Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2015
Anesthetic Management of Patients with Congenital Insensitivity to Pain with Anhidrosis: A Retrospective Analysis of 358 Procedures Performed Under General Anesthesia.
Congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal recessive disorder characterized by recurrent episodic fevers, anhidrosis, absent reaction to noxious stimuli, self-mutilating behavior, and mental retardation. The anesthetic management of patients with CIPA is challenging. Autonomic nervous system abnormalities are common, and patients are at increased risk for perioperative complications. ⋯ Regurgitation, hyperthermia, and aspiration were uncommon, but the incidence of bradycardia was higher than has been reported in previous studies. CIPA remains a challenge for anesthesiologists. Because of the rare nature of this disorder, the risk of various complications is difficult to predict.
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Anesthesia and analgesia · Nov 2015
Health Care Costs and the Perioperative Surgical Home: A Survey Study.
The perceptions of anesthesiologists of US health care finance reform are germane to informing the future of our specialty. For this reason, we sought to assess anesthesiologists' views of their own importance in cost-reduction strategies. In addition, respondents were asked a series of questions related to the Perioperative Surgical Home. ⋯ US anesthesiologists surveyed perceive other stakeholders, such as hospitals and insurance companies, as having a major responsibility in cost reduction. Furthermore, they are not enthusiastic about substantial financial reform such as cuts to Medicare payments.
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Anesthesia and analgesia · Nov 2015
Anesthesia-Induced Neuronal Apoptosis in the Developing Retina: A Window of Opportunity.
Anesthetics cause widespread apoptosis in the developing brain, resulting in neurocognitive abnormalities. However, it is unknown whether anesthesia-induced neurotoxicity occurs in humans because there is currently no modality to assess for neuronal apoptosis in vivo. The retina is unique in that it is the only portion of the central nervous system that can be directly visualized noninvasively. Thus, we aimed to determine whether isoflurane induces apoptosis in the developing retina. ⋯ These findings indicate that isoflurane-induced neuronal apoptosis occurs in the developing retina and lays the groundwork for development of a noninvasive imaging technique to detect anesthesia-induced neurotoxicity in infants and children.