Latest & greatest articles for anesthesia

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Anesthesia

Clinical anesthesia is used to induce a temporary medical state of controlled unconsciousness, inducing a loss of sensation or awareness. There are three main types of anesthesia:

  • Local and Regional
  • General
  • Sedation

Anesthesia is primarily used during surgical procedures to block pain. While unconscious, blood flow and heart rate is monitored.

Research and development in the use of anesthesia has helped anesthesiologists in the progression of patient safety before and after surgery and medical procedures. The developments and research of anesthesia through the years has massively influences medicine and surgery today.

Case studies and clinical trials help aid researchers in the development of aftercare during postoperative recovery. Research is a vital part in the field of anesthesia, it allows anesthesiologists to improve the delivery of patient safety while unconscious.

Learn more on the emerging technology in anesthesia and the advancements in anesthesia practise by searching Trip.

Top results for anesthesia

1. Effect of bilateral scalp nerve blocks on postoperative pain and discharge times in patients undergoing supratentorial craniotomy and general anesthesia: a randomized-controlled trial (Abstract)

Effect of bilateral scalp nerve blocks on postoperative pain and discharge times in patients undergoing supratentorial craniotomy and general anesthesia: a randomized-controlled trial Post-craniotomy pain is a common clinical issue and its optimal management remains incompletely studied. Utilization of a regional scalp block has the potential advantage of reducing perioperative pain and opioid consumption, thereby facilitating optimal postoperative neurologic assessment. The purpose (...) of this study was to assess the efficacy of regional scalp block on post-craniotomy pain and opioid consumption.We performed a prospective randomized-controlled trial in adults scheduled to undergo elective supratentorial craniotomy under general anesthesia to assess the efficacy of postoperative bilateral scalp block with 0.5% bupivacaine with 1:200,000 epinephrine compared with placebo on postoperative pain and opioid consumption. The primary outcome was the visual analogue scale (VAS) for pain at 24 hr

2020 EvidenceUpdates

2. Dose-Response Study of 4 Weight-Based Phenylephrine Infusion Regimens for Preventing Hypotension During Cesarean Delivery Under Combined Spinal-Epidural Anesthesia (Abstract)

Dose-Response Study of 4 Weight-Based Phenylephrine Infusion Regimens for Preventing Hypotension During Cesarean Delivery Under Combined Spinal-Epidural Anesthesia Prophylactic IV infusion of phenylephrine has been recommended to prevent hypotension during spinal anesthesia for cesarean delivery. However, the optimal infusion dose is unknown. This study aimed to determine the infusion dose of phenylephrine that would be effective in preventing hypotension in 50% (ED50) and 90% (ED90 (...) of no hypotension (defined as a decrease in systolic blood pressure by ≥20% below baseline and to <90 mm Hg) during the interval from the initiation of spinal anesthesia to delivery of the infant. Values for ED50 and ED90 of prophylactic phenylephrine were calculated using probit analysis.Hypotension occurred in 13/20, 8/20, 2/20, and 1/20 patients in the groups that received phenylephrine infusion at 0.25, 0.375, 0.5, or 0.625 µg/kg/min, respectively. The calculated values for ED50 and ED90 were 0.31 (95% CI

2020 EvidenceUpdates

3. Comparison of Intraoperative Sedation With Dexmedetomidine Versus Propofol on Acute Postoperative Pain in Total Knee Arthroplasty Under Spinal Anesthesia: A Randomized Trial (Abstract)

Comparison of Intraoperative Sedation With Dexmedetomidine Versus Propofol on Acute Postoperative Pain in Total Knee Arthroplasty Under Spinal Anesthesia: A Randomized Trial In patients undergoing total knee arthroplasty under spinal anesthesia, we compared the postoperative analgesic effect of intraoperative sedation with dexmedetomidine versus propofol. We hypothesized that sedation with dexmedetomidine would result in lower postoperative opioid analgesic consumption than with propofol.Forty

