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Researchers have found that pupillary light reflex (PLR) recovery from general anesthesia (GA) varies greatly among patients, regardless of the anesthesia drug used. Thus while PLR has long been used in the neurologic assessment of an anesthetized patient, physicians should be cautious about using the technique to measure brain stem function in patients who have […]
Read MoreValue-based reimbursement and alternative payment models are putting increased pressure on the profitability of joint replacement procedures. Although same-day discharge is not a common part of these programs yet, according to James D. Slover, MD, the new payment paradigm will favor ambulatory surgery in the future. At the 2017 Interdisciplinary Conference on Orthopedic Value-Based Care, […]
Read MoreConcerns with the safety and adverse effects of opioids have grown with increases in prescribing and dose, and higher doses have been associated with worse patient-reported outcomes in a study by researchers at Veterans Affairs (VA) and Kaiser Permanente health systems. Benjamin Morasco, PhD, and his colleagues at the VA Portland Health Care System and […]
Read MoreWidely used anesthetic “derails” kinesin motor proteins The widely used anesthetic propofol is considered a safe and effective drug for use in general anesthesia. But how propofol induces unconsciousness is poorly understood. Research published in the Proceedings of the National Academy of Science, and supported by the National Institutes of Health, identifies a previously unknown mechanism […]
Read MoreSix months after knee replacement surgery, pain outcomes were not as good for patients who previously took prescription opioids, according to a study published in The Journal of Bone & Joint Surgery. “Our results should be viewed as a warning that using opioids during the preoperative period may be problematic due to their negative effects […]
Read MoreThe commonly used antibiotic azithromycin is not linked to an increased risk for ventricular arrhythmia. Rather the adverse event is more likely due to infection or patient characteristics, according to a large study (CMAJ 2017 Apr 18. “Using an incredibly large and robust population and strong methods they show that the risk associated with azithromycin, a […]
Read MoreScientists have observed that standard timing for percutaneous endoscopic gastrostomy (PEG) placement in patients with traumatic brain injury (TBI), between seven and 14 days after the injury, is best for minimizing related mortality. However, further study is needed. PEG placement, a frequently performed procedure providing patients with nutrients via enteral feeding, comes with risks. Short-term […]
Read MoreAnesthesia type is a significant predictor of postoperative delirium in patients undergoing unilateral total knee arthroplasty. According to a retrospective analysis of anesthesia billing data, International Classification of Diseases, Ninth Revision (ICD-9) codes and demographic information, patients who have received general anesthesia may be twice as likely to develop delirium postoperatively when compared with combined […]
Read MoreCaudal blocks are increasingly being used in the pediatric population to provide pain control after abdominal surgery. Caudal block for postoperative analgesia in pediatric populations may result in an increase in intracranial pressure when performed with a high volume of local anesthetic, or at certain concentrations of anesthetic, according to a study recently published in […]
Read MoreHaving an internal jugular (IJ) catheter with a concurrent tracheostomy did not increase the risk for central line–associated bloodstream infections (CLABSIs) among ICU patients. “Our data challenges what seems to be the standard when placing lines in patients with tracheostomy,” said Dana L. Russell, MPH, the lead author of the single-center, retrospective, matched case-control study […]
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