Current Opinion in Anesthesiology最新文献_第2页

Coaching in residency training programs: moving toward learner-centered education in anesthesiology. 指导住院医师培训计划：向以学习者为中心的麻醉学教育迈进。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-04-28 DOI: 10.1097/ACO.0000000000001483

Sydney Nykiel-Bailey

{"title":"Coaching in residency training programs: moving toward learner-centered education in anesthesiology.","authors":"Sydney Nykiel-Bailey","doi":"10.1097/ACO.0000000000001483","DOIUrl":"10.1097/ACO.0000000000001483","url":null,"abstract":"Purpose of review: The review provides a comprehensive analysis of coaching within residency training programs, with a focus on examining foundational theoretical frameworks, exploring implementation strategies, and evaluating the impacts on learner competencies and overall well-being. The analysis aims to bridge gaps in the current lack of anesthesiology coaching literature and provide evidence-based insights to optimize the role of coaching in medical education and professional development.Recent findings: Coaching programs emphasize learner-centered education and the facilitation of professional growth. This review examines various coaching models, including communication-focused coaching, near-peer coaching, and the PRACTICE framework. The successful implantation of these models requires tailoring to the learner group to mitigate challenges and optimize acquisition of competencies, such as enhanced technical proficiency and communication skills. Evidence from coaching programs in nonanesthesiology specialties highlights their adaptability and potential applicability to the training of anesthesiology residents.Summary: Coaching programs in medical education show promise for adaption to anesthesiology, addressing its unique demands. Tailored approaches can improve technical skills, communication, and resident well-being. Embedding coaching within competency-based frameworks, tied to milestones and entrustable professional activities supports professional development and educational goals. Successful implantation depends on faculty training, interdepartmental collaboration, and ongoing evaluation, ensuring that coaching programs enhance resident performance and ultimately improve patient outcomes.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"236-241"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recent advancements in fetal anesthesia. 胎儿麻醉的最新进展。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-04-01 DOI: 10.1097/ACO.0000000000001490

Megan Dewey, Preeta George

引用次数: 0

Anesthetic considerations in cancer care. 癌症治疗中的麻醉考虑。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-03-14 DOI: 10.1097/ACO.0000000000001475

Adebukola Owolabi, Edward Tsai

{"title":"Anesthetic considerations in cancer care.","authors":"Adebukola Owolabi, Edward Tsai","doi":"10.1097/ACO.0000000000001475","DOIUrl":"10.1097/ACO.0000000000001475","url":null,"abstract":"Purpose of review: Cancer burden remains a global medical and financial challenge. Advances in surgical management have resulted in increased oncological surgeries that often involve anesthetic administration. This review aims to inform on anesthetic considerations when caring for cancer patients in the perioperative period.Recent findings: There are various retrospective studies and, more recently, several randomized controlled trials that have explored whether the choice of anesthesia (total intravenous anesthesia vs. inhaled anesthetic) results in a significant difference in cancer outcomes, mortality, cancer recurrence, and metastasis. To date, no definitive proof has been made, and the current conclusion remains that the anesthetic technique does not influence survival or overall long-term outcomes.Summary: Comprehensive risk assessment is essential in cancer patients before elective surgeries due to a variety of concerns such as malnutrition, aspiration risk, postradiation airway compromise, and antineoplastic systemic effects. Oncologic patients' exposure to chemotherapy and radiation causes immunosuppression and multiorgan toxicity that places them at increased perioperative risk for morbidity and mortality. Other concerns include the challenges of adequate pain management and pre-existing chronic pain.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"287-293"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anesthetic management of neurosurgical emergencies. 神经外科急诊的麻醉处理。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-02-17 DOI: 10.1097/ACO.0000000000001471

Vanessa Bou Sleiman, Bryan Benson, Sam Gumbert

{"title":"Anesthetic management of neurosurgical emergencies.","authors":"Vanessa Bou Sleiman, Bryan Benson, Sam Gumbert","doi":"10.1097/ACO.0000000000001471","DOIUrl":"10.1097/ACO.0000000000001471","url":null,"abstract":"Purpose of review: Neuroanesthesia presents unique challenges that require up-to-date knowledge in identification and management and multidisciplinary collaboration for optimal patient outcomes. This review paper aims to enhance the reader's understanding and preparedness for intraoperative emergencies based on current literature updates and consensus recommendations.Recent findings: Recent findings in traumatic brain injury (TBI) emphasize the importance of controlling intracranial pressure (ICP) and maintaining cerebral perfusion. However, they also challenge the efficacy of sole ICP targeting interventions, suggesting potential benefits from multimodal monitoring approaches. In the context of acute stroke, recent randomized trials have demonstrated that general anesthesia (GA) compared with sedation techniques results in higher recanalization rates, with no significant difference in complications or long-term outcomes. Furthermore, multiple trials and a meta-analysis have shown that intensive blood pressure management following recanalization with endovascular therapy (EVT) offers no benefit and may impose harm when compared with conservative blood pressure targets.Summary: Optimal management of neuroanesthetic emergencies requires up-to-date knowledge, training, and interdisciplinary coordination to ensure the best possible outcomes. Significant research effort has been devoted to advancing neuroanesthesia practice, so that in the last 2 years, several fundamental management questions have benefitted from randomized controlled trials (RCTs) from multiple groups, as well as meta-analyses of these RCTs. These address ICP and complementary physiologic monitoring for intracranial compartment syndrome after TBI, GA versus sedation for EVT, and postrecanalization blood pressure management. In this review, we have highlighted this important work as well as the next steps in further refining answers to these questions.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"303-309"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Integrating regional blocks into Enhanced Recovery After Surgery protocols for cesarean delivery: optimizing postoperative recovery. 将区域阻滞纳入增强剖宫产术后恢复方案：优化术后恢复。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-02-12 DOI: 10.1097/ACO.0000000000001459