2020 EvidenceUpdates

4. Checklist for draw-over anaesthetic equipment

in its use and are competent to do so. A self-in?ating bag should be immediately available in any location where anaesthesia is given. A two-bag test should be performed after the breathing system, vaporisers and ventilator have been individually checked. A record should be kept with the anaesthetic machine that these checks have been carried out. The ‘?rst user’ check, after servicing, is especially important and should be recorded. Recommendations 1. The checklist is intended to be used (...) settings where the checklist and guidance may be used are: • Military/defence/disaster relief anaesthesiaAnaesthesia in low and middle-income countries • In the future it is hoped the equipment can be used in the NHS or other modern anaesthetic settings to enable training to take place prior to anaesthesia secondment* *departments of anaesthesia wishing to approve the use of draw-over apparatus on NHS patients should give careful consideration to the governance issues related to their use in place

2020 Association of Anaesthetists of GB and Ireland

5. Network meta-analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia Full Text available with Trip Pro

Network meta-analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia Urinary retention and mortality after open repair of inguinal hernia may depend on the type of anaesthesia. The aim of this study was to investigate possible differences in urinary retention and mortality in adults after Lichtenstein repair under different types of anaesthesia.Systematic searches were conducted in the Cochrane, PubMed and Embase (...) databases, with the last search on 1 August 2018. Eligible studies included adult patients having elective unilateral inguinal hernia repair by the Lichtenstein technique under local, regional or general anaesthesia. Outcomes were urinary retention and mortality, which were compared between the three types of anaesthesia using meta-analyses and a network meta-analysis.In total, 53 studies covering 11 683 patients were included. Crude rates of urinary retention were 0·1 (95 per cent c.i. 0 to 0·2) per

2019 EvidenceUpdates

6. Combined spinal-epidural versus spinal anaesthesia for caesarean section. (Abstract)

adequate initial blockade (risk ratio (RR) 0.32, 95% confidence interval (CI) 0.05 to 1.97; 7 studies, 341 women; low-quality evidence). We are uncertain whether having CSE or spinal makes any difference in the number of women requiring supplemental intra-operative analgesia at any time after CSE or spinal anaesthetic insertion (average RR 1.25, 95% CI 0.19 to 8.43; 7 studies, 390 women; very low-quality evidence), or the number of women requiring intra-operative conversion to general anaesthesia (RR (...) Combined spinal-epidural versus spinal anaesthesia for caesarean section. Single-shot spinal anaesthesia (SSS) and combined spinal-epidural (CSE) anaesthesia are both commonly used for caesarean section anaesthesia. Spinals offer technical simplicity and rapid onset of nerve blockade which can be associated with hypotension. CSE anaesthesia allows for more gradual onset and also prolongation of the anaesthesia through use of a catheter.To compare the effectiveness and adverse effects of CSE

2019 Cochrane

7. Association of General Anesthesia vs Procedural Sedation With Functional Outcome Among Patients With Acute Ischemic Stroke Undergoing Thrombectomy: A Systematic Review and Meta-analysis. (Abstract)

Association of General Anesthesia vs Procedural Sedation With Functional Outcome Among Patients With Acute Ischemic Stroke Undergoing Thrombectomy: A Systematic Review and Meta-analysis. General anesthesia during thrombectomy for acute ischemic stroke has been associated with poor neurological outcome in nonrandomized studies. Three single-center randomized trials reported no significantly different or improved outcomes for patients who received general anesthesia compared with procedural (...) sedation.To detect differences in functional outcome at 3 months between patients who received general anesthesia vs procedural sedation during thrombectomy for anterior circulation acute ischemic stroke.MEDLINE search for English-language articles published from January 1, 1980, to July 31, 2019.Randomized clinical trials of adults with a National Institutes of Health Stroke Scale score of at least 10 and anterior circulation acute ischemic stroke assigned to receive general anesthesia or procedural

2019 JAMA

8. Lidocaine 2% with Epinephrine versus Lidocaine 1% with Epinephrine for Patients Requiring Local Anesthesia: Clinical Effectiveness and Guidelines

