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Published in Anesth Analg. 2014 Jul;119(1):170-8 Authors: Sawynok J. et al Abstract Ketamine, in subanesthetic doses, produces systemic analgesia in chronic pain settings, an action largely attributed to block of N-methyl-D-aspartate receptors in the spinal cord and inhibition of central sensitization processes. N-methyl-D-aspartate receptors also are located peripherally on sensory afferent nerve endings, and this […]
Read MoreThe multifaceted problem of sharply rising opioid prescribing and related overdose deaths, which peaked in 2009, has been further analyzed by a research group in a recently published paper PM R 2014 Jan 9. The Stanford University team used 1997-2009 data from the large National Ambulatory and National Health Ambulatory Medical Care Surveys from the […]
Read MorePublished in Anesth Analg. 2014 Jul;119(1):137-40. Authors: Buck D et al Abstract An otherwise healthy 11-month-old, 8-kg infant presented for an elective circumcision. After a penile block with an excessive dose of 0.5% bupivacaine, the patient progressed to ventricular tachycardia. He was resuscitated with intralipid and had an uneventful recovery. The case was classified as […]
Read MoreLocal infiltration analgesia (LIA) provides effective analgesia early after total knee arthroplasty but has limited efficacy after total hip arthroplasty, according to results of a systematic review. “LIA should preferably be used in combination with evidence-based multimodal systemic analgesia,” Dr. Lasse O. Andersen from Bispebjerg Hospital in Copenhagen, Denmark told Reuters Health by email. “For […]
Read MoreBy implementing protocols that restrict the use of erythropoietin-stimulating agents (ESAs), hospitals can successfully cut costs while maintaining an equivalent level of patient care, according to two recent studies. At St. John Hospital and Medical Center in Detroit, a policy that delayed ESA administration to certain patients decreased ESA purchases by more than $16,000 per […]
Read MorePublished in Br J Anaesth. 2014;112(5):784-787. Authors: S. Kozek-Langenecker, D. Fries, D. R. Spahn, K. Zacharowski A recent systematic review, ‘Fibrinogen concentrate in bleeding patients’, published by The Cochrane Collaboration, aimed to assess the benefits and harms of fibrinogen concentrate compared with placebo or other treatments in bleeding patients. We agree with the authors finding […]
Read MoreIn a period of rapid change, physician practices react differently to the resulting uncertainty. Hospitals seek to employ or otherwise “align” primary care physicians. They seek to control specialty referrals through employment models, accountable care organizations and other hospital-centric networks. And particularly for anesthesiologists, competitive pressure is mounting from large regional and national groups. Many […]
Read MorePreoperative medication compliance improved when patients were given a simple, standardized, multicolored medication instruction sheet combined with verbal instructions, according to an article published in the July issue of Anesthesiology. Failure to remember and comply with instructions can result in rescheduled same-day surgeries and longer hospital stays. Patients in the study were scheduled for general […]
Read MoreRates of infection secondary to CABG surgery varied widely across a 33-hospital consortium engaged in an adult cardiac-surgery quality initiative in Michigan[1]. The variation was less pronounced but still substantial after adjustment for comorbidities and other patient-related factors. Isolated pneumonia was overwhelmingly the most common CABG-related infection, seen in about 3% of the total population […]
Read MoreI thought this was interesting so I wanted to share it with our readers. A prior caesarean section is associated with a small increased rate of subsequent stillbirth and ectopic pregnancy. The increased rate is confounded, however, by underlying medical conditions, as well as the indication for the primary caesarean delivery. Sinéad M. O’Neill, MPH, […]
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