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Published in BMJ 2015 Apr 1; 350:h1603 Authors: Nerland US et al. Physical therapy and minimally invasive surgery both fared well in randomized trials against open surgery. Two recent studies shed light on options for treating patients with lumbar spinal stenosis. In a randomized trial, investigators compared surgical decompression versus a formal physical therapy (PT) program in […]
Read MoreOral prednisone confers modest improvements in function — but no improvement in pain — among patients with sciatica due to a herniated disk, a JAMA study finds. Some 270 adults with radicular pain of no more than 3 months’ duration, disability scores of 30 or higher (on a 100-point scale), and a confirmed herniated disk were randomized […]
Read MoreWhat’s in a name? Everything to proponents of the American Society of Anesthesiologists’ (ASA) concept of the Perioperative Surgical Home (PSH), which sees the anesthesiologists’ role in the surgical suite morphing into that of a “perioperativist.” Alan E. Curle, MD, associate professor of clinical anesthesiology and director, Center for Perioperative Medicine, University of Rochester Medical […]
Read MoreTo the well-documented analgesic benefits of IV ibuprofen add this: Preoperative administration of the nonsteroidal anti-inflammatory drug (NSAID) improves the overall quality of recovery. A recent study also revealed that IV ibuprofen might improve postoperative cognitive recovery. According to Vanny Le, MD, and a team of researchers from Rutgers New Jersey Medical School in Newark, […]
Read MoreThis is for our providers who practice pain management. The time has come to seriously explore the use of nonopioid analgesia for managing pain in the emergency department, said experts speaking at the American Academy of Emergency Medicine 21st Annual Scientific Assembly in Austin, Texas. “Relying on opioids as the primary analgesics for moderate to […]
Read MoreParacetamol, known as acetaminophen in the United States, may have more risks than originally thought, particularly when it is taken at the higher end of standard therapeutic doses, according to a new systematic review. The authors and an outside expert recommend caution when interpreting the data, as they are observational in nature and are subject […]
Read MoreChronic pain and inappropriate use of pain medications are common in people with early-stage chronic kidney disease (CKD), according to a study published in the Clinical Journal of the American Society of Nephrology. “We demonstrated that there is a link between pain and patient safety in CKD and that the CKD population warrants closer attention to […]
Read MorePublished in Crit Care Med. 2015;43(1):194-204. Authors: Jing Lan Mu et Objectives Postcardiac surgery delirium is associated with increased risks of morbidity, cognitive decline, poor health-related quality of life and mortality, and higher healthcare costs. We performed a systematic review of randomized controlled trials to examine the effect of pharmacologic agents for the prevention and the treatment […]
Read MorePublished in BMC Anesthesiol. 2014;14(83) Authors: Francisco Esteve et al Background The arterial partial pressure of O2 and the fraction of inspired oxygen (PaO2/FiO2) ratio is widely used in ICUs as an indicator of oxygenation status. Although cardiac surgery and ICU scores can predict mortality, during the first hours after cardiac surgery few instruments are available to […]
Read MorePublished in Anesthesiology 5 2015 Authors: Jonne Doorduin, M.Sc. et al Background: In patients with acute respiratory distress syndrome (ARDS), the use of assisted mechanical ventilation is a subject of debate. Assisted ventilation has benefits over controlled ventilation, such as preserved diaphragm function and improved oxygenation. Therefore, higher level of “patient control” of ventilator assist may be […]
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