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

161. Utilization of anesthesia services during outpatient endoscopies and colonoscopies and associated spending in 2003-2009. (PubMed)

Utilization of anesthesia services during outpatient endoscopies and colonoscopies and associated spending in 2003-2009. The frequency with which anesthesiologists or nurse anesthetists provide sedation for gastrointestinal endoscopies, especially for low-risk patients, is poorly understood and controversial.To quantify temporal comparisons and regional variation in the use of and payment for gastroenterology anesthesia services.A retrospective analysis of claims data for a 5% representative (...) sample of Medicare fee-for-service patients (1.1 million adults) and a sample of 5.5 million commercially insured patients between 2003 and 2009.Total number of upper gastrointestinal endoscopies and colonoscopies, proportion of gastroenterology procedures with associated anesthesia claims, payments for gastroenterology anesthesia services, and proportion of services and spending for gastroenterology anesthesia delivered to low-risk patients (American Society of Anesthesiologists physical status

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2012 JAMA

162. Effects of sitting up for five minutes versus immediately lying down after spinal anesthesia for Cesarean delivery on fluid and ephedrine requirement; a randomized trial (PubMed)

Effects of sitting up for five minutes versus immediately lying down after spinal anesthesia for Cesarean delivery on fluid and ephedrine requirement; a randomized trial Patient position after spinal anesthesia has had variable effects on blood pressure and ephedrine requirements. The aim of this study was to determine the effects that sitting the patient up for five minutes after spinal anesthesia would have on intraoperative fluid and ephedrine requirements.The study included 120 women (...) at term gestation who were scheduled for Cesarean delivery under spinal anesthesia. After anesthetic administration, the women were randomized either to sit up for five minutes then lie down (Group S) or to lie down immediately (Group L) to a tilted supine position. A blinded observer recorded sensory block level, systolic blood pressure, heart rate, ephedrine and fluid requirements, adverse events, and time to motor recovery (modified Bromage score of 2).Group S had a lower intraoperative sensory

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2012 EvidenceUpdates

163. Effect of regional anesthesia on the success rate of external cephalic version: a systematic review and meta-analysis (PubMed)

Effect of regional anesthesia on the success rate of external cephalic version: a systematic review and meta-analysis To estimate whether the use of regional anesthesia is associated with increased success of external cephalic version.We searched MEDLINE, EMBASE, the Cochrane Library, and clinical trial registries.Electronic databases were searched from 1966 through April 2011 for published, randomized controlled trials in the English language comparing regional anesthesia with no regional (...) anesthesia for external cephalic version. The primary outcome was external cephalic version success. Secondary outcomes included cesarean delivery, maternal discomfort, and adverse events. Pooled risk ratios (relative risk) were calculated using a random-effects model. Heterogeneity was assessed using the Cochran's Q statistic and quantified using the I Z method.Six randomized controlled trials met criteria for study inclusion. Regional anesthesia was associated with a higher external cephalic version

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2012 EvidenceUpdates

164. Malignant disease within 5 years after surgery in relation to duration of sevoflurane anesthesia and time with bispectral index under 45 (PubMed)

Malignant disease within 5 years after surgery in relation to duration of sevoflurane anesthesia and time with bispectral index under 45 Surgery, general anesthesia, and related events have been implicated to promote cancer proliferation. We investigated the incidence of cancer within 5 years after surgery in relation to duration of anesthesia (T(ANESTH)) and also by time with bispectral index (BIS) under 45 (T(BIS<45)) serving as a proxy for more profound anesthesia exposure.New malignant (...) diagnoses after surgery under sevoflurane anesthesia were obtained in a prospective cohort of 2972 BIS-monitored patients without any clinically diagnosed malignant disease at the time of index surgery. The risk of cancer during follow-up in relation to T(ANESTH) and T(BIS<45) was assessed by Cox regression. The cancer incidence in this surgical population was compared with the incidence in a standardized general population by calculation of standard incidence ratio.One hundred twenty-nine patients (4.3

