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Published in Anesthesiology 7 2015, Vol.123, 18-28 Authors: David O. Warner, MD et al Background: Decision aids can increase patient involvement in decision-making about health care. The study goal was to develop and test a decision aid for use by clinicians in discussion options for changing smoking behavior before and after elective surgery. Methods: In formative work, a […]
Read MorePublished in Anesthesiology 6/2015 Authors: Andra E. Duncan, MD Background: Glucose–insulin–potassium (GIK) administration during cardiac surgery inconsistently improves myocardial function, perhaps because hyperglycemia negates the beneficial effects of GIK. The hyperinsulinemic normoglycemic clamp (HNC) technique may better enhance the myocardial benefits of GIK. The authors extended previous GIK investigations by (1) targeting normoglycemia while administering a GIK […]
Read MorePublished in Anesthesiology 5 2015 Authors: Susan M. Lee MD FRCPC et al Background: Despite widespread use, there is limited information to guide perioperative management of angiotensin receptor blockers (ARBs). Methods: In this retrospective cohort study, the authors evaluated the patterns of postoperative ARB use in veterans regularly prescribed ARBs admitted for noncardiac surgery at the Veterans Affairs […]
Read MoreThe transition from extensive use of intravenous (IV) sedation for interventional pain procedures to almost exclusive use of oral anxiolysis at an outpatient pain center led to significant improvements in patient satisfaction and recovery times, a new study shows. But not all practitioners are on board with such a policy, citing potential safety issues. “The […]
Read MoreIt may be time to rethink the widespread practice of routinely giving a sedative before anesthesia to patients undergoing elective surgery, suggest findings of the randomized multicenter PremedX trial. Results published in the March 3 issue of JAMA show that compared with no premedication or a placebo, lorazepam premedication failed to improve patients’ overall satisfaction with the perioperative […]
Read MorePublished in Paediatr Anaeth 2015 May; 25 Authors: Ibacache ME et al BACKGROUND: The use of dexmedetomidine-ketamine combination to perform different diagnostic and surgical pediatric procedures has increased. The optimal ketamine dose to combine with dexmedetomidine has not been determined. The goal of this study was to determine the ED50 and ED95 of ketamine, which in […]
Read MorePublished in Paediatr Anaesth 2015 Jul;25(7):711-8 Authors: Anell-Olofsson M et al BACKGROUND: Administration of local anesthetics by a surgically placed wound catheter has recently been shown to reduce the need for postoperative morphine administration in extremely preterm infants undergoing ductus ligation. The primary aim of this randomized safety study was to define the plasma levels of […]
Read MoreUsing special magnetic resonance imaging (MRI), researchers have identified which patients will go on to develop chronic pain, disability, and post-traumatic stress disorder (PTSD) 1 to 2 weeks following whiplash injuries. This is the earliest these patients have ever been identified, according to James Elliott, MD, Northwestern University Feinberg school of Medicine, Chicago, Illinois, and […]
Read MoreCombining morphine and nortriptyline has been found to successfully relieve chronic neuropathic pain in 87% of patients, and significantly better than with either drug alone, according to a study published in the journal Pain. “Chronic pain is an increasingly common problem and can exert disastrous personal, societal, and socio-economic impacts on patients, their families, and […]
Read MoreLike all workers, anesthesiologists must determine the best ways to serve their “customers”—the hospital, surgeons, patients and bill payors. Although it is important to make each group happy, the “real” customers are the hospital administrators who renew contracts. Administrators should know your value and how your anesthesia practice is indispensable to the hospital. “This is […]
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