Perioperative Surgical Home Promotes Perioperativists

What’s in a name? Everything to proponents of the American Society of Anesthesiologists’ (ASA) concept of the Perioperative Surgical Home (PSH), which sees the anesthesiologists’ role in the surgical suite morphing into that of a “perioperativist.” Alan E. Curle, MD, associate professor of clinical anesthesiology and director, Center for Perioperative Medicine, University of Rochester Medical […]

Postoperative Benefits Seen With Preoperative IV Ibuprofen

To the well-documented analgesic benefits of IV ibuprofen add this: Preoperative administration of the nonsteroidal anti-inflammatory drug (NSAID) improves the overall quality of recovery. A recent study also revealed that IV ibuprofen might improve postoperative cognitive recovery. According to Vanny Le, MD, and a team of researchers from Rutgers New Jersey Medical School in Newark, […]

The Opioid-Free ED: Coming Soon to a Hospital Near You

This is for our providers who practice pain management. The time has come to seriously explore the use of nonopioid analgesia for managing pain in the emergency department, said experts speaking at the American Academy of Emergency Medicine 21st Annual Scientific Assembly in Austin, Texas. “Relying on opioids as the primary analgesics for moderate to […]

Acetaminophen Risks May Have Been Underestimated

Paracetamol, known as acetaminophen in the United States, may have more risks than originally thought, particularly when it is taken at the higher end of standard therapeutic doses, according to a new systematic review. The authors and an outside expert recommend caution when interpreting the data, as they are observational in nature and are subject […]

Chronic Pain, Misuse of Pain Meds Common in Kidney Disease

Chronic pain and inappropriate use of pain medications are common in people with early-stage chronic kidney disease (CKD), according to a study published in the Clinical Journal of the American Society of Nephrology. “We demonstrated that there is a link between pain and patient safety in CKD and that the CKD population warrants closer attention to […]

Pharmacologic Agents for the Prevention and Treatment of Delirium in Patients Undergoing Cardiac Surgery

Published in Crit Care Med. 2015;43(1):194-204. Authors: Jing Lan Mu et Objectives Postcardiac surgery delirium is associated with increased risks of morbidity, cognitive decline, poor health-related quality of life and mortality, and higher healthcare costs. We performed a systematic review of randomized controlled trials to examine the effect of pharmacologic agents for the prevention and the treatment […]

Evaluation of the PaO2/FiO2 Ratio After Cardiac Surgery as a Predictor of Outcome During Hospital Stay

Published in BMC Anesthesiol. 2014;14(83) Authors: Francisco Esteve et al Background The arterial partial pressure of O2 and the fraction of inspired oxygen (PaO2/FiO2) ratio is widely used in ICUs as an indicator of oxygenation status. Although cardiac surgery and ICU scores can predict mortality, during the first hours after cardiac surgery few instruments are available to […]

Assisted Ventilation in Patients with Acute Respiratory Distress Syndrome: Lung-distending Pressure and Patient–Ventilator Interaction

Published in Anesthesiology 5 2015 Authors: Jonne Doorduin, M.Sc. et al Background: In patients with acute respiratory distress syndrome (ARDS), the use of assisted mechanical ventilation is a subject of debate. Assisted ventilation has benefits over controlled ventilation, such as preserved diaphragm function and improved oxygenation. Therefore, higher level of “patient control” of ventilator assist may be […]

Abuse Risk Evaluation Changes Opioid Prescribing

Physicians would prescribe opioids less often to patients at high risk for abuse if they had information that could help them identify these patients, a new study shows. “It seemed to help simplify the decision making process,” said Alison Vargovich, PhD, from the Cleveland Clinic in Ohio. Dr Vargovich presented the finding here at the […]

Effect of 1.5% Topical Diclofenac on Clinical Neuropathic Pain

Published in Anesthesiology 5 2015 Authors: Shihab U. Ahmed, MBBS et al Background: Neuropathic pain is a condition resulting from injury to the peripheral and/or central nervous system. Despite extensive research over the last several decades, neuropathic pain remains difficult to manage. Methods: The authors conducted a randomized, placebo-controlled, double-blinded, and crossover clinical trial to examine the effect […]