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2012 EvidenceUpdates

165. Meta-analysis of thoracic epidural anesthesia versus general anesthesia for cardiac surgery

Meta-analysis of thoracic epidural anesthesia versus general anesthesia for cardiac surgery Meta-analysis of thoracic epidural anesthesia versus general anesthesia for cardiac surgery Meta-analysis of thoracic epidural anesthesia versus general anesthesia for cardiac surgery Svircevic V, van Dijk D, Nierich AP, Passier MP, Kalkman CJ, van der Heijden GJ, Bax L CRD summary The review found that thoracic epidural analgesia with general anaesthesia in patients who underwent cardiac surgery reduced (...) Heijden GJ, Bax L. Meta-analysis of thoracic epidural anesthesia versus general anesthesia for cardiac surgery. Anesthesiology 2011; 114(2): 271-282 PubMedID DOI Original Paper URL Indexing Status Subject indexing assigned by NLM MeSH Anesthesia, Epidural; Anesthesia, General; Cardiac Surgical Procedures; Humans; Randomized Controlled Trials as Topic; Thoracic Vertebrae AccessionNumber 12011001478 Date bibliographic record published 01/06/2011 Date abstract record published 20/10/2011 Record Status

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2011 DARE.

166. Dreaming in sedation during spinal anesthesia: a comparison of propofol and midazolam infusion. (PubMed)

Dreaming in sedation during spinal anesthesia: a comparison of propofol and midazolam infusion. Although sedation is often performed during spinal anesthesia, the details of intraoperative dreaming have not been reported. We designed this prospective study to compare 2 different IV sedation protocols (propofol and midazolam infusion) with respect to dreaming during sedation.Two hundred twenty adult patients were randomly assigned to 2 groups and received IV infusion of propofol or midazolam (...) for deep sedation during spinal anesthesia. Patients were interviewed on emergence and 30 minutes later to determine the incidence, content, and nature of their dreams. Postoperatively, patient satisfaction with the sedation was also evaluated.Two hundred fifteen patients (108 and 107 in the propofol and midazolam groups, respectively) were included in the final analysis. The proportion of dreamers was 39.8% (43/108) in the propofol group and 12.1% (13/107) in the midazolam group (odds ratio=4.78; 95

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2011 EvidenceUpdates

167. Comparison of bupivacaine and 2-chloroprocaine for spinal anesthesia for outpatient surgery: a double-blind randomized trial (PubMed)

Comparison of bupivacaine and 2-chloroprocaine for spinal anesthesia for outpatient surgery: a double-blind randomized trial We have always been searching for the ideal local anesthetic for outpatient spinal anesthesia. Lidocaine has been associated with a high incidence of transient neurological symptoms, and bupivacaine produces sensory and motor blocks of long duration. Preservative-free 2-chloroprocaine (2-CP) seems to be a promising alternative, being a short-acting agent of increasing (...) popularity in recent years. This study was designed to compare 2-CP with bupivacaine for spinal anesthesia in an elective ambulatory setting.A total of 106 patients were enrolled in this randomized double-blind study. Spinal anesthesia was achieved with 0.75% hyperbaric bupivacaine 7.5 mg (n = 53) or 2% preservative-free 2-CP 40 mg (n = 53). The primary endpoint for the study was the time until reaching eligibility for discharge. Secondary outcomes included the duration of the sensory and motor blocks

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2011 EvidenceUpdates

168. A Double-Blind, Randomized, Multicenter Study of MP4OX for Treatment of Perioperative Hypotension in Patients Undergoing Primary Hip Arthroplasty Under Spinal Anesthesia (PubMed)

