International Journal of Anesthetics and Anesthesiology is an open access peer reviewed journal that publishes discoveries in wide variety of drugs which are used in modern anesthetic practice and fundamental understandings in anesthesiology. The main objective of the journal is to act as a forum for publication, education, and exchange of opinions, and to promote research and publications globally. Through open access it expands knowledge across doctors, providing free, immediate availability of the published work online.

International Journal of Anesthetics and Anesthesiology is a bimonthly journal which accelerates the pace of research updates, discovery and innovation in various aspects of anesthetics and clinical anesthesiology. It publishes original articles, reviews, case reports, commentaries, etc. It addresses all aspects of anesthesia practice, including airway management, anesthetic administration, pharmacokinetics, preoperative, postoperative considerations, pain management etc. All articles published in the journal are subject to a stringent peer review process. It encourage authors to publish their experimental and theoretical results in detail.

 
Journal Information

Title: International Journal of Anesthetics and Anesthesiology

ISSN: 2377-4630

Editor-in-chief: Prof. Ike Eriator

NLM title abbreviation: Int J Anesthetic Anesthesiol

ISO abbreviation: Int J Anesthetic Anesthesiol

Other titles: IJAA

Category: Medicine

Country of publication: USA

Language: English

DOI: 10.23937/2377-4630

Publication format (s): Electronic and print

Publication policy: Open Access; COPE guide

Peer review: Double blind

Review speed: 3 weeks

Fast-track review: 10 days

Publication type(s): Periodicals

Publisher: ClinMed International Library

Contact email: contact@clinmedjournals.org

 
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 Open Access DOI:10.23937/2377-4630/1410072

When Equipment Misbehaves: Severe Respiratory Acidosis Resulting from a Compromised Coaxial Circuit

Anh Q Dang, Marc Rozner, Nicole Luongo and Shital Vachhani

Article Type: CASE REPORT | First Published: September 07, 2018

The construction of a coaxial circle breathing circuit encloses the inspiratory limb within the expiratory limb to preserve heat, humidity, anesthetic gas, and oxygen. However, the construction also makes kinks or breaks in the enclosed inspiratory limb difficult to detect. With kinking or disconnection of the central inspiratory limb, the patient may rebreathe expiratory gases, leading to a significant increase in dead space and concomitant respiratory acidosis. We describe a clinical case in w...
 

 Open Access DOI:10.23937/2377-4630/1410071

Uncommon Complication for Commonly Used Drugs: Cardiac Arrest after Administration of Succinylcholine

Mohd Nazri A, Nor Hidayah ZA, Suryati MP, Wan Nasrudin WI, Azhar M, Mazelan O, Nurul Ashikin H, Fazilawati Z, Maziah M, Khairul Has H and Puzizer S

Article Type: Case Report | First Published: August 04, 2018

Succinylcholine is a depolarizing, muscle relaxant, that commonly used to facilitate endotracheal intubation, especially in emergency surgery or patient with difficult intubation. However succinylcholine is associated with severe hyperkalaemia, arrhythmia and cardiac arrest especially in severe burn and neuromuscular disease and renal failure. We report a case of young boy with underlying Obstructive Sleep Apnoea (OSA) presented for bleeding post tonsillectomy, who developed cardiac arrest follo...
 

 Open Access DOI:10.23937/2377-4630/1410070

Lumbar Sympathetic Block for Bilateral Post-Prostatectomy Lower Extremity Pain in the Femoral Nerve Distribution

Fadi Farah, Antranig Kalaydjian, Yuen Cheng, Pascal Scemama and Martin Acquadro

Article Type: Case Report | First Published: July 26, 2018

Lower extremities nerves damage is a known complication of prostatectomies. Lumbar sympathetic block is a well-established treatment for sympathetically-mediated lower extremity pain. We report a case of bilateral lower extremity pain in a femoral distribution that developed after a robotic assisted prostatectomy and resolved after a lumbar sympathetic block....
 

 Open Access DOI:10.23937/2377-4630/1410069

An Accidental Arterial Puncture and Anticoagulation after Internal Jugular Vein Catheterization Resulting in Massive Hematoma and Airway Compromise

Kurt Ruetzler, Till Hauffe, Tobias Piegeler, Alkadhi Hatem and Donat R Spahn

Article Type: Case Report | First Published: July 05, 2018

Central Venous Catheterization is a common procedure in daily clinical practice. The internal jugular, subclavian and the femoral veins are the most frequently catheterized central veins. Pneumothorax, hematothorax, arterial puncture, hematoma, nerve lesions, damage to the left thoracic duct, and air embolism are among the main mechanical complications. Nowadays, there are two techniques in daily clinical use: the traditional technique and the ul...
 

 Open Access DOI:10.23937/2377-4630/1410068

Sevoflurane but not Propofol Induces Immunomodulatory Effects in Patients Undergoing Aortic Valve Replacement and Cardiopulmonary Bypass

Sonia Veiras, Raquel Rodrguez Gonzalez, Tomas Sobrino, Javier Rodriguez, Aurora Baluja and Julian Alvarez

Article Type: Research Article | First Published: June 25, 2018

Volatile anaesthetics, most of all sevoflurane, have been described as providers of myocardial preconditioning, but few articles are focused on immunomodulatory effects of these agents. We aimed to study the effects of different anaesthetic procotols with sevoflurane and propofol on immunomodulation in patients undergoing cardiopulmonary bypass (CBP)....
 

 Open Access DOI:10.23937/2377-4630/1410067

Interdisciplinary Anesthesia Tray Revision Project: Reducing the Opportunity for Human Error

Smith KL, Sharp C, Smith E, Currie M, Hall KP, Vu T, Lee M and Cooper RL

Article Type: Research Article | First Published: June 14, 2018

Medication errors cause an estimated 100,000 to 400,000 patient deaths in the United States annually (IOM). Previous reviews on this alarming statistic consistently identify human error as the most common etiology. The potential for medication errors is especially high risk in the operating suite, where the provider simultaneously selects, doses and verifies medications to be administered to patients. Additionally, a lack of standardization and e...
 

