Month: December 2020

Uncategorized Published - 31 December, 2020    By - Dr Clemens
Adverse Outcomes Associated With Delaying or Withholding β-Blockers After Cardiac Surgery

AUTHORS: Chanan, Emily L. MD et al Anesthesia & Analgesia: October 2020 – Volume 131 – Issue 4 – p 1156-1163 BACKGROUND:  Ideal timing of postoperative β-blockers is unclear. We hypothesized that patients who do not receive β-blockers immediately after cardiac surgery would have increased in-hospital mortality (primary outcome) and postoperative hemodynamic, pulmonary, neurologic, or […]

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Uncategorized Published - 31 December, 2020    By - Dr Clemens
The Use of Analgesia and Sedation in Mechanically Ventilated Patients With COVID-19 Acute Respiratory Distress Syndrome

AUTHORS: Kapp, Christopher M. MD et al Anesthesia & Analgesia: October 2020 – Volume 131 – Issue 4 – p e198-e200 To the Editor We read with great interest in the article by Hanidziar and Bittner.1 We have observed high sedation requirements in our coronavirus disease 2019 (COVID-19) patient population and sought to quantify the administered […]

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Uncategorized Published - 31 December, 2020    By - Dr Clemens
Postoperative Analgesic Effectiveness of Quadratus Lumborum Block for Cesarean Delivery under Spinal Anesthesia

Authors: Nasir Hussain, M.D., M.Sc. et al  Anesthesiology January 2021, Vol. 134, 72–87. Background Spinal morphine is the mainstay of postcesarean analgesia. Quadratus lumborum block has recently been proposed as an adjunct or alternative to spinal morphine. The authors evaluated the analgesic effectiveness of quadratus lumborum block in cesarean delivery with and without spinal morphine. Methods […]

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Uncategorized Published - 31 December, 2020    By - Dr Clemens
Hydroxyethyl Starch 6% 130/0.4 in a Balanced Electrolyte Solution and Renal Function After Nephrectomy

AUTHORS: Lee, Ho-Jin MD et al Anesthesia & Analgesia: October 2020 – Volume 131 – Issue 4 – p 1260-1269 BACKGROUND:  Although previous studies have reported nephrotoxicity associated with hydroxyethyl starch (HES), the long-term effect of HES on renal function after nephrectomy has rarely been reported. We evaluated the association between intraoperative HES administration and […]

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Uncategorized Published - 31 December, 2020    By - Dr Clemens
Bleeding After Musculoskeletal Surgery in Hospitals That Switched From Hydroxyethyl Starch to Albumin Following a Food and Drug Administration Warning

AUTHORS: Krishnamoorthy, Vijay MD, PhD et al Anesthesia & Analgesia: October 2020 – Volume 131 – Issue 4 – p 1193-1200 BACKGROUND:  While US Food and Drug Administration (FDA) black box warnings are common, their impact on perioperative outcomes is unclear. Hydroxyethyl starch (HES) is associated with increased bleeding and kidney injury in patients with sepsis, […]

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Uncategorized Published - 30 December, 2020    By - Dr Clemens
Preloading Head Supports to Avoid Anesthesia Circuit Disconnections During the COVID-19 Pandemic

AUTHORS: Green, James S. MBBS, FRCA et al Anesthesia & Analgesia: October 2020 – Volume 131 – Issue 4 – p e197-e198 To the Editor We read the recent articles by Brown et al,1 Lai et al,2 Tsai et al,3 and Endersby et al.4 describing barrier devices for reducing aerosol and droplet transmission in coronavirus disease 2019 (COVID-19) patients with […]

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Uncategorized Published - 30 December, 2020    By - Dr Clemens
Incidence of and Factors Associated With Prolonged and Persistent Postoperative Opioid Use in Children 0–18 Years of Age

AUTHORS: Ward, Andrew MS et al Anesthesia & Analgesia: October 2020 – Volume 131 – Issue 4 – p 1237-1248 BACKGROUND:  Long-term opioid use has negative health care consequences. Opioid-naïve adults are at risk for prolonged and persistent opioid use after surgery. While these outcomes have been examined in some adolescent and teenage populations, little is […]

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Uncategorized Published - 30 December, 2020    By - Dr Clemens
Influence of an “Electroencephalogram-Based” Monitor Choice on the Delay Between the Predicted Propofol Effect-Site Concentration and the Measured Drug Effect

AUTHORS: Sahinovic, Marko M. MD, PhD et al Anesthesia & Analgesia: October 2020 – Volume 131 – Issue 4 – p 1184-1192 BACKGROUND:  Clinicians can optimize propofol titration by using 2 sources of pharmacodynamic (PD) information: the predicted effect-site concentration for propofol (Ceprop) and the electroencephalographically (EEG) measured drug effect. Relation between these sources should […]

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Uncategorized Published - 30 December, 2020    By - Dr Clemens
ANAPHYLACTIC SHOCK

Cardiac Anesthesiologist website 1.Eliminate any allergy triggers 2.Get ready for intubation as edema can progress shortly. 3.Provide oxygen flow. 4.Provide reliable intravenous access with large bore cannula. 5.Give 20-30 mL/kg crystalloid iv. 6.Epinephrine. Try the available routs: Nebulized 5 mg standard epinephrine (5 mLs of 1 mg/mL) if patient has stridor. IM bolus 0.3-0.5 mg (use 1 mg/mL […]

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Uncategorized Published - 30 December, 2020    By - Dr Clemens
Major Short-term Complications of Arterial Cannulation for Monitoring in Children

Authors: Stephen J. Gleich, M.D. et al  Anesthesiology January 2021, Vol. 134, 26–34. Background Perioperative arterial cannulation in children is routinely performed. Based on clinical observation of several complications related to femoral arterial lines, the authors performed a larger study to further examine complications. The authors aimed to (1) describe the use patterns and incidence of […]

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