Anesthesiology
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An interesting exploration of the surgeon-anesthesiologist relationship, framed in terms of it being the critical dyad of the operating theatre team.
Cooper explores the positives and negatives, the stereotypes that each craftgroup holds of the other, and the ways in which these translate to team performance.
Most significantly, Cooper makes the point that when highly functional this relationship can lead to the highest quality patient care, but at its worst, dysfunction can lead to extreme harm and compromise patient safety.
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Meta Analysis
Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis.
Use of processed-EEG monitoring to guide anaesthesia depth is associated with a 38% odds reduction of developing postoperative delirium.
pearl -
The development of chronic pain is considered a major complication after surgery. Basic science research in animal models helps us understand the transition from acute to chronic pain by identifying the numerous molecular and cellular changes that occur in the peripheral and central nervous systems. It is now well recognized that inflammation and nerve injury lead to long-term synaptic plasticity that amplifies and also maintains pain signaling, a phenomenon referred to as pain sensitization. ⋯ This narrative review of the literature describes clinical investigations evaluating different preventative pharmacologic strategies that are routinely used by anesthesiologists in their daily clinical practices for preventing persistent postoperative pain. Nevertheless, further efforts are needed in both basic and clinical science research to identify preclinical models and novel therapeutics targets. There remains a need for more patient numbers in clinical research, for more reliable data, and for the development of the safest and the most effective strategies to limit the incidence of persistent postoperative pain.