Anesthesia for Athletes, An Issue of Anesthesiology Clinics

In this issue of Clinics in Sports Medicine, guest editor Dr. Ashley M. Shilling brings her considerable expertise to the topic of Sports Anesthesia. Top experts in the field focus on anesthesia approaches specifically for athletes and orthopaedic sports injuries, including unique medical considerations, pain management tactics for athletes, and more. Contains 14 relevant, practice-oriented topics including anesthesia for the patient undergoing hip arthroscopy; local anesthetics, liposomal anesthetics, and toxicity; pain management in the elite athlete; managing the complex pain patient through total joint arthroplasty; managing chronic pain following total joint arthroplasty; and more. Provides in-depth clinical reviews on sports anesthesia, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

In this issue of Clinics in Sports Medicine, guest editor Dr. Ashley M. Shilling brings her considerable expertise to the topic of Sports Anesthesia. Top experts in the field focus on anesthesia approaches specifically for athletes and orthopaedic sports injuries, including unique medical considerations, pain management tactics for athletes, and more. Contains 14 relevant, practice-oriented topics including anesthesia for the patient undergoing hip arthroscopy; local anesthetics, liposomal anesthetics, and toxicity; pain management in the elite athlete; managing the complex pain patient through total joint arthroplasty; managing chronic pain following total joint arthroplasty; and more. Provides in-depth clinical reviews on sports anesthesia, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

This issue brings the anesthesiologist up to date on current essential topics in regional analgesia and acute pain management, including the latest state-of-the-art techniques and drugs. Subjects covered include prevention and treatment of local anesthetic systemic and neurotoxicity; complications of RA and pain management (medicolegal issues including anticoagulation, infection, etc.); assessment and treatment of post block neurologic injury (history, physical, investigations, EMG, NCS); new ultrasound guided techniques for peripheral nerve blocks and evidence based outcome review; emerging techniques and drugs for neuraxial and paravertebral blocks; local infiltration analgesia (for a variety of surgical procedures, wound infusions, infusion devices); continuous PNB in hospital and at home; recent advances in multimodal analgesia (new drugs & strategies, such as capsaisin, long acting opioid and local anesthetics); challenges in acute pain management (including the opioid tolerant patient, patients with comorbidities such as MS, DM and renal failure); economics and practice management issues associated with acute pain management; pediatric pain management; new concepts of acute pain management (including strategies to prevent chronic pain, opioid induced hyperalgesia, and more).

Sports participation has been growing rapidly since the 1960s. Anesthesiologists are increasingly confronted with athletes in a perioperative setting. The right choice of type of anesthesia technique, pain management of injuries, specific physiologic adaptations of the athlete and knowledge of prohibited substances are eminent for a correct approach of this subpopulation. This review aims to give an overview of athleteu2019s specific anesthetic management in perioperative and postoperative settings. The authors retrieved 881 articles using all MeSH terms of which 243 articles were screened using the search criteria referring to anesthetic management in the perioperative setting and after removing duplicates. Seventy-nine articles were eligible for full-text assessment and 59 articles were included in this synthesis. Preoperative evaluation, intraoperative implications and postoperative pain management categorized included articles. An anesthesiologist should recognize the most common benign ECG findings in athletes like bradycardia, isolated left ventricle hypertrophy on voltage criteria and early repolarization as normal features in the athleteu2019s heart. Isotonic physiology typically produces four chamber dilation. In contrast, isometric stress creates high intravascular pressure leading to left ventricular hypertrophy. Preoperative evaluation should also identify possible consumers of performance-enhancing drugs. Intraoperative points of interest for the anesthesiologist is mainly avoiding drugs on the prohibited list of the world anti-doping agency (WADA). Post-operative and chronic pain management are still developing fields in this population. The International Olympic Committee (IOC) proposed treating acute pain with a combination of paracetamol, NSAIDs, topical analgesics, injectable NSAIDs and local anesthetics. . It may be suggested that chronic pain management in elite athletes could benefit from treatment in specialized multidisciplinary pain clinics.

In this issue of Anesthesiology Clinics, guest editors Drs. Philipp Lirk and Kamen Vlassakov bring their considerable expertise to the topic of Orthopedic Anesthesiology. Top experts in the field cover key topics such as rebound pain, anesthesia for the general orthopedic patient, anesthesia and analgesia for the pediatric orthopedic patient, same-day major orthopedic surgery, hip fracture, and more. Contains 18 relevant, practice-oriented topics including perioperative care of the orthopedic patient, including geriatric assessment and follow-up; outcomes after orthopedic and trauma surgery; evidence base for peripheral nerve blocks in orthopedic and trauma anesthesia; alternatives to nerve blockade: pericapsular infiltration and multimodal analgesia; and more. Provides in-depth clinical reviews on orthopedic anesthesiology, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

This issue of Anesthesiology Clinics covers the latest updates in cardiovascular anesthesia written by the world-leading experts on the topic. Procedurally-focused articles cover best practices in fluid and blood management, mechanical circulation support, anesthesia for robotic surgery, adult congenital heart surgery, transplantation and more. Achieve the best outcomes and keep current on this area of anesthesia practice.