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Lidocaine effects on neutrophil extracellular trapping and angiogenesis biomarkers in postoperative breast cancer patients with different anesthesia methods: a prospective, randomized trial

Anesthesia techniques and drug selection may influence tumor recurrence and metastasis. Neutrophil extracellular trapping (NETosis), an immunological process, has been linked to an increased susceptibility to ...

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Predictive value of S100B and brain derived neurotrophic factor for radiofrequency treatment of lumbar disc prolapse

This work aimed to analyze serum S100B levels and brain-derived neurotrophic factor (BDNF) in patients with lumbar disc prolapse to test their predictive values concerning the therapeutic efficacy of pulsed ra...

Correction: Evaluation the quality of bag-mask ventilation by E/C, T/E and hook technique (a new proposed technique)

The original article was published in BMC Anesthesiology 2023 23 :384

Continuous serratus posterior superior intercostal plane block for postoperative analgesia management in the patient who underwent right atrial mass excision: a case report

Serratus posterior intercostal plane block (SPSIPB) is a novel periparavertebral block. It provides anterolateral posterior chest wall analgesia. It is an interfascial plane block, performed under ultrasound g...

Impact of sarcopenia in elderly patients undergoing elective total hip arthroplasty on postoperative outcomes: a propensity score-matched study

Frailty poses a crucial risk for postoperative complications in the elderly, with sarcopenia being a key component. The impact of sarcopenia on postoperative outcomes after total hip arthroplasty (THA) is stil...

Determinants of difficult laryngoscopy based on upper airway indicators: a prospective observational study

The main cause of anesthesia-related deaths is the failure to manage difficult airways. Difficult laryngoscopic exposure is a major cause of unsuccessful management of difficult airways. Inadequate preoperativ...

Erector spinae plane block did not improve postoperative pain-related outcomes and recovery after video-assisted thoracoscopic surgery : a randomised controlled double-blinded multi-center trial

There is a sizable niche for a minimally invasive analgesic technique that could facilitate ambulatory video-assisted thoracoscopic surgery (VATS). Our study aimed to determine the analgesic potential of a sin...

Optimizing nicardipine dosage for effective control of pituitrin-induced hypertension in laparoscopic myomectomy undergoing total intravenous anesthesia

This study aimed to determine the median effective dose (ED50) and 95% effective dose (ED95) of nicardipine for treating pituitrin-induced hypertension during laparoscopic myomectomy, providing guidance for th...

Perioperative serum syndecan-1 concentrations in patients who underwent cardiovascular surgery with cardiopulmonary bypass and its association with the occurrence of postoperative acute kidney injury: a retrospective observational study

Various factors can cause vascular endothelial damage during cardiovascular surgery (CVS) with cardiopulmonary bypass (CPB), which has been suggested to be associated with postoperative complications. However,...

Regional analgesia using ultrasound-guided intermediate cervical plexus block versus cervical erector spinae block for anterior cervical spine surgery: a randomized trial

Regional analgesia techniques are crucial for pain management after cervical spine surgeries. Anesthesiologists strive to select the most effective and least hazardous regional analgesia technique for the cerv...

Comparison of bicarbonate Ringer’s solution with lactated Ringer’s solution among postoperative outcomes in patients with laparoscopic right hemihepatectomy: a single-centre randomised controlled trial

The study was aimed to investigate the positive impact of bicarbonate Ringer’s solution on postoperative outcomes in patients who underwent laparoscopic right hemihepatectomy. Patients in the two groups were i...

Effect of converting from propofol to remimazolam with flumazenil reversal on recovery from anesthesia in outpatients with mental disabilities: a randomized controlled trial

General anesthesia is often necessary for dental treatment of outpatients with mental disabilities. Rapid recovery and effective management of postoperative nausea and vomiting (PONV) are critical for outpatie...

Double lumen endobronchial tube intubation: lessons learned from anatomy

Double lumen endobronchial tubes (DLTs) are frequently used to employ single lung ventilation strategies during thoracic surgical procedures. Placement of these tubes can be challenging even for experienced cl...

50% efficacy dose of intravenous lidocaine in supressing sufentanil-induced cough in children: a randomised controlled trial

Opioids such as sufentanil are used as anaesthetics due to their rapid action and superior analgesic effect. However, sufentanil induces a huge cough in paediatric patients. In contrast, intravenous (IV) lidoc...

Profound hypoxemia and hypotension during posterior spinal fusion in a spinal muscular atrophy child with severe scoliosis: a case report

Anesthesia for spinal muscular atrophy (SMA) patients undergoing spinal deformity surgery is challenging. We report an unusual case of an SMA girl who developed severe intraoperative hypoxemia and hypotension ...

Application of propofol-remifentanil intravenous general anesthesia combined with regional block in pediatric ophthalmic surgery

The aim of this study is to observe the anesthetic effect and safety of intravenous anesthesia without muscle relaxant with propofol-remifentanil combined with regional block under laryngeal mask airway in ped...

Continuation of chronic antiplatelet therapy is not associated with increased need for transfusions: a cohort study in critically ill septic patients

The decision to maintain or halt antiplatelet medication in septic patients admitted to intensive care units presents a clinical dilemma. This is due to the necessity to balance the benefits of preventing thro...

The potentiating effect of intravenous dexamethasone upon preemptive pudendal block analgesia for hypospadias surgery in children managed with Snodgrass technique: a randomized controlled study

Evidence regarding the potentiating effects of intravenous dexamethasone on peripheral regional anesthesia in children is sparse. The objective of the current study was to investigate the potentiating effect o...

The efficacy and safety of perioperative glucocorticoid for total knee arthroplasty: a systematic review and meta-analysis

An increasing number of individuals undergo total knee arthroplasty (TKA), which can result in pain, limited motor function and adverse complications such as infection, nausea and vomiting. Glucocorticoids hav...

Anesthesia management for a child with the Koolen-de Vries syndrome: a case report

The Koolen-de Vries syndrome (KdVS) is a relatively new rare disease caused by micro-deletion of 17q21.31 which was first reported by Koolen in 2006. Typical phenotypes for KdVS include hypotonia, developmenta...

A novel combined approach to placement of a double lumen endobronchial tube using a video laryngoscope and fiberoptic bronchoscope: a retrospective chart review

The objective of this study was to evaluate a modern combined video laryngoscopy and flexible fiberoptic bronchoscope approach to placement of a double lumen endobronchial tube and further characterize potenti...

Retraction Note: Dose selection of central or peripheral administration of sufentanil affect opioid induced cough?: a prospective, randomized, controlled trial

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s12871-024-02522-9.

One-year survival of aneurysmal subarachnoid hemorrhage after airplane transatlantic transfer – a monocenter retrospective study

Aneurysmal subarachnoid hemorrhage (aSAH) is preferentially treated by prompt endovascular coiling, which is not available in Guadeloupe. Subsequently, patients are transferred to Paris, France mainland, by co...

Association between serum calcium and prognosis in patients with acute ischemic stroke in ICU: analysis of the MIMIC-IV database

While serum Ca has proven to be a reliable predictor of mortality across various diseases, its connection with the clinical outcomes of ischemic stroke (IS) remains inconclusive. Our research aimed to explore ...

Effect of subclavian vein diameter combined with perioperative fluid therapy on preventing post-induction hypotension in patients with ASA status I or II

Perioperative hypotension is frequently observed following the initiation of general anesthesia administration, often associated with adverse outcomes. This study assessed the effect of subclavian vein (SCV) d...

Ultrasound-guided stellate ganglion block benefits the postoperative recovery of patients undergoing laparoscopic colorectal surgery: a single-center, double-blinded, randomized controlled clinical trial

With the increasing prevalence of colorectal cancer (CRC), optimizing perioperative management is of paramount importance. This study investigates the potential of stellate ganglion block (SGB), known for its ...

Machine learning approach for predicting post-intubation hemodynamic instability (PIHI) index values: towards enhanced perioperative anesthesia quality and safety

Adequate preoperative evaluation of the post-intubation hemodynamic instability (PIHI) is crucial for accurate risk assessment and efficient anesthesia management. However, the incorporation of this evaluation...

Timing of early water intake post-general anaesthesia: a systematic review and meta-analysis

Early water intake has gained widespread attention considering enhanced recovery after surgery (ERAS). In the present systematic evaluation and meta-analysis, we assessed the effects of early water intake on t...

Effect of epidural dexmedetomidine in single-dose combined with ropivacaine for cesarean section

Dexmedetomidine has arousal sedation and analgesic effects. We hypothesize that epidural dexmedetomidine in single-dose combined with ropivacaine improves the experience of parturient undergoing cesarean secti...

Laparoscopic assisted versus ultrasound guided transversus abdominis plane block in laparoscopic bariatric surgery: a randomized controlled trial

Transversus abdominis plane block (TAPB) guided by laparoscopy and ultrasound showed promise in enhancing the multimodal analgesic approach following several abdominal procedures. This study aimed to compare t...

Super-refractory status epilepticus, rhabdomyolysis, central hyperthermia and cardiomyopathy attributable to spinal anesthesia: a case report and review of literature

There are only six past reports of super-refractory status epilepticus induced by spinal anesthesia. None of those patients have died. Only < 15 mg of bupivacaine was administered to all six of them and to our...

Analysis of influencing factors and construction of prediction model for postoperative nausea and vomiting in patients undergoing laparoscopic sleeve gastrectomy: a single-center retrospective cohort study

With the increasing number of bariatric surgeries, the high incidence of postoperative nausea and vomiting (PONV) associated with this surgery has also gradually attracted attention. Among the common bariatric...

Skin mottling score assesses peripheral tissue hypoperfusion in critically ill patients following cardiac surgery

Skin mottling is a common manifestation of peripheral tissue hypoperfusion, and its severity can be described using the skin mottling score (SMS). This study aims to evaluate the value of the SMS in detecting ...

Incidence and factors associated with failed spinal anaesthesia among patients undergoing surgery: a multi- center prospective observational study

Failed spinal anaesthesia causes prolonging of operation time, insufficient analgesia for surgery and needs repeating spinal anaesthesia which in turn causes local anaesthesia toxicity, high spinal and total s...

Echocardiographic features of right ventricle in septic patients with elevated central venous pressure

Elevated central venous pressure (CVP) is deemed as a sign of right ventricular (RV) dysfunction. We aimed to characterize the echocardiographic features of RV in septic patients with elevated CVP, and quantif...

Sex differences in pain catastrophizing and its relation to the transition from acute pain to chronic pain

Differences exist between sexes in pain and pain-related outcomes, such as development of chronic pain. Previous studies suggested a higher risk for pain chronification in female patients. Furthermore, pain ca...

Sedation versus general anesthesia on all-cause mortality in patients undergoing percutaneous procedures: a systematic review and meta-analysis

The comparison between sedation and general anesthesia (GA) in terms of all-cause mortality remains a subject of ongoing debate. The primary objective of our study was to investigate the impact of GA and sedat...

Incidence of intraoperative hypotension and its factors among adult traumatic head injury patients in comprehensive specialized hospitals, Northwest Ethiopia: a multicenter observational study

Traumatic head injury (THI) poses a significant global public health burden, often contributing to mortality and disability. Intraoperative hypotension (IH) during emergency neurosurgery for THI can adversely ...

Impact of intraoperative hypothermia on the recovery period of anesthesia in elderly patients undergoing abdominal surgery

This study aimed to investigate the impact of intraoperative hypothermia on the recovery period of anesthesia in elderly patients undergoing abdominal surgery.

