Latest & greatest articles for anesthesia

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This page lists the very latest high quality evidence on anesthesia and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.

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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

181. A comparison of liver function after hepatectomy with inflow occlusion between sevoflurane and propofol anesthesia (PubMed)

A comparison of liver function after hepatectomy with inflow occlusion between sevoflurane and propofol anesthesia In this study, we compared liver function tests after hepatectomy with inflow occlusion as a function of propofol versus sevoflurane anesthesia.One hundred patients undergoing elective liver resection with inflow occlusion were randomized into a sevoflurane group or a propofol group. General anesthesia was induced with 3 μg/kg fentanyl, 0.2 mg/kg cisatracurium, and target (...) -controlled infusion of propofol, set at a plasma target concentration of 4 to 6 μg/mL, or sevoflurane initially started at 8%. Anesthesia was maintained with target-controlled infusion of propofol (2-4 μg/mL) or sevoflurane (1.5%-2.5%). The primary end point was postoperative liver injury assessed by peak values of liver transaminases.Transaminase levels peaked between the first and the third postoperative day. Peak alanine aminotransferase was 504 and 571 U/L in the sevoflurane group and the propofol

2010 EvidenceUpdates

182. Effect of thoracic epidural anesthesia with different concentrations of ropivacaine on arterial oxygenation during one-lung ventilation (PubMed)

Effect of thoracic epidural anesthesia with different concentrations of ropivacaine on arterial oxygenation during one-lung ventilation Thoracic epidural anesthesia can contribute to facilitate the fast-track approach in lung surgery. However, data regarding the effects of thoracic epidural anesthesia on oxygenation during one-lung ventilation (OLV) are scarce and contradictory. Therefore, the authors conducted a prospective, randomized, double-blinded trial in patients undergoing lung surgery (...) under spectral entropy-guided intravenous anesthesia to evaluate the effects of thoracic epidural anesthesia with different concentrations of ropivacaine on oxygenation, shunt fraction (Qs/Qt) during OLV, and maintenance doses of propofol.One hundred twenty patients scheduled for lung surgery were randomly divided into four groups to epidurally receive saline (Group S), 0.25% (Group R0.25), 0.50% (Group R0.50), and 0.75% (Group R0.75) ropivacaine. Ropivacaine was administered intraoperatively (6-8

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2010 EvidenceUpdates

183. Brief reports: paravertebral block for anesthesia: a systematic review (PubMed)

Brief reports: paravertebral block for anesthesia: a systematic review The objective of this review was to assess the safety and efficacy of thoracic and lumbar paravertebral blocks (PVBs) for surgical anesthesia through a systematic review of the peer-reviewed literature. PVBs for surgical anesthesia were compared with general anesthesia (GA) or other regional anesthetic techniques.We searched literature databases including MEDLINE, EMBASE, and The Cochrane Library up to May 2008. Included (...) studies were limited to eligible randomized controlled trials. Eight randomized controlled trials were included in this review, 6 of which used PVBs for anesthesia during breast surgery, and 2 trials used PVB for anesthesia during herniorrhaphy.The ability to obtain firm conclusions was limited by the diversity of outcomes and how they were measured, which varied across studies. The PVB failure rate was not >13%, and patients were more satisfied with PVB than with GA. There was some indication

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2010 EvidenceUpdates

184. Comparison of safety and clinical and radiographic outcomes in endovascular acute stroke therapy for proximal middle cerebral artery occlusion with intubation and general anesthesia versus the nonintubated state (PubMed)

Comparison of safety and clinical and radiographic outcomes in endovascular acute stroke therapy for proximal middle cerebral artery occlusion with intubation and general anesthesia versus the nonintubated state There is considerable heterogeneity in practice patterns between sedation in the intubated state vs nonintubated state during endovascular acute stroke therapy. We sought to compare clinical and radiographic outcomes between these 2 sedation modalities.Consecutive patients with acute

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2010 EvidenceUpdates

185. The ability of pleth variability index to predict the hemodynamic effects of positive end-expiratory pressure in mechanically ventilated patients under general anesthesia (PubMed)

The ability of pleth variability index to predict the hemodynamic effects of positive end-expiratory pressure in mechanically ventilated patients under general anesthesia Pleth variability index (PVI) is a new algorithm allowing automated and continuous monitoring of respiratory variations in the pulse oximetry plethysmographic waveform amplitude. PVI can predict fluid responsiveness noninvasively in mechanically ventilated patients during general anesthesia. We hypothesized that PVI could

