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Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS Migraine in children is associated with increased risk for functional gastrointestinal disorders, according to a case-control study in the Lancet Gastroenterology & Hepatology. Researchers studied 425 children aged 6–17 years who were diagnosed with migraine or tension-type headache in the emergency department, and 650 children who […]
Read MoreHirsch JA and Chandra RV., Lancet 2016 Aug 17; The procedure benefitted some highly selected patients when performed a few weeks after vertebral fracture. Vertebroplasty is injection of polymethylmethacrylate “cement” into a fractured vertebral body to reduce pain and disability. The popularity of this procedure declined after 2009, when two randomized, sham-controlled trials showed no benefit (NEJM […]
Read MoreAuthors: Lia Mesbah-Oskui, M.Sc. et al Anesthesiology published on August 25, 2016. Background: Alterations in thalamic γ-aminobutyric acid–mediated signaling are thought to underlie the increased frontal α-β frequency electrocortical activity that signals anesthetic-induced loss of consciousness with γ-aminobutyric acid receptor type A (GABAAR)–targeting general anesthetics. The general anesthetic etomidate elicits phasic extrasynaptic GABAAR activation (“spillover” inhibition) […]
Read MoreEdited by André Sofair, MD, MPH, and William E. Chavey, MD, MS The number of drug products obtained by law enforcement that tested positive for fentanyl (so-called fentanyl submissions) increased five-fold and deaths from synthetic opioids nearly doubled from 2013 to 2014, according to an MMWR study. Annual fentanyl submissions increased from 1000 to 5300 during this period. At […]
Read MoreAuthors: Gaspard Montandon, Ph.D. et al Anesthesiology published on August 25, 2016 Background: Opioid analgesia is an essential component of perioperative care, but effective analgesia can be limited by excessive sedation and respiratory depression. The cortical signatures associated with sedation by opioids and the relationship between changes in cortical activity and respiratory function are not well understood. […]
Read MoreAuthors: Jeroen C. P. Simons, M.D. et al Anesthesiology 9 2016, Vol.125, 525-534. Background: Volatile anesthetics and propofol impair upper airway stability and possibly respiratory upper airway dilator muscle activity. The magnitudes of these effects have not been compared at equivalent anesthetic doses. We hypothesized that upper airway closing pressure is less negative and genioglossus activity […]
Read MoreAuthors: Hagen Bomberg, M.D. et al Anesthesiology 9 2016, Vol.125, 505-515. Background: Catheter-related infection is a serious complication of continuous regional anesthesia. The authors tested the hypothesis that single-dose antibiotic prophylaxis is associated with a lower incidence of catheter-related infections. Methods: Our analysis was based on cases in the 25-center German Network for Regional Anesthesia database […]
Read MoreAs part of the federal government’s efforts to address the opioid epidemic, the U.S. Food and Drug Administration (FDA) issued a drug safety communication that the Agency is adding Boxed Warnings to the drug labeling of prescription opioid pain and prescription opioid cough medicines, and benzodiazepines. For health care professionals, the drug safety communication states: “Health care […]
Read MoreChallenges In Selecting the Appropriate Analgesic Written by Timothy J. Atkinson, PharmD, BCPS, Jacqueline Pratt Cleary, PharmD and Jeffrey Fudin, PharmD, DAIPM, FCCP, FASHP In recent years, an avalanche of evidence against opioid and nonsteroidal anti-inflammatory drug (NSAID) use has been published in medical journals, leading many physicians to re-evaluate the risk-to-benefit ratio of these medications. Nearly […]
Read MoreAuthors: Stefan Muenster, M.D. et al Anesthesiology published on August 18, 2016. Background: Transfusion of packed erythrocytes stored for a long duration is associated with increased pulmonary arterial pressure and vascular resistance. Prolonged storage decreases erythrocyte deformability, and older erythrocytes are rapidly removed from the circulation after transfusion. The authors studied whether treating stored packed ovine […]
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