Articles: anesthetics.
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Anesthesia and analgesia · Jan 2025
Anesthesia Trauma Guidelines: A Systematic Review of Global Accessibility and Quality.
This systematic review describes the available clinical practice guidelines (CPGs) for the anesthetic management of trauma and appraises the accessibility and quality of these resources. This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was conducted across 8 databases (MEDLINE, Embase, Web of Science, CABI Digital Library, Global Index Medicus, SciELO, Google Scholar, and National Institute for Health and Care Excellence) for guidelines from 2010 to 2023. ⋯ Though many countries and societies have contributed to the development of anesthesia CPGs for trauma, there has been a disproportionate lack of representation from LMICs, where the burden of trauma mortality is highest. In this study, we identify barriers to accessibility and areas for improving future guideline quality. We recommend ongoing efforts to incorporate perspectives from diverse settings and to increase the availability of high-quality, open-access guidelines to improve worldwide health outcomes in trauma.
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Local anesthesia is a widely used technique for emergency wound closure, with lidocaine among the most commonly employed local anesthetics. Allergic reactions to lidocaine are rare, with anaphylaxis being even more uncommon. ⋯ Although rare, anaphylaxis induced by lidocaine can be fatal. Early recognition, prompt intervention, thorough preoperative assessment, and careful postoperative monitoring are critical to improving survival rates.
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Paediatric anaesthesia · Jan 2025
Evaluation of the Pediatric Regional Anesthesia Time-Out Checklist: A Simulation Study.
The Society for Pediatric Anesthesia Quality and Safety Committee developed the Pediatric Regional Anesthesia Time-Out Checklist, consisting of 14 safety items intended to be reviewed by an anesthesia team prior to a regional anesthetic. Primarily, we hypothesized that use of this Checklist would increase the number of safety items performed compared with no checklist, evaluating the usefulness of this tool. Secondarily, we hypothesized that, after checklist training, subjects would show better clinical judgment by electing to perform a regional anesthetic in scenarios in which no programmed error existed and electing to not perform a regional anesthetic in scenarios in which a programmed error did exist. ⋯ Pediatric Regional Anesthesia Time-Out Checklist training led to an increased number of safety items performed prior to a simulated anesthetic.
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Anesthesia and analgesia · Jan 2025
Comparing General Anesthesia-Based Regimens for Endovascular Treatment of Acute Ischemic Stroke: A Systematic Review and Network Meta-Analysis.
Total intravenous anesthesia (TIVA)-based and volatile-based general anesthesia have different effects on cerebral hemodynamics. The current work compares these 2 regimens in acute ischemic stroke patients undergoing endovascular therapy. ⋯ This network meta-analysis showed that the perioperative use of either general anesthesia-based regimen, or sedation, did not significantly impact various endovascular therapy-related outcomes. However, the current work was underpowered to detect differences in anesthetic agents, clinico-demographic characteristics, or procedural factors.