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2010 EvidenceUpdates

186. Comparison of single-use and reusable metal laryngoscope blades for orotracheal intubation during rapid sequence induction of anesthesia (PubMed)

Comparison of single-use and reusable metal laryngoscope blades for orotracheal intubation during rapid sequence induction of anesthesia Single-use metal laryngoscope blades are cheaper and carry a lower risk of infection than reusable metal blades. The authors compared single-use and reusable metal blades during rapid sequence induction of anesthesia in a multicenter cluster randomized trial.One thousand seventy-two adult patients undergoing general anesthesia under emergency conditions (...) statistical significance, although the same trend was noted (6.8% vs. 11.5%, P = not significant). An investigator survey and a measure of illumination pointed that illumination might have been responsible for this result.The single-use metal blade was more efficient than a reusable metal blade in rapid sequence induction of anesthesia.

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2010 EvidenceUpdates

187. Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia (PubMed)

Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia Midazolam has only sedative properties. However, dexmedetomidine has both analgesic and sedative properties that may prolong the duration of sensory and motor block obtained with spinal anesthesia. This study was designed to compare intravenous dexmedetomidine with midazolam and placebo on spinal block duration, analgesia, and sedation in patients undergoing transurethral resection of the prostate.In (...) this double-blind randomized placebo-controlled trial, 75 American Society of Anesthesiologists' I and II patients received dexmedetomidine 0.5 microg . kg(-1), midazolam 0.05 mg . kg(-1), or saline intravenously before spinal anesthesia with bupivacaine 0.5% 15 mg (n = 25 per group). The maximum upper level of sensory block and sensory and motor regression times were recorded. Postoperative analgesic requirements and sedation were also recorded.Sensory block was higher with dexmedetomidine (T 4.6 +/- 0.6

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2010 EvidenceUpdates

188. Preload or coload for spinal anesthesia for elective Cesarean delivery: a meta-analysis (PubMed)

Preload or coload for spinal anesthesia for elective Cesarean delivery: a meta-analysis Hypotension following spinal anesthesia for Cesarean delivery is common. Fluid loading is recommended to prevent hypotension, but preload is often ineffective. In non-pregnant patients, coloading has been shown to better maintain cardiac output after spinal anesthesia. The purpose of this meta-analysis was to determine whether the timing of the fluid infusion, before (preload) or during (coload) induction (...) of spinal anesthesia for Cesarean delivery, influences the incidence of maternal hypotension or neonatal outcome.We retrieved randomized controlled trials that compared a fluid preload with coload in patients undergoing spinal anesthesia for elective Cesarean delivery. We graded the articles for quality of reporting (maximum score = 5) and recorded the incidence of hypotension, lowest blood pressure, the incidence of maternal nausea and vomiting, umbilical cord pH, and Apgar scores. We combined

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2010 EvidenceUpdates

189. A randomized, dose-response study of sugammadex given for the reversal of deep rocuronium- or vecuronium-induced neuromuscular blockade under sevoflurane anesthesia (PubMed)

A randomized, dose-response study of sugammadex given for the reversal of deep rocuronium- or vecuronium-induced neuromuscular blockade under sevoflurane anesthesia Sugammadex is the first of a new class of selective muscle relaxant binding drugs developed for the rapid and complete reversal of neuromuscular blockade induced by rocuronium and vecuronium. Many studies have demonstrated a dose-response relationship with sugammadex for reversal of neuromuscular blockade in patients induced (...) and maintained under propofol anesthesia. However, sevoflurane anesthesia, unlike propofol, can prolong the effect of neuromuscular blocking drugs (NMBDs) such as rocuronium and vecuronium.We designed this randomized, open-label, dose-response trial to explore the dose-response relationship of sugammadex for the reversal of deep neuromuscular blockade induced by rocuronium or vecuronium under propofol-induced and sevoflurane-maintained anesthesia. As a secondary objective, the safety variables of sugammadex

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2010 EvidenceUpdates

190. Monitored anesthesia care with dexmedetomidine: a prospective, randomized, double-blind, multicenter trial (PubMed)

Monitored anesthesia care with dexmedetomidine: a prospective, randomized, double-blind, multicenter trial Dexmedetomidine (DEX) is increasingly being used as a sedative for monitored anesthesia care (MAC) because of its analgesic properties, "cooperative sedation," and lack of respiratory depression. In this randomized, multicenter, double-blind, Phase III Food and Drug Administration study, we evaluated the safety and efficacy of two doses of DEX for sedation of patients undergoing a broad

