Anesthesiology Commons^™

Esmolol Compared To Fentanyl On Hemodynamic Effects: A Scoping Review, Anna Mccleskey Bsn, Rn, Srna, Landon Mcdonald Msn, Rn, Cnl, Tim Moore Bsn, Rn, Srna, Jamie Pitcock Bsn, Rn, Srna, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Purpose The purpose of this DNP project is to compare the efficacy of esmolol to fentanyl in attenuation the hemodynamic response associated with direct laryngoscopy.

Specific Aims Compare the effects of esmolol to fentanyl on patient heart rate during laryngoscopy. Compare the effects of esmolol to fentanyl on patient mean arterial pressure during laryngoscopy.

Intraoperative Map, Vasopressors, And Opioids In Tf-Tavr Patients Undergoing Conscious Sedation Vs General Anesthesia, Brett J Friedman, Patrick Karabon, Wei C Lau

Posters

INTRODUCTION
Aortic stenosis is a progressive narrowing of the aortic valve that can cause serious cardiovascular harm such as syncope, heart failure, and death if left untreated. Transfemoral-transcatheter aortic valve replacement (TF-TAVR) emerged in the last 10 years as an alternative for previously inoperable, high-risk patients. Studies suggest that monitored anesthesia for TF-TAVR using minimalist conscious sedation results in better outcomes (e.g., shorter length of stay, lower 30-day mortality) when compared to general anesthesia. However, there is a gap in knowledge of why conscious sedation is more successful. Recent studies have demonstrated the association of intraoperative mean arterial pressure (MAP) …

Airway Management And The Hypoglossal Nerve Stimulator For Obstructive Sleep Apnea Patients, Chandler Barnes

Nurse Anesthesia Student Capstones

The pathophysiology of obstructive sleep apnea (OSA) relates to anatomical and non-anatomical factors. Anatomical considerations correlate to narrowing of the pharynx. When present, non-anatomical factors can intensify the severity of OSA and ease of collapsibility of upper airway tissue. The negative consequences of untreated OSA are well-defined and many treatment options are available. The novel hypoglossal nerve stimulator makes for a viable treatment option in patients who do not tolerate more traditional therapy, such as continuous positive airway pressure (CPAP), and meets eligibility requirements of device implantation as outlined by the Food and Drug Administration (FDA). The Inspire® Hypoglossal Nerve …

Recommendations For Effective Documentation In Regional Anesthesia: An Expert Panel Delphi Consensus Project, Hassan M Ahmed, Benjamin P Atterton, Gillian G Crowe, Jaime L Barratta, Mark Johnson, Eugene R. Viscusi, Sanjib Adhikary, Eric Albrecht, Karen Boretsky, Jan Boublik, Dara S Breslin, Kelly Byrne, Alan Ch'ng, Alwin Chuan, Patrick Conroy, Craig Daniel, Andrzej Daszkiewicz, Alain Delbos, Dan Sebastian Dirzu, Dmytro Dmytriiev, Paul Fennessy, H Barrie J Fischer, Henry Frizelle, Jeff Gadsden, Philippe Gautier, Rajnish K Gupta, Yavuz Gürkan, Harold David Hardman, William Harrop-Griffiths, Peter Hebbard, Nadia Hernandez, Jakub Hlasny, Gabriella Iohom, Vivian H Y Ip, Christina L Jeng, Rebecca L Johnson, Hari Kalagara, Brian Kinirons, Andrew Kenneth Lansdown, Jody C Leng, Yean Chin Lim, Clara Lobo, Danielle B Ludwin, Alan James Robert Macfarlane, Anthony T Machi, Padraig Mahon, Stephen Mannion, David H Mcleod, Peter Merjavy, Aleksejs Miscuks, Christopher H Mitchell, Eleni Moka, Peter Moran, Ann Ngui, Olga C Nin, Brian D O'Donnell, Amit Pawa, Anahi Perlas, Steven Porter, John-Paul Pozek, Humberto C Rebelo, Vicente Roqués, Kristopher M Schroeder, Gary Schwartz, Eric S. Schwenk, Luc Sermeus, George Shorten, Karthikeyan Srinivasan, Markus F Stevens, Kassiani Theodoraki, Lloyd R Turbitt, Luis Fernando Valdés-Vilches, Thomas Volk, Katrina Webster, T Wiesmann, Sylvia H Wilson, Morné Wolmarans, Glenn Woodworth, Andrew K Worek, E M Louise Moran

Department of Anesthesiology Faculty Papers

Background and objectives: Documentation is important for quality improvement, education, and research. There is currently a lack of recommendations regarding key aspects of documentation in regional anesthesia. The aim of this study was to establish recommendations for documentation in regional anesthesia.

