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AUTHORS: Lappen, Justin R., MD et al Anesthesia & Analgesia: August 2018 – Volume 127 – Issue 2 – p 457–464 BACKGROUND: Narrow pulse pressure has been demonstrated to indicate low central volume status. In critically ill patients, volume status can be qualitatively evaluated using Doppler velocimetry to assess hemodynamic changes in the carotid artery in response […]
Read MoreAUTHORS: Ruetzler, Kurt, MD et al Anesthesia & Analgesia: March 1, 2018 BACKGROUND: Laboratory testing is a common component of preanesthesia evaluation and is designed to identify medical abnormalities that might otherwise remain undetected. While blood testing might optimally be performed shortly before surgery, it is often done earlier for practical reasons. We tested the hypothesis that […]
Read MoreThe Food and Drug Administration (FDA) has approved Apadaz (benzhydrocodone and acetaminophen; KemPharm) for the short-term (≤14 days) management of acute pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. Apadaz is an immediate-release combination of benzhydrocodone, a prodrug of hydrocodone, and acetaminophen (APAP). Benzhydrocodone is chemically inert, however, once ingested, […]
Read MoreRecommendations for the perioperative use of buprenorphine during interventional pain procedures, including best practices for perioperative tapering of the drug, were recently published in Pain Physician. The researchers based their buprenorphine recommendations on an analysis of 12 studies in the literature researching buprenorphine. The recommendations include suggestions for tapering or continuing use of the drug in the […]
Read MoreThe American Society of Anesthesiologists (ASA) has offered recommendations for Congress to address the opioid epidemic through the Centers for Medicare & Medicaid Services programs. The recommendations include increasing funding for research, adding coverage for nonopioid therapies, and providing congressional support for educational programs for perioperative opioid-sparing practices. “With a unique understanding of the intricacies […]
Read MoreNaldemedine, a peripherally acting µ-opioid receptor antagonist, was found to be safe and effective for increasing bowel movement frequency and improving quality of life in patients with chronic non-cancer pain and opioid-induced constipation (OIC), in a randomized placebo-controlled phase 3 trial published in Pain. In addition, naldemedine was not found to affect opioid analgesia or to […]
Read MoreIt might not just be old age causing forgetfulness. A new study, published in the journal Anaesthesia, found associations with decreased cognitive function and time under general anesthesia or neuraxial blockade. This observational study followed nearly a thousand middle-aged patients at the Wisconsin Registry for Alzheimer’s Prevention, testing the memory and executive function of participants on […]
Read MoreThe quadratus lumborum and posterior transversus abdominis plane (TAP) blocks can be used interchangeably after laparoscopic gynecologic surgeries, a Japanese research team concluded. Although visual analog scale (VAS) pain scores were lower in patients who received the quadratus lumborum block at some time points, the demand for postoperative fentanyl and other analgesics was similar between […]
Read MoreFor hospitals that can effectively collaborate across service lines to redesign care processes, the perioperative surgical home (PSH) model of care can help lower costs, improve outcomes and enhance patient satisfaction for surgical cases. Persuading hospital administration to commit resources to support new initiatives, however, can prove difficult in today’s health care environment. At the […]
Read MoreThe Society for the Advancement of Blood Management has released a list of five practices clinicians should question as part of the Choosing Wisely campaign. Here are the recommendations: Delay elective surgery in patients who have correctable anemia until the anemia has been treated. To avoid iatrogenic anemia, don’t order blood tests unless they are […]
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