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2010 EvidenceUpdates

191. The effects of crystalloid and colloid preload on cardiac output in the parturient undergoing planned cesarean delivery under spinal anesthesia: a randomized trial (PubMed)

The effects of crystalloid and colloid preload on cardiac output in the parturient undergoing planned cesarean delivery under spinal anesthesia: a randomized trial Hypotension after spinal anesthesia for cesarean delivery remains a major clinical problem. Fluid preloading regimens together with vasopressors have been used to reduce its incidence. Previous studies have used noninvasive arterial blood pressure measurement and vasopressor requirements to evaluate the effect of preload. We used (...) a suprasternal Doppler flow technique to measure maternal cardiac output (CO) and corrected flow time (FTc, a measure of intravascular volume) before and after spinal anesthesia after 3 fluid preload regimens. We hypothesized that colloid solutions, compared with crystalloid, would produce the largest increase in CO and have the lowest incidence of hypotension.Sixty healthy term women scheduled for planned cesarean delivery under spinal anesthesia were recruited for this randomized, double-blind study

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2010 EvidenceUpdates

192. The Cardiopulmonary Consequences of the Trendelenburg Position in Patients Under General Anesthesia

The Cardiopulmonary Consequences of the Trendelenburg Position in Patients Under General Anesthesia "The Cardiopulmonary Consequences of the Trendelenburg Position in Pati" by Aaron T. Carter < > > > > > Title Author Date of Graduation 8-14-2010 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies First Advisor Rob Rosenow, PharmD, OD Second Advisor Annjanette Sommers MS, PAC Rights . Abstract Background: Acute hypotension has been treated (...) was conducted to identify pertinent articles. The inclusionary criteria were, the use of HDT of greater than, or equal 10̊, and patients under general anesthesia. Results: Six articles were identified and critically appraised. The data compiled in this systematic review suggest there is an increase in cardiac preload with no consequent increase in cardiac output or performance. The data suggest there are multiple negative consequences of HDT on pulmonary function including a decrease of functional residual

2010 Pacific University EBM Capstone Project

193. The impact of general and regional anesthesia on the incidence of post-operative cognitive dysfunction and post-operative delirium: a systematic review with meta-analysis

The impact of general and regional anesthesia on the incidence of post-operative cognitive dysfunction and post-operative delirium: a systematic review with meta-analysis The impact of general and regional anesthesia on the incidence of post-operative cognitive dysfunction and post-operative delirium: a systematic review with meta-analysis The impact of general and regional anesthesia on the incidence of post-operative cognitive dysfunction and post-operative delirium: a systematic review (...) for research. Funding Not reported. Bibliographic details Mason SE, Noel-Storr A, Ritchie CW. The impact of general and regional anesthesia on the incidence of post-operative cognitive dysfunction and post-operative delirium: a systematic review with meta-analysis. Journal of Alzheimer's Disease 2010; 22(Supplement 3): S67-S79 PubMedID DOI Original Paper URL Indexing Status Subject indexing assigned by NLM MeSH Aged; Anesthesia, Conduction /adverse effects; Anesthesia, General /adverse effects; Anesthetics

2010 DARE.

194. A greater incidence of post local anesthesia soft tissue trauma occurs in children less than 4 years of age compared to other children.

A greater incidence of post local anesthesia soft tissue trauma occurs in children less than 4 years of age compared to other children. UTCAT622, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title A Greater Incidence Of Post Local Anesthesia Soft Tissue Trauma Occurs In Children Less Than 4 Years Of Age Compared To Other Children Clinical Question What is the incidence of post local anesthesia and post operative soft (...) -procedural pain at 3 and 5 hours post-treatment. Evidence Search anesthesia, dental/adverse effects AND anesthetics, local/administration & dosage, AND postoperative complications AND mouth injuries Comments on The Evidence College studied 320 patients from ages 2-18. The patients received either a unilateral or bilateral mandibular nerve block injection and were being seen for routine operative cases. Adewumi phoned two hundred four patient interviews to determine the adverse effects of 4% septicane

2010 UTHSCSA Dental School CAT Library

195. Role of Phentolamine Mesylate in Reversal of Local Anesthesia for Adult Patients

Role of Phentolamine Mesylate in Reversal of Local Anesthesia for Adult Patients UTCAT487, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Role of Phentolamine Mesylate in Reversal of Local Anesthesia for Adult Patients Clinical Question Does phentolamine induce reversal of soft-tissue local anesthesia faster than no treatment? Clinical Bottom Line Phentolamine injection decreases the duration of soft-tissue local (...) anesthesia. (See Comments on the CAT below) Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Hersh/2008 484 subjects received local anesthesia for restorative or scaling procedures. After completion of the procedures, randomized subjects received either an injection of phentolamine or a sham injection (an injection where the needle does not penetrate the soft tissue) at the same site as the local anesthetic

