Anesthesia & Analgesia's supplement for education and dialog

Noninvasive Measurement of Hemoglobin Via CO-Oximetry: Is it Accurate in Children?

Noninvasive Measurement of Hemoglobin Via CO-Oximetry: Is it Accurate in Children?

Rainbow® Pulse CO-Oximetry™ sensors are single-piece, taped-on sensors that are placed like a pulse oximeter to provide a real-time, noninvasive measurement of arterial hemoglobin concentration (SpHb). This technology has been well studied in adults, but more data needs to be collected regarding its pediatric applicability. Because it is intended to be used to direct transfusion(…)

Perioperative Goal-Directed Fluid Therapy for Colorectal Surgery

Perioperative Goal-Directed Fluid Therapy for Colorectal Surgery

It’s not always clear how much fluid to give intraoperatively. Blood pressure and heart rate are two monitors to help determine how much fluid should be given, though the differential diagnosis for variations in each does not only include fluid volume. Dr. David Pestaña, originally from the Department of Anesthesiology and Critical Care, Hospital Universitario(…)

Development of a Short Version of the Modified Yale Preoperative Anxiety Scale

Development of a Short Version of the Modified Yale Preoperative Anxiety Scale

Preoperative anxiety has been extensively studied in the anesthesia literature.  Preoperative anxiety is associated with adverse outcomes in children such as nightmares, separation anxiety, and increased analgesic requirements postoperatively, and thus assessment and treatment are important components of optimum anesthesia care.  The Yale Preoperative Anxiety Scale was developed almost twenty years ago and has become one(…)

C-reactive protein kinetics after major surgery

C-reactive protein kinetics after major surgery

Circulating C-reactive protein (CRP) concentrations increase after surgery as a result of the inflammatory response to surgical trauma.  However, CRP values also increase with sepsis, so it can be difficult to differentiate between inflammation and infection when trying to interpret CRP changes after surgery. Dr. Jean-Louis Vincent, Department of Intensive Care, Erasme Hospital, Université Libre(…)

Neuraxial anesthesia for the prevention of postoperative morbidity and mortality

Neuraxial anesthesia for the prevention of postoperative morbidity and mortality

Does regional anesthesia improve outcomes, mortality, and major morbidity for patients undergoing intermediate- to high-risk surgery? This question has been a hot topic in anesthesiology for several decades. The latest contribution to the debate is an analysis of Cochrane reviews in order to summarize the effects of neuraxial anesthesia on the perioperative rates of death,(…)