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Postoperative use of opioid analgesics increases the risk of respiratory depression, which can lead to brain damage or death. Perioperative lidocaine does not reduce morphine use in the first 24 hours after posterior spinal arthrodesis and offers no measurable benefits, according to a randomized placebo-controlled trial recently published in Pain.1 Postoperative use of opioid analgesics increases the risk […]
Read MoreAuthors: Jessica L. Booth, M.D. et al Anesthesiology 7 2017, Vol.127, 50-57. Background: The addition of opioids to epidural local anesthetic reduces local anesthetic consumption by 20% but at the expense of side effects and time spent for regulatory compliance paperwork. Epidural neostigmine also reduces local anesthetic use. The authors hypothesized that epidural bupivacaine with neostigmine would […]
Read MoreAUTHORS: Lee, Alex T. MD et al Anesthesia & Analgesia: August 2017 – Volume 125 – Issue 2 – p 514–520 BACKGROUND: Antiplatelet medications are usually discontinued before elective neurosurgery, but this is not an option for emergent neurosurgery. We performed a retrospective cohort study to examine whether preoperative aspirin use was associated with worse outcomes […]
Read MoreNonspecific factors include a patient’s spirituality, their trust in a provider’s power to influence treatment outcomes, as well as their expectations. Contextual or nonspecific factors may influence treatment outcomes in patients with chronic pain, according to a study presented at the American Pain Society’s 36th Annual Scientific Meeting in Pittsburgh, Pennsylvania.1 Nonspecific factors include a patient’s spirituality […]
Read MoreNo, this is not a science fiction reference. Rather this represents, at least in my mind, the many skills necessary to become a superb clinician. I write this from the perspective of an internist, but I believe these skills are not specialty specific. 1. History taker. Most patient encounters start with taking a thorough history. […]
Read MoreResearchers Change Practice; Selection Bias Could Explain Results; Proper Technique Key Surgeons speaking at the 2017 annual meeting of the Americas Hernia Society questioned the value of perioperative epidural analgesia in patients undergoing ventral hernia repair after results from a new analysis suggested epidurals may contribute to longer hospital length of stay without any obvious […]
Read MoreAlthough supplemental oxygen is an essential element of patient care for a wide range of clinical conditions, it compromises both carbon dioxide and peripheral capillary O2 saturation monitoring methods, making it difficult to detect respiratory depression. However, that issue may be resolved by the development of a prototype intelligent O2 flowmeter, which delivers supplemental O2 at a variable […]
Read MoreThe benefits of robot-assisted laparoscopic prostatectomy (RALP) have been clouded by doubts about its effect on blood pressure and fluid management, but a new study has found that RALP reduced the volume of fluids and alleviated the need for blood transfusion compared with open radical prostatectomy. According to Hidehisa Saito, MD, a resident at the […]
Read MoreLower limb compression using a sequential compression device (SCD) significantly decreased the incidence of maternal hypotension in women receiving epidural anesthesia, researchers reported here at the annual meeting of the American College of Gynecologists and Obstetricians. Studies find that 30% of patients who choose epidural anesthesia during labor experience hypotension despite the standard prophylaxis of […]
Read MoreA new study assessed temporal summation of the nociceptive flexion reflex (a physiological marker of spinal nociception) and temporal summation of pain. A new study assessed temporal summation of the nociceptive flexion reflex (TS-NFR; a physiological marker of spinal nociception) and temporal summation of pain (TS-Pain), as presented at the American Pain Society 36th Annual Scientific […]
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