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Annals of Cardiac Anaesthesia Jan 2017Goldenhar syndrome or oculo-auriculo-vertebral dysplasia was defined by Goldenhar in 1952 and redefined by Grolin et al. later. As the name denotes, children with this... (Review)
Review
Goldenhar syndrome or oculo-auriculo-vertebral dysplasia was defined by Goldenhar in 1952 and redefined by Grolin et al. later. As the name denotes, children with this syndrome present with craniofacial and vertebral anomalies which increase the risk of airway compromise. Neonates and infants with this syndrome often have premature internal organs, low birth weight, and airway disorders. For this reason, safe anesthesia in such infants requires a complete knowledge regarding metabolism and side effects of the drugs. The association of cardiovascular abnormalities is not uncommon and possesses additional challenge for anesthetic management. The aim of this review is to draw attention to the various perioperative problems that can be faced in these infants when they undergo surgery or the correction of the underlying cardiac problem.
Topics: Adult; Anesthesia; Anesthesiologists; Cardiac Surgical Procedures; Child; Goldenhar Syndrome; Humans; Infant; Infant, Newborn
PubMed: 28074825
DOI: 10.4103/0971-9784.197802 -
Brazilian Journal of Anesthesiology... 2021
Topics: Anesthesiologists; Humans; Substance-Related Disorders
PubMed: 34229857
DOI: 10.1016/j.bjane.2021.06.001 -
The American Journal of Managed Care Oct 2019To determine the patient's perception of the role of an anesthesiologist and the patient's expectations of their anesthesiologist and their anesthesia care.
OBJECTIVES
To determine the patient's perception of the role of an anesthesiologist and the patient's expectations of their anesthesiologist and their anesthesia care.
STUDY DESIGN
Questionnaire survey.
METHODS
A total of 170 patients attending the preanesthesia clinic answered a survey prior to their clinic interview and another survey the day after their surgery. The questions pertained to their perception of the role of the anesthesia provider, their expectations, and their level of satisfaction.
RESULTS
A majority (>75%) of the participants had high expectations of their anesthesia provider. The satisfaction scores were higher among those who felt that their expectations were met and among those who felt that the anesthesiologist explained to them how they would feel after anesthesia.
CONCLUSIONS
Because satisfaction is a fulfillment of one's expectations, understanding what the patient expects from their anesthesiologist is the initial step to improve satisfaction scores. The onus is on the anesthesiologist to educate the patient about their role, to set realistic expectations of the postoperative course, and to involve the patient in decisions regarding their anesthesia care.
Topics: Adult; Aged; Anesthesiologists; Female; Humans; Interviews as Topic; Male; Middle Aged; Motivation; Patient Satisfaction; Physician's Role; Physician-Patient Relations
PubMed: 31622070
DOI: No ID Found -
Annals of Cardiac Anaesthesia 2018Perioperative management of pulmonary hypertension remains one of the most challenging scenarios during cardiac surgery. It is associated with high morbidity and... (Review)
Review
Perioperative management of pulmonary hypertension remains one of the most challenging scenarios during cardiac surgery. It is associated with high morbidity and mortality due to right ventricular failure, arrhythmias, myocardial ischemia, and intractable hypoxia. Therefore, this review article is intended toward the anesthetic considerations in the perioperative period, with particular emphasis on the selection of technique and choice of anesthesia with maintenance, anesthetic drugs, and the recent intraoperative recommendations for prevention and treatment of pulmonary hypertensive crisis.
Topics: Adult; Anesthesia; Anesthesiologists; Cardiac Surgical Procedures; Female; Humans; Hypertension, Pulmonary; Male; Perioperative Care; Pregnancy
PubMed: 29652270
DOI: 10.4103/aca.ACA_123_17 -
British Journal of Anaesthesia Mar 2022There is widespread variation in how anaesthesia is provided to individual patients even for the same types of surgery. This variation exists within departments, between...
There is widespread variation in how anaesthesia is provided to individual patients even for the same types of surgery. This variation exists within departments, between hospitals, and between countries. Patient and surgical factors are often cited as a justification for variation. Local and national norms, guidance, and standards, and the positive or negative roles of key opinion leaders likely all play a part. Although clinicians may disagree where the line falls between warranted and unwarranted variations, at least some of this variation is down to anaesthetist preference, not individualised patient care.
Topics: Anesthesiologists; Anesthesiology; Anesthetists; Hospitals; Humans
PubMed: 34980471
DOI: 10.1016/j.bja.2021.11.034 -
British Journal of Anaesthesia Feb 2022The use of motor vehicles to initiate mass casualty incidents is increasing in frequency and such events are called intentional vehicular assaults. Perpetrators are... (Review)
Review
The use of motor vehicles to initiate mass casualty incidents is increasing in frequency and such events are called intentional vehicular assaults. Perpetrators are inspired by a range of terrorist ideologies or have extremist views, criminal intent, or mental health issues. Assaults using a motor vehicle as the principal weapon of attack are easy to launch and require little to no forward planning. This makes them difficult for police and security agencies to predict, prevent, or interdict. With the increasing frequency of intentional vehicular assaults, anaesthesiologists in various settings may be involved in caring for victims and should be engaged in preparing for them. This narrative review examines the literature on vehicle assaults committed around the world and provides an overview of the unique injury patterns and considerations for the pre-hospital, perioperative, and critical care management of victims of these mass casualty events. The article discusses planning, education, and training in an attempt to reduce the mortality and morbidity of intentional vehicular assaults.
