Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2018
Research Productivity and Rankings of Anesthesiology Departments in Canada and the United States: The Relationship Between the h-Index and Other Common Metrics.
To evaluate the relative research productivity and ranking of anesthesiology departments in Canada and the United States, using the Hirsch index (h-index) and 4 other previously validated metrics. ⋯ Our study ranked the Canadian and US anesthesiology departmental research productivity using the h-index applied to each department, total number of publications, total number of citations, and average number of citations. The strong relationship between the h-index and both the number of publications and number of citations of anesthesiology departments shows that the departments with the highest number of publications are also producing research with the most highly cited articles (ie, most impact), as demonstrated by the h-index.
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Anesthesia and analgesia · Mar 2018
Meta AnalysisIntraoperative Esmolol as an Adjunct for Perioperative Opioid and Postoperative Pain Reduction: A Systematic Review, Meta-analysis, and Meta-regression.
Esmolol is an ultrashort β-1 receptor antagonist. Recent studies suggest a role for esmolol in pain response modulation. The authors performed a meta-analysis to determine if the intraoperative use of esmolol reduces opioid consumption or pain scores. ⋯ This meta-analysis demonstrates that intraoperative esmolol use reduces both intraoperative and postoperative opioid consumption, with no change in postoperative pain scores.
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Anesthesia and analgesia · Mar 2018
Meta AnalysisTargeted Temperature Management After Cardiac Arrest: Systematic Review and Meta-analyses.
Targeted temperature management (TTM) with therapeutic hypothermia is an integral component of postarrest care for survivors. However, recent randomized controlled trials (RCTs) have failed to demonstrate the benefit of TTM on clinical outcomes. We sought to determine if the pooled data from available RCTs support the use of prehospital and/or in-hospital TTM after cardiac arrest. ⋯ Our results suggest that TTM with therapeutic hypothermia may not improve mortality or neurologic outcomes in postarrest survivors. Using therapeutic hypothermia as a standard of care strategy of postarrest care in survivors may need to be reevaluated.
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Anesthesia and analgesia · Mar 2018
ReviewCardiac Arrest in the Operating Room: Resuscitation and Management for the Anesthesiologist: Part 1.
Cardiac arrest in the operating room and procedural areas has a different spectrum of causes (ie, hypovolemia, gas embolism, and hyperkalemia), and rapid and appropriate evaluation and management of these causes require modification of traditional cardiac arrest algorithms. There is a small but growing body of literature describing the incidence, causes, treatments, and outcomes of circulatory crisis and perioperative cardiac arrest. ⋯ Management of cardiac arrest of the perioperative patient is predicated on expert opinion, physiologic rationale, and an understanding of the context in which these events occur. Resuscitation algorithms should consider the evaluation and management of these causes of crisis in the perioperative setting.