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” […]
A study of learning disability and academic achievement in children following anesthesia exposure in the first year of life.
When infants are exposed to anesthesia, does it affect learning abilities later in life? In neonatal animals, exposure to an anesthetic is unambiguously associated with neuroapoptosis (cell death) in the brain. Human studies have not been as unambiguous. Dr. Choon Bong, Department of Paediatric Anaesthesia, KK Women’s and Children’s Hospital, Yong Loo Lin School of […]
Komatsu and colleagues (Anesthetic Induction with Etomidate, Rather than Propofol, Is Associated with Increased 30-Day Mortality and Cardiovascular Morbidity After Noncardiac Surgery) identified a 2.5 fold increase in likelihood of death and a 1.5 fold increase in cardiovascular morbidity in a retrospective study of 2144 patients who received etomidate for induction of noncardiac anesthesia as […]
Hypotension during anesthesia induction is not always due to the drugs used for anesthesia induction
Okay, quick: what is the most common cause of intraoperative anaphylaxis? Antibiotic allergy? Nope. The answer? Neuromuscular blocking drugs are the most common cause of intraoperative allergic reactions. Admittedly, these reactions are very uncommon. However, we shouldn’t let our guard down if a patient has had many anesthetics without problem, as allergic sensitivity can develop […]
Many may feel that history does not change. Dr. Rajesh P. Haridas, Victoria, Australia, found a letter, dated 1 December 1846, written by Charles Thomas Jackson, M.D., to Josiah Dwight Whitney. This letter contains a description and two illustrations of a Morton ether inhaler. Contents of the letter and a discussion of the letter’s importance in […]
One of the important factors in patient satisfaction after a surgical procedure is pain relief. A successful regional block may provide 12 hours of pain relief with the local anesthetics currently available. Dr. Brian M. Ilfeld, Department of Anesthesiology, University of California San Diego, San Diego, CA and colleagues designed a dose-response cohort study using […]