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AUTHORS: Moore, Albert MD et al Anesthesia & Analgesia: May 11, 2017 BACKGROUND: We hypothesized that an epidural catheter placed in a lower vertebral interspace will require less medication for labor analgesia. METHODS: Nulliparous women requesting neuraxial labor analgesia were randomized to epidural catheter placement at the ultrasound-confirmed L1-2 or L4-5 interspace. Patient-controlled epidural analgesia and […]
Read MoreObese patients showed less respiratory insufficiency (RI) than their nonobese counterparts during endoscopic surgery, according to a new study. The result was counterintuitive. Because of their higher rates of obstructive sleep apnea, pulmonary hypertension and other cardiopulmonary disorders, obese patients generally are thought to be at increased risk for sedation-related complications, such as RI. Consequently, […]
Read MoreRaeyat Doost E et al., Am J Emerg Med 2017 Apr 14; Nerve block was faster but sedation was somewhat more effective in this small randomized trial. For reduction of anterior shoulder dislocations, options include procedural sedation, intraarticular lidocaine injection, nerve block, and manipulation without sedation. Investigators in Iran randomized 60 adults undergoing anterior shoulder dislocation […]
Read MoreA new initiative to identify preoperative patients who may be predisposed to developing dependence on opioid analgesics could facilitate treatment plans that reduce their exposure to opioids and mitigate that risk. The joint endeavor by specialty pharmaceutical manufacturer Pacira Pharmaceuticals and therapeutic management firm GeneAlign has incorporated behavioral histories and pharmacogenetic and pharmacogenomic testing into […]
Read MoreAlthough anesthesiologists have been performing regional blocks with nerve stimulation for years, the introduction of ultrasound guidance has improved efficiency dramatically, leading to faster block placement and onset in skilled hands. These advancements have come at an opportune time, said Sonia Szlyk, MD, as opioid-related adverse events have become an increasing burden on the health […]
Read MoreBy SANJAY SAINT and MOLLY HARROD A good relationship between a patient and his or her physician is the cornerstone of superb medical care. That relationship is important when you know the doctor well. It may be even more important when you don’t, say when you are in the hospital. Growing competition for new customers is inspiring American hospitals […]
Read MoreAuthors: Jacqueline M. Leung, M.D., M.P.H. et al Anesthesiology 10 2017, Vol.127, 633-644. Background: Postoperative pain and opioid use are associated with postoperative delirium. We designed a single-center, randomized, placebo-controlled, parallel-arm, double-blinded trial to determine whether perioperative administration of gabapentin reduced postoperative delirium after noncardiac surgery. Methods: Patients were randomly assigned to receive placebo (N = 347) or […]
Read MoreThe observations of Karen Sullivan Sibert, MD a Los Angeles anesthesiologist The longer you practice a profession, the easier it is not to bother to learn the next new thing. We may think we’re doing just fine without that new drug, or that new piece of expensive equipment. We’ve seen how the new drug sometimes turns out […]
Read MoreAuthors: May Hua, M.D. et al Anesthesiology published on September 14, 2017. Background: Recent reports have raised concerns that public reporting of 30-day mortality after cardiac surgery may delay decisions to withdraw life-sustaining therapies for some patients. The authors sought to examine whether timing of mortality after coronary artery bypass graft surgery significantly increases after day 30 […]
Read MoreAuthors: Min-Ching Kuo, Ph.D. et al Anesthesiology published on September 14, 2017. Background: Previous studies showed that synaptic transmission is affected by general anesthetics, but an anesthetic dose response in freely moving animals has not been done. The hippocampus provides a neural network for the evaluation of isoflurane and pentobarbital on multisynaptic transmission that is relevant to […]
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