The effect of glycopyrrolate vs. atropine in combination with neostigmine on cardiovascular system for reversal of residual neuromuscular blockade in the elderly: a randomized controlled trial

Glycopyrrolate-neostigmine (G/N) for reversing neuromuscular blockade (NMB) causes fewer changes in heart rate (HR) than atropine-neostigmine (A/N). This advantage may be especially beneficial for elderly pati...

Thoracolumbar Interfascial Plane (TLIP) block verses other paraspinal fascial plane blocks and local infiltration for enhanced pain control after spine surgery: a systematic review

Spinal surgeries are accompanied by excessive pain due to extensive dissection and muscle retraction during the procedure. Thoracolumbar interfascial plane (TLIP) blocks for spinal surgeries are a recent addit...

Prevention of postoperative nausea and vomiting after orthognathic surgery: a scoping review

Postoperative nausea and vomiting (PONV) is one of the most common adverse events following orthognathic surgery. It’s a distressing feeling for patients and continues to be the cause of postoperative complica...

The value of local dexmedetomidine as an adjuvant to ultrasound-guided wide awake local anesthesia no tourniquet (WALANT) in flexor tendon repair surgeries: a randomized controlled trial

The Wide-Awake Local Anesthesia No Tourniquet (WALANT) technique allows intraoperative motor assessment of tendon repair integrity of the hand compared with general anesthesia or brachial plexus block. No stud...

Accelerated lymph flow from infusion of crystalloid fluid during general anesthesia

Kinetic analysis of crystalloid fluid yields a central distribution volume ( V c ) of the same size as the expected plasma volume (approximately 3 L) except during general anesthesia during which V c might be only ha...

Effects of remote ischemic preconditioning in hepatectomy: a systematic review and meta-analysis

Animal experiments have confirmed that remote ischemic preconditioning (RIPC) can reduce hepatic ischemia-reperfusion injuries (HIRIs), significantly improving early tissue perfusion and oxygenation of the res...

The effects of an IV fluid bolus on mitral annular velocity and the assessment of diastolic function: a prospective non-randomized study

Abnormal diastolic function is an independent predictor of adverse postoperative outcomes. Mitral annular tissue Doppler velocity (e’) is a key parameter for assessing diastolic function. The purpose of this s...

Effect of pretreatment with a small dose of esketamine on sufentanil-induced cough during anesthesia induction: a randomized controlled trial

Sufentanil-induced cough is common during the induction of anesthesia. The objective of this study was to determine whether pretreatment with a small dose of esketamine is effective in treating sufentanil-indu...

The effect of different endotracheal tube cuff pressure monitoring systems on postoperative sore throat in patients undergoing tracheal intubation: a randomized clinical trial

Postoperative sore throat (POST) is an unpleasant outcome that can occur as a result of tracheal intubation in adults. Increased pressure from the endotracheal tube (ETT) cuff often leads to local mucosal inju...

Preoperative routine measurement of NT-proBNP predicts postoperative morbidity after non-cardiac surgery with intermediate or high surgical risk: an observational study

Chronic heart failure (HF) is a common clinical condition associated with adverse outcomes in elderly patients undergoing non-cardiac surgery. This study aimed to estimate a clinically applicable NT-proBNP cut...

Combined sedation in pediatric magnetic resonance imaging: determination of median effective dose of intranasal dexmedetomidine combined with oral midazolam

The exact median effective dose (ED50) of intranasal dexmedetomidine combined with oral midazolam sedation for magnetic resonance imaging (MRI) examination in children remains unknow and the aim of this study ...

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Landmark Papers in Anaesthesia

Michael J. Avram, Ph.D., served as Handling Editor for this book review.

Accepted for publication October 3, 2014.

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Ronald D. Miller; Landmark Papers in Anaesthesia. Anesthesiology 2015; 122:475–476 doi: https://doi.org/10.1097/ALN.0000000000000503

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The Landmark Papers series by Oxford University Press is designed to identify “key” articles in the literature of a particular clinical specialty. The assumption is that fundamental articles represent the basis of every specialty in medicine. Landmark Papers in Anaesthesia summarizes 10 key articles in each of 19 chapters. Twelve of the chapters present fundamental articles on specific anesthesia specialties ( e.g. , neuroanesthesia); the remaining seven chapters are about specific anesthetic techniques ( e.g. , total intravenous anesthesia). The purpose of this book was to create a convenient and well-organized compendium of “classic” articles that would provide an overview of the core principles of anesthesia and also facilitate their review by practicing anesthesiologists.

Editors Webster and Galley began by identifying recognized experts for each of the specialties and techniques to be covered in this text. These experts then selected the 10 most important articles in their field of expertise. Each chapter was organized and managed by one or two experts. The appendix includes four tables listing the top 25 cited articles for Anaesthesia , Anesthesia and Analgesia , A nesthesiology , and British Journal of Anaesthesia . Interestingly, the experts for this text did not select most of the articles listed in the appendix citation tables.

In all, 29 experts were chosen, with 19 from the United Kingdom. The number of articles cited was understandably dominated by anesthesia journals ( e.g. , A nesthesiology [36] and British Journal of Anaesthesia [37]). The editors acknowledged that articles published by anesthetists in nonspecialist and basic science journals could not be easily identified, especially by using the citation index methodology. Yet, the editors did include these and are to be congratulated for citing articles from the Lancet (12 articles), JAMA (3 articles), New England Journal of Medicine (4 articles), Nature (3 articles), and the Royal Society of Medicine (1 article). Without a doubt, research, developments, and techniques published in the world’s leading general medical journals hasten their dissemination and impact on society overall. That the authors have cited anesthesia articles in these leading journals in science and medicine is a major strength of the book.

Depending on one’s definition of our specialty, there are omissions. Specifically, most anesthetic departments now have additional responsibilities that are not covered in this volume. Most obvious are critical care medicine, acute and chronic pain management, separate preoperative evaluation clinics, and transplant anesthesia overall ( i.e. , this text only considers liver transplantation). Also, anesthesia for ophthalmologic and ear, nose, and throat surgery is not considered.

Each review follows a consistent format that includes a summary of the findings, citation count, related references, principal message, strengths and weaknesses, and relevance. This format is superb and provides an excellent, organized approach for the reader to rapidly analyze each article. Perhaps a brief discussion of the role of the citation tables in the appendix would have been helpful to the clinician who does not have experience in the evaluation of the literature.

It was a surprising choice to have one component of anesthesia, “Neuromuscular Blockade,” appear as the first chapter in the book. Nevertheless, this reviewer especially enjoyed the chapter because it reminded me of the extensive debates in the 1980s regarding the virtues of atracurium versus vecuronium. These muscle relaxants generated a tremendous amount of clinical research and facilitated the careers of many young anesthesiologists including this reviewer’s as well as that of the senior author of this chapter. Unfortunately, this chapter’s introduction is not current. For example, the authors stated that “recurarization” and “prolonged block” have been largely confined to history. Examination of the recent literature does not support this conclusion; prolonged neuromuscular blockade is still a significant clinical problem. 1 , 2  

Does this book provide us with a complete understanding of the past and future of anesthesiology? The answer is a qualified yes, with two notable reservations. First, as previously indicated, this book does not address the entire spectrum of anesthesiology. Second, the editors neglected to include in their analysis journals with some acknowledged “classic articles”; for example, Severinghaus and Bradley’s blood gases, 3   Gasser and Erlanger’s article on the importance of nerve size for regional anesthesia, 4   and Melzack and Wall’s pain mechanisms. 5   Nor can anesthesiologists avoid the content of these journals: Cousins and Mather’s article on intrathecal and epidural administration of opioids 6   and Lindenbaum and Leifer’s article on the hepatic necrosis associated with halothane anesthesia. 7  

The text stimulated this reviewer to examine the influence of the past on the present state of anesthesiology. The selection of specific journals requires judgment and an understanding of the history of anesthesiology. In the preface, the editors even state that the choice of landmark articles was not precisely based on citation counts, but was subjective and based on their expert contributors’ judgments and personal likes and dislikes. This reviewer was intrigued by the editors’ parting suggestion to think about “which articles you would have chosen.” This book is an absolute delight to read. The format is excellent. Hopefully, more such publications will follow. Certainly, understanding the past may facilitate the design of the future.

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Hot topics in anaesthesia: a bibliometric analysis of five high-impact journals from 2010–2019

• Published: 22 August 2021
• Volume 126 , pages 8749–8759, ( 2021 )

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• S. G. Grace   ORCID: orcid.org/0000-0001-7583-717X 1 ,
• F. S. S. Wiepking   ORCID: orcid.org/0000-0002-3509-7549 1 &
• A. A. J. van Zundert   ORCID: orcid.org/0000-0002-1836-6831 1  

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Publication of research in anaesthesia is increasingly competitive. Understanding what topics of research are more likely to be published and where, is clearly valuable for authors seeking to optimise reach and impact of their work. This study aimed to identify the relative proportion of anaesthesia articles by topic for five anaesthesia journals over a 10-year period from 2010 to 2019, including any differences between journals and regions. We chose five anaesthesia journals based on current impact factor. All journal issues published between 2010–2019 were checked for total number of articles with only original research articles being further categorised by topic, country of research, funding status and citation count. Of 5782 original research articles analysed, the most frequent article topics published were translational studies (16%) and clinical practice (16%). Obstetric anaesthesia was the least frequent published (4%). Translational studies were the most frequently funded (84%) while articles on paediatric anaesthesia were least frequently funded (29%). The average number of citations per funded article was 37 versus 28 for non-funded articles. Translational studies were the most frequently published topic of research conducted in North America (25%) and Asia (25%), but of only average frequency in Europe (9%). Studies in obstetric and paediatric anaesthesia are less well-represented in anaesthesia literature and researchers may experience greater difficulty publishing these topics and obtaining funding accordingly. Authors should be aware of the diverse publishing tendencies of the different journals in anaesthesia in order to save time and effort when submitting research for publication.

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Abbreviations.

British Journal of Anaesthesia

European Journal of Anaesthesiology

Regional Anesthesia and Pain Medicine

High-income country

Low/middle-income country

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Acknowledgements

Many thanks to Rachel Ling and Aakanksha Sahu for their assistance with the original data collection.

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Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women’s Hospital, Brisbane and the University of Queensland, NHB, Butterfield St, Herston, Brisbane, QLD, 4006, Australia

S. G. Grace, F. S. S. Wiepking & A. A. J. van Zundert

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Samuel Grace: concept, design, literature search, data acquisition, original draft and critical revision of draft, approval final draft; Floris Wiepking: concept, design, literature search, data acquisition, original draft and critical revision of draft, approval final draft; André Van Zundert: concept, design, literature search, data acquisition, original draft and critical revision of draft, approval final draft.

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Correspondence to A. A. J. van Zundert .

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Grace, S.G., Wiepking, F.S.S. & van Zundert, A.A.J. Hot topics in anaesthesia: a bibliometric analysis of five high-impact journals from 2010–2019. Scientometrics 126 , 8749–8759 (2021). https://doi.org/10.1007/s11192-021-04129-0

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Received : 24 May 2021

Accepted : 05 August 2021

Published : 22 August 2021

Issue Date : October 2021

DOI : https://doi.org/10.1007/s11192-021-04129-0

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The following represent additions to UpToDate from the past six months that were considered by the editors and authors to be of particular interest. The most recent What's New entries are at the top of each subsection.

