Month: May 2017

Uncategorized Published - 31 May, 2017    By - Dr Clemens
A Three-arm Randomized Clinical Trial Comparing Continuous Femoral Plus Single-injection Sciatic Peripheral Nerve Blocks versus Periarticular Injection with Ropivacaine or Liposomal Bupivacaine for Patients Undergoing Total Knee Arthroplasty

Authors: Adam W. Amundson, M.D. et al Anesthesiology 6 2017, Vol.126, 1139-1150. Background: Multimodal analgesia is standard practice for total knee arthroplasty; however, the role of regional techniques in improved perioperative outcomes remains unknown. The authors hypothesized that peripheral nerve blockade would result in lower pain scores and opioid consumption than two competing periarticular injection solutions. Methods: This […]

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Uncategorized Published - 31 May, 2017    By - Dr Clemens
Prevalence and Impact on Weaning of Pleural Effusion at the Time of Liberation from Mechanical Ventilation: A Multicenter Prospective Observational Study

Authors: Martin Dres, M.D. et al Anesthesiology 6 2017, Vol.126, 1107-1115. Background: Pleural effusion is frequent in intensive care unit patients, but its impact on the outcome of weaning remains unknown. Methods: In a prospective study performed in three intensive care units, pleural ultrasound was performed at the first spontaneous breathing trial to detect and quantify pleural effusion […]

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Uncategorized Published - 31 May, 2017    By - Dr Clemens
Brachial Arterial Pressure Monitoring during Cardiac Surgery Rarely Causes Complications

Authors: Asha Singh, M.D. et al Anesthesiology 6 2017, Vol.126, 1065-1076. Background: Brachial arterial catheters better estimate aortic pressure than radial arterial catheters but are used infrequently because complications in a major artery without collateral flow are potentially serious. However, the extent to which brachial artery cannulation promotes complications remains unknown. The authors thus evaluated a large […]

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Uncategorized Published - 31 May, 2017    By - Dr Clemens
Risk of Epidural Hematoma after Neuraxial Techniques in Thrombocytopenic Parturients: A Report from the Multicenter Perioperative Outcomes Group

Authors: Linden O. Lee, M.D. et al Anesthesiology 6 2017, Vol.126, 1053-1063. Background: Thrombocytopenia has been considered a relative or even absolute contraindication to neuraxial techniques due to the risk of epidural hematoma. There is limited literature to estimate the risk of epidural hematoma in thrombocytopenic parturients. The authors reviewed a large perioperative database and performed a […]

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Uncategorized Published - 31 May, 2017    By - Dr Clemens
Long-Acting Opioids Tied to Increased Mortality Unrelated to Overdose

Edited by Susan Sadoughi, MD Use of long-acting opioids for chronic noncancer pain is associated with increased risk for all-cause and cardiovascular mortality, suggests a retrospective study in JAMA. Using Tennessee Medicaid data from 1999 through 2012, researchers matched nearly 23,000 new instances of long-acting opioid prescriptions with 23,000 episodes of control medication prescriptions (analgesic anticonvulsants or […]

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Uncategorized Published - 30 May, 2017    By - Dr Clemens
Clinical Judgment Is Not Reliable for Reducing Whole-body Computed Tomography Scanning after Isolated High-energy Blunt Trauma

Authors: Thomas Mistral, M.D. et al Anesthesiology 6 2017, Vol.126, 1116-1124. Background: The purpose of this study was to test the diagnostic performance of clinical judgment for the prediction of a significant injury with whole-body computed tomography scanning after high-energy trauma. Methods: The authors conducted an observational prospective study in a single level-I trauma center. Adult patients were […]

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Uncategorized Published - 30 May, 2017    By - Dr Clemens
The Effect of Fixation Technique on Continuous Interscalene Nerve Block Catheter Success: A Randomized, Double-Blind Trial

AUTHORS: Auyong, David B. MD et al Anesthesia & Analgesia: March 2017 – Volume 124 – Issue 3 – p 959–965 BACKGROUND: Continuous peripheral nerve blocks offer advantages over single-injection blocks, including extended analgesia and reduction in opioid consumption. These benefits require that the perineural catheter remain intact for the duration of the planned local anesthetic […]

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Uncategorized Published - 30 May, 2017    By - Dr Clemens
The Use of Ultrasound Guidance for Perioperative Neuraxial and Peripheral Nerve Blocks in Children: A Cochrane Review

AUTHORS: Guay, Joanne MD et al Anesthesia & Analgesia: March 2017 – Volume 124 – Issue 3 – p 948–958 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 […]

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Uncategorized Published - 30 May, 2017    By - Dr Clemens
Associations Between Impaired Cerebral Blood Flow Autoregulation, Cerebral Oxygenation, and Biomarkers of Brain Injury and Postoperative Cognitive Dysfunction in Elderly Patients After Major Noncardiac Surgery

AUTHORS: Goettel, Nicolai MD et al Anesthesia & Analgesia: March 2017 – Volume 124 – Issue 3 – p 934–942 BACKGROUND: Increasing evidence links postoperative cognitive dysfunction (POCD) to surgery and anesthesia. POCD is recognized as an important neuropsychological adverse outcome in surgical patients, particularly the elderly. This prospective cohort study aimed to investigate whether POCD […]

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Uncategorized Published - 30 May, 2017    By - Dr Clemens
Economic Evaluation of Pharmacologic Pre- and Postconditioning With Sevoflurane Compared With Total Intravenous Anesthesia in Liver Surgery: A Cost Analysis

AUTHORS: Eichler, Klaus MD, MPH et al Anesthesia & Analgesia: March 2017 – Volume 124 – Issue 3 – p 925–933 BACKGROUND: Pharmacologic pre- and postconditioning with sevoflurane compared with total IV anesthesia in patients undergoing liver surgery reduced complication rates as shown in 2 recent randomized controlled trials. However, the potential health economic consequences of […]

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