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Advances in Anesthesia Dec 2022A shortage of inpatient beds and nurses during the coronavirus disease 2019 pandemic has lent priority to safe same-day discharge after surgery. The minimally invasive... (Review)
Review
A shortage of inpatient beds and nurses during the coronavirus disease 2019 pandemic has lent priority to safe same-day discharge after surgery. The minimally invasive nature of robotic surgery has allowed an increasing number of procedures to be done on an outpatient basis. Anesthetic management should be designed to complement the technical advantages of robotic surgery in facilitating early discharge.
Topics: Humans; Robotic Surgical Procedures; Anesthesiologists; Outpatients; COVID-19; Robotics
PubMed: 36333045
DOI: 10.1016/j.aan.2022.06.001 -
Brazilian Journal of Anesthesiology... 2015Anaesthesiology is a specialty whose specificity of the working process results in high levels of stress as an inevitable condition - a particularly worrying situation... (Review)
Review
BACKGROUND
Anaesthesiology is a specialty whose specificity of the working process results in high levels of stress as an inevitable condition - a particularly worrying situation in the daily life of these professionals.
OBJECTIVES
This study, based on data from national and international literature, aims to discuss the basis of the occurrence of mental and behavioural disorders or of psychopathological injuries (psychological distress) related to working activity in anesthesiologists.
METHOD
A literature review was conducted, with papers selected from Medline and Lilacs databases, published between 2000 and 2012 in Portuguese, English and Spanish, and addressing the possible association between occupational hazards of the anaesthesiologist profession and mental health problems and psychic distress. Twenty-six publications were listed.
RESULTS
Several aspects of the anesthesiologist's work are important points to better understand the relationship between mental health at work and working organization. Poor temporal structuring of work, conflictuous interpersonal relationships and poor control over the activity itself may be mentioned as illness enhancers.
CONCLUSION
The working organization, when not appropriate, is an important occupational risk factor for the life and mental health of workers, mainly of professionals focused on the care of people. This paper focuses on anesthesiologists, who are constantly exposed to stressful and anxiogenic factors.
Topics: Adaptation, Psychological; Anesthesiologists; Female; Humans; Job Satisfaction; Male; Mental Disorders; Occupational Diseases; Stress, Psychological
PubMed: 26614149
DOI: 10.1016/j.bjane.2013.03.021 -
Minerva Anestesiologica Feb 2019
Topics: Algorithms; Anesthesiologists; Anesthetics; Brugada Syndrome; Electrocardiography; Humans
PubMed: 30621381
DOI: 10.23736/S0375-9393.18.13449-3 -
Journal of Cardiothoracic and Vascular... Dec 2021
Review
Topics: Female; Humans; Pregnancy; Anesthesiologists; Anesthesiology; Heart; Obstetrics; Pregnancy Complications, Cardiovascular
PubMed: 34253444
DOI: 10.1053/j.jvca.2021.06.012 -
Anesthesiology Apr 2020
Review
Topics: Anesthesiologists; Humans; Perioperative Care; Point-of-Care Systems; Ultrasonography, Interventional
PubMed: 31977521
DOI: 10.1097/ALN.0000000000003113 -
Korean Journal of Anesthesiology Aug 2020
Topics: Anesthesiologists; Bias; Humans; Propensity Score
PubMed: 32746540
DOI: 10.4097/kja.20348 -
International Journal of Environmental... Dec 2022Appropriate pain care should be regarded as a right and effectively guaranteed to people with chronic pain (CP). Law 38, enacted in Italy in 2010, establishes the... (Review)
Review
Appropriate pain care should be regarded as a right and effectively guaranteed to people with chronic pain (CP). Law 38, enacted in Italy in 2010, establishes the citizen's right not to suffer. Twelve years later, such right appears still disregarded in Italy and the current access to adequate pain care reveals significant shortcomings. In addition, a mismatch between CP-associated burden and the available healthcare resources in the framework of our national health system has been observed. This article gathers the perspectives of a Board of Italian anesthesiologists on the state of the art of CP management in Italy and aims at strengthening the scientific rationale and clinical relevance of pursuing the enforceability of the right not to suffer and at promoting widespread multidisciplinary care of patients with CP.
