Anesthesia & Analgesia's supplement for education and dialog

Drug-induced sleep endoscopy: use of an automated dosing strategy

Drug-induced sleep endoscopy: use of an automated dosing strategy

The incidence of obstructive sleep apnea is increasing. The diagnosis is typically made using overnight polysomnography in a sleep laboratory, a time consuming and expensive procedure. The standard therapy is continuous positive airway pressure at night, but this does not always work. Surgery can be performed, but requires anatomic determination of the reason for sleep […]

Keep breathing!

Keep breathing!

Awakening from inhaled anesthesia is a complicated business. Once the patient is no longer inhaling anesthetic, the concentration of anesthetic in the blood will drop as anesthetic gas is eliminated via the lungs. However, as the concentration in the blood decreases, the partial pressure in the blood will drop below the partial pressure in the […]

TEE is useful even during cardiopulmonary bypass

TEE is useful even during cardiopulmonary bypass

The cardiac anesthesiologist must constantly be on the look-out for adverse changes in physiology, and must be particularly vigilant during the transition on and off cardiopulmonary bypass. Even during bypass potential complications may arise that require acute intervention. Transesophageal echocardiography is particularly useful during bypass to watch for ventricular distension. Dr. Michael A. Fierro, Loyola […]

Is one opioid better than another when used as part of an epidural infusion?

Is one opioid better than another when used as part of an epidural infusion?

Opioids are commonly added to epidural infusions because of the additional analgesic properties provided by neuraxial opioids. Is there a “best” opioid to provide 24 hours of analgesia after surgery? Dr. James Paul, Department of Anesthesia, McMaster University, Hamilton, Ontario, and colleagues performed a meta-analysis of trials that compared perioperative epidural opioid infusions for postoperative […]

Hemoglobin-based oxygen carriers (HBOCs): are they a substitute for blood transfusions?

Hemoglobin-based oxygen carriers (HBOCs): are they a substitute for blood transfusions?

There was a lot of interest, particularly in the 1990s, in hemoglobin-based oxygen carriers (HBOCs) as a substitute for blood transfusions. HBOCs eliminate the need for cross-matching prior to use, they don’t require refrigeration, and they have a longer shelf life than banked blood. However, these cell-free hemoglobin oxygen substitutes have been shown to be […]