Author: Dr Clemens

Uncategorized Published - 12 May, 2023    By - Dr Clemens
Chronic Pain at the Pharmacy: Methadone Initiation for CRPS and Comorbidities 2023

Author: Amarquaye W. Pract Pain Manag. 2023 May/June;23(3). When a patient asks about beginning methadone therapy for CRPS, clinical pharmacist William Amarquaye advises on administration, titration, side effects, and interactions. Patient Scenario: Patient Prescribed Methadone for CRPS The Patient Patient Bob* called our pharmacy inquiring about a new prescription for methadone that he was placed […]

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Uncategorized Published - 12 May, 2023    By - Dr Clemens
Association of Preoperative Frailty With Intraoperative Hemodynamic Instability and Postoperative Mortality 2023

AUTHORS: James, Leslie A. BA et al  Anesthesia & Analgesia 128(6):p 1279-1285, June 2019. | BACKGROUND: Frailty, a state of decreased physiological reserve, is strongly associated with perioperative mortality in older adults. However, the mechanism by which frailty is associated with mortality is not yet understood. Autonomic dysfunction in the form of decreased intraoperative hemodynamic variability has […]

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Uncategorized Published - 11 May, 2023    By - Dr Clemens
The effect of adding goal-directed hemodynamic management for elective patients in an established enhanced recovery program for colorectal surgery 2023

Authors: Matthew D McEvoy et al  Perioper Med (Lond) 2020 Nov 23;9(1):35. Background: Recent literature has demonstrated that hemodynamic instability in the intraoperative period places patients at risk of poor outcomes. Furthermore, recent studies have reported that stroke volume optimization and protocolized hemodynamic management may improve perioperative outcomes, especially surgical site infection (SSI), in certain high-risk […]

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Uncategorized Published - 11 May, 2023    By - Dr Clemens
Goal-Directed Fluid Therapy and Postoperative Outcomes in an Enhanced Recovery Program for Colorectal Surgery 2023

Authors: Andres Zorrilla-Vaca et al  AM Surg 2021 Aug;87(8):1189-1195. Introduction: Goal-directed fluid therapy (GDFT) has increasingly been utilized in major surgery as a key component to ensure fluid optimization and adequate tissue perfusion, showing improvements in the rate of morbidity and mortality under conventional care. It is unclear if patients derive similar benefit as part of […]

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Uncategorized Published - 11 May, 2023    By - Dr Clemens
Chronic Opioid Use: An Interactive Case History 2023

Authors: Yaras R, Bettinger J Pract Pain Manage. 2023 MayJune:23(2). The following hypothetical case is intended to reflect the changes in the CDC opioid prescribing guidelines (see full background).¹ Below is a step-by-step guide through the management of “legacy” patients on chronic opioid medications. See our separate case on initiating opioid therapy under the new guidelines. Patient’s Medical and Psychiatric […]

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Uncategorized Published - 11 May, 2023    By - Dr Clemens
FDA Expands Approval of Oral Agent for Migraine 2023

Author: Heidi Splete Practical Pain Management People living with chronic migraine have a new oral option in the form of atogepant tablets. The FDA has approved an expanded indication of atogepant (Qulipta) to include the prevention of chronic migraine in adults, according to a statement from manufacturer AbbVie. Atogepant, an oral calcitonin gene-related peptide (CGRP) receptor […]

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Uncategorized Published - 11 May, 2023    By - Dr Clemens
Intravenous Dabigatran Provides Adequate Anticoagulation for Cardiopulmonary Bypass Using a Rabbit Model 2023

Authors: Sergiy M. Nadtochiy, Ph.D. et al  Anesthesiology May 2023, Vol. 138, 523–532. Background Heparin anticoagulation has been used successfully for cardiopulmonary bypass (CPB). However, an alternative anticoagulant approach is desirable due to the cases of heparin-induced thrombocytopenia. Dabigatran provides anticoagulation for an in vitro model of simulated CPB. The current analysis tests the hypothesis that dabigatran provides […]

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Uncategorized Published - 10 May, 2023    By - Dr Clemens
Oxylipin Profiles during the First Day of Mechanical Ventilation in an Intensive Care Unit Cohort 2023

Authors: Niklas Larsson, M.D. et al  Anesthesiology May 2023, Vol. 138, 561–563. To the Editor: Lipid mediators derived from arachidonic acid and other precursor polyunsaturated fatty acids, collectively known as oxylipins, are metabolized along different distinct pathways and play important roles in the modulation of inflammation.  Blood oxylipin profiles have been shown to correlate with the survival […]

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Uncategorized Published - 10 May, 2023    By - Dr Clemens
Potential Injuries During Anesthesia 2023

Radius Anesthesia blog Anesthesia is an important part of many medical procedures, especially surgery. While most uses of anesthesia remain uneventful, accidents or mistakes may occur in rare cases, ranging from failing to understand a patient’s medical history to improperly administering anesthesia during a procedure 1. These can result in a wide range of injuries 2. Unintended injuries […]

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Uncategorized Published - 10 May, 2023    By - Dr Clemens
Comparison of a Modern Digital Mechanomyograph to a Mechanomyograph Utilizing an Archival Grass Force Transducer 2023

Authors: Kelly E Michaelsen, MD PhD et al  Anesthesiology April 2023. Background Mechanomyography is the traditional gold standard research technique for quantitative assessment of neuromuscular blockade. Mechanomyography directly measures the isometric force generated by the thumb in response to ulnar nerve stimulation. Researchers must construct their own mechanomyographs since commercial instruments are no longer available. […]

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