Author: Dr Clemens

Uncategorized Published - 4 August, 2015    By - Dr Clemens
Endovascular and Open Repairs of Abdominal Aortic Aneurysms Have Similar Long-Term Mortality Rates

After endovascular repair of abdominal aortic aneurysms, mortality rises over time but doesn’t surpass that associated with open repair, a New England Journal of Medicine study suggests. From more than 125,000 Medicare beneficiaries who underwent either procedure, about 40,000 in each procedure group were matched according to propensity to undergo endovascular repair. Periprocedural mortality was 1.6% with […]

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Uncategorized Published - 4 August, 2015    By - Dr Clemens
Psychiatric Comorbidity Is Associated Prospectively with Diminished Opioid Analgesia and Increased Opioid Misuse in Patients with Chronic Low Back Pain

Anesthesiology published on 7 2015 Authors: Ajay D. Wasan MD, M.Sc et al Background: Opioids are frequently prescribed for chronic low back pain (CLBP), but there are little prospective data on which patient subgroups may benefit. Psychiatric comorbidity, such as high levels of depression and anxiety symptoms (termed comorbid negative affect [NA]), is a common presentation and may […]

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Uncategorized Published - 4 August, 2015    By - Dr Clemens
A Randomized Crossover Study Comparing a Novel Needle Guidance Technology for Simulated Internal Jugular Vein Cannulation

Anesthesiology published on 7 2015 Authors: David B Auyong MD et al Background: Despite ultrasound guidance for central line placement, complications persist, as exact needle location is often difficult to confirm with standard two-dimension ultrasound. A novel real-time needle guidance technology has recently become available (eZono, Germany) that tracks the needle during insertion. This randomized, blinded, crossover study examined […]

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Uncategorized Published - 4 August, 2015    By - Dr Clemens
Ability of the Nociception Level, a Multiparameter Composite of Autonomic Signals, to Detect Noxious Stimuli during Propofol–Remifentanil Anesthesia

Anesthesiology Published on 7 2015. Authors: Chris H. Martini MD et al Background: A novel multidimensional index of nociception, the nociception level (NoL) index, derived from the nonlinear composite of heart rate (HR), HR variability, amplitude of the photoplethysmogram, skin conductance, fluctuations in skin conductance, and their time derivatives, was used to assess nociception during anesthesia. Methods: […]

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Uncategorized Published - 4 August, 2015    By - Dr Clemens
Discharge Readiness after Tricompartment Knee Arthroplasty: Adductor Canal versus Femoral Continuous Nerve Blocks—A Dual-center, Randomized Trial

Anesthesiology 8 2015, Vol.123, 444-456 Authors: Anthony T. Machi MD et al Background: The authors conducted a randomized, controlled, parallel-arm, superiority study to test the hypothesis that a continuous adductor canal block decreases the time to attain four discharge criteria compared with a continuous femoral nerve block after tricompartment knee arthroplasty. Methods: Subjects undergoing tricompartment knee arthroplasty were randomized […]

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Uncategorized Published - 3 August, 2015    By - Dr Clemens
Sufentanil Sublingual Tablet System for the Management of Postoperative Pain after Knee or Hip Arthroplasty: A Randomized, Placebo-controlled Study

Anesthesiology 8 2015, Vol.123, 434-443 Authors: Maurice Jove, MD et al Background: Complications with IV patient-controlled analgesia include programming errors, invasive access, and impairment of mobility. This study evaluated an investigational sufentanil sublingual tablet system (SSTS) for the management of pain after knee or hip arthroplasty. Methods: This prospective, randomized, parallel-arm, double-blind study randomized postoperative patients at 34 U.S. sites […]

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Uncategorized Published - 3 August, 2015    By - Dr Clemens
A Perioperative Course of Gabapentin Does Not Produce a Clinically Meaningful Improvement in Analgesia after Cesarean Delivery: A Randomized Controlled Trial

Anesthesiology 8 2015, Vol.123, 320-326. Authors: David T. Monks, MD et al Background: Studies examining the efficacy of a single preoperative dose of gabapentin for analgesia after cesarean delivery (CD) have been inconclusive. The authors hypothesized that a perioperative course of gabapentin would improve analgesia after CD. Methods:  This single-center, randomized, double-blind, placebo-controlled, parallel-group, superiority trial was […]

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Uncategorized Published - 3 August, 2015    By - Dr Clemens
Association between Withholding Angiotensin Receptor Blockers in the Early Postoperative Period and 30-day Mortality: A Cohort Study of the Veterans Affairs Healthcare System

Anesthesiology 8 2015, Vol.123, 288-306. Authors: Susan M Lee, MD, FRCPC et al Background: Despite widespread use, there is limited information to guide perioperative management of angiotensin receptor blockers (ARBs). Methods:  In this retrospective cohort study, the authors evaluated the patterns of postoperative ARB use in veterans regularly prescribed ARBs admitted for noncardiac surgery at the Veterans […]

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Uncategorized Published - 3 August, 2015    By - Dr Clemens
Hyperinsulinemic Normoglycemia Does Not Meaningfully Improve Myocardial Performance during Cardiac Surgery: A Randomized Trial

Anesthesiology 8 2015, Vol.123, 272-287. Authors: Andra E Duncan, MD et al Background:  Glucose–insulin–potassium (GIK) administration during cardiac surgery inconsistently improves myocardial function, perhaps because hyperglycemia negates the beneficial effects of GIK. The hyperinsulinemic normoglycemic clamp (HNC) technique may better enhance the myocardial benefits of GIK. The authors extended previous GIK investigations by (1) targeting normoglycemia while […]

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Uncategorized Published - 3 August, 2015    By - Dr Clemens
Need to Exchange a Tracheal Tube? Use Video Laryngoscopy

Authors: Mort TC and Braffett BH., Anesth Analg 2015 Jun 23; Video laryngoscopy improved first-attempt success and lowered rates of complications compared with direct laryngoscopy in a single-center registry study of endotracheal tube exchanges using airway exchange catheters. Endotracheal tube (ETT) exchange is required when ventilation is ineffective because of either cuff failure or tube size. The […]

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