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Authors: Vanessa A. Olbrecht, M.D., M.B.A. et al Anesthesiology published on October 19, 2017. Background: General anesthesia during infancy is associated with neurocognitive abnormalities. Potential mechanisms include anesthetic neurotoxicity, surgical disease, and cerebral hypoxia–ischemia. This study aimed to determine the incidence of low cerebral oxygenation and associated factors during general anesthesia in infants. Methods: This multicenter study enrolled […]
Read MoreHaving women lie down during the second stage of labor after an epidural is associated with increased rates of spontaneous vaginal birth without an increase in complications, according to a randomized trial in The BMJ. Roughly 3200 nulliparous U.K. women who received low-dose epidurals were assigned to undergo the second stage of labor (after the cervix […]
Read MoreInjectable extended-release naltrexone (Vivitrol) appears to be as safe and effective as daily oral buprenorphine-naloxone for treating opioid dependence, according to a Norway-based, noninferiority trial in JAMA Psychiatry. Roughly 160 opioid-dependent adults who were discharged from addiction treatment programs were randomized to receive either oral buprenorphine-naloxone daily or extended-release intramuscular naltrexone every 4 weeks for 12 […]
Read MoreDaniel J. Pallin, MD, MPH reviewing Vinson DR et al. Ann Emerg Med 2017 Sep 29. Ibutilide successfully cardioverted 55% of patients within 4 hours in a multicenter retrospective cohort study. Ibutilide is a class III antiarrhythmic drug that is effective for cardioverting atrial fibrillation or flutter (AF/F). However, reported rates of induced ventricular tachycardia of around 1% may […]
Read MoreAuthors: Robert I. Block, Ph.D. et al Anesthesiology 11 2017, Vol.127, 788-799. Background: Anesthetics have neurotoxic effects in neonatal animals. Relevant human evidence is limited. We sought such evidence in a structural neuroimaging study. Methods: Two groups of children underwent structural magnetic resonance imaging: patients who, during infancy, had one of four operations commonly performed in otherwise healthy […]
Read MoreResearchers assessed more than 35,000 patients in an effort to tease out a clearer understanding of the association between gastroesophageal reflux disease and fibromyalgia. Interviews with Don Goldenberg, MD, and Michael R. Clark, MD, MPH, MBA Fibromyalgia (FM) and gastroesophageal reflux disease (GERD) appear to arise frequently in the same patient, an interrelationship that has […]
Read MoreAuthor: Robert M. Knapp, D.O., J.D. Anesthesiology 11 2017, Vol.127, 904-905. To the Editor: The editorial by Garcia and Sleigh1 provided an outstanding discussion of ketamine’s complexities. Their conclusion, that we use a flawed concept of anesthesia depth, was insightful and provides a reason as well as an opportunity to suggest something more meaningful. Anesthetic “depth” is […]
Read MoreAuthors: Deborah J. Culley, M.D. et al Anesthesiology 11 2017, Vol.127, 765-774. Background: The American College of Surgeons and the American Geriatrics Society have suggested that preoperative cognitive screening should be performed in older surgical patients. We hypothesized that unrecognized cognitive impairment in patients without a history of dementia is a risk factor for development of postoperative […]
Read MoreA Penned Point The observations of Karen Sullivan Sibert, MD a Los Angeles anesthesiologist, writer, and mother. No, I’m not talking about putting fentanyl into my own veins — a remarkably bad idea. I’m questioning the habitual, reflex use of fentanyl, a synthetic opioid, in clinical anesthesiology practice. I’ve been teaching clinical anesthesiology, supervising residents and […]
Read MoreAuthors: David W. Barbara, M.D.; Troy G. Seelhammer, M.D.; William J. Mauermann, M.D. Anesthesiology 11 2017, Vol.127, 902-903. To the Editor: We read with great interest the intriguing study by Mathis et al.1 involving 702 noncardiac procedures performed in patients with left ventricular assist devices (LVADs). We commend the authors for their work in this important area and share their […]
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