Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2021
CommentCON: The Length of Adult Cardiothoracic Anesthesiology Fellowship Training Should Not Be Extended Beyond One Year.
Fellowship training in adult cardiothoracic anesthesiology (ACTA) is a one-year postgraduate experience with formal accreditation by the Accreditation Council for Graduate Medical Education. ACTA is a competitive and evolving subspeciality. ⋯ The expanding responsibilities of the cardiothoracic anesthesiologist and strategies to best train the future of the subspecialty within the current training structure are discussed. It also briefly examines the history and current status of the fellowship training, reviews considerations for increasing fellowship duration, and highlights personal and financial considerations during the training.
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J. Cardiothorac. Vasc. Anesth. · Aug 2021
Observational StudyCardiac Stress in High-Risk Patients Undergoing Major Endovascular Surgery-Focus on Diastolic Function.
The purpose of this study was to determine the relationship between the changes in diastolic function and their association with cardiac biomarkers in the perioperative period in patients undergoing complex endovascular aortic repair. ⋯ Patients undergoing a branched endovascular aortic repair of a thoracoabdominal aortic aneurysm experience a cardiac insult that manifests with deterioration in diastolic parameters and concomitant increases of troponin and NT-proBNP concentrations. Additional large-scale prospective studies are required to confirm this phenomenon.
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J. Cardiothorac. Vasc. Anesth. · Aug 2021
Controlled Clinical TrialAre Thoracic Wall Blocks Efficient After Video-Assisted Thoracoscopy Surgery-Lobectomy Pain? A Comparison Between Serratus Anterior Plane Block and Intercostal Nerve Block.
Video-assisted thoracoscopy surgery-lobectomy is less invasive than conventional thoracotomy and is associated with fewer complications. However, the pain related is classified as moderate and requires adequate treatment. Ultrasound-guided serratus anterior plane block (SAPB) provides analgesia by blocking the lateral branches of the intercostal nerves, avoiding the complications of epidural analgesia and paravertebral block. The aim of the present study was to evaluate the efficacy and safety of the SAPB compared with the intercostal nerve block (ICNB). ⋯ The multimodal approach of SAPB, morphine-patient controlled analgesia, and paracetamol is effective, safe, and time efficient.