AIRWAY MANAGEMENT

Obesity and increased risk of perioperative cardiac arrest (March 2024)

Obesity is a risk factor for difficulty with airway management and for rapid apneic oxygen desaturation during airway management. Both can result in hypoxic brain damage or death. In an analysis of causes of perioperative cardiac arrest reported to the Seventh National Audit Project (NAP7) in the United Kingdom, 35 percent of airway- and respiratory-related cardiac arrests occurred in patients with body mass index 35 to 50 kg/m 2 , while this cohort comprised only 12 percent of the survey population [ 1 ]. These findings reinforce the need to consider obesity when choosing general versus regional anesthesia and planning the airway management strategy. (See "Airway management for induction of general anesthesia", section on 'Obesity as a risk factor' .)

CARDIOVASCULAR AND THORACIC ANESTHESIA

Moderate hypothermia during aortic arch surgery with antegrade cerebral perfusion (March 2024)

Observational data have supported a shift from deep to moderate hypothermia during circulatory arrest for aortic arch surgery, particularly with adjunctive antegrade cerebral perfusion (ACP). A recent trial has now compared outcomes for 251 patients undergoing aortic arch surgery with ACP and randomly assigned to deep (≤20.0°C), low-moderate (20.1 to 24.0°C), or high-moderate (24.1 to 28.0°C) circulatory arrest temperature [ 2 ]. At one-month follow-up, the three groups had similar neurocognitive and neuroimaging outcomes and similar mortality, major morbidity, and quality of life. The volume of transfused blood products was higher in the deep group, but transfusion-related complications were not different. Based on this trial, moderate (20.1 to 28.0°C) rather than deep hypothermia is reasonable during aortic arch surgery when ACP is also used. Whether a low-moderate or high-moderate temperature is selected depends on the complexity of the arch intervention and the anticipated duration of hypothermia. (See "Overview of open surgical repair of the thoracic aorta", section on 'Hypothermic circulatory arrest' .)

OBSTETRIC ANESTHESIA

Labor epidural analgesia and risk of emergency delivery (December 2023)

It is well established that contemporary neuraxial labor analgesia does not increase the overall risk of cesarean or instrument-assisted vaginal delivery. However, a new retrospective database study of over 600,000 deliveries in the Netherlands reported that epidural labor analgesia was associated with an increased risk of emergency delivery (cesarean or instrument-assisted vaginal) compared with alternative analgesia (13 versus 7 percent) [ 3 ]. Because of potential confounders and lack of detail on epidural and obstetric management, we consider these data insufficient to avoid neuraxial analgesia or change the practice of early labor epidural placement to reduce the potential need for general anesthesia in patients at high risk for cesarean delivery. (See "Adverse effects of neuraxial analgesia and anesthesia for obstetrics", section on 'Effects on the progress and outcome of labor' .)

PATIENT SAFETY

Use of a formal handoff tool during intraoperative transfer of anesthetic care (March 2024)

Intraoperative handoffs of care from one anesthesia provider to another have been associated with adverse outcomes, possibly due to inadequate communication of clinical information. A retrospective study noted that an intraoperative handoff (defined as transfer of care lasting more than 35 minutes) occurred in 40 percent of approximately 120,000 noncardiac surgical cases performed from 2016 to 2021 [ 4 ]. Adverse outcomes (defined as a composite of postoperative mortality or major morbidity) occurred more often when a handoff occurred (7.2 versus 6.2 percent with no handoff). After implementation of a structured electronic handoff tool in 2019, a correlation over time was noted between increased handoff tool usage and decreased likelihood of the composite adverse outcome. We use a formal handoff protocol during all phases of perioperative care. (See "Handoffs of surgical patients", section on 'Use of a formal handoff procedure' .)

PEDIATRIC ANESTHESIA

New guidelines for airway management in infants (January 2024)

Very young children are at higher risk of complications of airway management than children in older age groups; however, guidelines for infants have been lacking. In 2024, the European Society of Anesthesiology and Intensive Care and the British Journal of Anesthesia published joint guidelines for airway management in neonates and infants [ 5 ]. A summary of their recommendations appears in the following table ( table 1 ). (See "Airway management for pediatric anesthesia", section on 'Pediatric airway management guidelines' .)

Videolaryngoscopy for endotracheal intubation in critically ill children (January 2024)

Use of videolaryngoscopy (VL) in children provides a shared view during emergency endotracheal intubation (ETI) that permits an experienced physician observer to give assistance to the proceduralist. In a multicenter quality study of VL during ETI in pediatric intensive care units with standardized coaching by an attending, over 3500 ETIs were performed with VL, and use of VL increased from 30 percent to 89 percent of ETIs over four years [ 6 ]. Compared with direct laryngoscopy, VL was associated with lower adverse events (9 versus 15 percent). The majority of proceduralists were residents or fellows. These findings and prior studies confirm the safety of VL during emergency ETI in children and demonstrate the value of standardized coaching during the procedure for less experienced clinicians. (See "Technique of emergency endotracheal intubation in children", section on 'Video versus direct laryngoscopy' .)

PREOPERATIVE AND POSTOPERATIVE MANAGEMENT

Association of preoperative anemia with adverse outcomes after cardiac surgery (March 2024)

Studies continue to show a high rate of preoperative anemia in patients undergoing cardiac surgery and an association with adverse surgical outcomes. In a retrospective study of >4000 patients undergoing coronary artery bypass grafting surgery, 30 percent had preoperative anemia, which was associated with dose-dependent increases in postoperative acute kidney injury (AKI) and longer hospital stay [ 7 ]. In a 2024 meta-analysis with nearly 160,000 patients who underwent cardiac surgery, 28 percent had preoperative anemia, which was associated with increased mortality, AKI, other morbidities, and longer hospital stay [ 8 ]. When feasible, we postpone major surgery in patients with anemia to diagnose the cause and provide treatment. (See "Perioperative blood management: Strategies to minimize transfusions", section on 'Treatment of anemia' .)

Postoperative noninvasive ventilation or high-flow nasal oxygen for patients with obesity (November 2023)

The optimal postoperative ventilatory strategy for patients with severe obesity has been unclear. In a 2023 network meta-analysis of randomized trials that compared various postoperative noninvasive ventilatory strategies in these patients, high-flow nasal oxygen (HFNO) or bilevel positive airway pressure (BiPAP) reduced atelectasis; HFNO, BiPAP, or continuous positive airway pressure (CPAP) reduced postoperative pneumonia; and HFNO reduced length of stay compared with conventional oxygen therapy [ 9 ]. For patients with obesity who are hypoxic in the post-anesthesia care unit despite oxygen supplementation and incentive spirometry, we suggest a trial of HFNO, BiPAP, or CPAP prior to considering intubation. (See "Anesthesia for the patient with obesity", section on 'Post-anesthesia care unit management' .)

SURGICAL CRITICAL CARE

Tranexamic acid for burn wound excision (November 2023)

Randomized trials have established that tranexamic acid (TXA) reduces blood loss and transfusion requirements in various surgical settings, but data in burn surgery are limited. In a meta-analysis of observational studies evaluating intravenous and topical TXA in burn surgery, use of TXA was associated with reductions in blood loss, use of intraoperative transfusion, and number of units transfused but no change in venous thromboembolism or mortality rates [ 10 ]. Based on this review and data from other surgical settings, we routinely administer intravenous TXA for burn wound excisions over 20 percent of total body surface area. (See "Overview of the management of the severely burned patient", section on 'Coagulopathy' .)

OTHER ANESTHESIA

Updated guideline on postoperative delirium in adults (February 2024)

The European Society of Anaesthesiology and Intensive Care Medicine has published an updated guideline on postoperative delirium (POD) [ 11 ]. Recommendations include preoperatively screening older adults for risk factors for POD and multicomponent nonpharmacological interventions for all patients with risk factors. In addition, review of recent evidence showed that perioperative use of dexmedetomidine was associated with a lower incidence of POD, particularly when administered postoperatively in the intensive care unit. We agree with the recommendations and often use dexmedetomidine in the perioperative period to reduce the incidence of POD in high-risk patients. (See "Perioperative neurocognitive disorders in adults: Risk factors and mitigation strategies", section on 'Intravenous agents associated with lower risk' .)

Supplemental neuraxial or regional analgesia and postoperative neurocognitive disorders (January 2024)

Supplementing general anesthesia with neuraxial or regional analgesic techniques reduced postoperative neurocognitive disorders (PND) and/or delirium in some studies, but results have been inconsistent. Differences in techniques and timing of analgesic administration, and confounding patient variables may explain the inconsistencies. In a meta-analysis of randomized trials of patients undergoing major noncardiac surgery under general or neuraxial anesthesia, supplemental postoperative neuraxial or regional analgesia (eg, epidural or peripheral or fascial plane block) reduced PND (both delirium and delayed neurocognitive recovery) in the first postoperative month compared with no supplemental analgesia [ 12 ]. Although supplemental analgesia may reduce PND, selection of anesthetic techniques is based primarily on other considerations. (See "Perioperative neurocognitive disorders in adults: Risk factors and mitigation strategies", section on 'Choice of anesthetic technique' .)

Thyroid hormone administration in deceased organ donors (December 2023)

Thyroid hormone administration has been a longstanding component of some organ procurement protocols due to concern that acute hypothyroidism might contribute to hemodynamic instability and left ventricular dysfunction, reducing heart and other organ procurement; however, evidence for the practice has been inconsistent. In a recent trial of 838 hemodynamically unstable, brain-dead donors assigned to receive a levothyroxine infusion or saline placebo, there was little to no difference in number of hearts transplanted or 30-day cardiac graft survival [ 13 ]. Recovery of other organs was similarly unaffected. More cases of severe hypertension or tachycardia occurred in the levothyroxine group than in the saline group. Based on these data, we suggest avoiding thyroid hormone administration in deceased organ donors. (See "Management of the deceased organ donor", section on 'Thyroid hormone' .)

Aerosol generation during noninvasive respiratory support modalities (October 2023)

Studies have reported conflicting data as to whether high levels of aerosols are generated when noninvasive ventilation (NIV) or high-flow nasal oxygen (HFNO) is used. In a 2023 systematic review including 12 studies in patients with respiratory infections and 15 studies in healthy volunteers, use of NIV or HFNO was not associated with increased generation of pathogen-laden aerosols compared with controls with unsupported normal or labored breathing, low-flow nasal oxygen, or oxygen or nonrebreather mask [ 14 ]. Inconsistency among studies may reflect differences in sampling and detection methodologies and operating room ventilation. Notably, the National Health Service in the United Kingdom has removed mask ventilation, intubation, and extubation from its list of aerosol-generating procedures. (See "Overview of infection control during anesthetic care", section on 'Considerations during aerosol-generating procedures' .)

Effectiveness of intraoperative blood salvage for reducing need for allogenic transfusion (October 2023)

Intraoperative blood salvage is a blood conservation technique in which autologous blood is aspirated, concentrated, washed, and reinfused. A 2023 meta-analysis of randomized trials involving >14,000 patients found that it reduced the need for allogeneic red blood cell transfusions in cardiovascular surgery with or without cardiopulmonary bypass and in major orthopedic hip, knee, or spine surgery [ 15 ]. Benefits were uncertain in vascular, cancer, and obstetric surgery. We recommend intraoperative blood salvage in surgical procedures with blood loss >750 mL, particularly if transfusion of allogeneic blood is likely. (See "Surgical blood conservation: Intraoperative blood salvage", section on 'Benefits' .)

