Anesthesia and analgesia
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Anesthesia and analgesia · May 2017
Multicenter StudyAnesthesiologists and Disaster Medicine: A Needs Assessment for Education and Training and Reported Willingness to Respond.
Anesthesiologists provide comprehensive health care across the emergency department, operating room, and intensive care unit. To date, anesthesiologists' perspectives regarding disaster medicine and public health preparedness have not been described. ⋯ Few anesthesiologists reported receiving sufficient education and training in disaster medicine and public health preparedness. Providing education and training and enhancing related employee services may further bolster WTR and help to build a more capable and effective medical workforce for disaster response.
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Anesthesia and analgesia · May 2017
Diversity in the American Society of Anesthesiologists Leadership.
Women and minorities are underrepresented in US academic medicine. The Sullivan Commission on Diversity in the Healthcare Workforce emphasized the importance of diverse leadership for reducing health care disparities. The objective of this study was to evaluate the demographics of the American Society of Anesthesiologists leadership. We hypothesized that the percentage of women and underrepresented minorities is less than that of their respective proportions in the general physician workforce. ⋯ Women and minorities are underrepresented in the leadership of the American Society of Anesthesiologists. Efforts should be made to increase the diversity of the American Society of Anesthesiologists leadership with the goal of reducing overall anesthesia workforce disparities.
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Anesthesia and analgesia · May 2017
Comparative Study Observational StudyBlood Bupivacaine Concentrations After a Combined Single-Shot Sciatic Block and a Continuous Femoral Nerve Block in Pediatric Patients: A Prospective Observational Study.
We evaluated blood bupivacaine concentrations in children having a single-shot sciatic and continuous femoral blocks after anterior cruciate ligament repair. Dried blood spot samples were analyzed for bupivacaine levels at 0, 5, 15, 30, 60, and 120 minutes and 4, 24, and 48 hours. ⋯ The 99% upper confidence interval was below potentially toxic levels (1500 ng/mL) across all sampling times. The risk of local anesthetic toxicity in pediatric patients receiving single-shot sciatic and continuous femoral nerve blocks is very low.
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Anesthesia and analgesia · May 2017
Prophylactic Plasma Transfusion Is Not Associated With Decreased Red Blood Cell Requirements in Critically Ill Patients.
Critically ill patients frequently receive plasma transfusion under the assumptions that abnormal coagulation test results confer increased risk of bleeding and that plasma transfusion will decrease this risk. However, the effect of prophylactic plasma transfusion remains poorly understood. The objective of this study was to determine the relationship between prophylactic plasma transfusion and bleeding complications in critically ill patients. ⋯ Prophylactic administration of plasma in the critically ill was not associated with improved clinical outcomes. Further investigation examining the utility of plasma transfusion in this population is warranted.
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Anesthesia and analgesia · May 2017
Observational StudyTotal Spinal Anesthesia Failure: Have You Assessed the Sensory Anesthesia in Sacral Dermatomes?
Intrathecal local anesthetic maldistribution is a well-known cause of spinal anesthesia failure (SAF). This could potentially result in sensory blockade restricted to the sacral dermatomes. ⋯ Of the 72 presumed total failures based on the initial assessment, evaluation of the sacral dermatomes revealed sensory blockade in 32 (44%; 95% confidence interval, 32.7%-56.6%). Sacral dermatome assessment after SAF may be important in safely guiding subsequent anesthetic management.