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Eur J Anaesthesiol. 2015 Nov;32(11):751-8. doi: 10.1097/EJA.0000000000000248. AUTHORS:Huynh TM et al BACKGROUND: Dexamethasone decreases postoperative pain and prolongs the duration of local anaesthetic peripheral nerve blocks in studies including a limited number of patients. OBJECTIVE: The objective of this study is to evaluate the effect of combining dexamethasone with local anaesthetic on sensory and motor peripheral […]
Read MoreEur J Anaesthesiol. 2015 Nov;32(11):759-63 AUTHORS: Szucs S et al BACKGROUND: Femoral neck fractures usually require operative fixation. Spinal anaesthesia is the preferred technique for many anaesthetists, although single-shot spinal anaesthesia may have severe haemodynamic side-effects. OBJECTIVE: To determine the initial minimum intrathecal dose of 0.5% isobaric bupivacaine required in order to achieve surgical anaesthesia within […]
Read MoreCan 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 […]
Read MoreAnesthesiologists 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 […]
Read MoreDelirium 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 […]
Read MoreStaff 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 […]
Read MoreChest. 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 […]
Read MoreSurg 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. […]
Read MoreAmong 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, […]
Read MoreAuthors: 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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