Anesthesia and analgesia
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Anesthesia and analgesia · Sep 2024
Intrathecal Drug Delivery System in Prepontine Cistern for Patients with Intractable Craniofacial Cancer Pain: A Multicenter Retrospective Study.
Patients with craniofacial cancer frequently suffer from severe pain. The traditional intrathecal, oral, or intravenous analgesics could only provide insufficient pain relief with many side effects. Thus, a more effective analgesia approach is required. This study aimed to investigate the safety and efficacy of placing the catheter of an intrathecal morphine pump in the prepontine cistern for the treatment of craniofacial cancer pain. ⋯ Placing the catheter tip of an intrathecal morphine pump into the prepontine cistern could effectively relieve refractory craniofacial cancer pain with an extremely low total morphine dose requirement and few adverse events. This procedure could be considered in patients with severe refractory craniofacial cancer pain.
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Anesthesia and analgesia · Sep 2024
An Evaluation of the Transfer of Skills and Knowledge from Two World Federation of Societies of Anaesthesiologists Fellowship Programs.
Subspecialist training is an important part of developing human resources for health and for some learners, may require taking place in another, higher-resourced country. Despite effective learning of skills and knowledge in a different, more highly resourced context, transfer of these skills and knowledge back to a more poorly resourced context can be a challenge. We aimed to evaluate the transfer of skills and knowledge in 2 World Federation of Societies of Anaesthesiologists (WFSA) fellowship programs. ⋯ Our study found that the 2 fellowship programs had variable success in the transfer of learned skills and knowledge back to the fellows' "home" institutions. Contextual differences between the fellowship institution and the home institution were the main source of barriers to transfer, and fellows from different countries had diverse needs. Supporting the transfer of knowledge and skills should be an explicit goal of these fellowship programs, and as such, should be considered in the recruitment of fellows, curriculum development, and in how the success of a fellowship is evaluated. Curricula should not just focus on medical knowledge and skills, but also skills in leading change and in education.
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Anesthesia and analgesia · Sep 2024
Pro-Con Debate: Anesthesiologists Should Be Responsible for Treating Preoperative Anemia.
In this Pro-Con commentary article, we discuss whether anesthesiologists should be responsible for treating preoperative anemia. This debate was proposed based on the article published in this issue of Anesthesia & Analgesia by Warner et al, which is an advisory on managing preoperative anemia endorsed by both the Society of Cardiovascular Anesthesiologists and the Society for Advancement of Patient Blood Management. ⋯ Even if we agree that preoperative anemia is worth treating before surgery, the question remains who should be responsible for doing so, and therein lies the reason for this Pro-Con debate. Should it be the responsibility of the anesthesiologist, or not? Let the readers decide.
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Anesthesia and analgesia · Sep 2024
Anesthesiologists' Role in Recognition, Prevention, and Treatment of Childbirth-Related Posttraumatic Stress Disorder.
Childbirth-related posttraumatic stress disorder (CB-PTSD) is increasingly common and consequential for pregnant patients. Throughout the labor experience and beyond, anesthesiologists are central to creating a psychological safe space for patients and play an essential role in preventing, recognizing, and treating CB-PTSD. This narrative review summarizes the current literature surrounding risk factors for CB-PTSD that are relevant to anesthesiologists; patients' symptoms or signs anesthesiologists should look out for; and ways anesthesiologists may be involved in preventing and treating this condition.