Articles: cations.
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Paediatric anaesthesia · Nov 2023
Inhalation anesthesia without any intravenous management for pediatric proton beam therapy.
Proton beam therapy is an oncological treatment, argued to be an appropriate tumor irradiation technique for childhood solid tumors. Due to its duration and the need for immobility, many children require anesthesia for proton therapy sessions. As not many centers in the world provide this therapy, there is little published research about pediatric anesthesia for these cases, and the available data suggest a preference for intravenous anesthesia or combined intravenous and inhalation anesthesia. We conducted this study with the aim of describing and analyzing the inhalation anesthetic management of children undergoing proton therapy at our medical center, comparing our results with studies that have followed different anesthetic protocols. ⋯ Inhalation anesthesia without any intravenous management for pediatric proton therapy is, in our experience, an effective technique with a complication rate similar to other anesthetic approaches.
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The decades since the inauguration of the International Association for the Study of Pain have witnessed major advances in scientific concepts (such as the biopsychosocial model and chronic primary pain as a disease in its own right) and in new technologies and approaches (from molecular biology to brain imaging) that have inspired innovations in pain research. These have guided progress in pain management and education about pain for healthcare professionals, the general public, and administrative agencies.
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Surgical evacuation is the standard treatment for chronic subdural hematomas (CSDHs) but is associated with a high risk of recurrence and readmission. Middle meningeal artery embolization (MMAE) is a novel treatment approach which could be performed upfront or in adjunction to surgical evacuation. MMAE studies are limited by small sample sizes. This study aimed to describe and compare outcomes of MMAE in adjunction to surgery with those of surgery alone on a national level. ⋯ This analysis of large-scale national data indicates that MMAE performed in adjunction to surgery for treatment of CSDH is associated with higher direct costs, higher complication rates, and longer length of stay but lower readmission rates compared with surgical evacuation alone.
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Anesthesia and analgesia · Nov 2023
Associations Between Fresh Gas Flow and Duration of Anesthetic on the Maximum Potential Benefit of Anesthetic Gas Capture in Operating Rooms and in Postanesthesia Care Units to Capture Waste Anesthetic Gas.
Sevoflurane and desflurane are halogenated hydrocarbons with global warming potential. We examined the maximum potential benefit assuming 100% efficiency of waste gas capture technology used in operating rooms and recovery locations. ⋯ Simulations with Gas Man show a strong rationale based on agent uptake and distribution for using volatile anesthetic agent capture in operating rooms if the technology can be highly efficient at volatile agent recovery.
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This article summarizes the many initiatives and achievements of the International Association for the Study of Pain (IASP) in pain education worldwide since 1973. These range from major events such as the World Congress on Pain that attracts thousands of attendees to the more intimate and focused Pain Schools and Pain Camps. ⋯ The unique contribution of IASP to the study of pain is reflected in its consistent focus on a biopsychosocial approach to pain, the promotion of interactions between basic scientists and clinicians, as well as multidisciplinary and interdisciplinary collaborations. Details of these rich offerings can be found on the IASP web site, and this article provides a guide for those seeking to access them.