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Rates of severe maternal and neonatal morbidity were similar among superobese women undergoing primary cesarean delivery versus a trial of labor, most often ending in vaginal delivery. Researchers say a prospective clinical trial is needed to determine whether one method of birth is superior to the other in mothers who are superobese. According to Alexander […]
Read MoreAUTHORS: Christensen, Robert E. MD et al Anesthesia & Analgesia: April 2017 – Volume 124 – Issue 4 – p 1231–1236 BACKGROUND: Nearly 20% of anesthesia-related pediatric cardiac arrests (CAs) occur during emergence or recovery. The aims of this case series were to use the Wake Up Safe database to describe the following: (1) the nature […]
Read MoreWhile 70% of anesthesiologists say they “frequently” or “occasionally” encounter postoperative delirium in their practices, more than three-fourths (77%) lack a process to screen for at-risk patients. A survey of nearly 300 anesthesiologists revealed that postoperative delirium is extraordinarily common worldwide, with 95% of respondents reporting they have had such a patient. However, 60% said […]
Read MoreAUTHORS: Denault, André Y. MD, PhD et al Anesthesia & Analgesia: April 2017 – Volume 124 – Issue 4 – p 1109–1115 BACKGROUND: Portal venous flow pulsatility detected by Doppler ultrasound is a sign of congestive heart failure in noncritically ill patients. The assessment of portal and splenic venous flows has never been reported in patients […]
Read MoreAUTHORS: 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 […]
Read MoreAuthors: Timm FP et al., BMJ 2017 Jan 10; 356:i6635 Surgical patients with migraine, particularly those with aura, are at increased risk for perioperative ischemic stroke and postsurgical 30-day hospital readmission. To explore the association of migraine with perioperative stroke and 30-day hospital readmission, investigators reviewed prospective hospital registry data for all patients who underwent surgery under […]
Read MoreAlthough enhanced recovery pathways are beginning to gain a foothold in the inpatient arena, their place in the ambulatory setting is only now evolving, particularly for cancer patients. Research shows, however, that procedure-specific enhanced recovery pathways can be successfully implemented in outpatient centers, with marked success in terms of reduction in lengths of stay and […]
Read MoreAUTHORS: 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 […]
Read MoreWhen it comes to the position of the surgical table during elective cesarean delivery, recent research has concluded that leaving the table flat does not impair neonatal acid–base status compared with the 15-degree tilt position. The investigators also found that a 15-degree left lateral tilt had a negligible effect on maternal hemodynamic parameters (Figures 1 […]
Read MoreKathryn E. McGoldrick, MD, FCAI(Hon) ‘Into whatever houses I enter, I will go into them for the benefit of the sick and will abstain from every voluntary mischief and corruption.’ —Hippocratic Oath Although it is perhaps less true today than four or five decades ago, physicians are often perceived by the public—and possibly by doctors […]
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