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A consultation service to plan management of pediatric patients with difficult airways before problems arise is an effective use of resources, according to a recent study. The study described findings from the Pediatric Difficult Airway Program, implemented in two stages in the Department of Anesthesiology and Critical Care Medicine at the Johns Hopkins University School […]
Read MoreA new, team-based, primary care model is decreasing prescription opioid use among patients with chronic pain by 40%, according to a study published online by JAMA Internal Medicine. According to American Academy of Pain Medicine (AAPM) guidelines, physicians should monitor patient’s opioid use through urine drug testing at least once a year and have patients […]
Read MoreThe use of supraglottic airway (SGA) devices in pediatric patients with neck masses “almost always” has an effect on the appearance of the masses on MRI scans, according to a 10-year review at a single institution. Results from analyzing the MRI scans from databases at the Children’s Hospital of Philadelphia (CHOP) support avoidance of SGA […]
Read MoreAUTHORS: McQuade David MBChB et al Anesthesia & Analgesia: July, 2017 BACKGROUND: A critical safety component of emergency anesthesia is the avoidance of hypoxemia during the apneic phase of a rapid sequence intubation. Preoxygenation with a bag valve mask (BVM) or anesthetic circuit may be improved with supplemental oxygen by nasal cannula (NC) if there is […]
Read MoreAUTHORS: Xu, Zifeng MD, PhD et al Anesthesia & Analgesia: November 2017 – Volume 125 – Issue 5 – p 1560–1566 BACKGROUND: Aortocaval compression by the gravid uterus, low baseline vasomotor tone, and spinal anesthesia-related sympathetic blockade contribute to spinal anesthesia-induced hypotension during cesarean delivery. The finger perfusion index (PI) can predict spinal hypotension by reflecting baseline […]
Read MoreA meta-analysis of randomized controlled trials shows that gabapentin provides additional analgesia benefit in the regional anesthesia setting across a range of surgical procedures. According to the study authors, however, providers should consider limiting gabapentin to a one-time preoperative dose to maximize analgesic efficacy and modify its potential side-effect profile. “In the setting of regional […]
Read MoreResults of a quality improvement study suggest that current time-based guidelines for prophylactic enoxaparin before neuraxial procedures may need to be amended. Despite being more than 24 hours removed from a treatment dose of enoxaparin, nearly 60% of patients presenting for surgery had anti–factor Xa levels within the prophylactic or therapeutic range. Elderly patients appeared […]
Read MoreOn January 2, 2018, the American Society of Anesthesiologists® (ASA) submitted formal comments to the Centers for Medicare & Medicaid Services (CMS) focused on ensuring physician anesthesiologists have ample opportunities to meaningfully participate and succeed in either the Merit-based Incentive Payments System (MIPS) or Advanced Alternative Payment Models (APMs) pathways under the Quality Payment Program (QPP). […]
Read MoreFeeding patients in the pediatric ICU (PICU) requires a delicate balance between minimizing protein catabolism and meeting energy requirements, according to presentations at the 2017 annual meeting of the Society of Critical Care Medicine. “Globally, about a third of patients being admitted to the pediatric intensive care unit have preexisting malnutrition,” said Katri V. Typpo, MD, MPH, […]
Read MoreAUTHORS: Xu, Rui MD et al Anesthesia & Analgesia: September 2017 – Volume 125 – Issue 3 – p 958–966 The complication rate and efficacy of the Cobra Perilaryngeal Airway (CobraPLA) and laryngeal mask airways (LMAs®) have been evaluated in the published literature, but the conclusions have been inconsistent. The aim of this systematic review and […]
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