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Anesth Analg
January 2025
From the Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Background: Total intravenous anesthesia (TIVA)-based and volatile-based general anesthesia have different effects on cerebral hemodynamics. The current work compares these 2 regimens in acute ischemic stroke patients undergoing endovascular therapy.
Methods: We conducted a systematic literature search across MEDLINE, Embase, Cochrane, CINAHL, Web of Science, and Scopus.
J Clin Monit Comput
January 2025
GE Healthcare Finland Oy, Helsinki, Finland.
The measurement of nociception and the optimisation of intraoperative antinociceptive medication could potentially improve the conduct of anaesthesia, especially in the older population. The Surgical Pleth Index (SPI) is one of the monitoring methods presently used for the detection of nociceptive stimulus. Eighty patients aged 50 years and older who were scheduled to undergo major abdominal surgery were randomised and divided into a study group and a control group.
View Article and Find Full Text PDFA A Pract
January 2025
From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California.
In this case, the electroencephalogram (EEG) was used to guide anesthesia care for a pediatric patient with Alexander's Disease undergoing serial intrathecal injections. Previous procedures using a standard maintenance propofol dose of up to 225 µg/kg/min led to postanesthetic recovery times of over 6 hours, requiring a neurology consult for noncoherence. The EEG assisted in guiding maintenance propofol dosing to 75 µg/kg/min, decreasing postanesthetic wash-off and postanesthesia care unit (PACU) recovery time by 50%.
View Article and Find Full Text PDFBr J Hosp Med (Lond)
December 2024
Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, China.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the standard method for sampling mediastinal/hilar lymph node disease. However, the smaller samples obtained via needle aspiration have a lower diagnostic rate for benign compared to malignant diseases. The low diagnostic rates have been reported to be improved through using endobronchial ultrasound-guided intranodal forceps biopsy (EBUS-IFB), but the implementation of IFB presents technical challenges, as described with variable results in certain studies.
View Article and Find Full Text PDFBr J Hosp Med (Lond)
December 2024
Department of Anaesthesia, University College London Hospital NHS Foundation Trust, London, UK.
Placenta accreta spectrum (PAS) disorders pose significant challenges in the anaesthetic management of elective caesarean section. This article explores the anaesthetic considerations for patients with PAS focusing on the optimal techniques to ensure maternal safety and surgical success. The analysis examines the advantages and disadvantages of general anaesthesia, neuraxial anaesthesia, and combined techniques to inform considerations of anaesthetic management in this high-risk population.
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