Anesthesiology News

Anesthesiology News Anesthesiology News (AN), now in its 40th year, has been the best-read publication for the specialty for the last 17 years.

Anesthesiology News (AN), now in its 40th year, has been the best-read publication for the specialty for the last 17 years. All 47,524 anesthesiologists and anesthesiology residents in the United States receive a copy each month! Our news magazine offers extensive coverage of major scientific meetings affecting the specialty, feature articles on topics relevant to practicing anesthesiologists, in-depth clinical reviews written by thought leaders, practice management articles, medical education, as well as Special Editions, Buyer’s Guides, and a full line of digital media, including the AnesthesiologyNews.com website, e-Newsletters, iPad app, and multimedia content.

Pectoral Block Proven Effective As Motor Block but Not Skin Sensory Blockhttp://bit.ly/2W1EVan“The PEC1 block was firs...
05/14/2019

Pectoral Block Proven Effective As Motor Block but Not Skin Sensory Block

http://bit.ly/2W1EVan

“The PEC1 block was first described by Blanco in 2011 [Anaesthesia 2011;66(9):847-848],” said Maxim Roy, MD, a resident at the University of Montreal. “The goal of the technique is to block the medial and lateral pectoral nerves by injecting anesthetic between the pectoralis major and pectoralis minor muscles. One year later, the same author proposed a modification of this technique, called the PEC2 block.

“Since the description of these blocks, the vast majority of literature has evaluated the PEC2 block,” he noted. “However, nobody has really proven that the PEC1 block actually blocks the lateral and medial pectoral nerves. What’s more, no standardized test exists for objectifying the presurgical success of the PEC1 block.”

#AnesthesiologyNews #Anesthesiology #ASA #pharma #pharmaceutical #DigitalHealth #HealthTalk #airway #intubation #healthcare #healthinnovations #medicalconsulting #chronicpain #transfusions #medicine #surgery #blooduse #hospitals #FDA #fluidtherapy #ERAS

Are Surgical Caps on the Verge of a Comebackhttp://bit.ly/2W1BkJpIn February 2018, surgeons, nurses and infection contro...
05/13/2019

Are Surgical Caps on the Verge of a Comeback

http://bit.ly/2W1BkJp

In February 2018, surgeons, nurses and infection control experts met to review the latest evidence on OR attire. The task force—which included representatives from the Association of periOperative Registered Nurses, the American College of Surgeons and the Joint Commission—concluded that the scientific evidence “does not demonstrate any association between the type of hat or extent of hair coverage and ssI rates,” and the “requirement for ear coverage is not supported by sufficient evidence.”

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Many Hepatitis Infections Go Undiagnosed in Cancer Patientshttp://bit.ly/2Dv1mNTInvestigators from SWOG Cancer Research ...
05/10/2019
Many Hepatitis Infections Go Undiagnosed in Cancer Patients

Many Hepatitis Infections Go Undiagnosed in Cancer Patients

http://bit.ly/2Dv1mNT

Investigators from SWOG Cancer Research Network, an international cancer clinical trials group funded by the National Cancer Institute, found that a substantial portion of newly diagnosed cancer patients with HBV or HCV were unaware of their viral infection. Many had no identifiable risk factors for these infections, such as injection drug use (JAMA Oncol 2019 Jan 25. [Epub ahead of print]).

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An alarmingly high rate of patients with cancer have undiagnosed acute and chronic hepatitis.  

OR Air Contamination Standards Needed to Control SSI Riskhttp://bit.ly/2DuibbPThe technology now exists that can accurat...
05/09/2019

OR Air Contamination Standards Needed to Control SSI Risk

http://bit.ly/2DuibbP

The technology now exists that can accurately measure viable aerosol microbes in the OR, as well as to clean the air to substantially reduce the risk for contamination and infection of surgical wounds. So now is the time to adopt these standards, said Dr. Edmiston, who is an emeritus professor of surgery at the Medical College of Wisconsin, in Milwaukee.

