Characterizing the Relationships Amongst Psychological Safety, the Learning Environment, and Well-Being in Surgical Faculty and Trainees.

Objective: Learning environments affect the well-being of surgical faculty and trainees. Psychological safety (PS) has been linked with learning behaviors and aspects of well-being within medicine; however, given the unique challenges inherent to the surgical learning environment, there is a need to more closely examine these concepts for surgical faculty and trainees. The objective of this study is to examine the relationships between learning environment and PS, as well as PS and well-being with surgery.

An Analysis of the Top-cited Articles in Anesthesiology Education Literature.

Background: In the same way that impact factor is calculated for journals, the number of citations an article receives can indicate its influence or value to a particular field. This study was designed to identify the most frequently cited articles in anesthesiology education to yield insight into which articles have been most useful for researchers in ongoing research and publication.

Methods: The Web of Science database was searched to capture the top-cited articles in anesthesiology education both in anesthesiology and nonanesthesiology journals.

Propofol Drug Shortage Associated With Worse Postoperative Nausea and Vomiting Outcomes Despite a Mitigation Strategy.

Drug shortages negatively affect patient care and outcomes. Postoperative nausea and vomiting (PONV) can be mitigated using risk assessment and prophylaxis. A 2012 propofol shortage provided an opportunity to study the impact of using prophylactic antiemetics and changing the technique from a propofol infusion to inhaled agents in an ambulatory surgery setting.

A Survey of Simulation Utilization in Anesthesiology Residency Programs in the United States.

Given the evolution of competency-based education and evidence supporting the benefits of incorporating simulation into anesthesiology residency training, simulation will likely play an important role in the training and assessment of anesthesiology residents. Currently, there are little data available regarding the current status of simulation-based curricula across US residency programs. In this study, we assessed simulation-based training and assessment in US anesthesiology programs using a survey designed to elicit information regarding the type, frequency, and content of the simulation courses offered at the 132 Accreditation Council of Graduate Medical Education-certified anesthesiology training programs.

Patient selection for day case-eligible surgery: identifying those at high risk for major complications.

Background: Due to economic pressures and improvements in perioperative care, outpatient surgical procedures have become commonplace. However, risk factors for outpatient surgical morbidity and mortality remain unclear. There are no multicenter clinical data guiding patient selection for outpatient surgery.

Identifying patients at high risk for venous thromboembolism requiring treatment after outpatient surgery.

Objective: To identify independent predictors of 30-day venous thromboembolism (VTE) events requiring treatment after outpatient surgery.

Background: An increasing proportion of surgical procedures are performed in the outpatient setting. The incidence of VTE requiring treatment after outpatient surgery is unknown.

Symptomatic phrenic nerve palsy after supraclavicular block in an obese man.

Regional anesthesia has an expanding role in upper extremity surgery. Brachial plexus blocks offer several advantages including providing effective analgesia, reducing narcotic requirements, and facilitating ambulatory care surgery. Despite the popularity of nerve blocks, the surgeon must not forget the complications associated with regional anesthesia.

Antinociceptive effects of nociceptin/orphanin FQ administered intrathecally in monkeys.

Unlabelled: Nociceptin/orphanin FQ (N/OFQ) is the endogenous peptide for the NOP receptors. Depending on the doses, intrathecal administration of N/OFQ has dual actions (ie, hyperalgesia and antinociception) in rodents. However, the pharmacological profile of intrathecal N/OFQ is not fully known in primates.

Effects of butorphanol on morphine-induced itch and analgesia in primates.

Background: Butorphanol is an opioid analgesic with partial agonist actions at micro- and kappa-opioid receptors (MOR and KOR). Previous studies have demonstrated that both MOR antagonists and KOR agonists are effective in alleviating intrathecal morphine-induced itch in primates. The aim of the study was to investigate the effectiveness of butorphanol as an antipruritic and to elucidate the receptor mechanisms underlying butorphanol's antipruritic effect in primates.

A series of anesthesia-related maternal deaths in Michigan, 1985-2003.

Background: Maternal Mortality Surveillance has been conducted by the State of Michigan since 1950, and anesthesia-related maternal deaths were most recently reviewed for the years 1972-1984.

Methods: Records for pregnancy-associated deaths between 1985 and 2003 were reviewed to identify 25 cases associated with a perioperative arrest or major anesthetic complication. Four obstetric anesthesiologists independently classified these cases, and disagreements were resolved by discussion.

An analysis of reintubations from a quality assurance database of 152,000 cases.

Study Objective: To determine if the majority of reintubations, a potentially preventable adverse event, were predominantly due to residual muscle relaxant effects, we analyzed our quality assurance database to identify the causes of reintubation.

Design: Retrospective study.

Setting: University of Michigan Department of Anesthesiology Quality Assurance (QA) database.

Relative analgesic potencies of levobupivacaine and ropivacaine for epidural analgesia in labor.

Background: The minimum local analgesic concentration has been defined as the median effective local analgesic concentration (EC50) in a 20-ml volume for epidural analgesia in the first stage of labor. The aim of this study was to assess the relative analgesic potencies of epidural levobupivacaine and ropivacaine by determination of their respective minimum local analgesic concentrations.

Methods: Parturients at 7 cm of cervical dilation or less who requested epidural analgesia were allocated to one of two groups in this double-blind, randomized, prospective study.

Activation of kappa-opioid receptors inhibits pruritus evoked by subcutaneous or intrathecal administration of morphine in monkeys.

Pruritus (itch sensation) is the most common side effect associated with spinal administration of morphine given to humans for analgesia. A variety of agents have been proposed as antipruritics with poorly understood mechanisms and they are effective with variable success. kappa-Opioid agonists possess several actions that are opposite to micro -opioid agonists.

Effect of epidural epinephrine on the minimum local analgesic concentration of epidural bupivacaine in labor.

Background: The minimum local analgesic concentration (MLAC) has been defined as the median effective local analgesic concentration in a 20-ml volume for epidural analgesia in the first stage of labor. The aim of this study was to determine the local anesthetic-sparing efficacy of epidural epinephrine by its effect on the MLAC of bupivacaine.

Methods: In this double-blind, randomized, prospective study, 70 parturients who were at 7 cm or less cervical dilation and who requested epidural analgesia were allocated to one of two groups.