Month: January 2018

Uncategorized Published - 5 January, 2018    By - Dr Clemens
Supraglottic Airways Affect Appearance of Neck Masses on MRIs

The use of supraglottic airway (SGA) devices in pediatric patients with neck masses “almost always” has an effect on the appearance of the masses on MRI scans, according to a 10-year review at a single institution. Results from analyzing the MRI scans from databases at the Children’s Hospital of Philadelphia (CHOP) support avoidance of SGA […]

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Uncategorized Published - 5 January, 2018    By - Dr Clemens
Addition of Nasal Cannula Can Either Impair or Enhance Preoxygenation With a Bag Valve Mask: A Randomized Crossover Design Study Comparing Oxygen Flow Rates

AUTHORS: McQuade David MBChB et al Anesthesia & Analgesia: July, 2017 BACKGROUND: A critical safety component of emergency anesthesia is the avoidance of hypoxemia during the apneic phase of a rapid sequence intubation. Preoxygenation with a bag valve mask (BVM) or anesthetic circuit may be improved with supplemental oxygen by nasal cannula (NC) if there is […]

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Uncategorized Published - 5 January, 2018    By - Dr Clemens
Differential Roles of the Right and Left Toe Perfusion Index in Predicting the Incidence of Postspinal Hypotension During Cesarean Delivery

AUTHORS: Xu, Zifeng MD, PhD et al Anesthesia & Analgesia: November 2017 – Volume 125 – Issue 5 – p 1560–1566 BACKGROUND: Aortocaval compression by the gravid uterus, low baseline vasomotor tone, and spinal anesthesia-related sympathetic blockade contribute to spinal anesthesia-induced hypotension during cesarean delivery. The finger perfusion index (PI) can predict spinal hypotension by reflecting baseline […]

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Uncategorized Published - 5 January, 2018    By - Dr Clemens
Gabapentin Improves Postoperative Pain Control in Regional Anesthesia Setting

A meta-analysis of randomized controlled trials shows that gabapentin provides additional analgesia benefit in the regional anesthesia setting across a range of surgical procedures. According to the study authors, however, providers should consider limiting gabapentin to a one-time preoperative dose to maximize analgesic efficacy and modify its potential side-effect profile. “In the setting of regional […]

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Uncategorized Published - 5 January, 2018    By - Dr Clemens
Enoxaparin Bridging for Neuraxial Procedures: 24-Hour Wait May Not Be Enough

Results of a quality improvement study suggest that current time-based guidelines for prophylactic enoxaparin before neuraxial procedures may need to be amended. Despite being more than 24 hours removed from a treatment dose of enoxaparin, nearly 60% of patients presenting for surgery had anti–factor Xa levels within the prophylactic or therapeutic range. Elderly patients appeared […]

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Uncategorized Published - 4 January, 2018    By - Dr Clemens
ASA Urges CMS to Make Necessary Changes to 2018 QPP Implementation

On January 2, 2018, the American Society of Anesthesiologists® (ASA) submitted formal comments to the Centers for Medicare & Medicaid Services (CMS) focused on ensuring physician anesthesiologists have ample opportunities to meaningfully participate and succeed in either the Merit-based Incentive Payments System (MIPS) or Advanced Alternative Payment Models (APMs) pathways under the Quality Payment Program (QPP). […]

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Uncategorized Published - 4 January, 2018    By - Dr Clemens
Feeding in the PICU Is a Balancing Act

Feeding patients in the pediatric ICU (PICU) requires a delicate balance between minimizing protein catabolism and meeting energy requirements, according to presentations at the 2017 annual meeting of the Society of Critical Care Medicine. “Globally, about a third of patients being admitted to the pediatric intensive care unit have preexisting malnutrition,” said Katri V. Typpo, MD, MPH, […]

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Uncategorized Published - 4 January, 2018    By - Dr Clemens
Comparison Between the Cobra Perilaryngeal Airway and Laryngeal Mask Airways Under General Anesthesia: A Systematic Review and Meta-analysis

AUTHORS: Xu, Rui MD et al Anesthesia & Analgesia: September 2017 – Volume 125 – Issue 3 – p 958–966 The complication rate and efficacy of the Cobra Perilaryngeal Airway (CobraPLA) and laryngeal mask airways (LMAs®) have been evaluated in the published literature, but the conclusions have been inconsistent. The aim of this systematic review and […]

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Uncategorized Published - 4 January, 2018    By - Dr Clemens
Venovenous Bypass Is Associated With a Lower Incidence of Acute Kidney Injury After Liver Transplantation in Patients With Compromised Pretransplant Renal Function

AUTHORS: Sun, Kai MD et al Anesthesia & Analgesia: November 2017 – Volume 125 – Issue 5 – p 1463–1470 BACKGROUND: Although the hemodynamic benefits of venovenous bypass (VVB) during liver transplantation (LT) are well appreciated, the impact of VVB on posttransplant renal function is uncertain. The aim of this study was to determine if VVB was […]

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Uncategorized Published - 4 January, 2018    By - Dr Clemens
Lack of Association Between the Use of Nerve Blockade and the Risk of Persistent Opioid Use Among Patients Undergoing Shoulder Arthroplasty: Evidence From the Marketscan Database

AUTHORS: Mueller, Kathryn G. et al Anesthesia & Analgesia: September 2017 – Volume 125 – Issue 3 – p 1014–1020 BACKGROUND: Persistent opioid use following surgery has received increasing attention from policymakers, researchers, and clinicians. Perioperative nerve blockade has been hypothesized to decrease the risk of persistent opioid use. We examined whether nerve blockade was associated with […]

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