• Cook TM, Oglesby F, Kane AD, et al. Airway and respiratory complications during anaesthesia and associated with peri-operative cardiac arrest as reported to the 7th National Audit Project of the Royal College of Anaesthetists. Anaesthesia 2024; 79:368.
• Hughes GC, Chen EP, Browndyke JN, et al. Cognitive Effects of Body Temperature During Hypothermic Circulatory Arrest Trial (GOT ICE): A Randomized Clinical Trial Comparing Outcomes After Aortic Arch Surgery. Circulation 2024; 149:658.
• Damhuis SE, Groen H, Thilaganathan B, et al. Effect of intrapartum epidural analgesia on rate of emergency delivery for presumed fetal compromise: nationwide registry-based cohort study. Ultrasound Obstet Gynecol 2023; 62:668.
• Saha AK, Segal S. A Quality Improvement Initiative to Reduce Adverse Effects of Transitions of Anesthesia Care on Postoperative Outcomes: A Retrospective Cohort Study. Anesthesiology 2024; 140:387.
• Disma N, Asai T, Cools E, et al. Airway management in neonates and infants: European Society of Anaesthesiology and Intensive Care and British Journal of Anaesthesia joint guidelines. Br J Anaesth 2024; 132:124.
• Giuliano J Jr, Krishna A, Napolitano N, et al. Implementation of Video Laryngoscope-Assisted Coaching Reduces Adverse Tracheal Intubation-Associated Events in the PICU. Crit Care Med 2023; 51:936.
• Warner MA, Hanson AC, Schulte PJ, et al. Preoperative Anemia and Postoperative Outcomes in Cardiac Surgery: A Mediation Analysis Evaluating Intraoperative Transfusion Exposures. Anesth Analg 2024; 138:728.
• Lau MPXL, Low CJW, Ling RR, et al. Preoperative anemia and anemia treatment in cardiac surgery: a systematic review and meta-analysis. Can J Anaesth 2024; 71:127.
• Li R, Liu L, Wei K, et al. Effect of noninvasive respiratory support after extubation on postoperative pulmonary complications in obese patients: A systematic review and network meta-analysis. J Clin Anesth 2023; 91:111280.
• Fijany AJ, Givechian KB, Zago I, et al. Tranexamic acid in burn surgery: A systematic review and meta-analysis. Burns 2023; 49:1249.
• Aldecoa C, Bettelli G, Bilotta F, et al. Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients. Eur J Anaesthesiol 2024; 41:81.
• Singh NP, Makkar JK, Borle A, Singh PM. Role of supplemental regional blocks on postoperative neurocognitive dysfunction after major non-cardiac surgeries: a systematic review and meta-analysis of randomized controlled trials. Reg Anesth Pain Med 2024; 49:49.
• Dhar R, Marklin GF, Klinkenberg WD, et al. Intravenous Levothyroxine for Unstable Brain-Dead Heart Donors. N Engl J Med 2023; 389:2029.
• Zhang MX, Lilien TA, van Etten-Jamaludin FS, et al. Generation of Aerosols by Noninvasive Respiratory Support Modalities: A Systematic Review and Meta-Analysis. JAMA Netw Open 2023; 6:e2337258.
• Lloyd TD, Geneen LJ, Bernhardt K, et al. Cell salvage for minimising perioperative allogeneic blood transfusion in adults undergoing elective surgery. Cochrane Database Syst Rev 2023; 9:CD001888.

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High-impact papers in the field of anesthesiology: a 10-year cross-sectional study

Manuscrits à fort impact dans le domaine de l’anesthésiologie : une étude transversale sur 10 ans, lingmin chen.

1 Department of Anesthesiology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University and The Research Units of West China, Chinese Academy of Medical Sciences, Chengdu, China

2 Department of Medical Administration, West China Hospital, Sichuan University, Chengdu, China

Yonggang Zhang

3 Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China

4 Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China

5 Department of Periodical Press and National Clinical Research Center for Geriatrics & Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China

Associated Data

This study was performed to evaluate trends in and provide future direction for anesthesiology education, research, and clinical practice.

We collected high-impact papers, ranking in the top 10% in the field of anesthesiology and published from 2011 to 2020, by the InCites tool based on the Web of Science Core Collection. We analyzed the trends, locations, distribution of subject categories, research organizations, collaborative networks, and subject terms of these papers.

A total of 4,685 high-impact papers were included for analysis. The number of high-impact papers increased from 462 in 2011 to 520 in 2020. The paper with the highest value of category normalized citation impact (115.95) was published in Anesthesia and Analgesia in 2018. High-impact papers were mainly distributed in the subject categories of “Anesthesiology,” “Clinical Neurology,” “Neurosciences,” and “Medicine General Internal.” They were primarily cited in “Anesthesiology,” “Clinical Neurology,” “Neurosciences,” “Medicine General Internal,” and “Surgery.” Most of these high-impact papers came from the USA, UK, Canada, Germany, and Australia. The most productive institutions were the League of European Research Universities, Harvard University, University of Toronto, University of London, University of California System, and University Health Network Toronto. Research collaboration circles have been formed in the USA, UK, and Canada. Subject-term analysis indicated postoperative analgesia, chronic pain, and perioperative complications were high-interest topics, and COVID-19 became a new hot topic in 2020.

Conclusions

The current study provides a historical view of high-impact papers in anesthesiology in the past ten years. High-impact papers were mostly from the USA. Postoperative analgesia, chronic pain, and perioperative complications have been hot topics, and COVID-19 became a new topic in 2020. These findings provide references for education, research, and clinical practice in the field of anesthesiology.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12630-022-02363-5.

Résumé

Cette étude a été réalisée pour évaluer les tendances et fournir une orientation future à l’enseignement, la recherche et la pratique clinique en anesthésiologie.

Méthode

Nous avons colligé des articles à fort impact, classés dans le top 10 % dans le domaine de l’anesthésiologie et publiés de 2011 à 2020, par l’outil InCites basé sur la Web of Science Core Collection. Nous avons analysé les tendances, les emplacements, la répartition des catégories de sujets, les organismes de recherche, les réseaux de collaboration et les termes des sujets de ces articles.

Résultats

Au total, 4685 articles à fort impact ont été inclus pour analyse. Le nombre de manuscrits à fort impact est passé de 462 en 2011 à 520 en 2020. L’article ayant la valeur la plus élevée de l’impact normalisé des citations de catégorie (CNCI) (115,95) a été publié dans la revue Anesthesia and Analgesia en 2018. Les articles à fort impact ont été principalement distribués dans les catégories de thèmes « Anesthésiologie », « Neurologie clinique », « Neurosciences » et « Médecine générale interne ». Ils ont été principalement cités dans les catégories « Anesthésiologie », « Neurologie clinique », « Neurosciences », « Médecine générale interne » et « Chirurgie ». La plupart de ces articles à fort impact provenaient des États-Unis, du Royaume-Uni, du Canada, d’Allemagne et d’Australie. Les établissements les plus productifs étaient la League of European Research Universities, l’Université Harvard, l’Université de Toronto, l’Université de Londres, l’Université de Californie System et le University Health Network de Toronto. Des cercles de collaboration en recherche ont été formés aux États-Unis, au Royaume-Uni et au Canada. L’analyse des termes indiquait que l’analgésie postopératoire, la douleur chronique et les complications périopératoires étaient des sujets suscitant un fort intérêt, et la COVID-19 est devenue un nouveau sujet brûlant en 2020.

La présente étude propose une vue historique des articles à fort impact en anesthésiologie au cours des dix dernières années. Les manuscrits à fort impact provenaient principalement des États-Unis. L’analgésie postopératoire, la douleur chronique et les complications périopératoires ont été des sujets d’actualité, et la COVID-19 est devenue un nouveau sujet en 2020. Ces résultats fournissent des références pour la formation, la recherche et la pratique clinique dans le domaine de l’anesthésiologie.

Anesthesiology is a key discipline that ensures safety and comfort during invasive procedures, improves surgical work efficiency, and coordinates the relationships among various disciplines. 1 – 3 In recent years, significant progress has been made in anesthesiology, involving perioperative organ protection, perioperative anesthesia management for the elderly, development of new anesthetic drugs, and basic research into the mechanisms of anesthesia and chronic pain. 4 – 11 Especially during the COVID-19 pandemic, anesthesiologists played important roles 12 – 14 and undoubtedly saved many lives. Anesthesiology practice has been improved by the development of new anesthetics and monitoring equipment, 3 a better understanding of the physiologic changes during surgery and anesthesia, 15 and evidence of the clinical benefits of optimal perioperative management strategies. 16 Because of its multidisciplinary nature, anesthesiology research can be applied to neuroscience, surgery, cardiovascular medicine, respirology, critical care, and other fields.

Literature analysis using large bibliometric databases 17 can qualitatively and quantitatively evaluate current research trends, 18 , 19 to determine future research directions and provide policy guidance for decision-makers. 20 Several studies have analyzed literature in the field of anesthesiology. Robert et al . 21 analyzed the literature on pain from 1976 to 2007 and traced the evolution of the scientific literature on pain over 30+ years; they concluded that the evolution and explosion of pain research were rapid and caused substantial changes in the landscape of the contributing countries and the scientific journals in the pain field. Chen et al . 22 reported research trends in anesthesiology from 1995 to 2004 by analyzing 64,199 articles with 1,084,491 citations. They found that the number of articles increased slightly in the second decade. More than 45% of papers were published by the top five journals, and most publications originated from North America and European countries. It helped clinicians and researchers to understand the anesthesiology research activities in the second decade. Chen et al . 23 reported global publication trends in anesthesiology from 1999 to 2018 and argued that more high-quality research should be carried out in low and middle-income countries. Although these studies determined progress in anesthesiology research over specific periods, they did not identify high-impact papers. As a consequence, the research trends of high-impact anesthesiology papers are still unknown.

To analyze high-impact papers in other fields, previous studies have collected and analyzed the top 1% or 10% papers using the InCites ™ tool based on the Web of Science (WOS) Core Collection (Clarivate ™ , London, UK) and provided important evidence and references for research or education in nursing management, 24 pharmacology, and pharmacy. 25 Nevertheless, no such study has been performed in anesthesiology. Therefore, we designed a cross-sectional study to analyze the high-impact papers in anesthesiology.

Study design and ethical involvement

This was a cross-sectional study based on previously published studies, and institutional review board approval was not required. 25

Inclusion and exclusion criteria

The following inclusion criteria were used: 1) study was in the field of anesthesiology according to the InCites tool based on WOS Core Collection; 2) type of study was an article or review; 3) study was published between 2011 and 2020; 4) paper was high impact (defined according to a previous study, 24 using “% Documents in Top 10%” in the InCites tool, which meant the percentage of the top 10% of publications based on citations by category, year, and document type). The following exclusion criteria were used: 1) the study was not found in the WOS Core Collection and 2) data could not be found in the database.

Literature search and data extraction

We conducted the literature search on 25 October 2021, using the InCites tool to find high-impact papers in the field of anesthesiology, 25 and the search was updated on 7 July 2022. A total of 4,685 studies were identified. All data were downloaded by the InCites tool. The following information was extracted: Category Normalized Citation Impact (CNCI), title of article, journal name, location (country/region), and organization. The CNCI of a document was calculated by dividing the actual number of citing items by the expected citation rate for documents with the same document type, publication year, and subject area. When a document was assigned to more than one subject area, an average of the ratios of the actual to expected citations was used. 26 The CNCI values were used to represent the citation performance on the world average—a CNCI value of more than 1 meant the impact was higher than the global average. 26 To find the information of country or institution, the location or institution filter was used, respectively.

Statistical analysis and visualization analysis

The statistical and visualization analyses were carried out using Numbers software (Apple Inc., Cupertino, CA, USA) and VOS viewer (Leiden University, Leiden, The Netherlands). The Numbers software was used to draw figures to show the numbers of studies and the trends of studies. 25 VOS viewer was applied to construct and visualize bibliometric networks. The networks might include journals, researchers, or individual publications, and they could be built based on citation, bibliographic coupling, co-citation, or co-authorship relations. 27 The CNCI values, trends in the number and citation impact, subject areas, countries, institutions, collaborative networks, and subject terms were analyzed.

