Anesthesia and analgesia
-
Anesthesia and analgesia · Nov 2012
Comparative StudyDifferent roles of peripheral mitogen-activated protein kinases in carrageenan-induced arthritic pain and arthritis in rats.
Accumulating evidence suggests that extracellular signal-regulated protein kinase (ERK), p38, and c-Jun N-terminal kinase (JNK) might be involved in hypersensitivity of various pain models. However, there is a lack of direct evidence for actual involvement of peripheral ERK, p38, and JNK in induction and maintenance of arthritic pain and the development of arthritis. ⋯ These results suggest that ERK, p38, and JNK signaling pathways at the peripheral level may play different roles in arthritic pain and arthritis of the knee joint.
-
Anesthesia and analgesia · Nov 2012
Use of analgesic, anesthetic, and sedative medications during pediatric hospitalizations in the United States 2008.
The wide need for analgesia, anesthesia, and sedation in children and the lack of pediatric labeling leads to widespread off-label use of medications for pain and sedation in children. Any attempt to address the lack of labeling will require national estimates of the numbers of children using each medication, their ages, and other factors, to understand the overall use of these medications. We describe use of analgesics, anesthetics, and sedatives in pediatric inpatients by result of conducting a statistical analysis of medication data from >800,000 pediatric hospitalizations in the United States. The purpose was to provide national estimates for the percentage of hospitalized children receiving specific analgesics, anesthetics, and sedatives and their use by age group. ⋯ A variety of drug classes and individual medications were used to manage pain and sedation in hospitalized children. The variation in patterns of use reflects the heterogeneity of the dataset, comprising a wide range of ages and conditions in which analgesia, anesthesia, and sedation might be required. It was not possible to assess whether use of a specific medication was clinically appropriate, except to note use of medications in age subgroups without pediatric labeling.
-
Anesthesia and analgesia · Nov 2012
Deficits in the provision of cardiopulmonary resuscitation during simulated obstetric crises: results from the Israeli Board of Anesthesiologists.
Cardiac arrest in the parturient is often fatal, but appropriate resuscitation in this special situation may save the lives of the mother and/or unborn baby. Concern has arisen as to application of recommended techniques for resuscitation in the obstetric patient. The Israel Board of Anesthesiology has incorporated simulation assessment into accreditation examinations. ⋯ Cricoid pressure during bag-mask ventilation was performed by 48% (25%) but described in debriefing by 80% of candidates (53%) (P = 0.08), and time setting for perimortem cesarean delivery was performed by 40% (29%) but described by 80% (53%) (P = 0.05) of examinees. CONCLUSIONS Senior anesthesiology residents have poor knowledge of resuscitation of the pregnant patient. The results suggest 2-stage simulation including an oral component may reveal disparities in knowledge not assessed by simulation alone, but definitive conclusions require further study.
-
Anesthesia and analgesia · Nov 2012
Descriptive study of case scheduling and cancellations within 1 week of the day of surgery.
We performed a descriptive study of operating room (OR) case scheduling within 1 week of the day of surgery. ⋯ Planning anesthesia assignments, ORs to target, etc., can be done productively starting 2 working days ahead of surgery. There are so many changes to the OR schedule those last 2 workdays that anesthesia groups should be engaged with the scheduling office during that period. The primary predictor of additional net hours of cases to be scheduled is the difference between the allocated (i.e., forecasted) OR time and the hours scheduled so far.