Author: Dr Clemens

Uncategorized Published - 7 May, 2019    By - Dr Clemens
New Calibration Can Improve Needle Pressure Measurements in Nerve Blocks

Author: Michael Vlessides A new calibration methodology appears to have improved on existing nerve block needle pressure monitoring systems by calculating pressure gradient across the needle to estimate the pressure on tissue during injection. The new system may increase the sensitivity and specificity of detecting high injection pressures by eliminating the variability of needle selection […]

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Uncategorized Published - 7 May, 2019    By - Dr Clemens
Pulsed Radiofrequency Provides Durable Back Pain Relief

Author: Alex Morrisson Computed tomography (CT)-guided pulsed radiofrequency is superior to injection only for patients with back pain caused by nerve pressure, researchers reported here at the 2018 Annual Meeting of the Radiological Society of North America (RSNA). One year after undergoing the treatment 95% of the 113 patients in the studied reported they had […]

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Uncategorized Published - 7 May, 2019    By - Dr Clemens
Risk factors for admission after shoulder arthroscopy

AUTHORS: Christian R et al Journal of Shoulder and Elbow Surgery (Dec 2018) BACKGROUND Shoulder arthroscopy is a common orthopedic procedure typically performed on an outpatient basis. Occasionally, patients require an unplanned hospital admission. An understanding of the incidence and risk factors for admission after shoulder arthroscopy may assist surgeons in determining which patients may […]

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Uncategorized Published - 7 May, 2019    By - Dr Clemens
Muscle-building protein shakes may threaten health

I thought this was interesting so wanted to share it. Author: Maria Cohut The protein shakes that health supplement stores sell, which people sometimes buy as a dietary aid to build muscle mass, may not actually be safe for health in the long run according to a new study in mice.     Could protein […]

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Uncategorized Published - 6 May, 2019    By - Dr Clemens
Best Practice Advice on Coagulation in Patients with Cirrhosis

 Authors: O’Leary JG et al.  Gastroenterology 2019 Apr 12 Complications from both pro- and antithrombotic states are seen in patients with cirrhosis. Therefore, a common scenario for the clinician is considering anticoagulation in a patient while worrying about bleeding risk. Four experts reviewed the current and evolving data on coagulation in this population and provided […]

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Uncategorized Published - 6 May, 2019    By - Dr Clemens
High-Flow Nasal Oxygen Improves Safe Apnea Time in Morbidly Obese Patients Undergoing General Anesthesia

AUTHORS: Wong, David T., MD et al Anesthesia & Analgesia: January 2019 BACKGROUND: Morbidly obese patients undergoing general anesthesia are at risk of hypoxemia during anesthesia induction. High-flow nasal oxygenation use during anesthesia induction prolongs safe apnea time in nonobese surgical patients. The primary objective of our study was to compare safe apnea time, between patients given […]

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Uncategorized Published - 6 May, 2019    By - Dr Clemens
Fluid Challenge During Anesthesia

AUTHORS: Messina, Antonio, PhD et al Anesthesia & Analgesia: December 2018 – Volume 127 – Issue 6 – p 1353–1364 BACKGROUND: Assessing the volemic status of patients undergoing surgery is part of the routine management for the anesthesiologist. This assessment is commonly performed by means of dynamic indexes based on the cardiopulmonary interaction during mechanical ventilation […]

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Uncategorized Published - 6 May, 2019    By - Dr Clemens
Reversal of Deep Pipecuronium-Induced Neuromuscular Block With Moderate Versus Standard Dose of Sugammadex

AUTHORS: Tassonyi, Edömér, MD, PhD, DSc et al Anesthesia & Analgesia: December 2018 – Volume 127 – Issue 6 – p 1344–1350 BACKGROUND: Certain surgical interventions may require a deep neuromuscular block (NMB). Reversal of such a block before tracheal extubation is challenging. Because anticholinesterases are ineffective in deep block, sugammadex 4 mg/kg has been recommended […]

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Uncategorized Published - 6 May, 2019    By - Dr Clemens
Mild Perioperative Hypothermia and Myocardial Injury

AUTHORS: Schacham, Yehoshua N., MD et al Anesthesia & Analgesia: December 2018 – Volume 127 – Issue 6 – p 1335–1341 BACKGROUND: We tested the primary hypothesis that final intraoperative esophageal temperature is associated with increased odds of a composite of in-hospital all-cause mortality and myocardial injury within 7 days after noncardiac surgery. Secondary exposures were […]

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Uncategorized Published - 6 May, 2019    By - Dr Clemens
Cerebral Small Vessel, But Not Large Vessel Disease, Is Associated With Impaired Cerebral Autoregulation During Cardiopulmonary Bypass

AUTHORS: Nomura, Yohei, MD et al Anesthesia & Analgesia: December 2018 – Volume 127 – Issue 6 – p 1314–1322 BACKGROUND: Impaired cerebral blood flow (CBF) autoregulation during cardiopulmonary bypass (CPB) is associated with stroke and other adverse outcomes. Large and small arterial stenosis is prevalent in patients undergoing cardiac surgery. We hypothesize that large and/or […]

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