Methods: Following the formation of the executive committee and a directed literature review, a long list of potential documentation components was created. A modified Delphi process was then employed to achieve consensus amongst a group of international experts in regional anesthesia. This consisted of 2 rounds of anonymous electronic voting and a final virtual round table discussion with live …

Dexmedetomidine Vs. Propofol In Postoperative Delirium Prevention, Jaclyn Burnett Rn, Srna, Montana Betts Rn, Srna, Christhian De Ochoa Rn, Srna, Maciej Chec Rn, Srna, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Postoperative delirium (POD) is an acute neurological condition affecting large numbers of surgical patients in various practice settings. Patients suffering from this condition face postoperative complications, increased lengths of stay, and tremendous financial burden. Understanding the contributing factors for POD, and how adjustments in intraoperative agents can prevent or reduce the incidence, is a crucial aspect of anesthesia practice. This scoping review will examine associations between POD and the intraoperative use of propofol versus dexmedetomidine with general anesthesia.

Methods Studies in this review were limited to peer-reviewed literature, published in medical and nursing journals within the last five years. …

Effect Of Lipid-Lowering Medications In Patients With Coronary Artery Bypass Grafting Surgery Outcomes, Chunxia Shi, Zugui Zhang, Jordan E Goldhammer, David Li, Bob Kiaii, Victor Rudriguez, Douglas Boyd, David Lubarsky, Richard Applegate, Hong Liu

Department of Anesthesiology Faculty Papers

Background: Increased life expectancy and improved medical technology allow increasing numbers of elderly patients to undergo cardiac surgery. Elderly patients may be at greater risk of postoperative morbidity and mortality. Complications can lead to worsened quality of life, shortened life expectancy and higher healthcare costs. Reducing perioperative complications, especially severe adverse events, is key to improving outcomes in patients undergoing cardiac surgery. The objective of this study is to determine whether perioperative lipid-lowering medication use is associated with a reduced risk of complications and mortality after coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).

Methods: After IRB approval, we …

Maximising Access To Timely Trauma Care Across Population Of Karachi And Its Districts: A Geospatial Approach To Develop A Trauma Care Network, Muhammad Nabeel Ashraf, Mohammad Salman Khalil, Ahwaz Akhtar, Lubna Samad, Asad Latif

Department of Anaesthesia

Objectives: To develop and propose a cost-effective trauma care network for Karachi, Pakistan, by calculating maximum timely trauma care (TTC) coverage achieved with the addition of potential designated private and public level 1 and level 2 trauma centres (TCs).
Setting: A lower middle-income country metropolis, Karachi is Pakistan's largest city with a population of 16 million and a total of 56 hospitals as per government registry data.
Participants: 41 potential TCs selected using a two-level, contextually-relevant TC designation criteria adapted from various international guidelines.
Primary and secondary outcome measures: Maximum TTC coverage achievable with the addition of potential TCs. Proposed …

The Anxiolytic Effects Of Aromatherapy On Preprocedural Anxiety: An Integrated Review, Rebekah Smith

Senior Honors Theses

Anxiety before procedures can negatively impact patients by increasing cortisol levels which delays wound healing and increases infection risk, increasing pain and sedation medication needs, and increasing hospitalization time. This review was conducted to find how inhaled essential oils affect pre-procedural anxiety of adults in acute care settings. Nine databases and some gray literature were searched within the past ten years, and documented using the PRISMA flow chart. Ten articles fitting the inclusion criteria were retrieved. Nine of the articles found a significant difference between the aromatherapy group and control group and pre- and post- intervention anxiety scores, and none …

Comparison Of Liposomal Bupivacaine Versus Bupivacaine With Epinephrine Versus The Combination In Postoperative Pain Management Following Spinal Surgery, Arianne Dagdag

Annual Research Symposium

No abstract provided.