Trends of high-impact papers in anesthesiology

High-impact papers in the field of anesthesiology increased from 462 in 2011 to 520 in 2020. The average CNCI value of high-impact papers was 4.50, which ranked about 139 among the 254 research areas (Electronic Supplementary Material [ESM] eTable 1). It decreased from 4.69 in 2011 to 4.21 in 2017 and then increased to 4.38 in 2019. Finally, the CNCI value increased substantially in 2020, reaching 5.46 (Fig. ​ (Fig.1). 1 ). The characteristics of the top ten CNCI value papers and top ten cited papers are shown in ESM eTable 2. The study with the highest CNCI value was a methodological study entitled Correlation coefficients: appropriate use and interpretation, which was published in Anesthesia and Analgesia in 2018, 28 with a total of 1,176 citations and a CNCI value of 115.95. The publication with the second highest CNCI value was a guideline entitled Consensus guidelines for managing the airway in patients with COVID-19: Guidelines from the Difficult Airway Society, the Association of Anesthetists the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anesthetists , 29 which was published in Anaesthesia in 2020, with a total of 335 citations and a CNCI value of 75.75. The most cited publication was a review entitled Central sensitization: implications for the diagnosis and treatment of pain, 30 which was published in Pain in 2011, with a total of 2,010 citations and a CNCI value of 40.52. The journals with the highest impact factors were The Lancet , The New England Journal of Medicine (NEJM), JAMA, and The BMJ , which published 15, four, 19, and 14 high-impact papers, respectively.

Number and citation impact of high-impact papers in anesthesiology from 2011 to 2020. CNCI = Category Normalized Citation Impact

Subject categories of high-impact papers

When searching for the 4,685 papers via WOS Core Collection, only 4,682 were found, including 3,994 articles (reports of research on original works) and 688 reviews (renewed studies of material previously studied). The average and median citation times for articles were 72 and 57, respectively. The average and median citation times for reviews were 120 and 89, respectively. The results suggested that the reviews were cited more than the articles. The 4,682 high-impact papers could be divided into 15 WOS subject categories (ESM eFig. 1). After “Anesthesiology,” “Clinical Neurology” had the highest number of papers ( n = 1,475), followed by “Neurosciences” ( n = 1,126) and “Medicine General Internal” ( n = 331). The 4,582 high-impact papers were cited by a total of 179,117 papers, which were distributed in more than 100 WOS subject categories. The 15 most frequently cited subject categories are shown in ESM eFig. 2. “Anesthesiology” accounted for the largest number of papers, with 39,402 citing papers. The citation impact of these high-impact papers extended to “Clinical Neurology” ( n = 19,835), “Neurosciences” ( n = 17,944), “Medicine General Internal” ( n = 15,170), and “Surgery” ( n = 12,688).

Location of high-impact papers

The locations that published the most high-impact papers in the field of anesthesiology were the USA, UK, Canada, and Germany (ESM eTable 3).

Organization of origin of high-impact papers

The organizations that published the most high-impact papers in anesthesiology were the League of European Research Universities, Harvard University, University of Toronto, University of London, University of California System, and UDICE-French Research Universities (ESM eTable 4). The top 15 organizations and their CNCI values are shown in Fig. ​ Fig.2 2 and ESM eTable 4, respectively.

Numbers of high-impact papers in anesthesiology and CNCI values of the top 15 production institutions. APHP = Assistance Publique Hopitaux Paris; Inserm = Institut National de la Sante et de la Recherche Medicale, National Institute of Health and Medical Research in France; CNCI = Category Normalized Citation Impact; LERU = League of European Research Universities; UDICE = French Research Universities

Cooperation network of institutions of high-impact papers

Figure ​ Figure3 3 shows the network of cooperation among institutions with the highest number of high-impact papers in anesthesiology from 2011 to 2020. Each color represents a cluster, which means that there was cooperation between institutions with the same color. The size of each node represents the number of papers, and the connecting line indicates cooperation. The network map revealed that there were six leading collaborative circles among institutions, which were mainly universities from the same country and region. Specifically, the largest node was the university groups from the USA and Canada (at the above corner), including the University of Toronto, Stanford University, and Duke University. The top collaborative circles were mainly in the USA, UK, and Canada (ESM eFig. 3).

Map of collaborative networks among institutions of high-impact papers

Subject-term heatmap of high-impact papers

We used VOS viewer to perform natural language processing on the titles and abstracts of the 4,682 high-impact papers and divide the processed subject terms and phrases into clusters. The warmer the color of topic terms on the heatmap, the higher the frequency of terms appeared in the literature. In the heatmap of all studies (Fig. ​ (Fig.4), 4 ), three main hot research topics were found. Postoperative analgesia was the first hotspot, including “analgesia,” “block,” “ultrasound,” “opioid consumption,” “pain score,” “Visual Analogue Scale,” and “vomiting.” Pain, especially chronic pain, was the second hot research topic, including “pain,” “chronic pain,” “pain intensity,” “pain severity,” “pain modulation,” “depression,” and “disability.” Perioperative complications was the third research hotspot, including “complications,” “mortality,” “delirium,” “cardiac surgery,” “failure,” “discharge,” and “comorbidity.”

Subject terms heat map of high-impact papers in anesthesiology

To evaluate the latest progress, we performed a subject-term heatmap analysis on papers published in 2020. From the heatmap (ESM eFig. 4), COVID-19 was found to be the new research hotspot, which included “COVID,” “pandemic,” “recommendation,” “risk factor,” and “coronavirus disease.”

To evaluate the difference in progress between article types, we performed a further analysis based on the article and review. In the heatmap of all articles (ESM eFig. 5), three main hot research topics, including postoperative analgesia, pain, and perioperative complications, were found. In the heatmap of reviews (ESM eFig. 6), postoperative analgesia, pain, perioperative complications, and COVID-19 were the main research topics.

To evaluate the most high-impact papers, we performed a further analysis based on the top 1% papers. A total of 482 papers were included. In the heatmap (ESM eFig. 7), four main hot research topics were included, which included postoperative analgesia, pain, perioperative complications, and COVID-19.

In the present study on high-impact papers in anesthesiology over the past ten years, we hope it could provide reference for future education, research, and clinical practice in anesthesiology. We found that the number of high-impact papers published each year varied from 462 in 2011 to 443 in 2019 and significantly increased in 2020. The increased number of papers in 2020 might be due to the COVID-19 pandemic because anesthesiologists played important roles in fighting COVID-19. The increasing trend of high-impact papers in 2020 was similar to the results from previous pharmacology and pharmacy studies, 25 indicating that COVID-19 had influenced global studies.

In this study, we compared a few top CNCI value papers and top-cited papers. The results show that the papers with high CNCI values were all published in journals of the Anesthesiology category, and four of them were published in 2020 with the COVID-19 topic. The top ten cited papers were published from 2011 to 2018 and were mainly published in anesthesiology journals, and their CNCI values ranged from 15 to 115. The papers with the highest impact were published in the top four medical general journals— Lancet , NEJM , JAMA, and BMJ published 15, four, 19, and 14 papers, respectively. Interestingly, the top ten cited papers were not from the top impact-factor journals, which indicate that the research published in anesthesiology journals could be both high impact and highly cited. It was particularly encouraging that seven of the top ten cited papers were published in journals with an impact factor below 10. 24 , 25 This observation indicates a wide range of citation models in individual journals. Therefore, the impact factor of a journal should not always be used to assess the feature of citation and the impact of papers.

In the study, we analyzed the interactions between different subject categories by papers and their citations. All high-impact papers were from 15 WOS subject categories and cited by more than 100 WOS subject categories, which suggests a strong influence from the anesthesiology high-impact papers. Anesthesiology is a multidisciplinary category that has attracted attention from various categories. 23 Besides “Anesthesiology,” “Clinical Neurology” and “Neurosciences” were the top citing categories, indicating that the most important progress in anesthesiology has been made in the fields of “Clinical Neurology” and “Neuroscience.”

The results revealed that League of European Research Universities, Harvard University, University of Toronto, University of London, University of California System, and University Health Network Toronto were leading organizations in anesthesiology. Top-level cooperation was mainly based in the USA, Canada, and the UK, which implies that researchers collaborated more inside their own countries. It is necessary to conduct research cooperation with international institutions. The results show that the USA, UK, Canada, Germany, and Australia published the most high-impact papers, consistent with a previous study. 23 It suggested that the high-impact papers had always been from high-income countries, and not so many papers were from low- and middle-income countries because low- and middle-income countries might lack funds, skills, and technology, leading to limited research level and ability. It is necessary to improve research ability and increase funds and training to reduce inequality, and promote publications from low- and middle-income countries.

To analyze the difference between types of studies, we performed a further analysis based on the types of published papers. For articles, we found three main hot research topics, which were almost the same as the total analysis; for reviews, COVID-19 emerged as the new hot topic, which was slightly different from articles, suggesting that COVID-19 had a high impact on the field. In addition, we performed a further analysis of the most high-impact papers (top 1% papers), and the results were almost the same as the data in 2020, which suggests the high impact of COVID-19.

There are several limitations to this study. First, the search was based on the “Anesthesiology” category, which might have missed some studies. Second, we only searched published papers from 2011 to 2020. Papers published before and after this period were excluded so that some other high-impact papers might have been missed. Another limitation was the inherent bias in the high-impact papers, which referred to the top 1% or 10% papers in a certain research field. 24 , 25 The number of citations of papers accumulates over time, and thus, some papers might not be high impact at present, but they could be after a few months. This could have led to inaccuracy in analysis. Lastly, the study was based on the InCites tool. Misclassification that could not be excluded from research in some papers might also have led to inaccurate results.

Overall, the current research provides a historical view of the research progress in anesthesiology over the past ten years. High-impact papers were mostly from the USA. Postoperative analgesia, pain, and perioperative complications were topics of high interest, and COVID-19 emerged as a new hot topic in 2020. This research provides a reference for future education, research, and clinical practice in anesthesiology.

Below is the link to the electronic supplementary material.

Author contributions

Yonggang Zhang designed the study and edited the manuscript; Lingmin Chen searched for the data, analyzed the data, and drafted the manuscript; and Nian Li analyzed the data and drafted the manuscript.

Acknowledgments

This manuscript was edited by Enliven Co. (Beijing, China).

Disclosures

Funding statement.

This study was supported by the National Natural Science Foundation of China (No: 82001130), The Post-Doctoral Research Project of Sichuan University (2021SCU12001), and The Post-Doctoral Research Project of West China Hospital of Sichuan University (No. 19HXBH071).

Editorial responsibility

This submission was handled by Dr. Philip M. Jones, Deputy Editor-in-Chief, Canadian Journal of Anesthesia/Journal canadien d’anesthésie .

