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By Janaka Lagoo MD, MPH For far too long, we’ve tolerated poor communication and lack of professionalism by surgeons toward fellow clinicians and even patients. At the extreme, surgeons have been known to yell, bully or intimidate their clinical peers. However, there are also more commonplace examples of surgeons failing to inform all members of […]
Read MoreAuthors: Prabhu, Malavika, MD et al Obstetrics & Gynecology: July 2018 – Volume 132 – Issue 1 – p 70–78 OBJECTIVE: To evaluate whether a liposomal bupivacaine incisional block decreases postoperative pain and represents an opioid-minimizing strategy after scheduled cesarean delivery. METHODS: In a single-blind, randomized controlled trial among opioid-naive women undergoing cesarean delivery, liposomal bupivacaine or placebo […]
Read MoreAuthors: Thomas K. Henthorn, M.D. et al Anesthesiology 8 2018, Vol.129, 260-270. What We Already Know about This Topic: Recirculatory pharmacokinetic models describe intravascular mixing by incorporating cardiac output and its distribution to characterize the oscillations of arterial and venous drug concentrations in the minutes after rapid IV drug administration Arterial drug concentrations during a drug […]
Read MoreIt’s time for us all to face a hard truth: you can, in fact, compare apples and oranges. Really, they’re not all that dissimilar. The fundamental traits of each are pretty much the same: they’re both spherical fruits and they both can be made into delicious candy. By almost any measure, they’re much more similar […]
Read MoreRadiofrequency ablation of the basivertebral nerve may lead to significant short-term reduction in pain and functional disability in patients with chronic low back pain and type I or type II Modic changes of the vertebral bodies, according to findings from a randomized trial published in the European Spine Journal. The investigators targeted the basivertebral nerve in […]
Read MoreAuthors: Phi T. Ho, M.D., M.B.A. et al Anesthesiology 8 2018, Vol.129, 249-259. What We Already Know about This Topic: Prompt availability of dantrolene is important for treating malignant hyperthermia and has resulted in lowered mortality rates Maintaining a malignant hyperthermia cart and full treatment dose of dantrolene is expensive, particularly for locations with low incidence […]
Read MoreAuthors: Gianluca Cappelleri, M.D. et al Anesthesiology 8 2018, Vol.129, 241-248. What We Already Know about This Topic: Reducing the volume of local anesthetic administered for neural blockade may increase safety Local anesthetic administration can result in nerve damage What This Article Tells Us That Is New: The low volume intraneural injection of ropivacaine 1% provided […]
Read MoreAuthors: Takeshi Yoshida, M.D., Ph.D. et al Anesthesiology 7 2018, Vol.129, 163-172. Background: In supine patients with acute respiratory distress syndrome, the lung typically partitions into regions of dorsal atelectasis and ventral aeration (“baby lung”). Positive airway pressure is often used to recruit atelectasis, but often overinflates ventral (already aerated) regions. A novel approach to selective recruitment […]
Read MoreIn a study of patients undergoing corrective osteotomy for hallux valgus, those who received an ankle block with a mixture of bupivacaine and long-acting liposomal bupivacaine (Exparel, Pacira) experienced relief of postoperative pain and a marked reduction in opioid consumption, compared with use of general anesthesia alone or ankle block with bupivacaine alone. Both types […]
Read MoreThere are general risks when it comes to going under the knife, many of them related to general anesthesia—side effects from shivering to vomiting. Perhaps more unsettling for the patient, however, can be states of confusion in the minutes and hours after surgery, or even the long-term memory loss sometimes seen in senior patients. “The […]
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