Author: Dr Clemens

Uncategorized Published - 18 April, 2018    By - Dr Clemens
Adductor Canal Block in Arthroscopic Knee and ACL Surgeries Questioned

Although documented as an effective analgesic technique for major knee surgeries, the adductor canal block provides only minor analgesic benefit after ambulatory arthroscopic knee surgery, a study has concluded. In addition, a systematic review and meta-analysis found that the role of the block in anterior cruciate ligament (ACL) reconstruction also may be limited. “Adductor canal […]

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Uncategorized Published - 18 April, 2018    By - Dr Clemens
How a Child’s Behavior During Inhalational Induction Can Impact Your Sevoflurane Exposure

Pediatric Anesthesia Oct 2017 Authors Jennifer Herzog-Nieseryet et al Background Sevoflurane is commonly used for inhalational inductions in children, but the personnel’s exposure to it is potentially harmful. Guidance to reduce gas pollution refers mainly to technical aspects, but the impact of the child’s behavior has not yet been studied. Aims The purpose of this […]

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Uncategorized Published - 18 April, 2018    By - Dr Clemens
Adding Intrathecal Morphine to Multimodal Analgesia Benefits Total Joint Patients

In patients undergoing total joint arthroplasty who are already receiving multimodal analgesia, there may be added benefit to incorporating intrathecal morphine. According to a recent retrospective study, the addition of intrathecal morphine to a multimodal analgesic regimen improved analgesia after surgery and reduced postoperative opioid consumption and postoperative nausea and vomiting (PONV). “These data suggest […]

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Uncategorized Published - 17 April, 2018    By - Dr Clemens
Opioid vs. Prochlorperazine plus Diphenhydramine for Treating Migraine Symptoms

Authors: Friedman BW et al. Neurology 2017 Oct 18. Intravenous hydromorphone is a poor choice for first-line migraine treatment in the emergency department. Unfortunately, despite extensive evidence specifically demonstrating lack of efficacy, parenteral opioids are commonly used to treat migraine headaches in the emergency department (ED). In a randomized double-blind trial, researchers compared the efficacy of intravenous […]

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Uncategorized Published - 17 April, 2018    By - Dr Clemens
Multidisciplinary Perioperative Plans Help Autistic Children and Their Parents

Coming to an operating room (OR) near you: a child with autism spectrum disorder. Will you be ready to give them the personalized treatment they need? This was the message from a McMaster University research team, whose pilot study demonstrated the feasibility of multidisciplinary perioperative care plans that reduce anxiety and agitation in this special […]

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Uncategorized Published - 17 April, 2018    By - Dr Clemens
Timing of Beta Blocker Administration Post–Cardiac Surgery Explored

Administration of beta blockers after cardiac surgery provides a significant protective effect against postoperative atrial fibrillation, but the timing of administration does not seem to affect the incidence of the sometimes devastating adverse event, a study has concluded. The researchers thereforerecommended use of the agents on either postoperative day 1 or 2, in appropriate patient populations. “Most anesthesiologists […]

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Uncategorized Published - 17 April, 2018    By - Dr Clemens
Red Blood Cell Size May Predict Risk in Elective Cardiac Surgery

Hemoglobin level may not tell the whole story in cases of preoperative anemia. Instead, classifying anemia based on the size of red blood cells might predict clinical outcomes following elective cardiac surgery, a recent analysis concluded. Despite not having the most severe anemia, patients with macrocytic anemia had the highest risk for needing red blood […]

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Uncategorized Published - 17 April, 2018    By - Dr Clemens
Goal-Directed Fluid Therapy As Part of an ERAS Protocol: Value Added?

Intraoperative goal-directed fluid therapy has been an essential component of enhanced recovery after surgery (ERAS) protocols, but findings from a recent quality improvement initiative questioned its clinical value and impact. In the presence of an ERAS pathway that included early ambulation and alimentation, the addition of intraoperative goal-directed fluid therapy did not reduce complications, readmissions […]

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Uncategorized Published - 16 April, 2018    By - Dr Clemens
Acetaminophen Significantly Reduces Postoperative Shivering

Administering acetaminophen during surgery can reduce the incidence of post-operative shivering in surgical patients, a side effect of general anaesthesia that can stress the cardiovascular system, putting patients with cardiopulmonary problems at risk, according to research presented at the 2017 Annual Meeting of the American Society of Anesthesiologists (ASA). Takehiro Kinjo, MD, University of the […]

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Uncategorized Published - 16 April, 2018    By - Dr Clemens
Comparison of Anterior Suprascapular, Supraclavicular, and Interscalene Nerve Block Approaches for Major Outpatient Arthroscopic Shoulder Surgery: A Randomized, Double-blind, Noninferiority Trial

Authors: David B. Auyong, M.D. et al Anesthesiology April 2018 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 approach. […]

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