A Double-Blind, Randomized, Multicenter Study of MP4OX for Treatment of Perioperative Hypotension in Patients Undergoing Primary Hip Arthroplasty Under Spinal Anesthesia MP4OX (oxygenated polyethylene glycol-modified hemoglobin) is a novel oxygen therapeutic agent specifically developed to perfuse and oxygenate tissue at risk for ischemia and hypoxia. In this study, we investigated the ability of MP4OX to treat hypotensive episodes. In addition, the tolerability profile of MP4OX in a large (...) surgical population was established.Patients from 21 study sites in 5 countries, scheduled to undergo primary hip arthroplasty under spinal anesthesia, were randomized in a double-blind manner to receive MP4OX or hydroxyethyl starch (HES) solution (Voluven®; HES 130/0.4). Patients received the first 250-mL dose of investigational product when systolic blood pressure decreased to the predefined dosing trigger. A second 250-mL dose was given only if the systolic blood pressure decreased to the same

2011 EvidenceUpdates

169. Meta-analysis of thoracic epidural anesthesia versus general anesthesia for cardiac surgery (PubMed)

Meta-analysis of thoracic epidural anesthesia versus general anesthesia for cardiac surgery A combination of general anesthesia (GA) with thoracic epidural anesthesia (TEA) may have a beneficial effect on clinical outcomes after cardiac surgery. We have performed a meta-analysis to compare mortality and cardiac, respiratory, and neurologic complications in patients undergoing cardiac surgery with GA alone or a combination of GA with TEA.Randomized studies comparing outcomes in patients

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2011 EvidenceUpdates

170. Thoracic epidural anesthesia improves early outcomes in patients undergoing off-pump coronary artery bypass surgery: a prospective, randomized, controlled trial (PubMed)

Thoracic epidural anesthesia improves early outcomes in patients undergoing off-pump coronary artery bypass surgery: a prospective, randomized, controlled trial The aim of this two-center, open, randomized, controlled trial was to evaluate the impact of thoracic epidural anesthesia on early clinical outcomes in patients undergoing off-pump coronary artery bypass surgery.Two hundred and twenty-six patients were randomized to either general anesthesia plus epidural (GAE) (n = 109) or general (...) anesthesia only (GA) (n = 117). The primary outcome was length of postoperative hospital stay. Secondary outcomes were: arrhythmia, inotropic support, intubation time, perioperative myocardial infarction, neurologic events, intensive care stay, pain scores, and analgesia requirement.Baseline characteristics were similar in the two groups. One patient died in the GAE group. Median postoperative stay was significantly reduced in the GAE, compared with the GA, group (5 days, interquartile range [5-6] vs. 6

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2011 EvidenceUpdates

171. Low-dose, low-concentration levobupivacaine plus fentanyl selective spinal anesthesia for knee arthroscopy: a dose finding study (PubMed)

Low-dose, low-concentration levobupivacaine plus fentanyl selective spinal anesthesia for knee arthroscopy: a dose finding study Selective sensory spinal anesthesia preserves lower limb motor function and thus facilitates postanesthesia care unit (PACU) bypass and reduces ambulation recovery time.We compared the ambulation time and PACU bypass rate after using 3 low-dose, low-concentration levobupivacaine-fentanyl spinal solutions (5, 4, and 3 mg + 10 μg) in a double-blind study consisting (...) anesthesia with the shortest time to ambulation and the highest PACU bypass rate.

2011 EvidenceUpdates

172. Limited evidence favors articaine over lidocaine for dental local anesthesia of the first molar

Limited evidence favors articaine over lidocaine for dental local anesthesia of the first molar Limited evidence favors articaine over lidocaine for dental local anesthesia of the first molar ADA Websites Access news, member benefits and ADA policy Attend ADA's premier event Access cutting-edge continuing education courses Find evidence to support your clinical decisions Access member-only practice content Investing in better oral health for all. Together. Take advantage of endorsed, discounted (...) over lidocaine for dental local anesthesia of the first molar Arthur Jeske DMD, PhD; James Zahrowski DMD, MS, PharmD . Overview Systematic Review Conclusion Articaine 4%, when compared to Lidocaine 2%, provides more effective local anesthesia in the first molar region for routine dental procedures while demonstrating a similar short-term adverse effect profile. Critical Summary Assessment An appropriately designed and which followed a clear protocol for locating and assessing relevant randomized

