Month: September 2022

THE TOP 11 ANESTHESIA BOOKS

Author: Richard Novak, MD The Anesthesia Consultant There are hundreds of anesthesia textbooks, but which current books are the gold standards for anesthesia knowledge? Should you buy these books, or should you advocate that your hospital purchase them for the medical library? When I was in residency training, I bought earlier editions of many of […]

Respiratory Effects of the Atypical Tricyclic Antidepressant Tianeptine in Human Models of Opioid-induced Respiratory Depression

Authors: Hyke Algera, M.D. et al  Anesthesiology August 2022. Background Animal data suggest that the antidepressant and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor modulator tianeptine is able to prevent opioid-induced respiratory depression. The hypothesis was that oral or intravenous tianeptine can effectively prevent or counteract opioid-induced respiratory depression in humans. Methods Healthy male and female volunteers participated in […]

No Benefits of Adding Dexmedetomidine, Ketamine, Dexamethasone, and Nerve Blocks to an Established Multimodal Analgesic Regimen after Total Knee Arthroplasty

Authors: Felipe Muñoz-Leyva, M.D. et al  Anesthesiology August 2022. Background An optimal opioid-sparing multimodal analgesic regimen to treat severe pain can enhance recovery after total knee arthroplasty. The hypothesis was that adding five recently described intravenous and regional interventions to multimodal analgesic regimen can further reduce opioid consumption. Methods In a double-blinded fashion, 78 patients […]

Excessive Dynamic Airway Collapse with Induction of Anesthesia

AUTHORS: Emily L. Sturgill, M.D. et al  Anesthesiology September 2022, Vol. 137, 340. A 74-yr-old woman undergoing esophagogastroduodenoscopy experienced severe airway obstruction after initiation of sedation. This rapidly progressed to profound hypoxia resistant to jaw thrust, two-provider mask ventilation, paralysis, and intubation. We present an incidental computed tomography finding in this intubated and sedated patient with […]

Coagulated Cryoprecipitate in an Intravenous Line

AUTHORS: Alexander B. Shulman, M.D. et al  Anesthesiology July 2022. Cryoprecipitate contains fibrinogen, factor VIII, factor XIII, von Willebrand factor, and fibronectin. Cryoprecipitate production involves cold thawing of plasma to create a supraphysiologic concentrate of these cold-insoluble factors. Up to 20% of cryoprecipitate units are discarded during production because of precipitation or clotting, and careful […]

Isoflurane Disrupts Postsynaptic Density-95 Protein Interactions Causing Neuronal Synapse Loss and Cognitive Impairment in Juvenile Mice via Canonical NO-mediated Protein Kinase-G Signaling

Authors: Swati Agarwal, Ph.D. et al  Anesthesiology August 2022, Vol. 137, 212–231. Background Inhalational anesthetics are known to disrupt PDZ2 domain–mediated protein–protein interactions of the postsynaptic density (PSD)-95 protein. The aim of this study is to investigate the underlying mechanisms in response to early isoflurane exposure on synaptic PSD-95 PDZ2 domain disruption that altered spine densities […]

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Coffee Is Not a Clear Liquid

Authors: Pandit, Sujit K. MD; Loberg, Katherine W. BS; Pandit, Uma A. MD Anesthesia & Analgesia: November 2000 In Response: We greatly appreciate Dr. Sosis’s interest in our paper (1). This also gives us an opportunity to clarify the prevalent ambiguity about types of “clear” liquid that are allowed 2–3 h before elective surgery. Dr. Sosis […]

Ultrasound-Guided Clavipectoral Fascial Plane Block With Intermediate Cervical Plexus Block for Midshaft Clavicular Surgery

AUTHORS: Zhuo, Qian MD et al  Anesthesia & Analgesia: September 2022 – Volume 135 – Issue 3 – p 633-640 BACKGROUND: Regional anesthesia such as interscalene brachial plexus block (ISBPB) with intermediate cervical plexus block (ICPB) is generally a preferred choice for clavicular surgery. However, various studies have shown that these blocks, especially ISBPB, could cause […]

Risk Factors and Consequences of Acute Kidney Injury After Noncardiac Surgery in Children

AUTHORS: Hawkins, Jesse MD et al  Anesthesia & Analgesia: September 2022 – Volume 135 – Issue 3 – p 625-632 BACKGROUND: Postoperative acute kidney injury (AKI) is a serious complication that is associated with prolonged hospital stay, high risk of short-term postsurgical mortality, need for dialysis, and possible progression to chronic kidney disease. To date, very […]