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Published in Anaesthesia 2015 Apr 8 Authors: Ueda K et al. In this randomized, controlled trial of surgery patients, first-attempt radial arterial line placement by anesthesiologists was more successful when guided by ultrasound than palpation or Doppler. The radial artery is traditionally located by palpation, but this can be challenging in patients with hypotension, small-caliber vessels, […]
Read MoreThe number of women dying from overdoses of opioid painkillers increased 5-fold between 1999 and 2010, according to new data released today by the US Centers for Disease Control and Prevention (CDC). The problem of prescription opioid drug overdoses in women is “getting worse and getting worse quickly,” CDC director Tom Frieden, MD, MPH, said […]
Read MorePublished in Ann Emerg Med 2015 Apr 15 Authors: Calver L et al. The FDA’s black box warning about droperidol led to an unfortunate and unwarranted drop in its use; we should bring this safe drug back. In 2001, the FDA issued a warning about droperidol as a potential cause of QT prolongation and torsades de […]
Read MorePublished in BMJ 2015 Mar 24; 350:h1354 Authors: Holst LB et al. And this strategy saves healthcare resources. A growing body of evidence suggests that restrictive red blood cell transfusion strategies are safe. In this systematic review and meta-analysis of 31 randomized trials that involved 9800 patients, researchers compared benefits and harms of restrictive (triggers: hemoglobin, 7–9 […]
Read MorePublished in Anesthesiology 4 2015. doi:10.1097 Authors: Edward J. Mascha, Ph.D et al Background: Little is known about the relationship between intraoperative blood pressure variability and mortality after noncardiac surgery. Therefore, the authors tested the hypothesis that blood pressure variability, independent from absolute blood pressure, is associated with increased 30-day mortality. Methods: Baseline and intraoperative variables plus 30-day […]
Read MorePhysician anesthesiologists can now choose from 36 quality reporting measures when participating in the ASA QCDR, the American Society of Anesthesiologists® (ASA®) Qualified Clinical Data Registry (QCDR). The Centers for Medicare & Medicaid Services (CMS) approved two new Physician Quality Reporting System (PQRS) measures and 16 non-PQRS measures developed by ASA and its affiliated organization, Anesthesia […]
Read MoreA meta-analysis confirms that a continuous femoral nerve block (FNB) produces longer-lasting pain relief than a single-injection block after total knee arthroplasty (TKA). The findings were presented at the 2014 World Congress on Pain, in Buenos Aires, Argentina. These results were also published earlier this year as part of a Cochrane Review analyzing the effectiveness […]
Read MoreThe Neuromodulation Appropriateness Consensus Committee (NACC) has released the first comprehensive guidance on best practices for neurostimulation for chronic pain. The guidelines, four peer-reviewed articles totaling 101 pages that were authored by about 60 international experts, were published in the journal Neuromodulation (2014;17:515-615) and cover the following general areas: appropriate use of neurostimulation of the spinal cord […]
Read MoreElderly patients undergoing ambulatory gastrointestinal procedures often receive inappropriately high doses of anesthesia at induction, researchers have found. The study, a review of the anesthetic management of patients undergoing upper endoscopy and colonoscopy at Yale School of Medicine, in New Haven, Conn., found that even with age-adjusted dosing, significant drops in mean arterial pressure occur. […]
Read MoreWho controls certification? Author: Robert E. Johnstone, MD Four decades ago, board certification was a mark of excellence, a goal for achievers and not a practice requirement. Certification designated an anesthesiologist with consultant-level knowledge and extraordinary capabilities. But times have changed. Many institutions and groups now require certification for clinician credentialing. No certification increasingly means […]
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