2011 ADA Center for Evidence-Based Dentistry

173. Limited evidence favors articaine over lidocaine for dental local anesthesia of the first molar

Limited evidence favors articaine over lidocaine for dental local anesthesia of the first molar Limited evidence favors articaine over lidocaine for dental local anesthesia of the first molar ADA Websites Access news, member benefits and ADA policy Attend ADA's premier event Access cutting-edge continuing education courses Find evidence to support your clinical decisions Access member-only practice content Investing in better oral health for all. Together. Take advantage of endorsed, discounted (...) over lidocaine for dental local anesthesia of the first molar Arthur Jeske DMD, PhD; James Zahrowski DMD, MS, PharmD . Overview Systematic Review Conclusion Articaine 4%, when compared to Lidocaine 2%, provides more effective local anesthesia in the first molar region for routine dental procedures while demonstrating a similar short-term adverse effect profile. Critical Summary Assessment An appropriately designed and which followed a clear protocol for locating and assessing relevant randomized

2011 ADA Center for Evidence-Based Dentistry

174. Limited evidence favors articaine over lidocaine for dental local anesthesia of the first molar

Limited evidence favors articaine over lidocaine for dental local anesthesia of the first molar Limited evidence favors articaine over lidocaine for dental local anesthesia of the first molar ADA Websites Access news, member benefits and ADA policy Attend ADA's premier event Access cutting-edge continuing education courses Find evidence to support your clinical decisions Access member-only practice content Investing in better oral health for all. Together. Take advantage of endorsed, discounted (...) over lidocaine for dental local anesthesia of the first molar Arthur Jeske DMD, PhD; James Zahrowski DMD, MS, PharmD . Overview Systematic Review Conclusion Articaine 4%, when compared to Lidocaine 2%, provides more effective local anesthesia in the first molar region for routine dental procedures while demonstrating a similar short-term adverse effect profile. Critical Summary Assessment An appropriately designed and which followed a clear protocol for locating and assessing relevant randomized

2011 ADA Center for Evidence-Based Dentistry

175. Thoracic epidural anesthesia for cardiac surgery: a randomized trial (PubMed)

Thoracic epidural anesthesia for cardiac surgery: a randomized trial The addition of thoracic epidural anesthesia (TEA) to general anesthesia (GA) during cardiac surgery may have a beneficial effect on clinical outcomes. TEA in cardiac surgery, however, is controversial because the insertion of an epidural catheter in patients requiring full heparinization for cardiopulmonary bypass may lead to an epidural hematoma. The clinical effects of fast-track GA plus TEA were compared with those (...) (P = 0.23). At 1 yr follow-up, survival free from myocardial infarction, pulmonary complications, renal failure, and stroke was 84.6% in the TEA group and 87.2% in the GA group (P = 0.42). Postoperative pain scores were low in both groups.This study was unable to demonstrate a clinically relevant benefit of TEA on the frequency of major complications after elective cardiac surgery, compared with fast-track cardiac anesthesia without epidural anesthesia. Given the potentially devastating

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2011 EvidenceUpdates

176. The dose-dependent effects of phenylephrine for elective cesarean delivery under spinal anesthesia (PubMed)

The dose-dependent effects of phenylephrine for elective cesarean delivery under spinal anesthesia Hypotension is the most common serious side effect of spinal anesthesia for cesarean delivery. There has been a move recently toward the use of phenylephrine as a vasopressor infusion to improve maternal cardiovascular stability and fetal outcome. Although it seems safe in the elective setting, there have been concerns about its propensity for causing an increase in afterload and a baroreceptor (...) to maintain maternal baseline systolic blood pressure (SBP), from induction of spinal anesthesia until delivery. The maternal cardiovascular variables recorded included heart rate (HR) and SBP. A suprasternal Doppler monitor measured CO and stroke volume, as well as measures of venous return (corrected flow time) and contractility, at baseline, and then every 5 minutes for 20 minutes after initiation of spinal anesthesia. Apgar scores and umbilical cord blood gases were recorded.SBP control

