{"title":"Acute perioperative neurological emergencies.","authors":"Michelle S H Lam, Astri M V Luoma, Ugan Reddy","doi":"10.1097/AIA.0000000000000404","DOIUrl":"https://doi.org/10.1097/AIA.0000000000000404","url":null,"abstract":"Perioperative neurological complications can be a result of anesthesia or surgical procedures. Both surgery and anesthesia increases the risk of neurological sequelae due to ischemia, hemorrhage, hypoxia, or metabolic disorder (Table 1). The impact can be devastating, leading to morbidity, increased length of stay, impaired quality of life, and mortality. During anesthesia, there is no standard monitoring for the neurological system compared with other organs (eg, electrocardiograph and blood pressure for the cardiovascular system, pulse oximetry, and capnography for the respiratory system). When patients present with neurological signs and symptoms perioperatively, early assessment and imaging is needed to facilitate prompt diagnosis and management. This article will provide an overview of common neurological complications in the perioperative period. To cover details of all neurological emergencies will be beyond the scope of this article. We will focus on common emergencies in general surgery with a brief discussion of neurological complications in specific surgical populations. The common presentation of these complications will be explored, followed by the diagnosis and management of these pathologies.","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"61 3","pages":"53-63"},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10429524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Airway management pearls in cervical spine disorders.","authors":"Kiran Jangra, Girija Prasad Rath","doi":"10.1097/AIA.0000000000000405","DOIUrl":"https://doi.org/10.1097/AIA.0000000000000405","url":null,"abstract":"Cervical spine (C-spine) pathologies that can cause compression on the spinal cord include acute trauma, congenital","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"61 3","pages":"44-52"},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10429528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Geraldine Raphaela B Jose, Gerardo D Legaspi, Mark Gibson D Ibale, Alec Brandon C Duñgo
{"title":"Awake craniotomy: nuts and bolts.","authors":"Geraldine Raphaela B Jose, Gerardo D Legaspi, Mark Gibson D Ibale, Alec Brandon C Duñgo","doi":"10.1097/AIA.0000000000000408","DOIUrl":"https://doi.org/10.1097/AIA.0000000000000408","url":null,"abstract":"","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"61 3","pages":"8-12"},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10449889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Trauma","authors":"L. Maerz, K. Davis, S. Rosenbaum","doi":"10.1097/AIA.0b013e3181950030","DOIUrl":"https://doi.org/10.1097/AIA.0b013e3181950030","url":null,"abstract":"The June 2023 Trauma Roundup360 looks at: Aspirin or low-molecular-weight heparin for thromboprophylaxis?; Lateral plating or retrograde nailing for distal femur fractures?; Sciatic nerve palsy after acetabular fixation: what about patient position?; How reliable is the new OTA/AO classification for trochanteric hip fractures?; Young hip fractures: is a medial buttress the answer?; When is the best time to ‘flap’ an open fracture?; The mortality burden of nonoperatively managed hip fractures.","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"47 1","pages":"25-36"},"PeriodicalIF":0.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/AIA.0b013e3181950030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42364647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Geriatric surgery centers: the way forward.","authors":"Angela M Bader","doi":"10.1097/AIA.0000000000000390","DOIUrl":"https://doi.org/10.1097/AIA.0000000000000390","url":null,"abstract":"","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"61 2","pages":"55-61"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10064096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Polypharmacy in older surgical patients: practical steps for managing perioperative medications.","authors":"Rebecca M Gerlach, Christina C Kim","doi":"10.1097/AIA.0000000000000395","DOIUrl":"https://doi.org/10.1097/AIA.0000000000000395","url":null,"abstract":"The likelihood of developing a medical condition requiring pharmacologic therapy increases with age. Older patients frequently take multiple medications, including prescription, over-the-counter (OTC) or complementary medicines, often termed polypharmacy. The average age of surgical patients is older than that of the general population, 1 so encountering polypharmacy perioperatively is common. In a South Korean review of 7.36 million patients in the National Health Insurance claims database, 36.9% of patients over the age of 65 used ≥ 5 prescription medications, while 7.1% used 10 or more medications. 2 In the United States, examination of the National Ambulatory Medical Care Survey revealed a point prevalence of polypharmacy ( ≥ 5 medications) of 44% in community-dwelling patients 65 years or older who did not have dementia, and 72% in those who did have dementia. 3 In a Danish population, the broader issues of potentially inappropriate medication (PIM) use was examined through a population-based register. 4 PIM can include inappropriate drug choice, polypharmacy, or potential drug-drug interactions, but generally refers to medications that should be avoided in older people due to the potential risks outweighing the bene fi ts. Although the use of PIM decreased from 2000 to 2015 (from 54.7% to 43.5% in people with dementia and from 39.5% to 28.8% in people without dementia), there remained a high prevalence of potentially inappropriate prescribing practices, including in patients with dementia. 4 While the term polypharmacy indicates the administration of multiple medications in a patient, there is no consensus de fi nition. A systematic review of polypharmacy de fi nitions categorized them as “ (1) numerical only (using the number of medications to de fi ne polypharmacy), (2) numerical with an associated duration of therapy or health care setting (such as during hospital stay), or (3) descriptive (using a brief description to de fi ne polypharmacy).","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"61 2","pages":"16-22"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9120497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ellene Yan, David He, Tarek K Rajji, Frances Chung
{"title":"Cognitive impairment and its adverse outcomes in older surgical patients: an under-recognized problem!","authors":"Ellene Yan, David He, Tarek K Rajji, Frances Chung","doi":"10.1097/AIA.0000000000000392","DOIUrl":"https://doi.org/10.1097/AIA.0000000000000392","url":null,"abstract":"The older population, aged 65 years or older, is projected to nearly triple from 524 million in 2010 to 1.5 billion by 2050, representing 8.5% to 16.7% of the global population, respectively. 1 This increase is particularly pronounced in comparison to the trend of the younger population aged 20 years or below, which is estimated to remain relatively static from 2.5 billion in 2015 to 2.6 billion in 2050. With the increase in life expectancy, the number of individuals with cognitive impairment (CI) has increased by 117% in the last 25 years. 2 It will continue to increase with the aging forecast. The susceptibility of older individuals to develop CI partly derives from the complexity of the aging process. Aging involves in fl ammatory and physiological changes across multiple organ systems including the brain, ren-dering the older population more vulnerable and less resilient to future in fl ammatory insults. 3 Globally, 313 million surgeries are performed with 4 million postoperative deaths and","PeriodicalId":46852,"journal":{"name":"INTERNATIONAL ANESTHESIOLOGY CLINICS","volume":"61 2","pages":"23-28"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10077396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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