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Critical Reviews in Biomedical... 2017This article reviews the various modeling techniques for neuromonitoring depth of anesthesia (DOA). Traditional techniques such as parametric, predictive, optimal, and... (Review)
Review
This article reviews the various modeling techniques for neuromonitoring depth of anesthesia (DOA). Traditional techniques such as parametric, predictive, optimal, and adaptive modeling; proportional, integral, derivative (PID) modeling; together with modern techniques such as bispectral-based, artificial neural-network-based, fuzzy logic, and neuro-fuzzy modeling, bring us to the current state of the art in DOA neuromonitoring. This article reviews historical information about each of the modern techniques and provides an example demonstrating its implementation; reviews drug pharmacokinetic/pharmacodynamic (PK/PD) and drug interaction PK/PD modeling techniques for a balanced total intravenous anesthesia (TIVA) administration; and discusses the existing technical problems and clinical challenges, suggesting new techniques necessary for the future development of a DOA monitoring and control system.
Topics: Algorithms; Anesthesia; Anesthesiology; Fuzzy Logic; Humans; Intraoperative Neurophysiological Monitoring; Models, Biological; Monitoring, Intraoperative
PubMed: 29953380
DOI: 10.1615/CritRevBiomedEng.v45.i1-6.110 -
Journal of Clinical Anesthesia Dec 2018To review research highlights of manuscripts published in 2017 that pertain to all aspects of the clinical practice of anesthesiology. (Review)
Review
STUDY OBJECTIVE
To review research highlights of manuscripts published in 2017 that pertain to all aspects of the clinical practice of anesthesiology.
DESIGN
Narrative review.
SETTING
N/A.
MATERIALS
The major themes addressed in this review include recent studies examining airway management, obstetrical and gynecological anesthesia, pediatric anesthesia, cardiac anesthesia, regional analgesia and pain management.
INTERVENTIONS
N/A.
MAIN RESULTS
N/A.
CONCLUSIONS
This review will highlight and inform anesthesiologists of the developing trends in clinical anesthesia and will also pose new challenges for further studies.
Topics: Airway Management; Anesthesia; Anesthesiology; Humans; Pain Management; Pain, Postoperative; Surgical Procedures, Operative
PubMed: 30103101
DOI: 10.1016/j.jclinane.2018.08.012 -
Journal of Clinical Anesthesia Dec 2017To review research highlights of manuscripts published in 2016 that pertain to all aspects of the clinical practice of anesthesiology. (Review)
Review
STUDY OBJECTIVE
To review research highlights of manuscripts published in 2016 that pertain to all aspects of the clinical practice of anesthesiology.
DESIGN
Narrative review.
SETTING
N/A.
MATERIALS
The major themes address broad categories of general anesthesia including airway management, abdominal surgery, and obstetrical and gynaecological anesthesia. In addition, recent advancements in specialties of anesthesiology including regional anesthesia are reviewed.
INTERVENTIONS
N/A.
MAIN RESULTS
N/A.
CONCLUSIONS
This recent body of evidence will both help inform anesthesiologists of the developing trends in anesthesiology and will also pose new challenges for further studies.
Topics: Airway Management; Anesthesia; Anesthesiology; Biomedical Research; Humans; Patient Positioning; Surgical Procedures, Operative
PubMed: 29100739
DOI: 10.1016/j.jclinane.2017.10.002 -
Journal of Cardiothoracic and Vascular... Mar 2019Adult cardiothoracic anesthesiology (ACTA) is a competitive fellowship. Despite increases in both the number of programs offering cardiothoracic fellowships and the... (Review)
Review
Adult cardiothoracic anesthesiology (ACTA) is a competitive fellowship. Despite increases in both the number of programs offering cardiothoracic fellowships and the number of residents applying each year, there is little direction or advice for prospective candidates. This review aims to educate anesthesiology residents who are hoping to pursue cardiothoracic anesthesiology, by examining a brief history of the advanced perioperative echocardiography qualification, the credentialing goals of ACTA fellowships, and the current status of ACTA fellowships. The second part of the review covers the ACTA fellowship application and aims to assist the candidate in navigating this process. The review examines the qualifications that fellowship programs look for in a candidate, including a discussion on professional behavior, and what an applicant can look for in a program. Finally, there is a brief discussion on post-match preparation.
