Currently, there are approximately 4.2 million adults in the United States who are visually impaired. Early diagnosis and treatment, including surgery, have the potential to reverse vision impairment, such as cataract extraction, or slow and reduce the progression of diseases such as glaucoma and diabetic retinopathy (1). Anesthesia providers who specialize in ophthalmic procedures are critical to ensuring that patients have a comfortable and safe surgical experience. There are several options for anesthesia during eye surgery, including local, regional, or general anesthesia. Regional anesthe ..read more

General anesthesia induces a state of unconsciousness, amnesia, and immobility via the suspension of neural activity, including physiological processes mediated by the spinal cord. Research on the mechanisms of anesthesia has been extensively conducted at both micro- and macro- levels. On the microscopic scale, it has been found that anesthetic agents work primarily on GABAA receptors, the brain’s main inhibitory receptor. However, NMDA receptors, which are pivotal in mediating excitatory neurotransmission, are also heavily affected, although they are mostly inhibited by inhalational anestheti ..read more

Older individuals contemplating surgery often express concerns regarding potential complications, returning home, and the anticipated improvement in their quality of life. Notably, the avoidance of new or worsening disability becomes a paramount consideration with advancing age. To better guide patients, clinicians must not only discuss surgical success rates but also apprise them of the likelihood of developing new or worsening disability after surgery. In a recent single-center analysis encompassing 2,176 patients aged 70 and older who received surgery, 12% of patients had passed away, 23% e ..read more

Over the past couple of decades, drug shortages have become a relatively common occurrence in clinical settings. According to an American Hospital Association (AHA) survey of community hospitals, nearly 50% of responding hospitals reported at least 21 drug shortages within the first 6 months of 2011, and more than 99% of hospitals reported at least 1 drug shortage within the same time period. Approximately 80% of drug shortages involve sterile injectable drugs, such as anesthetic agents and chemotherapy drugs (1). One of the most commonly used anesthetic agents is propofol, as it has many clin ..read more

In July 2020, remimazolam, a novel short-acting drug, was approved in the US for procedural sedation in adults (1). Like midazolam (a common anesthetic adjunct), remimazolam is a benzodiazepine and operates by modulating γ-aminobutyric acid (GABA) receptor activity to induce cell membrane hyperpolarization, thereby inhibiting neural activity via an increase in chloride ion influx (2). Its structural and metabolic properties have generated interest in whether, and in what situations, remimazolam is superior to other drugs for intravenous anesthesia and sedation.  Remimazolam was designed t ..read more

Medicare, the federal health insurance program that provides coverage for Americans aged 65 and older, has been a cornerstone of the nation’s healthcare system for decades. As healthcare costs have continued to rise, the need for fiscal responsibility and sustainability has become increasingly critical (1). In response to economic challenges, Medicare implemented several cost-saving measures, including the introduction of a budget neutrality rule (2). This new policy aims to strike a balance between providing quality healthcare to beneficiaries while ensuring the program’s financial stability ..read more

Experimental design is at the heart of scientific inquiry. Its primary purpose is to ensure that the data obtained is sufficiently reliable and valid to draw meaningful conclusions. Anesthesia research, which delves into the science of inducing a loss of sensation or consciousness, necessitates meticulous planning, given the potential risks involved and the need for absolute clarity in results. Let’s explore the crucial elements of experimental design within the context of anesthesia research. 1. Objectives and Hypotheses Every research study begins with an objective: what do you wish to disco ..read more

Extracorporeal membrane oxygenation (ECMO) is a life-saving technique that provides temporary support for patients with severe cardiac or respiratory failure (or both) [1,2]. It is implemented in cases where no other treatment is likely to be successful and all other options have been exhausted [2]. In recent years, ECMO has become increasingly common in critical care settings and has even found its place in the field of anesthesia.  Often described as a modification of the cardiopulmonary bypass circuit routinely used in cardiac surgery, ECMO functions by removing deoxygenated blood from ..read more

Approximately 10 million people in the U.S. suffer from osteoporosis, a disease that slows the growth of healthy bone and weakens bones over time. Osteoporosis affects nearly 20% of women aged 50 and over and can increase the risk of a fragility fracture during or after joint replacement surgery, of which falling is the most common cause 1. Greater fragility in the bones of a patient with osteoporosis can complicate orthopedic surgery.  Joint replacement is a core type of orthopedic surgery that is affected by osteoporosis. Unfortunately, patients who need joint replacements tend to be ol ..read more

Cancer treatment, including surgery, chemotherapy, and radiotherapy, results in major physiological and health changes. Impacts on everyday life can be significant and are relatively well-known. Impacts on other areas are also important. In particular, there are unique considerations for patients undergoing cancer treatment, especially radiation therapy, who need anesthesia.   Chemotherapy can damage healthy cells, resulting in side effects impacting the cardiovascular, respiratory, nervous, renal, hepatic, gastrointestinal, or hematopoietic systems 1. Anesthesiologists therefore nee ..read more