Author: Dr Clemens

Uncategorized Published - 21 February, 2018    By - Dr Clemens
Using Activity Trackers to Quantify Postpartum Ambulation: A Prospective Observational Study of Ambulation after Regional Anesthesia and Analgesia Interventions

Authors: Julia Ma, B.Sc., M.P.H. et al Anesthesiology 3 2018, Vol.128, 598-608. Background: Early postoperative ambulation is associated with enhanced functional recovery, particularly in the postpartum population, but ambulation questionnaires are limited by recall bias. This observational study aims to objectively quantify ambulation after neuraxial anesthesia and analgesia for cesarean delivery and vaginal delivery, respectively, by using […]

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Uncategorized Published - 21 February, 2018    By - Dr Clemens
Sevoflurane Blocks the Induction of Long-term Potentiation When Present during, but Not When Present Only before, the High-frequency Stimulation

Authors: Jinyang Liu, M.S. et al Anesthesiology 3 2018, Vol.128, 555-563. Background: This study tests the hypothesis that sevoflurane blocks long-term potentiation only if it is present during the high-frequency stimulation that induces long-term potentiation. Methods: Long-term potentiation, an electrophysiologic correlate of memory, was induced by high-frequency stimulation and measured as a persistent increase in the field excitatory […]

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Uncategorized Published - 21 February, 2018    By - Dr Clemens
Physiologic Evaluation of Ventilation Perfusion Mismatch and Respiratory Mechanics at Different Positive End-expiratory Pressure in Patients Undergoing Protective One-lung Ventilation

Authors: Savino Spadaro, M.D., Ph.D. et al Anesthesiology 3 2018, Vol.128, 531-538. Background: Arterial oxygenation is often impaired during one-lung ventilation, due to both pulmonary shunt and atelectasis. The use of low tidal volume (VT) (5 ml/kg predicted body weight) in the context of a lung-protective approach exacerbates atelectasis. This study sought to determine the combined physiologic effects […]

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Uncategorized Published - 21 February, 2018    By - Dr Clemens
Four Types of Pulse Oximeters Accurately Detect Hypoxia during Low Perfusion and Motion

Authors: Aaron Louie, B.S. et al Anesthesiology 3 2018, Vol.128, 520-530. Background: Pulse oximeter performance is degraded by motion artifacts and low perfusion. Manufacturers developed algorithms to improve instrument performance during these challenges. There have been no independent comparisons of these devices. Methods: We evaluated the performance of four pulse oximeters (Masimo Radical-7, USA; Nihon Kohden OxyPal Neo, […]

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Uncategorized Published - 20 February, 2018    By - Dr Clemens
Effect of Thoracic Epidural Ropivacaine versus Bupivacaine on Lower Urinary Tract Function: A Randomized Clinical Trial

Authors: Stefan A. Girsberger, M.D. et al Anesthesiology 3 2018, Vol.128, 511-519. Background: Thoracic epidural analgesia with bupivacaine resulted in clinically relevant postvoid residuals due to detrusor underactivity. This study aimed to compare the risk of bladder dysfunction with ropivacaine versus bupivacaine using postvoid residuals and maximum flow rates. Our hypothesis was that ropivacaine would result in lower postvoid […]

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Uncategorized Published - 20 February, 2018    By - Dr Clemens
Temporal Trends in Difficult and Failed Tracheal Intubation in a Regional Community Anesthetic Practice

Authors: Rebecca A. Schroeder, M.D. et al Anesthesiology 3 2018, Vol.128, 502-510. Background: When tracheal intubation is difficult or unachievable before surgery or during an emergent resuscitation, this is a critical safety event. Consensus algorithms and airway devices have been introduced in hopes of reducing such occurrences. However, evidence of improved safety in clinical practice related to […]

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Uncategorized Published - 20 February, 2018    By - Dr Clemens
Advancing Patient Safety in Airway Management

Author: Michael F. Aziz, M.D. Anesthesiology 3 2018, Vol.128, 434-436. TRACHEAL intubation is a critical procedure that unites anesthesiologists as the definitive experts in the field of medicine. Not surprisingly, difficult airway management is the primary patient safety concern among anesthesiologists.1  Decades ago, the introduction of pulse oximetry and end-tidal CO2 were associated with a reduction in respiratory-related […]

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Uncategorized Published - 20 February, 2018    By - Dr Clemens
Prediction of Bispectral Index during Target-controlled Infusion of Propofol and Remifentanil: A Deep Learning Approach

Authors: Hyung-Chul Lee, M.D. et al Anesthesiology 3 2018, Vol.128, 492-501. doi:10.1097/ALN.0000000000001892 Background: The discrepancy between predicted effect-site concentration and measured bispectral index is problematic during intravenous anesthesia with target-controlled infusion of propofol and remifentanil. We hypothesized that bispectral index during total intravenous anesthesia would be more accurately predicted by a deep learning approach. Methods: Long short-term memory […]

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Uncategorized Published - 20 February, 2018    By - Dr Clemens
Association of Hospital-level Neuraxial Anesthesia Use for Hip Fracture Surgery with Outcomes: A Population-based Cohort Study

Authors: Daniel I. McIsaac, M.D., M.P.H., F.R.C.P.C. et al Anesthesiology 3 2018, Vol.128, 480-491. Background: There is consistent and significant variation in neuraxial anesthesia use for hip fracture surgery across jurisdictions. We measured the association of hospital-level utilization of neuraxial anesthesia, independent of patient-level use, with 30-day survival (primary outcome) and length of stay and costs (secondary […]

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Uncategorized Published - 19 February, 2018    By - Dr Clemens
Do Anesthetic Choices Signal Quality?

Authors: Catherine L. Chen, M.D., M.P.H. et al Anesthesiology 3 2018, Vol.128, 429-430. HOW does one identify high-quality anesthetic care? Although the specialty of anesthesiology has succeeded in improving the safety and quality of care over time, with a 97% reduction in anesthesia-related deaths between 1948 and 2005, from 3.3 per 100,000 population to 1.1 per […]

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