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Anaesthesia Aug 2004
Topics: Anesthesiology; Anesthetics; Asphyxia; Chloroform; History, 19th Century; Humans; Lung Diseases
PubMed: 15270988
DOI: 10.1111/j.1365-2044.2004.03890.x -
British Journal of Anaesthesia Jan 1949
Topics: Anesthesia; Anesthesiology; Anesthetics; Death; Humans
PubMed: 18115864
DOI: 10.1093/bja/21.3.107 -
Drug Design, Development and Therapy 2021The aim of this work is to identify the most influential initial clinical studies that fomented important developments in anesthesiology over the past 50 years. Studies... (Review)
Review
The aim of this work is to identify the most influential initial clinical studies that fomented important developments in anesthesiology over the past 50 years. Studies fomenting new development can be selected using vastly different approaches and, therefore, might provide diverse outcomes. In the present work, two basic aspects of study assessments - the stage of development (eg, generation of idea, preclinical studies, clinical trials) and the method of selection (eg, committee vote, various types of citation analysis, method of finding the invention disclosure) - were chosen according to the following model. The stage of development: the initial clinical studies demonstrating the basic advantage of an innovation for providing anesthesia. The method: a combination of two factors - the study priority in terms of the time of its publication and the degree of its acknowledgement in the form of citation impact; the time of study publication was regarded as a primary factor, but only if the study's citation count was =/>20. The initial high-impact studies were selected for 16 drug-related topics (ketamine, isoflurane, etomidate, propofol, midazolam in anesthesia, vecuronium, alfentanil, atracurium, sevoflurane, sufentanil, rocuronium, desflurane, ropivacaine, remifentanil, dexmedetomidine in anesthesia, and sugammadex), and 9 technique-related topics (ultrasound-guided peripheral nerve block, capnography in anesthesia, target-controlled intravenous anesthesia, pulse oximetry in anesthesia, total intravenous anesthesia, transesophageal echocardiography in anesthesia, combined spinal-epidural anesthesia, and bispectral index). Twenty-five studies were designated the first high-impact studies (one for each topic); 16 are drug-related and 9 are technique-related. Half of the first high-impact studies had a citation count of =/>100, (range: 100 to 555). The citation count of the other half of high-impact studies did not reach the 100-citation threshold (range: 41 to 97). If a selected first high-impact study had a citation count <100, a next-on-timeline, additional study with citation count =/>100 was also selected; (range: 100 to 344). The present results show that an initial high-impact clinical study on a new development in anesthesiology can be determined and that related citations usually vary from one hundred to five hundred.
Topics: Anesthesia; Anesthesiology; Anesthetics; Animals; Clinical Trials as Topic; Drug Development; History, 20th Century; History, 21st Century; Humans; Publications
PubMed: 34149285
DOI: 10.2147/DDDT.S316636 -
PloS One 2023Despite the large number of pigs involved in translational studies, no gold standard depth of anaesthesia indicators are available. We undertook a scoping review to... (Review)
Review
BACKGROUND
Despite the large number of pigs involved in translational studies, no gold standard depth of anaesthesia indicators are available. We undertook a scoping review to investigate and summarize the evidence that sustains or contradicts the use of depth of anaesthesia indicators in this species.
METHODS
Medline, Embase and CAB abstract were searched up to September 22nd 2022. No limits were set for time, language and study type. Only original articles of in vivo studies using pigs or minipigs undergoing general anaesthesia were included. The depth of anaesthesia indicators reported in the selected papers were divided in two categories: A, indicators purposely investigated as method to assess depth of anaesthesia; B, indicators reported but not investigated as method to assess depth of anaesthesia.
RESULTS
Out of 13792 papers found, 105 were included after the screening process. Category A: 17 depth of anaesthesia indicators were found in 19 papers. Studies were conducted using inhalant anaesthetics as the main anaesthetic agent in the majority of the cases (13/19 = 68.4%), while 3/19 (15.8%) used propofol. The most investigated depth of anaesthesia indicators were bispectral index (8/19 = 42.1%) and spectral edge frequency 95% (5/19 = 26.3%). Contrasting results about the specific usefulness of each depth of anaesthesia indicators were reported. Category B: 23 depth of anaesthesia indicators were found in 92 papers. The most reported depth of anaesthesia indicators were: motor response following a stimulus (37/92 = 40.2%), depth of anaesthesia scores (21/92 = 23.3%), bispectral index (16/92 = 17.8%) and spectral edge frequency 95% (9/92 = 9.8%).
CONCLUSION
Results highlight the lack of scientifically valid and reliable indicators to ensure adequate depth of anaesthesia in pigs.
Topics: Animals; Swine; Swine, Miniature; Anesthetics; Anesthesia, General; Propofol; Anesthesiology; Electroencephalography
PubMed: 36952576
DOI: 10.1371/journal.pone.0283511 -
BMC Anesthesiology Aug 2023The decision about which type of general anesthetic to administer is typically made by the clinical team without patient engagement. This study examined patients'...
