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Uncategorized Published - 27 April, 2016    By - Dr Clemens
Why Fentanyl Is So Much More Deadly Than Heroin

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 […]

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Uncategorized Published - 27 April, 2016    By - Dr Clemens
Oxygen Reserve Index: A Novel Noninvasive Measure of Oxygen Reserve—A Pilot Study

Authors: 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 […]

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Uncategorized Published - 27 April, 2016    By - Dr Clemens
Injury and Liability Associated with Implantable Devices for Chronic Pain

Authors: 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. […]

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Uncategorized Published - 27 April, 2016    By - Dr Clemens
Postoperative Urinary Catheterization Thresholds of 500 versus 800 ml after Fast-track Total Hip and Knee Arthroplasty: A Randomized, Open-label, Controlled Trial

Authors: 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 […]

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Uncategorized Published - 26 April, 2016    By - Dr Clemens
Effects of Volatile Anesthetics on Mortality and Postoperative Pulmonary and Other Complications in Patients Undergoing Surgery: A Systematic Review and Meta-analysis

Authors: 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 […]

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Uncategorized Published - 26 April, 2016    By - Dr Clemens
In Spinal Stenosis, Adding Fusion to Decompression Surgery of Little Benefit

Edited 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 […]

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Uncategorized Published - 26 April, 2016    By - Dr Clemens
Anesthesia Use for Colonoscopy Attracts New Scrutiny

Anesthesia 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 […]

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Uncategorized Published - 26 April, 2016    By - Dr Clemens
AF After Cardiac Surgery: Does Strict Rhythm Control Improve Outcomes?

Authors: 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 […]

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Uncategorized Published - 26 April, 2016    By - Dr Clemens
No Need for Chest X-Ray After Ultrasound-Guided Right Internal Jugular Lines?

Authors: 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. […]

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Uncategorized Published - 25 April, 2016    By - Dr Clemens
Mixed malpractice news for anesthesia providers

While 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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