Anesthetics Affect Peripheral Venous Pressure Waveforms And The Cross-Talk With Arterial Pressure, Ali Z. Al-Alawi, Kaylee R. Henry, Lauren D. Crimmins, Patrick C. Bonasso, Md Abul Hayat, Melvin S. Dassinger, Jeffrey M. Burford, Hanna K. Jensen, Joseph Sanford, Jingxian Wu, Kevin W. Sexton, Morten O. Jensen

Biomedical Engineering Faculty Publications and Presentations

Analysis of peripheral venous pressure (PVP) waveforms is a novel method of monitoring intravascular volume. Two pediatric cohorts were studied to test the effect of anesthetic agents on the PVP waveform and cross-talk between peripheral veins and arteries: (1) dehydration setting in a pyloromyotomy using the infused anesthetic propofol and (2) hemorrhage setting during elective surgery for craniosynostosis with the inhaled anesthetic isoflurane. PVP waveforms were collected from 39 patients that received propofol and 9 that received isoflurane. A multiple analysis of variance test determined if anesthetics influence the PVP waveform. A prediction system was built using k-nearest neighbor (k-NN) …

The Demographics Of Pain After Spinal Cord Injury: A Survey Of Our Model System., James J Bresnahan, Benjamin R Scoblionko, Devon Zorn, Daniel E Graves, Eugene R Viscusi

Department of Anesthesiology Faculty Papers

STUDY DESIGN: Survey OBJECTIVES: Better understand the demographics of pain after spinal cord injury (SCI).

SETTING: Academic Level 1 trauma center and SCI Model System.

METHODS: A survey including general demographic questions, questions of specific interest to the authors, the standardized SCI Pain Instrument (SCIPI), International SCI Pain Data Set, Basic form (ISCIPDS:B), Patient Reported Outcomes Measurement Information System (PROMIS) neuropathic 5a (PROMIS-Neur), and PROMIS nociceptive 5a (PROMIS-No).

RESULTS: 81% of individuals with SCI experience chronic pain and 86% of individuals with pain have neuropathic pain. 55% of individuals had shoulder pain. Females and those who recall >5/10 pain during …

Senior Academic Ranks In Us Anesthesiology Programs: Differences Between Women And Men And Examination Of Independent Factors For Success, Brenda Lee, Farhad Zahedi, Ina Zaimi, Roman Schumann

Journal of Maine Medical Center

Introduction: Gender equality among faculty is a challenge in academic medicine, including anesthesiology. We investigated the likelihood that several factors were associated with academic success in the United States (US), defined as having achieved a senior academic rank (SAR) in a US anesthesiology training program.

Methods: We collected data available on the Internet on 131 anesthesiology programs, including faculty academic rank, gender, number of faculty, graduate status from an American medical school, fellowship training status, number of residents, number of program fellowships, and geographic location. SAR was defined as either associate professor or professor. Data were analyzed with logistic regression. …

Surgical Management During The Covid-19 Era At A Private Tertiary Care Hospital Of Karachi, Pakistan: A Cross-Sectional Study, Nida Zahid, Erum Baig, Gulzar S. Lakhani, Hasnain Zafar, Asad Latif, Syed Ather Enam

Department of Surgery Docs

Background: The coronavirus disease 2019 (COVID-19), declared a pandemic in March 2020, has affected the entire healthcare system, including the surgical practice. Guidelines for the management of surgical patients during this COVID-19 era need to be established to provide timely yet safe surgical care. In this study, we aimed to evaluate the outcomes of the COVID-19 testing algorithm established for surgery patients presenting to a tertiary care hospital in Karachi, Pakistan, and to compare the outcomes among patients who underwent elective versus emergency surgery.
Methodology: This is a cross-sectional study conducted at a tertiary care hospital in Pakistan to apply …

Implementation Of The Comprehensive Unit-Based Safety Program To Improve Infection Prevention And Control Practices In Four Neonatal Intensive Care Units In Pune, India, Julia Johnson, Asad Latif, Bharat Randive, Abhay Kadam, Uday Rajput, Aarti Kinikar, Nandini Malshe, Sanjay Lalwani, Tushar B. Parikh, Umesh Vaidya

Department of Anaesthesia

Objective: To implement the Comprehensive Unit-based Safety Program (CUSP) in four neonatal intensive care units (NICUs) in Pune, India, to improve infection prevention and control (IPC) practices.
Design: In this quasi-experimental study, we implemented CUSP in four NICUs in Pune, India, to improve IPC practices in three focus areas: hand hygiene, aseptic technique for invasive procedures, and medication and intravenous fluid preparation and administration. Sites received training in CUSP methodology, formed multidisciplinary teams, and selected interventions for each focus area. Process measures included fidelity to CUSP, hand hygiene compliance, and central line insertion checklist completion. Outcome measures included the rate …

