Journal of clinical anesthesia and pain management最新文献_第3页

Relationship among Preoperative, Pre and Postinduction Blood Pressure in Normotensive and Hypertensive Patients 正常高血压患者术前、诱导前后血压的关系

Journal of clinical anesthesia and pain management Pub Date : 2020-12-31 DOI: 10.36959/377/346

Bernardi G. de, Souza Helena Knebel Vieira De, Izquierdo Jesse Abimael Infante, Siaulys Mônica Maria, S. P. Da, Vitoreli Marcel Veronez, Pinheiro Pedro Ferretti, Yamamura Silvio Julio Bittencourt, Mathias Ligia Andrade Da Silva Telles

{"title":"Relationship among Preoperative, Pre and Postinduction Blood Pressure in Normotensive and Hypertensive Patients","authors":"Bernardi G. de, Souza Helena Knebel Vieira De, Izquierdo Jesse Abimael Infante, Siaulys Mônica Maria, S. P. Da, Vitoreli Marcel Veronez, Pinheiro Pedro Ferretti, Yamamura Silvio Julio Bittencourt, Mathias Ligia Andrade Da Silva Telles","doi":"10.36959/377/346","DOIUrl":"https://doi.org/10.36959/377/346","url":null,"abstract":"Objectives: This study aimed to verify the relationship between blood pressure (BP) obtained during preoperative evaluation at preinduction and compared to BP at 20 min after induction for normotensive and hypertensive patients. Methods: Data from patients who underwent elective surgical procedures from July 2018 to September 2019 were retrospectively extracted and analyzed. The data included patient characteristics (age, sex, weight, height, body mass index (BMI)), physical status (ASA classification), comorbidities, medications in use, and mean arterial BP (MAP) recorded preoperatively (MAPpre-op), before induction of anesthesia (MAPpre-ind), and 20 min after induction (MAPpost-ind). Results: A total of 1026 patients were selected, 341 were included in the final analysis (normotensive patients (GNT n = 203), treated hypertensive patients (GTREAT n = 98), untreated hypertensive patients (GNO TREAT n = 40). There was an increase in the median MAP from preoperation to preinduction in the total sample and the three groups (GNT, GTREAT, and GNO TREAT). There was a statistically significant reduction in MAPpost-ind concerning MAPpre-ind and MAPpre-op in the three groups. The three groups’ comparison showed a statistically significant difference between MAPpost-ind and MAPpre-ind and between MAPpost-ind and MAPpre-op. Conclusions: Our study showed that normotensive and hypertensive patients showed a significant BP increase at the preinduction time point. Treated and untreated hypertensive patients had a more considerable increase in preinduction BP and BP reduction at 20 min after anesthesia induction than normotensive patients. These changes were more significant in hypertensive patients without treatment.","PeriodicalId":92399,"journal":{"name":"Journal of clinical anesthesia and pain management","volume":"38 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91437041","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: 1

Intravenous Iron to Treat Anemia becomes an Essential Service to Conserve Blood during the COVID-19 Pandemic 静脉注射铁治疗贫血成为COVID-19大流行期间保存血液的一项基本服务

Journal of clinical anesthesia and pain management Pub Date : 2020-12-31 DOI: 10.36959/377/348

O. Obianuju, Luan-Erfe Betty M, Peace Jack M, Sweitzer Bobbie Jean

{"title":"Intravenous Iron to Treat Anemia becomes an Essential Service to Conserve Blood during the COVID-19 Pandemic","authors":"O. Obianuju, Luan-Erfe Betty M, Peace Jack M, Sweitzer Bobbie Jean","doi":"10.36959/377/348","DOIUrl":"https://doi.org/10.36959/377/348","url":null,"abstract":"With the outbreak of Coronavirus Disease 2019 (COVID-19), blood drives have been cancelled, resulting in significantly fewer donations. However, blood components are still being used to treat patients with acute and chronic hemorrhage, trauma, cancer, hematologic disorders and even COVID-19 with disseminated intravascular coagulation. Consequently, national and local blood supplies will dwindle and may become critically limited. The clinician’s stewardship in anemia management and blood use has become ever more important during this pandemic. Clinicians are responsible for the timely diagnosis of anemia, its treatable causes and prompt therapy with alternatives to blood transfusions. However, there are challenges during this pandemic with restrictions on travel with many institutions and practitioners limiting patient visits to prevent community spread of COVID-19. To conserve the supply of blood components during the COVID-19 pandemic, proactive and efficient measures to diagnose anemia and timely treat with intravenous iron when indicated, while minimizing clinic visits are imperative. We","PeriodicalId":92399,"journal":{"name":"Journal of clinical anesthesia and pain management","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88617684","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: 1

