Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2024
Gender and Pathways to Leadership in Academic Anesthesiology: A Qualitative Content Analysis of US Chairpersons' Curricula Vitae.
Women are underrepresented in medicine and academic anesthesiology, and especially in leadership positions. We sought to characterize career achievement milestones of female versus male academic anesthesiology chairs to understand possible gender-related differences in pathways to leadership. ⋯ Female chairpersons who were members of the Association of Academic Anesthesiology Chairs in the United States demonstrated similar patterns of academic achievement as compared to male chairpersons at the time the position of chair was assumed, suggesting that they were equally qualified for the role as compared to men. Four patterns of career achievements were evident in the chairperson group, suggesting multiple viable pathways to this leadership position.
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Anesthesia and analgesia · Jan 2024
Women in Anesthesiology and the Mid-Career Stall: Why They Are Not Advancing Into Senior Leadership.
Women anesthesiologists face many challenges when trying to advance their careers and find balance in personal and professional endeavors. In this article, we introduce the reader to several concepts central to understanding the challenges faced by mid-career women anesthesiologists and highlight why these challenges become particularly pronounced when women enter the mid-career stage. We describe how lack of constructive actionable feedback combined with lack of mentorship and sponsorship negatively affects women in the workplace. ⋯ We present a discussion of mistreatment and burnout, which are compounded by concurrent demands of parenthood and a professional career. We conclude with the impact that these barriers have on mid-career women anesthesiologists and recommendations for mitigating these challenges. They include a systematic increase in mentorship and sponsorship, an individualized professional development strategy, and an improved and comprehensive approach to promotion.
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Anesthesia and analgesia · Jan 2024
Mechanism-Based Modeling of Perioperative Variations in Hemoglobin Concentration in Patients Undergoing Laparoscopic Surgery.
Hemoglobin concentration ([Hb]) in the perioperative setting should be interpreted in the context of the variables and processes that may affect it to differentiate the dilution effects caused by changes in intravascular volume. However, it is unclear what variables and processes affect [Hb]. Here, we modeled the perioperative variations in [Hb] to identify the variables and processes that govern [Hb] and to describe their effects. ⋯ Our model provides a mechanistic and quantitative understanding of the causes underlying the perioperative [Hb] variations.
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Anesthesia and analgesia · Jan 2024
Randomized Controlled Trial Multicenter StudyDexmedetomidine Infusion Versus Placebo During Light or Deep Anesthesia on Postoperative Delirium in Older Patients Undergoing Major Noncardiac Surgery: A Pilot Randomized Factorial Trial.
Postoperative delirium (POD) is common among older surgical patients and may be affected by dexmedetomidine and depth of anesthesia. We designed this pilot study to assess the feasibility of comparing dexmedetomidine with normal saline during light versus deep anesthesia on POD in older patients undergoing major noncardiac surgery. ⋯ The findings of this pilot study demonstrate the feasibility of assessing dexmedetomidine versus placebo during light versus deep anesthesia on POD among older patients undergoing major noncardiac surgery, and justify a multicenter randomized factorial trial.
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Cannabidiol (CBD) is one of the most interesting constituents of cannabis, garnering significant attention in the medical community in recent years due to its proven benefit for reducing refractory seizures in pediatric patients. Recent legislative changes in the United States have made CBD readily available to the general public, with up to 14% of adults in the United States having tried it in 2019. CBD is used to manage a myriad of symptoms, including anxiety, pain, and sleep disturbances, although rigorous evidence for these indications is lacking. A significant advantage of CBD over the other more well-known cannabinoid delta-9-tetrahydroncannabinol (THC) is that CBD does not produce a "high." As patients increasingly self-report its use to manage their medical conditions, and as the opioid epidemic continues to drive the quest for alternative pain management approaches, the aims of this narrative review are to provide a broad overview of the discovery, pharmacology, and molecular targets of CBD, its purported and approved neurologic indications, evidence for its analgesic potential, regulatory implications for patients and providers, and future research needs.