Comparing Intravenous And Inhalation Anesthetics For Intraoperative Anesthesia In Adult Patients With An Acute Traumatic Brain Injury, Natasha K. Moody

Nurse Anesthesia Student Capstones

As research and science has progressed to further analyze the effects of anesthetics on cerebral physiology, the margin of safety for each anesthetic is reassessed to enhance patient outcomes and recovery. The purpose of this review is to strategically examine and provide updated information on the impact of specific anesthetics administered during the intraoperative period as it applies to patients with acute traumatic brain injury (TBI). In efforts to preserve the cerebral physiology of the patient, current research has identified benefits of administering intravenous over inhalation anesthetics to reduce secondary injuries that have been linked to chronic TBI, morbidity, and …

The Impact Of Dexmedetomidine Use In Patients Over The Age Of 60 Undergoing General Anesthesia On Postoperative Delirium Incidence, Elaina Branco

Nurse Anesthesia Student Capstones

Postoperative cognitive dysfunction (POCD) and postoperative delirium (POD) are of concern in the elderly population undergoing an anesthetic due to increased mortality and decreased quality of life that can ensue. Sui et al. (2021) reported a 15-50% incidence of POD in elderly surgical patients. Dexmedetomidine is a highly selective, alpha-2 agonist with sedative, analgesic, and anxiolytic properties that mimics a sleep-like state and causes bradycardia and hypotension but not respiratory depression. Dexmedetomidine has neuroprotective properties, including anti-apoptosis and anti-inflammation (Wu et al., 2019). A current review of the literature revealed that dexmedetomidine use can decrease POD incidence in the aged …

The Effect Of Clonidine On Hyperbaric Bupivacaine And Opioid In Cesarean Section Women Under Spinal Anesthesia, Novisi Abba

Nurse Anesthesia Student Capstones

Pain is undoubtedly one of the most undesirable outcomes associated with cesarean section in parturients. The most effective post-cesarean section pain relief option should prioritize maternal, fetal, and neonatal safety, with minimal to no medication transfer to the fetus and neonate. In obstetric anesthesia, neuraxial approaches, with the inclusion of adjuncts like clonidine for pain management may provide some additional benefits. Consequently, obstetric anesthesia practitioners have increasingly used intrathecal clonidine to alleviate post-cesarean section pain. This manuscript examines whether intrathecal clonidine, when combined with hyperbaric bupivacaine and/or opioids (fentanyl and/or preservative-free morphine), has a sustained analgesic effect in parturients following …

Do The Benefits Of Sugammadex Outweigh Its Higher Cost Compared To Neostigmine?, Ashley Mcdonald

Nurse Anesthesia Student Capstones

Neuromuscular blocking agents (NMBAs) are frequently utilized in anesthetic practice to relax the vocal cords in preparation for endotracheal intubation and to facilitate optimal operating conditions for various surgical procedures. Residual muscle paralysis in the postoperative period is a serious consequence of NMBAs that can lead to severe consequences including airway obstruction, hypoxia, reintubation, aspiration, and pneumonia. Neuromuscular blockade (NMB) is overcome either by spontaneous recovery or, in most cases, with the use of a reversal agent. Two of the most common reversal agents are neostigmine, a cholinesterase inhibitor, and sugammadex, a modified gamma-cyclodextrin. Of the two medications, sugammadex is …

Efficacy Of Dexmedetomidine As An Opioid Sparing Adjunct To Regional Anesthesia For Shoulder Surgery, Matthew Austin

Nurse Anesthesia Student Capstones

Regional anesthetics are often the preferred route for patients who are having orthopedic shoulder procedures (Rai & Bhutia, 2017). Traditionally, plain local anesthetics, like bupivacaine or ropivacaine, are used as the local anesthetic of choice because of their fast onset and relatively predictable duration of action. However, several different additives have been trialed to prolong the duration or improve the density of regional blocks. When looking at additives to regional anesthetic techniques, side effects and duration of the block can be unpredictable and unpleasant. For example, additives like fentanyl, morphine, and dexamethasone have been trialed in regional techniques and have …

One Block: Two Bridges To Analgesia, William Wall, Casey Wilson

South Atlantic Division GME Research Day 2022

No abstract provided.