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Anesthesia & Analgesia: September 2016 – Volume 123 – Issue 3 – p 715–721 AUTHORS: Schwartz, Lawrence I. MD et al BACKGROUND: Dexmedetomidine is a selective α-2 receptor agonist with a sedative and cardiopulmonary profile that makes it an attractive anesthetic for pediatric patients with congenital heart disease (CHD). Although several smaller, single-center studies suggest […]
Read MoreAnesthesia & Analgesia: September 2016 – Volume 123 – Issue 3 – p 705–714 AUTHORS: Chau, Destiny F. MD et al BACKGROUND: Complex surgical and critically ill pediatric patients rely on syringe infusion pumps for precise delivery of IV medications. Low flow rates and in-line IV filter use may affect drug delivery. To determine the […]
Read MoreAnesthesia & Analgesia: September 2016 – Volume 123 – Issue 3 – p 698–702 AUTHORS: Downing, John W. MD et al BACKGROUND: Vasoactive agents administered to counter maternal hypotension at cesarean delivery may theoretically intensify the hypoxemic fetoplacental vasoconstrictor response and, hence, negatively impact transplacental oxygen delivery to the fetus. Yet, this aspect of their […]
Read MoreAnesthesia & Analgesia:September 2016 – Volume 123 – Issue 3 – p 690–697 AUTHORS: Sviggum, Hans P. MD et al BACKGROUND: Intrathecal (IT) morphine is considered the “gold standard” for analgesia after cesarean delivery under spinal anesthesia, most commonly administered at a dose of 100 to 200 μg. There is less experience with IT hydromorphone […]
Read MoreAnesthesia & Analgesia: September 2016 – Volume 123 – Issue 3 – p 641–649 AUTHORS: Goldhaber-Fiebert, Sara N. MD et al BACKGROUND: Emergency manuals (EMs), context-relevant sets of cognitive aids or crisis checklists, have been used in high-hazard industries for decades, although this is a nascent field in health care. In the fall of 2012, […]
Read MoreAnesthesia & Analgesia: September 2016 – Volume 123 – Issue 3 – p 636–640 AUTHORS: Kim, Eugene MD et al BACKGROUND: It remains unclear whether we have to interrupt mechanical ventilation during infraclavicular subclavian venous catheterization. In practice, the clinicians’ choice about lung deflation depends on their own discretion. The purpose of this study was […]
Read MoreAnesthesia & Analgesia: September 2016 – Volume 123 – Issue 3 – p 626–633 AUTHORS: Applegate, Richard L. II MD et al BACKGROUND: The use of intraoperative pulse oximetry (SpO2) enhances hypoxia detection and is associated with fewer perioperative hypoxic events. However, SpO2 may be reported as 98% when arterial partial pressure of oxygen (PaO2) is […]
Read MoreAnesthesia & Analgesia: September 2016 – Volume 123 – Issue 3 – p 610–615 AUTHORS: Langford, Roger A. BMBS, FRCA et al BACKGROUND: We compared plasma and cerebrospinal fluid (CSF) pharmacokinetics of paracetamol after intravenous (IV) and oral administration to determine dosing regimens that optimize CSF concentrations. METHODS: Twenty-one adult patients were assigned randomly to […]
Read MoreAnesthesia & Analgesia: September 2016 – Volume 123 – Issue 3 – p 597–606 AUTHORS: Qiu, Chunyuan MD, MS et al BACKGROUND: In this article, we report on the implementation and impact of a Perioperative Surgical Home (PSH) model for the total knee arthroplasty at an integrated delivery system (Kaiser Permanente). METHODS: A multidisciplinary committee […]
Read MoreFor the antifibrinolytic agent tranexamic acid, doses varying between 5 and 15 mg/kg failed to produce a dose-dependent drop in hemoglobin after total knee (TKA) or total hip arthroplasty (THA), leading study investigators to recommend using the lowest of these doses in orthopedic patients. “At my institution, we reviewed quite a bit of data while […]
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