 Open Access DOI:10.23937/2377-4630/1410066

Transient Unilateral Lower Limb Palsy after Open Surgery Thoraco-Abdominal Aorta Repair

Francesco Corazzi, Stefania Brusa, Enrico Giustiniano, Efrem Civilini, Giorgio Luca Poletto and Ferdinando Raimondi

Article Type: Case Report | First Published: May 30, 2018

Anamnesis included cholecystectomy, hypertension and coronary artery by-pass graft (CABG) due to acute myocardial infarction (AMI), dislipidemia, G6PD deficit, allergy to milk proteins, liver steatosis and severe chronic obstructive pulmonary disease (COPD) with FEV1/FVC ratio 0.43 and FEV1 1.12 L (44%)....
 

 Open Access DOI:10.23937/2377-4630/1410065

Anesthesia Implications of the Use of Essential Oils in Alzheimer's Dementia

James L Geiger

Article Type: Review Article | First Published: May 25, 2018

The diagnosis and treatment of Alzheimer's dementia (AD) has gained much attention due to the current and predicted prevalence of the disease. The biomarkers of neural inflammation, oxidative stress, genetics and the multiple medical etiologies of AD coupled with the poly-pharmacy of comorbid conditions and diseases associated with AD are complex....
 

 Open Access DOI:10.23937/2377-4630/1410064

Analyzing Volatile Anesthetic Consumption by Auditing Fresh Gas Flow: An Observational Study at an Academic Hospital

Luis Tollinche, KaySee Tan, Austin Han , Leslie Ojea and Cindy Yeoh

Article Type: Research Article | First Published: April 26, 2018

In a climate of cost containment, it is critical to analyze and optimize all perioperative variable costs. Fresh gas flow is one important variable that determines utilization of inhalational agents and can be tightly controlled by the anesthesia provider. Manufacturers of inhalational agents have recommendations for minimum gas flow for their respective agents. Any gas flow above these recommendations is considered misuse and leads to unnecessary expense. The purpose of this study was to charac...
 

 Open Access DOI:10.23937/2377-4630/1410063

Acute Pain Management in a Child: A Case Report of 46-Days of Popliteal Sciatic Nerve Catheter

Hertz Laurent, Sola Chrystelle, De La Arena Pablo and Dadure Christophe

Article Type: Case Report | First Published: April 25, 2018

The use of perineural catheter for more than 72 hours is rare in perioperative practice, but was especially reported for chronic pain, oncologic related pain or palliative care. The main concern remains the risk of neurological or infectious complication. No guideline clearly specifies the maximum duration of perineural catheter maintenance and the safety of long-term catheters is discussed....
 

 Open Access DOI:10.23937/2377-4630/1410062

Perioperative Cardiac Stent Thrombosis Versus Bleeding: A Clinical Dilemma in Trauma Patients

Nwokolo Omonele O and Wegner Robert C

Article Type: Case Report | First Published: April 05, 2018

Heart disease is prevalent in current patient population at an increasing level. Some of these patients have had interventions such as stent placements to improve quality of life and are started on antiplatelet therapy for a definite period of time or indefinitely based on their risk factors, comorbidities or type of stents placed. When these patients present to the hospital with major trauma, the surgical and anesthetic management threads a delicate line between protection of the stents and pre...
 

 Open Access DOI:10.23937/2377-4630/1410061

Phenytoin in Topical Formulations Augments Pain Reduction of Other Analgesics in the Treatment of Neuropathic Pain

David J Kopsky and Jan M Keppel Hesselink

Article Type: Case Report | First Published: February 03, 2018

Topical analgesic formulations are gaining interest for the treatment of peripheral neuropathic pain since the beginning of 2000. Advantages of topical analgesics over oral medication are the absence of systemic side effects and drug-drug interactions, higher concentrations of active compound at the pain area, fast onset on action, improvement of compliance, and no risk of abuse. In many peripheral neuropathic pain states the pain area is small and thus topical analgesics are suitable. Most pati...
 

 Open Access DOI:10.23937/2377-4630/1410060

Timely Detection of Epidural Catheter Migration: Diagnosis and Management: A Case Report

YC Tay and MJ Abrahams

Article Type: Case Report | First Published: November 29, 2017

Epidural catheters that are commonly placed for anaesthesia or analgesia have a serious complication of migration. Besides intravascular local anaesthetic infusion which could lead to systemic toxicity, a subdural migration is often diagnosed late and presents with life-threatening outcomes noted either at post-mortem or requiring intensive care management....
 

 Open Access DOI:10.23937/2377-4630/1410059

Pourfour Du Petit Syndrome Presenting as Subdural Block. A Rare Complication of Obstetric Epidural Analgesia: A Case Report

Edward M Becerra, Jose L Aguilar, Raquel Pelaez, Jakeline R Jurado and Jordi Ballabriga

Article Type: Case Report | First Published: October 26, 2017

To report a rare case of Pourfour du Petit Syndrome (PDPS), presenting clinically as subdural block (SDB), as a complication of Obstetric Epidural Analgesia (OEA). PDPS is described as reverse HornerĀ“s syndrome. It is characterized by mydriasis, exophthalmos, eye-lid retraction and hyperhidrosis....
 

 Open Access DOI:10.23937/2377-4630/1410058

Extubating Techniques for the Difficult Airway

Jens Tan, Javier Lasala, Jose Soliz, Jonathan Wilks, January Tsai, Teresa Moon Calderon, Shital Vachhani, Jagtar Singh Heir and Gabriel Eduardo Mena

Article Type: Review Article | First Published: March 13, 2017

PACU or ICU patients generally require reintubation for two main reasons-inadequate airway patency (extubation failure) and residual need for mechanical support (weaning failure). Such events are relatively common and can be associated with significant morbidity, mortality and costs....
 

 Open Access DOI:10.23937/2377-4630/1410057

Trachway Intubating Stylet Facilitates the Double-Lumen Endobronchial Tube Placement in Patients with Limited Mouth Opening

Wen-Ming Chuang, Hung-Te Hsu, Shah-Hwa Chou, Chia-Chen Wu, Kuang-Yi Tseng, Kuang-I Cheng and Miao-Pei Su

Article Type: Case Report | First Published: March 13, 2017

Intubation for one lung ventilation in patients with difficult airways can be a challenge. Severely limited mouth opening restricts the use of direct laryngoscopy or video-assisted laryngoscopy. We present two patients with limited mouth opening undergoing video-assisted thoracoscopic decortication, who were successfully intubated with left-sided double-lumen endobronchial tube (DLT) using the Trachway® intubating stylet. This technique provi...
 