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Protocol Results in Less Opioids Higher Satisfaction in Outpatient Mastectomyhttp://bit.ly/2DFfrbN“This is not only en...
05/08/2019

Protocol Results in Less Opioids Higher Satisfaction in Outpatient Mastectomy

http://bit.ly/2DFfrbN

“This is not only encouraging as something preventative in a fight back against the opioid epidemic itself, but it is encouraging that we’re making sure that we’re doing the right thing by our patients,” said Cameron T. Ward Coker, MD, one of the study authors and a fourth-year surgical resident at Louisiana State University Health Sciences Center New Orleans.

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Study of Effect of Cannabis on Anesthetics Creates Buzzhttp://bit.ly/2Duez9LA small study has concluded that regular can...
05/07/2019

Study of Effect of Cannabis on Anesthetics Creates Buzz

http://bit.ly/2Duez9L

A small study has concluded that regular cannabis users may require as much as twice the level of sedation before a medical procedure, compared with those who abstain. The report, in the Journal of the American Osteopathic Association ([Epub Apr 15, 2019]. doi:10.7556/jaoa.2019.052), defined regular users as those who smoked or ingested edibles on a weekly or more frequent basis. Those who were either occasional users or abstainers were considered nonusers.

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‘I Am an Opioid Moderate and I Am Seen as a Villain By Both Sides’http://bit.ly/2DxohbjMichael Schatman, PhD, is the...
05/06/2019
‘I Am an Opioid Moderate, and I Am Seen as a Villain By Both Sides’

‘I Am an Opioid Moderate and I Am Seen as a Villain By Both Sides’

http://bit.ly/2Dxohbj

Michael Schatman, PhD, is the director of research and network development at Boston Pain Care, an adjunct clinical assistant professor of public health and community medicine at Tufts University, and the editor-in-chief of the Journal of Pain Research. Here he discusses pain medicine in the midst of the opioid crisis and the rise of medical marijuana.

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Michael Schatman, PhD, discusses pain medicine in the midst of the opioid crisis and the rise of medical marijuana.

05/03/2019

Open Thought Research A Proposal

http://bit.ly/2DvtFLY

Medical research today, yesterday, perhaps always, is highly secretive at the outset, although intensely publicity-hungry once completed. Secrecy causes delay of various kinds: in setting up potentially dynamic collaborations, bringing good work to fruition, making scientific progress, curing disease, helping humankind.

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05/02/2019
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Can All Sepsis Deaths Be Prevented

http://bit.ly/2DudY81

Sepsis appears to be the most common cause of death in U.S. hospitals, said Chanu Rhee, MD, MPH, an assistant professor of population medicine at Harvard Medical School and the Harvard Pilgrim Health Care Institute, and an assistant professor of medicine at Brigham and Women’s Hospital, in Boston. However, he said, “our study indicates that most sepsis-related deaths may not be preventable through better hospital-based care because most cases occur in very medically complex patients with severe chronic illnesses.”

#AnesthesiologyNews #Anesthesiology #ASA #pharma #pharmaceutical #DigitalHealth #HealthTalk #airway #intubation #healthcare #healthinnovations #medicalconsulting #chronicpain #transfusions #medicine #surgery #blooduse #hospitals #FDA #fluidtherapy #ERAS

Skull Cap or Bouffant Cap Why It Mattershttp://bit.ly/2DtILl7The surgical community took umbrage at the skull cap prohib...
05/02/2019

Skull Cap or Bouffant Cap Why It Matters

http://bit.ly/2DtILl7

The surgical community took umbrage at the skull cap prohibition. The American College of Surgeons released a statement that “the skull cap is symbolic of the surgical profession … [it] may be worn when close to the totality of hair is covered by it,” to which the AORN responded that “wearing a particular hair covering based on its symbolism is not evidence-based … our emphasis is on patient safety.” This exchange between the AORN and ACS eventually spilled into the lay press.