A Consecutive Cohort with COVID-19 in Wuhan, China: Natural History, Clinical Features and Considerations 中国武汉COVID-19连续队列:自然史、临床特征和注意事项

Journal of clinical anesthesia and pain management Pub Date : 2020-12-31 DOI: 10.36959/377/351

S. Bin, Wang Hao, Hui Xu, Gui-Jun Zhang

引用次数: 0

Impact of Academic Detailing on Opioid Prescribing at the Veterans Health Administration 退伍军人健康管理局学术细节对阿片类药物处方的影响

Journal of clinical anesthesia and pain management Pub Date : 2020-12-31 DOI: 10.36959/377/349

B. Mark, Harvey Michael A, Wells Daina L, Himstreet Julianne E, Lau Marcos K, Kay Chad L, Popish Sarah J, Phillips Andrea G, Freeman Blake A, Morillo Christina, Mullins-Cunningham Sophia, Christopher Melissa LD

{"title":"Impact of Academic Detailing on Opioid Prescribing at the Veterans Health Administration","authors":"B. Mark, Harvey Michael A, Wells Daina L, Himstreet Julianne E, Lau Marcos K, Kay Chad L, Popish Sarah J, Phillips Andrea G, Freeman Blake A, Morillo Christina, Mullins-Cunningham Sophia, Christopher Melissa LD","doi":"10.36959/377/349","DOIUrl":"https://doi.org/10.36959/377/349","url":null,"abstract":"Opioid overdose and mortality have become a serious national epidemic in the United States (U.S.). The annual death toll due to opioids was over 46,000 in 2018 [1] and exceeded that of motorized vehicles by 150% starting in 2014 [2]. This was paralleled by a 64% increase in opioid-related inpatient stays and a doubling of the rate of opioid-related emergency department visits from 2005 to 2014 in the general population [3]. In the U.S., mortality risk associated with Abstract Introduction: In 2014, the United States Veterans Health Administration (VHA) Pharmacy Benefits Management Academic Detailing Service (ADS) began national implementation of academic detailing (AD), a one-on-one educational outreach program delivered by specially trained clinical pharmacy specialists to address mental health disorders and pain management. Consequently, ADS adopted the mission of the VHA Opioid Safety Initiative (OSI) to align providers’ opioid prescribing with evidence-based practice. This program evaluation assessed AD’s impact on the monthly trends of highdose opioid utilization and average morphine milligram equivalent (MME) between providers exposed (AD-exposed) and unexposed (AD-unexposed) to OSI-specific educational outreach.","PeriodicalId":92399,"journal":{"name":"Journal of clinical anesthesia and pain management","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88747873","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: 1

Treatment of Post-Stroke Shoulder Pain of Multi-Factorial Etiology 脑卒中后肩部多因素疼痛的治疗

Journal of clinical anesthesia and pain management Pub Date : 2020-12-31 DOI: 10.36959/377/350

H. Stephen, Channagiri Varun, Gaballa Mina, G. James, W. Robert, Calvert Timothy, K. Carolyn, G KaufmanAndrew

引用次数: 0

Obstructive Sleep Apnea Syndrome as an Important Risk Factor in Severe Covid-19 Disease 阻塞性睡眠呼吸暂停综合征是重症Covid-19疾病的重要危险因素

Journal of clinical anesthesia and pain management Pub Date : 2020-12-23 DOI: 10.36959/377/347

