Current Opinion in Anesthesiology最新文献_第7页

Spinal anesthesia in ambulatory patients. 流动病人的脊髓麻醉。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2024-12-01 Epub Date: 2024-07-09 DOI: 10.1097/ACO.0000000000001412

Ignacio Ledesma, Andrea Stieger, Markus M Luedi, Carolina S Romero

{"title":"Spinal anesthesia in ambulatory patients.","authors":"Ignacio Ledesma, Andrea Stieger, Markus M Luedi, Carolina S Romero","doi":"10.1097/ACO.0000000000001412","DOIUrl":"10.1097/ACO.0000000000001412","url":null,"abstract":"Purpose of review: To assess current practice in the use of spinal anesthesia in major ambulatory surgery, highlighting its advantages over general anesthesia and identifying potential areas for improvement to facilitate a transition to a sustainable healthcare system.Recent findings: Spinal anesthesia might be preferred in selected populations when compared to general anesthesia providing the highest standards of healthcare quality.The use of local anesthetics with short half-life has proven to be efficient in achieving high anesthesia success rates. Spinal anesthesia does not increase perioperative complications; instead, it has shown a reduction in postoperative nausea and vomiting, an improvement in patient comfort, and a favorable economic impact when compared to general anesthesia.Summary: Spinal anesthesia is an appropriate method for anesthesia in ambulatory patients, offering advantages over general anesthesia in selected populations.The use of spinal anesthesia is expanding to meet surgical needs. Therefore, it is crucial to plan ahead and anticipate organizational failures in the ambulatory setting to maintain safety and efficiency during outpatient procedures and surgeries.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"661-665"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of human factors engineering in patient safety. 人因工程在患者安全中的作用。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2024-12-01 Epub Date: 2024-10-18 DOI: 10.1097/ACO.0000000000001437

Lilibeth Fermin, Lauren Lobaugh, K Gage Parr, Morgan Currie

引用次数: 0

The electronic health record: does it enhance or distract from patient safety? 电子病历：是加强了患者安全，还是分散了患者安全？

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2024-12-01 Epub Date: 2024-09-02 DOI: 10.1097/ACO.0000000000001429

George Tewfik, Steven Rivoli, Emily Methangkool

引用次数: 0

Caring for patients with diabetes in the outpatient surgical setting: current recommendations and controversies. 在门诊手术环境中照顾糖尿病患者：当前的建议和争议。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2024-12-01 Epub Date: 2024-09-19 DOI: 10.1097/ACO.0000000000001438

Elizabeth W Duggan, Guillermo E Umpierrez

{"title":"Caring for patients with diabetes in the outpatient surgical setting: current recommendations and controversies.","authors":"Elizabeth W Duggan, Guillermo E Umpierrez","doi":"10.1097/ACO.0000000000001438","DOIUrl":"https://doi.org/10.1097/ACO.0000000000001438","url":null,"abstract":"Purpose of review: Perioperative outpatient (ambulatory) care of the adult patient with diabetes requires unique considerations that vary from the inpatient setting. This review highlights specific pre, intra, and postoperative care steps for patients with diabetes undergoing ambulatory surgery, summarizing recent clinical trials, expert reviews, and emerging evidence.Recent findings: There is a paucity of evidence examining optimal diabetes management in the outpatient setting. Currently, there are limited studies regarding preoperative management of oral hypoglycemic agents, home insulin, and carbohydrate-containing beverages.Summary: Future research needs to specifically examine chronic blood glucose control, day of surgery targets, effective home medication management and the risk of perioperative hyperglycemia in ambulatory surgery. Education, protocols and resources to support the care of perioperative patients in the outpatient setting will aid providers on the day of surgery and provide optimal diabetes care leading up to surgery.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":"37 6","pages":"651-660"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548686","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

More than pacemakers and defibrillators: perioperative management of implantable devices for patient safety. 不仅仅是起搏器和除颤器：为患者安全而进行的植入式设备围手术期管理。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2024-12-01 Epub Date: 2024-08-19 DOI: 10.1097/ACO.0000000000001427

Monica W Harbell, Molly B Kraus, Andrea Lopez-Ruiz, Madina Gerasimov, Jillian A Maloney

{"title":"More than pacemakers and defibrillators: perioperative management of implantable devices for patient safety.","authors":"Monica W Harbell, Molly B Kraus, Andrea Lopez-Ruiz, Madina Gerasimov, Jillian A Maloney","doi":"10.1097/ACO.0000000000001427","DOIUrl":"10.1097/ACO.0000000000001427","url":null,"abstract":"Purpose of review: The use of implantable medical devices (IMDs) continues to increase with estimates that 10% of the American population will have an IMD in their lifetime. IMDs require special considerations for management in the perioperative period to ensure optimal patient care and patient safety. This review summarizes the current perioperative considerations for IMDs.Recent findings: This review summarizes perioperative recommendations for spinal cord stimulators, deep brain stimulators, peripheral nerve stimulators, vagus nerve stimulators, muscle stimulators, intrathecal drug delivery systems, implantable infusion pumps, artificial pancreas devices, continuous glucose monitors, and cochlear implants. There are multiple publications and guidelines regarding the perioperative considerations of cardiac implantable electronic devices; thus, this review excludes those devices. This review includes recommendations on management of the device perioperatively, the potential complications, and postoperative care of the device.Summary: There are very few guidelines regarding the perioperative management of IMDs. Given the significant impact that these devices have on patient care and safety, evidence-based guidelines should be established.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"705-711"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156494","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 update on the perioperative management of postcraniotomy pain. 开颅术后疼痛围手术期处理的最新进展。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2024-10-01 Epub Date: 2024-07-08 DOI: 10.1097/ACO.0000000000001409