 Open Access DOI:10.23937/2377-4630/1410056

Treatment-Resistant Severe Hypothermia in an Infant Caused by the AirSeal® Insufflator

Kiyotaka Nakagawa, Kazuo Arakawa, Tomohide Kamiya, Koichi Kataoka and Katsuhiro Sakai

Article Type: Case Report | First Published: March 02, 2017

The valveless trocar system is a novel insufflator that circulates carbon dioxide in the abdominal cavity. Herein, we report an infant with severe hypothermia due to use of this insufflator. An 83-day-old infant (body weight 3862 g) with gastroesophageal reflux underwent laparoscopic Nissen fundoplication. After insufflation was initiated, his body temperature acutely dropped to 34.4 °C. Standard treatments had no effect on the patient's hyp...
 

 Open Access DOI:10.23937/2377-4630/1410055

A Case Report: Adaptive Servo Ventilation for a Patient with Acute Heart Failure and Central Sleep Apnea

Chol Kim, Yoshihiko Seino and Atsuhiro Sakamoto

Article Type: Case Report | First Published: January 18, 2017

A 50-year-old male presented to the emergency room at night with complaints of paroxysmal nocturnal dyspnea and worsening shortness of breath on exertion. He was an active tireless estate agent till three months before, when he noticed shortness of breath on climbing the stairs at the station....
 

 Open Access DOI:10.23937/2377-4630/3/4/1054

Systemic Air Embolism during ERCP with Full Recovery

Quy Tran, Gurpreet Dhaliwal, Christopher Lee and Zohreh Steffens

Article Type: Case Report | First Published: November 28, 2016

Air embolism during gastrointestinal endoscopy procedures is a rare phenomenon but can lead to a catastrophic and fatal event resulting from cardiovascular collapse and neurological injury. Oftentimes, the diagnosis is difficult because the cardiovascular and neurologic symptoms are not specific to systemic air embolism. High index of suspicion with early recognition and treatment is crucial in improving patient outcome....
 

 Open Access DOI:10.23937/2377-4630/3/4/1053

Perioperative Management of Patients Refusing Blood Products

Rispoli Marco, Bizzarri Federico Tommaso, Zani Gianluca, Agnoletti Vanni, Corcione Antonio, Buono Salvatore and Fusari Maurizio

Article Type: Review Article | First Published: October 03, 2016

The Jehovah's Witnesses are best known to outsider for their refusal of blood products, even such a refusal may result in death. In years, a "bloodless surgery" was developed with the aim of avoid blood transfusions and improve patient outcome, shifting from a product-centred to a patient-centred approach. An accurate teamwork is needed to define a perioperative transfusion-alternative program, individualized for patients' characteristics and sur...
 

 Open Access DOI:10.23937/2377-4630/3/4/1052

Renal Transplantation: An Update for Anaesthetists

Emma Aitken, Richard Stevenson, Faisal Hanif, Diana Raj, Karen Stevenson and David Kingsmore

Article Type: Original Article | First Published: October 01, 2016

Renal transplantation (RTx) is well established as the optimal method of renal replacement therapy (RRT); however the imbalance between organ supply and demand has led to increased numbers of organs coming from marginal donors. This, in conjunction with an increase in the number of 'marginal recipients', necessitates optimisation of other aspects of transplantation including perioperative care to maintain the excellent outcomes and survival benef...
 

 Open Access DOI:10.23937/2377-4630/3/3/1051

A New Age for Sepsis/Septic Shock Diagnosis and Management?

Enrico Giustiniano

Article Type: Original Article | First Published: September 08, 2016

On April 2014 the New England Journal of Medicine published the results of the trial ProCESS (Protocolized Care for Early Septic Shock): a multi centers study conducted on 1341 patients of 31 academic hospitals of United States. The trial compared three different way to approach and care the septic shock during the first 6 hs....
 

 Open Access DOI:10.23937/2377-4630/3/3/1050

Which Guidance Method during Tracheotomy Procedure in Patients with Short Neck in the ICU? A Prospective Randomized Study

Esra Ozayar, Handan Gulec, Zehra Baykal Tutal, Munire Babayigit, Mehmet Sirin, Aysun Kurtay and Eyup Horasanli

Article Type: Original Article | First Published: July 20, 2016

Percutaneous tracheotomy is a common procedure in the intensive care units (ICU). Although majority of the complications related to this procedure are considered minor, serious complications secondary to tracheotomies are still being reported. Definition of short neck is not clear in the medical literature, but well known to anesthesiologists since they are flagged for possible difficult airway. Thyromental and sternomental distance, range of nec...
 

 Open Access DOI:10.23937/2377-4630/3/3/1049

Pre-Clinical Pharmacokinetics of Sufentanil-2-Hydroxypropyl-Β-Cyclodextrin Inclusion Complex

Silvana Aparecida Calafatti, Marcelo de Macedo, Juliana Zampoli Boava Papini, Edvaldo Coelho, Cintia Maria Saia Cereda, Jose Pedrazzoli Junior, Eneida de Paula, Daniele Ribeiro de Araujo and Giovana Radomille Tofoli

Article Type: Research Article | First Published: July 18, 2016

Opioids are used for the postoperative period, cancer pain and for moderate to severe chronic noncancer pain. Sufentanil (SUF) is a highly lipophilic opioid that presents rapid and highly effective pain relief, but it presents short duration of action. Due to this short duration of action, SUF is currently used as an intravenous anesthetic agent and analgesic adjuvant for surgery and labor....
 

 Open Access DOI:10.23937/2377-4630/3/2/1048

Ultrasound-guided Transmuscular Quadratus Lumborum (TQL) Block for Pain Management after Caesarean Section

Nina Maenchen, Christian Kruse Hansen, Mette Dam and Jens Borglum

Article Type: Case Report | First Published: June 28, 2016

The ultrasound-guided transmuscular quadratus lumborum (TQL) block performed in the lumbar paravertebral region exerts its effect by spreading into the thoracic paravertebral space with blockade of both somatosensory and visceral nerves of the abdominal and retroperitoneal region. We discovered an inadequate management of post-operative pain by the conventional analgesic regimen among caesarean section patients in our hospital. In this report we ...
 

