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There are headaches, and then there is post–dural puncture headache (PDPH)—a severe and debilitating side effect of spinal and epidural anesthesia that may last three weeks or more without treatment. Epidural steroid injections are regarded as a safe and effective treatment for PDPH, but minor complications such as wrong-site tissue injection and dural puncture can […]
Read MoreThe Cardiac Surgery Score (CASUS), which includes parameters for mechanical circulatory support, appears to be an accurate predictor of mortality in patients admitted to the ICU after cardiac surgery. “CASUS is essentially a sequential organ failure score modified for unique pathophysiologies and therapies seen in patients admitted to the ICU after cardiac surgery,” said Brock […]
Read MoreThe patch used in the study is approved in the United States for postherpetic neuralgia and in Europe for PNP arising from any etiology. Results from the ASCEND study recently published in BioMed Central Neurology indicate that an 8% capsaicin patch is effective in relieving peripheral neuropathic pain resulting from a wide range of etiologies.1 […]
Read MorePresurgical factors that were predictive of chronic postsurgical pain included presurgical pain intensity, child anxiety and pain coping efficacy, and parental pain catastrophizing. According to a meta-analysis published in the Journal of Pain, an estimated 20% of children have chronic postsurgical pain (CPSP) 12 months after surgery; several presurgical factors predict CPSP in these patients.1 Between 10% and […]
Read MoreThe term clearance implies that a patient can proceed with surgery and will have no risk for complications — which is a fictional state. As a cardiologist, I am often asked to perform preoperative cardiovascular “clearance” — whatever that means — on patients prior to elective procedures. The term clearance implies that a patient can proceed with […]
Read More“Many patients receive their first exposure to opioids following surgery, but the incidence of new persistent opioid use after surgical care is not well defined.” In a population-based study reported in JAMA Surgery, researchers from the University of Michigan Medical School found elevated rates of new persistent opioid use in patients undergoing both minor and major […]
Read MoreUpper gastrointestinal endoscopic procedures may be commonplace, but they have surprisingly high complication and mortality rates. The advent of a modified laryngeal mask that can simultaneously protect the airway and facilitate the passage of an endoscope may reduce some of these adverse events. Preliminary results from an Australian study found that the mask facilitated endoscopic […]
Read MoreHow healthy is “healthy”? According to the results of an analysis from the University of California, San Diego, surgical mortality in a relatively healthy (ASA I and II) patient population is decreasing across the United States. Nevertheless, the study of more than 1.5 million patients identified several clinical predictors of increased mortality risk in this population. Consideration […]
Read MoreUnderbody warming blankets ultimately may prove to be a better choice than their overbody counterparts, with respect to both treating and preventing hypothermia, according to a recent study. “A few years have passed since underbody-type blankets were introduced to the market,” began Hiroshi Sumida, MD, a staff anesthesiologist at the Tohoku University School of Medicine, […]
Read MoreInfections can be lethal in the hospital setting, of course, but awareness of anesthesiologists’ role in contamination is just starting to emerge. According to data presented at the 2017 annual meeting of the Society for Technology in Anesthesia (abstract 29), anesthesia machines, which are notoriously difficult to clean, have been shown to be a potent […]
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