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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• Introduction

The Top 25 Up-To-Date Dissertation Topics In Anaesthesiology

• A comparative study into the effectiveness of using variable dosage of intravenous fluid used during a transurethral resection of the prostrate to prevent hyponatremia.
• A study into the results of the performance of Nurse anaesthetists in National Board Certification Exams.
• The development of a model of Anaesthesiology Care (during and post operative) that can be provided by Physicians and Nurses.
• Research into the effect of the use of PCA (patient controlled analgesia) with young patients (under 15) who have undergone hip replacement.
• The impact of using an early tracheotomy (in comparison to a late one) on patients who have suffered a severe head injury.
• The effect of using a lighter state of anaesthetic (with a spinal block) as opposed to a full general anaesthetic on the recovery and immediate mobility after hip replacement.
• Quality of care and patient satisfaction after anaesthesia has been delivered within an office-based surgery.
• Research in the effect of bio-feedback prior to surgery and its correlation to the reported post-opt recovery.
• The effectiveness of a rectally administered pre-medication in comparison to an orally administered pre-medication in young children.
• The positive effect of music-therapy as a tool to reduce sedation and cortisol levels in patients undergoing lower limb arthroscopic procedure under spinal anaesthesia.
• An evaluation into the use and effectiveness of a bacteriostatic heat and moisture exchanger in comparison to a non- bacteriostatic exchanger.
• A study in to the factors that influence parental anxiety and satisfaction if they are allowed to be present during administration of anaesthesia to their child.
• Study into the effectiveness of the percutaneous nerve stimulation for the performance and education of the peripheral nerve block administration.
• A comparative study on the prevention of pain by the use of propofol injection of Novocaine; pethidine; dexamethasone and placebo.
• A study based on the 2002 paper “Maternal hypo-tension and epidural anaesthesia for Caesarean section”.
• Research into the possible current need for anaesthesia during and MRI scan and the possibility of designing and monitoring its protocols.
• A study to determine the selection criteria and academic progression for doctors who express an interest in becoming anaesthetists.
• A Comparative study in to the use of epidural anaesthesia for caesarean patients with pregnancy induced hypertension.
• An evaluation of the use of epidural tramadol and its effects on the duration of the need for postoperative analgesia in urological surgical patients.
• A study into the prevention of postoperative nausea and vomiting in patients undergoing a laproscopic cholecystectomy (a randomised, double-blind placebo-controlled study).
• A comparative study into the effects of the use of pre-operative low dose ketamine infusion on postoperative males and females.
• A comparative study into the efficiency of graisetron as opposed to droperidsol as a preventative of postoperative nausea and vomiting.
• Research into the advantages of using tramadol as a wound filtration in children comparison to bupivacaine.
• An evaluation into the use of sedation monitors that are used during conscious sedation procedures during a colonoscopy.
• The effectiveness of bi-spectral monitoring as a tool for predicting the recovery time following a procedure that was performed under conscious sedation.
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A List Of Unexplored Dissertation Topics In Anaesthesia

Anaesthesia is a medical term which means “loss of sensation”. The medications and their related catalysts are called anaesthetics. These anaesthetics are very useful and crucial in performing the medical tests and the surgical operations in order to induce sleep. It is necessary to put the patient to sleep because this prevents the person from feeling any kind of discomfort and pain and it also enables the surgeons to perform a very wide range of medical procedures that regularly need to be performed for various reasons.

Here we have a number of dissertation topics for your inspiration and needs. These topics are perfect and very suitable for your purpose of starting a good thesis based on a strong but unexplored research in field of anaesthesia. One can do their homework on any of these terms of interest. These dissertation topics are also a good choice for writing an essay for your medical speeches and exhibitions.

Here is a list of some interesting dissertation topics in the field of anaesthesia that have not been appropriately explored yet are:

• The comparatively exhaustive relation between fentanyl, hyperbaric lignocaine and intrathecal hyperbaric lignocaine during spinal blockade.
• Pain relief via intramuscular route post operation with comparison of inhibitors NSAID and COX-2
• The effect of intrathecal tramadol for surgery of hernia on the behavior of subarachnoid blocks.
• The overall influence and effect of intrathecal midazolam on the block of subarachnoid for the caesarean section.
• Comparatively vigorous study of pre operated bilateral infraorbital block of nerve along with the peri incisional infiltration for the need of post-operative pain relief in the cleft lip surgery in the matters of pediatric cases.
• Comparison of intra venous esmolol and oral clonidine for attenuation of the stress response to intubation and laryngoscopy in the middle ear surgery procedures.
• Effects of low dose dexmedetomidine upper infusion on the perioperative hemodynamic response and the post-operative analgesia requirements in the patients that are undergoing laparoscopic cholecystectomy.
• Dexmedetomidine acting as an adjuvant to the intrathecal hyperbaric bupivacaine for the spinal block characteristics and the post-operative analgesia for the lower limb orthopedic surgeries.
• Air way management in the field of pediatric anaesthesia (the Pro seal laryngeal mask airway v/s the endtracheal intubation).
• The efficiency and effectiveness of dexamethasone while getting added as an adjuvant to the combination of local anaesthetics in the brachial plexus block for the post-operative analgesia.
• The placental morphology and mechanism in the pregnancy induced hyper tension along with its clinical significance.

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Anesthesia Thesis Topics For MD/DNB

Remember Subscribing to the premium thesis topics not only will enable you to browse through premium thesis topics but also you will get access to online guidance about synopsis writing, sample size calculation, inclusion and exclusion criteria and guidance throughout thesis writing. In case you dont subscribe still do not hesitate to contact me for guidance.

Below is the list of 100 free Anesthesia thesis topics for MD/DNB. You can select any good Anesthesia thesis topics for MD/DNB from here. For more thesis topics you can avail the service of premium Anesthesia thesis topics. The premium Anesthesia thesis topics include list of 2000+ premium and updated Anesthesia thesis topics as well as recent Anesthesia topics which has been published in various national and international Anesthesia journals. 

Though Anesthesia thesis topics can be searched online and for this purpose various Anesthesia journals can be browsed but its a time consuming process. We have collected all important Anesthesia thesis topics by painstakingly browsing through past and present issues of Anesthesiology journals. Not only the Anesthesia journals but also we have compiled the list of all top Anesthesia thesis topics by physically going through the libraries of various medical colleges.

Needless to say collecting thousands of Anesthesia thesis topics at one place was a time consuming job. You can browse all these Anesthesia thesis topics by subscribing to premium Anesthesia thesis topics. Please share this page with your friends who may be searching for good Anesthesia thesis topics.  