 Open Access DOI:10.23937/2377-4630/3/2/1047

Comparison of the Analgesic Effects of Preemptive Lornoxicam and Paracetamol after Laparoscopic Cholecystectomy

Tugba Karaman, Tamer Kuzucuoglu, Gulten Arslan, Serkan Karaman and Mujge Hatun

Article Type: Original Article | First Published: June 13, 2016

Despite increasing knowledge about pain, postoperative pain management is still a challenge. Opioids are widely used drugs in the treatment, but the side effects of the opioids lead to investigations about the novel pain management strategies. We aimed to compare the effects of preemptive intravenous lornoxicam and paracetamol on postoperative pain scores, opioid consumption, and patient satisfaction during laparoscopic cholecystectomy recovery.....
 

 Open Access DOI:10.23937/2377-4630/3/2/1046

A Retrospective Review of Corneal Abrasions after Oncologic Surgery in a Tertiary Cancer Center

SJ Gandhi, A Zavala, U Williams, A Van Meter, P Hsu, DS Gombos and P Owusu-Agyemang

Article Type: Research Article | First Published: May 07, 2016

Corneal abrasions are the single most common ocular injury in the perioperative period. The exact etiology of perioperative corneal abrasions is usually unclear, and several risk factors have been described. The aim of our study was to determine the incidence of known and hypothetical risk factors for corneal abrasion in a cohort of cancer patients who had developed corneal abrasion after oncologic surgery. Our review showed a high incidence of r...
 

 Open Access DOI:10.23937/2377-4630/3/2/1045

Feasibility and Timing of Craniosynostosis Surgery in a Child with Hypoplastic Left Heart Syndrome

C Hochhold, P Paal, G Luckner, M Rasse and C Velik-Salchner

Article Type: Case Report | First Published: April 11, 2016

Nowadays, children with hypoplastic left heart syndrome (HLHS) survive longer. Thus, the management of such patients undergoing non-cardiac surgery is of increasing relevance. A 12-month-old boy with HLHS following stage II Norwood palliation and Apert syndrome required extended craniosynostosis surgery because of elevated intracerebral pressure. Since extensive blood loss as well as hemodynamic instability were expected, anesthetic and surgical ...
 

 Open Access DOI:10.23937/2377-4630/3/2/1044

A Comparison of Three Different Supraglottic Airway Devices in Neonatal Airway Training during Resuscitation Simulation

Markus Ritzka, Domagoj Schunk, Susanne Hopf, Diane Bitzinger, Bernhard M. Graf and Benedikt Trabold

Article Type: Research Article | First Published: April 1, 2016

Three groups of health care professionals were given a brief supervised training in using the devices. For each participant the positioning of each device was recorded. Success rate of insertion and time until adequate ventilation was measured. Furthermore, use and handling of a SAD was scored for ease of insertion, clinical and fiber-optic position, and ventilation....
 

 Open Access DOI:10.23937/2377-4630/3/1/1043

Are Advertisement Claims in Anaesthetic Journals based on High-Quality Evidence?

Christian Zedler, Alexander Schnabel, Peter Kranke and Leopold Eberhart

Article Type: Original Article | First Published: February 26, 2016

Many medical journals contain advertisements for pharmaceuticals products. While the WHO demands that claims in pharmaceutical advertisements should be based on scientific evidence, past investigations demonstrated that some advertisements fail to fulfill these demands. As there is currently no investigation dealing with advertisements in anaesthetic journals, we aimed to find out whether claims in these journals are accompanied by references to ...
 

 Open Access DOI:10.23937/2377-4630/3/1/1042

Integrated Pulmonary Index: A New Strategy for Respiratory Patients Evaluation

Guldem Turan, Yildiz Kuplay, Ceren Karip, Ceren Koksal, Cansu Akin and Nur Akgun

Article Type: Original Article | First Published: February 13, 2016

There are different monitorisation methods for following patients in intensive care units. Monitorisation of respiratory parameters is also important besides monitorisation of hemodynamic parameters. Integrated pulmonary index (IPI) algorithm incorporates four real-time respiratory measurements (end-tidal CO2, respiratory rate, pulse rate and SpO2) into a single value that represents respiratory profile including these parameters. IPI gives an id...
 

 Open Access DOI:10.23937/2377-4630/3/1/1041

Anesthesiologists as Operating Room Directors: Results of a Survey

Steven Boggs, Elizabeth Frost and Jessica Feinleib

Article Type: Research Article | First Published: January 30, 2016

Many ideas have gone into the development of the concept of the Perioperative Surgical Home (PSH) and Enhanced Recovery after Surgery (ERAS). Many anesthesiologists have advocated for an increased role in operating room (OR) management, advancing from OR managers to OR directors with greater decision making and improved means of communication. However, there is little uniformity at present in the running of ORs around the country....
 

 Open Access DOI:10.23937/2377-4630/3/1/1040

The Evaluation of 1-Physician Versus 2-Physician Deep Sedation with Propofol

Lindsay M Harmon, Anthony J Perkins, Beth Sandford and Christopher S Weaver

Article Type: Original Article | First Published: January 25, 2016

Emergency physicians routinely perform emergency department procedural sedation (EDPS) with propofol and its safety is well established. However, in 2009 the Centers for Medicare and Medicaid Services (CMS) enacted guidelines defining propofol as deep sedation and requiring administration by a physician. Common EDPS practice had been one-physician performing both the sedation and procedure. EDPS has proven safe under this 1-physician practice. Ho...
 

 Open Access DOI:10.23937/2377-4630/3/1/1039

Difficult Airway Management in Patients Submitted to General Anesthesia. Is it a Matter of Devices or Predictive Scores?

Lavinia Bergesio, Nadia Ruggieri, Orazio Difrancesco, Enrico Giustiniano and Franco Cancellieri

Article Type: Research Article | First Published: January 13, 2016

Airway management is mostly performed in the operating room, and unexpected difficult tracheal intubation may be a life-threatening event which incidence varies in a wide range with estimated pooled frequency of 6.8%. Difficulty at laryngoscopy or intubation, if inability to maintain a patient airway occurs, exposes the patient to the risk of complications basically related to hypoxia. Its incidence has been reported around 1-4% of patients with ...
 

 Open Access DOI:10.23937/2377-4630/2/4/1038

The Effect of Perioperative Restrictive Fluid Therapy on Postoperative Edema and Ecchymosis in Rhinoplasty

Erden V, Sever E, Dagdelen S, Guler C, Kirgezen T, Toprak N and Yigit O

Article Type: Original Research Article | First Published: December 22, 2015

Postoperative edema and ecchymosis can usually occur after rhinoplasty and can cause disgruntled results which influence the satisfaction of patient and surgeon. Prolonged periorbital ecchymosis and severe edema may cause a delay in healing and affect the result of surgery. Many of agents have been used to reduce the influence of edema and ecchymosis developing around the eyes after rhinoplasty, such as corticosteroids, lidocaine and adrenaline c...
 