BACKGROUND
The decision about which type of general anesthetic to administer is typically made by the clinical team without patient engagement. This study examined patients' preferences, experiences, attitudes, beliefs, perceptions, and perceived social norms about anesthesia and about engaging in the decision regarding general anesthetic choice with their clinician.
METHODS
We conducted a survey in the United States, sent to a panel of surgical patients through Qualtrics (Qualtrics, Provo, UT) from March 2022 through May 2022. Questions were developed based on the Theory of Planned Behavior and validated measures were used when available. A patient partner who had experienced both intravenous and inhaled anesthesia contributed to the development and refinement of the questions.
RESULTS
A total of 806 patients who received general anesthesia for an elective procedure in the last five years completed the survey. 43% of respondents preferred a patient-led decision making role and 28% preferred to share decision making with their clinical team, yet only 7.8% reported being engaged in full shared decision making about the anesthesia they received. Intraoperative awareness, pain, nausea, vomiting and quickly returning to work and usual household activities were important to respondents. Waking up in the middle of surgery was the most commonly reported concern, despite this experience being reported only 8% of the time. Most patients (65%) who searched for information about general anesthesia noted that it took a lot of effort to find the information, and 53% agreed to feeling frustrated during the search.
CONCLUSIONS
Most patients prefer a patient-led or shared decision making process when it comes to their anesthetic care and want to be engaged in the decision. However, only a small percentage of patients reported being fully engaged in the decision. Further studies should inform future shared decision-making tools, informed consent materials, educational materials and framing of anesthetic choices for patients so that they are able to make a choice regarding the anesthetic they receive.
Topics: Humans; Decision Making, Shared; Anesthesia, General; Anesthesiology; Anesthetics, General; Surveys and Questionnaires
PubMed: 37592215
DOI: 10.1186/s12871-023-02219-5 -
Anesthesia and Analgesia Aug 2022Technological innovation has been closely intertwined with the growth of modern anesthesiology as a medical and scientific discipline. Anesthesia & Analgesia, the...
Technological innovation has been closely intertwined with the growth of modern anesthesiology as a medical and scientific discipline. Anesthesia & Analgesia, the longest-running physician anesthesiology journal in the world, has documented key technological developments in the specialty over the past 100 years. What began as a focus on the fundamental tools needed for effective anesthetic delivery has evolved over the century into an increasing emphasis on automation, portability, and machine intelligence to improve the quality, safety, and efficiency of patient care.
Topics: Analgesia; Anesthesia; Anesthesiology; Anesthetics; History, 20th Century; Humans; Technology
PubMed: 35839833
DOI: 10.1213/ANE.0000000000006027 -
British Journal of Anaesthesia Jan 2022
Topics: Anesthesia; Anesthesiology; Anesthetics; Animals; Humans; Religion and Medicine; Vegans
PubMed: 34657664
DOI: 10.1016/j.bja.2021.09.019 -
Anesthesiology Jul 2016Although Ernest Shackleton's Endurance Antarctic expedition of 1914 to 1916 is a famous epic of survival, the medical achievements of the two expedition doctors have...
Although Ernest Shackleton's Endurance Antarctic expedition of 1914 to 1916 is a famous epic of survival, the medical achievements of the two expedition doctors have received little formal examination. Marooned on Elephant Island after the expedition ship sank, Drs. Macklin and McIlroy administered a chloroform anesthetic to crew member Perce Blackborow to amputate his frostbitten toes. As the saturated vapor pressure of chloroform at 0°C is 71.5 mmHg and the minimum alveolar concentration is 0.5% of sea-level atmospheric pressure (3.8 mmHg), it would have been feasible to induce anesthesia at a low temperature. However, given the potentially lethal hazards of a light chloroform anesthetic, an adequate and constant depth of anesthesia was essential. The pharmacokinetics of the volatile anesthetic, administered via the open-drop technique in the frigid environment, would have been unfamiliar to the occasional anesthetist. To facilitate vaporization of the chloroform, the team burned penguin skins and seal blubber under overturned lifeboats to increase the ambient temperature from -0.5° to 26.6°C. Chloroform degrades with heat to chlorine and phosgene, but buildup of these poisonous gases did not occur due to venting of the confined space by the stove chimney. The anesthetic went well, and the patient-and all the ship's crew-survived to return home.
Topics: Anesthesia; Anesthesiology; Anesthetics; Animals; Antarctic Regions; Caniformia; Chloroform; Frostbite; History, 20th Century; Humans; Ships; Spheniscidae
PubMed: 27148920
DOI: 10.1097/ALN.0000000000001151 -
Postgraduate Medical Journal Oct 1948
Topics: Analgesia; Anesthesia; Anesthesiology; Anesthetics; Humans; Pain Management
PubMed: 18888920
DOI: 10.1136/pgmj.24.276.539 -
Postgraduate Medical Journal Oct 1948
Topics: Aged; Anesthesia; Anesthesia, Inhalation; Anesthesiology; Anesthetics; Anesthetics, Inhalation; Humans; Inhalation
PubMed: 18888916
DOI: 10.1136/pgmj.24.276.510