Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2019
Prospective External Validation of the Pediatric Risk Assessment Score in Predicting Perioperative Mortality in Children Undergoing Noncardiac Surgery.
Early identification of children at high risk for perioperative mortality could lead to improved outcomes; however, there is a lack of well-validated risk prediction tools. The Pediatric Risk Assessment (PRAm) score is a new model to prognosticate perioperative risk of mortality in pediatric patients undergoing noncardiac surgery. It was derived from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) Pediatric database. In this study, we aimed to externally validate the PRAm score at 1 large institution. ⋯ The PRAm score is a simple and objective tool that has excellent ability to predict perioperative risk of mortality in pediatric patients undergoing noncardiac surgery and can be easily used by clinicians. The application of the PRAm score could have important implications on the safety and quality of care delivered to infants and children and on the resource utilization in the pediatric health care system.
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Anesthesia and analgesia · Oct 2019
Comparative Study Observational StudyDistinguished Service Awards in Anesthesiology Specialty Societies: Analysis of Gender Differences.
The authors queried 9 anesthesiology societies to examine Distinguished Service Award recipients over time by gender. Of the 211 total Distinguished Service Awards given by all 9 societies, women received 25 (11.8%). ⋯ Low levels of awardees stand in contrast to the increasing number of women in the academic pipeline. The authors recommend that societies collect gender membership data and study their award processes from nomination to selection.
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Anesthesia and analgesia · Oct 2019
General Anesthesia Alters the Diversity and Composition of the Intestinal Microbiota in Mice.
Dysbiosis of the intestinal microbiota has been shown to result in altered immune responses and increased susceptibility to infection; as such, the state of the intestinal microbiome may have profound implications in the perioperative setting. In this first-in-class study, we used 16s ribosomal RNA sequencing and analysis in a mouse model of general anesthesia to investigate the effects of volatile anesthetics on the diversity and composition of the intestinal microbiome. ⋯ Taxonomic alterations included depletion of several commensal bacteria including Clostridiales. These data identify volatile anesthetics as potential contributors to microbial dysbiosis in the postoperative patient.
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Anesthesia and analgesia · Oct 2019
Association of Interindividual Variation in Plasma Oxytocin With Postcesarean Incisional Pain.
Oxytocin has known antinociceptive effects and is upregulated perinatally. This pilot study investigated the association of plasma oxytocin and postcesarean incisional pain. ⋯ Pain was assessed at 1 day, 8 weeks, 3 months, and 6 months postoperatively. Incisional pain at 24 hours was inversely correlated with 1- and 24-hour oxytocin levels, with higher plasma oxytocin associated with lower pain (ρ, -0.52 and -0.66; P < .05).