Knowledge

Collections of articles, notes and knowledge from the metajournal community.

Renal impairment

Perioperative medicine Renal impairment
- Review
  
  Patient with chronic renal failure undergoing surgery.
  
  Curr Opin Anaesthesiol. 2016 Jun 1; 29 (3): 413-20.
- Review
  
  Early referral strategies for management of people with markers of renal disease: a systematic review of the evidence of clinical effectiveness, cost-effectiveness and economic analysis.
  
  Health Technol Assess. 2010 Apr 1;14(21):1-184.
- Randomized Controlled Trial
  
  Atracurium, cisatracurium, vecuronium and rocuronium in patients with renal failure.
  
  Minerva Anestesiol. 2003 Jul 1;69(7-8):605-11, 612, 5.
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Non-technical qualities of anesthesiology

Anesthesia Decision making
- Review
  
  Decision-making errors in anesthesiology.
  
  Int Anesthesiol Clin. 2014 Jan 1;52(1):84-96.
- Review
  
  Characteristics of a high-quality anesthesia practice.
  
  Int Anesthesiol Clin. 2014 Jan 1;52(1):15-41.
- Article
  
  How excellent anaesthetists perform in the operating theatre: a qualitative study on non-technical skills.
  
  Br J Anaesth. 2013 Jan 1; 110 (1): 115121115-21.
  
  Non-technical skills are of equal importance to technical anaesthesia skills, but are more challenging to define, measure and acquire.
  pearl
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Is remifentanil associated with Opioid Induced Hyperalgesia and Acute Opioid Tolerance?

Analgesia Opioid Remifentanil
- Remifentanil infusions above 0.20-0.25 μg/kg/min are associated with hyperalgesia (OIH = Opioid Induced Hyperalgesia) and tolerance (AOT = Acute Opioid Tolerance) respectively.
- Some of these effects can be mitigated by multimodal analgesia (notably ketamine), and possibly by gradual weaning of a remifentanil infusion.
- The findings have been predominately identified in rats and volunteer human studies. The clinical and longterm significance is still uncertain.
- Although OIH and AOT arise from different physiological mechanisms, they are clinically difficult (if not impossible) to differentiate.
- The clinical priority for management is prevention.
summary
...and 1 more note
- Review
  
  Remifentanil-acute opioid tolerance and opioid-induced hyperalgesia: a systematic review.
  
  Am J Ther. 2015 May 1; 22 (3): e62-74.
- Randomized Controlled Trial
  
  Gradual withdrawal of remifentanil infusion may prevent opioid-induced hyperalgesia.
  
  Br J Anaesth. 2016 Apr 1; 116 (4): 524-30.
- Review
  
  Opioid-induced hyperalgesia in clinical anesthesia practice: what has remained from theoretical concepts and experimental studies?
  
  Curr Opin Anaesthesiol. 2017 Aug 1; 30 (4): 458-465.
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Decision Making in Anaesthesia & Critical Care

Anesthesia Critical care Decision making
- Review
  
  Understanding Decision Making in Critical Care.
  
  Clin Med Res. 2015 Dec 1; 13 (3-4): 156-68.
- Editorial
  
  Obstetric difficult airway guidelines - decision-making in critical situations.
  
  Anaesthesia. 2015 Nov 1; 70 (11): 1221-5.
- Article
  
  Decision-making and accountability: differences of distribution.
  
  Sociol Health Illn. 2014 Jan 1; 36 (1): 44-59.
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Shared decision making in anaesthesia & perioperative medicine

Anesthesia Decision making Perioperative medicine
- Review
  
  Shared decision-making in peri-operative medicine: a narrative review.
  
  Anaesthesia. 2019 Jan 1; 74 Suppl 1: 13-19.
- Editorial
  
  Anaesthesia, not for resuscitation orders, and shared decision-making.
  
  Anaesth Intensive Care. 2017 May 1; 45 (3): 289-290.
- Article
  
  A survey of Australian and New Zealand anaesthetists' attitudes towards resuscitation orders in the perioperative setting.
  
  Anaesth Intensive Care. 2017 May 1; 45 (3): 396-402.
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