 Open Access DOI:10.23937/2377-4630/2/4/1037

Use of Human Fibrinogen Concentrate in Pediatric Cardiac Surgery Patients

Christopher F. Tirotta, Richard G. Lagueruela, Danielle Madril, Jorge Ojito, Chelsea Balli, Evelio Velis, Marilyn Torres, Francisco Alonso, Robert Hannan and Redmond P. Burke

Article Type: Original Research Article | First Published: December 21, 2015

Bleeding after cardiac surgery can cause increased morbidity and mortality. This is a particularly serious problem in pediatric patients, especially neonates and infants, who may receive multiple units of blood products intra- and postoperatively. The aim of this study is to demonstrate that the use of human fibrinogen concentrate (HFC) during cardiopulmonary bypass (CPB) decreased operative blood loss and the need for perioperative blood compone...
 

 Open Access DOI:10.23937/2377-4630/2/4/1036

A Comparative study on Efficacy of 10% and 20% Mannitol for Inducing Diuresis During Renal Transplant Surgery

Mohammed Husam Nafie

Article Type: Original Research Article | First Published: November 19, 2015

Mannitol is one of the most commonly used osmotic diuretics during renal transplant surgery. Two concentrations of mannitol, 10% and 20%, are available, however there is no consensus about which concentration is to be preferred. The purpose of this study was to compare between the efficacy of the two concentrations of mannitol for inducing diuresis during renal transplant surgery and the need for further diuretics (furosemide)....
 

 Open Access DOI:10.23937/2377-4630/2/4/1035

Severe Respiratory Suppression Secondary to Buprenorphine Treated with Volume Assured Pressure Support (VAPS)

Robert J Farney, Boaz Markewitz, Amanda M McDonald and Jill Rhead

Article Type: Case Report | First Published: November 16, 2015

The optimal therapy of chronic opioid induced sleep disordered breathing (SDB) is unclear. Supplemental oxygen may potentially prolong central apneas and increase respiratory suppression. Continuous positive airway pressure (CPAP) is generally ineffective or may even augment central apneas. Therapy with an Adaptive Servo-Ventilation (ASV) device is the most successful option for most etiologies of central apnea including opioids, but we have obse...
 

 Open Access DOI:10.23937/2377-4630/2/3/1034

The Effect of Dexmedetomidine and Propofol on Oxidative Stress Parameters during Lower Extremity Surgery: A Prospective Randomized Trial

Safinaz Karabayirli, Ismail Uras, Cemile Koca, Merve Ergin, Ruveyda Irem Demircioglu, Bunyamin Muslu

Article Type: Original Research Article | First Published: September 12, 2015

Tourniquets are routinely applied during lower extremity surgery in order to reduce bleeding during surgery, provide better surgical conditions and consequently to shorten the duration of the operation. However, an inflammatory response is often activated by tourniquet application, leading to prolonged ischemia and reperfusion; consequently, organ damage such as acute lung injury may occur. Muscular ischemia causes hypoxic cellular changes and an...
 

 Open Access DOI:10.23937/2377-4630/2/3/1033

Safety and Efficacy of Remifentanil for Single Agent Procedural Sedation: A Systematic Review

Jeppe T Jensen, Peter Vilmann, Lars Konge and Moller

Article Type: Review Article | First Published: August 19, 2015

Hospitals and healthcare centers are continuously pushed to deliver a better quality of care with a higher turnover. Hence, there is an increasing demand for shorter procedures and shorter time to discharge. Some of these requirements can be met if sedation is used instead of general anesthesia. Furthermore, sedation, as an alternative to nothing, has its benefits. Two recent studies have shown that sedation for endoscopies increases endoscopist ...
 

 Open Access DOI:10.23937/2377-4630/2/3/1032

The Effects of High-Dose Sugammadex on Erythrocyte Deformability in Rats with Renal Failure Generated by Unilateral Ureteral Obstruction

Fusun Bozkirli, Fikriye Dogrul, Faruk Metin Comu, Hande Arpaci, Omer Bayrak, Mustafa Arslan and Yusuf unal

Article Type: Original Article | First Published: August 18, 2015

One of the most common causes of renal insufficiency in children and adults is obstructive nephropathy. Unilateral ureteral obstruction (UUO) is a well-known model to imitate the obstructive nephropathy process in a simple, accelerated and species-independent manner. Previous studies have revealed that morphological lesions in the obstructed kidney are peritubular capillaries rarefaction, tubular atrophy, inflammatory infiltration, widen intersti...
 

 Open Access DOI:10.23937/2377-4630/2/3/1031

Aminophylline does not Prevent Postdural Puncture Headache in Caesarean Section

Ismail Sirit, Ibrahim Ozturk, Dilek Yazicioglu

Article Type: Original Research | First Published: June 20, 2015

We aimed to investigate that whether intraoperative intravenous aminophylline is effective for prevention of postdural puncture headache after caesarean section or not. Materials and method: Records of patients who underwent caesarean section between January, 2013 and November, 2013 with spinal anesthesia were examined retrospectively. Patients older than 18 were included in the study. Failed and conversion to general anesthesia was the exclusion...
 

 Open Access DOI:10.23937/2377-4630/2/3/1030

Perceptions and Attitudes of Anesthesiologists toward Pain Management: A Survey of Pain Categories

David D. Nguyen, Daneshvari Solanki, Christopher Babl, Nikolaus Gravenstein and Rene Przkora

Article Type: Commentary | First Published: May 30, 2015

Pain is a global epidemic and in America is considered the fifth vital sign. It causes significant suffering and disability, and pain contributes to massively increased healthcare costs. Effective pain management is an important outcome and quality measure....
 

 Open Access DOI:10.23937/2377-4630/2/2/1029

Early Signs and Perinatal Diagnosis of Tracheal Agenesis

Mayke E. van der Putten, Viola Christmann, Lucas E. Matthyssens, Arthur R.T. Scheffer and Chris Bleeker

Article Type: Case Report | First Published: May 11, 2015

A preterm boy of 30 weeks and fie days did not breathe spontaneously at birth and despite visualization of the vocal cords, intubation attempts did not succeed, until a tube 2.0 was placed using an Eschmann stylette, mistakenly considered endotracheal. A few hours later, suspicion of tube dislocation arose and renewed intubation attempts failed. The ENT specialist performed a tracheoscopy and found a blind ending of the trachea in the subglottic ...
 

