Articles: anesthesia.
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Drug administration errors (DAEs) in anaesthesia are common, the aetiology multifactorial and though mostly inconsequential, some lead to substantial harm. The extend of DAEs remain poorly quantified and effective implementation of prevention strategies sparse. ⋯ DAEs in anaesthesia remain prevalent. Known error traps continue to drive these incidents. Implementation of system based preventative strategies are paramount to guard against human error. Efforts should be made to encourage scrupulous reporting and training of anaesthesia providers, with the aim of rendering them proficient and resilient to handle these events.
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Anesthesia and analgesia · Aug 2024
Electroencephalogram-Based Anesthesia Indices Differently React to Modulations of Alpha-Oscillatory Activity.
The electroencephalographic (EEG) provides the anesthesiologist with information regarding the level of anesthesia. Processed EEG indices are available that reflect the level of anesthesia as a single number. Strong oscillatory EEG activity in the alpha-band may be associated with an adequate level of anesthesia and a lower incidence of cognitive sequelae. So far, we do not know how the processed indices would react to changes in the alpha-band activity. Hence, we modulated the alpha-oscillatory activity of intraoperative EEG to assess possible index changes. ⋯ While the alpha-band in the intraoperative EEG seems to carry information regarding the quality of anesthesia, changes in the alpha-band activity do neither strongly nor uniformly influence processed EEG indices. Hence, to assess alpha-oscillatory activity's strength, the user needs to focus on the raw EEG or its spectral representation also displayed on the monitoring systems.
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General laryngeal mask anesthesia with the preservation of spontaneous breathing has accelerated the advancement of the enhanced recovery after surgery concept in thoracoscopic surgery. However, the need for increased doses of anesthetic drugs to reduce laryngeal mask airway (LMA) stimulation poses challenges due to the increased risk of hypotension, respiratory depression, susceptibility to hypoxemia, and carbon dioxide retention, particularly in the lateral position. ⋯ We used pharyngeal mucosal surface anesthesia and thoracic paravertebral nerve block in combination with remimazolam sedation to provide precise analgesia, moderate sedation, and successful LMA general anesthesia with preservation of spontaneous respiration in patients undergoing thoracoscopic pulmonary wedge resection.
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Anesthesia and analgesia · Aug 2024
A Slow-Exchange Interstitial Fluid Compartment in Volunteers and Anesthetized Patients: Kinetic Analysis and Physiology.
Physiological studies suggest that the interstitial space contains 2 fluid compartments, but no analysis has been performed to quantify their sizes and turnover rates. ⋯ Kinetic analysis supported that Ringer's solution distributes in 2 interstitial compartments with different turnover times. The slow compartment became dominant when large amounts of fluid were infused and during general anesthesia. These findings may explain why fluid accumulates in peripheral tissues during surgery and why infused fluid can remain in the body for several days after general anesthesia.
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Dementia is a prevalent neurological condition, yet the relationship between dementia and general anesthesia remains uncertain. The study aimed to explore the association between general anesthesia and dementia using a nationwide population-based database. ⋯ Neither general anesthesia nor regional anesthesia in hip/knee surgery was associated with dementia. Different numbers and durations of anesthesia exposure showed no significant differences in the odds for dementia.