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In patients undergoing total joint arthroplasty who are already receiving multimodal analgesia, there may be added benefit to incorporating intrathecal morphine. According to a recent retrospective study, the addition of intrathecal morphine to a multimodal analgesic regimen improved analgesia after surgery and reduced postoperative opioid consumption and postoperative nausea and vomiting (PONV). “These data suggest […]
Read MoreAuthors: Friedman BW et al. Neurology 2017 Oct 18. Intravenous hydromorphone is a poor choice for first-line migraine treatment in the emergency department. Unfortunately, despite extensive evidence specifically demonstrating lack of efficacy, parenteral opioids are commonly used to treat migraine headaches in the emergency department (ED). In a randomized double-blind trial, researchers compared the efficacy of intravenous […]
Read MoreComing to an operating room (OR) near you: a child with autism spectrum disorder. Will you be ready to give them the personalized treatment they need? This was the message from a McMaster University research team, whose pilot study demonstrated the feasibility of multidisciplinary perioperative care plans that reduce anxiety and agitation in this special […]
Read MoreAdministration of beta blockers after cardiac surgery provides a significant protective effect against postoperative atrial fibrillation, but the timing of administration does not seem to affect the incidence of the sometimes devastating adverse event, a study has concluded. The researchers thereforerecommended use of the agents on either postoperative day 1 or 2, in appropriate patient populations. “Most anesthesiologists […]
Read MoreHemoglobin level may not tell the whole story in cases of preoperative anemia. Instead, classifying anemia based on the size of red blood cells might predict clinical outcomes following elective cardiac surgery, a recent analysis concluded. Despite not having the most severe anemia, patients with macrocytic anemia had the highest risk for needing red blood […]
Read MoreIntraoperative goal-directed fluid therapy has been an essential component of enhanced recovery after surgery (ERAS) protocols, but findings from a recent quality improvement initiative questioned its clinical value and impact. In the presence of an ERAS pathway that included early ambulation and alimentation, the addition of intraoperative goal-directed fluid therapy did not reduce complications, readmissions […]
Read MoreAdministering acetaminophen during surgery can reduce the incidence of post-operative shivering in surgical patients, a side effect of general anaesthesia that can stress the cardiovascular system, putting patients with cardiopulmonary problems at risk, according to research presented at the 2017 Annual Meeting of the American Society of Anesthesiologists (ASA). Takehiro Kinjo, MD, University of the […]
Read MoreAuthors: David B. Auyong, M.D. et al Anesthesiology April 2018 Background: The interscalene nerve block provides analgesia for shoulder surgery, but is associated with diaphragm paralysis. One solution may be performing brachial plexus blocks more distally. This noninferiority study evaluated analgesia for blocks at the supraclavicular and anterior suprascapular levels, comparing them individually to the interscalene approach. […]
Read MoreInteresting article I wanted to share JAMA Otolaryngology Head & Neck Surgery, online March 15, 2018. Children who have their tonsils removed before they’re at least three years old may be more likely to have complications afterward than kids who have the surgery when they’re older, a U.S. study suggests. Researchers examined data on 1,817 […]
Read MoreDavid M. Dickerson, MD Assistant Professor, Anesthesiology and Pain Medicine Director, Acute Pain Service Department of Anesthesia & Critical Care University of Chicago Medicine Chicago, Illinois Following the guidelines on acute postoperative pain management requires the hard work of institutionalizing and implementing the recommendations. Updating the 2012 practice advisory of the American Society of Anesthesiologists […]
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