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Authors: Allison J. Lee, M.D. Background: Current recommendations for women undergoing cesarean delivery include 15° left tilt for uterine displacement to prevent aortocaval compression, although this degree of tilt is practically never achieved. We hypothesized that under contemporary clinical practice, including a crystalloid coload and phenylephrine infusion targeted at maintaining baseline systolic blood pressure, there would […]
Read MoreEdited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM Concurrent prescription of psychotropic medications and opioids in pregnant women may put their infants at increased risk for neonatal drug withdrawal, according to a study in The BMJ. Using Medicaid data, researchers studied over 200,000 women who were prescribed opioids in the last 45 days of […]
Read MoreAuthors: Stephens RJ et al., Chest 2017 Jun 29; In a prospective study of mechanically ventilated emergency department patients, deeper sedation levels were associated with increased mortality. Deeper sedation levels within the first 48 hours of intensive care unit admission have been associated with longer duration of mechanical ventilation and increased mortality. Unclear, however, is whether deeper […]
Read MoreAuthors: Jacqueline M. Leung, M.D., M.P.H. et al Anesthesiology published on July 20, 2017 Background: Postoperative pain and opioid use are associated with postoperative delirium. We designed a single-center, randomized, placebo-controlled, parallel-arm, double-blinded trial to determine whether perioperative administration of gabapentin reduced postoperative delirium after noncardiac surgery. Methods: Patients were randomly assigned to receive placebo (N = 347) […]
Read MoreAuthors: Juch JNS et al., JAMA 2017 Jul 4; 318:68 The procedure conferred no clinically important improvement in pain related to facet or sacroiliac joints or intervertebral discs. Radiofrequency denervation, or nerve ablation, is used to treat patients with chronic low back pain associated with facet or sacroiliac joints or intervertebral discs. However, evidence of the procedure’s […]
Read MoreAUTHORS: Pustavoitau, Aliaksei MD, MHS et al Anesthesia & Analgesia: May 2017 – Volume 124 – Issue 5 – p 1644–1652 BACKGROUND: Patients undergoing liver transplantation frequently but inconsistently require massive blood transfusion. The ability to predict massive transfusion (MT) could reduce the impact on blood bank resources through customization of the blood order schedule. […]
Read MoreThe 16% of Americans who have mental health disorders receive over half of all opioids prescribed in the United States. Improving pain management among this population is critical to reduce national dependency on opioids, noted the authors. By Vickie Connor and Kaiser Health News Adults with a mental illness receive more than 50% of the 115 million opioid […]
Read MoreAuthors: Paul J. Zufferey, M.D., Ph.D. et al Anesthesiology 9 2017, Vol.127, 413-422. Background: Preoperative administration of the antifibrinolytic agent tranexamic acid reduces bleeding in patients undergoing hip arthroplasty. Increased fibrinolytic activity is maintained throughout the first day postoperation. The objective of the study was to determine whether additional perioperative administration of tranexamic acid would further reduce […]
Read MoreAnesthesiology 9 2017, Vol.127, 423-431. Authors: Eun-Hee Kim, M.D. et al Background: We evaluated the posterior tibial artery as an alternative arterial cannulation site to the radial artery in small children. Methods: A two-stage study was conducted. First, we evaluated the anatomical characteristics of the posterior tibial artery compared with the radial and dorsalis pedis arteries. Next, a […]
Read MoreAuthors: Binks MJ et al. Am J Emerg Med 2017 Jun 24; Two meta-analyses used different methods but have similar findings. Apneic oxygenation is the delivery of high-flow oxygen by nasal cannula during endotracheal intubation. Two separate meta-analyses provide pooled results from trials of apneic oxygenation. The first meta-analysis included 8 studies and 1953 patients in […]
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