Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2023
Randomized Controlled TrialModified Manual Chest Compression for Prevention and Treatment of Respiratory Depression in Patients Under Deep Sedation During Upper Gastrointestinal Endoscopy: Two Randomized Controlled Trials.
We aimed to determine the preventive and therapeutic efficacy of modified manual chest compression (MMCC), a novel noninvasive and device-independent method, in reducing oxygen desaturation events in patients undergoing upper gastrointestinal endoscopy under deep sedation. ⋯ MMCC may exert preventive and therapeutic effects against oxygen desaturation events during upper gastrointestinal endoscopy.
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Anesthesia and analgesia · Oct 2023
Chronic Pain, Analgesics, and Cognitive Status: A Comprehensive Mendelian Randomization Study.
Observational studies have suggested an intricate relationship among chronic pain (CP), use of analgesics, and cognitive status, but it remains unclear whether these associations are of a causal nature. ⋯ Our findings indicate that an elevated number of CP sites predict future cognitive decline. Patients with dementia had lower exposure to anilides and NSAIDs, suggesting that they might not be adequately medicated for pain.
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Anesthesia and analgesia · Oct 2023
The Timing of Initiating Hydrocortisone and Long-term Mortality in Septic Shock.
Previous studies on the association between the timing of corticosteroid administration and mortality in septic shock focused only on short-term mortality and produced conflicting results. We performed a retrospective review of a large administrative database of intensive care unit (ICU) patients to evaluate the association between the timing of hydrocortisone initiation and short- and long-term mortality in septic shock. We hypothesized that a longer duration between the first vasopressor use for sepsis and steroid initiation was associated with increased mortality. ⋯ In patients with septic shock, initiating hydrocortisone >12 hours after vasopressor use was associated with an increased risk of both short-term and long-term mortality, and a prolonged length of hospital stay.
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Anesthesia and analgesia · Oct 2023
Using Preanesthesia Clinic Visits to Improve Advance Directives Completion: An Interrupted Time Series Analysis.
Advance directives documentation can increase the likelihood that patient's wishes are respected if they become incapacitated. Unfortunately, completion rates are suboptimal overall, and disparities may exist, especially for vulnerable groups. We assessed whether implementing an initiative to standardize advance directives discussions during preanesthesia visits was associated with changes in rates of advance directives completion over time, and whether the association depends on race, insurance type, or income. ⋯ Standardizing advance directives discussions during preanesthesia visits was associated with more patients completing advance directives, particularly in vulnerable patient groups.
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Anesthesia and analgesia · Oct 2023
Assuring the Groundwork for Success: Mentorship, Sponsorship, and Allyship for Practicing Anesthesiologists.
The challenges facing the health care industry in the post-coronavirus disease 2019 (COVID-19) pandemic world are numerous, jeopardizing wellness, and performance. Maintaining engagement and fulfillment of anesthesiologists in their work is now a critical issue in various practice settings: academic, private practice, and corporate medicine. In this article, we offer insights on how mentorship, sponsorship, and allyship are important in the advancement of the anesthesiology workforce including women and underrepresented minorities inclusive of race, gender, and disability. ⋯ These 3 distinct yet interrelated concepts are defined with a discussion on the value of implementation. In addition, the concept of "belonging" and its importance in enhancing the culture in anesthesiology is explored. We believe that part of the solution to wellness, recruitment and retention and improved job satisfaction of clinicians is having an environment where mentorship, sponsorship, and allyship are foundational.