 Open Access DOI:10.23937/2377-4630/2/2/1028

Long-Term Function, Pain and Medication Use Outcomes of Radiofrequency Ablation for Lumbar Facet Syndrome

Zachary L. McCormick, Benjamin Marshall, Jeremy Walker, Robert McCarthy and David R. Walega

Article Type: Original Article | First Published: April 06, 2015

Radiofrequency ablation (RFA) of the medial branch nerves for facet-mediated low back pain demonstrates clinical benefit for 6-12 months and possibly up to 2 years. This study investigated function, pain, and medication use outcomes of RFA for lumbar facet syndrome in a cohort with long-term follow-up....
 

 Open Access DOI:10.23937/2377-4630/2/2/1027

Prevention of Postoperative Acute Lung Injury (ALI) - The Anaesthetist Role

Surjya Prasad Upadhyay, Ulka Samant, Sudhakar Seth Tellicherry, Himanshu Chauhan and Piyush N Mallick

Article Type: Review Article | First Published: March 28, 2015

Postoperative pulmonary complications such as Pneumonia, Acute Lung Injury (ALI), Acute Respiratory Distress Syndrome (ARDS) substantially increases the risk of morbidity, mortality, length of hospitalisation and financial burden. Risk factors can be broadly categorized into patient related, procedure related, anaesthesia related and post procedural care related....
 

 Open Access DOI:10.23937/2377-4630/2/2/1026

Effect of Sevoflurane and Desflurane on Erythrocyte Deformability during Ischaemia-Reperfusion Injury of Lower Extremity in Diabetic Rats

Muhammed Enes Aydin, Meral Erdal Erbatur, Faruk Metin Comu and Mustafa Arslan

Article Type: Original Article | First Published: March 28, 2015

It is known that blood viscosity and erythrocyte aggregation are increased and erythrocyte deformability is decreased in diabetic patients. Ischemia reperfusion injury (I/R) in lower extremity is a frequent and important clinical phenomenon. Blood rheology is known to be affected by numerous factor including anaesthetic drugs. Accordingly, we aimed to investigate the effects of sevoflurane and desflurane on erythrocyte deformability in infrarenal...
 

 Open Access DOI:10.23937/2377-4630/2/2/1025

Retention of Finger Blood Flow against Postural Change Has the Potential to Become a New Indicator of Sympathetic Block in the Upper Limb - A Preliminary Study

Toshihiko Nakatani, Tatsuhito Miyamoto, Tatsuya Hashimoto and Yoji Saito

Article Type: Original Article | First Published: March 23, 2015

Increased skin temperature and decreased sweating are used to identify the adequacy of sympathetic block in the upper limb. This, however, requires a thermography device to precisely evaluate skin temperature and a diaphoremeter to measure sweating. Baroreflexes elicited by postural change induce a reduction in peripheral blood flow to sustain systemic blood pressure and cerebral blood flow. We hypothesized that sympathetic blockade in the upper ...
 

 Open Access DOI:10.23937/2377-4630/2/1/1024

The Concentration for Loss of Consciousness by Propofol does not differ between Morning and Afternoon

Kumiko Tanabe, Shigemi Matsumoto, Mayumi Nakanishi and Hiroki Iida

Article Type: Short Communication | First Published: March 20, 2015

Background: Circadian rhythms influence the pharmacology and effects of anesthetic agents such as local anesthetics, general anesthetics, and muscle relaxants. However, the influences of the circadian rhythm on new anesthetics such as propofol are unknown. Results: Thirty-seven patients underwent induced anesthesia at 8:30. Twenty-eight patients were induced between 14:00 and 16:00.There was no significant difference between the two groups in the...
 

 Open Access DOI:10.23937/2377-4630/2/1/1023

Cost - Benefit Analysis of Focused Pre-Operative Transthoracic Echocardiography in the Pre-Operative Clinic in Patients at Increased Cardiac Risk Presenting for Non-Cardiac Surgery - A Pilot Study

David Neale, Daryl Williams and David Canty

Article Type: Original Research | First Published: March 13, 2015

In a prospective observational study, focused transthoracic echocardiography (TTE) performed in the preoperative clinic on 100 patients with increased cardiac risk resulted in a change in management of 54% and a net reduction in use of hospital resources. The aims of this study are to apply a cost benefit analysis to demonstrate whether or not this translated into saving money for the hospital....
 

 Open Access DOI:10.23937/2377-4630/2/1/1022

Management of Anesthesia in A Patient with Myasthenia Gravis

Semih Baskan, Dilsen Ornek, Adem Guney, Fahri Acar, Ozlem Sacan and Mustafa Baydar

Article Type: Case Report | First Published: March 09, 2015

Purpose: This report describes the management of anesthesia in a patient with myasthenia gravis, undergoing thymectomy. Clinical features: The patient was a 22-yr-old female. Thoracic computed tomography revealed a thymoma and a right-side paratracheal lymph node 46x44mm in size. A thymectomy operation was required....
 

 Open Access DOI:10.23937/2377-4630/2/1/1021

Airway Management following Facial Trauma Caused by a Pit Bull Attack

Jaime Ortiz and Kelly A. Frew

Article Type: Case Report | First Published: February 28, 2015

Airway management of patients following facial trauma poses many challenges to the acute care team. An 80 year old male presented following a pit bull attack with massive trauma to his face, scalp and extremities. After carefully considering the options available, we were able to safely secure his airway by utilizing a WuScope. We confirm that the WuScope is a useful tool for airway management in a case of severe facial trauma....
 

 Open Access DOI:10.23937/2377-4630/2/1/1020

Fontan Physiology: Anaesthetic Implications for Non-Cardiac Surgery: A Case Report

Harikrishnan Kothandan, Lim Michelle Leanne and Shital Kumar Sharad Shah

Article Type: Case Report | First Published: February 06, 2015

Patients with congenital heart diseases are a growing population and noncardiac surgeries will become an important health care issue. Modification of surgical techniques and medical advances has improved the survival of patients with complex congenital cardiac abnormalities, resulting in more adult patients with fontan physiology presenting for non-cardiac surgery. The older fontan patient is at particular risk of thromboembolism, arrhythmias, pr...
 

