Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2020
Randomized Controlled TrialA Prospective, Randomized, Double-Blinded Study of the Effect of Intravenous Ondansetron on the Effective Dose in 50% of Subjects of Prophylactic Phenylephrine Infusions for Preventing Spinal Anesthesia-Induced Hypotension During Cesarean Delivery.
Pre-spinal-anaesthesia administration of IV ondansetron 4 mg reduces the ED50 of prophylactic phenylephrine infusion by 26% among patients undergoing elective Caesarean section.
pearl -
Anesthesia and analgesia · Aug 2020
Comparative Study Observational StudyAnesthesia With and Without Nitrous Oxide and Long-term Cognitive Trajectories in Older Adults.
Although exposure to surgery/anesthesia is associated with a small cognitive decline among the elderly, there is no impact from the presence or absence of nitrous oxide.
pearl -
Anesthesia and analgesia · Aug 2020
ReviewFourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting.
This consensus statement presents a comprehensive and evidence-based set of guidelines for the care of postoperative nausea and vomiting (PONV) in both adult and pediatric populations. The guidelines are established by an international panel of experts under the auspices of the American Society of Enhanced Recovery and Society for Ambulatory Anesthesia based on a comprehensive search and review of literature up to September 2019. The guidelines provide recommendation on identifying high-risk patients, managing baseline PONV risks, choices for prophylaxis, and rescue treatment of PONV as well as recommendations for the institutional implementation of a PONV protocol. ⋯ This includes recent studies of newer pharmacological agents such as the second-generation 5-hydroxytryptamine 3 (5-HT3) receptor antagonists, a dopamine antagonist, neurokinin 1 (NK1) receptor antagonists as well as several novel combination therapies. In addition, it also contains an evidence-based discussion on the management of PONV in enhanced recovery pathways. We have also discussed the implementation of a general multimodal PONV prophylaxis in all at-risk surgical patients based on the consensus of the expert panel.
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Anesthesia and analgesia · Aug 2020
Multicenter StudyAssessment Scores of a Mock Objective Structured Clinical Examination Administered to 99 Anesthesiology Residents at 8 Institutions.
Objective Structured Clinical Examinations (OSCEs) are used in a variety of high-stakes examinations. The primary goal of this study was to examine factors influencing the variability of assessment scores for mock OSCEs administered to senior anesthesiology residents. ⋯ Since many residency programs aim to develop their own mock OSCEs, this study provides evidence that it is possible for programs to create a meaningful mock OSCE experience that is statistically reliable for separating resident performance.
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Anesthesia and analgesia · Aug 2020
Observational StudyRatios of Plasma and Platelets to Red Blood Cells in Surgical Patients With Acute Intraoperative Hemorrhage.
The relationships between the ratios of transfused allogeneic blood products and clinical outcomes in patients with acute intraoperative hemorrhage are poorly defined. ⋯ Transfusion ratios in surgical patients with critical intraoperative hemorrhage were largely related to surgical and hemostatic features rather than baseline patient characteristics. Higher ratios were not associated with improved outcomes.