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Authors: Wenhua Zhang, M.D. et al Anesthesiology published on September 15, 2016. Background: The median effective dose (ED50) of intranasal dexmedetomidine after failed chloral hydrate sedation has not been described for children. This study aims to determine the ED50 of intranasal dexmedetomidine for rescue sedation in children aged 1 to 36 months, who were inadequately sedated by chloral […]
Read MoreAuthors: Brian S. Rothman, M.D. et al Anesthesiology 9 2016, Vol.125, 484-494 Background: “Wrong surgery” is defined as wrong site, wrong operation, or wrong patient, with estimated incidence up to 1 per 5,000 cases. Responding to national attention on wrong surgery, our objective was to create a care redesign intervention to minimize the rate of wrong surgery. […]
Read MoreAuthors: Jacques T. YaDeau, M.D., Ph.D. et al Anesthesiology 9 2016, Vol.125, 561-572 Background: Duloxetine is effective for chronic musculoskeletal and neuropathic pain, but there are insufficient data to recommend the use of antidepressants for postoperative pain. The authors hypothesized that administration of duloxetine for 15 days would reduce pain with ambulation at 2 weeks after total […]
Read MoreAuthors: Xin-Hai Wu, M.D. et al Anesthesiology published on September 1, 2016 Background: Patients admitted to the intensive care unit (ICU) after surgery often develop sleep disturbances. The authors tested the hypothesis that low-dose dexmedetomidine infusion could improve sleep architecture in nonmechanically ventilated elderly patients in the ICU after surgery. Methods: This was a pilot, randomized controlled trial. […]
Read MoreAuthors: Philippe Sitbon, M.D. et al Anesthesiology published on September 1, 2016 Background: Opiorphin is a naturally occurring potent analgesic human peptide. It protects enkephalins from degradation and inhibits pain perception in various acute pain models via activation of endogenous opioid pathways. However, the efficacy of opiorphin continuous infusion and its chemically stable form, STR-324, in postoperative […]
Read MoreAuthors: Jessica M. Booth, M.D. et al Anesthesiology 9 2016, Vol.125, 516-524. Background: It is unclear whether recognition of epidural catheter failures is delayed with combined spinal epidural technique (CSE) compared to traditional epidural technique (EPID) when used for labor analgesia. The authors hypothesized that recognition of failed catheters is not delayed by CSE. Methods: Anesthetic, obstetric, and […]
Read MoreAleva FE et al., Chest 2016 Aug 12; This systematic review shows a high rate of PE in patients hospitalized for exacerbation of chronic obstructive pulmonary disease. Pulmonary embolism (PE) is a notoriously difficult clinical diagnosis, and symptoms of PE can overlap with those of acute exacerbations of chronic obstructive pulmonary disease (COPD). Further, the inflammation of […]
Read MoreHarlan M. Krumholz, MD, SM Reviewing McEvoy RD et al., N Engl J Med 2016 Aug 28; In a multicenter trial, patients with cardiovascular disease and obstructive sleep apnea had no reduction in risk. Continuous positive airway pressure (CPAP) is a common treatment for obstructive sleep apnea, a risk factor for cardiovascular disease. However, little is known about […]
Read MoreEdited by André Sofair, MD, MPH, and William E. Chavey, MD, MS Migraine in children is associated with increased risk for functional gastrointestinal disorders, according to a case-control study in the Lancet Gastroenterology & Hepatology. Researchers studied 425 children aged 6–17 years who were diagnosed with migraine or tension-type headache in the emergency department, and 650 children who […]
Read MoreHirsch JA and Chandra RV., Lancet 2016 Aug 17; The procedure benefitted some highly selected patients when performed a few weeks after vertebral fracture. Vertebroplasty is injection of polymethylmethacrylate “cement” into a fractured vertebral body to reduce pain and disability. The popularity of this procedure declined after 2009, when two randomized, sham-controlled trials showed no benefit (NEJM […]
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