Anesthesia & Analgesia's supplement for education and dialog

Insuring Patient Safety During Procedural Sedation

Insuring Patient Safety During Procedural Sedation

Lying on a stretcher awaiting a procedure, one cannot help but have some anxiety about the potential for complications. To anyone trained in anesthesiology, the serious complications related to sedation are very real. It is essential that as we change care paradigms for procedural sedation, we find methods for evaluating the risk of adverse events.(…)

Improving quality and safety in the cardiovascular OR: SCA efforts

Improving quality and safety in the cardiovascular OR:  SCA efforts

For more than ten years, the Society of Cardiovascular Anesthesiologists (SCA) has realized the need to make quality and safety a priority. Dr. Atilio Barbeito, Department of Anesthesiology, Duke University Medical Center, Veterans Affairs Medical Center, Durham, North Carolina, and colleagues from throughout the United States describe the SCA’s 10-year effort to improve patient safety(…)

Transcatheter aortic valve replacement: A less invasive means to replace the aortic valve

Transcatheter aortic valve replacement: A less invasive means to replace the aortic valve

Patients with severe aortic stenosis (AS) may be old, frail, have significant comorbidities, and have by definition have highly compromised ventricular function. They may also have had previous cardiac surgery. These risk factors may place the patient at inordinate risk from conventional aortic valve replacement (AVR). Transcatheter aortic valve replacement (TAVR) is potentially far less(…)

Serum progesterone concentration may influence the anesthetic requirement of a parturient undergoing cesarean delivery

Serum progesterone concentration may influence the anesthetic requirement of a parturient undergoing cesarean delivery

In clinical practice, pregnant women have lower anesthetic requirements for general anesthesia than nonpregnant women. This effect has been well studied in animals (mice & rabbits) as well as in different phases of the human menstrual cycle.  Progesterone concentration is lower in early pregnancy than term pregnancy, declines rapidly after delivery, and returns to normal values(…)

Radical prostatectomy for cancer: A comparison between general anesthesia and epidural anesthesia with fentanyl analgesia

Radical prostatectomy for cancer: A comparison between general anesthesia and epidural anesthesia with fentanyl analgesia

There has been great interest recently in the possibility that the anesthetic technique for oncological surgery may influence long-term survival by modulating immune function in the perioperative period. Dr. Juraj Sprung, Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minnesota, and colleagues from the United States and Singapore compared the outcomes of patients undergoing(…)

Supraglottic airways can be associated with serious patient morbidity

Supraglottic airways can be associated with serious patient morbidity

Most of us think that laryngeal mask airways (LMAs) and other supraglottic airway devices pose minimal risk to the oropharynx. That’s one reason they are so popular. However, no intervention is without risk. Dr. Henri J. D. de Graaff, Department of Anesthesiology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands, and colleagues describe a palatal ulceration after(…)