Topics: Accidents, Traffic; Anesthesia; Anesthesiologists; Disaster Planning; Humans; Mass Casualty Incidents; Physician's Role; Terrorism; Wounds and Injuries
PubMed: 34654520
DOI: 10.1016/j.bja.2021.08.030 -
Journal of Neurosurgical Anesthesiology Jan 2022Translational science seeks to accelerate the multi-step process by which scientific discoveries are transformed into therapies that can improve the health of...
Translational science seeks to accelerate the multi-step process by which scientific discoveries are transformed into therapies that can improve the health of individuals and their communities. To facilitate crossing the traditional boundaries between basic and clinical research for instance, a systematic understanding of the scientific and operational principles that underlie each step of the translational cycle is developed to identify and address barriers to translation. Skills required by translational scientists, such as being systems thinkers and process innovators, overlap with those of anesthesiologists, and therefore, it is no surprise that anesthesiologists have contributed to this field. Indeed, the safety and efficacy of anesthesia care has greatly evolved over many decades because anesthesiologists have recognized the importance of readily incorporating physiological and pharmacological basic research findings into clinical practice. This article highlights the characteristics that make anesthesiologists well suited to be translational scientists. We also discuss one example of anesthesiology contributing to the field of translational science during the COVID-19 pandemic. We show that anesthesiologists, regardless of their specific clinical or research interests, have the skill set to become effective and critical players in the field of translational science and emphasize the importance of continued leadership in this field to academic anesthesiology.
Topics: Anesthesiologists; Anesthesiology; COVID-19; Humans; Pandemics; SARS-CoV-2; Translational Science, Biomedical
PubMed: 34870632
DOI: 10.1097/ANA.0000000000000807 -
Anesthesia and Analgesia Feb 2022Ensuring a productive clinical and research workforce requires bringing together physicians and communities to improve health, by strategic targeting of initiatives with... (Review)
Review
Ensuring a productive clinical and research workforce requires bringing together physicians and communities to improve health, by strategic targeting of initiatives with clear and significant public health relevance. Within anesthesiology, the traditional perspective of the field's health impact has focused on providing safe and effective intraoperative care, managing critical illness, and treating acute and chronic pain. However, there are limitations to such a framework for anesthesiology's public health impact, including the transient nature of acute care episodes such as the intraoperative period and critical illness, and a historical focus on analgesia alone-rather than the complex psychosocial milieu-for pain management. Due to the often episodic nature of anesthesiologists' interactions with patients, it remains challenging for anesthesiologists to achieve their full potential for broad impact and leadership within increasingly integrated health systems. To unlock this potential, anesthesiologists should cultivate new clinical, research, and administrative roles within the health system-transcending traditional missions, seeking interdepartmental collaborations, and taking measures to elevate anesthesiologists as dynamic and trusted leaders. This special article examines 3 core themes for how anesthesiologists can enhance their impact within the health care system and pursue new collaborative health missions with nonanesthesiologist clinicians, researchers, and administrative leaders. These themes include (1) reframing of traditional anesthesiologist missions toward a broader health system-wide context; (2) leveraging departmental and institutional support for professional career development; and (3) strategically prioritizing leadership attributes to enhance system-wide anesthesiologist contributions to improving overall patient health.
Topics: Anesthesiologists; Anesthesiology; Career Mobility; Humans; Leadership; Physician-Patient Relations
PubMed: 33684091
DOI: 10.1213/ANE.0000000000005428 -
Canadian Journal of Anaesthesia =... May 2023Monkeypox (or "mpox" as preferred by the World Health Organization) is an emerging infectious disease with sustained global transmission occurring outside of West Africa... (Review)
Review
PURPOSE
Monkeypox (or "mpox" as preferred by the World Health Organization) is an emerging infectious disease with sustained global transmission occurring outside of West Africa and the Democratic Republic of Congo. The recent 2022 mpox outbreak has involved widespread atypical presentations. Infected patients requiring surgery can increase the exposure of health care professionals and other patients to the virus. As it is a relatively new infectious disease internationally, there is less familiarity in managing this risk, especially in the surgical and anesthesia setting. This paper aims to provide information about mpox and how to manage suspected or confirmed cases.
SOURCE
Various authorities such as the World Health Organization, Infection Prevention and Control Canada, Public Health Agency of Canada, the Centers for Disease Control and Prevention (USA), and the National Centre for Infectious Diseases (Singapore) have recommended that public health and hospital systems prepare to recognize, isolate, and care for suspected and confirmed cases appropriately, as well as manage any possible exposure of staff and patients.
PRINCIPAL FINDINGS
Local authorities and hospitals should set up protocols for health care providers (HCPs) to minimize nosocomial transmission and risk to HCPs. Antivirals used in patients with more severe disease may cause renal or hepatic impairment and thus anesthetic drug pharmacology. Anesthesiologists and surgeons should be able to recognize mpox, and work with local infection control and epidemiologic programs to familiarize themselves with relevant infection prevention guidelines.
CONCLUSION
Essential measures include clear protocols for transferring and managing surgical patients who are suspected or confirmed to be infected with the virus. Care in use of personal protective equipment and handling contaminated material is necessary to prevent inadvertent exposure. Risk stratification after exposure should be done to determine need for post-exposure prophylaxis for staff.
Topics: United States; Humans; Mpox (monkeypox); Anesthesiologists; Anesthesiology; Anesthesia; Canada
PubMed: 36899136
DOI: 10.1007/s12630-023-02441-2 -
Anesthesiology Clinics Jun 2022
Topics: Anesthesiologists; Anesthesiology; COVID-19; Humans
PubMed: 35659413
DOI: 10.1016/j.anclin.2022.01.015