Month: December 2022

Uncategorized Published - 14 December, 2022    By - Dr Clemens
What medication options exist for migraine prophylaxis when solid oral dosage forms cannot be administered?

Author: Holshouser B et al Pract Pain Manag. 2022 September/October;22(5). For children and adolescents, the prevalence of migraine by age 15 is 8% to 23%, and around 38.8% of Americans age 12 and older should be offered or considered for preventive migraine treatment.¹˒² Due to the debilitating nature of migraine disorder, it is important to […]

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Uncategorized Published - 14 December, 2022    By - Dr Clemens
Local Anesthetic Cardiac Toxicity Is Mediated by Cardiomyocyte Calcium Dynamics

Authors: Julia Plakhotnik, B.Sc. et al  Anesthesiology December 2022, Vol. 137, 687–703. Background Long-lasting local anesthetic use for perioperative pain control is limited by possible cardiotoxicity (e.g., arrhythmias and contractile depression), potentially leading to cardiac arrest. Off-target cardiac sodium channel blockade is considered the canonical mechanism behind cardiotoxicity; however, it does not fully explain the observed […]

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Uncategorized Published - 14 December, 2022    By - Dr Clemens
Quantitative Monitoring Practice Change: Comment

Authors: Andrew Bowdle, M.D., Ph.D., F.A.S.E.; Srdjan Jelacic, M.D., F.A.S.E.; Kelly Michaelsen, M.D., Ph.D Anesthesiology November 2022. To the Editor: We strongly support the implementation of quantitative twitch monitoring to guide neuromuscular blocker administration and to ensure that patients have recovered adequately before extubation, and we applaud the efforts of Weigel et al.  and others  to do so. Weigel et al.  used […]

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Uncategorized Published - 14 December, 2022    By - Dr Clemens
Quantitative Monitoring Practice Change: Reply

Authors: Wade A. Weigel, M.D.; Wyndam M. Strodtbeck, M.D. Anesthesiology November 2022. In Reply: We thank Dr. Bowdle et al.  for their interest in our article showing how quantitative monitoring can be incorporated into clinical practice.  We fear they may have missed the major lesson of this work, however, which was modifying clinician behavior so that the vast majority […]

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Uncategorized Published - 14 December, 2022    By - Dr Clemens
Perioperative Concussion: Learning from Football and Improving Patient Safety

Author: Arnoley S. Abcejo, MD ASA Monitor November 2022, Vol. 86, 44. Concussion, or mild traumatic brain injury, results from a physical blow to the head, often synonymous with post-injury concussive symptoms such as headache, cognitive impairment, and sleep disturbance. Our understanding of this disease has grown rapidly over the last two decades. We know that […]

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Uncategorized Published - 13 December, 2022    By - Dr Clemens
Review of Postoperative Respiratory Depression: From Recovery Room to General Care Unit

Authors: Toby N. Weingarten, M.D.; Juraj Sprung, M.D., Ph.D. Anesthesiology December 2022, Vol. 137, 735–741. Postoperative respiratory failure secondary to opioid-induced respiratory depression (hereafter termed respiratory depression) can result in permanent morbidity, such as anoxic brain injury, or even death. In many cases, the respiratory failure seems to develop acutely and without warning, often shortly after seemingly reassuring […]

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Uncategorized Published - 13 December, 2022    By - Dr Clemens
Medical Marijuana Research Grant to Look More Closely at CBD for Chronic Pain

Author: Avery Hurt Practical Pain Management Oct 21, 2022 Pain researchers at the University of Michigan have been awarded $7.4 million from the Veteran Marijuana Research (VMR) grant program to study the effectiveness of cannabidiol (CBD) and medical cannabis products. The grant study, “Pragmatic Trial of Cannabidiol and Tailored Cannabis Coaching to Improve Chronic Pain […]

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Uncategorized Published - 13 December, 2022    By - Dr Clemens
Pain physician convicted in $4.5M fentanyl kickback scheme

Author: Patsy Newitt Becker’s ASC Review Former CEO and owner of Sarasota (Fla.) Pain Associates Steven Chun, MD, has been sentenced to three years and six months in prison for his role in a $4.5 million fentanyl kickback scheme, the Justice Department said Dec. 7. Dr. Chun, 59, must also forfeit $278,900, the proceeds of his offenses. […]

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Uncategorized Published - 13 December, 2022    By - Dr Clemens
Did Ancient Egyptians Discover Local Anesthetics?

Author: Mohammad Hazem I. Ahmad Sabry, M.D., F.R.C.P.C., A.B.P.M. Anesthesiology November 2022. The tomb of Ankh-Ma-Hor who served King Teti of the sixth dynasty (circa 2345 to 2323 BC) in Saqqara, Giza, Egypt, was discovered by Victor Loret (1897) and reexamined by Kanawati and Hassan in 1995.  The tomb was dated 2340 BC by the Egyptian […]

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Uncategorized Published - 12 December, 2022    By - Dr Clemens
Lidocaine Intraoperative Infusion Pharmacokinetics during Partial Hepatectomy for Living Liver Donation

Authors: Cara E Crouch, M.D. et al  Anesthesiology October 2022. Background. Postoperative pain associated with open partial hepatectomy can be intense and persistent. Our multimodal approach to lessen this problem includes an intraoperative intravenous infusion of lidocaine hydrochloride. Decreased hepatic metabolism after resection raises concerns about safe lidocaine dosing in this patient population. We hypothesized […]

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