• Effects of intravenous dexmedetomidine in patients receiving 0 5% hyperbaric bupivacaine spinal asaesthesia.
• A comparative study of patient controlled epidural analgesia vs continous epidural infusion in labour analgesia using ropivacaine with fentanyl.
• To study correlation of extravascular lung water and compliance of lung in mechanicaly ventilated patients in ICU of a tertiary care centre.
• Combination of ropivacaine and dexmedetomidine for supraclavicular brachial plexus block using ultrasound and nerve stimulator guided technique: An intervention study to determine the effective volume.
• Comparison of efficacy of sedation with dexmedetomidine plus ketamine and propofol plus fentanyl in adult patients undergoing out-patient colonoscopy.
• To study the correlation between cerebral,rSO2 and outcomes in severe head injury cases.
• Comparision of dexmedetomidine and ketamine vs propofol and ketamine for procedural sedation in children undergoing minor cardiac procedures in cardiac catheterisation lab.
• To compare the analgesic efficacy of continuous femoral nerve block (CFNB) with local anaesthetic through a catheter versus patient controlled analgesia with intravenous morphine after total knee arthroplasty.
• Correlation between centrally versus peripherally transduced venous pressure in patients undergoing craniotomy.
• To study the incidence and risk factors of post-operative sore throat in patients undergoing elective surgeries under general anaesthesia with endotracheal tube.
• A comparative study of scoring systems used to predict difficult airway.
• An assessment of satisfaction of family members of patients admitted in the ICU.
• Comparative study of IV dexmedetomidine vs IV midazolam for sedation during tympanoplasty and modified plasty and modified radical mastoidectomy.
• Comparison between epidural tramadol and fentanyl for post operative analgesia.
• The efficacy of dexmedetomidine as an adjuvant in brachial plexus block by supraclavicular approach with 0.25% bupivacaine.
• Effect of low dose intravenous dexmedetomidine on characteristics of spinal anaesthesia with 05% hyperbaric bupivacaine.
• Effects of IV dexmedetomidine as a pre-medication on clinical profile of bupivacaine spinal anaesthesia in lower abdominal surgeries.
• Comparison of haemodynamic changes of proseal LMA and endotracheal tube for laparoscopic surgeries.
• Comparative study of intrathecal isobaric 0.5% bupivacaine and isobaric 0.75% ropivacaine for lower abdominal and lower limb surgeries.
• Comparison of recovery characteristics of desflurane, sevoflurane and propofol in patients undergoing laparoscopic cholecystectomy.
• Effect of preoperative intramuscular morphine injection for post operative analgesia in patients undergoing joint replacement surgery.
• Evaluation of efficacy of tranversus abdominis plane block for post operative analgesia in patients undergoing total abdominal hysterectomy.
• A comparative study between ropivacaine with fentanyl versus bupivacaine with fentanyl for post operative epidural analgesia in patients undergoing elective lower abdominal and lower limb surgeries.
• To compare the effect of preloading with 6% (HES) hexaethyl starch versus intravenous ephedrine for the prevention of hypotension following spinal anesthesia for parturients undergoing caesarean section.
• Comparative study of dexmedetomidine and lignocaine for attenuation of cardiovascular stress response to laryngoscopy and endotracheal intubation.
• Effect of addition of intrathecal fentanyl to hyperbaric bupivacaine (0.5%) for casearean section.
• Comparative study of the intubating conditions and cardiovascular effects following succinylcholine and rocuronium in adult elective surgical patients.
• Attenuation of the circulatory responses to endotracheal intubation with preinduction intravenous labetalol.
• Comparative evaluation of bupivacaine and bupivacaine with dexmedetomidine in subarachnoid block.
• Comparative evaluation of thiopentone sodium and propofol for electro convulsive therapy.
• Comparative study of 0.5% lignocaine with dexmedetomidine and 0.5% lignocaine in intravenous regional anaesthesia.
• Comparison of efficacy of levobupivacaine and clonidine with bupivacaine and clonidine in spinal anaesthesia for lower segment caesarean section.
• A comparative study of intrathecal dexmedetomidine and fentanyl as an adjuvant to bupivacaine.
• Comparision of bupivacaine,bupivacaine plus clonidine, bupivacaine plus dexmeditomedine intrathecally in lower abdominal surgeries.
• The effects of ephedrine infusion for the prevention of hypotension during spinal anaesthesia for elective lower segment caesarean section.
• The comparative study of epidural anaesthesia between isobaric ropivacaine 0.5% and isobaric bupivacaine 0.5% for lower abdominal surgeries in tertiary care institute.
• A comparative study on effect of adding dexmedetomidine and dexamethasone to local anaesthetics in brachial plexus block.
• A randomised study on the efficacy of ketamine and pethidine in the treatment of postoperative shivering in patients undergoing general anaesthesia.
• A double blinded randomized control trial to compare hyperbaric ropivacaine (18 mg) with hyperbaric bupivacaine (18 mg) for spinal anaesthesia in lower limb orthopedic surgeries.
• Comparative evaluation of addition of dexamethasone to two different local anaesthetics in supraclavicular brachial plexus block
• Comparative study of propofol versus ketamine as inducing agent on hemodynamic and seizure activity in modified electroconvulsive therapy.
• Prevention of sevoflurane related emergence agitation in children undergoing general anaesthesia : a comparison study between dexmedetomidine and propofol.
• A comparative study of hernial block versus subarachanoid block for elective inguinal hernia repair.
• Effect of dexmedetomidine in supraclavicular brachial plexus block as an adjuvent : A comparative study.
• Mechanical complications during insertion of central venous catheter in subclavian vein and internal jugular vein – A comparitive study.
• Comparison of ambu laryngeal mask airway with soft seal laryngeal mask airway during routine surgical procedure.
• Study of efficacy of dexmethasone as preemptive analgesic in patients undergoing total abdominal hysterectomy under spinal anaesthesia.
• A clinical assessment of macintosh,miller blades and king visionTM video laryngoscope for laryngeal exposure and difficulty in endotracheal intubation.
• Comparison of two doses of dexmedetomidine combined with ketamine for anesthesia in dilatation and curettage.
• Evaluation of effect of low dose of intravenous dexmedetomidine supplementation on sensory and motor blockade produced by intrathecal hyperbaric bupivacaine.
• Comparison of the effects of lateral and sitting position during induction of spinal anaesthesia with plain levobupivacaine in cesarean section.
• Comparitive study of bupivacaine with dexmedetomidine and bupivacaine alone in supraclavicular brachial plexus block.
• A comparative study of propofol and thiopentone with local anaesthetic spray as inducing agents for I gel insertion.
• A comparative study of perioperative effects of preemptive dose of dexamethasone versus clonidine in lower abdominal surgeries under spinal anaesthesia.
• Intravenous dexmedetomidine vs. intravenous clonidine to prolong bupivacaine spinal anesthesia.
• Comparative study of the effect of IV ketamine and IV tramadol for control of shivering in cases of caesarean section under spinal anaesthesia.
• Comparison of inj. Lignocaine (preservative free) 1.5mg/kg IV with oral pregabalin 150 mg for attenuation of haemodyanamic response to laryngoscopy and tracheal intubation.
• Comparative study of supraclavicular block using bupivacaine with perineural dexamethasone, bupivacaine with I.V. dexamethasone and bupivacaine only.
• Comparative study of intrathecal bupivacaine with fentanyl and intrathecal bupivacaine with clonidine for quality of anaesthesia and duration of post operative pain relief in patients undergoing lower abdominal and lower limb surgeries.
• A comparison of efficacy of pre-emptive analgesia with three small doses of N-Methyl-D- aspartate antagonist ketamine for improving post operative analgesia after laparoscopic surgeries,
• A study of perioperative airway and respiratory complications in children undergoing cleft lip and palate repair.
• Identification of risk factors for hypotension after spinal anaesthesia in patients undergoing casarean section.
• Use of McCoy and truview laryngoscope blades for intubation in patients with anticipated difficult airway with respect to ease of intubation and haemodynamic response.
• Audit of perioperative complication of patients unergoing turp surgeries :: an anaesthetist’s perspective.
• An audit of blood and blood products transfusion practices in elective spine surgery.
• The type of anaesthesia and outcome in preeclamptic patients undergoing caesarean section an observational study.
• Comparison of palonosetron, ondansetron, and metoclopramide in controlling post operative nausea and vomiting in obstetrical and gynaecological surgeries.
• Comparison between intranasal dexmedetomidine and intranasal midazolam for preanaesthetic sedation in children.
• Comparison between 0.125% bupivacaine and 0.125% ropivacaine for epidural analgesia during labour.
• Dexamethasone as an adjuvant to local anaesthetic in supra clavicular block a comparitive study.
• Observational study of hemodynamic effects of etomidate and propofol used as induction agents in patients planned for off pump cabg
• An observational study to compare the haemodynamic parameters following spinal anaesthesia with hyperbaric bupivacaine in hypertensive and normotensive patients.
• Correlation of leak around uncuffed endotracheal tube and postoperative morbidity in children: an observational study.
• A cross-sectional observational analysis of preoperative blood glucose levels in patients presenting for surgery.
• Monitoring of depth of anaesthesia using entropy monitor during cardiopulmonary bypass-a prospective study.
• An evaluation of procedural sedation techniques in duchenne muscular dystrophy patients undergoing stem cell therapy.
• Anaesthesia risk stratifaction: comparison between silverman-holt aggregate preoperative evaluation (SHAPE) and american society of anaesthesiologists physical status (ASA PS) evaluation systems.
• Efficacy of spinal anaesthesia for laparoscopic ventral hernia repair
• Comparative study of nalbuphine vs. pentazocine for postoperative analgesia.
• Comparative study of intrathecal isobaric levobupivacaine versus hyperbaric bupivacaine in lower abdominal surgery.
• Comparative study of 0.5% (heavy) intrathecal bupivacaine alone with 0.5% (heavy) intrathecal bupivacaine midazolam combination in patients undergoing elective inguinal hernia repair.
• Comparative evaluation of induction with propofol and sevoflurane for insertion of laryngeal mask airway in children.
• Hemodynamic behaviour,ECG changes and postoperative outcome of hypertensive and normotensive patients under spinal anaesthesia.
• The comparision of single bolus dose of dexmedetomidine with bolus plus infusion of dexmedetomidine on characteristics of spinal anaesthesia with hyperbaric bupivacaine.
• Evaluation of airway and predicting difficult endo- tracheal intubation in diabetic patients -A comparison with non diabetic patients.
• Observational study for dose-response characteristics of intrathecal hyperbaric bupivacaine(0.5%) by using sequential combined spinal epidural anesthesia (SCSEA) in patients aged over sixty year for orthopedic surgeries.
• A comparison of thyromental height with the ratio of patient’s height to thyromental distance and the upper lip bite test in predicting difficult laryngoscopy.
• A comparetive study of arterial PH and chloride levels following 6% HES 130/0.4 saline solution or 6% HES 130/0.4 balanced solution used during cardiac surgery involving cardiopulmonary bypass.
• A prospective study to compare efficacy of interlaminar vs caudal epidural steroids in chronic lower back pain.
• A prospective comparative study of ondansetron against tramadol pretreatment to reduce pain on injection of propofol.
• A comparative study between clinical efficacies of levobupivacain plain and levobupivacaine with fentanyl for urological surgeries under subarachnoid block.
• A comparison of the efficacy of fentanyl and clonidine for attenuation of pressor response to endotracheal intubation.
• Pre treatment with intravenous granisetron to alleviate pain on propofol injection: A double blind randomised controlled study using normal saline as control.
• Randomised prospective study of comparison of USG guided subcostal transversus abdominis plane block techinque (sta block) versus conventional port site infiltration techinque used in laparoscopic cholecystectomy for post operative analgesia.
• Correlation of bispectral index with depth of sedation: A comparison between dexmedetomidine versus propofol in patients undergoing infraumabilical surgery under subarachnoid block.
• Ultrasonographic measurement of optic nerve sheath diameter to detect raised intracranial pressure in head injury patients in ICU and its correlation with CT scan findings.
• Comparison between palonosetron and granisetron in prevention of postoperative nausea and vomiting (PONV) in elective laparoscopic surgeries under general anaesthesia.
• A comparison of upper Lip Bite Test with modified mallampati classification in predicting difficulty in endotracheal intubation.
• Effect of dexmedetomidine hydrochloride as an adjuvant to lignocaine hydrochlorid for intravenous regional anaesthesia.
• Postoperative nausea and vomiting -prophylaxis with palonosetron hydrochloride.
• Comparison of dexmedetomidine and midazolam for sedation in post -operative surgical patients.
• Study of hemodynamic changes during laparoscopic surgery using non-invasive cardiac output monitor (NICOM) Low flow anaesthesia : a prospective observational study.

Disclaimer!

There are many methods of sample size determination. It is one of the first hurdle when someone starts writing a thesis. I have tried to give simplest way of determination of sample size. You need to show the method to your PG teacher before you include this method in your thesis. First confirm from your PG teacher and then only proceed.

Anesthesia for the elderly: selected topics

Affiliation.

• 1 Department of Anesthesia and Critical Care, Massachusetts General Hospital, Boston, Massachusetts 02114-2696, USA.
• PMID: 16735817
• DOI: 10.1097/01.aco.0000192807.63785.59

Purpose of review: With the graying of the Western population, there is a continuous increase in the proportion of elderly patients undergoing surgical procedures. Geriatric anesthesia is emerging from a 'subspecialty' to the mainstream of today's anesthesia and perioperative care. Much has been written on anesthesia for the elderly, but this review will concentrate on selected topics related to elderly care that represent current unresolved and pertinent issues for the care of the elderly surgical patient.

Recent findings: Postoperative cognitive dysfunction, cardiac diastolic dysfunction and prophylactic perioperative beta-blockade in the process of major noncardiac surgery are three main topics that have recently attracted great interest in clinical practice and research, and have therefore been chosen as the selected topics for this current review.

Summary: Although age is a clear risk factor for postoperative cognitive dysfunction, the association of general anesthesia with cognitive dysfunction is less clear, as is the effect of anesthesia per se or surgery on long-term cognitive dysfunction. Cardiac diastolic dysfunction is a relatively new and evolving concept in anesthesia and perioperative medicine, yet clearly diastolic dysfunction even with a normal ejection fraction may have a significant effect on the perioperative outcome and management of elderly patients. Small, but powerful studies have shown significant outcome benefit with prophylactic perioperative beta-blockade in high-risk patients undergoing major noncardiac surgery. Data from other studies, however, are still conflicting and the final verdict awaits larger scale outcome studies.

Publication types

• Adrenergic beta-Antagonists / therapeutic use
• Aged, 80 and over
• Anesthesia, General* / adverse effects
• Cognition Disorders / chemically induced
• Diastole / drug effects
• Middle Aged
• Postoperative Complications / chemically induced
• Postoperative Complications / prevention & control
• Risk Factors
• Adrenergic beta-Antagonists

Home > MAHE Student Work > KMCMLR

Kasturba Medical College, Mangalore Theses and Dissertations

Theses/dissertations from 2021 2021.

“The Impact of Self-Stigma of Seeking Help and Perceived Social Support on Burnout among Clinical Psychologists” , Aavrita A

The impact of self-stigma of seeking help &percieved social support on burnout among clinical psychologists. , Aavrita .

Immediate Effects of Novel Hand Rehabilitation Board on Fine Motor Skills in Children with Cerebral Palsy. , Romita Fernandes. Abraham

"COMPARISON OF THREE SCORING CRITERIA TO ASSESS RECOVERY FROM GENERAL ANAESTHESIA IN THE POST-ANAESTHESIA CARE UNIT- A LONGITUDINAL OBSERVATIONAL STUDY " , Shagun Aggarwal

Comparative predictive validity of Alberta Infant Motor Scale and Infant Neurological International Battery in Low Birth Weight Infants- A Prospective Longitudinal Study. , Polisetti Siva Sai Anand

Antagonistic Asynchrony in Muscle Recruitment Pattern of Forward Reach Movement In Children With Cerebral Palsy. , Sanya Anklesaria

Muscle fatigue response of rotator cuff muscles in sitting and standing postures , Lisanne Aranha

Effectiveness of static weight bearing versus modified constraint induced movement therapy on improving hand function in hemiplegic cerebral palsy- A Randomized Clinical Trial. , Ruth Bavighar

How informed are our patients about generic medicines? – A study from coastal South India , Darshan BB

Morphological variants of the human spleen, a cadaveric study , Murlimanju BV

Association between cervical breast cancer and Diabtetes mellitus among women seeking health care in tertiary hospitals od south India: A cross sectional study , Pratik Kumar Chatterjee

Carcinoma Breast in among Women with Diabetes Mellitus: A Case Control Study , Pratik Kumar Chatterjee

Perception of Empathy among medical students: A cross sectional study , Pratik Kumar Chatterjee

CLINICOMYCOLOGICAL PROFILE OF DERMATOPHYTOSIS IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA , Adyashree Dalai

Study of outcome of Ponseti technique of management for idiopathic clubfoot in a tertiary center in south India , Lulu Damsas

Comparative study of emotional labour &burnout on life satisfaction among school teachers across different educational settings , Meghana Dharampalan

“Comparative Study of Emotional Labor and Burnout on Life Satisfaction Among School Teachers Across Different Educational Settings” , Meghana V. Dharmapalan

“Relationship Between Sexual Fantasy, Sexual Communication, Personality Traits and Sexual Satisfaction in Married Individuals” , Rhea Dhir

