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AUTHORS: Patel, Selina D. BMedSci, MBBS, FRCA et al Anesthesia & Analgesia: July 2017 BACKGROUND: The objective of this meta-analysis was to determine the efficacy of glycopyrrolate at reducing spinal hypotension during cesarean delivery. METHODS: A literature search was performed to identify randomized controlled trials investigating the effect of glycopyrrolate on spinal-induced hypotension during cesarean delivery. […]
Read MoreAUTHORS: MacKay, Emily J. DO et al Anesthesia & Analgesia: September 2017 – Volume 125 – Issue 3 – p 895–901 BACKGROUND: Admission hypocalcemia predicts both massive transfusion and mortality in severely injured patients. However, the effect of calcium derangements during resuscitation remains unexplored. We hypothesize that any hypocalcemia or hypercalcemia (either primary or from overcorrection) in […]
Read MoreAUTHORS: Cahill, Christine M. MS et al Anesthesia & Analgesia: July 2017 BACKGROUND: Extracorporeal membrane oxygenation supplies oxygenated blood to the body supporting the heart and lungs. Survival rates of 20% to 50% are reported among patients receiving ECMO for cardiac arrest, severe cardiogenic shock, or failure to wean from cardiopulmonary bypass following cardiac surgery. […]
Read MoreAUTHORS: Logvinov, Ilana I. RN, MSN, CCRP et al Anesthesia & Analgesia: July 2017 BACKGROUND: Studies of shared (patient-provider) decision making for elective surgical care have examined both the decision whether to have surgery and patients’ understanding of treatment options. We consider shared decision making applied to case scheduling, since implementation would reduce labor costs. METHODS: […]
Read MoreAlthough previous surrogate outcomes have suggested that IV dexamethasone can prolong the duration of peripheral nerve blockade, new research indicates otherwise. When sensory blockade was measured by an objective pinprick assessment, neither a 4- nor 8-mg dose of systemic dexamethasone given at the time of peripheral nerve blockade had an effect on block duration. “Based […]
Read MoreIf the experience of researchers at Duke University Medical Center is indicative of the nation as a whole, then infused medications are being wasted throughout the perioperative process. This is the product of preparing and priming standard infusions regardless of patient and procedural characteristics. The good news is that such practices seem to be easily […]
Read MoreBetter pain management protocols are needed for patients who undergo orthotopic liver transplantation, according to research presented here at the 2017 Annual Meeting of the Canadian Anesthesiologists Society (CAS). “Liver transplantation is very painful surgery,” said Hussein Sadkhan, MD, London Health Sciences Center/Western University, London, Ontario. “We conducted a retrospective study to assess pain control […]
Read MoreAlthough general anesthesia is preferred by many anesthesiologists because of a perceived superior safety profile, a study has found that it is no safer than sedation in patients undergoing transcatheter aortic valve replacement (TAVR). The retrospective trial concluded that compared with sedation, TAVR patients who receive general anesthesia do not have smaller volume requirements, fewer […]
Read MoreUsing biomarkers such as procalcitonin (PCT) in the ER can help physicians assess the risk for sepsis before patients are admitted to the ICU. The Society of Critical Care Medicine recently updated its sepsis guidelines, recommending early empirical broad-spectrum antibiotics that are then adjusted or de-escalated as more information becomes available. “The early identification of sepsis […]
Read MoreAuthor: Landisch RM et al., JAMA Pediatr 2017 Jun 19; The time to appendectomy, if performed within 24 hours of presentation, was not associated with perforation or other complications. Although studies are inconclusive, many physicians feel that a delay in appendectomy may result in complications (perforation) and prolonged hospital stay. Using the Pediatric National Surgical Quality Improvement […]
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