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Ask the pt to open his/her mouth wide just as you are ready to bolus propofol. As the jaw slackens just drop the LMA into the still open mouth without touching the teeth or sides of the oral cavity.
Read MoreAuthors: Frédérique Hovaguimian, M.D., M.Clin.Res.Meth. et al Anesthesiology 7 2016, Vol.125, 46-61. Background: Blood transfusions are associated with morbidity and mortality. However, restrictive thresholds could harm patients less able to tolerate anemia. Using a context-specific approach (according to patient characteristics and clinical settings), the authors conducted a systematic review to quantify the effects of transfusion strategies. Methods: The authors searched […]
Read MoreOpioid-epidemic legislation aimed at helping everyone from pregnant women and infants to veterans and inmates goes to President Barack Obama for his yea or nay after the Senate passed it in a 92-to-2 vote today. The bill, called the Comprehensive Addiction and Recovery Act (CARA), also allows nurse practitioners and physician assistants to prescribe buprenorphine […]
Read MoreWith surgery still the primary treatment for breast cancer, strategies to minimize acute postoperative pain have the potential for significant benefit, perhaps even preventing development of chronic pain. A research team at the University of California, San Francisco (UCSF) has moved much closer to this lofty goal. They developed an enhanced recovery after surgery (ERAS) […]
Read MoreAuthors: R. A. Moore et al BMC Anesthesiol. 2016;16(9) Background: Dexketoprofen trometamol plus tramadol hydrochloride is a new oral combination of two analgesics, which have different mechanisms of action for the treatment of moderate to severe acute pain. Methods: Randomised, double-blind, parallel, placebo and active-controlled, single and multiple-dose study to evaluate the analgesic efficacy and safety of dexketoprofen/tramadol […]
Read MoreAuthors: Y. Schuller et al BMC Neurol. 2016;16(25) Background: Neuropathic pain is one of the key features of (classical) Fabry disease (FD). No randomized clinical trials comparing effectiveness of different pain management strategies have been performed. This review aims to give an overview of existing pain management strategies. Methods: PubMed and Embase were searched up to September 2014 […]
Read MoreAuthors: Walley AY and Green TC., Ann Intern Med 2016 Jun 28; Coprescribing naloxone was associated with fewer opioid-related emergency room visits. Many communities that use targeted distribution of the short-acting opioid antagonist naloxone to reverse unintentional opioid overdoses have seen declines in community-level opioid overdose–related mortality. In this observational study from six “safety net” clinics in […]
Read MoreBuprenorphine implants are at least as effective as sublingual buprenorphine as a maintenance treatment for opioid dependence, according to a noninferiority trial in JAMA. Roughly 175 adults who were clinically stable on sublingual buprenorphine were randomized to receive four buprenorphine implants plus sublingual placebo or four placebo implants plus sublingual buprenorphine. The primary endpoint — the […]
Read MoreAuthors: Shay P. McGuinness, M.B.Ch.B. et al Anesthesiology published on 7 2016 Background: Cardiac surgery utilizing cardiopulmonary bypass (CPB) is one of the most common forms of major surgery. Cardiac surgery–associated multiorgan dysfunction (CSA-MOD) is well recognized and includes acute kidney injury (AKI), hepatic impairment, myocardial damage, and postoperative neurologic deficit. Pathophysiology of CSA-MOD involves numerous injurious […]
Read MoreAuthors: M. Ruth Graham, M.D., F.R.C.P.(C). et al Anesthesiology published on 7 2016 Background: Animal studies demonstrate general anesthetic (GA) toxicity in the developing brain. Clinical reports raise concern, but the risk of GA exposure to neurodevelopment in children remains uncertain. Methods: The authors undertook a retrospective matched cohort study comparing children less than 4 yr of […]
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