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On Friday the FDA approved a supplemental new drug application (sNDA) for the administration of liposomal bupivacaine (Exparel, Pacira) via interscalene brachial plexus block for postoperative regional analgesia. Liposomal bupivacaine now becomes the first long-acting, single-dose nerve block available for upper extremity surgeries, such as total shoulder arthroplasty. The approval comes despite an earlier, marginally […]
Read MoreAuthors: Stavros G. Memtsoudis, M.D., Ph.D., F.C.C.P. et al Anesthesiology 9 2018, Vol.129, 428-439. What We Already Know about This Topic: Neuraxial anesthesia is being used more frequently for elective hip and knee replacements It is unclear whether increasing rates of hospital-level use of neuraxial anesthesia are associated with beneficial medical or economic outcomes What This […]
Read MoreAuthor: Jeffrey B. Cooper, Ph.D. Anesthesiology 9 2018, Vol.129, 402-405. Abstract Teamwork is now recognized as important for safe, high-quality perioperative care. The relationship in each surgeon–anesthesiologist dyad is perhaps the most critical element of overall team performance. A well-functioning relationship is conducive to safe, effective care. A dysfunctional relationship can promote unsafe conditions and contribute […]
Read MoreAuthors: Chad M. Brummett, M.D. et al Anesthesiology 9 2018, Vol.129, 396-398. Low back pain is one of the most common causes of chronic pain, disability, lost productivity, and cost, affecting more than 66 million Americans in 2012.1–3 A large number of treatments are available, including behavioral therapies, chiropractic care, exercise, injections, massage, medications, surgery, and others, […]
Read MoreAuthors: Michael J. Devinney, M.D., Ph.D. et al Anesthesiology 9 2018, Vol.129, 389-391. “…[is] delirium…simply a marker for other factors that may contribute to postoperative cognitive dysfunction risk…[or does] delirium itself actually contribute to longer-term postoperative cognitive dysfunction[?]” Are postoperative delirium and postoperative cognitive dysfunction entirely separate disorders, or are they two manifestations of the same […]
Read MoreNot about anesthesia but I wanted to share this with our readers. American Academy of Neurology Summary: Women with high physical fitness at middle age were nearly 90 percent less likely to develop dementia decades later, compared to women who were moderately fit, according to a new study. The study […]
Read MoreYou arrive at high quality surgical outcomes the same way you arrive at Carnegie Hall: practice, practice, practice. It may not be the only — or even the most important — driver of superlative operative results, but it’s fairly well established that people (and places) who do a lot of operations tend to have better […]
Read MorePreoperative chronic opioid use is associated with poor outcomes and continued dependence after posterior lumbar fusion, according to a study published online in Spine. Nikhil Jain, M.D., from The Ohio State University in Columbus, and colleagues used commercial insurance data (from 2007 to Q3-2015) to evaluate preoperative opioid use in 24,610 patients undergoing primary one- and two-level posterior […]
Read MorePatients with a lumbar disc herniation (LDH) and associated back pain may experience improvements in back pain, leg pain, and disability 12 months after single- or 2-level lumbar discectomy, according to a longitudinal observational cohort study published in Spine Journal. Using data from the Quality and Outcomes Database, investigators assessed 2262 adult patients with LDH with baseline scores […]
Read MoreIn a preliminary study published in Neuromodulation, high-frequency spinal cord stimulation was found to be more effective in treating chronic pain than conventional stimulation. Although spinal cord stimulation (SCS) effectively alleviates chronic axial back pain in 50% to 70% of cases, it is accompanied by adverse effects (eg, frequent paresthesias). In the current pilot study, investigators sought to […]
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