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Author: Uday Jain, BSEE, MD, PhD, FASA ASA Monitor June 2022, Vol. 86, 31–32. Nausea, pain, and pruritus have a high degree of prevalence and severity after discharge following ambulatory surgery, for which they may be inadequately treated. Nausea and vomiting Incidence In a multicenter study of over 2,000 U.S. adults, the overall incidence of post-discharge […]
Read MoreAuthors: Sarah G. Bodin, MD, FASA ASA Monitor June 2022, Vol. 86, 30. Today I reviewed another “low-risk clearance” checkbox note from an advanced practice registered nurse, for a topical cataract case, under monitored anesthesia care. Prior to the patient’s topical cataract extraction, my healthy 64-year-old patient had visited her primary care physician to be cleared […]
Read MoreAuthor: Niraja Rajan, MBBS, FAAP, SAMBA-F, FASA ASA Monitor June 2022, Vol. 86, 28–29. Many pediatric surgeries are performed on an outpatient basis either in a hospital or a freestanding ambulatory surgery center (ASC) with tonsillectomy and/or adenoidectomy, myringotomy, appendectomy, urological procedures, and other operating room therapeutic procedures on nose, mouth, and pharynx accounting for the […]
Read MoreASA Monitor June 2022, Vol. 86, 11. Three minutes after administering a standard intubating dose of rocuronium (0.6 mg/kg) to a patient with cirrhosis, you discover the vocal cords are closed during laryngoscopy and the patient is moving. An alteration in which of the following MOST likely explains this finding? □ (A) Hepatic clearance □ (B) The neuromuscular […]
Read MoreAuthors: John J. Finneran, IV, M.D. et al Anesthesiology June 2022, Vol. 136, 970–982. Background The common technique using a basal infusion for an ambulatory continuous peripheral nerve blocks frequently results in exhaustion of the local anesthetic reservoir before resolution of surgical pain. This study was designed to improve and prolong analgesia by delaying initiation using […]
Read MoreAuthors: Sher-Lu Pai, MD, FASA, SAMBA-F; Kelly Lebak, MD, FASA ASA Monitor June 2022, Vol. 86, 27. The coronavirus disease (COVID-19) pandemic has changed the world, and it may have changed the practice of medicine, including the specialty of anesthesiology (Anesth Analg 2020;131:31-6). From cancellation of elective procedures, perioperative testing protocols, lack of hospital inpatient beds, intraoperative […]
Read MoreAuthors: Emily Methangkool, MD, MPH; Richard D. Urman, MD, MBA ASA Monitor June 2022, Vol. 86, 25–26. Figure: Opportunities for quality improvement in non-operating room anesthetizing locations. NORA=non-operating room anesthesia; M&M=mortality and morbidity. Communication failures contribute to adverse events, morbidity, and mortality and may be complicated by both interprofessional and interdisciplinary dynamics within the procedural setting (J […]
Read MoreAuthor: Girish P. Joshi, MBBS, MD, FFARCSI ASA Monitor June 2022, Vol. 86, 24. Minimally invasive approaches, facilitated with advanced technology such as augmented reality, mixed reality, and robotics, as well as artificial intelligence (AI), novel imaging, innovative navigation systems, and 3D printing, will extend the capabilities of surgeons and proceduralists. Next-generation surgical robotics will be […]
Read MoreAuthors: David Amar, M.D. et al Anesthesiology June 2022, Vol. 136, 916–926. Background Postoperative atrial fibrillation may identify patients at risk of subsequent atrial fibrillation, with its greater risk of stroke. This study hypothesized that N-acetylcysteine mitigates inflammation and oxidative stress to reduce the incidence of postoperative atrial fibrillation. Methods In this double-blind, placebo-controlled trial, patients at […]
Read MoreAuthors: Marcelo Gama de Abreu, M.D. et al Anesthesiology July 2022, Vol. 137, 6–8. “[In mechanical ventilation,] power may be a better marker of lung injury than isolated parameters such as tidal volume, driving pressure, or respiratory rate.” Image: J. P. Rathmell. The concept of elastic and resistive energy transfer from mechanical ventilators to the respiratory […]
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