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Authors: Stefan A. Girsberger, M.D. et al Anesthesiology 3 2018, Vol.128, 511-519. Background: Thoracic epidural analgesia with bupivacaine resulted in clinically relevant postvoid residuals due to detrusor underactivity. This study aimed to compare the risk of bladder dysfunction with ropivacaine versus bupivacaine using postvoid residuals and maximum flow rates. Our hypothesis was that ropivacaine would result in lower postvoid […]
Read MoreAuthors: Rebecca A. Schroeder, M.D. et al Anesthesiology 3 2018, Vol.128, 502-510. Background: When tracheal intubation is difficult or unachievable before surgery or during an emergent resuscitation, this is a critical safety event. Consensus algorithms and airway devices have been introduced in hopes of reducing such occurrences. However, evidence of improved safety in clinical practice related to […]
Read MoreAuthor: Michael F. Aziz, M.D. Anesthesiology 3 2018, Vol.128, 434-436. TRACHEAL intubation is a critical procedure that unites anesthesiologists as the definitive experts in the field of medicine. Not surprisingly, difficult airway management is the primary patient safety concern among anesthesiologists.1 Decades ago, the introduction of pulse oximetry and end-tidal CO2 were associated with a reduction in respiratory-related […]
Read MoreAuthors: Hyung-Chul Lee, M.D. et al Anesthesiology 3 2018, Vol.128, 492-501. doi:10.1097/ALN.0000000000001892 Background: The discrepancy between predicted effect-site concentration and measured bispectral index is problematic during intravenous anesthesia with target-controlled infusion of propofol and remifentanil. We hypothesized that bispectral index during total intravenous anesthesia would be more accurately predicted by a deep learning approach. Methods: Long short-term memory […]
Read MoreAuthors: Daniel I. McIsaac, M.D., M.P.H., F.R.C.P.C. et al Anesthesiology 3 2018, Vol.128, 480-491. Background: There is consistent and significant variation in neuraxial anesthesia use for hip fracture surgery across jurisdictions. We measured the association of hospital-level utilization of neuraxial anesthesia, independent of patient-level use, with 30-day survival (primary outcome) and length of stay and costs (secondary […]
Read MoreAuthors: Catherine L. Chen, M.D., M.P.H. et al Anesthesiology 3 2018, Vol.128, 429-430. HOW does one identify high-quality anesthetic care? Although the specialty of anesthesiology has succeeded in improving the safety and quality of care over time, with a 97% reduction in anesthesia-related deaths between 1948 and 2005, from 3.3 per 100,000 population to 1.1 per […]
Read MoreCurrent use of prescription opioids is associated with increased risk for invasive pneumococcal disease (IPD), suggests an Annals of Internal Medicine study. Researchers studied Tennessee patients who’d filled an opioid prescription between 1995 and 2014. Of these, they compared 1200 patients with an IPD diagnosis with 24,000 controls without IPD. After multivariable adjustment, current opioid use was […]
Read MoreAuthors: A. Kisilevsky et al British Journal of Anesthesia February 2018 Summary Both anaemia and blood transfusion are associated with poor outcomes in the neurosurgical population. Based on the available literature, the optimal haemoglobin concentration for neurologically injured patients appears to be in the range of 9.0–10.0 g dl−1, although the individual risks and benefits […]
Read MoreAuthor: MYLES GART, MD After years of exaggeration, misinformation and a national epidemic of opioid and heroin abuse, the nation is finally coming to terms with the fact that pain is not the fifth vital sign. This heresy, as I understand it, has existed for close to three decades and, in my opinion, has been […]
Read MoreThe FDA has updated the indication of naloxegol (Movantik, AstraZeneca) tablets for the treatment of opioid-induced constipation (OIC) in adult patients with chronic noncancer pain to include patients with chronic pain related to prior cancer or its treatment who do not require frequent (e.g., weekly) opioid dosage escalation. This label update follows initial FDA approval for naloxegol in 2014 […]
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