Authors: Avery Tung, MD, FCCM et al Anesthesiology News Not Only Successful Intubations but Avoidance of Complications Choosing an airway management technique based primarily on success rate is itself a form of outcome bias that may lead to inadequate planning or preparation. Introduction Airway management in patients with oropharyngeal (OP) masses may be extremely challenging.1,2 Depending […]
Intraoperative Ketamine in Total Knee Arthroplasty Does Not Decrease Pain and Narcotic Consumption
AUTHORS: Tan T et al Journal of Arthroplasty 34 (8), 1640-1645 (Aug 2019) BACKGROUND Multiple studies have demonstrated that ketamine, a glutamate receptor blocker, may decrease postoperative pain in abdominal and orthopedic surgeries. However, its role with spinal anesthesia and total knee arthroplasty (TKA) remains unknown. The purpose of this study is to determine the […]
Effectiveness of Magnesium in Preventing Shivering in Surgical Patients
AUTHORS: Kawakami, Hiromasa MD et al Anesthesia & Analgesia: September 2019 – Volume 129 – Issue 3 – p 689-700 BACKGROUND: Clinical trials regarding the antishivering effect of perioperative magnesium have produced inconsistent results. We conducted a systematic review and meta-analysis with Trial Sequential Analysis to evaluate the effect of perioperative magnesium on prevention of shivering. […]
Cuff Leaks in the ICU: Etiologies, Management and Complications
Anesthesiology News Authors: Sagar Patel, DO et al Anesthesia providers are often confronted with the management of a “cuff leak” in mechanically ventilated patients in the OR and ICU.1 Certainly, the advantage of the OR environment is that the patient is in a relatively more controlled setting, monitored by health care providers (HCPs) who are familiar […]
Nearly All Types of Menopausal Hormone Therapy Tied to Higher Breast Cancer Risk
Author: Amy Orciari Herman Edited by William E. Chavey, MD, MS All types of menopausal hormone therapy (HT), except vaginal estrogen, are associated with increased breast cancer risk, according to a large meta-analysis in the Lancet. Researchers examined prospective data on over 100,000 postmenopausal women who developed breast cancer. Among the other findings: Excess risk for breast […]
Invasive Respiratory or Vasopressor Support and/or Death as a Proposed Composite Outcome Measure for Perioperative Care Research
AUTHORS: Mizota, Toshiyuki MD, PhD et al Anesthesia & Analgesia: September 2019 – Volume 129 – Issue 3 – p 679-685 BACKGROUND: There is a need for a clinically relevant and feasible outcome measure to facilitate clinical studies in perioperative care medicine. This large-scale retrospective cohort study proposed a novel composite outcome measure comprising invasive respiratory […]
Transport of Critically Ill Patients by the Anesthesia Versus the Intensive Care Unit Service: A Before–After Study of Operating Room Workflows
AUTHORS: Dupont, Frank W. MD et al Anesthesia & Analgesia: September 2019 – Volume 129 – Issue 3 – p 671-678 BACKGROUND: We implemented a new policy at our institution where the responsibility for intensive care unit (ICU) patient transports to the operating room (OR) was changed from the anesthesia to the ICU service. We hypothesized […]
Coagulation Factor Levels and Underlying Thrombin Generation Patterns in Adult Extracorporeal Membrane Oxygenation Patients
AUTHORS: Mazzeffi, Michael MD, MPH, MSc et al Anesthesia & Analgesia: September 2019 – Volume 129 – Issue 3 – p 659-666 BACKGROUND: There is a paucity of data on the underlying procoagulant–anticoagulant balance during extracorporeal membrane oxygenation (ECMO). We hypothesized that adult ECMO patients would have an imbalance between procoagulant and anticoagulant factors, leading to […]
Grade 3 Echocardiographic Diastolic Dysfunction Is Associated With Increased Risk of Major Adverse Cardiovascular Events After Surgery
AUTHORS: Zhou, Yan MD, PhD et al Anesthesia & Analgesia: September 2019 – Volume 129 – Issue 3 – p 651-658 BACKGROUND: Diastolic dysfunction is common and may increase the risk of cardiovascular complications. This study investigated the hypothesis that, in patients with isolated left ventricular diastolic dysfunction, higher grade diastolic dysfunction was associated with greater […]
Homing in on Optimal Compression Rate and Depth for CPR
Authors: Duval S et al. JAMA Cardiol 2019 Aug 14 Compression at a rate of 86 to 129 per minute and depth of 3.8 to 5.6 cm was associated with higher survival to discharge. Adult cardiac arrest guidelines recommend delivery of chest compressions at a rate of 100 to 120 per minute and a depth of […]