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Anesthesiologists at Massachusetts General Hospital, in Boston, have documented the positive results from a mid-2013 switch to a “morphine first” policy, which they implemented in the wake of mounting reports of serious adverse events from hydromorphone that were highlighted in a 2012 alert by the Massachusetts State Board of Medicine. At the end of June […]
Read MoreThe FDA issued a warning about possible infections associated with heater–cooler devices and issued steps that health care providers and facilities could take to mitigate risks to patients. Heater–cooler devices are used during cardiothoracic surgeries, as well as other medical and surgical procedures to warm or cool a patient to optimize medical care and improve […]
Read MorePatients who receive statins along with beta-blockers prior to cardiac surgery do better than those given no such medication, according to a new study. Senior author Peyman Benharash, MD, told Reuters Health by email, “professional society guidelines have mandated the use of beta blockers in patients taking these agents prior to cardiac surgery. Our group, […]
Read MoreAuthors: Kate Leslie, MBBS, MD, M.Epid, M.Hlth Serv, Mt FANZCA, et al Anesthesiology 12 2015, Vol.123, 1267-1280. Background: The Evaluation of Nitrous Oxide in the Gas Mixture for Anaesthesia (ENIGMA)-II trial randomly assigned 7,112 noncardiac surgery patients at risk of perioperative cardiovascular events to 70% N2O or 70% N2 groups. The aim of this follow-up study was to determine […]
Read MoreAuthors: Hillenn Cruz Eng, MD, et al Anesthesiology 12 2015, Vol.123, 1256-1266. Background: Common standard practice after complex arthroscopic elbow surgery includes hospital admission for 72 h. The authors hypothesized that an expedited care pathway, with 24 h of hospital admission and ambulatory brachial plexus analgesia and continuous passive motion at home, results in equivalent elbow range of […]
Read MoreAuthors: Sinziana Avramescu, MD, PhD, et al Anesthesiology published on 11 2015. Background: Critically ill patients with severe inflammation often exhibit heightened sensitivity to general anesthetics; however, the underlying mechanisms remain poorly understood. Inflammation increases the number of γ-aminobutyric acid type A (GABAA) receptors expressed on the surface of neurons, which supports the hypothesis that inflammation increases up-regulation […]
Read MoreAuthors: Daniel J. Johnson, B.S. el at Anesthesiology published on 11 2015. Background: It is well recognized that increased transfusion volumes are associated with increased morbidity and mortality, but dose–response relations between high- and very-high-dose transfusion and clinical outcomes have not been described previously. In this study, the authors assessed (1) the dose–response relation over a wide […]
Read MoreAuthors: Karim S. Ladha, MD M.Sc et al Anesthesiology published on 11 2015. Background: Opioids play a crucial role in providing analgesia throughout the perioperative period; however, patients may become persistent users of these medications months after surgery. Epidurals have been posited to prevent the development of persistent pain, but there are little data on the effect […]
Read MoreAuthors: Lisbeth Evered, B.Sc, M.Biostat, PhD et al Anesthesiology published on 11 2015. Background: Postoperative cognitive dysfunction (POCD) affects 16 to 21% of the elderly 3 months after anesthesia and surgery and is associated with adverse outcomes. The exact cause of POCD remains unknown. The authors hypothesized that elderly individuals with Alzheimer disease (AD) neuropathology, identified by cerebrospinal […]
Read MoreAuthors: Christoffer C. Jorgensen MD, et al Anesthesiology 12 2015, Vol.123, 1281-1291. doi:10.1097/ALN.0000000000000632 Background: Psychiatric disorder (PsD) is rarely considered when evaluating perioperative risk factors. Studies on PsD are often limited by use of administrative coding, incomplete follow-up, and lack of preoperative data on psychopharmacological treatment. Methods: A multicenter study with prospective registration on preoperative comorbidity, complete 90-day follow-up, […]
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