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In recent years, transmucosal fentanyl formulations have been shown to be superior to immediate-release oral morphine. Fentanyl sublingual tablets (FST) are preferred over subcutaneous morphine (SCM) in patients with severe breakthrough cancer pain, but FST may not be as effective as SCM, according to a study published in the Journal of Clinical Oncology.1 Patients who require […]
Read MoreCase Report: Adam A. Dalia, MD, MBA Cardiothoracic Anesthesiology Fellow Department of Anesthesia, Critical Care, and Pain Medicine Massachusetts General Hospital Boston, Massachusetts Michael K. Essandoh, MD Associate Director of Clinical Research Associate Professor, Clinical Cardiovascular Anesthesiology Department of Anesthesiology The Ohio State University Medical Center Columbus, Ohio Routine mediastinoscopy can be a fairly low-risk […]
Read MoreAUTHORS: Karkouti, Keyvan MD, FRCPC et al Anesthesia & Analgesia: June 2017 – Volume 124 – Issue 6 – p 1986–1991 BACKGROUND: Red cell viability is impaired during storage, resulting in excess hemolysis during storage and after transfusion. As a result, transfusions may oversaturate the hemoglobin clearance pathways, resulting in cell-free hemoglobin and iron toxicity in […]
Read MoreThe Johns Hopkins Armstrong Institute for Patient Safety and Quality has been awarded nearly $4 million to improve surgical care across the United States, Johns Hopkins Medicine announced. This money will be used, in collaboration with the American College of Surgeons, to help implement enhanced recovery after surgery (ERAS) protocols in more than 750 hospitals. […]
Read MoreNew-onset atrial fibrillation (AF) after surgery still occurs frequently among cardiac surgery patients, despite advances in therapeutic options, and leads to significantly more morbidity. “Atrial fibrillation is the most common postoperative complication in cardiac surgery, has numerous negative effects on patients and is very costly for the health care system as a whole,” said Jean […]
Read MoreNondrug treatment alternatives should be considered as first-line therapy for patients with low back pain (LBP), according to an updated clinical practice guideline from the American College of Physicians (ACP). The new guideline offered three main recommendations for treating acute (less than four weeks), subacute (four to 12 weeks) and chronic (>12 weeks) LBP: • Nonpharmacologic treatments […]
Read MoreRepetitive transcranial magnetic stimulation (rTMS) significantly reduced phantom limb pain in patients who had lost limbs to land mine explosions for up to 15 days, according to a study in the Journal of Pain (2016 ;17:911-918). Sixty-three percent of patients experienced a greater than 50% reduction in pain. No significant side effects were reported. Fifty-four patients with […]
Read MoreA large French study has shown that monitoring both hemoglobin (SpHb) and plethysmography variability index (PVI) as part of a vascular filling algorithm allows for optimal transfusion among surgical patients, thereby reducing mortality. The researchers noted that inclusion of such noninvasive devices may significantly affect patient outcomes in the future, particularly among patients undergoing serious, […]
Read MoreA study that compared epidurals placed in the L5-S1 interspace and those placed in the most clinically accessible lumbar interspace cephalad found no significant differences in efficacy. The mean number of dermatomes blocked, number of interventions required to achieve adequate analgesia, and pain scores following epidural placement and at delivery were all similar in the […]
Read MoreAuthors: Lascarrou J et al Journal of the American Medical Association (JAMA) 317 (5), 483-493 (2017) Importance In the intensive care unit (ICU), orotracheal intubation can be associated with increased risk of complications because the patient may be acutely unstable, requiring prompt intervention, often by a practitioner with nonexpert skills. Video laryngoscopy may decrease this […]
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