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2011 EvidenceUpdates

177. Postoperative Analgesic Effects of Favorite Music After Cesarean Delivery Under General Anesthesia

Postoperative Analgesic Effects of Favorite Music After Cesarean Delivery Under General Anesthesia "Postoperative Analgesic Effects of Favorite Music After Cesarean Deliv" by Harsimranpreet Kaur < > > > > > Title Author Date of Graduation Spring 5-15-2011 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies First Advisor Torry Cobb, DHSc, MPH, PA-C Rights . Abstract Background: This systematic review was designed to evaluate the analgesic effects (...) of patient’s “favorite music.” The music was chosen by the elective cesarean section patient undergoing general anesthesia and it was played during the perioperative period. The review was designed to evaluate the evidence using GRADE and determine the effectiveness of music in reducing the overall pain and opioid usage in postoperative cesarean section patients. Method: The medical literature was exhaustively searched using the keywords listed below. The search was limited to randomized controlled trials

2011 Pacific University EBM Capstone Project

178. American College of Chest Physicians Consensus Statement on the Use of Topical Anesthesia, Analgesia, and Sedation During Flexible Bronchoscopy in Adult Patients

American College of Chest Physicians Consensus Statement on the Use of Topical Anesthesia, Analgesia, and Sedation During Flexible Bronchoscopy in Adult Patients CHEST Consensus Statement 1342 Consensus Statement Executive Summary Performing Bronchoscopy With No Sedation There is an equal safety record of sedation 1. vs no sedation in bronchoscopy, but patients’ satisfaction and procedure tol- erance are signi? cantly improved with sedation. Sedation is suggested in all patients un- 2. dergoing (...) bronchoscopy unless contra- indications exist. The extent of sedation (minimal, mod- 3. erate, deep, or general anesthesia) used during bronchoscopy can vary based on American College of Chest Physicians Consensus Statement on the Use of Topical Anesthesia, Analgesia, and Sedation During Flexible Bronchoscopy in Adult Patients Momen M. W ahidi , MD, MBA, FCCP ; Prasoon Jain , MD, FCCP ; Michael Jantz , MD, FCCP ; Pyng Lee , MD, FCCP ; G. Burkhard Mackensen , MD, PhD ; Sally Y . Barbour , PharmD ; Carla

2011 American College of Chest Physicians

179. Intravenous regional anesthesia: a review of common local anesthetic options and the use of opioids and muscle relaxants as adjuncts

Intravenous regional anesthesia: a review of common local anesthetic options and the use of opioids and muscle relaxants as adjuncts Intravenous regional anesthesia: a review of common local anesthetic options and the use of opioids and muscle relaxants as adjuncts Intravenous regional anesthesia: a review of common local anesthetic options and the use of opioids and muscle relaxants as adjuncts Flamer D, Peng PW CRD summary This review found that ropivacaine was effective for intravenous (...) treatments that could provide effective analgesia after tourniquet removal. Funding Not stated. Bibliographic details Flamer D, Peng PW. Intravenous regional anesthesia: a review of common local anesthetic options and the use of opioids and muscle relaxants as adjuncts. Local and Regional Anesthesia 2011; 4: 57-76 PubMedID DOI Original Paper URL Indexing Status Subject indexing assigned by CRD MeSH Anesthesia, Conduction; Anesthesia, Intravenous; Anesthetics, Local; Humans; Muscle Relaxants, Central

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2011 DARE.

180. Efficacy and safety of clonidine as additive for caudal regional anesthesia: a quantitative systematic review of randomized controlled trials

Efficacy and safety of clonidine as additive for caudal regional anesthesia: a quantitative systematic review of randomized controlled trials 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.

2011 DARE.