Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2021
Safety of Continuous Erector Spinae Catheters in Chest Trauma: A Retrospective Cohort Study.
The erector spinae block is an efficacious analgesic option for the management of rib fracture--related pain. Despite there being minimal published data specifically addressing the safety profile of this block, many societies have made statements regarding its safety and its use as an alternative to traditional regional anesthesia techniques in patients at risk of complications. The primary aim of this study was to characterize the safety profile of erector spinae plane block catheters by determining the incidence of early complications. The secondary aim of this study was to characterize the incidence of late adverse events, as well as the erector spinae plane block catheter failure rate. ⋯ This study supports the statements made by regional anesthesia societies regarding the safety of the erector spinae plane block. Based on the results presented in this population of trauma patients, the erector spinae plane block catheter is a low-risk analgesic technique that may be performed in the presence of abnormal coagulation status or systemic infection.
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Anesthesia and analgesia · Nov 2021
Practice GuidelineThe World Federation of Societies of Anaesthesiologists Minimum Capnometer Specifications 2021-A Guide for Health Care Decision Makers.
Capnometry, the measurement of respiratory carbon dioxide, is regarded as a highly recommended safety technology in intubated and nonintubated sedated and/or anesthetized patients. Its utility includes confirmation of initial and ongoing placement of an airway device as well as in detecting gas exchange, bronchospasm, airway obstruction, reduced cardiac output, and metabolic changes. The utility applies prehospital and throughout all phases of inhospital care. ⋯ The WFSA-Minimum Capnometer Specifications 2021 is based on the International Organization for Standardization (ISO) capnometer specifications. While industry is familiar with such specifications and their presentation format, most clinicians are not; therefore, this article serves to more clearly explain the requirements. In addition, the specifications as described can be used as a purchasing guide by clinicians.
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Anesthesia and analgesia · Nov 2021
Comparative Study Biography Historical ArticleThe First Cardiac Anesthesiology Fellow, William A. Lell: A Brief History.
Fifty years ago, on August 1, 1971, William A. Lell became the first cardiac anesthesia fellow at Harvard's Massachusetts General Hospital (MGH) Department of Anesthesiology, training with the world's first group of anesthesiologists whose clinical practice, teaching, and research efforts were exclusively devoted to cardiac anesthesia. ⋯ The challenges a young pioneer faced in establishing and maintaining an academic cardiac anesthesia program during the initial and rapid growth of an exciting new subspecialty are described. Dr Lell's experience emphasizes the importance of seizing new opportunities and establishing meaningful working relationships with colleagues based on mutual trust as fundamental to successful career development and research in a new medical subspecialty.
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Anesthesia and analgesia · Nov 2021
The Association of Dexmedetomidine on Perioperative Opioid Consumption in Children Undergoing Adenotonsillectomy With and Without Obstructive Sleep Apnea.
Dexmedetomidine is used to reduce opioid consumption in pediatric anesthesia. However, there is conflicting evidence in pediatric adenotonsillectomy literature regarding the total perioperative opioid-sparing effects of dexmedetomidine. The aim of this study was to examine the association between dexmedetomidine and total perioperative opioid consumption in children undergoing adenotonsillectomy. ⋯ Dexmedetomidine is associated with an overall perioperative opioid-sparing effect in children undergoing adenotonsillectomy and a small but statistically significant increase in PACU duration. Additionally, children with OSA did not have reduced perioperative opioid consumption.
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Anesthesia and analgesia · Nov 2021
Comparative StudyRelationship Between the Loaded Pressure and Flow Rate of Packed Red Blood Cells and Various Infusion Solutions in Normal Infusion Lines and Catheters.
We investigated the relationship between the loaded pressure and flow rate in various catheters and the entire infusion line including the catheters, in several infusion solutions and packed red blood cells. ⋯ Regardless of the type of infusion solution or transfusion, the pressure-flow relationship in the catheter was nonlinear and not directly proportional. However, within the clinical pressure range (up to 450 mm Hg), the relationship between the flow rate and pressure in the entire infusion line was almost linear and proportional.