AUTHORS: Albrecht, Eric, MD et al Anesthesia & Analgesia: March 2019 – Volume 128 – Issue 3 – p 543–554 BACKGROUND: Both dexamethasone and dexmedetomidine are effective peripheral nerve block (PNB) perineural adjuncts that prolong block duration. However, each is associated with side effects. With paucity of head-to-head comparisons of these adjuncts, the question of the […]
Does the Incidence of Postoperative Complications After Inguinal Hernia Repair Justify Hospital Admission in Prematurely and Term Born Infants?
AUTHORS: Massoud, Marina, BSc et al Anesthesia & Analgesia: March 2019 – Volume 128 – Issue 3 – p 525–532 BACKGROUND: Postoperatively, young infants are admitted overnight in view of the risk for respiratory complications such as desaturation and apnea. This risk seems much lower than previously reported. Until what age this risk persists, and which […]
Prospective Observational Investigation of Capnography and Pulse Oximetry Monitoring After Cesarean Delivery With Intrathecal Morphine
AUTHORS: Weiniger, Carolyn F., MBChB et al Anesthesia & Analgesia: March 2019 – Volume 128 – Issue 3 – p 513–522 BACKGROUND: Intrathecal morphine provides excellent analgesia after cesarean delivery; however, respiratory events such as apnea, bradypnea, and hypoxemia have been reported. The primary study aim was to estimate the number of apneas per subject, termed […]
Enteral versus intravenous approach for the sedation of critically ill patients: a randomized and controlled trial
AUTHORS: Giovanni Mistraletti et al Critical Care 2019 23:3 Background ICU patients must be kept conscious, calm, and cooperative even during the critical phases of illness. Enteral administration of sedative drugs might avoid over sedation, and would be as adequate as intravenous administration in patients who are awake, with fewer side effects and lower costs. […]
EEG-Guided Anaesthetic Administration Does Not Prevent Postoperative Delirium in Older Adults
By Denise Baez Electroencephalography (EEG)-guided anaesthetic administration does not decrease the incidence of postoperative delirium in older patients undergoing major surgery, according to a study published in JAMA. “In this randomised study involving 1,232 patients aged 60 years and older undergoing major surgery, postoperative delirium occurred in 26.0% of the EEG-guided anaesthetic group and in 23.0% […]
Association of Neuraxial Anesthesia With Postoperative Venous Thromboembolism After Noncardiac Surgery
AUTHORS: Turan, Alparslan, MD et al Anesthesia & Analgesia: March 2019 – Volume 128 – Issue 3 – p 494–501 BACKGROUND: Neuraxial anesthesia improves components of the Virchow’s triad (hypercoagulability, venous stasis, and endothelial injury) which are key pathogenic contributors to venous thrombosis in surgical patients. However, whether neuraxial anesthesia reduces the incidence of venous thromboembolism […]
Continuous Noninvasive Arterial Pressure Monitoring in Obese Patients During Bariatric Surgery
AUTHORS: Rogge, Dorothea E., MD et al Anesthesia & Analgesia: March 2019 – Volume 128 – Issue 3 – p 477–483 BACKGROUND: Continuous monitoring of arterial pressure is important in severely obese patients who are at particular risk for cardiovascular complications. Innovative technologies for continuous noninvasive arterial pressure monitoring are now available. In this study, we […]
Pupillary Pain Index Changes After a Standardized Bolus of Alfentanil Under Sevoflurane Anesthesia
AUTHORS: Sabourdin, Nada, MD et al Anesthesia & Analgesia: March 2019 – Volume 128 – Issue 3 – p 467–474 BACKGROUND: The pupillary pain index (PPI) is a novel pupillometric index, designed to assess intraoperative analgesia. It is based on the evaluation of the pupillary response to electrical stimuli of increasing intensity. It ranges from 1 […]
Evidence Basis for Regional Anesthesia in Ambulatory Anterior Cruciate Ligament Reconstruction
AUTHORS: Yung, Eric M., BHSc, MD (Cand) et al Anesthesia & Analgesia: March 2019 – Volume 128 – Issue 3 – p 426–437 BACKGROUND: Local infiltration analgesia offers effective postoperative analgesia after knee arthroplasty, but the role of its counterpart, local instillation analgesia (LIA), in anterior cruciate ligament reconstruction (ACLR) is unclear. This systematic review and […]
Andexanet for Major Hemorrhage in Patients on Factor Xa Inhibitors
Authors: Connolly SJ et al. N Engl J Med 2019 Feb 7 An uncontrolled study shows rapid efficacy in reducing elevated anti-FXa inhibitor levels. The anticoagulant activity of oral direct factor Xa (FXa) inhibitors and low-molecular-weight heparins such as enoxaparin can be reversed by andexanet, a modified, recombinant inactive form of FXa. Andexanet was recently approved […]