 Open Access DOI:10.23937/2377-4630/2/1/1019

Proposing a Novel Concept to Evaluate Safety of Supraglottic Devices Regarding Seal Pressure during Laparoscopic Surgery

Jose M. Belena, Monica Nunez and Alfonso Vidal

Article Type: Opinion | First Published: January 23, 2015

It is a fact that Supraglottic Airway Devices (SAD) are currently present at many clinical scenarios in anesthesia and they are also a good alternative to endotracheal intubation in some routine anesthetic procedures. Nowadays, laparoscopy is one of the most common and widely established surgical techniques. This procedures increase airway pressure due to the peritoneal insufflation and consequently the risk of regurgitation and aspiration. Over ...
 

 Open Access DOI:10.23937/2377-4630/1/3/1018

Time and Motion Study Assessment of Simulated Rapid Sequence Intubation

Trung Du, David Bramley, Justin Nazareth and David T Andrews

Article Type: Research Article | First Published: December 29, 2014

We carried out an observational study using a system of time and motion analysis that was developed to critically evaluate work systems by correlating the number and type of hand and equipment movements that were associated with the time taken to perform the stereotypical anaesthetic technique of rapid sequence intubation (RSI). The number and type of hand movements required to complete RSI exhibited significant correlation with, and were linearl...
 

 Open Access DOI:10.23937/2377-4630/1/3/1017

Robotic Surgery, Hypertrophic Cardiomyopathy and Difficult Airway - A Challenging Combination for the Anesthesiologist! : A Case Report

Uma Hariharan, Shagun Bhatia Shah and Binod Kumar Naithani

Article Type: Case Report | First Published: December 23, 2014

The introduction of robotic surgery has heralded new challenges for the anesthesiologists. The daVinci TM robotic system provides a three-dimensional view and better work ergonomics for the surgeon, especially in complex and radical cancer surgeries. Innovation of robotic surgery has opened the doors for newer concerns in patient safety for the anesthesia team. This is of greater importance in patients with concurrent serious conditions like hype...
 

 Open Access DOI:10.23937/2377-4630/1/3/1016

Ultrasound Guided Regional Anesthesia Training Simulator Using Microsoft Kinect

Aparajith Sairam, Jian Feng, Norman I. Badler, Jiabin Liu, Kenneth Richman and Nabil Elkassabany

Article Type: Research Article | First Published: November 24, 2014

We present a system for the interactive simulation of ultrasound guided peripheral nerve blocks using a Microsoft Kinect. The system performs motion tracking of both the ultrasound probe and the nerve block needle. Software generates synthetic ultrasound images from previously captured ultrasound images. Details of the software elements in the system are described. Some of the current challenges and future work in this research are discussed....
 

 Open Access DOI:10.23937/2377-4630/1/3/1015

Endotracheal Repair of an Iatrogenic Tracheal Laceration in A 83-Year-Old Critically Ill Woman with Aspiration Pneumonitis and Sepsis

Stefan Welter, Danjouma Cheufou, Thomas Ehmann, Sandra Kampe and Peter Scharmann

Article Type: Case Report | First Published: November 24, 2014

Tracheal laceration is a rare complication of emergency intubation. The treatment decision depends on severity of accompanying problems, available resources, condition and perspectives of the patient and experience of the responsible intensivist and surgeon. The life saving application of endotracheal suture in a disastrous situation is demonstrated in this report. We present the case of a 83-year-old woman who presented with an acute abdomen and...
 

 Open Access DOI:10.23937/2377-4630/1/3/1014

Need of Ultrasound in Emergency Department for Suprapubic Catheterization

Prerana N. Shah, Vaishali P Chaskar, Pradeep Rathod, Anand Komawar and Barakha Gadpale

Article Type: Case Report | First Published: November 20, 2014

Acute retention of urine is a medical emergency which needs immediate intervention. Urethral catheterization is a common procedure in the emergency department. Repeated unsuccessful attempts for urethral catheterization demand alternative procedure like suprapubic catheterization. Traditionlly, anatomical landmarks are used to achieve suprapubic catheterization. The confirmation of successful catheterization by ultrasound is recommended. Often ...
 

 Open Access DOI:10.23937/2377-4630/1/3/1013

Allergy to General Anesthetics: Evaluation of Patients Profile

Carla Irani, C. Saade, C. Dagher and P.Yazbeck

Article Type: Original Article | First Published: November 02, 2014

8 millions procedures requiring anesthesia are performed yearly in France with 75% of them being general anesthesia. In 45% of those procedures, a NMBA (neuromuscular blocking agents) is used. Th incidence of allergy to general anesthetics ranges between 1/20000 in Australia and 1/350 in Great-Britain. Th incidence of peranesthestic allergic reactions estimated in 1996 in France was 1/9000, all drugs confounded and the incidence of allergic react...
 

 Open Access DOI:10.23937/2377-4630/1/3/1012

Supplementary Low - Dose Oral Ketamine Provides Better Parental Separation and Face Mask Acceptance

Zeinab Ahmed El Seify and Ahmed Metwally Khattab

Article Type: Original Article | First Published: November 01, 2014

Background: Anesthesia is stressful for children and parents. Although anxiolytics can keep children calm, side effects may exist. No single method shows a clear advantage in keeping the child calm and cooperative. This study aimed to test the effiacy and safety of adding a small dose ketamine to midazolam-based oral premedication on child-parents separation and acceptance of face mask. Methods: Eighty preschool children scheduled for elective ...
 

 Open Access DOI:10.23937/2377-4630/1011

Six Month Quality of Life of Trauma Patients from A Non- Trauma Regional Hospital in Singapore

Shahla Siddiqui, Lim WoanWui and Koh Kwong Fah

Article Type: Case Report | First Published: October 27, 2014

Introduction: Trauma is a leading cause of mortality and morbidity in Singapore. In our peripheral hospital we have a large trauma load despite being a non level one trauma center. Whilst we have many studies done in the West documenting the quality of life of trauma victims using scoring systems such as the EQ5DTM and GOSE, there is a paucity of literature from this part of the World. Methods: We analyzed the results of 6 months of data collec...
 

 Open Access DOI:10.23937/2377-4630/1010

What Happens if The Patient Does Not Tell the Truth to His Anesthesiologist?

