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Uncategorized Published - 25 January, 2019    By - Dr Clemens
Opioid Use and Overdose Risk After Discharge From Surgery in the VA

A study published in Pain Medicine found that people undergoing surgery at the Veterans Health Administration were 11 times more likely to experience opioid overdose in the first 30 days postdischarge than during the remaining days of the year following surgery. This retrospective cohort study sought to determine the association between postdischarge opioid use (ongoing […]

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Uncategorized Published - 24 January, 2019    By - Dr Clemens
Perioperative Pain Management in Patients With Opioid Use Disorder

Clinical Pain Advisor Although there has been an increasing focus on addressing opioid use disorders (OUDs) in outpatient settings, there is a dearth of research regarding perioperative pain management in people with a history of OUD. Opioid tolerance and medications used for OUD treatment present significant challenges in this setting. “Patients with OUD have been […]

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Uncategorized Published - 24 January, 2019    By - Dr Clemens
Bedside Lung Ultrasound Can Detect Lung Disease in Women With Pre-Eclampsia

Bedside lung ultrasound can help detect alveolar lung disease in women with pre-eclampsia, according to a study presented here at the 2018 Annual Meeting of the American Society of Anesthesiologists (ASA). “Ultrasound is a routinely performed test by doctors to know about the status of unborn babies such as weight, growth, heart rate, and importantly, […]

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Uncategorized Published - 24 January, 2019    By - Dr Clemens
Experts Recommend New Way to Describe Cognitive Changes After Anaesthesia, Surgery in Elderly Patients

A multidisciplinary, international group of experts has recommended changing the way clinicians and patients describe cognitive changes experienced in some patients after anaesthesia and surgery. The recommendations are being published simultaneously in 6 peer-reviewed journals including, Anesthesiology, Acta Anaesthesologica Scandinavica, Anesthesia & Analgesia, British Journal of Anaesthesia, Canadian Journal of Anesthesia, and the Journal of […]

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Uncategorized Published - 24 January, 2019    By - Dr Clemens
The beach chair position for shoulder surgery in intravenous general anesthesia and controlled hypotension: Impact on cerebral oxygenation, cerebral blood flow and neurobehavioral outcome

Authors: Aguirre J et al Journal of Clinical Anesthesia (JCA) 53 40-48 (Oct 2018) STUDY OBJECTIVES The aim of this study was to assess the impact of intravenous general anesthesia and controlled hypotension on cerebral saturation (rScO 2 ), cerebral blood flow measured as middle cerebral artery blood flow velocity (Vmax MCA) and neurobehavioral outcome […]

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Uncategorized Published - 24 January, 2019    By - Dr Clemens
Diagnosing Heart Failure in the Person with Dyspnea and Preserved Ejection Fraction

Author: Reddy YNV et al. Circulation 2018 May 23 A 10-point risk score based on noninvasive characteristics might be helpful in identifying patients who need further testing. Establishing the diagnosis of heart failure (HF) in people presenting with dyspnea can be challenging when they lack corroborative structural abnormalities like reduced left ventricular ejection fraction (LVEF) […]

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Uncategorized Published - 23 January, 2019    By - Dr Clemens
Diagnostic Criteria and Characteristics of Spinal Cord Infarction

Authors: Zalewski NL et al. JAMA Neurol 2018 Sep 24 Hyperacute or acute onset was the most consistent clinical symptom. Spinal cord infarction is an underrecognized etiology of myelopathy that is sometimes misdiagnosed as transverse myelitis (NEJM JW Neurol Mar 2018 and Neurology 2018; 90:e96). Investigators reviewed data from 133 adults (median age, 60; interquartile […]

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Uncategorized Published - 23 January, 2019    By - Dr Clemens
Opioids Often Prescribed in the Absence of Pain Diagnosis

Many outpatient opioid prescriptions have no documented medical indication, according to a research letter published in the Annals of Internal Medicine. Tisamarie B. Sherry, M.D., Ph.D., from the RAND Corporation in Boston, and colleagues examined the percentage of opioid prescriptions with a documented medical indication between 2006 and 2015 using data from the National Ambulatory […]

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Uncategorized Published - 23 January, 2019    By - Dr Clemens
Reviewing the Efficacy of Intrathecal Morphine, Ziconotide for Cancer- and Noncancer Chronic Pain

The use of morphine and ziconotide is consistently recommended as first-line intrathecal (IT) therapy in the management of cancer- and non-cancer chronic pain, respectively, according to a literature review and analysis of evidence-based guidelines from the 2016 Polyanalgesic Consensus Conference (PACC) published in Pain Medicine. For morphine, the studies examined were mainly non-controlled and prospective or retrospective in […]

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Uncategorized Published - 23 January, 2019    By - Dr Clemens
Performance of Air Seal of Flexible Reinforced Laryngeal Mask Airway in Thyroid Surgery Compared With Endotracheal Tube: A Randomized Controlled Trial.

Authors: Gong Y et al Department of Anesthesiology, Beijing Luhe Hospital, Beijing, China. BACKGROUND: Flexible reinforced laryngeal mask airway (FLMA®) has gained popularity in thyroid surgery, but air leak and displacement are still concerns. METHODS: In this randomized, single-blinded, noninferiority, controlled trial, we randomized patients scheduled for elective radical thyroidectomy to an endotracheal tube (ETT) group or a FLMA group. The primary outcomes were ventilation leak volume, […]

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