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Authors: Christian M. Schulz, M.D. et al Anesthesiology Newly Published on May 4, 2017. Background: Situational awareness errors may play an important role in the genesis of patient harm. The authors examined closed anesthesia malpractice claims for death or brain damage to determine the frequency and type of situational awareness errors. Methods: Surgical and procedural anesthesia death and […]
Read MoreAuthors: Juan C. Gómez-Izquierdo, M.D. et al Anesthesiology Newly Published on May 4, 2017. Background: Inadequate perioperative fluid therapy impairs gastrointestinal function. Studies primarily evaluating the impact of goal-directed fluid therapy on primary postoperative ileus are missing. The objective of this study was to determine whether goal-directed fluid therapy reduces the incidence of primary postoperative ileus […]
Read MoreAuthors: Phillip E. Vlisides, M.D. et al Anesthesiology published on May 11, 2017. Background: Previous studies have demonstrated inconsistent neurophysiologic effects of ketamine, although discrepant findings might relate to differences in doses studied, brain regions analyzed, coadministration of other anesthetic medications, and resolution of the electroencephalograph. The objective of this study was to characterize the dose-dependent effects […]
Read MoreAuthors: Sandra Funcke, M.D. et al Anesthesiology published on May 11, 2017. doi:10.1097/ALN.0000000000001670 Background: This study compares the analgesic indices Analgesia Nociception Index (heart rate variability), Surgical Pleth Index (photoplethysmography), and pupillary dilatation, to heart rate, mean arterial pressure, and bispectral index, with regard to diagnostic accuracy and prediction probability for nociceptive response. The primary endpoint was […]
Read MoreAuthors: Jessica L. Booth, M.D. et al Anesthesiology published on May 11, 2017 Background: The addition of opioids to epidural local anesthetic reduces local anesthetic consumption by 20% but at the expense of side effects and time spent for regulatory compliance paperwork. Epidural neostigmine also reduces local anesthetic use. The authors hypothesized that epidural bupivacaine with neostigmine […]
Read MoreEdited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM Use of nonsteroidal anti-inflammatory drugs (NSAIDs) for even 1 week is associated with increased risk for myocardial infarction, a meta-analysis in The BMJ finds. Using individual patient data from four studies from healthcare databases, researchers identified over 61,000 cases of acute MI and 385,000 controls […]
Read MoreWriting Committee for the VISION Study Investigators, JAMA 2017 Apr 25; 317:1642 Most troponin elevations were not obviously symptomatic. In a 2014 study, investigators showed that even modestly elevated non–high-sensitivity troponin T levels during the 3 days after noncardiac surgery were associated independently with excess 30-day mortality (NEJM JW Gen Med Apr 1 2014 and Anesthesiology 2014; 120:564). Now, this […]
Read MoreAuthors: Pickering JW et al., Ann Intern Med 2017 Apr 18; However, samples for the troponin assay should be drawn at least 3 hours after symptom onset, and a positive troponin does not rule in acute myocardial infarction. Several studies have demonstrated the potential utility of high-sensitivity cardiac troponin T (hs-cTnT) assays combined with electrocardiograms (ECGs) in […]
Read MoreAuthors: Roy G. Soto, M.D. et al ASA Monitor 05 2017, Vol.81, 30-31. Mivacurium is a benzylisoquinolinium nondepolarizing neuromuscular-blocking drug that was developed in the early 1980s and disappeared from the U.S. market in 2006. It was reintroduced in December 2016, and many have asked what the appropriate niche is for this seemingly resurrected medication. Since […]
Read MoreInterview with Alec Peniche, MD, Lawrence Poree, MD, PhD, Xiaobing Yu, MD Patient-controlled anesthesia (PCA) is not new to pain management, but using intrathecal patient-controlled anesthesia (IT-PCA) does remain a controversial topic amidst concerns over patient safety. However, a team of researchers at the University of California San Francisco recently reported their first successful case […]
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