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Anesthesia & Analgesia: March 2016 AUTHORS: Mirzakhani, Hooman MD, PhD, MMSc et BACKGROUND: Neuromuscular blockade is required to control excessive muscle contractions during electroconvulsive therapy (ECT). In a crossover, assessor-blinded, prospective randomized study, we studied the minimum effective dose (MED) of succinylcholine and rocuronium for ECT. The MED was the lowest dose to provide a […]
Read MoreAnesthesia & Analgesia: March 9, 2016 AUTHORS: Monahan, Amanda M. MD et al BACKGROUND: Multiple studies have demonstrated that, for single-injection popliteal sciatic nerve blocks, block characteristics are dependent upon local anesthetic injection relative to the sciatic nerve bifurcation. In contrast, this relation remains unexamined for continuous popliteal sciatic nerve blocks. We, therefore, tested the […]
Read MoreBuprenorphine (multiple brands) may be superior to opioids in the treatment of veterans with the difficult triad of chronic pain, posttraumatic stress disorder (PTSD), and substance use disorders (SUDs), new research shows. In a retrospective cohort study, investigators found that twice as many veterans treated with the partial nociceptin opioid receptor agonist experienced improvement in […]
Read MoreAlthough the use of femoral nerve catheters is commonplace after total knee arthroplasty (TKA), many patients will still require a postoperative sciatic nerve block for pain rescue. That cumbersome reality may be avoided in the future, however, thanks to the development of a nomogram that predicts which patients will need supplemental analgesia after TKA. “The […]
Read MoreNo matter how successful the surgery, a patient’s experience of postoperative nausea and vomiting (PONV) can contribute to patient dissatisfaction, longer PACU stays, hospital readmission and overall perioperative costs. Pupillometric assessment can serve as a simple but accurate tool to help identify patients with PONV, a study has found, which can allow physicians to offer […]
Read MorePatients should not receive intra-articular steroid injections in the hip in the 3 months before total hip arthroplasty because it could put them at higher risk for postoperative infection, new research shows. “I’ve spoken with surgeons who have been reluctant to perform hip injections before surgery because of the theoretical risk of infection due to […]
Read MoreMigraine and tension-type headache may share links with irritable bowel syndrome (IBS), a preliminary study hints. “Our results suggest a high possibility of phenotypic and genotypic associations between IBS and primary headache disorders (particularly migraine) and support the presence of some shared pathophysiology,” Derya Uluduz, MD, from Istanbul University in Turkey, told Medscape Medical News. “Greater […]
Read MoreThere has been a 25% fall in anesthesia-related complications for women undergoing cesarean deliveries, with mortality rates falling as well, a comprehensive study of New York state hospital records has found. The bad news: Nonanesthetic perioperative complications jumped nearly 50%. The study (Anesthesiology 2015;123:1013-1023) examined 785,854 cesarean deliveries in hospitals across New York state from 2003 […]
Read MoreA new handoff protocol boosted communication while slashing errors among nurses, anesthesiologists and surgeons during the transfer of patients from the operating room (OR) to the PACU. There was a dramatic decrease in lapses in the surgery and anesthesia reports after the rollout of the new handoff process at The Johns Hopkins Hospital, in Baltimore, […]
Read MoreEnd-tidal carbon dioxide (ETCO2) monitoring could aid resuscitation of trauma patients presenting with hypovolemic shock undergoing emergency surgery, a retrospective study suggests. ETCO2 of less than 20 mm Hg was a 95% predictor of intraoperative cardiac arrest or death. “Our results suggest that end-tidal carbon dioxide is a valuable short-term prognostic indicator in trauma patients underdoing […]
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