Topics: Humans; Chronic Pain; Italy; Long-Term Care; Anesthesiologists
PubMed: 36612872
DOI: 10.3390/ijerph20010551 -
Minerva Anestesiologica 2023
Topics: Humans; Anesthesiologists; Anesthesiology
PubMed: 36884343
DOI: 10.23736/S0375-9393.23.17225-7 -
Reconfiguring the scope and practice of regional anesthesia in a pandemic: the COVID-19 perspective.Regional Anesthesia and Pain Medicine Jul 2020The COVID-19 outbreak is on the world. While many countries have imposed general lockdown, emergency services are continuing. Healthcare professionals have been infected... (Review)
Review
The COVID-19 outbreak is on the world. While many countries have imposed general lockdown, emergency services are continuing. Healthcare professionals have been infected with the virulent severe acute respiratory syndrome coronavirus-2 (SARS), which spreads by close contact and aerosols. The anesthesiologist is particularly vulnerable to aerosols while performing intubation and other airway related procedures. Regional anesthesia (RA) minimizes the need for airway manipulation and the risks of cross infection to other patients, and the healthcare personnel. In this context, for prioritizing RA over general anesthesia, wherever possible, a structured algorithmic approach is outlined. The role of percentage saturation of hemoglobin with oxygen (oxygen saturation), blood pressure and early use of point-of-care ultrasound in differential diagnosis and specific management is detailed. The perioperative anesthetic implications of multisystem manifestations of COVID-19, anesthetic management options, the scope of RA and considerations for its safe conduct in operating rooms is described. An outline for safe and rapid training of healthcare personnel, with an Entrustable Professional Activity framework for ascertaining the practice readiness among trained residents for RA in COVID-19, is suggested. These are the authors' experiences gained from the current pandemic and similar SARS, Middle East Respiratory Syndrome and influenza outbreaks in recent past faced by our authors in Singapore, India, Hong Kong and Canada.
Topics: Anesthesia, Conduction; Anesthesiologists; Betacoronavirus; COVID-19; Clinical Decision-Making; Coronavirus Infections; Cross Infection; Humans; Pandemics; Pneumonia, Viral; SARS-CoV-2
PubMed: 32471930
DOI: 10.1136/rapm-2020-101541 -
JAMA Network Open Dec 2023There is marked variability in red blood cell (RBC) transfusion during the intraoperative period. The development and implementation of existing clinical practice...
IMPORTANCE
There is marked variability in red blood cell (RBC) transfusion during the intraoperative period. The development and implementation of existing clinical practice guidelines have been ineffective in reducing this variability.
OBJECTIVE
To develop an internationally endorsed consensus statement about intraoperative transfusion in major noncardiac surgery.
EVIDENCE REVIEW
A Delphi consensus survey technique with an anonymous 3-round iterative rating and feedback process was used. An expert panel of surgeons, anesthesiologists, and transfusion medicine specialists was recruited internationally. Statements were informed by extensive preparatory work, including a systematic reviews of intraoperative RBC guidelines and clinical trials, an interview study with patients to explore their perspectives about intraoperative transfusion, and interviews with physicians to understand the various behaviors that influence intraoperative transfusion decision-making. Thirty-eight statements were developed addressing (1) decision-making (interprofessional communication, clinical factors, procedural considerations, and audits), (2) restrictive transfusion strategies, (3) patient-centred considerations, and (4) research considerations (equipoise, outcomes, and protocol suspension). Panelists were asked to score statements on a 7-point Likert scale. Consensus was established with at least 75% agreement.
FINDINGS
The 34-member expert panel (14 of 33 women [42%]) included 16 anesthesiologists, 11 surgeons, and 7 transfusion specialists; panelists had a median of 16 years' experience (range, 2-50 years), mainly in Canada (52% [17 of 33]), the US (27% [9 of 33]), and Europe (15% [5 of 33]). The panel recommended routine preoperative and intraoperative discussion between surgeons and anesthesiologists about intraoperative RBC transfusion as well as postoperative review of intraoperative transfusion events. Point-of-care hemoglobin testing devices were recommended for transfusion guidance, alongside an algorithmic transfusion protocol with a restrictive hemoglobin trigger; however, more research is needed to evaluate the use of restrictive triggers in the operating room. Expert consensus recommended a detailed preoperative consent discussion with patients of the risks and benefits of both anemia and RBC transfusion and routine disclosure of intraoperative transfusion. Postoperative morbidity and mortality were recommended as the most relevant outcomes associated with intraoperative RBC transfusion, and transfusion triggers of 70 and 90 g/L were considered acceptable hemoglobin triggers to evaluate restrictive and liberal transfusion strategies, respectively, in clinical trials.
CONCLUSIONS AND RELEVANCE
This consensus statement offers internationally endorsed expert guidance across several key domains on intraoperative RBC transfusion practice for noncardiac surgical procedures for which patients are at medium or high risk of bleeding. Future work should emphasize knowledge translation strategies to integrate these recommendations into routine clinical practice and transfusion research activities.
Topics: Humans; Anesthesiologists; Blood Transfusion; Canada; Erythrocyte Transfusion; Hemoglobins; Consensus; Intraoperative Care; Surgical Procedures, Operative; Surgeons
PubMed: 38153742
DOI: 10.1001/jamanetworkopen.2023.49559