Cassandra Dean, Ian McCullough, Alex Papangelou

引用次数: 0

Spaceflight-associated pain. 太空飞行相关疼痛。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2024-10-01 Epub Date: 2024-06-11 DOI: 10.1097/ACO.0000000000001401

Ariana M Nelson, Ryan A Lacinski, Jonathan G Steller

{"title":"Spaceflight-associated pain.","authors":"Ariana M Nelson, Ryan A Lacinski, Jonathan G Steller","doi":"10.1097/ACO.0000000000001401","DOIUrl":"10.1097/ACO.0000000000001401","url":null,"abstract":"Purpose of review: Consequences of the expanding commercial spaceflight industry include an increase in total number of spaceflight participants and an accompanying surge in the average number of medical comorbidities compared with government-based astronaut corps. A sequela of these developments is an anticipated rise in acute and chronic pain concerns associated with spaceflight. This review will summarize diagnostic and therapeutic areas of interest that can support the comfort of humans in spaceflight.Recent findings: Painful conditions that occur in space may be due to exposure to numerous stressors such as acceleration and vibration during launch, trauma associated with extravehicular activities, and morbidity resulting directly from weightlessness. Without normal gravitational forces and biomechanical stress, the hostile environment of space causes muscle atrophy, bone demineralization, joint stiffness, and spinal disc dysfunction, resulting in a myriad of pain generators. Repeated insults from abnormal environmental exposures are thought to contribute to the development of painful musculoskeletal and neuropathic conditions.Summary: As humanity invests in Lunar and Martian exploration, understanding the painful conditions that will impede crew productivity and mission outcomes is critical. Preexisting pain and new-onset acute or chronic pain resulting from spaceflight will require countermeasures and treatments to mitigate long-term health effects.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"581-587"},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621670","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

Update on the anesthesia management in adult patients with moyamoya disease. moyamoya病成人患者麻醉管理的最新进展。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2024-10-01 Epub Date: 2024-06-28 DOI: 10.1097/ACO.0000000000001411

Kevin J Yang, Porus Mistry, Eugenia Ayrian

{"title":"Update on the anesthesia management in adult patients with moyamoya disease.","authors":"Kevin J Yang, Porus Mistry, Eugenia Ayrian","doi":"10.1097/ACO.0000000000001411","DOIUrl":"10.1097/ACO.0000000000001411","url":null,"abstract":"Purpose of review: The anesthetic management of patients with Moyamoya disease (MMD) is challenging and continues to evolve. The goal of this review is to provide updated recommendations on the anesthetic management of adult MMD patients based on the relevant existing literature.Recent findings: Key findings include the importance of aggressive hydration preoperatively to sustain cerebral perfusion. Hypertension induced intraoperatively may prevent cerebral hypoperfusion. Vigilance against cerebral hyperperfusion after revascularization is necessary, with specific blood pressure targets recommended. Fluid management should aim for normovolemia to mild hypervolemia. Maintaining body temperature helps prevent cerebral vasospasm induced by hypothermia. Maintaining adequate oxygen supply during surgery is crucial. In cases of ischemic stroke, managing hematocrit and oxygen carrying capacity is essential to prevent further ischemia. Extubation decisions should consider baseline neurological function, while postoperative normocapnia helps prevent cerebral hyperperfusion and hypertension. In intensive care, cautious blood pressure management is crucial to prevent secondary complications.Summary: Strategies in the preoperative, intraoperative, and postoperative anesthetic management of MMD patients should aim to maintain adequate cerebral perfusion to prevent cerebral ischemia.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"439-445"},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621671","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

Kratom: a primer for pain physicians. 桔梗：疼痛科医生入门指南。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2024-10-01 Epub Date: 2024-07-08 DOI: 10.1097/ACO.0000000000001413

Trent Emerick, Shravani Durbhakula, Maria R Eibel, Lynn Kohan

{"title":"Kratom: a primer for pain physicians.","authors":"Trent Emerick, Shravani Durbhakula, Maria R Eibel, Lynn Kohan","doi":"10.1097/ACO.0000000000001413","DOIUrl":"10.1097/ACO.0000000000001413","url":null,"abstract":"Purpose of review: Kratom is used commonly in the United States, usually to mitigate pain, opioid withdrawal, or fatigue. A comprehensive discussion on kratom, tailored to pain management physicians, is needed, given its associated risks and potential interactions.Recent findings: Kratom and its main metabolites, mitragynine and 7-OH-mitragynine, bind to a variety of receptors including mu opioid receptors. Still, kratom cannot be described as a classic opioid. Kratom has been utilized without FDA approval as an alternative to traditional medications for opioid use disorder and opioid withdrawal. Lower doses of kratom typically cause opioid-like effects while higher doses can have sedating effects. Tolerance, dependence and withdrawal still occur, although kratom withdrawal appears to be more moderate than opioid withdrawal. Contamination with heavy metals and biological toxins is concerning and there is potential for serious complications, including seizures and death.Summary: The use of kratom as an opioid-sparing alternative as a part of a multimodal pain regimen is not without significant risks. It is of utmost importance for pain physicians to be aware of the risks and adverse effects associated with kratom use.","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":" ","pages":"575-580"},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621663","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

Transitional pain services updates and a novel service for the obstetric population. 产科过渡性疼痛服务的更新和一项新服务。

IF 2.3 3区医学

Current Opinion in Anesthesiology Pub Date : 2024-10-01 Epub Date: 2024-08-01 DOI: 10.1097/ACO.0000000000001417

Rafael Blanco, Tarek Ansari

引用次数: 0