Though the use of flexible fiberoptic bronchoscopes has been recommended when confronted with a patient whose trachea is difficult to intubate, video-laryngoscopes (VLS) have become the new standard of care for managing difficult airways. Stylets are often needed when video-laryngoscopes are used. However, the user cannot adjust the angulation of the stylet while attempting intubation. […]
Does anesthesia exposure for surgery for malignant disease affect the risk of malignancy after surgery?
Anesthetics are known to affect the immune response, yet recently in this journal it was shown that the risk of malignant disease within 5 years postoperatively could not be associated with the duration of general anesthesia and time with Bispectral Index (BIS) under 45 in patients without a history of malignancy. What about patients with […]
For the critically ill patient, some anesthesiologists might give “a little” propofol whilst others might give more anesthesia and use etomidate instead. Those that prefer propofol note that etomidate suppresses adrenocortical function, which might affect outcome postoperatively. Dr. Ryu Komatsu, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, and coauthors used their institution’s Perioperative Health Documentation System […]
Central line-associated bloodstream infections, called CLABSIs, are associated with serious complications. Simple interventions, such as hand washing, and technologic interventions, such as use of chlorhexidine-impregnated dressings, are associated with reduced infection rates. Dr. J. Matthias Walz, MD, Departments of Anesthesiology and Surgery, University of Massachusetts Medical School and UMass Memorial Medical Center, Worcester, MA and […]
Modifying the vital sign measurement interval can affect the scores used to determine outcome after surgery
In 1973, Dr. Virginia Apgar, an anesthesiologist, introduced an eponymous five-item score to determine the ability of a neonate to adjust to extrauterine life. The score is based on heart rate, respiratory effort, muscle tone, reflex irritability, and color, important signs for the anesthesiologist. More recently our surgical colleagues have devised a “surgical Apgar score” […]
Fires require fuel, oxygen, and a heat source. To minimize the risk of an airway fire, we can reduce the available oxygen. If the inspired oxygen concentration is 60 or 100%, how long does it take to get the ambient oxygen concentration <30%? Dr. Mark J. Rice, MD, Department of Anesthesiology,University of Florida College of […]