Month: May 2018

Uncategorized Published - 4 May, 2018    By - Dr Clemens
End-Expiratory Occlusion Test Predicts Fluid Responsiveness in Patients With Protective Ventilation in the Operating Room

AUTHORS: Biais, Matthieu, MD, PhD et al Anesthesia & Analgesia: December 2017 – Volume 125 – Issue 6 – p 1889–1895 BACKGROUND: End-expiratory occlusion test (EEOT) has been proposed to predict fluid responsiveness in mechanically ventilated intensive care unit patients. The utility of this test during low-tidal-volume ventilation remains uncertain. This study aimed to determine whether hemodynamic […]

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Uncategorized Published - 4 May, 2018    By - Dr Clemens
Ultrasound-Assisted Versus Fluoroscopic-Guided Lumbar Sympathetic Ganglion Block: A Prospective and Randomized Study

AUTHORS: Ryu, Jung-Hee, MD, PhD et al Anesthesia & Analgesia: April 2018 – Volume 126 – Issue 4 – p 1362–1368 BACKGROUND: Fluoroscopy (FL)-guided lumbar sympathetic ganglion block (LSGB) is widely performed to diagnose and manage various diseases associated with sympathetically maintained pain. Recently, numerous ultrasound (US)-assisted procedures in pain medicine have been attempted, showing an advantage […]

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Uncategorized Published - 4 May, 2018    By - Dr Clemens
Risk of respiratory depression with opioids and concomitant gabapentinoids

Journal of Pain Research November 2017 Volume 2017:10 Pages 2635—2641 Authors: Savelloni J et al Introduction: The combination of opioids and central nervous system depressants such as benzodiazepines and barbiturates has an additive effect on the frequency of oversedation and respiratory depression requiring naloxone use in hospitalized patients. Gabapentinoids (gabapentin and pregabalin) are frequently prescribed with opioids for their […]

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Uncategorized Published - 3 May, 2018    By - Dr Clemens
Alkalinized Lidocaine Preloaded Endotracheal Tube Cuffs Reduce Emergence Cough After Brief Surgery: A Prospective Randomized Trial

AUTHORS: Nath, Papu, MD, FRCPC et al Anesthesia & Analgesia: February 2018 – Volume 126 – Issue 2 – p 615–620 BACKGROUND: Alkalinized lidocaine in the endotracheal tube (ETT) cuff decreases the incidence of cough and throat pain on emergence after surgery lasting more than 2 hours. However, alkalinized lidocaine needs 60–120 minutes to cross the ETT […]

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Uncategorized Published - 3 May, 2018    By - Dr Clemens
Low- Versus High-Chloride Content Intravenous Solutions for Critically Ill and Perioperative Adult Patients: A Systematic Review and Meta-analysis

AUTHORS: Kawano-Dourado, Leticia, MD et al Anesthesia & Analgesia: February 2018 – Volume 126 – Issue 2 – p 513–521 BACKGROUND: To assess whether use of low-chloride solutions in unselected critically ill or perioperative adult patients for maintenance or resuscitation reduces mortality and renal replacement therapy (RRT) use when compared to high-chloride fluids. METHODS: Systematic review and meta-analysis […]

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Uncategorized Published - 3 May, 2018    By - Dr Clemens
Epidural Space Identification With Loss of Resistance Technique for Epidural Analgesia During Labor: A Randomized Controlled Study Using Air or Saline—New Arguments for an Old Controversy

AUTHORS: Brogly, Nicolas, MD, PhD, DESAR, DESA et al Anesthesia & Analgesia: February 2018 – Volume 126 – Issue 2 – p 532–536 BACKGROUND: The best technique to identify the epidural space for labor analgesia is still unclear despite the publication of various randomized controlled studies and meta-analyses. Our aim was to assess the superiority of the […]

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Uncategorized Published - 3 May, 2018    By - Dr Clemens
Safety Violations Compound Pain Of Painkiller Shortages

Safety violations at a major compounding pharmacy are exacerbating hospital shortages of key painkillers, particularly in California where health officials have taken the “extraordinary” step of prohibiting sales from one of its plants. In late March, California’s Board of Pharmacy barred the distribution of medications — including lidocaine and other local anesthetics — from a […]

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Uncategorized Published - 3 May, 2018    By - Dr Clemens
Effects of Increasing Airway Pressures on the Pressure of the Endotracheal Tube Cuff During Pelvic Laparoscopic Surgery

AUTHORS: Rosero, Eric, B., MD, MSc et al Anesthesia & Analgesia: November 2017 BACKGROUND: Tracheal tube cuff pressures exceeding the perfusion pressures of the tracheal mucosa have been associated with complications such as sore throat, tracheal mucosa ulcers, tracheal rupture, and subglottic stenosis. Despite appropriate inflation, many factors can increase the tracheal cuff pressure during mechanical ventilation. […]

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Uncategorized Published - 2 May, 2018    By - Dr Clemens
How Long Should Patients Receive Opioids After Surgery?

Authors: Scully RE et al.  JAMA Surg 2017 Sep 27. For common surgical procedures, 7 days usually sufficed for opioid-naive patients, but duration depended on the type of procedure performed. Surgeons vary considerably in the dose and duration of opioids they prescribe to patients postoperatively. To better define optimal postoperative opioid prescribing, researchers used a U.S. […]

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Uncategorized Published - 2 May, 2018    By - Dr Clemens
Novel Preconditioning Approach Did Not Reduce Postoperative Nausea and Vomiting After General Anesthesia

A novel approach to prevention of postoperative nausea and vomiting (PONV) failed to reduce its incidence after exposure to general anesthesia. Results of a study, which entailed a gradual preconditioning of several receptor groups involved in the nausea reflex arc, showed a trend toward improved outcomes, but a statistically significant difference was not observed. “We […]

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