their postoperative recovery profile. The extent and underlying mechanisms for these sex-related differences in general anaesthesia are unclear.Methods
In a multicentre, prospective, matched cohort study, 500 ASA physical status I or II patients of either Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-31826391610060804382011-06-15T09:19:00.001-03:002011-06-15T09:20:54.771-03:00ACE Inhibitors Before Surgery May Do No Harm
Patients on blood pressure drugs experienced lower 30-day mortalityby Alison McCookResearchers at Toronto General Hospital used data from more than 61,000 patients to compare people who took ACE inhibitors with those who did not, and found that being on the blood pressure medication long-term leading up to noncardiac surgery was associated with lower 30-day mortality.
When they looked more Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-32075014503561309472011-06-07T15:50:00.003-03:002011-06-07T15:54:23.426-03:00Anesthesiology News - More Evidence One Size of Anesthesia Doesn’t Fit All
Study also suggests acetaminophen in recovery reduces postpartum depressionby Alison McCookFor women at risk for pain and depression in the months following a cesarean delivery, adding more pain medicine during the operation may help, according to a small study presented at the annual meeting of the Society for Obstetric Anesthesia and Perinatology (SOAP).
All of the 50 women included in Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-56211074551019583242011-03-24T10:30:00.001-03:002011-12-09T14:39:35.154-02:00In-vitro contracture testing for susceptibility to malignant hyperthermia: can Halothane be raplced?Malignant hyperthermia is a potentially lethal inherited hypermetabolic syndrome that develops in susceptible individuals following administration of depolarising neuromuscular relaxants or volatile anaesthetics. Genetic analysis can only confirm a diagnosis of malignant hyperthermia in about 70%, and in the remainder an in-vitro contracture test, with halothane and caffeine, on muscle obtained Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-7636035053929401112011-03-14T09:55:00.000-03:002018-12-30T01:46:04.425-02:00Central Line Placement / Catheterization: Subclavian approach
INDICATIONS
Administration of agents into the central vasculature
Central circulation and intracardiac access
Maintenance of venous access
Hemodialysis and plasmapheresis
CONTRAINDICATIONS
Absolute contraindications
Adequate peripheral IV access (see Intravenous Cannulation for further details.
Operator inexperience
Uncooperative patient
Relative contraindications
Significant Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-33475235972404243052011-03-14T09:09:00.000-03:002011-03-14T09:09:27.990-03:00Apples no worse than pears | theheart.org
Cambridge, UK - A new study has cast doubt on the widely held belief that obesity in an apple shape, with fat accumulation around the stomach area, is more damaging in terms of cardiovascular risk than other types of obesity.
The study, published online in the Lancet on March 11, 2011, was conducted by the international group known as the Emerging Risk Factors Collaboration.
Coauthor Dr EmanueleUnknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-85498460318065204352011-02-16T09:47:00.000-02:002011-02-16T09:47:25.650-02:00OFF: How Fast You Walk May Predict How Long You’ll Live?Doctors who are interested in measuring life expectancy may now have a simple way to do it — researchers have discovered that walking speed can be a useful predictor of how long older adults live.Those who walked 1 meter per second (about 2.25 mph) or faster consistently lived longer than others of their age and sex who walked more slowly, the study showed."We're able to show that a person's Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-4988496382023319982011-02-10T09:34:00.000-02:002011-12-09T14:39:35.150-02:00Are Opioids Safe?Charles E. Argoff, MD
Hi. I am Dr. Charles Argoff, Professor of Neurology and Director of the Comprehensive Pain Center at Albany Medical College and Albany Medical Center in Albany, New York. I would like to talk briefly about, although it is a huge topic, the near crisis (if not actual crisis) we face right now in grappling with the issue of opioid prescribing.The Opioid Prescribing Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-88468087550870008392011-02-09T21:21:00.000-02:002011-02-09T21:21:38.576-02:00Positive Pressure Ventilation (Bag Mask Ventilation) from NEJMProviding positive-pressure ventilation with a face mask and a bag-valve device can be a lifesaving maneuver. Although seemingly simple, the technique requires an understanding of the airway anatomy, the equipment, and the indications. Developing manual skills is necessary to provide adequate face-mask ventilation. While endotracheal intubation is frequently the definitive airway management Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-87294254138071585512011-01-24T09:32:00.000-02:002011-01-24T09:32:17.440-02:00Duoble-Lumen ETT - Management of Intraoperative Hypoxemia during One-lung Ventilationfrom Anesthesiology.com
Case Report:
A 50-yr-old man undergoing resection of the upper right lung for neoplasia developed hypoxemia 15 min after the start of OLV. Preoperative examination revealed satisfactory cardiopulmonary status. Preoperative rest and dobutamine stress echocardiography revealed normal left ventricular function without any wall motion abnormalities. Doppler ultrasound Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-29805725795534182462011-01-17T11:54:00.001-02:002011-01-17T11:54:59.948-02:00New concepts of atelectasis during general anaesthesiaAt the beginning of the last century, Pasteur described postoperative pulmonary atelectasis, analysed postoperative pulmonary complications (PCC; see below) and noted: ‘when the true history of postoperative lung complications comes to be written, active collapse of the lung, from deficiency of inspiratory power, will be found to occupy an important position among determining causes’. Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-77934206222133804042011-01-13T21:55:00.001-02:002018-12-30T01:47:24.968-02:00Brachial Plexus Block: Ultrasound Guided Supraclavicular approach
The primary ventral rami of C5 and C6 unite to form the upper trunk above the subclavian artery, C7 becomes the middle trunk and C8 and T1 unite to form the lower trunk. Both the brachial plexus and the subclavian artery lie on top of the first rib. The brachial plexus is located lateral and posterior to the subclavian artery. The subclavian vein and anterior scalene muscle are found medial to Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-31315012981872023482011-01-13T19:33:00.001-02:002011-01-13T19:34:41.745-02:00Off-topic. Or not? Limit screen viewing to less than two hours per day!Too much TV ups risk of death, cardiovascular events
London, UK - People who spend two hours or more a day in front of a screen during their leisure time—primarily watching television—have more than double the risk of cardiovascular events over four years compared with those who spend less than two hours a day in front of a screen, even after adjustment of the findings for physical activity,Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-10472891364323801742011-01-12T11:08:00.003-02:002011-01-13T21:31:18.870-02:00Anesthesia Awareness: Consciousness During SurgeryDr. Orin Guidry, MUSC anesthesiologist, discusses intraoperative awareness -- the medical phenomenon commonly known as awareness under anesthesia. Dr. Guidry discusses the frequency of occurrences, gives an overview of what happens under intraoperative awareness and explains the various measures taken to decrease instances. This video is brought to you by the Medical University of South Carolina Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-65534110230951670602011-01-11T22:35:00.001-02:002011-01-12T12:26:26.910-02:00Preoperative Statin Therapy on Adverse Postoperative Outcomesfrom Anesthesiology.org
Background: Chronic statin therapy is associated with reduced postoperative mortality. Renal and cardiovascular benefits have been described, but the effect of chronic statin therapy on postoperative adverse events has not yet been explored.Methods: In this observational study involving 1,674 patients undergoing aortic reconstruction, we prospectively assessed chronic Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-20279684614376898222011-01-10T22:58:00.002-02:002011-01-11T01:09:56.867-02:00Bad Day at the Office - from AnaesthesiaCasesThanks to Dr Bill Griggs from Adelaide South Australia for sharing this case!
I am going to share a case that was not a lot of fun.
I travelled to a small rural area in Australia by helicopter to pick a 60 y.o. woman with CREST syndromewho had been unwell in a small local hospital with "gastroenteristis" for 2-3 days. We went to get her because she was anuric and had no recordable Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-50659966378828738982011-01-09T21:37:00.001-02:002018-12-30T01:44:50.234-02:00Popliteal Nerve Block: Indications and technique
INDICATIONS
Anesthesia for procedures on the distal tibia and fibula, ankle, and foot
Post-operative pain relief for procedures on the distal tibia and fibula, ankle, and foot
CONTRAINDICATIONS
Absolute contraindications
Patient refusal
Allergy to local anesthetics
Infection at the site of insertion
Relative contraindications
Coagulopathy or systemic anticoagulation
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-75530056080716751332011-01-09T20:04:00.000-02:002011-01-09T20:04:20.967-02:00Transfusions overused in cardiac surgery?from theheart.org
São Paulo, Brazil and Durham NC - More evidence that blood transfusions are being used too liberally in cardiac-surgery patients has come from two new studies, both published in the October 13, 2010, issue of the Journal of the American Medical Association.
One study, conducted in Brazil, found no difference in outcomes between two transfusion strategies, oneUnknownnoreply@blogger.comtag:blogger.com,1999:blog-2352288137921031914.post-54190491211484336292011-01-07T15:07:00.001-02:002011-01-07T15:09:53.492-02:00Anesthetic shortage worries hospitals, CBC says
"For many of the drugs that are short in the community pharmacy setting, there are other drugs available in the same classes," McKinnon said. "For drugs used for anesthesiology, the drugs are more limited." Many hospital pharmacies have been unable to get pentothal for months.
"We went from adequate stocks with no real concern that we were going to run out of them to having none of it Unknownnoreply@blogger.com