M. Calixto, A DeFinaPhillip, M. Yanin, Chinchilla Mauricio, Cuspineda Elena, Machado Yazmina

引用次数: 1

Value of Rotation Thrombelastometry in Cardiac Surgical Patients with Normal Bleeding Risk-A Pilot Study 旋转血栓测量在心脏手术患者正常出血风险中的价值——一项初步研究

Journal of clinical anesthesia and pain management Pub Date : 2020-11-26 DOI: 10.36959/377/345

P. WirtzStefan, R. FritzscheFlorian, Schmidt Christoph, Bormann Benno von, Brodner Gehard, Berendes Elmar

{"title":"Value of Rotation Thrombelastometry in Cardiac Surgical Patients with Normal Bleeding Risk-A Pilot Study","authors":"P. WirtzStefan, R. FritzscheFlorian, Schmidt Christoph, Bormann Benno von, Brodner Gehard, Berendes Elmar","doi":"10.36959/377/345","DOIUrl":"https://doi.org/10.36959/377/345","url":null,"abstract":"Study objective: The ROTEM® Whole Blood Haemostasis Analyser has been introduced for point-of-care monitoring using computerized rotation thrombelastometry, an enhancement of thrombelastography®. This study aimed to investigate the clinical relevance of the ROTEM® device in patients undergoing routine cardiac surgery. Design: Prospective, double-blinded clinical study. Setting: University hospital, operating room, intensive care unit. Patients: Forty-two cardiac surgical patients with normal bleeding risk. Interventions: Routine cardiac surgical procedures with cardiopulmonary bypass. Measurements: In addition to clinical data assessment, ROTEM®-measurements were performed intraand postoperatively. Standard ROTEM®-tests comprised three different assays, i.e. INTEM: Intrinsic system-activation, EXTEM: Extrinsic system-activation, and HEPTEM: INTEM + heparinase. Main results: All ROTEM®-variables showed the typical impairment of coagulation after cardiopulmonary bypass, such as impaired clot formation and stability. Independent samples t-tests demonstrated that there were no differences in blood loss and transfusions 2 and 8 hours postoperatively in patients with low and high ROTEM®-values. Multivariate logistic regression analyses revealed a significant effect only of the duration of cardiopulmonary bypass on postoperative transfusion requirements. ROTEM®-parameters, the total amount of administered fluids, and type of surgery were not associated with postoperative allogeneic transfusions and blood loss. Conclusions: Although thrombelastometry with the ROTEM®-device reflects the perioperative alterations in coagulation, the parameter changes to be expected in routine procedures with normal bleeding risk patients are of only limited predictive value in respect to postoperative blood loss and transfusion requirements. Therefore, thrombelastometry with ROTEM® is not mandatory.","PeriodicalId":92399,"journal":{"name":"Journal of clinical anesthesia and pain management","volume":"98 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81175111","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

The Use of Cocaine and Derivatives and the Cancellation of Surgery 可卡因及其衍生物的使用和手术的取消

Journal of clinical anesthesia and pain management Pub Date : 2020-10-31 DOI: 10.36959/377/344

Imbelloni Luiz Eduardo, Araujo André Augusto de, Sakamoto Jaime Weslei, Viana Eduardo Piccinini

引用次数: 0

Case Report: The Combined Spinal and Caudal (CSC) Anesthetic-Is this the New Ideal Anesthetic in a Formerly Preterm, High-Risk Infant with Chronic Lung Disease Undergoing Infraumbilical Surgery? 病例报告:脊髓和尾侧联合(CSC)麻醉药——对于接受脐下手术的早产儿、慢性肺病高危婴儿来说，这是一种新的理想麻醉剂吗?

Journal of clinical anesthesia and pain management Pub Date : 2020-10-16 DOI: 10.36959/377/343

T. Kelly, Liu Chang Amber

引用次数: 0

The Value of Digital Subtraction Angiography in Interlaminar Cervical Epidural Steroid Injections 数字减影血管造影在宫颈层间硬膜外类固醇注射中的价值

Journal of clinical anesthesia and pain management Pub Date : 2020-08-31 DOI: 10.36959/377/342

P. Anand, Anand Suwarna, C. Arvind

引用次数: 0