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Anesthesia & Analgesia: September 2016 – Volume 123 – Issue 3 – p 587–596 AUTHORS: Mirzakhani, Hooman MD, PhD et al BACKGROUND: Neuromuscular blockade is required to control excessive muscle contractions during electroconvulsive therapy (ECT). In a crossover, assessor-blinded, prospective randomized study, we studied the minimum effective dose (MED) of succinylcholine and rocuronium for ECT. […]
Read MoreAnesthesia & Analgesia: September 2016 – Volume 123 – Issue 3 – p 570–577 AUTHORS: Fabbro, Michael II DO et al BACKGROUND: The inflated costs and documented deleterious effects of excess perioperative transfusion have led to the investigation of targeted coagulation factor replacement strategies. One particular coagulation factor of interest is factor I (fibrinogen). Hypofibrinogenemia […]
Read MorePreoperative frailty assessments may help predict mortality and functional decline among seniors undergoing cardiac surgical procedures. The results of this systematic review were published online August 23 in the Annals of Internal Medicine. “Despite various ways of measuring frailty, we found strong evidence that it predicts mortality at 6 months or later after major or minimally invasive procedures,” […]
Read MoreAuthors: Lamy A et al., N Engl J Med 2016 Oct 23; Data on outcomes, cost, and quality of life did not differ significantly between the two coronary artery bypass grafting strategies. In the multinational, randomized CORONARY trial, comparing off-pump (beating heart) with on-pump coronary artery bypass grafting (CABG), the primary endpoint did not differ significantly between […]
Read MoreEuropean Journal of Anaesthesiology: April 2016 – Volume 33 – Issue 4 – p 275–282 AUTHORS: Lee, Su Hyun et al BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a risk factor that increases the incidence of postoperative cardiopulmonary morbidity and mortality after lung resection. Dexmedetomidine, a selective α2-adrenoreceptor agonist, has been reported previously to attenuate intrapulmonary […]
Read MoreAnesthesia & Analgesia: September 2016 – Volume 123 – Issue 3 – p 626–633 AUTHORS: Applegate, Richard L. II MD et al BACKGROUND: The use of intraoperative pulse oximetry (SpO2) enhances hypoxia detection and is associated with fewer perioperative hypoxic events. However, SpO2 may be reported as 98% when arterial partial pressure of oxygen (PaO2) is […]
Read MoreAuthors: Pavel S. Roshanov, M.D., M.Sc. et al Anesthesiology published on October 23, 2016. Background: The effect on cardiovascular outcomes of withholding angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers in chronic users before noncardiac surgery is unknown. Methods: In this international prospective cohort study, the authors analyzed data from 14,687 patients (including 4,802 angiotensin-converting enzyme inhibitor/angiotensin II […]
Read MoreAuthors: Patrick J. McCormick, M.D. et al Anesthesiology published on October 23, 2016. Background: We tested the hypothesis that an electronic alert for a “double low” of mean arterial pressure less than 75 mmHg and a bispectral index less than 45 reduces the primary outcome of 90-day mortality. Methods: Adults having noncardiac surgery were randomized to receive either […]
Read MoreIn a soul-searching Emery A. Rovenstine Memorial Lecture on Monday, David Chestnut, M.D., examined the key attributes of professionalism and his own journey on the road to professionalism in anesthesiology. “Each of us helps shape the culture of professionalism in our practice environment. Professionalism is not something that we learn once. None of us is […]
Read MoreDavid J. Bjorkman, MD, MSPH (HSA), SM (Epid.) Reviewing Kumar NL et al., Gastrointest Endosc 2016 Sep 29; Earlier endoscopy — performed within 12 versus 24 hours of bleeding presentation — was associated with worse outcomes in low-risk patients. Most guidelines recommend that patients with nonvariceal upper gastrointestinal bleeding (UGIB) undergo endoscopy within 24 hours of presentation. But […]
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