Total knee arthroplasty (TKA) is amenable to various regional anesthesia techniques that may improve patient outcome. We sought to answer whether regional anesthesia decreased mortality, cardiovascular morbidity, deep venous thrombosis and pulmonary embolism, blood loss, duration of surgery, pain, opioid-related adverse effects, cognitive defects, and length of stay. We also questioned whether ...

Pain, which is often inadequately treated, accompanies the more than 23 million surgical procedures performed each year and may persist long after tissue heals. Preemptive analgesia, an evolving clinical concept, involves the introduction of an analgesic regimen before the onset of noxious stimuli, with the goal of preventing sensitization of the nervous system to subsequent stimuli that could ...

Understanding the risk factors for the development of PPCs allows targeted interventions aimed at reducing the frequency and severity of PPCs. The broad categories of what increases the likelihood of developing a PPC are understood but specific understanding of how individual risk factors act to cause PPCs is lacking,and there is little information regarding the interaction or synergy between r...

Based on theoretical grounds, remifentanil, an ultra-short acting opioid, has a favorable pharmacodynamic and pharmacokinetic profile for obstetric anesthesia/analgesia (13). When regional anesthesia is contraindicated, remifentanil is an intriguing option to provide labor analgesia using patient controlled intravenous analgesia (PCIA) (22). The rapid onset and offset would allow easy titration...

PURPOSE OF REVIEW Despite some controversy regarding the strength of the available data, the use of regional anesthesia and analgesia does provide improvement in patient outcomes. Although the majority of available data have examined the effect of epidural anesthesia and analgesia on patient outcomes, an increasing number of studies recently have investigated the effect of peripheral regional t...

background pain is an important consideration after renal surgery. a multimodal approach to postoperative pain management could enhance analgesia by risking fewer side effects after surgery. objectives the aim of this study was to evaluate the clinical efficacy of the subcutaneous infiltration of ketamine and tramadol at the incision site to reduce postoperative pain. methods sixty-four patient...

Supportive care and childbirth have been connected for all of recorded history. The impact of supportive care on health outcomes, however, has only been investigated over the last few decades. Research provides powerful evidence of improved outcomes for mothers and babies when mothers are supported in labor. These outcomes include, but are not limited to, lower rates of analgesia and anesthesia...

BACKGROUND Delirium is a common complication in elderly patients after surgery and associated with increased morbidity and mortality. Studies suggest that deep anesthesia and intense pain are important precipitating factors of postoperative delirium. Neuraxial block is frequently used in combination with general anesthesia for patients undergoing major thoracic and abdominal surgery. Compared w...

BACKGROUND Improvement in patient outcome and reduced use of medical resources may result from using epidural anesthesia and analgesia as compared with general anesthesia and intravenous opioids, although the relative importance of intraoperative versus postoperative technique has not been studied. This prospective, double-masked, randomized clinical trial was designed to compare alternate comb...

I am a board-certified anesthesiologist with an active practice at Brigham and Women’s Hospital in Boston, MA. I am familiar with the issues and challenges administering anesthesia and analgesia to neonates and young children. I am also Vice President of Medical Affairs at Aspect Medical Systems. Aspect manufactures a patient monitoring system which measures the effects of anesthetic agents in ...