Lidocaine 2% with Epinephrine versus Lidocaine 1% with Epinephrine for Patients Requiring Local Anesthesia: Clinical Effectiveness and Guidelines Lidocaine 2% with Epinephrine versus Lidocaine 1% with Epinephrine for Patients Requiring Local Anesthesia: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Lidocaine 2% with Epinephrine versus Lidocaine 1% with Epinephrine for Patients Requiring Local Anesthesia: Clinical Effectiveness and Guidelines Lidocaine 2 (...) % with Epinephrine versus Lidocaine 1% with Epinephrine for Patients Requiring Local Anesthesia: Clinical Effectiveness and Guidelines Last updated: May 3, 2019 Project Number: RA1030-000 Product Line: Research Type: Drug Report Type: Reference List Result type: Report Question What is the comparative clinical effectiveness of lidocaine 2% with epinephrine versus lidocaine 1% with epinephrine for patients requiring local anesthesia? What are the evidence-based guidelines regarding the use of lidocaine (1% or 2

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

9. Statement on Environmental Sustainability in Anaesthesia and Pain Medicine Practice

Anaesthesia Agents The contribution of inhalational anaesthetic agents to climate change on the global scale is small, however anaesthetists are uniquely placed in that the choices we make at work can have an impact on our carbon footprint many times greater than that of our other day-to-day activities. The effect of each agent is dependent on its absorption of infrared radiation that would otherwise leave the Earth’s lower atmosphere, the amount used, and its atmospheric lifetime. As they are used (...) , Paulsen W, et al. Greening the Operating Room and Perioperative Arena: Environmental Sustainability for Anesthesia Practice. [Internet]. American Society of Anesthesiologists; [Updated 2017 Jan; cited 2019 Mar 4]. Available from: https://www.asahq.org/about-asa/governance-and-committees/asa-committees/committee-on- equipment-and-facilities/environmental-sustainability. 8. Pungsornruk K, Forbes MP, Hellier C, Bryant M. A renewed call for environmentally responsible anaesthesia. Anaesth Intensive care

2019 Australian and New Zealand College of Anaesthetists

10. Guidelines for crises in anaesthesia - Quick Reference Handbook

potential causative agents and maintain anaesthesia. • Important culprits: antibiotics, neuromuscular blocking agents, patent blue. • Consider chlorhexidine as cause (impregnated catheters, lubricants, cleansing agents). • Consider i.v. colloids as a possible cause. • Change to inhalational anaesthetic agent (if not already). ? Give 100% oxygen and ensure adequate ventilation: • Maintain the airway and, if necessary, secure it with tracheal tube. ? Elevate patient’s legs if there is hypotension (...) by the clinician in the light of the clinical data presented and the diagnostic and treatment options 3-11 High central neuraxial block v.1 • Can occur with deliberate or accidental injection of local anaesthetic drugs into the subarachnoid space. • Symptoms are – in sequence – hypotension and bradycardia – difficulty breathing – paralysis of the arms – impaired consciousness – apnoea and unconsciousness. • Progression through this sequence can be slow or fast. Box A: INDUCING ANAESTHESIA • Consider reduced

2019 Association of Anaesthetists of GB and Ireland

11. Regional or General Anesthesia in the Surgical Treatment of Distal Radial Fractures: A Randomized Clinical Trial (Abstract)

Regional or General Anesthesia in the Surgical Treatment of Distal Radial Fractures: A Randomized Clinical Trial Most patients undergoing surgery for the treatment of a distal radial fracture are treated in a day-surgery setting and are given either general anesthesia (GA) or regional anesthesia (RA). The main purpose of this study was to investigate the impact of the anesthesia method on patients' postoperative opioid consumption during the first 3 days following surgery.This was a single (...) , maximum pain, postoperative nausea and vomiting, perioperative time consumption (surgical, preoperative, and postoperative anesthesia care time), functional outcomes, and Patient-Rated Wrist Evaluation (PRWE) and EuroQol-5 Dimensions-3 Levels (EQ-5D-3L) scores up to 6 months.The total median OEC during the first 3 postoperative days was 85 mg (range, 0 to 218 mg) in the GA group and 60 mg (range, 3 to 150 mg) in the RA group (p = 0.1). The groups differed significantly in OEC and VAS for pain scores

2019 EvidenceUpdates

12. The Efficacy of Liposomal Bupivacaine Over Traditional Local Anesthetics in Periarticular Infiltration and Regional Anesthesia During Total Knee Arthroplasty: A Systematic Review and Meta-Analysis (Abstract)

