Author: Dr Clemens

Uncategorized Published - 3 February, 2016    By - Dr Clemens
Effects of changing from sevoflurane to desflurane on the recovery profile after sevoflurane induction: a randomized controlled study

Can J Anaesth. 2015 Oct AUTHORS: Mikuni I et al PURPOSE: Desflurane has the lowest solubility of currently available volatile anesthetics and may allow for more rapid emergence and recovery compared with sevoflurane. Nevertheless, after volatile induction with sevoflurane, it has not been determined whether the use of desflurane provides faster emergence and recovery. The present […]

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Uncategorized Published - 3 February, 2016    By - Dr Clemens
Tight Hypertension Control Reduces Serious Adverse Outcomes in Cardiac Surgery Patients

Anesthesiologists should place greater emphasis on blood pressure control during the perioperative period, because success or failure in achieving postoperative blood pressure targets can have significant effects on short- and long-term outcomes. Recent studies have linked acute alterations in perioperative blood pressure to adverse outcomes in cardiac surgery, including acute kidney injury, higher mortality rate […]

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Uncategorized Published - 2 February, 2016    By - Dr Clemens
Intra-op Dexmedetomidine Lowers Delirium in Elderly Cardiac Patients

Delirium may be a troubling consequence of high-risk cardiac surgery in elderly patients, but that can be avoided with the administration of intraoperative dexmedetomidine, according to a team of Toronto researchers. This benefit, they added, does not come with the burden of negative hemodynamic changes. “Delirium affects as many as one in five elderly patients […]

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Uncategorized Published - 2 February, 2016    By - Dr Clemens
Staff Breaks Help Improve Outcomes

Staff breaks are associated with improved surgical outcomes, a study has concluded. However, the study failed to find an association between handoffs and outcomes. Elucidating the relationship between transitions of care and outcomes is critical for determining best practices for safe patient care. “We read with great interest the Cleveland Clinic study, which demonstrated that […]

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Uncategorized Published - 2 February, 2016    By - Dr Clemens
Associations between different sedatives and ventilator-associated events, length-of-stay, and mortality in mechanically ventilated patients

Chest. 2015 Oct 22. doi: 10.1378/chest.15-1389 AUTHORS: Klompas M et al BACKGROUND: Current sedation guidelines recommend avoiding benzodiazepines but express no preference for propofol versus dexmedetomidine. In addition, there are limited data on how well randomized controlled trials on sedatives generalize to routine practice where conditions tend to be more varied and complex. METHODS: We gathered […]

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Uncategorized Published - 2 February, 2016    By - Dr Clemens
Acetazolamide reduces postoperative pain following laparoscopic inguinal herniorrhaphy

Surg Endosc. 2015 Oct 20 AUTHORS: Pourladian I et al BACKGROUND: Carbonic acid accumulation, which results from CO2 insufflation, can produce visceral and referred pain in the postoperative setting. Acetazolamide inhibits carbonic anhydrase, an enzyme that accelerates carbonic acid formation. We hypothesized that preoperative administration of acetazolamide would decrease postoperative pain in patients undergoing laparoscopic inguinal herniorrhaphy. […]

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Uncategorized Published - 2 February, 2016    By - Dr Clemens
Few Frivolous Claims of Malpractice End in Payment

Among nearly 1 million active physicians in the U.S., about 6% were involved in at least one paid malpractice claim during a 10-year period ending in 2014, with a total payout of $13.6 billion, researchers said. The vast majority of claims were for death or major or significant physical injury, according to David M. Studdert, LLB, […]

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Uncategorized Published - 1 February, 2016    By - Dr Clemens
Observational Study of Cerebral Blood Flow Velocity During Hypotensive Epidural Anesthesia

Authors: Bombardieri AM et al Anesth Analg 2016 Jan;122 (1): 226-33 BACKGROUND: Hypotensive epidural anesthesia (HEA), as practiced at our institution, uses sympathetic blockade to achieve mean arterial blood pressure (MAP) of ≤50 mm Hg while administering epinephrine by infusion to support the circulation. HEA has not been associated with gross adverse effects on neurologic outcome […]

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Uncategorized Published - 1 February, 2016    By - Dr Clemens
The Effect of Systemic Magnesium on Postsurgical Pain in Children Undergoing Tonsillectomies: A Double-Blinded, Randomized, Placebo-Controlled Trial

Anesthesia & Analgesia: December 2015 – Volume 121 – Issue 6 – p 1627–1631 Authors: Benzon, Hubert A. MD, MPH et al BACKGROUND: Tonsillectomy is a frequently performed surgical procedure in children; however, few multimodal analgesic strategies have been shown to improve postsurgical pain in this patient population. Systemic magnesium infusions have been shown to […]

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Uncategorized Published - 1 February, 2016    By - Dr Clemens
Clinical predictors of prolonged postresection hypotension after laparoscopic adrenalectomy for pheochromocytoma

Surgery. 2015 Oct Authors: Namekawa T et al BACKGROUND: Although the perioperative management of patients with pheochromocytoma has been improving recently, severe hypotensive episodes can occur that require postoperative catecholamine support and are challenging to manage. Our aim was to identify the clinical factors that predict prolonged postresection hypotension in patients after laparoscopic adrenalectomy for pheochromocytoma. […]

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