Overview and Limitations of Database Research in Anesthesiology: A Narrative Review.

The utilization of large-scale databases for research in medical fields, including anesthesiology, has increased in popularity over the last decade, likely due to their structured content and relative ease of access. These databases have been used in a variety of perioperative studies, including analyses of risk stratification, preoperative testing, complications, and cost. While these databases contain a wealth of information that allows for an abundance of research opportunities, there are unique limitations to their use.

Differential Ventilation Using Flow Control Valves as a Potential Bridge to Full Ventilatory Support during the COVID-19 Crisis.

Background: During the COVID-19 pandemic, ventilator sharing was suggested to increase availability of mechanical ventilation. The safety and feasibility of ventilator sharing is unknown.

Methods: A single ventilator in pressure control mode was used with flow control valves to simultaneously ventilate two patients with different lung compliances.

Forehead pulse oximeter-associated pressure injury.

Peripherally placed transmittance pulse oximeter sensors have been associated with patient injury including burns, gangrene, and necrosis. There are 2 reports of burn injuries associated with the use of forehead reflectance sensors, but there is no report of a pressure injury associated with the use of an OxiMax™ MAX-FAST™ forehead sensor and headband. We report the case of a patient who developed tissue necrosis associated with prolonged application of a forehead pulse oximeter sensor under a headband and displacement of the sensor cable.

Patient injuries from anesthesia gas delivery equipment: a closed claims update.

Background: Improvements in anesthesia gas delivery equipment and provider training may increase patient safety. The authors analyzed patient injuries related to gas delivery equipment claims from the American Society of Anesthesiologists Closed Claims Project database over the decades from 1970s to the 2000s.

Methods: After the Institutional Review Board approval, the authors reviewed the Closed Claims Project database of 9,806 total claims.

Severe anaphylactoid reaction to thymoglobulin in a pediatric renal transplant recipient.

Intraoperative administration of thymoglobulin is an integral part of the anti-rejection regimen during organ transplantation. However, its administration may be associated with complications. An anaphylactoid reaction that occurred in a pediatric recipient of a living-related renal transplant, on initiating an intravenous infusion of thymoglobulin, is presented.

The safety and efficacy of regional anesthesia in an office-based setting.

Study Objective: To determine the safety and efficacy of regional anesthesia techniques when administered in the office-based setting.

Design: Retrospective chart review.

Setting: Free-standing orthopedic office with an operating room suite.

Anesthetic considerations for thoracic neurosurgical procedures.

Anesthetic considerations for thoracic and thoracoscopic neurosurgical procedures are considered, emphasizing the need to provide anesthetic stability during prolonged periods of one-lung ventilation, while optimizing conditions for intraoperative monitoring of spinal cord integrity.

Hypoxic pulmonary vasoconstriction.

Hypoxic pulmonary vasoconstriction is a local reflex in the lung that diverts blood away from poorly oxygenated regions. Improvements in understanding of modulators of this response have led to pharmacologic methods whereby V/Q matching may potentially be improved in certain types of pulmonary pathology and during anesthesia for thoracic surgical procedures.

Anesthetic implications of myasthenia gravis.

Myasthenia gravis is a disease of great significance to the anesthesiologist, because it affects the neuromuscular junction. Many patients with this condition are treated by surgical thymectomy, using techniques developed by Mount Sinai physicians, including Dr. Paul Kirschner, Dr.

The visual analog scale for pain: clinical significance in postoperative patients.

Background: The visual analog scale is widely used in research studies, but its connection with clinical experience outside the research setting and the best way to administer the VAS forms are not well established. This study defines changes in dosing of intravenous patient-controlled analgesia as a clinically relevant outcome and compares it with VAS measures of postoperative pain.

Methods: Visual analog scale measurements were obtained from 150 patients on the morning after intraabdominal surgery.

The use of propofol, nitrous oxide, or isoflurane does not affect the reproductive success rate following gamete intrafallopian transfer (GIFT): a multicenter pilot trial/survey.

Background: Whether anesthetic agents administered during gamete intrafallopian transfer (GIFT) affect reproductive outcome is controversial. This multicenter pilot trial and survey had two purposes: to evaluate the effect of propofol, nitrous oxide, midazolam, and isoflurane on pregnancy outcome after GIFT, and to determine if a larger prospective, randomized study is warranted.

Methods: A written invitation was mailed to all 50 fertility programs in the United States that are members of the Society for Assisted Reproductive Technology and perform more than 30 GIFT procedures per year.

Prolonged surgery increases the likelihood of admission of scheduled ambulatory surgery patients.

Study Objective: To identify variables influencing the likelihood of unanticipated admission following scheduled ambulatory surgery.

Design: Retrospective case-controlled chart review study.

Setting: A large academic tertiary care hospital.

Positive end-expiratory pressure during one-lung ventilation improves oxygenation in patients with low arterial oxygen tensions.

Objective: The application of 10 cm H2O of positive end-expiratory pressure (PEEP10) to the ventilated lung during one-lung ventilation (OLV) has an unpredictable effect on PaO2. It was hypothesized that patients with a low PaO2 (< 80 mmHg) during OLV may benefit from application of PEEP.

Design: Prospective, open.

Propofol permits tracheal intubation but does not affect postoperative myalgias.

Study Objective: To determine the effect of propofol without succinylcholine on intubating conditions and postoperative myalgias in ambulatory surgical patients undergoing general anesthesia.

Design: Prospective, double-blind, randomized study.

Setting: Ambulatory surgery adult patients.

Predictors of pulse oximetry data failure.

Background: Pulse oximeters have been reported to fail to record data in 1.12-2.50% of cases in which anesthesia records were handwritten.