The Efficacy of Liposomal Bupivacaine Over Traditional Local Anesthetics in Periarticular Infiltration and Regional Anesthesia During Total Knee Arthroplasty: A Systematic Review and Meta-Analysis Since its Food and Drug Administration approval in 2011 as a local anesthetic for postsurgical analgesia, liposomal bupivacaine (LB) has been incorporated into the periarticular injection (PAI) of many knee surgeons. The slow release of this medication from vesicles should significantly extend

2019 EvidenceUpdates

13. Effect of Intravenous Dexamethasone on the Regression of Isobaric Bupivacaine Spinal Anesthesia: A Randomized Controlled Trial (Abstract)

Effect of Intravenous Dexamethasone on the Regression of Isobaric Bupivacaine Spinal Anesthesia: A Randomized Controlled Trial The effect of intravenous dexamethasone on the regression of sensory and motor block after isobaric bupivacaine spinal anesthesia is unknown. We conducted a prospective, double-blind, randomized controlled trial on 60 patients who received intravenously either placebo (group P) or 8-mg dexamethasone (group D) during the intrathecal injection of 12-mg isobaric (...) bupivacaine 0.5%. Primary outcome was the time from bupivacaine injection to regression of 2 dermatomes in relation to the highest dermatome blocked by the spinal local anesthetic. Time to 2-dermatome regression was 85 minutes (74-96 minutes) in group P versus 87 minutes (76-98 minutes) in group D (P = .79).

2019 EvidenceUpdates

14. Combined ultrasound-guided Pecs II block and general anesthesia are effective for reducing pain from modified radical mastectomy Full Text available with Trip Pro

Combined ultrasound-guided Pecs II block and general anesthesia are effective for reducing pain from modified radical mastectomy Purpose: Combined regional and general anesthesia are often used for the management of breast cancer surgery. Thoracic spinal block, thoracic epidural block, thoracic paravertebral block, and multiple intercostal nerve blocks are the regional anesthesia techniques which have been used in breast surgery, but some anesthesiologists are not comfortable because (...) of the complication and side effects. In 2012, Blanco et al introduced pectoralis nerve (Pecs) II block or modified Pecs block as a novel approach to breast surgery. This study aims to determine the effectiveness of combined ultrasound-guided Pecs II block and general anesthesia for reducing intra- and postoperative pain from modified radical mastectomy. Patients and methods: Fifty patients undergoing modified radical mastectomy with general anesthesia were divided into two groups randomly (n=25), to either Pecs

2019 EvidenceUpdates

15. Pain Management for Ambulatory Arthroscopic Anterior Cruciate Ligament Reconstruction: Evidence-Based Recommendations From the Society for Ambulatory Anesthesia (Abstract)

Pain Management for Ambulatory Arthroscopic Anterior Cruciate Ligament Reconstruction: Evidence-Based Recommendations From the Society for Ambulatory Anesthesia Ambulatory arthroscopic anterior cruciate ligament reconstruction is associated with moderate pain, even when nonopioid oral analgesics such as acetaminophen and nonsteroidal anti-inflammatory drugs are used. Regional analgesia can supplement nonopioid oral analgesics and reduce postoperative opioid requirements, but the choice (...) , clinicians might use adductor canal block or femoral nerve block (weak recommendation, weak level of evidence). These recommendations have been endorsed by the Society of Ambulatory Anesthesia and approved by its board of directors.

2019 EvidenceUpdates

16. Obstetric Analgesia and Anesthesia

Obstetric Analgesia and Anesthesia Sign In (ACOG) Sign in to your ACOG account Email is required. Please enter valid Email. was not found in our system. Would you like to associated with your account? Forgot your email address? JSOG Member? © 2019 - American College of Obstetricians and Gynecologists

