Author: Dr Clemens

Readmissions to Different Hospitals After Common Surgical Procedures and Consequences for Implementation of Perioperative Surgical Home Programs

Gender Inequality in Anesthesiology Less Than That Seen in Other Specialties

Female anesthesiologists face less gender bias than those in other fields of medicine, according to a recent study. Yet women still earn far less than their male counterparts and face significant career hurdles. Researchers at the Pennsylvania State University reviewed salary and male/female participation data from 15 medical specialties, including anesthesiology. The specialties were sorted […]

Post-Intubation ICU Hypotension Rates Higher Among Critically Ill Immunocompromised Patients

Researchers found higher rates of post-intubation hypotension (PIH) among critically ill patients who were immunocompromised compared with those who were not. The study, presented at the Society of Critical Care Medicine’s 2017 Critical Care Congress (abstract 1031), found that significant predictors of PIH were advanced age, higher illness severity, pre-intubation hemodynamic instability and prior use […]

Vibrating, Cold Device Enables Quick IV Insertion While Reducing Kids’ Pain in Emergency Room

A vibrating device, used with a cold pack, relieves a child’s pain while emergency department caregivers insert an intravenous (IV) catheter, equally as well as the currently used anesthetic, topical lidocaine. The device can be used quickly, unlike lidocaine, which requires 30 minutes to fully take effect. The findings are published early online ahead of […]

Pupillary Light Reflex Recovery From General Anesthesia Varies Greatly

Researchers have found that pupillary light reflex (PLR) recovery from general anesthesia (GA) varies greatly among patients, regardless of the anesthesia drug used. Thus while PLR has long been used in the neurologic assessment of an anesthetized patient, physicians should be cautious about using the technique to measure brain stem function in patients who have […]

Same-Day Discharge for TJR: Clinical Guidelines and Caveats

Value-based reimbursement and alternative payment models are putting increased pressure on the profitability of joint replacement procedures. Although same-day discharge is not a common part of these programs yet, according to James D. Slover, MD, the new payment paradigm will favor ambulatory surgery in the future. At the 2017 Interdisciplinary Conference on Orthopedic Value-Based Care, […]

Patients Report Worse Outcomes With Higher Opioid Doses

Concerns with the safety and adverse effects of opioids have grown with increases in prescribing and dose, and higher doses have been associated with worse patient-reported outcomes in a study by researchers at Veterans Affairs (VA) and Kaiser Permanente health systems. Benjamin Morasco, PhD, and his colleagues at the VA Portland Health Care System and […]

Research Uncovers a Novel Mechanism of Common Anesthetic Propofol

Widely used anesthetic “derails” kinesin motor proteins The widely used anesthetic propofol is considered a safe and effective drug for use in general anesthesia. But how propofol induces unconsciousness is poorly understood. Research published in the Proceedings of the National Academy of Science, and supported by the National Institutes of Health, identifies a previously unknown mechanism […]

Worse Pain Outcomes After Knee Replacement for Patients Who Took Opioids Before Surgery

Six months after knee replacement surgery, pain outcomes were not as good for patients who previously took prescription opioids, according to a study published in The Journal of Bone & Joint Surgery. “Our results should be viewed as a warning that using opioids during the preoperative period may be problematic due to their negative effects […]

Azithromycin Not Linked to Increased Arrhythmia Risk

The commonly used antibiotic azithromycin is not linked to an increased risk for ventricular arrhythmia. Rather the adverse event is more likely due to infection or patient characteristics, according to a large study (CMAJ 2017 Apr 18. “Using an incredibly large and robust population and strong methods they show that the risk associated with azithromycin, a […]