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AUTHORS: Hirabayashi, Masato MD et al Anesthesia & Analgesia: June 2017 – Volume 124 – Issue 6 – p 1930–1934 BACKGROUND: The incidence of pruritus after cesarean delivery under spinal anesthesia with opioids is high, ranging from 50% to 100%. Pruritus is difficult to prevent; however, pentazocine has been shown to be an effective treatment. Despite […]
Read MoreAUTHORS: Delaney, Meghan DO, MPH et al Anesthesia & Analgesia: June 2017 – Volume 124 – Issue 6 – p 1777–1782 BACKGROUND: Cardiac surgery is the most common setting for massive transfusion in medically advanced countries. Studies of massive transfusion after injury suggest that the ratios of administered plasma and platelets (PLT) to red blood cells […]
Read MoreAUTHORS: Kubota, Kenta MD et al Anesthesia & Analgesia: June 2017 – Volume 124 – Issue 6 – p 1771–1776 BACKGROUND: Acute kidney injury (AKI) often occurs after cardiac surgery. During cardiac surgery, plasma free hemoglobin (fHb) would increase due to hemolysis. Since plasma fHb is thought to be nephrotoxic, haptoglobin, which is an fHb scavenger, […]
Read MorePostoperative use of opioid analgesics increases the risk of respiratory depression, which can lead to brain damage or death. Perioperative lidocaine does not reduce morphine use in the first 24 hours after posterior spinal arthrodesis and offers no measurable benefits, according to a randomized placebo-controlled trial recently published in Pain.1 Postoperative use of opioid analgesics increases the risk […]
Read MoreAuthors: Jessica L. Booth, M.D. et al Anesthesiology 7 2017, Vol.127, 50-57. Background: The addition of opioids to epidural local anesthetic reduces local anesthetic consumption by 20% but at the expense of side effects and time spent for regulatory compliance paperwork. Epidural neostigmine also reduces local anesthetic use. The authors hypothesized that epidural bupivacaine with neostigmine would […]
Read MoreAUTHORS: Lee, Alex T. MD et al Anesthesia & Analgesia: August 2017 – Volume 125 – Issue 2 – p 514–520 BACKGROUND: Antiplatelet medications are usually discontinued before elective neurosurgery, but this is not an option for emergent neurosurgery. We performed a retrospective cohort study to examine whether preoperative aspirin use was associated with worse outcomes […]
Read MoreNonspecific factors include a patient’s spirituality, their trust in a provider’s power to influence treatment outcomes, as well as their expectations. Contextual or nonspecific factors may influence treatment outcomes in patients with chronic pain, according to a study presented at the American Pain Society’s 36th Annual Scientific Meeting in Pittsburgh, Pennsylvania.1 Nonspecific factors include a patient’s spirituality […]
Read MoreNo, this is not a science fiction reference. Rather this represents, at least in my mind, the many skills necessary to become a superb clinician. I write this from the perspective of an internist, but I believe these skills are not specialty specific. 1. History taker. Most patient encounters start with taking a thorough history. […]
Read MoreResearchers Change Practice; Selection Bias Could Explain Results; Proper Technique Key Surgeons speaking at the 2017 annual meeting of the Americas Hernia Society questioned the value of perioperative epidural analgesia in patients undergoing ventral hernia repair after results from a new analysis suggested epidurals may contribute to longer hospital length of stay without any obvious […]
Read MoreAlthough supplemental oxygen is an essential element of patient care for a wide range of clinical conditions, it compromises both carbon dioxide and peripheral capillary O2 saturation monitoring methods, making it difficult to detect respiratory depression. However, that issue may be resolved by the development of a prototype intelligent O2 flowmeter, which delivers supplemental O2 at a variable […]
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