2019 American College of Obstetricians and Gynecologists

17. Safe provision of anaesthesia in magnetic resonance units

andtheCounciloftheNeuroAnaesthesiaandCriticalCareSocietyofGreatBritainandIreland(NACCSGBI).Ithasbeen endorsed by the Safe Anaesthesia Liaison Group, the Royal College of Anaesthetists, the Association of Paediatric Anaesthetists of Great Britain and Ireland, the Society of British Neurosurgical Surgeons, the Royal College of RadiologistsandtheSocietyofAnaesthetistsinRadiology. Dateofnextreview:2023 Whatotherguidelinesandstatements areavailableonthistopic? The?rstAssociationofAnaesthetistsguidelineonprovision of anaesthetic services in magnetic resonance (MR) units (...) are essential. The increasing need for anaesthesia within the MR environmentmeansthatmoreanaesthetistswillbeinvolved in providing this service. When new procedures are planned, it is essential that the anaesthetic department is involvedinanydevelopmentoftheservice. The aim of this document is to update the guidelines published by the Association of Anaesthetists in 2002 and 2010[1,2],andtoofferpracticalsupportfortheprovisionof safeanaesthesiawithintheMRscanner. Hazards Magnetic resonance imaging is based

2019 Association of Anaesthetists of GB and Ireland

18. Concise practice guidance on the prevention and management of accidental awareness during general anaesthesia

organisational factors such as overbooked or reorganised surgical lists) and highlight these at the WHO premeet/team brief 5. During induction of anaesthesia, practitioners should adhere to suitable dosing of intravenous agent, check anaesthetic effect before paralysis or instrumentation of the airway and maintain anaesthetic administration, including during transfer of patients (which is facilitated by a simple ABCDE checklist) 6. If AAGA is suspected during maintenance (e.g., by patient movement), prompt (...) to consent [11]. This section incorporates that new evidence, and extends the results of NAP5 to focus specifically on the AAGA-related aspects of consent. There are two guiding principles: (a) to provide information on risk, its mitigation and use of appropriate monitoring, and allay anxieties about AAGA; (b) to offer a choice of anaesthetic technique, where possible.5 Association of Anaesthetists Association of Anaesthetists 5 Pre-hospital information (pre-assessment clinic) General anaesthesia

2019 Association of Anaesthetists of GB and Ireland

19. Effect of Local Anesthetic Versus Botulinum Toxin-A Injections for Myofascial Pain Disorders: A Systematic Review and Meta-Analysis (Abstract)

Effect of Local Anesthetic Versus Botulinum Toxin-A Injections for Myofascial Pain Disorders: A Systematic Review and Meta-Analysis Myofascial pain is a chronic pain disorder characterized by the presence of painful localized regions of stiff muscle and/or myofascial trigger points. Intramuscular myofascial trigger point injections are considered first-line treatments for myofascial pain. Common injectates include local anesthetics and botulinum toxin-A (BTX-A). The objective of this systematic (...) review was to compare the effectiveness of local anesthetics and BTX-A on pain intensity in patients with myofascial pain.A comprehensive systematic search of 3 databases, EMBASE, CENTRAL, and Medline was conducted. The search was comprised of words to describe "myofascial pain" and "injections." We performed a meta-analysis comparing local anesthetic and BTX-A injections across these follow-up week periods: 0 (immediately following the injection), 1 to 2, 3 to 4, 5 to 6, 7 to 8, 9 to 10, 11 to 12

2019 EvidenceUpdates

20. Dexmedetomidine as an Adjuvant to Local Anesthetics in Transversus Abdominis Plane Block: A Systematic Review and Meta-analysis Full Text available with Trip Pro

Dexmedetomidine as an Adjuvant to Local Anesthetics in Transversus Abdominis Plane Block: A Systematic Review and Meta-analysis The objective of this meta-analysis was to evaluate the analgesic effects of dexmedetomidine (DEX) in transversus abdominis plane (TAP) blocks for abdominal surgery.Electronic databases, including PubMed, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Wan Fang, and the Cochrane Library, were conducted to collect the randomized controlled trials (RCTs) from (...) inception to March 2018. RCTs investigating the impact of adding DEX to local anesthetics for TAP blocks were included in this analysis. Pain scores (at rest and movement), opioid consumption, the duration of the TAP block and the common adverse effects were analyzed.Twenty published trials including 1212 patients met the inclusion criteria. The addition of DEX significantly reduced pain scores 8 hours postoperatively at rest (WMD, -0.78; 95% CI, -1.27 to -0.30; P=0.001), 4 hours postoperatively

2019 EvidenceUpdates