Month: August 2016

Anesthesia Alert: Reduce PONV by “Bookending” Propofol

The key is to get gas out of the patient’s system. Michael Reines, MD Take advantage of propofol’s antiemetic properties by reintroducing it toward the end of the procedure. I‘ve developed an anesthetic technique that significantly reduces PONV and costs, and improves patient, surgeon and nurse satisfaction. I call it “bookending,” because it involves using […]

The Impact of Surgery and Stored Red Blood Cell Transfusions on Nitric Oxide Homeostasis

Anesthesia & Analgesia: August 2016 – Volume 123 – Issue 2 – p 274–282 AUTHORS: Nagababu, Enika PhD et al BACKGROUND: Cell-free hemoglobin (Hb) forms in stored red blood cells (RBCs) as a result of hemolysis. Studies suggest that this cell-free Hb may decrease nitric oxide (NO) bioavailability, potentially leading to endothelial dysfunction, vascular injury, […]

The Use of Ultrasound Guidance for Perioperative Neuraxial and Peripheral Nerve Blocks in Children: A Cochrane Review.

Anesthesia & Analgesia: June 15, 2016 AUTHORS: Guay, Joanne MD et BACKGROUND: Objectives were to determine whether the use of ultrasound guidance offers any clinical advantage in the performance of neuraxial or peripheral nerve blocks in children in terms of increasing the success rate or decreasing the rate of complications. METHODS: We searched the following […]

Researchers Surprised by Opioid Scripts for Low-Risk Surgical Procedures

Tissue Oximetry and Clinical Outcomes.

Anesthesia & Analgesia: June 15, 2016 AUTHORS: Bickler, Philip MD, PhD et al A number of different technologies have been developed to measure tissue oxygenation, with the goal of identifying tissue hypoxia and guiding therapy to prevent patient harm. In specific cases, tissue oximetry may provide clear indications of decreases in tissue oxygenation such as […]

Effect of Individual Surgeons and Anesthesiologists on Operating Room Time

Anesthesia & Analgesia: August 2016 – Volume 123 – Issue 2 – p 445–451 AUTHORS: van Eijk, Ruben P. A. MD et al BACKGROUND: Variability in operating room (OR) time causes overutilization and underutilization of the available ORs. There is evidence that for a given type of procedure, the surgeon is the major source of […]

Clinical Practice Guidelines for the Management of Neuropathic Pain

A Systematic Review Authors: Yunkun Deng et al BMC Anesthesiol. 2016;16(12) Background: The management of neuropathic pain (NP) is challenging despite it being the recent focus of extensive research. A number of clinical practice guidelines (CPGs) for the management of NP have been published worldwide over the past 2 decades. This study aimed to assess the quality […]

Anesthesia Exposure and Risk of Dementia and Alzheimer’s Disease: A Prospective Study

Authors: Erin J. Aiello Bowles, MPH et al J Am Geriatr Soc. 2016;64(3):602-607. Objectives: To evaluate the associations between anesthesia and dementia or Alzheimer’s disease (AD) risk using prospectively collected data. Design: Cohort study. Participants: Community-dwelling members of the Adult Changes in Thought cohort aged 65 and older and free of dementia at baseline (N = 3,988). Measurements: Participants self-reported […]

Researchers Surprised by Opioid Scripts for Low-Risk Surgical Procedures

Opioid-naive adults who underwent at least one of four low-risk surgical procedures—carpal tunnel release, laparoscopic cholecystectomy (gallbladder removal), inguinal hernia repair and knee arthroscopy—in the years 2004, 2008 and 2012 were prescribed over time an increasing mean opioid morphine equivalent for postoperative pain. The adjusted increase was highest for knee arthroscopy (18%), according to a JAMA research […]

Does the Perioperative Surgical Home Model Affect Malpractice Coverage?

Do the increased responsibilities inherent in the perioperative surgical home (PSH) model mean that anesthesiologists are necessarily increasing their legal vulnerabilities? Although the advent of the PSH concept has been a boon for many anesthesiologists looking to expand the scope of their responsibilities and cement their position in this innovative medical care model, these impending […]