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Uncategorized Published - 18 December, 2017    By - Dr Clemens
Ringer’s Lactate Versus Normal Saline in Urgent Cesarean Delivery in a Resource-Limited Setting: A Pragmatic Clinical Trial

AUTHORS: Ayebale, Emmanuel Timarwa MBChB, MMED et al Anesthesia & Analgesia: August 2017 – Volume 125 – Issue 2 – p 533–539 BACKGROUND: Crystalloids are used routinely for perioperative fluid management in cesarean delivery. Few studies have determined the crystalloid of choice in obstetric anesthesia. We compared the effects of Ringer’s lactate (RL) versus 0.9% […]

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Uncategorized Published - 15 December, 2017    By - Dr Clemens
Remote Ischemic Preconditioning Decreases Oxidative Lung Damage After Pulmonary Lobectomy: A Single-Center Randomized, Double-Blind, Controlled Trial

AUTHORS: García-de-la-Asunción, José MD, PhD et al Anesthesia & Analgesia: August 2017 – Volume 125 – Issue 2 – p 499–506 BACKGROUND: During lobectomy in patients with lung cancer, the operated lung is often collapsed and hypoperfused. Ischemia/reperfusion injury may then occur when the lung is re-expanded. We hypothesized that remote ischemic preconditioning (RIPC) would […]

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Uncategorized Published - 15 December, 2017    By - Dr Clemens
Blood Product Utilization Among Trauma and Nontrauma Massive Transfusion Protocols at an Urban Academic Medical Center

AUTHORS: Patel, Eshan U. MPH et al Anesthesia & Analgesia: September 2017 – Volume 125 – Issue 3 – p 967–974 BACKGROUND: Hospital-wide massive transfusion protocols (MTPs) primarily designed for trauma patients may lead to excess blood products being prepared for nontrauma patients. This study characterized blood product utilization among distinct trauma and nontrauma MTPs at a […]

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Uncategorized Published - 15 December, 2017    By - Dr Clemens
A New Buprenorphine Preparation for Treating Narcotic Dependence

Authors: Walsh SL et al., JAMA Psychiatry 2017 Jun 22; An investigational depot form of the medication has positive early results. The opioid receptor partial agonist buprenorphine, as sublingual monotherapy or in combination with the opioid antagonist naloxone (Suboxone), attenuates narcotic withdrawal and craving and blocks euphoria from concurrent narcotics. Still, buprenorphine is itself subject to misuse […]

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Uncategorized Published - 15 December, 2017    By - Dr Clemens
Perioperative Management of Buprenorphine Requires Multimodal Strategy

A comprehensive, multimodal pain strategy is the cornerstone of policy formation for managing buprenorphine perioperatively at Stanford University Medical Center. As awareness of the pervasiveness of the opioid epidemic increases, clinicians have begun to take steps to do what they can to control it. “We are having more and more patients coming for surgery that […]

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Uncategorized Published - 15 December, 2017    By - Dr Clemens
Risk Factors for Severe Postpartum Hemorrhage After Cesarean Delivery: Case-Control Studies

AUTHORS: Butwick, Alexander J. MBBS, FRCA, MS et al Anesthesia & Analgesia: August 2017 – Volume 125 – Issue 2 – p 523–532 BACKGROUND: Women who undergo intrapartum caesarean delivery (CD) are at increased risk of postpartum hemorrhage (PPH) compared with those undergoing prelabor CD. To determine whether the presence and strength of the associations […]

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Uncategorized Published - 14 December, 2017    By - Dr Clemens
A Randomized Crossover Study Comparing Cervical Spine Motion During Intubation Between Two Lightwand Intubation Techniques in Patients With Simulated Cervical Immobilization: Laryngoscope-Assisted Versus Conventional Lightwand Intubation

AUTHORS: Kim, Tae Kyong MD et al Anesthesia & Analgesia: August 2017 – Volume 125 – Issue 2 – p 485–490 BACKGROUND: In patients with cervical immobilization, jaw thrust can cause cervical spine movement. Concurrent use of a laryngoscope may facilitate lightwand intubation, allowing midline placement and free movement of the lightwand in the oral cavity without […]

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Uncategorized Published - 14 December, 2017    By - Dr Clemens
Safety of Large-Volume, Same-Day Oral Bowel Preparations During Deep Sedation: A Prospective Observational Study

AUTHORS: Tandon, Kanwarpreet MD et al Anesthesia & Analgesia: August 2017 – Volume 125 – Issue 2 – p 469–476 BACKGROUND: Colonoscopy quality is directly related to the bowel preparation. It is well established that bowel preparations are improved when at least part of the laxative is ingested on the day of the procedure. However, there is […]

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Uncategorized Published - 14 December, 2017    By - Dr Clemens
Intranasal Medication Administration Using a Squeeze Bottle Atomizer Results in Overdosing if Deployed in Supine Patients

AUTHORS: Goldhammer, Jordan E. MD et al Anesthesia & Analgesia: August 2017 – Volume 125 – Issue 2 – p 453–457 BACKGROUND: Vasoconstrictors and local anesthetics are commonly administered using a squeeze bottle atomizer to the nasal mucosa to reduce edema, limit bleeding, and provide analgesia. Despite widespread use, there are few clinical guidelines that address technical […]

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Uncategorized Published - 14 December, 2017    By - Dr Clemens
Skeletal Muscle Metabolic Dysfunction in Patients With Malignant Hyperthermia Susceptibility

AUTHORS: Thompson, Sara J. MSc et al Anesthesia & Analgesia: August 2017 – Volume 125 – Issue 2 – p 434–441 BACKGROUND: Malignant hyperthermia (MH), a pharmacogenetic disorder of skeletal muscle, presents with a potentially lethal hypermetabolic reaction to certain anesthetics. However, some MH-susceptible patients experience muscle weakness, fatigue, and exercise intolerance in the absence of anesthetic […]

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