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The Case of the Sweaty Patient: Despite a zero-tolerance policy at many institutions and organizations, wrong-sided blocks still occur, although many go unreported. Yet as a near miss at Duke University Medical Center helps illustrate, implementation of an anesthesiologist-led block protocol helps prevent such accidents from taking place. “We’ve always had an institutional guideline for […]
Read MorePreliminary analysis of data from an ongoing multicenter trial suggests that epidural analgesia may be about to take its most radical turn in more than a century. The analysis found that a novel computerized injection pump technology is as successful in identifying the epidural space as are fluoroscopy and loss of resistance, which one of […]
Read MoreIs moderate sedation safer than general anesthesia for transcatheter aortic valve replacement (TAVR), or is it that lower-risk patients are more likely to receive moderate sedation? That is the question raised by a new 11,000-patient study that found 30-day mortality rates were 38% lower among TAVR patients who received moderate sedation than those who were […]
Read MoreAuthors: Viviane G. Nasr, MD et al Pediatr Crit Care Med. 2016;17(S1):S225-S231. Objectives: This review will focus on the pharmacokinetics (with an emphasis on the context-sensitive half-time), pharmacodynamics, and hemodynamic characteristics of the most commonly used sedative/hypnotic, analgesic, and IV anesthetics used in cardiac intensive care. In addition, the assessment of pain and agitation and withdrawal will […]
Read MoreAuthors: John W. Eikelboom, M.B.B.S. et al Anesthesiology 12 2016, Vol.125, 1121-1129. Background: The PeriOperative ISchemia Evaluation-2 (POISE-2) trial compared aspirin with placebo after noncardiac surgery. Methods: The authors randomly assigned 10,010 patients undergoing noncardiac surgery to receive 200 mg aspirin or placebo 2 to 4 h before surgery and then 100 mg aspirin daily or placebo daily […]
Read MoreAuthors: Hernández G et al., JAMA 2016 Oct 18; 316:1565 High-flow oxygen was noninferior to noninvasive positive pressure ventilation for preventing reintubation. During the last 2 years, we have seen a rapid rise in use of high-flow oxygen. Although its use is supported during the immediate postextubation period for patients at low risk for reintubation (NEJM JW […]
Read MoreAuthors: Ross A. Davenport, Ph.D. et al Anesthesiology published on November 17, 2016 Background: Major trauma is a leading cause of morbidity and mortality worldwide with hemorrhage accounting for 40% of deaths. Acute traumatic coagulopathy exacerbates bleeding, but controversy remains over the degree to which inhibition of procoagulant pathways (anticoagulation), fibrinogen loss, and fibrinolysis drive the pathologic process. […]
Read MoreThe U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has posted its Work Plan for FY2017. The 2017 Work Plan includes two issues specific to anesthesia care. These issues have been included in previous editions of the Work Plan. ASA members are reminded to be certain that they provide anesthesia services […]
Read MorePain: August 2016 – Volume 157 – Issue 8 – p 1733–1743 Authors: Rosenbloom, Brittany N et al Abstract: Traumatic musculoskeletal injury results in a high incidence of chronic pain; however, there is little evidence about the nature, quality, and severity of the pain. This study uses a prospective, observational, longitudinal design to (1) examine […]
Read MorePAIN Reports: August 2016 – Volume 1 – Issue 2 – p 570 Authors: Rivat, Cyril et al Introduction: In the past 2 decades, opioids have been used increasingly for the treatment of persistent pain, and doses have tended to creep up. As basic science elucidates mechanisms of pain and analgesia, the cross talk between […]
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