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A Note About an Earlier Cuban Professional Exchangehttp://bit.ly/2DveWkjIn mid-1998, the U.S. Department of State implem...
04/30/2019

A Note About an Earlier Cuban Professional Exchange

http://bit.ly/2DveWkj

In mid-1998, the U.S. Department of State implemented a “Support for the Cuban People” program that promoted licensed professional exchanges and people-to-people humanitarian programs between Cuban and U.S. citizens. John Freedman, MD, who had been well regarded as a volunteer in the ASA Overseas Teaching Program in Africa, received an invitation from the State Department via Bob Everett, the president of an organization called U.S. Exchanges, which specialized in people-to-people professional exchange programs. The invitation was to organize and lead a delegation for a professional exchange in Havana and its environs. The events leading to the invitation began with Zambian anesthesiologists enthusiastically telling their Cuban colleagues about Dr. Freedman after he volunteered there. Those conversations resulted in a letter from Cuban anesthesiologists to the State Department requesting formal contact with their U.S. counterparts, simply because they were eager to share knowledge and collegial relationships with U.S. physicians. Cuban physicians were well regarded internationally but had had very little contact with their U.S. counterparts for 40 years.

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Overlapping Surgery Shown Safe but With Caveatshttp://bit.ly/2IRLedr“This study strengthens the evidence that overlapp...
04/30/2019
Overlapping Surgery Shown Safe, but With Caveats

Overlapping Surgery Shown Safe but With Caveats

http://bit.ly/2IRLedr

“This study strengthens the evidence that overlapping surgery is a reasonable practice for many cases,” wrote the authors, who included Eric Sun, MD, PhD, an assistant professor of anesthesiology, pain and preoperative medicine at Stanford University School of Medicine in California, and Anupam B. Jena, MD, PhD, in the Department of Health Care Policy, Harvard Medical School in Boston.

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The common but controversial practice of overlapping surgery has been found to be safe, with two exceptions: patients deemed preoperatively to be at high risk for death or complications and those undergoing coronary artery bypass graft (CABG) surgery, according to a multicenter study.

Cardiac Surgery Patients With Persistent Opioid Use Incur More Complications Longer Hospitalizationhttp://bit.ly/2IQT07G...
04/30/2019
Cardiac Surgery Patients With Persistent Opioid Use Incur More Complications, Longer Hospitalization

Cardiac Surgery Patients With Persistent Opioid Use Incur More Complications Longer Hospitalization

http://bit.ly/2IQT07G

“OUD has been a growing problem across the country for several years now,” said principal investigator Edward Soltesz, MD, the surgical director of the Kaufman Center for Heart Failure Treatment and Recovery at the Cleveland Clinic, in Ohio. “Over the course of the 16-year study, we found the proportion of cardiac surgery patients with a history of OUD increased ninefold, from 0.06% of all cases in 1998 to 0.54% of all cases in 2013.”

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Although patients undergoing cardiovascular surgery with persistent opioid use or dependence have roughly the same mortality rate as those without (3.1% vs. 4.0%), the opioid group experiences a higher number of complications overall, a longer hospital length of stay and higher costs, according to a...

Commentary: Goop What a Messhttp://bit.ly/2IQdQnrPatients are frustrated. A 2018 Harris Poll survey of 2,000 adults foun...
04/30/2019

Commentary: Goop What a Mess

http://bit.ly/2IQdQnr

Patients are frustrated. A 2018 Harris Poll survey of 2,000 adults found that Americans want a deeper relationship with their doctor, one that goes beyond treating illness. In fact, nine out of 10 patients agreed that health means more than treating sickness; it involves being happy, calm, relaxed and living independently. But doctors don’t address these needs. Only about 50% of doctors discuss exercise; fewer than half discuss diet (42%), sleep (40%) or mental health (36%); and only 10% mention spiritual health. The majority of patients want to discuss nonmedical therapies such as nutrition, acupuncture or meditation with their physicians. Patients are unsatisfied with their allopathic medicine experience, which focuses on sickness and pharmacotherapy, and they understandably are going elsewhere.

