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Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS The number of drug products obtained by law enforcement that tested positive for fentanyl (so-called fentanyl submissions) increased five-fold and deaths from synthetic opioids nearly doubled from 2013 to 2014, according to an MMWR study. Annual fentanyl submissions increased from 1000 to 5300 during this period. At […]
Read MoreAuthors: Gaspard Montandon, Ph.D. et al Anesthesiology published on August 25, 2016 Background: Opioid analgesia is an essential component of perioperative care, but effective analgesia can be limited by excessive sedation and respiratory depression. The cortical signatures associated with sedation by opioids and the relationship between changes in cortical activity and respiratory function are not well understood. […]
Read MoreAuthors: Jeroen C. P. Simons, M.D. et al Anesthesiology 9 2016, Vol.125, 525-534. Background: Volatile anesthetics and propofol impair upper airway stability and possibly respiratory upper airway dilator muscle activity. The magnitudes of these effects have not been compared at equivalent anesthetic doses. We hypothesized that upper airway closing pressure is less negative and genioglossus activity […]
Read MoreAuthors: Hagen Bomberg, M.D. et al Anesthesiology 9 2016, Vol.125, 505-515. Background: Catheter-related infection is a serious complication of continuous regional anesthesia. The authors tested the hypothesis that single-dose antibiotic prophylaxis is associated with a lower incidence of catheter-related infections. Methods: Our analysis was based on cases in the 25-center German Network for Regional Anesthesia database […]
Read MoreAs part of the federal government’s efforts to address the opioid epidemic, the U.S. Food and Drug Administration (FDA) issued a drug safety communication that the Agency is adding Boxed Warnings to the drug labeling of prescription opioid pain and prescription opioid cough medicines, and benzodiazepines. For health care professionals, the drug safety communication states: “Health care […]
Read MoreChallenges In Selecting the Appropriate Analgesic Written by Timothy J. Atkinson, PharmD, BCPS, Jacqueline Pratt Cleary, PharmD and Jeffrey Fudin, PharmD, DAIPM, FCCP, FASHP In recent years, an avalanche of evidence against opioid and nonsteroidal anti-inflammatory drug (NSAID) use has been published in medical journals, leading many physicians to re-evaluate the risk-to-benefit ratio of these medications. Nearly […]
Read MoreAuthors: Stefan Muenster, M.D. et al Anesthesiology published on August 18, 2016. Background: Transfusion of packed erythrocytes stored for a long duration is associated with increased pulmonary arterial pressure and vascular resistance. Prolonged storage decreases erythrocyte deformability, and older erythrocytes are rapidly removed from the circulation after transfusion. The authors studied whether treating stored packed ovine […]
Read MorePublished in ASA Monitor 08 2016, Vol.80, 48-49. Review of unusual patient care experiences is a cornerstone of medical education. Each month, the AQI-AIRS Steering Committee abstracts a patient history submitted to the Anesthesia Incident Reporting System (AIRS) and authors a discussion of the safety and human factors challenges involved. Real-life case histories often include multiple […]
Read MoreAs with all chronic pain conditions, osteoarthritis (OA) is associated with an increased risk for depression, anxiety, pain catastrophizing, and sleep problems. By Ajay Wasan, MD and Kristin Della Volpe Practical Pain Management spoke with Ajay Wasan, MD, to better understand how mood and sleep affect pain processing in OA, and how providers can help detect and manage these comorbidities. […]
Read MoreStudies now confirm that osteoarthritis pain is affected not just by structural and inflammatory joint changes but also by central pain sensitization. Author: Don L. Goldenberg, MD Traditionally, osteoarthritis (OA) has been considered to be a peripheral pain disorder, related to progressive cartilage and bone damage, with little evidence for tissue inflammation. During the last […]
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