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In patients with acute, nontraumatic low back pain, adding cyclobenzaprine or oxycodone/acetaminophen to naproxen alone did not improve functional outcomes or pain at 1-week follow-up in a new randomized study. “Naproxen alone was just as good as using it in combination with the muscle relaxant or the opioid,” lead author Benjamin W. Friedman, MD, Albert […]
Read MoreOn January 13, 2016, ASA and the American Society of Regional Anesthesia and Pain Medicine (ASRA) submitted formal recommendations to the Centers for Disease Control and Prevention (CDC) offering support for the proposed 2016 Guideline for Prescribing Opioids for Chronic Pain while expressing caution on its impact on therapies used to treat acute and chronic pain. The Guideline […]
Read MoreThe US Food and Drug Administration (FDA) has approved the Algovita Spinal Cord Stimulation System (Greatbatch Inc), a device to treat chronic pain, the company announced in a press release. The device is indicated as an aid in the management of chronic, intractable pain of the trunk and/or limbs, including unilateral or bilateral pain associated with […]
Read MoreNew American Academy of Pediatrics (AAP) guidelines, published November 30 in Pediatrics, identify key components for the pediatric perioperative anesthesia environment to optimize anesthetic care and reduce adverse events. “[T]he pediatric perioperative anesthesia environment is defined as areas of a patient care facility in which the patient preparation for, performance of, and recovery from surgical procedures occur […]
Read MoreAnesthesia & Analgesia: January 2016 – Volume 122 – Issue 1 – p 173–185 Egal, Mohamud MD et al BACKGROUND: We investigated whether resuscitation protocols to achieve and maintain urine output above a predefined threshold—including oliguria reversal as a target––prevent acute renal failure (ARF). METHODS: We performed a systematic review and meta-analysis using studies found […]
Read MoreAnesthesia & Analgesia: October 26, 2015 Prin, Meghan MD et al BACKGROUND: Pruritus is a common side effect of intrathecal fentanyl or sufentanil that decreases patient satisfaction and may delay hospital discharge. There are conflicting reports about the efficacy of prophylactic ondansetron in reducing the incidence of pruritus. This meta-analysis aimed to assess the effect […]
Read MoreAnesthesia & Analgesia: January 2016 – Volume 122 – Issue 1 – p 219–225 Triffterer, Lydia MD et al BACKGROUND: Perioperative hypothermia is a common problem, challenging the anesthesiologist and influencing patient outcome. Efficient and safe perioperative active warming is therefore paramount; yet, it can be particularly challenging in pediatric patients. Forced-air warming technology is […]
Read MoreThe opioid tramadol is an effective analgesic for patients with clinically suspected acute appendicitis, according to the results of a prospective study presented at the 2015 Annual Meeting of the American College of Surgeons (ACS). “Tramadol…can provide significant reduction in abdominal pain and tenderness without altering the diagnostic confidence of the surgeon…in patients with suspected […]
Read MoreAuthors: Friedman BW et al. JAMA 2015 Oct 20. Neither cyclobenzaprine nor opioids are helpful as adjuncts to naproxen therapy for low back pain. Cyclobenzaprine (Flexeril) is a tricyclic antidepressant that is viewed as having “muscle relaxant” properties, even though it has no effect on motor neurons or skeletal muscle. Opioids act at the mu receptor […]
Read MoreAnesthesia & Analgesia: October 26, 2015 Tusman, Gerardo MD et al BACKGROUND: We sought to determine whether the response of pulmonary elimination of CO2 (VCO2) to a sudden increase in positive end-expiratory pressure (PEEP) could predict fluid responsiveness and serve as a noninvasive surrogate for cardiac index (CI). METHODS: Fifty-two patients undergoing cardiovascular surgery were […]
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