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INFOGRAPHICS IN ANESTHESIOLOGY
Complex Information for Anesthesiologists Presented Quickly and Clearly
THIS MONTH IN

Factors Affecting Admission to Anesthesiology 243

Innate Immune Dysfunction in 411 Residency in the United States: Choosing the Future of
Trauma Patients: From Our Specialty
Pathophysiology to Treatment The proportion of anesthesiology residents from U.S. medical schools has more than dou-
(Clinical Concepts and bled since 1995. This retrospective cohort study evaluated the 2010 and 2011 residency
Commentary) applicants to determine the
Recent insights into posttraumatic immune dysfunction factors associated with a suc-
have defined new targets for immunointervention that cessful admission to resi-
hold promise for improving outcomes in such critically ill dency training programs.
patients.
The sample represented 58%
of the total national applicant
pool; 66% of the applicants
successfully matched to anes-
thesiology. The odds for a suc-
High Intraoperative Inspired 271 cessful match were higher for
applicants from U.S. medical
Oxygen Does Not Increase
schools, those with United
Postoperative Supplemental States Medical Licensing
Oxygen Requirements Examination scores greater
High inspired oxygen may be reasonable in lower risk than 210, younger appli-
surgery to improve wound oxygenation.
cants, and females. Prior
graduate education or peer-
reviewed publications did not offer any advantage. This study suggests the potential for age
and gender bias in the selection process. See the accompanying Editorial View on page 230.

Accuracy of Ultrasound-guided 347 What Factors Affect Intrapartum Maternal Temperature? 302
Nerve Blocks of the Cervical A Prospective Cohort Study: Maternal Intrapartum
Zygapophysial Joints Temperature
Ultrasound imaging was an accurate technique for cervi-
cal zygapophysial joint nerve blocks in volunteers. See the The cause of rises in intrapartum maternal temperature is not known. In this prospective
accompanying Editorial View on page 236. study of 81 women scheduled for labor induction, hourly oral temperatures were recorded
and analyzed based on race, body mass index, duration of labor, and time to epidural.
Overall, temperature rose in a significant linear trend over time. Positive temperature trends
were associated with significantly longer time from membrane rupture to delivery and higher
body mass index. Temperature slopes did not differ before compared with after epidural
analgesia. This study suggests that epidural analgesia alone does not increase the risk of high
Estimation of the Contribution 353 temperatures in intrapartum women.
of Norketamine to Ketamine-
induced Acute Pain Relief and
Neurocognitive Impairment in Postoperative QT Interval Prolongation in Patients 321
Healthy Volunteers Undergoing Noncardiac Surgery under General
Norketamine has an effect opposite to that of ketamine Anesthesia
on pain relief.
Electrocardiograms (ECG) can identify abnormal cardiac repolarization by observation of a
prolonged QT interval. QT interval prolongation is often caused by drugs and can result in
sudden cardiac death. In this ancillary study to the Vitamins in Nitrous Oxide trial, serial
IV = intravenous; NMBAs = neuromuscular blocking agents.
postoperative 12-lead ECG were obtained from 469 patients undergoing major noncardiac
Infographic created by Jonathan P. Wanderer, Vanderbilt University surgeryMedical
underCenter,
generaland James P. Rathmell,
anesthesia. Brighamofand
Eighty percent Women’s
patients Health Care/Harvard
experienced Medical
a significant QT
School. Illustration
Severe Emergence by Annemarie Johnson, Vivo Visuals.
Agitation 399 Address correspondence
interval to Dr.and
prolongation, Wanderer: jonathan.p.wanderer@vanderbilt.edu.
approximately half had increases greater than 440 ms at the end of
after
1. Lee Myringotomy
AI, McCarthy RJ, Toledoin a 3-yr-old
P, Jones surgery.
MJ, White N, Wong CA: Epidural laborOne patient developed
analgesia—fentanyl dose and torsade de pointes.
breastfeeding success:Drugs associated
A randomized withtrial.
controlled prolonged QT
Anesthesiology
2017; 127:614–24 interval included isoflurane, methadone, ketorolac, cefoxitin, zosyn, unasyn, epinephrine,
Child (Case Scenario)
2. Cobb B, Liu R, Valentine E, Onuoha O: Breastfeeding after anesthesia: A review for anesthesia providers regarding the transfer of medications into breast milk. Transl Perioper Pain
Emergence agitation, the associated risk factors, and its ephedrine, and calcium. Although the exact cause of the association between perioperatively
Med 2015; 1:1–7
prevention
3. D and
alal PG, treatment
Bosak areC:discussed.
J, Berlin
administered drugs and QT interval prolongation is not known, further study is warranted to
Safety of the breast-feeding infant after maternal anesthesia. Paediatr Anaesth 2014; 24:359–71
4. Drugs and Lactation Database (LactMed), United States National Library determine the clinical
of Medicine, Nationalrelevance.
Institutes of Health, Department of Health and Human Services. Available at: https://
toxnet.nlm.nih.gov/newtoxnet/lactmed.htm. Accessed August 5, 2017

Anesthesiology, V 127 • No 4 October 2017

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