Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2012
ReviewReview article: cerebral near-infrared spectroscopy in adults: a work in progress.
Near-infrared spectroscopy (NIRS) has potential as a noninvasive brain monitor across a spectrum of disorders. In the last decade, there has been a rapid expansion of clinical experience using NIRS to monitor cerebral oxygenation, and there is some evidence that NIRS-guided brain protection protocols might lead to a reduction in perioperative neurologic complications after cardiac surgery. ⋯ Although increasingly sophisticated apparatuses, including broadband and time-resolved spectroscopy systems, provide insights into the potential of NIRS to measure regional cerebral oxygenation, hemodynamics, and metabolism in real-time, these innovations have yet to translate into effective monitor-guided brain protection treatment strategies. NIRS has many potential advantages over other neuromonitoring techniques, but further investigation and technological advances are necessary before it can be introduced more widely into clinical practice.
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Anesthesia and analgesia · Dec 2012
Multicenter StudyPediatric Regional Anesthesia Network (PRAN): a multi-institutional study of the use and incidence of complications of pediatric regional anesthesia.
Regional anesthesia is increasingly used in pediatric patients to provide postoperative analgesia and to supplement intraoperative anesthesia. The Pediatric Regional Anesthesia Network was formed to obtain highly audited data on practice patterns and complications and to facilitate collaborative research in regional anesthetic techniques in infants and children. ⋯ Regional anesthesia in children as commonly performed in the United States has a very low rate of complications, comparable to that seen in the large multicenter European studies. Ultrasound may be increasing the use of peripheral nerve blocks. Multicenter collaborative networks such as the Pediatric Regional Anesthesia Network can facilitate the collection of detailed prospective data for research and quality improvement.
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Anesthesia and analgesia · Dec 2012
Multicenter StudyBariatric surgery with operating room teams that stayed fixed during the day: a multicenter study analyzing the effects on patient outcomes, teamwork and safety climate, and procedure duration.
Bariatric surgery durations vary considerably because of differences in surgical procedures and patient factors. We studied the effects on patient outcomes, teamwork and safety climate, and procedure durations resulting from working with operating room (OR) teams that remain fixed for the day instead of OR teams that vary during the day. ⋯ Working with fixed teams in bariatric surgery reduced procedure durations and improved teamwork and safety climate, without adverse effects on patient outcomes.
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Anesthesia and analgesia · Dec 2012
Biography Historical ArticleSpecial Article: Ronald D. Miller: tribute to a past editor-in-chief.
For anesthesiologists around the world who have practiced or trained in the past 4 decades, the name Ronald Miller, MD, has been synonymous with a commitment to excellence that has been evident in all aspects of his remarkable career as a distinguished clinician-scientist, editor, writer, and educator. Dr. Miller's contributions as Editor-in-Chief of Anesthesia & Analgesia (1991-2006) have stimulated this salutation of his career and of his influence on transforming the Journal.
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Anesthesia and analgesia · Dec 2012
Case ReportsCase report: neurological complications associated with epidural analgesia in children: a report of 4 cases of ambiguous etiologies.
The safety and utility of pediatric epidural analgesia is well established, but the risk of permanent neurological injury is unknown and largely must be extrapolated from adult literature. In this article we present a series of 4 cases of longterm or permanent neurologic complications associated with epidural analgesia. Possible mechanisms of injury and implications for practice are discussed.