Author: Dr Clemens

Uncategorized Published - 24 May, 2022    By - Dr Clemens
Allergy to Local Anesthetics is a Rarity

DG Journal Club Shirley Jiang, Monica Tang Clin Rev Allergy Immunol. 2022 Apr 28 [Epub ahead of print] Local anesthetics (LA) are commonly used in procedures and in topical agents for pain management. With the increasing use of LA drugs, the management of LA reactions is more frequently encountered in the office and in operating […]

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Uncategorized Published - 23 May, 2022    By - Dr Clemens
Effects of Thoracic Epidural Anesthesia on Systemic and Local Inflammatory Responses in Patients Undergoing Lung Cancer Surgery

DG Journal Club AUTHORS: Jun Okuda, Takeshi Suzuki, Kenta Wakaizumi, Jungo Kato J Cardiothorac Vasc Anesth. 2022 05; 36(5): 1380-1386 OBJECTIVE Inflammatory responses play major roles in the development of acute lung injury following lung cancer surgery. The authors tested the hypothesis that thoracic epidural anesthesia (TEA) during surgery could attenuate both systemic and local […]

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Uncategorized Published - 23 May, 2022    By - Dr Clemens
Intrathecal morphine in combination with bupivacaine as pre-emptive analgesia in posterior lumbar fusion surgery

DG Journal Club AUTHORS: R Trivedi, J John, A Ghodke, J Trivedi J Orthop Surg Res. 2022 Apr 18; 17(1): 241 BACKGROUND The purpose of this study was to evaluate the efficacy of intrathecal morphine (ITM) in combination with bupivacaine as pre-emptive analgesia in patients undergoing posterior lumbar fusion surgery. This is in comparison with […]

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Uncategorized Published - 23 May, 2022    By - Dr Clemens
Comparison of intravenous sedation using midazolam versus dexmedetomidine in elderly patients with dementia

DG Journal Club Yoshinari Morimoto, Megumi Hayashi, Yuki Yao, Hitomi Nishizaki Sci Rep. 2022 Apr 15; 12(1): 6293 Differences between the effects of intravenous sedation with midazolam (MID) and dexmedetomidine (DEX) on the cerebral function of elderly patients with severe dementia are unclear. This study aimed to compare the effects of intravenous sedation with MID […]

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Uncategorized Published - 23 May, 2022    By - Dr Clemens
Referral Indications for Malignant Hyperthermia Susceptibility Diagnostics in Patients without Adverse Anesthetic Events in the Era of Next-generation Sequencing

Authors: Luuk R. van den Bersselaar, M.D.,M.Sc. et al  Anesthesiology June 2022, Vol. 136, 940–953. Background The introduction of next-generation sequencing into the diagnosis of neuromuscular disorders has resulted in an increased number of newly identified RYR1 variants. The hypothesis was that there is an increased referral of patients to malignant hyperthermia units without a personal/family history of […]

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Uncategorized Published - 23 May, 2022    By - Dr Clemens
Midazolam at Low Nanomolar Concentrations Affects Long-term Potentiation and Synaptic Transmission Predominantly via the α1–γ-Aminobutyric Acid Type A Receptor Subunit in Mice

Authors: Xènia Puig-Bosch, M.Sc. et al Anesthesiology June 2022, Vol. 136, 954–969. Background Midazolam amplifies synaptic inhibition via different γ-aminobutyric acid type A (GABAA) receptor subtypes defined by the presence of α1-, α2-, α3-, or α5-subunits in the channel complex. Midazolam blocks long-term potentiation and produces postoperative amnesia. The aims of this study were to identify the GABAA receptor […]

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Uncategorized Published - 20 May, 2022    By - Dr Clemens
Facial Pressure Ulcers: Unsightly Complication of Prone Positioning

Authors: Eliane Varga, M.D. et al  Anesthesiology May 2022, Vol. 136, 827–828. The image depicts a 67-yr-old man who had significant periorbital skin injury after 5 h of prone spine surgery using a foam headrest with standard taping of eyes. The patient underwent facial laser skin resurfacing 2 months before the event. Facial pressure ulcers are a […]

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Uncategorized Published - 20 May, 2022    By - Dr Clemens
Fascial Plane Blocks in Cardiothoracic Surgery

Author: Dibash Kumar Das, PhD ASA Monitor March 2021, Vol. 85, 34–35. Cardiothoracic surgeries are associated with significant pain. Optimal analgesia is a vital part of enhanced recovery after surgery strategies intended to improve patients’ perioperative experience and outcomes. Traditionally, analgesia in these types of surgeries has depended on large doses of I.V. opioids (Anesth Analg […]

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Uncategorized Published - 20 May, 2022    By - Dr Clemens
Recent U.S. Food and Drug Administration Labeling Changes for Hydroxyethyl Starch Products Due to Concerns about Mortality, Kidney Injury, and Excess Bleeding

Authors: Laurence Landow, M.D. et al  Anesthesiology May 2022, Vol. 136, 868–870. To the Editor: The U.S. Food and Drug Administration (Silver Spring, Maryland) is requiring safety labeling changes to the prescribing information for hydroxyethyl starch products to warn about the risk of mortality, acute kidney injury (AKI), and coagulopathy in all patient populations. The changes […]

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Uncategorized Published - 20 May, 2022    By - Dr Clemens
SEE Question

ASA Monitor June 2021, Vol. 85, 21. A recent observational cohort study compared the annualized rate of major adverse cardiac events (MACE) in patients with abnormal exercise electrocardiograms (+ECG) but normal stress echocardiograms (–Echo) to patients with normal exercise ECGs (–ECG) and normal stress echocardiograms (–Echo). According to this study, which of the following statements is […]

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