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Results 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 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 More… But use may not yet be optimized According to a retrospective analysis of national claims data, use of IV acetaminophen is associated with modestly reduced perioperative opioid utilization and its related adverse effects in patients undergoing open colectomy. Patients given more than one dose of IV acetaminophen on the day of surgery had an […]
Read MoreIncreased need for anesthetics in children undergoing MRI scans is raising costs and could cause an accountable care organization (ACO) cost containment problem, according to researchers at Nationwide Children’s Hospital, in Columbus, Ohio, who set out to study trends in anesthesia use in children receiving these tests. Researchers obtained insurance claims data from the hospital’s […]
Read MoreThe DEA compiled this list in consultation with several law enforcement entities, in addition to online resources. In light of the plethora of street names used to refer to a number of drugs of abuse, the Drug Enforcement Administration (DEA) has issued an unclassified intelligence report designed as a “ready reference for law enforcement personnel […]
Read MoreManagement of the Unanticipated Difficult Airway Fran D’Ercole, MD Professor of Anesthesiology University of North Carolina at Chapel Hill School of Medicine Chapel Hill, North Carolina The focus of this article is on methods to better understand the variables and triggers involved in the management of the unanticipated difficult airway that defaults to an emergency surgical airway. As a […]
Read MoreAuthors: Christian M. Schulz, M.D. et al Anesthesiology 8 2017, Vol.127, 326-337. Background: Situational awareness errors may play an important role in the genesis of patient harm. The authors examined closed anesthesia malpractice claims for death or brain damage to determine the frequency and type of situational awareness errors. Methods: Surgical and procedural anesthesia death and brain damage […]
Read MoreAuthor: Ronald J. Gordon, M.D., Ph.D. Anesthesiology 8 2017, Vol.127, 401. To the Editor: I read with interest the study published recently by Eikelboom et al.1 in Anesthesiology. Because venous thromboembolism (VTE) is infrequently discussed in the anesthesia literature and is the leading cause of preventable death in surgical patients, certain aspects of the publication by Eikelboom et al.1 merit […]
Read MoreExtended-release tramadol may help reduce withdrawal symptoms in patients being treated for opioid use disorder, according to a JAMA Psychiatry study partly funded by industry. Roughly 100 adults with opioid use disorder were stabilized with morphine for 7–10 days in a residential research facility. During the subsequent 7-day taper phase, they were randomized to receive clonidine, buprenorphine, […]
Read MoreAuthor: Michael C. Reade, M.B.B.S., D.Phil. Anesthesiology 8 2017, Vol.127, 398. To the Editor: In the November 2016 issue of Anesthesiology, Wu et al.1 reported the results of their randomized controlled trial of low-dose (0.1 µg kg−1 h−1, nontitrated) dexmedetomidine in 76 nonmechanically ventilated noncardiac surgery patients aged 65 yr or older (an off-label use), in which dexmedetomidine was […]
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