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AnesthesiologyNews.com • J a n u a r y 2 0 1 4 • Volume 40 Number 1
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Researchers Close In on Causes of CRPS Toronto—Researchers tasked with developing a rudimentary understanding of complex regional pain syndrome (CRPS) are dividing their attention ttention in several different directions. Acccor o di ding n ng to experts who spoke at the 2013 Int I ter ernational Congress on Neuropathic Pain, there is evidence for inflammatory, neuropathic and immunologic roots to her the enigmatic syndrome, and furth investigation into these three aspeccts of the condition is necessary forr the development of more effective treatments. “These different contributing fa facctors all influence each other, so we nee eedd atie ient ie ntss nt to address all of them so that paat don’t get onto a downward spiral whe herre
Anesthesia an The Real-Time Interdisciplinary group seeks mechanism of action for inhalation agents
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allopius of Padua, the 16th-century anatomist and physician, famously complained, “When soporifics are weak, they are useless, and when strong, they kill.” Western medicine has come a long way in the centuries since, but anesthesiologists are only beginning to understand how the drugs of their trade work at the most fundamental level. “We don’t understand how general aneesthetics work in any detail,” said Roderic Eckenhoff, MD, the Austin Lamont Professoor of Anesthesiology and Critical Care at the Perrelman
see CRPS pag p page 20
see voltage e page 18
Consciousness Raising George Mashour, MD, PhD, hopes the darkness of anesthesia will shed light on the nature of the mind
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f you want to commingle the arts with the science of anesthesiology without scaring away the audience for either, telling a zombie tale never hurts. That’s what George A. Mashour, MD, PhD, did when he co-authored a 2008 article in the journal Consciousness and Cognition that could have passed peer review in a Poe anthology. The paper argued that a “philosophical zombie”—an unconscious creature that behaves and responds like a human—is “naturally improbable.” But
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an “inverse zombie”—a creature that appears to be unconscious but in fact is not—is possible. Indeed, such a state fairly describes a patient experiencing awareness during anesthesia. Dr. Mashour’s blending of scifi horror with anesthesiology produced “an absolutely brilliant article,” said Max B. Kelz, MD PhD, professor of anesthesiology at the University of Pennsylvania, in Philadelphia. Dr. Mashour “is see consciousness page 16
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COMMENTARY
Go “Team”!—how a single word is changing medicine.
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CLINICAL ANESTHESIOLOGY
Even when healthy, obese patients receive a higher ASA surgical status.
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CLINICAL ANESTHESIOLOGY
After outbreaks linked to nerve blocks, practice guidelines look to improve patient safety.
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AD LIB
For Afghan boy with rare bladder malformation, a soldier’s efforts lead to life-altering surgery.
TOP TEN
of 2013
The Top 10 Articles of 2013 on AnesthesiologyNews.com, see page 4.