Evolving Concepts of Pain Management in Elderly Patients.

Purpose Of Review: The elderly population typically suffer from a variety of diseases that mostly reflect the degenerative changes linked with the aging process. These diseases may be exacerbated by acute pain or by an abrupt aggravation of previously stable chronic pain.

Recent Findings: Physical and psychological changes associated with aging may influence one's experience of pain and, as a result, the severity of pain.

Ketamine: Pro or antiepileptic agent? A systematic review.

Purpose: of Review: This evidence-based systematic review evaluated the safety of ketamine as regard the potential to provoke epilepsy to help better guide anesthesiologists in their practice.

Recent Findings: Ketamine, originally developed as a dissociative anesthetic, has gained attention for its potential therapeutic applications in various medical conditions, including epilepsy. Ketamine is generally well-tolerated and widely used in anesthesia, however, conflicting data are confusing the anesthesiologists regarding the potential risk of seizures associated with its use.

Efficacy and Safety of Ketamine-Dexmedetomidine Versus Ketamine-Propofol Combination for Periprocedural Sedation: A Systematic Review and Meta-analysis.

Purpose Of Review: The combination of ketamine with propofol and dexmedetomidine has gained popularity for sedation and general anesthesia in different populations. In our meta-nalysis, we helped the anesthesiologists to know the efficiency and the efficacy of both combinations in adult and pediatric patients.

Methods: We searched PubMed, CENTRAL, Web of Science, and Scopus from inception to August 1, 2023.

Telemedicine, E-Health, and Multi-Agent Systems for Chronic Pain Management.

Telemedicine, telehealth, and E-health all offer significant benefits for pain management and healthcare services by fostering the physician-patient relationship in otherwise challenging circumstances. A critical component of these artificial-intelligence-based health systems is the "agent-based system", which is rapidly evolving as a means of resolving complicated or straightforward problems. Multi-Agent Systems (MAS) are well-established modeling and problem-solving modalities that model and solve real-world problems.

Pediatric obesity and anesthetic challenges of metabolic surgery.

Obesity in the pediatric population is considered a growing problem. It is likely that there will be a significant impact related to obesity on the health of future generations. Obesity has increased the incidence of a spectrum of diseases ranging from microvascular complications over the retina and peripheral nerves to an increased incidence of cancer.

The role of ultrasonography in anesthesia for bariatric surgery.

Bariatric surgeries are effective long-term management for morbid obesity with its adverse sequelae. Anesthesia of bariatric surgeries poses unique challenges for the anesthesiologist in every step starting with vascular access till tracheal extubation. The usage of ultrasound in anesthesia is becoming more prevalent with a variety of benefits, especially in the obese population.

Mitral Regurgitation in Patients Undergoing Noncardiac Surgery.

Mitral regurgitation (MR) is one of the most frequently encountered types of valvular heart disease in the United States. Patients with significant MR (moderate-to-severe or severe) undergoing noncardiac surgery have an increased risk of perioperative cardiovascular complications. MR can arise from a diverse array of causes that fall into 2 broad categories: primary (diseases intrinsic to the valvular apparatus) and secondary (diseases that disrupt normal valve function via effects on the left ventricle or mitral annulus).

Anesthetic Considerations for Cesarean Delivery After Uterine Transplant.

Infertility has many etiologies and can have devastating consequences for young couples attempting to bring children into the world. Uterine factor for infertility is related to either uterine agenesis (Mayer-Rokitansky-Küster-Hauser [MRKH] syndrome), unexpected hysterectomy, or presence of a nonfunctioning uterus. In this review, a patient with MRKH syndrome underwent donor uterus transplantation at the Cleveland Clinic, conceived, and delivered the first healthy baby in the United States and the second worldwide.

A Comprehensive Review and Update of the Use of Dexmedetomidine for Regional Blocks.

Purpose Of Review: This evidence-based systematic review will focus on the use of dexmedetomidine and its role as adjuvant anesthetics in regional blocks to help better guide physicians in their practice. This review will cover background and mechanism of dexmedetomidine as well as the use in various regional blocks.

Recent Findings: Local anesthetics are preferred for nerve blocks over opioids; however, both due come with its own side effects.

Acupuncture for the Management of Low Back Pain.

Purpose Of Review: This evidence-based systematic review will focus on the use of acupuncture and its role in the treatment of low back pain to help better guide physicians in their practice. It will cover the background and the burden of low back pain and present the current options for treatment and weigh the evidence that is available to support acupuncture as a treatment modality for low back pain.

Recent Findings: Low back pain (LBP), defined as a disorder of the lumbosacral spine and categorized as acute, subacute, or chronic, can be a debilitating condition for many patients.

Preoperative, Multidisciplinary Clinical Optimization of Patients with Severely Depressed Left Ventricular Ejection Fraction Who Are Undergoing Coronary Artery Bypass Grafting.

Coronary artery bypass grafting (CABG) remains a routine operation despite major advancements in angioplastic procedures. Around 200,000 CABG procedures are performed annually in the U.S.

Postoperative Management of Hyperinflated Native Lung in Single-Lung Transplant Recipients with Chronic Obstructive Pulmonary Disease: A Review Article.

End-stage chronic obstructive pulmonary disease (COPD) is the most common indication for single- or double-lung transplantation. Acute native lung hyperinflation (ANLH) is a unique postoperative complication of single-lung transplantation for COPD patients, with incidence varying in the medical literature from 15 to 30%. The diagnosis is made radiographically by contralateral mediastinal shift and ipsilateral diaphragmatic flattening.

Global Longitudinal Strain: Is It Time to Change the Preoperative Cardiac Assessment of Oncology Patients?

The introduction of new anticancer treatment modalities has improved survival rates, transforming cancer into a chronic disease in many instances. One of the most devastating complications of cancer treatment is cancer therapy-related cardiac dysfunction. Adequate preoperative assessment of any significant cancer therapy-related cardiac impairment is critical, and may be missed with conventional measures.

Elective cardiac surgery during the COVID-19 pandemic: Proceed or postpone?

During this coronavirus disease 2019 (COVID-19) pandemic, there is an international call to postpone all elective surgeries. Cardiac surgery carries a combined risk for cardiac patients, who are at risk for higher complications of COVID-19, and healthcare workers. In response to the COVID-19 pandemic, the American College of Surgeons and the American Society of Anesthesiologists recommended a sustained reduction in the rate of new COVID-19 cases for 14 days before the resumption of the elective surgery, but postponing surgery may impact patients' daily activities and increase the risk the of deterioration of their cardiac condition.

Pneumomediastinum, Pneumothorax, Pneumoperitoneum, and Subcutaneous Emphysema Complicating Extubation of a Difficult Airway Using an Airway Exchange Catheter: Is Oxygen Insufflation Innocent?: A Case Report.

Airway exchange catheter is a valuable tool where an airway is anticipated to be difficult to reintubate. We report a case of subcutaneous emphysema, pneumomediastinum, pneumoperitoneum, and pneumothorax after extubation using an exchange catheter. There was an iatrogenic tracheal tear during airway management that filled the connected spaces with oxygen insufflation through the catheter.