Author: Dr Clemens

Uncategorized Published - 15 April, 2016    By - Dr Clemens
Optimal Depth for Nasopharyngeal Temperature Probe Positioning

Anesthesia & Analgesia: March 2016 AUTHORS: Wang, Mi MD et al BACKGROUND: The nasopharynx is considered 1 of the 4 generally reliable core temperature measurement sites. But curiously, there is no consensus on how far past the nares to insert the probe. Insertion depth is likely to influence the accuracy of nasopharyngeal temperature measurements because […]

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Uncategorized Published - 14 April, 2016    By - Dr Clemens
Haptoglobin Lowers Risk for Post-Op Acute Kidney Injury In Cardiac Surgery Patients With Chronic Renal Impairment

Given its prevalence after cardiac surgery—particularly in patients with chronic renal impairment—finding a way to curb postoperative acute kidney injury (AKI) stands to have a significant effect on patient outcomes. A Japanese research team seems to have taken a step in that direction; their study found that intraoperative administration of haptoglobin was independently associated with […]

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Uncategorized Published - 14 April, 2016    By - Dr Clemens
Intrathecal Hydromorphone and Morphine for Postcesarean Delivery Analgesia: Determination of the ED90 Using a Sequential Allocation Biased-Coin Method.

Anesthesia & Analgesia: March 2016 AUTHORS: Sviggum, Hans P. MD et al BACKGROUND: Intrathecal (IT) morphine is considered the “gold standard” for analgesia after cesarean delivery under spinal anesthesia, most commonly administered at a dose of 100 to 200 [mu]g. There is less experience with IT hydromorphone for postcesarean analgesia and limited information on its […]

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Uncategorized Published - 14 April, 2016    By - Dr Clemens
Femoral Nerve Block-sciatic Nerve Block vs. Femoral Nerve Block-local Infiltration Analgesia for Total Knee Arthroplasty

A Randomized Controlled Trial Authors: Mari Nagafuchi et al BMC Anesthesiol. 2015;15(182) Background: The use of femoral nerve block (FNB) combined with sciatic nerve block (SNB) after total knee arthroplasty (TKA) has recently become controversial. Local infiltration analgesia (LIA) has been reported to be effective for postoperative TKA pain control. We aimed to assess whether […]

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Uncategorized Published - 14 April, 2016    By - Dr Clemens
Role of Cardiopulmonary Exercise Testing as a Risk-assessment Method in Patients Undergoing Intra-abdominal Surgery

A Systematic Review Authors: J. Moran; F. Wilson et al Br J Anaesth. 2016;116(2):177-191. Background: Cardiopulmonary exercise testing (CPET) is used as a preoperative risk-stratification tool for patients undergoing non-cardiopulmonary intra-abdominal surgery. Previous studies indicate that CPET may be beneficial, but research is needed to quantify CPET values protective against poor postoperative outcome [mortality, morbidity, […]

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Uncategorized Published - 14 April, 2016    By - Dr Clemens
Less Than an Hour of Sevoflurane in Infancy Does Not Harm Neurodevelopment

An international multicenter trial has concluded that just under an hour of sevoflurane anesthesia during infancy does not increase the risk for adverse neurodevelopmental outcome at 2 years of age, relative to awake regional anesthesia. The finding is in contrast to some previous cohort studies. According to Andrew J. Davidson, MD, senior anesthesiologist and director […]

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Uncategorized Published - 13 April, 2016    By - Dr Clemens
Agreement on Physical Status Scores Poor Among Anesthesiologists, Others

Although inconsistencies among anesthesiologists have been demonstrated in the American Society of Anesthesiologists (ASA) physical status classification system, one study from the State University of New York (SUNY) Downstate Medical Center, in New York City, has found that agreement between anesthesiologists and nonanesthesiologists is exceedingly weak. These discrepancies are particularly evident in patients with higher […]

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Uncategorized Published - 13 April, 2016    By - Dr Clemens
Hypertension in Pregnancy Portends Lasting Cardiomyopathy Risk

Hypertensive disorders in pregnancy (HDP) are associated with an increased risk of cardiomyopathy years after an affected pregnancy and regardless of hypertension severity, a large registry study involving one million Danish women shows. “The fact that we could drop the first 5 years after pregnancy and still see this risk was really fascinating,” senior author […]

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Uncategorized Published - 13 April, 2016    By - Dr Clemens
Soaring Rates of Opioid Addiction Challenge Hospitalists

The toll that opioid addiction has taken in the United States is staggering, said Jesse Theisen-Toupal, MD, from the Veterans Administration Medical Center in Washington, DC. “In 2000, there were 4400 opioid overdose-related deaths,” he reported here at the Society of Hospital Medicine 2016 Annual Meeting. “In 2013, there were 16,000.” Despite this crisis, some […]

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Uncategorized Published - 13 April, 2016    By - Dr Clemens
Are Smoking, Obesity Risky With Spinal Cord Stimulation for Pain?

Contrary to expectations, smoking and obesity do not appear to affect the efficacy of, or increase the infection rate related to, spinal cord stimulator implantation, a new study shows. “It’s very well known that smoking, for example, can increase the risk of infection and of complications in different types of major surgery, especially spinal surgery,” […]

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