Comparing the efficacy of USG guided supraclavicular brachial plexus block with or without intercostobrachial nerve block for forearm surgeries – an observational study , DIKSHA D’MELLO

Does Quality of Sitting influence Functional Mobility in Cerebral Palsy? A cross-sectional study , Kaiorisa N. Doctor

Factors effecting gait velocity in osteoarthritis knee-An observational study. , Lisha Gretal D’silva

Effect of Inspiratory Muscle Training on Pulmonary Function, Functional Capacity, Quality Of Life And Length Of Stay in individuals undergoing Cardiac Surgery , Fiona Verdine Dsouza

Relationship of Academic Resilience with Self-Efficacy, and Perceived Social Support; Among Civil Service Aspirants , Neha Eldho

EFFICACY, FEASIBILITY, AND SAFETY OF PERCUTANEOUS IMAGE-GUIDED CATHETER DRAINAGE OF THORACIC, ABDOMINAL, AND PELVIC FLUID COLLECTION , Aishwarya Gadwal

Comparison of efficacy of two different bolus doses of norepinephrine as prophylac-tic to prevent post-spinal hypotension during elective caesarean section , PRANATHI GARAPATI

Trends in Frailty and its Associated factors in Community Dwelling Elderly Indian Population during COVID-19 Pandemic- A Prospective Analytical Study , Karan Gautam

Speech Sound acquisition in some south Indian Dravidian languages: A systematic review , Jesica George

Comparison of Femoral nerve block with Dexmedetomidine and Adductor canal block with Dexmedetomidine for postoperative analgesia for Total Knee Arthroplasty . , NEHA GEORGE

Assessment Of Cardiovascular Risk Factors In Patients With Osteoarthritis Knee , Sagar Goel

Effectiveness of Intermittent Cervical Traction with and without Neural Mobilization in Discogenic Cervical Radiculopathy , Aditi Goyal

Study of maternal and cord blood vitamin B12 levels with anthropometry in term neonates born to normal and malnourished mothers: a hospital based cross sectional study , Sugapradha a. GR

Development of a Questionnaire to Determine the Intervention and Service Delivery Practices of Speech-Language Pathologists for Children with Speech Sound Disorders in India , Shaily Gupta

Relationship between Physical Activity, Objective Sleep Parameters and Circadian Rhythm in Patients with Head and Neck Cancer receiving Chemoradiotherapy- A Longitudinal Study , Rachita Gururaj

“Emotional Contagion, Perceived Stress and Coping Strategies Among Nurses” , Saumya Hariharan

Assessment of knowledge and belief about stuttering among undergraduate medical students , Anushree Harihar

Association of serum lipid levels and other systemic risk factors with retinal hard exudates in diabetic retinopathy patients. , Harshita Mukesh Hiran

Assessment of risk of Diabetes Mellitus by using Indian Diabetes Risk Score among Housekeeping staff , Ramesh Holla

“Emotional Intelligence, Self-compassion, and Life-Satisfaction In Clinical Psychologists” , Vania Jacob

UPPER-CROSSED SYNDROME AND DISABILITY IN SHOULDER ADHESIVE CAPSULITIS. , Aishwarya Jaideep

Study to assess the role of doppler ultrasound in evaluation of arteriovenous hemodialysis fistula and the complications of hemodialysis access , Ishank Jain

Relationship between burnout compassion fatigue, work environment & mindfulness in medical residents , Pranay Javeri

“Relationship Between Burnout, Compassion Fatigue, Work Environment and Mindfulness in Medical Residents” , Pranay Harichandra Javeri

“Dating Anxiety in Emerging Adults” , Jisha V. Jayaprakash

“Relationship Between Tolerance for Disagreement and Mindfulness in Married Males and Married Females” , Jahnavi Jha

Antibiotic usage and susceptibility patterns in Uncomplicated UTI in a Tertiary Hospital in South India , Christy John

Association of bed rise difficulty scale with trunk impairment and functional scales among stroke patients , Leena G. John

Is there a correlation between Pediatric Berg Balance Scale and Centre of Pressure Excursion measured through Dual Axis Static Force Plate™ to assess Balance in Children with Spastic Cerebral Palsy and Typically Developing? , Niharika Joshi

Comparison of Sensory Processing Responses in Cerebral Palsy Subtypes and Typically Developing Children (7-36 months): A Cross Sectional Study. , Archana Antony K

‘A study on the Role of Learned Helplessness, Selfefficacy and Perceived Social Support in Determining Resilience in Parents of Children with Neurodevelopmental Disorders’ , Benaisha Khurshed Katrak

A study of correlation of maternal serum zinc levels with breast milk and cord blood of late preterm neonates , Rashmi Katti

Correlation of histopathology and direct immunofluorescence findings in clinically diagnosed prurigo nodularis , Haritha K

Difference in proximal femur loading due to muscle activity during partial weight bearing and NWB standing- A cross-sectional study. , Smital Kshirsagar

Effect of Sesamol on neurobiochemical changes in diet induced (DIO) obesity model of Zebra fish (Danio rerio) , Rashmii K.S.

Importance of integration of medical ethics with undergraduate medical curriculum- Instructors and student’s perspectives. , Rashmii K.S.

Long-term potentiation (LTP): A simple yet powerful cellular process in learning and memory , Rashmii K.S.

Parkinson's Disease Overview: Alternative Potential Curcumin Treatment, Current Treatment and Prevalence Among Ethnic Groups , Rashmii K.S.

Smart brain of India vs. tricky drugs , Rashmii K.S.

The Role of Professionalism and Ethics Training: Instructor’s and Student’s perspectives in a medical College , Rashmii K.S.

Violence Against Doctors: A Qualitative Study On This Rising Predicament , Rashmii K.S.

Morphometric study of the gracilis muscle and its pedicles , Chettiar Ganesh Kumar

Comparative study of bed side tests to assess difficult airway in paediatric patients , S.Abinandha Kumar

Euphorbia thymifolia (Linn.)- A review on ethno pharmacological properties , Vasavi Kumblekar

COMPARISON OF KNOWLEDGE, ATTITUDE, AND PRACTICE TOWARDS THE USE OF SUNSCREEN IN DAILY LIFE BETWEEN FIRST -AND THIRD -YEAR MEDICAL STUDENTS , Aarushi Lall

‘Feminist Identity, Socio-cultural Attitude Towards Appearance, and Body Images issues in Emerging Adult Women’ , Sheena Lonappan

A novel approach to quantify the Dynamic Windlass Mechanism , Ishita Mahajan

METFORMIN VERSUS INSULIN IN THE MANAGEMENT OF GESTATIONAL DIABETES , Varikuti Manogna

Cognitive abilities among employed and unemployed middle-aged women – a systematic review , Aswini M

‘Emotional Intelligence, Job Satisfaction and Psychological Well-being Among Nurses’ , Chetna M

RELATIONSHIP OF COMPUTER AIDED DESIGN(CAD)-BASED PHOTOGRAMMETRY FOR FACIAL DYSFUNCTION WITH FACIAL GRADING SYSTEMS FOR BELL’S PALSY: A PROSPECTIVE OBSERVATIONAL STUDY , Ankita Mehendale

“Effect of Sensation Seeking and Anxious Traits on Suicidal Ideation Among Adults by Birth Order” , Haripriya G. M

Clinical & radiological assessment of intertrochanteric fractures treated with PFN A2 , Harish M

Effect of a home-based pulmonary rehabilitation programme on respiratory function, functional capacity, and quality of life in patients with chronic obstructive pulmonary disease , Vaibhavi Mhatre

Profiling Communication Characteristics of Individuals with Acquired Neuro-communication Disorder in a Tertiary Care Setup , Nikita Subudhi M

Relationship between weight bearing symmetry, trunk control and fear of fall amongst subjects with stroke: A cross sectional study , VIVIAN NEHAL MONIS

Lower extremity muscle recruitment pattern during sit to stand transfer in children with cerebral palsy as compared to typically developing children- a cross sectional study. , Kiran P. Nadgauda

Knowledge, attitudes and practices of Indian classical singers towards vocal healthcare , Raveena Muralidharan Nair

"Perspectives of Indian Speech Language Pathologists on Adolescent Language Assessment" , Rohana Muralidharan Nair

Effect Of Yoga On Perceived Stress And Pulmonary Function In High Stressed Postmenopausal Women , Vinodini NA

Refractory errors, blood groups & diabetes mellitus: A corrleative study in south Indian population , Vinodini NA

Comparison of Functional outcomes for displaced extra-articular distal radius fractures managed by Conservative versus Operative methods: A Prospective cohort study , Muhammed Ehsan Nazeer

COMPARATIVE STUDYOF THE EFFECTIVENESS OF VAPOCOOLANT SPRAY VERSUS EMLA®® CREAM IN REDUCING PAIN DURING INTRAVENOUS CANNULATION IN ADULT POPULATION , Sisla Nazer P

Assessment of attitude among public towards stuttering in a coastal city of Southern Karnataka , Prithvi N

"Severity assessment of acute pancreatitis using ct severity index and modified ct severity index: association with clinical outcomes and ranson’s criteria. " , GEETANJALI PARMAR

“The Effect of Culture Shock on Adjustment and Psychological Wellbeing Among College Going Students” , Akanksha Patra

‘Effect of Religiosity on Attitude Towards Euthanasia in Medical Students’ , Sumedha Pawar

Development Of A Questionnaire To Determine The Clinical Assessment Practices Of Speech-Language Pathologists For Children With Speech Sound Disorders In India , Prasila Elsa Philip

Correlation of oxidised LDL with oxidant and antioxidant enzymes in subjects with elevated LDL levels , Pooja p

Association of emotional intelligence of primigravida mothers with breastfeeding self efficacy in the early postpartum period and exclusive breastfeeding rates up to 6 months. , Priyanka Reddy p

Morphometric study of the Sartorius muscle and its vascular pedicles , M.D. Prameela

Comparison of the analgesic duration using ultrasound guided popliteal sciatic nerve block between diabetics with neuropathy and non-diabetics without neuropathy , GANESH PRASAD

Early follicular and Mid-luteal phase associated changes in Lower extremity Muscle strength , length and Agility in amateur female athletes – a Prospective Analytical study , Vishnu Priya

Assessment of mobile device based educational intervention on breastfeeding technique in multigravida mothers and its effect on early infant feeding pattern- A randomized controlled trial. , Keerthi Raj

THERMAL ULTRASOUND, MANIPULATION AND EXERCISE ON PAIN AND MOUTH OPENING IN CHRONIC TEMPOROMANDIBULAR JOINT DISORDER: A CASE REPORT , Suchita S. Rao

Correlation of Histopathology and Direct Immunofluorescence: Findings in clinically diagnosed Prurigo nodularis in a Tertiary care hospital , Haritha Reddy

EFFECT OF POSITIONING ON THE PAIN RESPONSE OF INFANTS VACCINATED WITH IPV AND PENTAVALENT (dtwp-HEPATITIS B-HEMOPHILUS INFLUENZA B) VACCINES , Sontosh Reddy

Assessment of the acceptable length of Right internal jugular central venous catheters. , Nivedhitha R

PRELEVANCE OF WORK RELATED DERMATOLOGICAL SYMPTOMS IN HEALTH CARE WORKERS IN COVID-19 ERA , Rana R

COMPARISON OF TWO ROUTINE FACIAL EXERCISE PROTCOLS FOR BELL’S PALSY- A RANDOMIZED CONTROLLED TRIAL , Stephanie Santiago

Profiling selected speech characteristics in individuals with Chronic Cough , Nawal Palakkal Sathar

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