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Authors: Daniel I. McIsaac, M.D., M.P.H., F.R.C.P.C. et al Anesthesiology 3 2018, Vol.128, 480-491. Background: There is consistent and significant variation in neuraxial anesthesia use for hip fracture surgery across jurisdictions. We measured the association of hospital-level utilization of neuraxial anesthesia, independent of patient-level use, with 30-day survival (primary outcome) and length of stay and costs (secondary […]
Read MoreAuthors: Catherine L. Chen, M.D., M.P.H. et al Anesthesiology 3 2018, Vol.128, 429-430. HOW does one identify high-quality anesthetic care? Although the specialty of anesthesiology has succeeded in improving the safety and quality of care over time, with a 97% reduction in anesthesia-related deaths between 1948 and 2005, from 3.3 per 100,000 population to 1.1 per […]
Read MoreCurrent use of prescription opioids is associated with increased risk for invasive pneumococcal disease (IPD), suggests an Annals of Internal Medicine study. Researchers studied Tennessee patients who’d filled an opioid prescription between 1995 and 2014. Of these, they compared 1200 patients with an IPD diagnosis with 24,000 controls without IPD. After multivariable adjustment, current opioid use was […]
Read MoreAuthors: A. Kisilevsky et al British Journal of Anesthesia February 2018 Summary Both anaemia and blood transfusion are associated with poor outcomes in the neurosurgical population. Based on the available literature, the optimal haemoglobin concentration for neurologically injured patients appears to be in the range of 9.0–10.0 g dl−1, although the individual risks and benefits […]
Read MoreAuthor: MYLES GART, MD After years of exaggeration, misinformation and a national epidemic of opioid and heroin abuse, the nation is finally coming to terms with the fact that pain is not the fifth vital sign. This heresy, as I understand it, has existed for close to three decades and, in my opinion, has been […]
Read MoreThe FDA has updated the indication of naloxegol (Movantik, AstraZeneca) tablets for the treatment of opioid-induced constipation (OIC) in adult patients with chronic noncancer pain to include patients with chronic pain related to prior cancer or its treatment who do not require frequent (e.g., weekly) opioid dosage escalation. This label update follows initial FDA approval for naloxegol in 2014 […]
Read MoreThe best approach to balancing analgesia, opioid use and passive range of motion after total knee arthroplasty (TKA) is to block multiple nerves rather than any single nerve, according to a sophisticated network meta-analysis. This approach proved better than periarticular local anesthetic infiltration and epidural analgesia. “Based on available evidence, we found that combinations of […]
Read MoreAUTHORS: Yoshikawa, Yusuke MD et al Anesthesia & Analgesia: February 2018 – Volume 126 – Issue 2 – p 443–452 BACKGROUND: Dexmedetomidine (DEX) has a direct cardioprotective effect against ischemia/reperfusion injury through endothelial nitric oxide synthase (eNOS) phosphorylation via α2-adrenoreceptor (α2-AR). By using spontaneously hypertensive rat (SHR) and Wistar-Kyoto (WKY) rat models, the cardioprotective effect of DEX […]
Read MoreAUTHORS: Kawakami, Hiromasa MD et al Anesthesia & Analgesia: December 2017 – Volume 125 – Issue 6 – p 2072–2080 BACKGROUND: Caudal anesthesia has been used for postoperative pain control in pediatric surgical patients, but the duration of the analgesic effect is occasionally unsatisfactory. Intravenous steroids have been shown to be effective for postsurgical pain management after […]
Read MorePlease take this very serious one of our groups lost a pt that could not be reintubated after being extubated. Sally Stander, MD Assistant Professor of Anesthesiology Department of Anesthesiology University of North Carolina at Chapel Hill School of Medicine “Please come exchange the endotracheal tube in the ICU. We think there is a cuff leak.” […]
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