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Uncategorized Published - 22 April, 2024    By - Dr Clemens
Topographical Features of Pediatric Electroencephalography during High Initial Concentration Sevoflurane for Inhalational Induction of Anesthesia

Authors: Jessica C. Martin, Ph.D., B.Sc. (Hons.), B.Eng et al  Anesthesiology May 2024, Vol. 140, 890–905. Background High-density electroencephalographic (EEG) monitoring remains underutilized in clinical anesthesia, despite its obvious utility in unraveling the profound physiologic impact of these agents on central nervous system functioning. In school-aged children, the routine practice of rapid induction with high concentrations […]

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Uncategorized Published - 22 April, 2024    By - Dr Clemens
Thermodilution-derived Recirculation and Cardiac Output Measurement during Veno-venous Extracorporeal Membrane Oxygenation

Authors: Michael Mazzeffi, M.D., M.P.H., M.Sc., F.A.S.A.; Jacob Gutsche, M.D. Anesthesiology May 2024, Vol. 140, 887–889. “Cardiac output cannot be accurately measured during veno-venous ECMO using traditional pulmonary artery catheter thermodilution because recirculation in the ECMO circuit tends to overestimate true cardiac output.” Veno-venous extracorporeal membrane oxygenation (ECMO) has become a widely accepted therapy for adults with […]

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Uncategorized Published - 22 April, 2024    By - Dr Clemens
Analgesic Effectiveness of Liposomal Bupivacaine versus Plain Local Anesthetics for Abdominal Fascial Plane Blocks

Authors: Nasir Hussain, M.D., M.Sc. et al  Anesthesiology May 2024, Vol. 140, 906–919. Background Liposomal bupivacaine is reported to prolong the duration of analgesia when used for abdominal fascial plane blocks compared to plain local anesthetics; however, evidence from randomized trials is mixed. This meta-analysis aims to compare the analgesic effectiveness of liposomal bupivacaine to plain […]

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Uncategorized Published - 22 April, 2024    By - Dr Clemens
Liposomal Bupivacaine, Scientific Evidence, and the Clinician’s Conundrum

Author: James P. Rathmell, M.D. Anesthesiology May 2024, Vol. 140, 865–867. “Understanding that the scientific process is messy and imperfect, let’s heed the courts’ direction by continuing open and respectful debate in the published literature […].” It is New Year’s Day 2024, and I am in my office in Boston on the first day in my […]

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Uncategorized Published - 19 April, 2024    By - Dr Clemens
Meta-analyses of Randomized Clinical Trials in Postsurgical Pain: Verify before Trusting

Authors: Jonathan Slonin, M.D., M.B.A. et al  Anesthesiology May 2024, Vol. 140, 874–876. “[M]eta-analyses play a primary role in evidence-based medicine, yet several pervasive challenges can undermine their interpretability […].” Systematic reviews and meta-analyses of randomized clinical trials are widely considered the highest level of clinical evidence.  Because of their substantial influence on medical practice, meta-analyses […]

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