Post-operative anesthesia rounds: Need of the hour

Bajwa, Sukhminder Jit Singh; Takrouri, Mohamad Said Maani

doi:10.4103/0259-1162.123205

Cited by 12 publications

(13 citation statements)

References 14 publications

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“…Fourth, failure to detect myotoxic complications may be attributed to limited patient follow-up beyond the immediate postoperative period. 131,132 In practice, more than one of these scenarios may explain underdetection. For example, LA is deposited between scalene muscles during an interscalene block, and myotoxicity may adversely affect the motor function of the sternocleidomastoid, and the anterior and middle scalene muscles.…”

Section: Recognitionmentioning

confidence: 99%

Local anaesthetic-induced myotoxicity in regional anaesthesia: a systematic review and empirical analysis

Hussain

McCartney

Neal

et al. 2018

British Journal of Anaesthesia

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Recent reports of local-anaesthetic (LA)-induced myotoxicity after peripheral nerve blocks have increased the interest in this less commonly known complication. Basic science evidence investigating LA-induced myotoxicity seems to demonstrate a pattern, but findings from human studies vary. This systematic review summarises the existing myotoxicity evidence and empirically examines its implications. Databases were searched for all in vitro animal and human studies evaluating LA-induced myotoxicity. Studies were stratified by design. Data sought included the model examined, LA used, injury mechanisms, nature of damage, and extent of recovery. For human studies, we also aimed to estimate prevalence and recovery rates. One hundred and fifteen studies, mainly animal and ophthalmic, were included. Myotoxicity risk factors included higher concentrations and prolonged exposure to LA, and use of bupivacaine. Injury mechanisms involved early and late aberrations to cytoplasmic calcium (Ca) homeostasis by the sarcoplasmic reticulum Ca ATPase. Incidence in ophthalmic studies was 0.77% (392 of 50 618). Inflammatory changes within a few days after exposure marked the onset of myotoxicity, and myo-degeneration followed within the first week post-exposure. Time to recovery in human muscles ranged between 4 days to 1 yr. None/partial and complete recovery were observed in 61% and 38% of patients, respectively. Across all experimental models, skeletal muscles exposed to LA consistently display myotoxic effects. Evidence is robust in animal and ophthalmic studies, and displays a concerning signal with continuous adductor canal block use in human case reports. Exploring the clinical prevalence, severity, and risk-reducing strategies of myotoxicity should be prioritised.

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Section: Recognitionmentioning

confidence: 99%

Local anaesthetic-induced myotoxicity in regional anaesthesia: a systematic review and empirical analysis

Hussain

McCartney

Neal

et al. 2018

British Journal of Anaesthesia

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“…3 Postoperative visits by the anesthesiologist have been critically reviewed. 4 First hand feedback from the patient helps the resident understand the patient's anesthesia experience and pain relief. 4 These visits can also help design institute-specific protocols.…”

Section: To the Editormentioning

confidence: 99%

“…4 First hand feedback from the patient helps the resident understand the patient's anesthesia experience and pain relief. 4 These visits can also help design institute-specific protocols. 4 Should this clinical follow-up be replaced with automated tools, which are prone to failures and limited to the type of data captured?…”

Section: To the Editormentioning

confidence: 99%

A call for feedback on postoperative care: Do we need an automated tool?

Bakshi

2018

Can J Anesth/J Can Anesth

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“…These therapeutic and diagnostic errors should be minimized as much as possible. This age group should be administered only necessary medications so as to fulfill the second domain of quaternary prevention, thus protecting the patient from pharmacological invasion [6]. These aspects are more important in developing nations which invariably are resource challenged in terms of health care delivery system.…”

Section: Pre-requisites For Quaternary Preventionmentioning

confidence: 99%

Quaternary Prevention in Geriatric Anesthesiology

Bajwa¹

2017

J Gerontol Geriatr Res

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Anesthesia administration in geriatric patients has always been challenging. Besides, the variable pharmacokinetics and pharmacodynamics, numerous other factors need to be considered for any surgical procedure or during treatment of critically ill geriatric patients in intensive care units. Besides taking care of clinical comorbidities, many other preventive measures are necessary to minimize the morbidity and mortality in this subset of population. The concept of 'quaternary prevention' has recently gained popularity but its application in geriatric population presenting for surgery has been very limited. The current brief review discusses various aspects of quaternary prevention applicable to anesthesia procedures in geriatric patients during peri-operative period.

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Post-operative anesthesia rounds: Need of the hour

Cited by 12 publications

References 14 publications

Local anaesthetic-induced myotoxicity in regional anaesthesia: a systematic review and empirical analysis

Local anaesthetic-induced myotoxicity in regional anaesthesia: a systematic review and empirical analysis

A call for feedback on postoperative care: Do we need an automated tool?

Quaternary Prevention in Geriatric Anesthesiology

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