When prescription opioids started getting too difficult or too expensive to procure, people addicted to them started turning to heroin–a shift that’s created an “epidemic” of heroin use in whole new groups of people. Now, a new opioid is rising in use and overdose: Fentanyl, a synthetic opioid, is 50-100 times more potent than morphine, according […]
Read MoreAuthors: Peter Szmuk, M.D. et al Anesthesiology 4 2016, Vol.124, 779-784 Background: Pulse oximetry provides no indication of downward trends in Pao2 until saturation begins to decrease. The Oxygen Reserve Index (ORI) is a novel pulse oximeter–based nondimensional index that ranges from 1 to 0 as Pao2 decreases from about 200 to 80 mmHg and is measured by optically […]
Read MoreAuthors: Dermot R. Fitzgibbon, M.D. et al Anesthesiology published on 4 2016 Background:: Due to an increase in implantable device–related anesthesia pain medicine claims, the authors investigated anesthesia liability associated with these devices. Methods:: After institutional review board approval, the authors identified 148 pain medicine device claims from 1990 or later in the Anesthesia Closed Claims Project Database. […]
Read MoreAuthors: Lars S. Bjerregaard, M.D. et al Anesthesiology published on 4 2016 Background:: No evidence-based threshold exists for postoperative urinary bladder catheterization. The authors hypothesized that a catheterization threshold of 800 ml was superior to 500 ml in reducing postoperative urinary catheterization and urological complications after fast-track total hip arthroplasty (THA) and total knee arthroplasty (TKA). Methods:: This […]
Read MoreAuthors: Christopher Uhlig, M.D. et al Anesthesiology published on 4 2016 Background: It is not known whether modern volatile anesthetics are associated with less mortality and postoperative pulmonary or other complications in patients undergoing general anesthesia for surgery. Methods: A systematic literature review was conducted for randomized controlled trials fulfilling following criteria: (1) population: adult patients undergoing general […]
Read MoreEdited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, FASAM Adding fusion surgery to decompression surgery in patients with spinal stenosis offers little to no benefit and is associated with longer hospital stays and increased costs, according to two New England Journal of Medicine trials. In the first, nearly 250 adults with lumbar spinal stenosis were randomized […]
Read MoreAnesthesia adds risk and cost to the screening procedure, research shows, raising fresh questions about how providers weigh patient satisfaction against outcomes and profit. New findings on risks associated with the use of anesthesia during colonoscopies and the demise of the first automated sedation device for use in such procedures add sparks to the debate […]
Read MoreAuthors: Gillinov AM et al., N Engl J Med 2016 Apr 4; In a randomized comparison with rate control, rhythm control conferred no net clinical benefit. Atrial fibrillation (AF) occurs after cardiac surgery in up to 50% of patients. In a study funded by the NIH and the Canadian Institutes of Health Research, investigators compared aggressive rhythm-control […]
Read MoreAuthors: Hourmozdi JJ et al., Crit Care Med 2016 Mar 31; Very few complications were picked up by routine chest x-ray at a large academic hospital system. For decades, dogma has been that chest x-ray should be performed to confirm placement of all internal jugular (IJ) central lines, despite evidence that ultrasound can significantly reduce complication rates. […]
Read MoreWhile overall malpractice claims related to anesthesia care are declining, the proportion of outpatient claims has increased in comparison to inpatient ones, says Richard J. Kelly, MD, JD, MPH, FCLM, clinical associate professor of anesthesiology and perioperative care at the University of CA Irvine School of Medicine. Dr Kelly recently completed a study looking at […]
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