Topics: Adult; Anesthesia, Cardiac Procedures; Anesthesiology; Echocardiography, Transesophageal; Fellowships and Scholarships; Humans
PubMed: 30683596
DOI: 10.1053/j.jvca.2018.12.006 -
Anaesthesia Nov 2023
Topics: Humans; Anesthesia, Obstetrical; Anesthesiology
PubMed: 37527548
DOI: 10.1111/anae.16106 -
Anesthesia and Analgesia Nov 2014
Topics: Anesthesiology
PubMed: 25329014
DOI: 10.1213/ANE.0000000000000445 -
Journal of Anesthesia History Jul 2017One-lung anesthesia presents many practical, anatomical, and physiological challenges to the anesthetist in modern day practice. The techniques and equipment that we use... (Review)
Review
One-lung anesthesia presents many practical, anatomical, and physiological challenges to the anesthetist in modern day practice. The techniques and equipment that we use today have developed slowly over the course of the last century. The idea of isolated lung ventilation came from bronchospirometry studies by pioneering physiologists as early as 1871, and some of their original equipment was adapted for clinical use in the 1930s. Anesthetic techniques have generally been developed to facilitate surgical advances, and the development of double-lumen tubes is no exception. The development of the double-lumen tube was sporadic and occurred mainly to allow more complex thoracic procedures, mostly associated with suppurative lung disease. Once the need for independent ventilation of the lungs was identified in clinical practice, pioneers of the technique developed their own methods and often their own equipment. This led to the ability of the anesthetist to be able to control ventilation to each lung, including collapse of the operative lung and protection of the isolated lung against contamination. As these anesthetics became more reliable, the surgical scope for one-lung anesthesia began to broaden, and today one-lung ventilation is used to facilitate thoracic surgery, mainly on the lung, but also esophageal, thoracic wall, and mediastinal surgical procedures.
Topics: Anesthesia; Anesthesiology; History, 19th Century; History, 20th Century; One-Lung Ventilation; Thoracic Surgical Procedures
PubMed: 28842155
DOI: 10.1016/j.janh.2017.05.002 -
British Journal of Anaesthesia Jan 2024Neonatal airway management comes with exclusive anatomical, physiological, and environmental complexities, and probably higher incidences of accidents and complications....
Neonatal airway management comes with exclusive anatomical, physiological, and environmental complexities, and probably higher incidences of accidents and complications. No dedicated airway management guidelines were available until the recently published first joint guideline released by a task force supported by the European Society of Anaesthesiology and Intensive Care and the British Journal of Anaesthesia and focused on airway management in children under 1 yr of age. The guideline offers a series of recommendations based on meticulous methodology including multiple Delphi rounds to complement the sparse and scarce available evidence. Getting back from Brobdingnag, the land of giants with many guidelines available, this guideline represents a foundational cornerstone in the land of Lilliput.
Topics: Child; Infant, Newborn; Humans; Airway Management; Anesthesia; Anesthesiology; Critical Care; Advisory Committees; Intubation, Intratracheal
PubMed: 38036322
DOI: 10.1016/j.bja.2023.11.001 -
British Journal of Anaesthesia Mar 2020
Topics: Anesthesiology; Biomedical Research; Career Mobility; Cultural Diversity; Female; Humans; Leadership; Physicians, Women; Sexism
PubMed: 31973824
DOI: 10.1016/j.bja.2019.12.038 -
Current Opinion in Anaesthesiology Oct 2018This narrative review describes the current framework for informed consent discussions for regional anesthesia practice from an ethical and medicolegal stand point as... (Review)
Review
PURPOSE OF REVIEW
This narrative review describes the current framework for informed consent discussions for regional anesthesia practice from an ethical and medicolegal stand point as the cornerstone of the patient-physician relationship and the respect for patient autonomy. Recent guidelines and position statements from anesthesia societies have emphasized the importance of these discussions and their appropriate documentation.
RECENT FINDINGS
Recent studies have shown that patients want to know more about both common and benign, as well as rare but serious adverse events, as it relates to their anesthetic care. Several strategies have been recently recommended as a means to facilitate a meaningful consent discussion and proper documentation in the perioperative environment.
SUMMARY
Defining the material risks of ultrasound-guided regional anesthetic procedures remains challenging, due in part to the difficulty in quantifying incidence rates of relatively rare events. However, well informed discussions are of great importance to support patient autonomy and lay a strong foundation for the patient-anesthesiologist relationship.
Topics: Anesthesia, Conduction; Anesthesiology; Documentation; Humans; Informed Consent; Ultrasonography, Interventional
PubMed: 30063486
DOI: 10.1097/ACO.0000000000000635