Month: January 2016

Uncategorized Published - 13 January, 2016    By - Dr Clemens
Impact of Metabolic Syndrome in Surgical Patients

Tzimas et al Br J Anaesth. 2015;115(2):194-202. Abstract Clinicians inevitably encounter patients who meet the diagnostic criteria for the metabolic syndrome (MetS); these criteria include central obesity, hypertension, atherogenic dyslipidaemia, and hyperglycaemia. Regardless of the variations in its definition, MetS may be associated with adverse outcomes in patients undergoing both cardiac and non-cardiac surgery. There is […]

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Uncategorized Published - 13 January, 2016    By - Dr Clemens
Epidural Blockade Affects the Pharmacokinetics of Propofol in Surgical Patients

Anesthesia & Analgesia: December 2015 Sitsen, Elske MD et al BACKGROUND: Neuraxial blockade reduces the dose requirements of sedative agents. It is unclear whether neuraxial blockade affects the pharmacokinetics and/or the pharmacodynamics of IV hypnotics. We therefore studied the influence of epidural blockade on the pharmacokinetics of propofol in patients scheduled for general surgery. METHODS: […]

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Uncategorized Published - 13 January, 2016    By - Dr Clemens
A Comparison of Photoplethysmography Versus Esophageal Doppler for the Assessment of Cardiac Index During Major Noncardiac Surgery

Anesthesia & Analgesia: December 2015 Blanié, Antonia MD et al BACKGROUND: In this prospective observational study, we compared changes in cardiac index (CI) during fluid challenge using photoplethysmography (PPG; Nexfin(TM)) (CIPPG) versus esophageal Doppler (ED) (CIED) in major noncardiac surgery patients. METHODS: Measurements were obtained when the attending anesthesiologist decided to perform a fluid challenge. […]

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Uncategorized Published - 13 January, 2016    By - Dr Clemens
Discordance in Grading Methods of Aortic Stenosis by Pre-Cardiopulmonary Bypass Transesophageal Echocardiography

Anesthesia & Analgesia: December 2015 Whitener, George MD et al BACKGROUND: Current guidelines define severe aortic valve stenosis (AS) as an aortic valve area (AVA) <=1.0 cm2 by the continuity equation and mean gradient ([DELTA]Pm) >= 40 mm Hg. However, these measurements can be discordant when classifying AS severity. Approximately one-third of patients with normal […]

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Uncategorized Published - 13 January, 2016    By - Dr Clemens
Risk for Cognitive Decline Greater in Older Women Following General Anesthesia and Surgery

Older women appear to be at higher risk than older men for deterioration in neurologic and cognitive functioning as well as ventricular brain volumes following the administration of general anesthesia and surgery. That was the conclusion of a study that tracked cognitive aging in more than 500 elderly people over time. Elderly women and men […]

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Uncategorized Published - 12 January, 2016    By - Dr Clemens
GlideScope Outperforms C-MAC D-Blade for Trainee Intubations of Predicted Difficult Airways

Aziz MF et al., Anesth Analg 2015 Nov In patients with predicted difficult airways intubated in the operating room, the GlideScope had a higher first-attempt intubation success rate than the C-MAC D-Blade. Video laryngoscopy (VL) improves intubation success in patients with predicted difficult airways primarily by ensuring glottic visualization. While VL with acute-angled devices has been compared […]

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Uncategorized Published - 12 January, 2016    By - Dr Clemens
Attending Handoff Is Correlated with the Decision to Delay Extubation After Surgery.

  Anesthesia & Analgesia: December 2015 Anastasian, Zirka H. MD et al BACKGROUND: Factors including ASA physical status, blood loss, and case length have been described as correlating with the decision to delay tracheal extubation after specific surgical procedures. In this retrospective study, we investigated whether handoffs by anesthesia attendings were associated with delayed extubation […]

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Uncategorized Published - 12 January, 2016    By - Dr Clemens
The Shamrock lumbar plexus block: A dose-finding study

Eur J Anaesthesiol. 2015 Nov;32(11):764-70 Sauter AR et al BACKGROUND: The Shamrock technique is a new method for ultrasound-guided lumbar plexus blockade. Data on the optimal local anaesthetic dose are not available. OBJECTIVE: The objective of this study is to estimate the effective dose of ropivacaine 0.5% for a Shamrock lumbar plexus block. DESIGN: A prospective […]

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Uncategorized Published - 12 January, 2016    By - Dr Clemens
Comparison of efficacy and safety of lateral-to-medial continuous transversus abdominis plane block with thoracic epidural analgesia in patients undergoing abdominal surgery: A randomised, open-label feasibility study

Eur J Anaesthesiol. 2015 Nov;32(11):797-804 Authors: Ganapathy S et al BACKGROUND: We recently described a lateral-to-medial approach for transversus abdominis plane (LM-TAP) block, which may permit preoperative initiation of the block. OBJECTIVE: Our objective was to evaluate the feasibility of continuous LM-TAP blocks in clinical practice in comparison with thoracic epidural analgesia (TEA). DESIGN: A randomised, […]

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Uncategorized Published - 12 January, 2016    By - Dr Clemens
Point-of-Care Viscoelastic Testing Reduces Transfusions, Improves Outcomes in Severe Postpartum Hemorrhage

Point-of-care viscoelastic testing with rotational thromboelastography (ROTEM) is associated with significant reductions in transfusion requirements and better outcomes in patients with severe postpartum hemorrhage. “Contrary to our success in other areas in medicine, maternal mortality in the U.S. continues to grow, slowly but steadily,” said Denis Snegovskikh, MD, assistant professor of anesthesiology and associate chief […]

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