Author: Dr Clemens

Uncategorized Published - 8 April, 2016    By - Dr Clemens
Pupillometry Accurately Predicts Postoperative Nausea and Vomiting, Allows Earlier Intervention

No matter how successful the surgery, a patient’s experience of postoperative nausea and vomiting (PONV) can contribute to patient dissatisfaction, longer PACU stays, hospital readmission and overall perioperative costs. Pupillometric assessment can serve as a simple but accurate tool to help identify patients with PONV, a study has found, which can allow physicians to offer […]

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Uncategorized Published - 8 April, 2016    By - Dr Clemens
Steroids Before Hip Arthroplasty Increase Infection Risk

Patients should not receive intra-articular steroid injections in the hip in the 3 months before total hip arthroplasty because it could put them at higher risk for postoperative infection, new research shows. “I’ve spoken with surgeons who have been reluctant to perform hip injections before surgery because of the theoretical risk of infection due to […]

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Uncategorized Published - 8 April, 2016    By - Dr Clemens
Migraine Linked to Irritable Bowel Syndrome

Migraine and tension-type headache may share links with irritable bowel syndrome (IBS), a preliminary study hints. “Our results suggest a high possibility of phenotypic and genotypic associations between IBS and primary headache disorders (particularly migraine) and support the presence of some shared pathophysiology,” Derya Uluduz, MD, from Istanbul University in Turkey, told Medscape Medical News. “Greater […]

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Uncategorized Published - 8 April, 2016    By - Dr Clemens
Anesthesia Complications Reduced for Cesarean Deliveries … But Other Perioperative Complications Rise

There has been a 25% fall in anesthesia-related complications for women undergoing cesarean deliveries, with mortality rates falling as well, a comprehensive study of New York state hospital records has found. The bad news: Nonanesthetic perioperative complications jumped nearly 50%. The study (Anesthesiology 2015;123:1013-1023) examined 785,854 cesarean deliveries in hospitals across New York state from 2003 […]

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Uncategorized Published - 8 April, 2016    By - Dr Clemens
OR-to-PACU Handoff Protocol Succeeds in Reducing Errors

A new handoff protocol boosted communication while slashing errors among nurses, anesthesiologists and surgeons during the transfer of patients from the operating room (OR) to the PACU. There was a dramatic decrease in lapses in the surgery and anesthesia reports after the rollout of the new handoff process at The Johns Hopkins Hospital, in Baltimore, […]

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Uncategorized Published - 7 April, 2016    By - Dr Clemens
ETCO2 Concentration Correlates With Trauma Mortality

End-tidal carbon dioxide (ETCO2) monitoring could aid resuscitation of trauma patients presenting with hypovolemic shock undergoing emergency surgery, a retrospective study suggests. ETCO2 of less than 20 mm Hg was a 95% predictor of intraoperative cardiac arrest or death. “Our results suggest that end-tidal carbon dioxide is a valuable short-term prognostic indicator in trauma patients underdoing […]

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Uncategorized Published - 7 April, 2016    By - Dr Clemens
No Need for Chest X-Ray After Ultrasound-Guided Right Internal Jugular Lines?

Authors: Hourmozdi JJ et al., Crit Care Med 2016 Mar 31; Very few complications were picked up by routine chest x-ray at a large academic hospital system. For decades, dogma has been that chest x-ray should be performed to confirm placement of all internal jugular (IJ) central lines, despite evidence that ultrasound can significantly reduce complication rates. […]

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Uncategorized Published - 7 April, 2016    By - Dr Clemens
Liposome Bupivacaine Femoral Nerve Block for Postsurgical Analgesia after Total Knee Arthroplasty

Anesthesiology published on 4 2016. Authors: Admir Hadzic, M.D. et al Background: The authors evaluated the efficacy of liposome bupivacaine in a femoral nerve block (FNB) after total knee arthroplasty. Methods: Part 1: subjects received FNB with 20 ml liposome bupivacaine (67, 133, or 266 mg) or placebo. Part 2: subjects were randomized to FNB with liposome bupivacaine […]

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Uncategorized Published - 7 April, 2016    By - Dr Clemens
Self-reported Mobility in Older Patients Predicts Early Postoperative Outcomes after Elective Noncardiac Surgery

Anesthesiology 4 2016, Vol.124, 815-825 Authors: Sunghye Kim, M.D., M.M.Sc. et al  Background: Specific geriatric assessment tools may complement traditional perioperative risk stratification. The aim of this study was to evaluate whether self-reported mobility is predictive of postoperative outcomes in older patients undergoing elective noncardiac surgery. Methods: Patients aged 69 yr or older (n = 197) underwent (1) […]

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Uncategorized Published - 7 April, 2016    By - Dr Clemens
Perioperative Opioids and Public Health

Anesthesiology 4 2016, Vol.124, 960-965. Authors: Evan D. Kharasch, M.D., Ph.D. et al Description opioid diversion, abuse, addiction, and overdose are epidemic. Although unclear whether postoperative opioid prescribing is contributory, or how anesthesiologists and surgeons can contribute to a solution, nonetheless awareness and a research agenda are needed. ANESTHESIOLOGISTS and surgeons face three challenges in the […]

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