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Authors: Douglas J. Eleveld, Ph.D. et al Anesthesiology 6 2017, Vol.126, 1005-1018. Background: Pharmacokinetic and pharmacodynamic models are used to predict and explore drug infusion schemes and their resulting concentration profiles for clinical application. Our aim was to develop a pharmacokinetic-pharmacodynamic model for remifentanil that is accurate in patients with a wide range of age and weight. […]
Read MoreAuthors: Steven L. Shafer, M.D. et al Anesthesiology 6 2017, Vol.126, 993-994. ANESTHESIOLOGISTS are expected to be equally competent treating a 5-kg child and a 250-kg adult. For infused drugs, such as remifentanil, this means selecting an initial infusion rate appropriate for the patient. A practice we have observed is to set a dose that is […]
Read MoreAuthors: Antonio Martinez-Simon, M.D., Ph.D. et al Anesthesiology 6 2017, Vol.126, 1033-1042 Background: Deep brain stimulation electrodes can record oscillatory activity from deep brain structures, known as local field potentials. The authors’ objective was to evaluate and quantify the effects of dexmedetomidine (0.2 μg·kg-1·h-1) on local field potentials in patients with Parkinson disease undergoing deep brain stimulation […]
Read MoreA Randomized, Multicenter, Semiblinded, Noninferiority, Controlled Trial Authors: Eske Kvanner Aasvang, M.D., Ph.D. et al Anesthesiology 6 2017, Vol.126, 1043-1052. Post anesthesia care unit (PACU) discharge without observation of lower limb motor function after spinal anesthesia has been suggested to significantly reduce PACU stay and enhance resource optimization and early rehabilitation but without enough data to […]
Read MoreAuthors: Raeyat Doost E et al., Am J Emerg Med 2017 Apr 14; Nerve block was faster but sedation was somewhat more effective in this small randomized trial. For reduction of anterior shoulder dislocations, options include procedural sedation, intraarticular lidocaine injection, nerve block, and manipulation without sedation. Investigators in Iran randomized 60 adults undergoing anterior shoulder dislocation […]
Read MoreAuthors: Adam W. Amundson, M.D. et al Anesthesiology 6 2017, Vol.126, 1139-1150. Background: Multimodal analgesia is standard practice for total knee arthroplasty; however, the role of regional techniques in improved perioperative outcomes remains unknown. The authors hypothesized that peripheral nerve blockade would result in lower pain scores and opioid consumption than two competing periarticular injection solutions. Methods: This […]
Read MoreAuthors: Martin Dres, M.D. et al Anesthesiology 6 2017, Vol.126, 1107-1115. Background: Pleural effusion is frequent in intensive care unit patients, but its impact on the outcome of weaning remains unknown. Methods: In a prospective study performed in three intensive care units, pleural ultrasound was performed at the first spontaneous breathing trial to detect and quantify pleural effusion […]
Read MoreAuthors: Asha Singh, M.D. et al Anesthesiology 6 2017, Vol.126, 1065-1076. Background: Brachial arterial catheters better estimate aortic pressure than radial arterial catheters but are used infrequently because complications in a major artery without collateral flow are potentially serious. However, the extent to which brachial artery cannulation promotes complications remains unknown. The authors thus evaluated a large […]
Read MoreAuthors: Linden O. Lee, M.D. et al Anesthesiology 6 2017, Vol.126, 1053-1063. Background: Thrombocytopenia has been considered a relative or even absolute contraindication to neuraxial techniques due to the risk of epidural hematoma. There is limited literature to estimate the risk of epidural hematoma in thrombocytopenic parturients. The authors reviewed a large perioperative database and performed a […]
Read MoreEdited by Susan Sadoughi, MD Use of long-acting opioids for chronic noncancer pain is associated with increased risk for all-cause and cardiovascular mortality, suggests a retrospective study in JAMA. Using Tennessee Medicaid data from 1999 through 2012, researchers matched nearly 23,000 new instances of long-acting opioid prescriptions with 23,000 episodes of control medication prescriptions (analgesic anticonvulsants or […]
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