For patients with severe, chronic back and leg pain, a new high-frequency spinal cord stimulation (SCS) technique provides superior clinical outcomes, compared to conventional low-frequency SCS, reports a clinical trial in the November issue of Neurosurgery. The new ‘HF10′ technique offers lasting reductions in back and leg pain after other treatments have failed, according to […]
Read MoreFor patients undergoing noncardiac surgery, rates of death, stroke, and myocardial injury are reduced when angiotensin-converting-enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are discontinued 24 hours before the procedure, according to new research. “We believe clinicians should consider withholding ACE inhibitors and ARBs in major noncardiac surgery patients in the 24 hours before surgery,” […]
Read MoreAuthor: M. R. Pinsky Br J Anaesth. 2016;116(6):736-738. Cardiovascular homeostasis is a complex and beautiful interplay between the functional differences between various vascular circuits in the body and their tissue’s metabolic demand, the physical nature of the endothelial barrier to fluid flux, the circulating blood volume, and reflex-mediated autonomic tone. When at rest, as occurs during […]
Read MoreAuthors: S. Weibel et al Br J Anaesth. 2016;116(6):770-783. Background: Improvement of postoperative pain and other perioperative outcomes remain a significant challenge and a matter of debate among perioperative clinicians. This systematic review aims to evaluate the effects of perioperative i.v. lidocaine infusion on postoperative pain and recovery in patients undergoing various surgical procedures. Methods: CENTRAL, MEDLINE, EMBASE, […]
Read MorePatients with severe chronic pain, including those with arachnoiditis, have low serum cortisol levels, a new study has shown. Before prescribing opioids to such patients, clinicians should check cortisol levels, and if these levels are below normal, they should consider cortisol supplements, said Forest Tennant, MD, from Veract Intractable Pain Clinic, West Covina, California. “One […]
Read MoreThe possibility of symptomatic or permanent phrenic nerve palsy (PNP) need not loom over every patient administered an interscalene nerve block. Ki Jinn Chin, MD, associate professor in the Department of Anesthesia at Toronto Western Hospital, University of Toronto, told attendees of the 2016 International Symposium of Ultrasound for Regional Anesthesia, Pain Medicine, and Peri-operative […]
Read MoreA new study shows marked differences in opioid prescribing trends, even within the same institution. The study establishes “benchmarks” for opioid prescribing and sheds light on trends, which might help address the worrisome rise in opioid use, says Alan F. Kaul, PharmD, Department of Pharmacy, Brigham and Women’s Hospital (BWH), Boston, Massachusetts. “Everyone is concerned […]
Read MoreAuthors: M. Abdulatif et al This randomised, controlled, double-blind study investigated the effects of different doses of perineural dexmedetomidine on the pharmacodynamic profile of femoral nerve block in patients undergoing arthroscopic knee surgery. Ultrasound-guided femoral nerve block was performed before general anaesthesia using 25 ml of bupivacaine 0.5% combined with normal saline in the control group, […]
Read MoreAUTHORS: Krishnan S et al Journal of Clinical Anesthesia (JCA) 33 432-7 (Sep 2016) BACKGROUND AND OBJECTIVES For the hundreds of thousands of patients who undergo total knee arthroplasty (TKA) in the United States each year, early mobilization has been demonstrated to improve functional outcomes and reduce complications. Management of postoperative pain is a critical […]
Read MoreAUTHORS: Kendale S, Blitz J Journal of Clinical Anesthesia (JCA) 33 97-104 (Sep 2016) STUDY OBJECTIVE Obese patients regularly present for surgery and have greater hypoxemia risk. This study aimed to identify the risk and incidence of intraoperative hypoxemia with increasing body mass index (BMI). DESIGN This was a retrospective cohort study. SETTING Operating room. […]
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