By Kelsey Waddill Health Payer Intelligence February 24, 2020 – Surprise billing occurrences can become more likely when providers and payers are locked in a contract dispute, like UnitedHealthcare’s (UHC’s) dispute with MEDNAX that is set to end contracts with 11 provider organizations across four states. On February 20, MEDNAX, a medical staffing firm that specializes in anesthesiology, neonatology, […]
Transfusion of Red Blood Cells, Fresh Frozen Plasma, or Platelets Is Associated With Mortality and Infection After Cardiac Surgery in a Dose-Dependent Manner
AUTHORS: Ming, Yue MMed et al Anesthesia & Analgesia: February 2020 – Volume 130 – Issue 2 – p 488-497 BACKGROUND: It is unclear whether transfusion of platelets or fresh frozen plasma, in addition to red blood cells, is associated with an increased risk of mortality and infection after cardiac surgery. METHODS: Patients who underwent valve […]
Effects of Obstructive Sleep Apnea and Obesity on Morphine Pharmacokinetics in Children
AUTHORS: Dalesio, Nicholas M. MD, MPH et al Anesthesia & Analgesia: October 31, 2019 BACKGROUND: Obesity increases susceptibility to chronic pain, increases metabolism, and is associated with obstructive sleep apnea syndrome (OSAS), all which can complicate perioperative pain management of patients. In addition, obesity and OSAS can cause elevation of the adipose-derived hormone leptin, which […]
Neostigmine Versus Sugammadex for Reversal of Neuromuscular Blockade and Effects on Reintubation for Respiratory Failure or Newly Initiated Noninvasive Ventilation
AUTHORS: Krause, Martin MD et al Anesthesia & Analgesia: November 5, 2019 BACKGROUND: Pulmonary complications related to residual neuromuscular blockade lead to morbidity and mortality. Using an interrupted time series design, we tested whether proportions of reintubation for respiratory failure or new noninvasive ventilation were changed after a system-wide transition of the standard reversal agent […]
Surprise: Inpatient Setting Not Always Best for Outcomes
Author: Michael Vlessides Anesthesiology News Surgical procedures done in the outpatient setting have long been touted as a cost-effective alternative to their inpatient counterparts. Now, analyses of two databases have found that certain outpatient surgeries may actually be safer, too. In a pair of presentation s at the 2019 annual meeting of the International Anesthesia […]
Medical error is not the third leading cause of death
Author: SKEPTICAL SCALPEL, MD Ever since the publication of the infamous 2016 BMJ opinion piece claiming medical error should be considered the third leading cause of death in the U.S., the debate on the true incidence of deaths caused by medical error has been raging. Many, including me, felt the estimate of 251,000 deaths per year from medical […]
Focusing on Spectrogram May Be Best Strategy to Reduce Unintended Awareness During Cardiac Surgery
Author: Michael Vlessides Anesthesiology News Researchers may have uncovered a simple way to avoid potential unintended awareness during high-risk cardiac surgery. Their study found that EEG signatures similar to those seen during emergence—decreasing theta power with increasing alpha frequency—occur regularly during cardiac surgery. Paying close attention to these signals in the form of a spectrogram, […]
Dexmedetomidine Best Adjuvant for Caudal Epidural Block in Pediatric Surgery
Author: Michael Vlessides Anesthesiology News A meta-analysis of adjuvants for caudal epidural block has found that dexmedetomidine prolongs the duration of analgesia and also reduces total acetaminophen consumption and number of acetaminophen doses in the first 24 hours after pediatric infraumbilical surgery. The study also found that neostigmine extended the analgesia duration longer than any […]
Anterior quadratus lumborum block for postoperative recovery after total hip arthroplasty
AUTHORS: Masaru Kikuchi et al BMC Trial Feb 2020 BACKGROUND Appropriate pain management is essential to improve the postoperative recovery after total hip arthroplasty (THA). Various case reports have indicated that anterior quadratus lumborum block (QLB) provides effective postoperative analgesia in lower limb surgeries. However, few randomized controlled trials have confirmed the efficacy of anterior […]
Takotsubo Cardiomyopathy: Broken Heart Syndrome
Authors: Alma Juels, MD, and Parker Juels Anesthesiology News The Frost Series #355 Case Presentation A 22-year-old woman presented to the OR for a rectal examination and rectal fistula repair. She had a body mass index of 35 kg/m2 and a history of hypothyroidism, depression and migraines. Upon presentation, her hypothyroidism had resolved and levels of […]