Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2022
Keeping an Open Mind About Open Notes: Sharing Anesthesia Records With Patients.
Please note that in the interim since this paper was accepted for publication, new governmental regulations, pertinent to the topic, have been approved for implementation. The reader is thus directed to this online addendum for additional relevant information: http://links.lww.com/AA/E44.
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Anesthesia and analgesia · Oct 2022
Biography Historical ArticleThomas Drysdale Buchanan, MD, and the Birth of Academic Anesthesiology.
Thomas Drysdale Buchanan, MD (1876-1940), founding president of the American Board of Anesthesiology, was the first person in the United States to hold the title "Professor of Anesthesiology" in a medical school faculty position dedicated exclusively to the specialty. An 1897 graduate of New York Medical College, Dr Buchanan joined the faculty of his alma mater in 1902 in response to demands by medical students and recent graduates for a dedicated instructor in anesthesia. Within a decade, the instructorship had become a professorship, and Dr Buchanan was on his way to distinction as one of the founders of academic anesthesiology. This chapter in Dr Buchanan's early career illustrates how anesthesiology took shape as a distinct body of knowledge during the formative decades of modern medical education at the turn of the century, laying the groundwork for its recognition 30 years later as a specialty in its own right.
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Postoperative cognitive dysfunction and delirium are undesirable consequences of surgery and anesthesia that regrettably do not have consistent predictive markers. Nor do they have reliable prophylactic or treatment methodologies. In an effort to better understand how anesthetic drugs alter the rate of postoperative delirium, Chang et al explore how patients with preoperative cognitive impairment respond to the influence of intraoperative ketamine. ⋯ Is it possible that ketamine and other drugs could be used as agents to stratify cognitive risk? Should we definitively avoid such drugs as potentiators of cognitive dysfunction? A variety of contextual limitations must be entertained when interpreting the results of this study as summarized in this infographic. These are also elaborated in greater detail in both the primary article as well as its attendant editorial. The reader is encouraged to review both in their entirety for an in-depth scope of understanding.
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Anesthesia and analgesia · Oct 2022
Observational StudyIntraoperative Blood Pressure and Long-Term Neurodevelopmental Function in Children Undergoing Ambulatory Surgery.
Some studies have found surgery and anesthesia in children to be associated with neurodevelopmental deficits, but specific reasons for this association have not been fully explored. This study evaluates intraoperative mean arterial pressure (MAP) during a single ambulatory procedure in children and subsequent mental disorder diagnoses. ⋯ Presence in a predefined mean intraoperative MAP category was not associated with subsequent mental disorder diagnoses within our follow-up period. However, the limitations of this study, including uncertainty regarding what constitutes an adequate blood pressure in children, may limit the ability to form definitive conclusions.
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Anesthesia and analgesia · Oct 2022
A Call to Action: A Specialty-Specific Course to Support the Next Generation of Clinician Scientists in Anesthesiology.
Clinical production pressure is a significant problem for faculty of anesthesiology departments who seek to remain involved in research. Lack of protected time to dedicate to research and insufficient external funding add to this long-standing issue. Recent trends in funding to the departments of anesthesiology and their academic output validate these concerns. ⋯ Directed toward early career academic anesthesiologists who wish to gain competency specifically in the fundamentals of clinical research and receive mentorship to develop an investigative project, the yearlong course will provide participants with the skills necessary to design research initiatives, ethically direct research teams, successfully communicate ideas with data analysts, and write and submit scientific articles. Additionally, the course, articulated in a series of interactive lectures, mentored activities, and workshops, will teach participants to review articles submitted for publication to medical journals and to critically appraise evidence in published research. It is our hope that this initiative will be of interest to junior faculty of academic anesthesiology departments nationally and internationally.