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Simplified OSA Screening Tool Proves Efficacyhttp://bit.ly/2DrPA6O“In 2006, the Joint Commission recommended that hosp...
04/30/2019
Simplified OSA Screening Tool Proves Efficacy

Simplified OSA Screening Tool Proves Efficacy

http://bit.ly/2DrPA6O

“In 2006, the Joint Commission recommended that hospitals establish screening tools for OSA,” said Katharina S. Platzbecker, MD, a research fellow at Beth Israel Deaconess Medical Center, in Boston. “At that time, the BOSTN score was developed at our institution by a multidisciplinary team led by Eswar Sundar, MD.”

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San Francisco—A screening tool designed to identify surgical patients at high risk for obstructive sleep apnea (OSA) bolsters clinical decision making and reduces both respiratory complications and hospital utilization rates.

New Score Uses Intra-op Variables To Predict Respiratory Complicationshttp://bit.ly/2DtiSlA“Postoperative respiratory ...
04/29/2019

New Score Uses Intra-op Variables To Predict Respiratory Complications

http://bit.ly/2DtiSlA

“Postoperative respiratory complications are common, leading to increased costs and health care resource utilization, and may be associated with increased mortality and adverse discharge disposition,” said Charlotte Lukannek, CandMed, a medical student at Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School, both in Boston. “To minimize the risk of respiratory failure after surgery, the Agency for Healthcare Research and Quality recommends the assessment of risk factors to better prepare physicians to anticipate potential postoperative adverse events, as well as improve the allocation of health care resources after surgery.”

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Incidence of Post Discharge Nausea and Vomiting Higher Than Expectedhttp://bit.ly/2Dvs0pI“The incidence of PDNV was de...
04/26/2019
Incidence of Post-Discharge Nausea and Vomiting Higher Than Expected

Incidence of Post Discharge Nausea and Vomiting Higher Than Expected

http://bit.ly/2Dvs0pI

“The incidence of PDNV was definitely higher than we thought it was going to be,” said Adam K. Jacob, MD, a consultant in the Department of Anesthesiology and Perioperative Medicine and an associate professor of anesthesiology at Mayo Clinic, in Rochester, Minn. “These results reinforce the need to utilize non–opiate-based approaches to pain relief and to use an aggressive PDNV protocol in patients found to be at higher risk.”

#AnesthesiologyNews #Anesthesiology #ASA #pharma #pharmaceutical #DigitalHealth #HealthTalk #airway #intubation #healthcare #healthinnovations #medicalconsulting #chronicpain #transfusions #medicine #surgery #blooduse #hospitals #FDA #fluidtherapy #ERAS

Boston—A prospective survey of patients undergoing outpatient surgery has identified a high incidence of post-discharge nausea and vomiting (PDNV).

Greater Intra op Fluids Increase Peri op Morbidity - Anesthesiology Newshttp://bit.ly/2Dsl2C4“The anecdotal experience...
04/25/2019

Greater Intra op Fluids Increase Peri op Morbidity - Anesthesiology News

http://bit.ly/2Dsl2C4

“The anecdotal experience that many of us have seen in the field is actually showing up in the data,” said Thomas J. Hopkins, MD, MBA, an anesthesiologist at Duke Health, in Durham, N.C. “There are some hospitals that are following a more regimented approach with how we think about fluids, and other hospitals that are not.”

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Triple Low Alerts Do Not Reduce 90 Day Mortalityhttp://bit.ly/2Do41sH“Several previous studies showed that triple-low ...
04/24/2019

Triple Low Alerts Do Not Reduce 90 Day Mortality

http://bit.ly/2Do41sH

“Several previous studies showed that triple-low events predict postoperative mortality,” said Daniel I. Sessler, MD, the Michael Cudahy Professor and Chair of the Department of Outcomes Research at Cleveland Clinic in Ohio. “No one component—low MAP, low BIS or low MAC—was especially predictive. But any two of them combined roughly doubled mortality, and the three combined quadrupled mortality [Anesthesiology 2012;116(6):1195-1203].

“The question, of course, was whether this is a causal relationship or whether it simply predicted deaths that we couldn’t prevent,” Dr. Sessler said. “We therefore tested the primary hypothesis that alerting clinicians to triple-low events reduces 90-day postoperative mortality.”

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