Journal of Clinical Anesthesia RSS feed: Articles in Press. The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained. The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice. JCA is affiliated with four societies that make it their official journal: Society for Education in Anesthesia ( SEA ); the American Association of Clinical Directors ( AACD ); the Society for Airway Management ( SAM ); and the Orthopedic Anesthesia Pain Rehabilitation Society ( OAPRS ). Visit JCA Online at URL: http://www.JCAfulltextonline.com/ http://www.jcafulltextonline.com//inpress?rss=yesElsevier Inc.en © 2012 Elsevier Inc. All rights reserved. Journal of Clinical Anesthesia0952-81802012-05-17 © 2012 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.jcafulltextonline.com/article/PIIS095281801200150X/abstract?rss=yesA contribution by Garfield et al, titled “Practice policies for older anesthesiologists in academic departments: a national survey of academic departmental chairpersons”, appears in this issue of the Journal of Clinical Anesthesia . Most who can identify with the term “older academic anesthesiologists” probably would immediately think, as I did, “Well, it's about time this was addressed!” Closer consideration subsequently generated a much more complex reaction that was framed largely by one crucial question: What is the evidence that practice policies specifically related to physician age are either needed or beneficial?Do all anesthesiologists have a “sell by” date? - Corrected ProofStanley Muravchick10.1016/j.jclinane.2012.04.002Journal of Clinical Anesthesia (2012)2012-05-17Journal of Clinical Anesthesia2012-05-17EDITORIALhttp://www.jcafulltextonline.com/article/PIIS0952818012001602/abstract?rss=yesAbstract: Study Objective: To evaluate the analgesic efficacy of transversus abdominis plane (TAP) blocks in patients undergoing ileostomy reversal.Design: Retrospective chart review.Setting: University-affiliated hospital.Subjects: The charts of 104 consecutive patients who underwent ileostomy reversal between November 1, 2008 and December 31, 2009 were reviewed. The charts of 69 patients were included in the study. Of these, 31 received a preoperative TAP block.Measurements: Patients’ opioid requirements intraoperatively, in the Postanesthesia Care Unit (PACU), and during the 24-hour period after discharge from the PACU were recorded and converted to intravenous (IV) morphine equivalents. Patient-reported numerical pain scores (0-10) from the PACU and from the 24-hour postoperative period also were recorded. Additional nonopioid means of perioperative analgesia were noted, as were duration of stay in the PACU and the hospital.Main Results: Patients receiving TAP blocks required statistically significantly fewer opioids intraoperatively (P = 0.002), in the PACU (P = 0.003), and over the 24-hour period postoperatively (P = 0.01) than did patients who did not receive a TAP block. Mean numerical pain scores while in the PACU and for 24 hours postoperatively also were significantly lower (P = 0.015 and P = 0.019, respectively) in patients receiving a TAP block, as were numerical pain scores immediately on arrival at the PACU (P = 0.013).Conclusion: TAP blocks are an effective means of reducing perioperative pain in patients undergoing ileostomy reversal.The analgesic efficacy of transversus abdominis plane blocks in ileostomy takedowns: a retrospective analysis - Corrected ProofCorey A. Amlong, Kristopher M. Schroeder, Adin-Cristian Andrei, Seungbong Han, Melanie J. Donnelly10.1016/j.jclinane.2011.10.014Journal of Clinical Anesthesia (2012)2012-05-17Journal of Clinical Anesthesia2012-05-17ORIGINAL CONTRIBUTIONhttp://www.jcafulltextonline.com/article/PIIS0952818012001183/abstract?rss=yesAbstract: Study Objective: To evaluate the effectiveness of the CTrach Laryngeal Mask Airway (LMA) when used electively.Design: Retrospective analysis.Setting: Operating room of an academic hospital.Measurements: Data from 126 patients who were electively intubated with the CTrach LMA over a 16-month period were reviewed. Each patient's weight, height, ASA physical status classification, Mallampati score, thyromental distance, and cervical spine range of motion were recorded.Main Results: Successful ventilation was achieved in 100% of patients, while successful intubation was achieved in 89.7% of patients. The most common reason for failure to intubate was poor airway visualization and the inability to appropriately position the device anterior to the vocal cords.Conclusions: The major advantage of the CTrach LMA is that it is the only device that allows airway visualization during patient ventilation; however, it does not have 100% success with intubation.Use of the CTrach Laryngeal Mask Airway in adult patients: a retrospective review of 126 cases - Corrected ProofMarco A. Maurtua, Michael Fernando, Patrick S. Finnegan, Behram Mehta, Jiang Wu, Joseph Foss, Mauricio Perilla, Andrew Zura, D. John Doyle10.1016/j.jclinane.2011.10.007Journal of Clinical Anesthesia (2012)2012-05-11Journal of Clinical Anesthesia2012-05-11ORIGINAL CONTRIBUTIONhttp://www.jcafulltextonline.com/article/PIIS0952818012001195/abstract?rss=yesAbstract: Study Objectives: 1) To develop an in vitro system to simulate the kinetics of ionized calcium in mixed venous blood during rapid transfusion of fresh frozen plasma (FFP) and 2) to use the in vitro data to estimate the effect of the transfusion rate relative to cardiac output (CO) on ionized calcium.Design: Experimental study.Setting: Research laboratory of an academic hospital.Measurements: Citrated FFP was mixed with compatible heparinized whole blood at various volume ratios in vitro to simulate the mixed venous blood obtained at various flow ratios of FFP transfusion to the recipient’s venous system in vivo. Ionized calcium was measured after each mixture.Main Results: Mixing FFP and whole blood at volume ratios of 0:100, 5:95, 10:90, and 15:85 yielded ionized calcium levels (mean ± SD, mmol/L) of 1.23, 0.81 ± 0.02, 0.54 ± 0.08, and 0.34 ± 0.02, respectively. The 50% reduction in ionized calcium occurred at a volume ratio of 7:93.Conclusions: An instantaneous 50% reduction in ionized calcium occurs in vitro at a proportion equivalent to a transfusion rate of FFP representing 7% of CO.New insights into the effect of rapid transfusion of fresh frozen plasma on ionized calcium - Corrected ProofDemet S. Sulemanji, Jonathan D. Bloom, Walter H. Dzik, Yandong Jiang10.1016/j.jclinane.2011.10.008Journal of Clinical Anesthesia (2012)2012-05-11Journal of Clinical Anesthesia2012-05-11ORIGINAL CONTRIBUTION