Anesthesia & Analgesia's supplement for education and dialog

Fall-prevention strategies after total knee arthroplasty

Fall-prevention strategies after total knee arthroplasty

Postoperative falls may cause serious morbidity. Fall prevention has become part of quality improvement programs at many hospitals. Dr. Rebecca Johnson, Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minnesota, and colleagues ascertained the incidence of falls after total knee arthroplasty (TKA) between 2003 and 2012 to determine whether the incidence decreased with the […]

Early management of acute hemorrhagic shock

Early management of acute hemorrhagic shock

How should patients who have suffered severe trauma and who then have acute hemorrhagic shock be treated prior to the initiation of hemostatic therapy? Dr. Herbert Schöchl, Department of Anaesthesiology and Intensive Care, AUVA Trauma Hospital, Salzburg, Austria, and the Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstrasse, Vienna, Austria, and Dr. Christoph J. […]

Ultrasound use to determine gastric content in severely obese individuals

Ultrasound use to determine gastric content in severely obese individuals

Ultrasound has become quite popular in regional anesthesia, as well as to guide cannulation of central veins and peripheral veins and arteries. Ultrasound can also be used to measure preoperative gastric content. Gastric fluid volume is estimated based on a measurement of the cross-sectional area (CSA) of the antrum. Most studies have been performed in […]

Dr. Freeman Allen: an anesthesiology pioneer

Dr. Freeman Allen: an anesthesiology pioneer

Although Morton demonstrated the anesthetizing properties of ether in 1846, it was not until late 19th century that a few physicians began devoting their careers exclusively to administering anesthesia to patients, educating others about its use, and studying ways to administer it in a more safe and effective manner. One such physician was Dr. Freeman […]

Can dexamethasone reduce delirium incidence after cardiac surgery?

Can dexamethasone reduce delirium incidence after cardiac surgery?

Delirium is seen in at least 50% of patients after cardiac surgery. Patients with delirium have a greater likelihood extended hospital stay, long-term cognitive impairment, and death after surgery. Cardiac surgery and cardiopulmonary bypass trigger an inflammatory response. This response may contribute to neuroinflammation, brain injury, and postoperative delirium. Steroids may decrease neuroinflammation and the […]

Proper care of patients who suffer myocardial infarction after vascular surgery

Proper care of patients who suffer myocardial infarction after vascular surgery

Postoperative myocardial infarction (MI) is a well-documented and potentially fatal complication of vascular surgery. Elevated troponin I levels can suggest a myocardial infarction even without ECG evidence. Medical management of ischemic heart disease is well understood, and involves the use of HMG-CoA reductase inhibitors (i.e., statins), antiplatelet drugs, beta-adrenergic receptor blockers, and angiotensin-converting enzyme (ACE) […]