Alessandra Lauretta, Vedran Frkovic, Andrea Saporito

{"title":"Integrating regional blocks into Enhanced Recovery After Surgery protocols for cesarean delivery: optimizing postoperative recovery.","authors":"Alessandra Lauretta, Vedran Frkovic, Andrea Saporito","doi":"10.1097/ACO.0000000000001459","DOIUrl":"10.1097/ACO.0000000000001459","url":null,"abstract":"Purpose of review: This review aims to synthesize the current literature on the use of regional blocks to enhance and optimize postoperative recovery after cesarean delivery, highlighting key strategies, challenges, and emerging trends.Recent findings: Recent developments in postoperative analgesia for cesarean delivery point toward more personalized treatment approaches. This involves identifying patients at high risk for severe postoperative pain and offering them tailored multimodal analgesic regimens.Summary: Managing pain after cesarean delivery continues to pose a significant challenge. The overall prevalence of acute postoperative pain remains high (58%) and, even when strict adherence to established guidelines is ensured, approximately 25% of patients report inadequate pain control. Within a multimodal analgesic framework, when neuraxial morphine - still considered the gold standard - is not an option, the use of peripheral nerve and fascial plane blocks has demonstrated clear benefits. Recent literature suggests that quadratus lumborum block may serve as a promising alternative to intrathecal morphine for women who cannot tolerate opioids. Additionally, incorporating certain regional techniques alongside neuraxial morphine may further improve postoperative analgesia, especially for patients at high risk of severe postoperative pain and those who have contraindications to other analgesic modalities.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"179-185"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bleeding management in pelvic trauma: state of the art. 骨盆创伤出血处理：最新进展。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-02-28 DOI: 10.1097/ACO.0000000000001478

Paul Puchwein, Barbara Hallmann, Nicolas Eibinger

{"title":"Bleeding management in pelvic trauma: state of the art.","authors":"Paul Puchwein, Barbara Hallmann, Nicolas Eibinger","doi":"10.1097/ACO.0000000000001478","DOIUrl":"10.1097/ACO.0000000000001478","url":null,"abstract":"Purpose of review: Bleeding complications from pelvic injuries occur after high-energy trauma as well as after low-energy trauma in elderly patients and are the main contributors to mortality. Demographic changes necessitate focussing on both entities and targeted therapies throughout the course of management.Recent findings: This article reviews the recent evidence and expertise on bleeding management for haemodynamically unstable patients with pelvic fractures with insights from prehospital care to trends in resuscitation and endovascular techniques and revival of older strategies, to challenges of definitive treatment. It also takes a closer look into pelvic fractures of the elderly and their most recent treatment options.Summary: Bleeding management in pelvic trauma begins prehospitally with targeted transportation, infusion of crystalloids and blood products, and a differentiated use of pelvic binders. In the emergency department, care involves rapid evaluation, massive transfusion protocols and computed tomography (CT) angiography. Resuscitative Endovascular Balloon Occlusion of the Aorta can serve as bridging to diagnostics and bleeding control. Bleeding control management includes mechanical stabilization, preperitoneal pelvic packing or angioembolization. In elderly patients, rigid vessels and anticoagulation contribute to bleeding complications. Selective CT angiography is advised for certain injury patterns and haemodynamic instability. Depending on bleeding localization, selective angioembolization is preferred.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"323-330"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Updates in Non-Operating Room Anesthesia. 非手术室麻醉的最新进展。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-03-05 DOI: 10.1097/ACO.0000000000001472

Aaron Primm, Diana Anca

引用次数: 0

Point-of-care ultrasound in obstetric anesthesia clinical practice. 护理点超声在产科麻醉临床实践中的应用。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-04-08 DOI: 10.1097/ACO.0000000000001501