Alev Oztas, Ezgi Erkilic, Elvin Kesimci, İbrahim Keser and Duran Canatan

Article Type: Case Report | First Published: October 20, 2014

This is the case report of a young man, whose clinical condition has not been identified properly in the preoperative evaluation. A 27-yr-old man presented with complaints of nasal obstruction. His clinical examination was almost unremarkable, except for indistinct cyanosis at the lips. He denied any symptoms related cardiovascular and respiratory systems. A chest radiograph was normal, as were all laboratory investigations. He had received gener...
 

 Open Access DOI:10.23937/2377-4630/1009

Platelet Count and INR Profile after Hepatic Resection in Cirrhotic Patients: Implications for Epidural Analgesia

Siniscalchi A, Gamberini L, Carini A, Laici C, Tassinari S and Faenza S

Article Type: Original Article | First Published: October 15, 2014

Introduction: Since cirrhotic patients undergoing hepatic resection are at increased risk of developing postoperative coagulopathy, epidural catheter placement in this group of patients is still debated. This retrospective study aimed to evaluate postoperative course of coagulation parameters after surgical hepatic resection in cirrhotic patients and their relation to extent of resection and perioperative risk factors. Methods: Perioperative da...
 

 Open Access DOI:10.23937/2377-4630/1008

Is Left Ventricular Hypertrophy Early Regression Possible?

Delgado-Baeza Emilio, Quintana-Villamandos Begona

Article Type: Editorial | First Published: September 30, 2014

It is well established that hypertension is associated with increased cardiovascular morbidity and mortality. Left Ventricular Hypertrophy (LVH) is a relevant problem in patients with hypertension because of its role in long-term severe cardiovascular diseases, including ventricular arrhythmia, congestive heart failure, myocardial infarction, stroke and sudden death. There is a relationship between the regression of LVH and a decreased morbidity ...
 

 Open Access DOI:10.23937/2377-4630/1007

Airway Management in a Patient with Metatropic Dysplasia: Grossly Abnormal Anatomy Combined with a Low Functional Residual Capacity

Joseph G. Werner, Alberto A. Uribe, Karina Castellon-Larios, Sergio D. Bergese and Matthew P. McKierna

Article Type: Case Report | First Published: September 29, 2014

Difficult intubation is a constant concern in surgical and critical care settings due to its direct relationship with morbidity and mortality. The incidence reported in literature varies between 0.1% to 13% and reaches 14% in the obese population. The American Society of Anesthesiologists (ASA) defined difficult airway as a situation in which a trained anesthesiologist experiences difficulty with facemask ventilation of the upper airway, difficul...
 

 Open Access DOI:10.23937/2377-4630/1006

Preemptive Analgesia of Ultrasound - Guided Transversus Abdominis Plane Block Compared with Deep Wound Infiltration in Patients Undergoing Urological Surgery

Karim Omar Elsaeed and Hoda Shokri

Article Type: Case Report | First Published: September 18, 2014

Background: Transversus abdominus plane (TAP) block is suitable for unilateral urologic surgeries. Blind TAP block has many complications and uncertainty of its effects. Use of ultrasonography increases the safety and efficacy. This study was conducted to evaluate the analgesic efficacy of ultrasound (USG) guided TAP block compared with wound infiltration with bupivacaine (0.25%) in patients undergoing urologic surgeries. Methods: In a prospect...
 

 Open Access DOI:10.23937/2377-4630/1004

Intrathecal Dexmedetomidine or Meperidine for Post-spinal Shivering

Mohamed Hamdy Ellakany

Article Type: Research Article | First Published: September 11, 2014

Background: Shivering occurs frequently during the perioperative period. A prospective, randomized, double-blind study was done to compare between intrathecal dexmedetomidine (5mcg) and intrathecal meperidine (0.2mg/kg) for decreasing the incidence and intensity of shivering after spinal anesthesia for lower abdominal operations. Methods: Seventy five patients scheduled for lower abdominal operations under spinal anesthesia were randomly alloca...
 

 Open Access DOI:10.23937/2377-4630/1005

Anaesthetic Management in a Patient with Glomus Jugulare Tumour for Ankle Surgery

Monu Yadav, R Gopinath, B Rajesh Kumar, Shibani Padhy, A Anand Ram and Suresh Kumar Chintha

Article Type: Case Report | First Published: September 11, 2014

Anaesthesia has special considerations in any case of intracranial space occupying lesions. Not much of literature is available about anaesthetic considerations in a patient with Glomus jugulare tumour requiring surgery for non neurosurgical procedure. Glomus jugulare tumours arise from the glomus body within the adventitia of the jugular bulb. Glomus bodies are histologically similar to carotid bodies. They are composed of epitheloid cells embed...
 

 Open Access DOI:10.23937/2377-4630/1003

MOCA - 'Improving Home Improvement'

Semyon Fishkin

Article Type: Editorial | First Published: August 13, 2014

ABA requires re-certification for all Diplomates of the Board who passed oral exam after 1999. This process called MOCA and designed as a 10 years cycle of activities, which results in re-certification. Anesthesiology is not unique in this process - other 23 specialty Boards require maintenance of the certification program. The goal is to assure continuous improvement, so physicians keep up with growing body of medical knowledge and skills....
 

 Open Access DOI:10.23937/2377-4630/1002

Postoperative Respiratory Complications

Rudin Domi, Myzafer Kaci, Herion Dredha, Artan Bodeci, Hektor Sula, Ilir Ohri, Sokol Paparisto, Gjergj Andrea and Enton Bollano

Article Type: Review | First Published: August 04, 2014

The incidence of postoperative pulmonary complications (PRC) it is recently considered to be up to 5%. In the high-risk group, the incidence may reach or even exceed 20%. The mortality associated with PRC can be ranged 10-25%. Fleischman et al found that the incidence of PRC was higher than perioperative cardiac events, considered to be a common postoperative problem. Other authors reported that PRC is associated with a high morbidity profile....
 

 Open Access DOI:10.23937/2377-4630/1001

Anesthesia and Critical Care: Profession or Art?

Giustiniano Enrico

Article Type: Editorial | First Published: July 10, 2014

If I ask to a man on the street about Medicine and its progress, only few events came to his mind. Antimicrobial therapy, vaccinations, surgical therapy of cancer and continuous surgical innovations, to cite only some instances, did ameliorate human health. But most of the people forget that many surgical innovations and the care of a lot of infectious disease were due to the birth and upgrading of an often neglected branch of Medicine: Anesthesi...

Editor-in-chief


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