Author: Dr Clemens

Uncategorized Published - 16 November, 2015    By - Dr Clemens
First Day After Surgery Indicates Chance for Chronic Pain Later

The longer a patient is in severe pain during the first 24 hours following surgery, the more likely he or she will still be experiencing some form of chronic postsurgical pain one year later, according to a study presented at Euroanaesthesia 2015. This prospective, observational study (abstract ESAPC1-2), designed to investigate the incidence, characteristics and […]

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Uncategorized Published - 13 November, 2015    By - Dr Clemens
The Analgesic Efficacy of Ultrasound-Guided Transversus Abdominis Plane Block in Adult Patients: A Meta-Analysis

Anesthesia & Analgesia: Sept 2015 Authors: Baeriswyl, Moira MD, et al BACKGROUND: Previous meta-analyses of the transversus abdominis plane (TAP) block have examined a maximum of 12 articles, including fewer than 650 participants, and have not examined the effect of ultrasound-guided techniques specifically. Recently, many trials that use ultrasound approaches to TAP block have been […]

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Uncategorized Published - 13 November, 2015    By - Dr Clemens
Efficacy of palonosetron for preventing postoperative nausea and vomiting: a systematic review and meta-analysis.

Can J Anaesth, 2015 Dec;62(12):1268-1278. Authors: Xiong C et al PURPOSE: Palonosetron, a second-generation 5-hydroxytryptamine 3 receptor antagonist (5-HT3RA), has unique characteristics relative to first-generation 5-HT3RAs such as ondansetron. Nevertheless, it remains unclear if palonosetron is better than ondansetron for the prevention of nausea and vomiting during the first 24 hr after surgery and is thus the […]

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Uncategorized Published - 13 November, 2015    By - Dr Clemens
A randomized controlled trial of light versus deep propofol sedation for elective outpatient colonoscopy: recall, procedural conditions, and recovery.

Can J Anaesth, 2015 Nov;62(11):1169-1178. Authors: Allen M et al PURPOSE: This study aimed to determine if the incidence of recall was equivalent between light and deep sedation for colonoscopy. Secondary analysis included complications, patient clinical recovery, and post-procedure cognitive impairment. METHODS: Two hundred patients undergoing elective outpatient colonoscopy were randomized to light (bispectral index [BIS] 70-80) […]

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Uncategorized Published - 13 November, 2015    By - Dr Clemens
Failure of metyrosine therapy for preoperative management of pheochromocytoma: a case report.

Can J Anaesth, 2015 Dec;62(12):1303-1307 Authors: Thanapaalasgham K et al PURPOSE: Pheochromocytomas (PHEOS) are rare catecholamine-secreting adrenal tumours requiring surgical resection. Preoperative alpha-adrenergic receptor blockade to prevent intraoperative hypertension has traditionally been achieved with phenoxybenzamine. Due to changes in the availability of phenoxybenzamine in Canada, alternate therapies are needed for patients. We report our first experience using […]

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Uncategorized Published - 13 November, 2015    By - Dr Clemens
Capsaicin 8% Patch Effective for Painful Diabetic Peripheral Neuropathy

Capsaicin 8% patch is well-tolerated and provides significant improvements in pain and sleep quality compared with placebo for patients with painful diabetic peripheral neuropathy (PDPN), according to a study presented here at the 51st Annual Meeting of the European Association for the Study of Diabetes (EASD). Capsaicin 8% patch has been used as an analgesic […]

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Uncategorized Published - 12 November, 2015    By - Dr Clemens
FDA Approves First Dabigatran Reversal Agent

The FDA has granted accelerated approval for idarucizumab (Praxbind) to reverse the anticoagulant effects of dabigatran (Pradaxa) in emergency situations. Idarucizumab, an injectable monoclonal antibody fragment, binds to dabigatran and thereby neutralizes its effect. Approval was based on three trials in which some 280 healthy adults who did not require anticoagulant therapy were given dabigatran […]

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Uncategorized Published - 12 November, 2015    By - Dr Clemens
Induced Hypothermia Can Worsen Outcomes After Traumatic Brain Injury

Authors: Andrews PJD et al., N Engl J Med 2015 Oct 7; A multicenter randomized trial was stopped early because hypothermia worsened outcomes when used as second-line therapy for elevated intracranial pressure. Induced hypothermia has become popular for treating cerebral edema from traumatic brain injury (TBI), but we do not know the effect on long-term […]

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Uncategorized Published - 12 November, 2015    By - Dr Clemens
Problems with Automated Anesthesia Machine Checkout

Dear Q&A, We write to describe an instance of anesthesia machine ventilator failure during provision of anesthesia. The case in point was an emergency vascular operation for a pulseless lower extremity. In preparation for the case, the anesthesia machine checkout was performed on the Dräger GS Premium. All tests confirmed that the anesthesia machine was […]

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Uncategorized Published - 12 November, 2015    By - Dr Clemens
Medical Air Supply Causes Rapid Inflow of Water Into Flow Meters

Dear Q&A, We were using oxygen and air with sevoflurane for a case in the cystoscopy suite. During the maintenance phase of the case, we found what we assumed to be water inside the air flowmeter, with its float rising and dropping rapidly and the liquid spilling into the next flowmeter (nitrous oxide). We promptly […]

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