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Postoperative use of opioid analgesics increases the risk of respiratory depression, which can lead to brain damage or death. Perioperative lidocaine does not reduce morphine use in the first 24 hours after posterior spinal arthrodesis and offers no measurable benefits, according to a randomized placebo-controlled trial recently published in Pain.1 Postoperative use of opioid analgesics increases the risk […]
Read MoreAuthors: Jessica L. Booth, M.D. et al Anesthesiology 7 2017, Vol.127, 50-57. Background: The addition of opioids to epidural local anesthetic reduces local anesthetic consumption by 20% but at the expense of side effects and time spent for regulatory compliance paperwork. Epidural neostigmine also reduces local anesthetic use. The authors hypothesized that epidural bupivacaine with neostigmine would […]
Read MoreAUTHORS: Lee, Alex T. MD et al Anesthesia & Analgesia: August 2017 – Volume 125 – Issue 2 – p 514–520 BACKGROUND: Antiplatelet medications are usually discontinued before elective neurosurgery, but this is not an option for emergent neurosurgery. We performed a retrospective cohort study to examine whether preoperative aspirin use was associated with worse outcomes […]
Read MoreNonspecific factors include a patient’s spirituality, their trust in a provider’s power to influence treatment outcomes, as well as their expectations. Contextual or nonspecific factors may influence treatment outcomes in patients with chronic pain, according to a study presented at the American Pain Society’s 36th Annual Scientific Meeting in Pittsburgh, Pennsylvania.1 Nonspecific factors include a patient’s spirituality […]
Read MoreNo, this is not a science fiction reference. Rather this represents, at least in my mind, the many skills necessary to become a superb clinician. I write this from the perspective of an internist, but I believe these skills are not specialty specific. 1. History taker. Most patient encounters start with taking a thorough history. […]
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