ASA Monitor February 2021, Vol. 85, 11–12. Special thanks to Aubrey Samost-Williams, MD, for her contributions to this article. CASE 2021-2: Systems Problem An urgent caesarean section presented to the OR when one of the narcotic dispensing drawers was unable to be closed. This disabled the entire cart, which was a combined automated medication dispensing system […]
Updated Results from Insurance Carrier and Contracting Survey
Author: Beverly K. Philip MD FACA, FASA President of ASA Monday Morning Outreach We now have three weeks’ worth of data from our insurance carrier survey, where we’re learning about unilateral reduction in payments and contract terminations from some of you. We will use this data to advocate on behalf of our many members and […]
Comparison of Monotherapy Versus Combination of Intravenous Ibuprofen and Propacetamol (Acetaminophen) for Reduction of Postoperative Opioid Administration in Children Undergoing Laparoscopic Hernia Repair
AUTHORS: Lee, Hye-Mi MD et al Anesthesia & Analgesia: November 2020 BACKGROUND: Extensive efforts have been made toward reducing postoperative opioid use in children. In this study, we assessed whether propacetamol, or a nonsteroidal anti-inflammatory drug (NSAID), or their combination could effectively reduce opioid use in children after laparoscopic inguinal hernia repair. METHODS: This randomized, […]
“Silent” Presentation of Hypoxemia and Cardiorespiratory Compensation in COVID-19
Authors: Philip E. Bickler, M.D., Ph.D.et al Anesthesiology February 2021, Vol. 134, 262–269. The Coronavirus infection disease 2019 (COVID-19) pandemic is bringing unprecedented numbers of patients with significant hypoxemia to medical care. It is critical that clinicians caring for hypoxemic patients recognize two facts: (1) it is common for hypoxemia to exist without dyspnea (“silent hypoxia”); […]
Clinical Effectiveness of Liposomal Bupivacaine Administered by Infiltration or Peripheral Nerve Block to Treat Postoperative Pain
Authors: Brian M. Ilfeld, M.D., M.S. et al Anesthesiology February 2021, Vol. 134, 283–344. The authors provide a comprehensive summary of all randomized, controlled trials (n = 76) involving the clinical administration of liposomal bupivacaine (Exparel; Pacira Pharmaceuticals, USA) to control postoperative pain that are currently published. When infiltrated surgically and compared with unencapsulated bupivacaine or […]
Application of a High-Flow Nasal Cannula for Prevention of Postextubation Atelectasis in Children Undergoing Surgery
AUTHORS: Lee, Ji-Hyun MD, PhD et al Anesthesia & Analgesia: November 2020 BACKGROUND: General anesthesia-induced atelectasis is common, and persistent postoperative atelectasis is associated with pulmonary complications. We aimed to evaluate the preventive effects of a high-flow nasal cannula (HFNC) on postoperative atelectasis and respiratory complications in infants and small children. METHODS: In this prospective […]
Parental Psychosocial Factors Moderate Opioid Administration Following Children’s Surgery
AUTHORS: Kain, Alexandra S. BA et al Anesthesia & Analgesia: November 2020 BACKGROUND: This investigation aimed to examine the impact of parental psychosocial variables on the administration of opioids to young children experiencing postoperative pain. METHODS: Participants in this longitudinal analysis were children ages 2–12 undergoing tonsillectomy with or without adenoidectomy and their parents. Parents […]
Rifampin Reduces the Plasma Concentrations of Oral and Intravenous Hydromorphone in Healthy Volunteers
AUTHORS: Lohela, Terhi J. MD, PhD et al Anesthesia & Analgesia: November 2020 BACKGROUND: Several opioids are metabolized by the inducible cytochrome P450 (CYP) 3A isozymes. Coadministration with strong inducers of drug metabolism, such as rifampin, can dramatically reduce systemic exposure to these opioids. As the CYP metabolism of hydromorphone is of minor importance, we […]
Intraoperative Hypotension Is Associated With Adverse Clinical Outcomes After Noncardiac Surgery
AUTHORS: Gregory, Anne MD, MSc, FRCPC et al Anesthesia & Analgesia: November 2020 BACKGROUND: Intraoperative hypotension (IOH) occurs frequently during surgery and may be associated with organ ischemia; however, few multicenter studies report data regarding its associations with adverse postoperative outcomes across varying hemodynamic thresholds. Additionally, no study has evaluated the association between IOH exposure […]
Logistical Considerations and Clinical Outcomes Associated with Converting Operating Rooms into an Intensive Care Unit during the Covid-19 Pandemic in a New York City Hospital
AUTHORS: Mittel, Aaron M. MD et al Anesthesia & Analgesia: October 2020 Background: Covid-19 emerged as a public health crisis that disrupted normal patterns of health care in the New York City metropolitan area. In preparation for a large influx of critically ill patients, operating rooms (ORs) at NewYork-Presbyterian Hospital/Columbia University Irving Medical Center (NYP-Columbia) […]