Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2022
Historical ArticleJohn Henry Evans, MD: Founding Chairman of the Board of Governors of the International Anesthesia Research Society, and a Forgotten Pioneer of Oxygen Therapy.
The theoretical and practical foundations of modern oxygen therapy were established during the first half of the 20th century. John Henry Evans, MD, inaugural chairman of the Board of Governors of the International Anesthesia Research Society (IARS), was an early pioneer in this field. ⋯ Additionally, Evans experimented with the subcutaneous injection and intravenous infusion of oxygen, reporting significant benefits of the former in several acute inflammatory conditions, as well as a variety of chronic ailments. While these contributions have largely been forgotten, Evans expanded the remit of anesthesiology beyond the operating theater and the original charter of the IARS and helped lay the foundations for the rational use of oxygen as a therapeutic agent in all areas of medicine.
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Anesthesia and analgesia · Aug 2022
ReviewPerioperative Brain Health in the Older Adult: A Patient Safety Imperative.
While people 65 years of age and older represent 16% of the population in the United States, they account for >40% of surgical procedures performed each year. Maintaining brain health after anesthesia and surgery is not only important to our patients, but it is also an increasingly important patient safety imperative for the specialty of anesthesiology. Aging is a complex process that diminishes the reserve of every organ system and often results in a patient who is vulnerable to the stress of surgery. ⋯ As we age, a number of changes occur in the human brain, resulting in a patient who is less resilient to perioperative stress, making older adults more susceptible to the phenotypic expression of perioperative neurocognitive disorders. This review summarizes the current scientific and clinical understanding of perioperative neurocognitive disorders and recommends patient-centered, age-focused interventions that can better mitigate risk, prevent harm, and improve outcomes for our patients. Finally, it discusses the emerging topic of sleep and cognitive health and other future frontiers of scientific inquiry that might inform clinical best practices.