2010 UTHSCSA Dental School CAT Library

196. Preload or coload for spinal anesthesia for elective cesarean delivery: a meta-analysis

Preload or coload for spinal anesthesia for elective cesarean delivery: a meta-analysis Preload or coload for spinal anesthesia for elective cesarean delivery: a meta-analysis Preload or coload for spinal anesthesia for elective cesarean delivery: a meta-analysis Banerjee A, Stocche RM, Angle P, Halpern SH CRD summary The review found that in women who underwent elective caesarean delivery under spinal anaesthesia, the timing of fluid loading did not affect the incidence of hypotension (...) for unpublished data was conducted with C . Search terms were reported. The reviewers checked reference lists of reviews and randomised controlled trials (RCT) retrieved and searched published abstracts from meetings of American Society of Anesthesiologists , Society of Obstetric Anesthesia and Perinatology and European Society of Anaesthesia from 2000 to 2009. Study selection RCTs that compared fluid administration before induction of spinal anaesthesia (preloading) in women scheduled for elective Caesarean

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2010 DARE.

197. A randomized comparison of low doses of hyperbaric bupivacaine in combined spinal-epidural anesthesia for cesarean delivery (PubMed)

A randomized comparison of low doses of hyperbaric bupivacaine in combined spinal-epidural anesthesia for cesarean delivery The aim of our study was to investigate the block characteristics of intrathecal hyperbaric bupivacaine 7, 8, or 9 mg administered during combined spinal-epidural anesthesia for cesarean delivery and to elucidate the dose that produces adequate sensory blockade for surgery while minimizing the incidence of hypotension, high neuroblockade, and the need for intraoperative (...) epidural supplementation.Sixty women presenting for elective cesarean delivery were randomly assigned to one of the 3 groups. Group 7 received intrathecal hyperbaric bupivacaine 7 mg, Group 8 received 8 mg, and Group 9 received 9 mg. Women in all 3 groups received intrathecal morphine 100 microg and IV hydroxyethyl starch 15 mL/kg at the time of initiation of combined spinal-epidural anesthesia. Surgery began when a sensory level of T4 was achieved. Patients were monitored for block characteristics

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2010 EvidenceUpdates

198. The effect of stimulating versus nonstimulating catheter techniques for continuous regional anesthesia: a semiquantitative systematic review

The effect of stimulating versus nonstimulating catheter techniques for continuous regional anesthesia: a semiquantitative systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2010 DARE.

199. Morphine-based cardiac anesthesia provides superior early recovery compared with fentanyl in elective cardiac surgery patients (PubMed)

Morphine-based cardiac anesthesia provides superior early recovery compared with fentanyl in elective cardiac surgery patients Experimental and clinical data suggest that morphine possesses unique cardioprotective and antiinflammatory properties. In this clinical investigation, we sought to determine whether the choice of intraoperative opioid (morphine or fentanyl) influences early recovery after cardiac surgery.Ninety patients undergoing cardiac surgery with cardiopulmonary bypass were

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2009 EvidenceUpdates

200. Reversal of neuromuscular blockade by sugammadex after continuous infusion of rocuronium in patients randomized to sevoflurane or propofol maintenance anesthesia (PubMed)

Reversal of neuromuscular blockade by sugammadex after continuous infusion of rocuronium in patients randomized to sevoflurane or propofol maintenance anesthesia Sugammadex rapidly reverses neuromuscular blockade induced by bolus rocuronium doses, but it has not been investigated after continuous rocuronium infusion in surgical patients. We therefore examined the clinical effect of sugammadex for neuromuscular blockade induced by continuous rocuronium infusion in adults undergoing surgery under (...) maintenance anesthesia with sevoflurane or propofol.This four-center, comparative, parallel-group study, randomly assigned 52 adult patients (American Society of Anesthesiologists Class I-III) to maintenance anesthesia with sevoflurane or propofol. Neuromuscular blockade was induced by bolus injection of 0.6 mg/kg rocuronium followed by continuous infusion of 7 microg x kg(-1) x min(-1) rocuronium adjusted to maintain a neuromuscular blockade depth of zero response to train-of-four and a posttetanic count

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2009 EvidenceUpdates