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Authors: Sebastian Zaremba, M.D. et al Anesthesiology published on 5 2016. Background: Bariatric surgery patients are vulnerable to sleep-disordered breathing (SDB) early after recovery from surgery and anesthesia. The authors hypothesized that continuous positive airway pressure (CPAP) improves postoperative oxygenation and SDB and mitigates opioid-induced respiratory depression. Methods: In a randomized crossover trial, patients after bariatric surgery received […]
Read MoreAnesthesia & Analgesia: May 2016 – Volume 122 – Issue 5 – p 1603–1613 AUTHORS: Glance, Laurent G. MD et al BACKGROUND: In creating the Merit-Based Incentive Payment System, Congress has mandated pay-for-performance (P4P) for all physicians, including anesthesiologists. There are currently no National Quality Forum–endorsed risk-adjusted outcome metrics for anesthesiologists to use as the […]
Read MoreAuthors: Eun-Ho Lee, M.D. et al Anesthesiology 5 2016, Vol.124, 1001-1011 Background: Hypoalbuminemia may increase the risk of acute kidney injury (AKI). The authors investigated whether the immediate preoperative administration of 20% albumin solution affects the incidence of AKI after off-pump coronary artery bypass surgery. Methods: In this prospective, single-center, randomized, parallel-arm double-blind trial, 220 patients with preoperative […]
Read MoreStudy finds fentanyl transdermal patches are too often prescribed to opioid-naïve and elderly patients, raising their risks of fatal adverse drug events. Interview with Caleb Alexander, MD Fentanyl patches are a highly potent options for cancer and non-cancer pain patients, but are contraindicated in opioid naïve patients. However, new research indicates that physicians may be […]
Read MoreAuthors: Andrew P. Wojtovich, Ph.D. et al Anesthesiology 5 2016, Vol.124, 1065-1076. Background: Anesthetic preconditioning (APC) is a clinically important phenomenon in which volatile anesthetics (VAs) protect tissues such as heart against ischemic injury. The mechanism of APC is thought to involve K+ channels encoded by the Slo gene family, and the authors showed previously that slo-2 is required for APC inCaenorhabditis […]
Read MoreEdited by Susan Sadoughi, MD, and André Sofair, MD, MPH Contrary to its marketing claims, OxyContin’s pain-relieving effects often fall short of 12 hours in many patients, which can lead to a host of other problems, according to an investigation by the Los Angeles Times. OxyContin is approved for 12-hour dosing. Several studies found that the drug’s effects […]
Read MoreAuthors: Roy G. Soto, M.D. et al ASA Monitor 05 2016, Vol.80, 28-29. First off, let’s agree on two basic concepts: capitalism is good and patient safety is good. For decades we have been tempted with a never-ending parade of new, expensive devices and medications that are touted to improve safety and outcomes. Sometimes the acquisition cost […]
Read MoreAuthors: Matthew E. Patterson, M.D. et al ASA Monitor 05 2016, Vol.80, 26-27. The Perioperative Surgical Home (PSH) model of care has been developed in an attempt to streamline patient recovery by providing evidence-based care and reducing care variability. Although much attention has been placed on medications, techniques and devices that can accomplish this variability reduction, we […]
Read MoreAuthors: Keith J. Ruskin, M.D. et al ASA Monitor 05 2016, Vol.80, 20-21. Every industry has taken steps to improve employee safety by decreasing the possibility of industrial accidents and individual injuries. Mass transportation and health care are significantly different from other business sectors (e.g., manufacturing) and share several common features. For example, a factory might […]
Read MoreAuthors: Antoine Monsel, M.D., M.Sc. et al Anesthesiology 5 2016, Vol.124, 1041-1052. Background: Patients undergoing major vascular surgery often develop postoperative pneumonia that impacts their outcomes. Conflicting data exist concerning the potential benefit of tapered-shaped cuffs on tracheal sealing. The primary objective of this study was to assess the efficiency of a polyvinyl chloride tapered-cuff endotracheal tube […]
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