AUTHORS: Davies, Simon James MD, PhD et al Anesthesia & Analgesia: March 2019 BACKGROUND: Intraoperative hypotension is associated with worse perioperative outcomes for patients undergoing major noncardiac surgery. The Hypotension Prediction Index is a unitless number that is derived from an arterial pressure waveform trace, and as the number increases, the risk of hypotension occurring in […]
Read MoreAUTHORS: Komen, Helga MD et al Anesthesia & Analgesia: April 2019 – Volume 128 – Issue 4 – p 802-810 BACKGROUND: Approximately 50 million US patients undergo ambulatory surgery annually. Postoperative opioid overprescribing is problematic, yet many patients report inadequate pain relief. In major inpatient surgery, intraoperative single-dose methadone produces better analgesia and reduces opioid use […]
Read MoreAUTHOR: Drummond, John C. MD Anesthesia & Analgesia: April 2019 – Volume 128 – Issue 4 – p 759-771 There are occasionally intraoperative circumstances in which reduction of mean arterial pressure (MAP) to levels well below those that occur in nonanesthetized adults is necessary or unavoidable. In these situations, clinicians are inevitably concerned about the limits […]
Read MoreRarities With Anesthetic Implications Elizabeth A.M. Frost, MD Professor of Anesthesiology Mount Sinai Medical Center New York, New York Anesthesiology News Fetal Alcohol Spectrum Disorders What Is It? The term “fetal alcohol spectrum disorders” (FASDs) indicates several pathologies that affect children born of mothers who drank alcohol during pregnancy. Disorders vary from mild to severe, […]
Read MoreAUTHORS: Shaydenfish, Denys Cand Med et al Anesthesia & Analgesia: March 2019 BACKGROUND: The anticholinesterase neostigmine and the muscarinic inhibitor glycopyrrolate are frequently coadministered for the reversal of neuromuscular blockade. This practice can precipitate severe bradycardia or tachycardia, but whether it affects the incidence of cardiovascular complications remains unclear. We hypothesized that anticholinesterase reversal with neostigmine and […]
Read MoreAUTHORS: Freundlich, Robert E. MD, MS et al Anesthesia & Analgesia: March 2019 BACKGROUND: Although the surgical pause or time-out is a required part of most hospitals’ standard operating procedures, little is known about the quality of execution of the time-out in routine clinical practice. An interactive electronic time-out was implemented to increase surgical team compliance with […]
Read MoreRarities With Anesthetic Implications Elizabeth A.M. Frost, MD Professor of Anesthesiology Mount Sinai Medical Center New York, New York Anesthesiology News Rubinstein-Taybi Syndrome What Is It? First described by Michail et al in 19571 as broad thumb–hallux disorder, the syndrome was named for Drs. Rubenstein and Taybi who published a case series of seven cases in […]
Read MoreAUTHORS: Abdallah, Faraj W. MD et al Anesthesia & Analgesia: April 2019 – Volume 128 – Issue 4 – p 631-640 Ambulatory arthroscopic anterior cruciate ligament reconstruction is associated with moderate pain, even when nonopioid oral analgesics such as acetaminophen and nonsteroidal anti-inflammatory drugs are used. Regional analgesia can supplement nonopioid oral analgesics and reduce postoperative […]
Read MoreAUTHORS: Smith, Bradford B. MD et al Anesthesia & Analgesia: April 2019 – Volume 128 – Issue 4 – p 621-628 BACKGROUND: Noncardiac surgery (NCS) following percutaneous coronary intervention (PCI) with stenting is sometimes associated with major adverse cardiac events (MACEs). Second-generation drug-eluting stents (DES) were developed to decrease the incidence of MACE seen with bare […]
Read MoreAUTHORS: Argalious, Maged Y. MD, MSc, MBA, MEd, FASE, FASA et al Anesthesia & Analgesia: March 2019 BACKGROUND: Data on testosterone replacement therapy and cardiovascular outcomes are conflicting, with the Food and Drug Administration requiring prescription testosterone preparations to indicate a possible increased cardiovascular risk. Whether patients on testosterone replacement therapy undergoing cardiac surgery have an increased […]
Read More