Anesthetic Considerations for Repair of Thoracoabdominal Aortic Aneurysms.

Anesthetic management of open thoracoabdominal aneurysm (TAAA) repair poses a number of challenges for even the most experienced of cardiovascular anesthesiologists. This procedure encompasses a large number of unique anesthetic techniques, including one-lung ventilation, invasive hemodynamic monitoring, left-heart bypass, massive transfusion, selective renal and visceral perfusion, and central nervous system monitoring with CSF drainage. In this article, we aim to describe the anesthetic management for thoracoabdominal aortic aneurysm repair, including preoperative workup, intraoperative management, as well as postoperative concerns in the intensive care unit.

Anesthetic Considerations for Endovascular Repair of the Thoracic Aorta.

Thoracic aorta pathologies, especially those of the ascending aorta and aortic arch, were traditionally approached via open surgical repair. This carries risk of ischemic end-organ damage and other complications. Endovascular repair of ascending aorta and aortic arch pathologies is becoming more successful and widespread, thereby posing numerous challenges to the anesthesiologist.

The Use of Unilateral Erector Spinae Plane Block in Minimally Invasive Cardiac Surgery.

Objectives: To examine the efficacy of continuous unilateral erector spinae plane (ESP) blocks in minimally invasive cardiac surgery patients.

Design: A retrospective nonrandomized study.

Setting: At a single-center, tertiary academic institution.

Anesthetic Management of Laser Lead Extraction for Cardiovascular Implantable Electronic Devices.

Cardiovascular implantable electronic devices (CIEDs) play a significant role in the modern management of cardiovascular disease. CIEDs include implantable pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. These devices improve the quality of life of their recipients and help reduce the incidence of sudden cardiac death.

Anesthetic Management of Patients Undergoing Percutaneous Endocardial and Epicardial Left Atrial Appendage Occlusion.

Atrial fibrillation is the most common cardiac arrhythmia in adults affecting almost 6 million adults in the United States. The 2 most common comorbidities associated with atrial fibrillation are heart failure and thromboembolic events. Heart failure symptoms may be treated with rate control, antiarrhythmic medications or by catheter ablation.

Resection of Celiac Artery Aneurysm with Bypass Grafting to the Splenic and Common Hepatic Arteries.

Celiac artery aneurysms are rare and typically warrant surgical treatment. Atherosclerosis is their chief cause. Symptomatic patients usually present with abdominal pain.

Anesthetic Management in Radiofrequency Catheter Ablation of Ventricular Tachycardia.

Radiofrequency catheter ablation is increasingly being used to treat patients who have ventricular tachycardia, and anesthesiologists frequently manage their perioperative care. This narrative review is intended to familiarize anesthesiologists with preprocedural, intraprocedural, and postprocedural implications of this ablation. Ventricular tachycardia typically arises from structural heart disease, most often from scar tissue after myocardial infarction.

Electromyography as a new means of navigation during endotracheal intubation.

This study tested a method of using rapid analysis of electromyographic response patterns to electrical stimulation to enable real-time navigation during endotracheal intubation. An electromyographic response detection device was constructed and integrated into a standard endotracheal tube. The rebound rates of the response voltages were measured in the trachea and oesophagus after stimulation in an acute study performed in three freshly euthanized male Suffolk sheep.

[Preoperative patient education: can we improve satisfaction and reduce anxiety?].

Background And Objectives: Patients' knowledge deficits concerning anesthesia and the anesthesiologist's role in their care may contribute to anxiety. The objective of this study was to develop anesthesia patient education materials that would help improve patient's satisfaction regarding their knowledge of the perioperative process and decrease anxiety in a community hospital with a large Spanish-speaking population.

Methods: A survey (Survey A) in English and Spanish was administered to all adult anesthesiology preoperative clinic patients during a 4-week period.

Association Between Preoperative Aspirin-dosing Strategy and Mortality After Coronary Artery Bypass Graft Surgery.

Objective: To determine whether preoperative aspirin-acetylsalicylic acid (ASA)-timing or dose independently affects 30-day all-cause mortality.

Background: Preoperative ASA administration is associated with reduced morbidity and mortality after coronary artery bypass graft (CABG). However, data are lacking regarding optimal timing and dosing of ASA.

Randomized, controlled trial comparing the effects of anesthesia with propofol, isoflurane, desflurane and sevoflurane on pain after laparoscopic cholecystectomy.

Background: Pain is the primary complaint and the main reason for prolonged recovery after laparoscopic cholecystectomy. The authors hypothesized that patients undergoing laparoscopic cholecystectomy will have less pain four hours after surgery when receiving maintenance of anesthesia with propofol when compared to isoflurane, desflurane, or sevoflurane.

Methods: In this prospective, randomized trial, 80 patients scheduled for laparoscopic cholecystectomy were assigned to propofol, isoflurane, desflurane, or sevoflurane for the maintenance of anesthesia.