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Quality Queries and Quandaries: Emil Engels, MD, MBA, CPC This is a familiar story: A patient with health insurance has an accident and seeks care at a hospital. She receives care in the ER and undergoes an operation. The health care team provides the necessary care, regardless of her health insurance policy. After discharge from […]
Read MoreUltrasound-guided regional anesthesia appears to be the superior treatment for supracondylar fractures in the pediatric population when compared with IV opioids. According to a recent pediatric study, regional anesthesia for closed reduction and percutaneous pinning demonstrated superior pain scores throughout hospitalization and at home when compared with standard therapy. The authors also reported decreased opioid […]
Read MoreA comparison of interscalene and supraclavicular approaches with brachial plexus block during shoulder surgery suggests that using larger volumes of local anesthetic does not provide a longer duration of effect. According to the study’s authors, when compared with the interscalene approach, the supraclavicular approach provided similar post operative pain control along with a lower incidence […]
Read MoreA bioimpedance respiratory monitor seems to be carving out a niche for itself in perioperative monitoring. A group of Texas researchers has found that this novel technology (ExSpiron, Respiratory Motion Inc.) allows clinicians to adjust total IV anesthesia (TIVA) to minute ventilation in outpatient GI procedures, thereby preventing potential episodes of inadequate ventilation. “Death or […]
Read MorePrescriptions for hydrocodone fixed-dose combination products have plummeted since the opioid was rescheduled from Schedule III to the much more restrictive Schedule II, according to new study results. The total number of hydrocodone combination tablets prescribed fell by more than 1 billion during the first year after the rescheduling. The rescheduling likely resulted in a […]
Read MoreThe CDC reported the first death from carbapenem-resistant Enterobacteriaceae (CRE) that was resistant to all antibiotics available in the United States (MMWR Morb Mortal Wkly Rep 2017;66[1]:3). The Nevada woman, who was in her 70s, died from septic shock last September, but the CDC just reported the case, emphasizing that continued surveillance showed that it […]
Read MoreAuthors: Fabienne M. A. van Hout, M.D. et al Anesthesiology 3 2017, Vol.126, 441-449. Background: Conflicting results have been reported concerning the effect of platelet transfusion on several outcomes. The aim of this study was to assess the independent effect of a single early intraoperative platelet transfusion on bleeding and adverse outcomes in cardiac surgery patients. […]
Read MoreAuthors: Ryu Komatsu, M.D. et al Anesthesiology February 23, 2017. Background: Statins may reduce the risk of pulmonary and neurologic complications after cardiac surgery. Methods: The authors acquired data for adults who had coronary artery bypass graft, valve surgery, or combined procedures. The authors matched patients who took statins preoperatively to patients who did not. […]
Read MoreAuthors: Michael R. Mathis, M.D. et al Anesthesiology 3 2017, Vol.126, 450-460. Background: Patients with left ventricular assist devices presenting for noncardiac surgery are increasingly commonplace; however, little is known about their outcomes. Accordingly, the authors sought to determine the frequency of complications, risk factors, and staffing patterns. Methods: The authors performed a retrospective study at their academic tertiary […]
Read MoreIn adult patients undergoing internal fixation of a fracture of the femur, anterior 3-in-1 femoral block and posterior lumbar plexus block have been found to provide comparable analgesia in a recent clinical study. Although the anterior approach resulted in a higher percentage of incomplete blockade, pain scores and opioid requirements did not differ significantly from […]
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