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Authors: P J Devereaux et al N Engl J Med. 2022 May 26;386(21):1986-1997 Background: Perioperative bleeding is common in patients undergoing noncardiac surgery. Tranexamic acid is an antifibrinolytic drug that may safely decrease such bleeding. Methods: We conducted a trial involving patients undergoing noncardiac surgery. Patients were randomly assigned to receive tranexamic acid (1-g intravenous bolus) or […]
Read MoreAuthors: Christine Jette, MD, FASA et al ASA Monitor April 2023, Vol. 87, 10–12. Safe access to pediatric surgery and anesthesia care in rural America is critical to having an equitable health care system. The American College of Surgeons (ACS) Children’s Surgery Verification (CSV) Quality Improvement Program provides standards defining “the resources believed necessary to achieve […]
Read MoreAuthor: Amarquaye W. Pract Pain Manag. 2023 May/June;23(3). When a patient asks about beginning methadone therapy for CRPS, clinical pharmacist William Amarquaye advises on administration, titration, side effects, and interactions. Patient Scenario: Patient Prescribed Methadone for CRPS The Patient Patient Bob* called our pharmacy inquiring about a new prescription for methadone that he was placed […]
Read MoreAUTHORS: James, Leslie A. BA et al Anesthesia & Analgesia 128(6):p 1279-1285, June 2019. | BACKGROUND: Frailty, a state of decreased physiological reserve, is strongly associated with perioperative mortality in older adults. However, the mechanism by which frailty is associated with mortality is not yet understood. Autonomic dysfunction in the form of decreased intraoperative hemodynamic variability has […]
Read MoreAuthors: Matthew D McEvoy et al Perioper Med (Lond) 2020 Nov 23;9(1):35. Background: Recent literature has demonstrated that hemodynamic instability in the intraoperative period places patients at risk of poor outcomes. Furthermore, recent studies have reported that stroke volume optimization and protocolized hemodynamic management may improve perioperative outcomes, especially surgical site infection (SSI), in certain high-risk […]
Read MoreAuthors: Andres Zorrilla-Vaca et al AM Surg 2021 Aug;87(8):1189-1195. Introduction: Goal-directed fluid therapy (GDFT) has increasingly been utilized in major surgery as a key component to ensure fluid optimization and adequate tissue perfusion, showing improvements in the rate of morbidity and mortality under conventional care. It is unclear if patients derive similar benefit as part of […]
Read MoreAuthors: Yaras R, Bettinger J Pract Pain Manage. 2023 MayJune:23(2). The following hypothetical case is intended to reflect the changes in the CDC opioid prescribing guidelines (see full background).¹ Below is a step-by-step guide through the management of “legacy” patients on chronic opioid medications. See our separate case on initiating opioid therapy under the new guidelines. Patient’s Medical and Psychiatric […]
Read MoreAuthor: Heidi Splete Practical Pain Management People living with chronic migraine have a new oral option in the form of atogepant tablets. The FDA has approved an expanded indication of atogepant (Qulipta) to include the prevention of chronic migraine in adults, according to a statement from manufacturer AbbVie. Atogepant, an oral calcitonin gene-related peptide (CGRP) receptor […]
Read MoreAuthors: Sergiy M. Nadtochiy, Ph.D. et al Anesthesiology May 2023, Vol. 138, 523–532. Background Heparin anticoagulation has been used successfully for cardiopulmonary bypass (CPB). However, an alternative anticoagulant approach is desirable due to the cases of heparin-induced thrombocytopenia. Dabigatran provides anticoagulation for an in vitro model of simulated CPB. The current analysis tests the hypothesis that dabigatran provides […]
Read MoreAuthors: Niklas Larsson, M.D. et al Anesthesiology May 2023, Vol. 138, 561–563. To the Editor: Lipid mediators derived from arachidonic acid and other precursor polyunsaturated fatty acids, collectively known as oxylipins, are metabolized along different distinct pathways and play important roles in the modulation of inflammation. Blood oxylipin profiles have been shown to correlate with the survival […]
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