Anesthesiology
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Observational Study
Neuropsychological and Behavioral Outcomes after Exposure of Young Children to Procedures Requiring General Anesthesia: The Mayo Anesthesia Safety in Kids (MASK) Study.
Few studies of how exposure of children to anesthesia may affect neurodevelopment employ comprehensive neuropsychological assessments. This study tested the hypothesis that exposure to multiple, but not single, procedures requiring anesthesia before age 3 yr is associated with adverse neurodevelopmental outcomes. ⋯ Anesthesia exposure before age 3 yr was not associated with deficits in the primary outcome of general intelligence. Although secondary outcomes must be interpreted cautiously, they suggest the hypothesis that multiple, but not single, exposures are associated with a pattern of changes in specific neuropsychological domains that is associated with behavioral and learning difficulties.
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Historical Article
History of the Development of Anesthesia for the Dolphin: A Quest to Study a Brain as Large as Man's.
It is important for academic-minded human anesthesiologists to have an interdisciplinary perspective when engaging in cutting-edge research as well as the practice of human anesthesiology. This was a philosophy promoted by Dr. Robert Dripps, former pioneering Chairman of the Anesthesiology Department at the University of Pennsylvania (Philadelphia, Pennsylvania). ⋯ The motivation to anesthetize dolphins came from the fact that scientists and physicians wanted to study the brain of the dolphin, a brain as large as man's. Also, investigators wanted to develop anesthesia for the dolphin in order to study the electrophysiology of the dolphin's highly sophisticated auditory system, which facilitates the dolphin's amazing echolocation capability. Dolphin anesthesia involves a complex matter of unique neural control, airway anatomy, neuromuscular control of respiration, and sleep behavior.
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Randomized Controlled Trial Comparative Study
Comparison of Anterior Suprascapular, Supraclavicular, and Interscalene Nerve Block Approaches for Major Outpatient Arthroscopic Shoulder Surgery: A Randomized, Double-blind, Noninferiority Trial.
The interscalene nerve block provides analgesia for shoulder surgery, but is associated with diaphragm paralysis. One solution may be performing brachial plexus blocks more distally. This noninferiority study evaluated analgesia for blocks at the supraclavicular and anterior suprascapular levels, comparing them individually to the interscalene approach. ⋯ The anterior suprascapular block, but not the supraclavicular, provides noninferior analgesia compared to the interscalene approach for major arthroscopic shoulder surgery. Pulmonary function is best preserved with the anterior suprascapular nerve block.