Refresher courses in anesthesiology最新文献

Long-term Functional Outcomes after Regional Anesthesia: A Summary of the Published Evidence and a Recent Cochrane Review. 区域麻醉后的长期功能结果:已发表的证据总结和最近的Cochrane综述。

Refresher courses in anesthesiology Pub Date : 2015-01-01 DOI: 10.1097/ASA.0000000000000033

Arthur Atchabahian, Michael Andreae

{"title":"Long-term Functional Outcomes after Regional Anesthesia: A Summary of the Published Evidence and a Recent Cochrane Review.","authors":"Arthur Atchabahian, Michael Andreae","doi":"10.1097/ASA.0000000000000033","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000033","url":null,"abstract":"population-based average effects or biomarkers as evidence of meaningful improvement in care are unconvincing in this day and age. Outcomes suitable as arguments for the sustained value of regional anesthesia should instead be patient centered. Patient preferences, shared decision-making, and individualized tailored care are the hallmarks of this new paradigm in outcomes research, differentiating it from previous concepts of comparative effectiveness research. Much needs to be done to define and investigate patient-centered outcomes in anesthesiology and pain medicine, especially long-term outcomes. Pay for performance is another emerging concept, forcing us to emphasize our unique contribution to the quality of patient outcomes. What is the added value that anesthesiologists providing patients regional anesthesia contribute in the long run in the perioperative surgical home, where these anesthesiology subspecialists serve as the shepherds guiding the individualized perioperative recovery process? Outcomes suitable as arguments for the sustained value of regional anesthesia should be patient centered. Pain, Function, and Cognition as Cornerstones of Meaningful Long-term Recovery In this chapter, we examine the clinical evidence suggesting that regional anesthesia has meaningful benefits for our patients and society beyond the immediate perioperative period. Although there are several other outcomes of interest, such as morbidity and mortality or cancer recurrence, we focus on three long-term outcomes after elective surgery based on their particular importance: (1) Persistent pain (2) Joint function (3) Cognitive outcomes We also selected these outcomes because their impact and significance are easy to convey to any interlocutor—surgical colleague, lay person, hospital administrator, or politician— regardless of their previous training or experience. FOCUS 1: REGIONAL ANESTHESIA FOR THE PREVENTION OF PERSISTENT PAIN AFTER SURGERY","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"43 1","pages":"15-26"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34078770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

Catheter-based Cardiac Surgery: Anesthesia in the Hybrid Suite and Cath Lab 基于导管的心脏手术:混合套件和导管实验室的麻醉

Refresher courses in anesthesiology Pub Date : 2015-01-01 DOI: 10.1097/ASA.0000000000000032

N. Weitzel

引用次数: 0

Different Strokes for Operative Folks: Prevention of the Perioperative Cerebrovascular Accident 手术人群的不同中风:围手术期脑血管意外的预防

Refresher courses in anesthesiology Pub Date : 2015-01-01 DOI: 10.1097/ASA.0000000000000035

George W Williams

引用次数: 0

Advanced Teaching Skills for the Fast-paced OR: How to Educate Successfully When Faced With High Clinical Workload, Lack of Protected Time, and Limited Funding 快节奏手术室的先进教学技能:如何在面对高临床工作量，缺乏保护时间和有限资金的情况下成功进行教育

Refresher courses in anesthesiology Pub Date : 2015-01-01 DOI: 10.1097/ASA.0000000000000037

M. Brzezinski, J. Mitchell

引用次数: 0

Neuromuscular Management and Patient Outcomes 神经肌肉管理和患者预后

Refresher courses in anesthesiology Pub Date : 2015-01-01 DOI: 10.1097/ASA.0000000000000022

G. Murphy

引用次数: 1

Obesity and Anesthesia: Crossroads of a Challenge 肥胖和麻醉:挑战的十字路口

Refresher courses in anesthesiology Pub Date : 2015-01-01 DOI: 10.1097/ASA.0000000000000036

A. Sinha

引用次数: 0

Acute Postoperative Pain Management in Infants and Children: Size and Age Do Matter 婴幼儿术后急性疼痛的处理:大小和年龄的关系

Refresher courses in anesthesiology Pub Date : 2015-01-01 DOI: 10.1097/ASA.0000000000000028

P. Birmingham

引用次数: 0

Perioperative Renoprotection 围手术期Renoprotection

Refresher courses in anesthesiology Pub Date : 2015-01-01 DOI: 10.1097/ASA.0000000000000030

E. Baird, M. Hutchens

引用次数: 3

Heart Failure and Perioperative Care 心力衰竭和围手术期护理

Refresher courses in anesthesiology Pub Date : 2015-01-01 DOI: 10.1097/ASA.0000000000000027

G. Ackland

{"title":"Heart Failure and Perioperative Care","authors":"G. Ackland","doi":"10.1097/ASA.0000000000000027","DOIUrl":"https://doi.org/10.1097/ASA.0000000000000027","url":null,"abstract":"Over the next 10 years, it is estimated that more than 20% of the US population will be older than 65 years. Globally, older patients comprise an ever-expanding proportion of more than 234 million surgical procedures performed each year. This demographic group is overrepresented in major surgery, particularly for malignancy. With increasing age, cardiac reserve and function decline. The overall prevalence of heart failure in patients older than 45 years is estimated at 2.2%. However, with age, this picture changes dramatically. The Framingham Heart Study found a prevalence of heart failure in men of 8 per 1,000 between the ages of 50 and 59 years, which subsequently increased eight-fold by the ninth decade. Broadly similar increases in prevalence have been reported in women. The prevalence in African Americans is around 25% higher than in whites. The American Heart Association estimated that there were 5.1 million people with heart failure in the United States in 2006, and this estimate has certainly risen, given predicted increases in life expectancy. In addition to the increasingly elderly population exhibiting overt cardiac failure, it has become apparent that many patients present for surgery with poor cardiopulmonary reserve that physiologically resembles many features of heart failure, albeit without the formal recognition of this syndrome. Recent epidemiological data demonstrate that for patients with an established diagnosis of heart failure, perioperative morbidity and mortality are increased. Most importantly, the risk conferred by heart failure appears to outweigh other preoperative morbidities that have attracted more academic and clinical attention (Supplemental Digital Content 1, http://links.lww. com/ASA/A537). Heart failure encompasses a complex multiorgan syndrome, and its cardiac and extracardiac pathophysiological features present many perioperative challenges.","PeriodicalId":91163,"journal":{"name":"Refresher courses in anesthesiology","volume":"43 1","pages":"7-14"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/ASA.0000000000000027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62017310","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}

引用次数: 0

Perioperative Lung Protection Strategies in One-lung and Two-lung Ventilation 单肺和双肺通气围手术期肺保护策略

Refresher courses in anesthesiology Pub Date : 2015-01-01 DOI: 10.1097/ASA.0000000000000024

P. Slinger

引用次数: 1