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NEJM Journal Watch Daniel D. Dressler, MD, MSc, MHM, FACP, reviewing Douketis JD et al. Chest 2022 Nov Douketis JD et al. Chest 2022 Nov New recommendations guide management of perioperative and periprocedural antithrombotic agents. Background In their previous guideline on perioperative antithrombotic management (published a decade ago; Chest 2012;141:2 Suppl:e326S. opens in new tab), the ACCP addressed 11 questions; now, […]
Read MoreAuthors: Cara E. Crouch, M.D. et al Anesthesiology January 2023, Vol. 138, 71–81. Background Postoperative pain associated with open partial hepatectomy can be intense and persistent. The multimodal approach used to lessen this problem includes an intraoperative intravenous infusion of lidocaine hydrochloride. Decreased hepatic metabolism after resection raises concerns about safe lidocaine dosing in this patient […]
Read MoreAuthors: Brian M. Ilfeld, M.D., M.S. et al Anesthesiology January 2023, Vol. 138, 82–97. Background Postamputation phantom pain is notoriously persistent with few validated treatments. Cryoneurolysis involves the application of low temperatures to reversibly ablate peripheral nerves. The authors tested the hypothesis that a single cryoneurolysis treatment would decrease phantom pain 4 months later. Methods The […]
Read MoreAuthors: Scott Greenwald, PhD et al Anesthesiology December 2022. Background We previously reported a broad suite of individualized Risk Stratification Index 3.0 models for various meaningful outcomes in patients admitted to a hospital for medical or surgical reasons. The models used ICD-10 trajectories, and were restricted to information available at hospital admission, including coding history […]
Read MoreNEJM Journal Watch Neil H. Winawer, MD, SFHM And the difference in accuracy might have clinical consequences. Pulse oximeters estimate the oxygen saturation of blood (SpO2) noninvasively by passing two wavelengths of light through the body and measuring the change in absorbance. This reading can be affected by the amount of melanin in the skin, […]
Read MoreAuthors: Pieter Simons, MD et al Anesthesiology December 2022. Background Oliceridine is a G protein-biased µ-opioid, a drug class that is associated with less respiratory depression than non-biased opioids, such as morphine. We quantified the respiratory effects of oliceridine and morphine in elderly volunteers. We hypothesized that these opioids differ in their pharmacodynamic behavior, measured […]
Read MoreAuthors: Tomonori Takazawa, M.D., Ph.D. et al Anesthesiology December 2022. Background There are no effective pharmacologic interventions for preventing postoperative cognitive dysfunction in daily practice. Since the antibiotic minocycline is known to suppress postoperative neuroinflammation, this study hypothesized and investigated whether minocycline might have a preventive effect on postoperative cognitive dysfunction after noncardiac surgery. Methods […]
Read MoreAuthor: Tony Mira F1rstNews blog Summary Projecting group revenues into the coming year is a difficult proposition for many practices. At the very least, groups should calculate the likely potential relative to three key factors: case volume, case acuity and unit yield. As we close out 2022, most of our clients are wondering what their […]
Read MoreNEJM Journal Watch Allan S. Brett, MD, reviewing Pfeifer KJ et al. Mayo Clin Proc 2021 Dec Oprea AD et al. Mayo Clin Proc 2022 Feb Oprea AD et al. Mayo Clin Proc 2022 Feb During 2021 and 2022, a multidisciplinary group has issued consensus statements on perioperative management of drugs commonly used in pulmonary, gastroenterology, neurology, psychiatry, and rheumatology practice. Sponsoring […]
Read MoreAuthor: Tony Mira F1rstNews Summary The year-end coding and compliance rule changes have been finalized and widely addressed, but there are always a few smaller actions by federal officials that don’t get as much attention. In this alert, we take a look at some recent rules and […]
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