Anesthesiology

Memtsoudis, Stavros G.; Ma, Yan; González Della Valle, Alejandro; Mazumdar, Madhu; Gaber-Baylis, Licia K.; MacKenzie, C Ronald; Sculco, Thomas P.

Anesthesiology. 111(6):1206-1216, December 2009.

doi: 10.1097/ALN.0b013e3181bfab7d

An inpatient nationwide database was analyzed for differences in perioperative outcomes between unilateral total knee arthroplasties (UTKAs) and bilateral total knee arthroplasties (BTKAs) from 1998 to 2006. BTKAs performed during the same versus different operations at the same hospitalization were also compared. BTKAs carry increased risk of perioperative complications and mortality compared with UTKAs. Staging BTKA procedures during the same hospitalization offered no mortality benefit, and may even expose patients to increased morbidity.

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Bijker, Jilles B.; van Klei, Wilton A.; Vergouwe, Yvonne; Eleveld, Douglas J.; van Wolfswinkel, Leo; Moons, Karel G. M.; Kalkman, Cor J.

Anesthesiology. 111(6):1217-1226, December 2009.

doi: 10.1097/ALN.0b013e3181c14930

A simple causal relation between intraoperative hypotension and 1-yr mortality after noncardiac surgery could not be demonstrated. However, advanced analyses did suggest that lower blood pressures are tolerated for shorter durations in elderly patients.

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Payen, Jean-Francois; Bosson, Jean-Luc; Chanques, Gérald; Mantz, Jean; Labarere, José; for the DOLOREA Investigators

Anesthesiology. 111(6):1308-1316, December 2009.

doi: 10.1097/ALN.0b013e3181c0d4f0

Pain assessment, with concomitant high rates of sedation assessment and a restricted use of midazolam, is independently associated with a decreased duration of mechanical ventilation in the intensive care unit.

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Nelson, Ariana M.; Battersby, Alanna S.; Baghdoyan, Helen A.; Lydic, Ralph

Anesthesiology. 111(6):1327-1333, December 2009.

doi: 10.1097/ALN.0b013e3181bdf894

Opioids significantly decreased adenosine levels in the substantia innominata and pontine reticular formation. The morphine-induced decrease in adenosine was blocked by naloxone and reversed by an adenosine deaminase inhibitor.

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Aprili, Daniel; Bandschapp, Oliver; Rochlitz, Christoph; Urwyler, Albert; Ruppen, Wilhelm

Anesthesiology. 111(6):1346-1355, December 2009.

doi: 10.1097/ALN.0b013e3181bfab9a

A systematic review and a pooled analysis of observational studies were performed. The authors found that serious complications such as infection, bleeding, and neurologic damage are rare in both hospitalized and homebound patients with intrathecal catheters.

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Perouansky, Misha; Hemmings, Hugh C. Jr

Anesthesiology. 111(6):1365-1371, December 2009.

doi: 10.1097/ALN.0b013e3181bf1d61

Accumulating evidence indicates that general anesthetics can have persistent adverse neurologic effects. Identification of risk factors and understanding their mechanisms is important to identify and minimize the risks.