Transcutaneous electrical nerve stimulation (TENS) may represent an effective treatment for the prevention and management of migraine, according to a meta-analysis published in the Journal of Headache and Pain. Although promising, the findings presented by the researchers are based on low quality of evidence. TENS consists of the delivery of pulsed low-voltage electrical currents across the […]

Patients undergoing surgery for degenerative spondylolisthesis are more likely to have a dependency on opioid medications before surgery than afterward, according to research published in the Journal of Neurosurgery: Spine. For the study, Mayur Sharma, MD, Cleveland Clinic, Cleveland, Ohio, and colleagues analysed a database containing 10,708 patients who had undergone surgery for degenerative spondylolisthesis. The […]

Intravenous (IV) acetaminophen does not meaningfully decrease opioid use following colorectal procedures, especially compared with oral acetaminophen, according to a study published in Anesthesiology. “With any new drug that is introduced to the US market, it is very important to monitor how it is used and if this results in the desired outcomes,” said Jashvant Poeran, […]

Authors: Al-Ashqar M et al  Annals of the Royal College of Surgeons of England 1-5 (Jun 2018) Introduction The ‘weekend effect’ is said to occur when patient outcomes are adversely affected by the day of the week on which they present to hospital or have surgery. However, it is uncertain whether such a phenomenon exists […]

The passive leg raise (PLR) results in fewer attempts at intravenous (IV) access than no leg raise in paediatric patients, according to a study presented here at the 2018 Annual Meeting of the Canadian Anesthesiologists Society (CAS). “Obtaining IV access can be a challenge in the paediatric setting,” explained Patrick Valcke, MD, University of Saskatchewan, […]

Frost Series #339 Written by: David Kaplan, MD, and Dmitri Bezinover, MD Reviewed by: Sonia Vaida, MD Since Thomas Starzl, MD, PhD, performed the first successful liver transplant in 1967, optimal intraoperative hemodynamic monitoring has been debated. In the early years, transesophageal echocardiography (TEE) was reserved primarily for patients undergoing cardiac surgery, but is increasingly […]

Authors: Lizaur-Utrilla A et al International Orthopaedics (May 2018) PURPOSE The purposes of this study were to identify the reasons for delayed surgery following hip fractures and analyze the impact of these reasons on 1-year mortality. METHODS A prospective cohort study of 1234 patients with mean age of 83.1 (range 65-92, SD 8.0) who underwent […]

Authors: Wang P et al.  Gut 2018 May 18 Postprocedure infections are not unusual after colonoscopy or esophagogastroduodenoscopy. Although concerns have been raised regarding bleeding and perforation with endoscopic procedures, little attention has been given to the risk for infection after colonoscopy and esophagogastroduodenoscopy (EGD). To estimate the rate of infections following these procedures, researchers analyzed […]

Authors: Jonathan P. Wanderer et al  Anesthesiology 9 2018, Vol.129, A19. Complex Information for Anesthesiologists Presented Quickly and Clearly  A. fib = atrial fibrillation; CABG = coronary artery bypass graft; MAP = mean arterial pressure; OR = odds ratio. Infographic created by Jonathan P. Wanderer, Vanderbilt University Medical Center, and James P. Rathmell, Brigham and Women’s […]

The incidence rate of major adverse cardiac events (MACEs) after electroconvulsive therapy (ECT)—still commonly used in cases of intractable psychiatric disorders—has been unclear. A new meta-analysis, however, has found that such events occur after ECT in as many as one in 50 patients and after approximately one in 500 treatments. “Evidence indicates that ECT use […]