Month: May 2022

Uncategorized Published - 23 May, 2022    By - Dr Clemens
Midazolam at Low Nanomolar Concentrations Affects Long-term Potentiation and Synaptic Transmission Predominantly via the α1–γ-Aminobutyric Acid Type A Receptor Subunit in Mice

Authors: Xènia Puig-Bosch, M.Sc. et al Anesthesiology June 2022, Vol. 136, 954–969. Background Midazolam amplifies synaptic inhibition via different γ-aminobutyric acid type A (GABAA) receptor subtypes defined by the presence of α1-, α2-, α3-, or α5-subunits in the channel complex. Midazolam blocks long-term potentiation and produces postoperative amnesia. The aims of this study were to identify the GABAA receptor […]

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Uncategorized Published - 20 May, 2022    By - Dr Clemens
Facial Pressure Ulcers: Unsightly Complication of Prone Positioning

Authors: Eliane Varga, M.D. et al  Anesthesiology May 2022, Vol. 136, 827–828. The image depicts a 67-yr-old man who had significant periorbital skin injury after 5 h of prone spine surgery using a foam headrest with standard taping of eyes. The patient underwent facial laser skin resurfacing 2 months before the event. Facial pressure ulcers are a […]

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Uncategorized Published - 20 May, 2022    By - Dr Clemens
Fascial Plane Blocks in Cardiothoracic Surgery

Author: Dibash Kumar Das, PhD ASA Monitor March 2021, Vol. 85, 34–35. Cardiothoracic surgeries are associated with significant pain. Optimal analgesia is a vital part of enhanced recovery after surgery strategies intended to improve patients’ perioperative experience and outcomes. Traditionally, analgesia in these types of surgeries has depended on large doses of I.V. opioids (Anesth Analg […]

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Uncategorized Published - 20 May, 2022    By - Dr Clemens
Recent U.S. Food and Drug Administration Labeling Changes for Hydroxyethyl Starch Products Due to Concerns about Mortality, Kidney Injury, and Excess Bleeding

Authors: Laurence Landow, M.D. et al  Anesthesiology May 2022, Vol. 136, 868–870. To the Editor: The U.S. Food and Drug Administration (Silver Spring, Maryland) is requiring safety labeling changes to the prescribing information for hydroxyethyl starch products to warn about the risk of mortality, acute kidney injury (AKI), and coagulopathy in all patient populations. The changes […]

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Uncategorized Published - 20 May, 2022    By - Dr Clemens
SEE Question

ASA Monitor June 2021, Vol. 85, 21. A recent observational cohort study compared the annualized rate of major adverse cardiac events (MACE) in patients with abnormal exercise electrocardiograms (+ECG) but normal stress echocardiograms (–Echo) to patients with normal exercise ECGs (–ECG) and normal stress echocardiograms (–Echo). According to this study, which of the following statements is […]

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Uncategorized Published - 20 May, 2022    By - Dr Clemens
Quality Reporting for 2022: Performance Threshold Raised to 75 Points

Author: Matthew T. Popovich, PhD ASA Monitor March 2022, Vol. 86, 37. In the first quarter of each year, anesthesiologists and their groups encounter a number of burdens for federal quality reporting. These burdens include choosing quality measures, updating measure specifications, and modifying workflows to accommodate new quality measure data capture. For 2022, ASA was able […]

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Uncategorized Published - 19 May, 2022    By - Dr Clemens
Selecting an Anesthetic Technique for TAVI

Author: Dibash Kumar Das ASA Monitor April 2021, Vol. 85, 1–13. Transcatheter aortic valve replacement (TAVI) has become the standard of care for patients with severe symptomatic aortic stenosis. Since its introduction, the majority of TAVI procedures have been performed under general anesthesia. Initially developed as a less invasive alternative to surgical aortic valve replacement for […]

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Uncategorized Published - 19 May, 2022    By - Dr Clemens
Amiodarone with or without N-Acetylcysteine for the Prevention of Atrial Fibrillation after Thoracic Surgery

Authors: David Amar, M.D. et al  Anesthesiology June 2022, Vol. 136, 916–926. Background Postoperative atrial fibrillation may identify patients at risk of subsequent atrial fibrillation, with its greater risk of stroke. This study hypothesized that N-acetylcysteine mitigates inflammation and oxidative stress to reduce the incidence of postoperative atrial fibrillation. Methods In this double-blind, placebo-controlled trial, patients at […]

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Uncategorized Published - 19 May, 2022    By - Dr Clemens
Prolonged Phrenic Nerve Blockade with Liposomal Bupivacaine

Authors: Lei Xu, M.D. et al  Anesthesiology April 2022, Vol. 136, 525–527. “…at 24 h after [interscalene] nerve block, the liposomal bupivacaine group had sustained reductions in both diaphragm excursion and respiratory function…” In orthopedic shoulder surgery, obtaining optimal pain control extending beyond the immediate postoperative period is desired for better outcomes second to improved mobilization and […]

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Uncategorized Published - 19 May, 2022    By - Dr Clemens
Anesthesia Incident Reporting System (AIRS) Case 2022-3: Structured Handoffs

ASA Monitor March 2022, Vol. 86, 17. A 16-yr-old patient underwent uneventful surgery for scoliosis. Uneventful intraop course, which included a low-dose ketamine infusion. Ketamine infusion was supposed to be d/c’d in the OR but was not and the patient was transported to the PACU with it infusing. PACU nurses assumed that ketamine was part of […]

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