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Patients after cardiac surgery experience moderate to severe pain in the immediate postoperative period as a result of surgical interventions, such as incision, sternotomy, sternal retraction, pericardiotomy, tissue dissection, and the presence of chest tubes. 1 Poorly controlled acute pain increases suffering, cardiovascular stress, and respiratory complications and may develop into persistent postoperative pain, which adversely affects patients' daily activities, psychological well-being, and quality of life. 2

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Purpose of reviewPerioperative myocardial injury related to cardiac surgery is associated with organ dysfunction and increased mortality. Volatile anesthetics (VA) have been used during cardiac surgery for decades because of their direct and indirect preconditioning and protection against ischemia-reperfusion injury. The current review provides a summary of the latest literature comparing pharmacological preconditioning and the potential benefits of using VA versus total intravenous anesthesia (TIVA) for general anesthesia to improve outcomes after cardiac surgery. Recent findingsRecent literature reports lower mortality and better outcomes when VA is used alone or in combination with remote ischemic preconditioning compared with groups receiving TIVA. However, inconsistent research findings over the years have led to continued debate regarding the anesthetic technique considered more favorable for cardiac surgery.

Poorly designed and implemented medication labels have been identified as a source of medication errors within anesthesia delivery. Previous studies noted that simplified text and icons are useful in warning labels used for prescription drugs, especially for people with low literacy levels. In addition, Tallman lettering can reduce errors due to the custom capitalization of text. However, icons, color, and Tallman lettering have not been explored for improving the readability of anesthesia medication labels. This study utilizes a user- centered approach to design and evaluate icons and other graphical features to be included on secondary medication labels placed on infusion bags within anesthesia point-of-care. The study utilizes an iterative design process to examine the potential efficacy of these design characteristics by evaluating them with the anesthesia providers/clinicians through an online survey. Findings suggest that introducing graphical components like icons and color may be useful and accepted by clinicians to improve medication recognition.