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Authors: Isaac Wasserman, M.P.H. et al Anesthesiology 7 2018, Vol.129, 77-88. Background: The value of intravenous acetaminophen in postoperative pain management remains debated. The authors tested the hypothesis that intravenous acetaminophen use, in isolation and in comparison to oral, would be associated with decreased opioid utilization (clinically significant reduction defined as 25%) and opioid-related adverse effects in […]
Read MoreAuthors” Alexander J. Butwick, M.B.B.S., F.R.C.A., M.S. et al Anesthesiology 9 2018, Vol.129, 448-458. What We Already Know about This Topic: Neuraxial labor analgesia for parturients is often recommended to avoid airway instrumentation in case of urgent surgical delivery The extent to which neuraxial use varies by maternal body mass index using modern, national data remains […]
Read MoreGas insufflation during any endoscopic procedure runs the risk for increased abdominal pressure, potentially leading to an unplanned cardiovascular event. “Anesthesiologists should be concerned with the amount of time an endoscopy procedure may entail,” said Paul Terracciano, MD, a senior attending anesthesiologist and the former director of anesthesiology at Phelps Hospital (Northwell Health), in Sleepy […]
Read MoreAuthors: Kamen Vlassakov, M.D.et al Anesthesiology 8 2018, Vol.129, 221-224. “… the distinction between reversible nerve blockade and reversible nerve injury may be fuzzier than we dare to admit.” A SUCCESSFUL regional anesthetic has to result in a sensory (and often also motor) block that is reliable and completely reversible. From the site of injection all […]
Read MoreBelzile D et al. J Thromb Haemost 2018 Jun If pretest probability of pulmonary embolism is high, probably not. The 2008 PIOPED II study demonstrated that computed tomographic pulmonary angiography (CTPA) had high specificity (96%) but only moderate sensitivity (83%) for identifying patients with pulmonary embolism (PE; NEJM JW Gen Med Jul 15 2006 and N Engl J Med 2006; 354:2317). […]
Read MorePerineural administration, compared with intravenous administration, of dexamethasone prolongs analgesia of brachial plexus blocks, according to a study presented here at the 2018 Annual Meeting of the Canadian Anesthesiologists Society (CAS). “When we do surgeries that involve the upper arm, we freeze the arm with regional anaesthesia,” explained Billy Sun, BHSc, University of Calgary, Calgary, […]
Read MoreThe administration of propofol as a bolus fails to decrease cough after use of desflurane in general anaesthesia, according to a study presented here at the 2018 Annual Meeting of the Canadian Anesthesiologists Society (CAS). Cough is not just bothersome, but it can interfere with clinical outcomes, making the prevention of cough clinically significant in […]
Read MoreAuthors: David B. Auyong, M.D. et al Anesthesiology 7 2018, Vol.129, 47-57. Background: The interscalene nerve block provides analgesia for shoulder surgery, but is associated with diaphragm paralysis. One solution may be performing brachial plexus blocks more distally. This noninferiority study evaluated analgesia for blocks at the supraclavicular and anterior suprascapular levels, comparing them individually to the interscalene […]
Read MoreAuthors: Annalotta Scheinin, M.D. Anesthesiology 7 2018, Vol.129, 22-36. Background: Differentiating drug-related changes and state-related changes on the electroencephalogram during anesthetic-induced unconsciousness has remained a challenge. To distinguish these, we designed a rigorous experimental protocol with two drugs known to have distinct molecular mechanisms of action. We hypothesized that drug- and state-related changes can be separated. Methods: Forty-seven […]
Read MoreExposure to hyperoxia in the immediate post-intubation period after admission to the emergency department (ED) is associated with worse outcomes in mechanically ventilated patients, according to researchers. “We found that the unnecessary administration of excessive amounts of oxygen and resultant elevated levels of oxygen in the bloodstream were very common in the emergency department,” said […]
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