Pedram Aleshi, Clemens M Ortner, Alexander J Butwick

{"title":"Point-of-care ultrasound in obstetric anesthesia clinical practice.","authors":"Pedram Aleshi, Clemens M Ortner, Alexander J Butwick","doi":"10.1097/ACO.0000000000001501","DOIUrl":"10.1097/ACO.0000000000001501","url":null,"abstract":"Purpose of the review: Point-of-care ultrasound (POCUS) is increasingly recognized as a valuable tool in obstetric anesthesia. This review synthesizes key studies and reviews published within the last 2 years on its application in clinical practice with relevant supporting literature.Recent findings: Handheld ultrasound-assisted neuraxial block placement modestly reduces periprocedure time compared with landmark-based techniques. Devices with integrated three-dimensional or artificial intelligence-guided software may improve first-attempt success, particularly in obese patients. Focused cardiac ultrasound has gained interest as a potential tool for predicting postspinal hypotension through predelivery inferior vena cava collapsibility assessment. POCUS is also valuable for evaluating shock and cardiovascular compromise, aiding in the diagnosis and clinical management of amniotic fluid embolism and maternal cardiomyopathy. Gastric ultrasound can be performed qualitatively, aids aspiration risk assessment, and can be used in studies evaluating drug effects on gastric contents and antral cross-sectional area. Robust training programs are essential to equip obstetric anesthesiologists with sustainable POCUS skill sets.Summary: POCUS is associated with reduced neuraxial block placement times, provides critical hemodynamic data in patients with amniotic fluid embolism and cardiomyopathy, and allows gastric content evaluation for aspiration risk assessment. Expanding structured training and research is crucial to maximizing its clinical utility.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"202-207"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perioperative management of pediatric patients with obstructive sleep apnea syndrome presenting for adenotonsillectomy. 以腺扁桃体切除术为表现的儿童阻塞性睡眠呼吸暂停综合征的围手术期处理。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-04-11 DOI: 10.1097/ACO.0000000000001492

Kristen K Penberthy, Nicholas M Dalesio

{"title":"Perioperative management of pediatric patients with obstructive sleep apnea syndrome presenting for adenotonsillectomy.","authors":"Kristen K Penberthy, Nicholas M Dalesio","doi":"10.1097/ACO.0000000000001492","DOIUrl":"10.1097/ACO.0000000000001492","url":null,"abstract":"Purpose of review: The prevalence and severity of pediatric obstructive sleep apnea syndrome (OSAS) is increasing, and patients with severe OSAS are at higher risk for perioperative adverse events because of an increased sensitivity to opioid medications. This review highlights new strategies for perioperative medication management for children presenting for adenotonsillectomy.Recent findings: Fewer than 10% of patients presenting for adenotonsillectomy have undergone testing to determine the severity of their OSAS, despite cost-effective and practical diagnostic alternatives to polysomnography, such as nocturnal oximetry. With an increasing incidence of severe OSAS, recent research is focusing on opioid-sparing perioperative management including the use of alternative surgical techniques, regional anesthesia, and use of nonsteroidal anti-inflammatory medications that provide optimal analgesia with minimal adverse complications.Summary: Severe OSAS increases perioperative risks for pediatric patients, but diagnostic techniques that stratify OSAS severity are underutilized preoperatively, leading to a lack of information on how best to care for patients on the day of surgery. Nonopioid analgesic adjuncts are becoming more common, improving safety for this patient population.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"253-260"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An overview of sickle cell disease and chronic pain and perioperative considerations. 当前观点：镰状细胞病和慢性疼痛的综述及围手术期注意事项。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2025-06-01 Epub Date: 2025-02-14 DOI: 10.1097/ACO.0000000000001461

Dolapo Akintunde, Ada Ezihe-Ejiofor, Janefrances Ogbah, Tolulope Oso

{"title":"An overview of sickle cell disease and chronic pain and perioperative considerations.","authors":"Dolapo Akintunde, Ada Ezihe-Ejiofor, Janefrances Ogbah, Tolulope Oso","doi":"10.1097/ACO.0000000000001461","DOIUrl":"10.1097/ACO.0000000000001461","url":null,"abstract":"Purpose: This review aims to provide the practicing anesthesiologist with information on the pathophysiology, physiology, and management of patients with sickle cell disease. This includes the evaluation of common intraoperative management issues as well as perioperative concerns related to the disease. This review will also discuss the outpatient care of sickle cell patients concerning disease-modifying agents and chronic pain management.Recent findings: There has been less funding for research on sickle cell disease and a relative deficit in treatment options for patients and their vaso-occlusive crises (VOC). In the chronic pain setting, adjuvants to therapy have been utilized, such as anti-inflammatories, neuropathic agents, and antihistamines; however, the mainstay of therapy for pain crises is the use of opioids. New medications for the treatment of VOCs include crinaluzimab and L-glutamine. In terms of intraoperative management, it is imperative to maintain homeostasis for the patients, and research does not show a benefit in preoperative blood transfusions when not clinically indicated.Summary: The sociopolitical context and pathophysiology of sickle cell disease make it a unique disease to manage for the practicing anesthesiologist. Tailoring management via developing a patient-specific approach to maintain homeostasis and minimize the perioperative prevalence of VOCs.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"281-286"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0