204 results match your criteria Perioperative Management of the Female Patient


Patient Beliefs and Preferences Regarding Surrogate Decision Makers.

South Med J 2018 09;111(9):518-523

From the Department of Anesthesiology and Perioperative Medicine and Clinical Ethics Program, University of Alabama at Birmingham.

Objectives: Many patients lose the capacity to make medical decisions because of severe illness or the effects of sedation or anesthesia. Most states in the United States designate the next of kin (NOK) as a default surrogate decision maker (SDM), but this may not always reflect patient preferences. Our objective was to determine how frequently the default SDM matched the patient's preferred SDM, and whether patients knew who would serve as their SDM should they become incapacitated. Read More

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http://sma.org/southern-medical-journal/article/patient-beli
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http://dx.doi.org/10.14423/SMJ.0000000000000863DOI Listing
September 2018
11 Reads

Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery.

N Engl J Med 2018 09 26;379(13):1224-1233. Epub 2018 Aug 26.

From the Department of Anesthesia (C.D.M., G.M.T.H., N.M.) and the Department of Surgery, Division of Cardiac Surgery (S.V.), St. Michael's Hospital, Keenan Research Centre for Biomedical Science, the Li Ka Shing Knowledge Institute of St. Michael's Hospital (C.D.M., G.M.T.H., K.T., S.V., P.J.), Applied Health Research Centre (J.H., D.D., K.T., S.V., P.J.), Sunnybrook Health Sciences Centre (S.F.), Division of Hematology, Mount Sinai Hospital (N.S.), the Departments of Medicine (P.J., N.S.), Physiology (C.D.M., G.M.T.H), and Laboratory Medicine and Pathobiology (N.S.), Dalla Lana School of Public Health (K.T.), and Institute of Health Policy, Management and Evaluation, University of Toronto, and Canadian Blood Services (N.S.), Toronto, the Population Health Research Institute (R.P.W., E.B.-C.), Hamilton Health Sciences Center (R.P.W., E.B.-C., K.C., S.S.), McMaster University (R.P.W., E.B.-C., K.C., S.S.), Hamilton, ON, the Ottawa Hospital Research Institute, University of Ottawa, Ottawa (D.A.F.), the Cumming School of Medicine and Libin Cardiovascular Institute, University of Calgary, Calgary (A.J.G.), and the Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton (S.M.B.), CHUS-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke (É.M.), and the Department of Anesthesiology and Critical Care Medicine, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Laval (F.L.), QC, the Departments of Anesthesia and Medicine, Division of Critical Care, Centre Hospitalier de l'Université de Montréal, Montreal (F.M.C.), and the Department of Anesthesia, Perioperative and Pain Medicine, St. Boniface Hospital, University of Manitoba, Winnipeg (H.P.G.) - all in Canada; the Department of Cardiothoracic Anesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen (B.K.); Medical Research Institute of New Zealand, Wellington (S.M., P.J.Y.), and Waikato Hospital, Hamilton (K.B.) - both in New Zealand; Fundación Cardioinfantil-Instituto de Cardiología and Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia (J.C.V.); the Department of Surgery, University of Melbourne (A.R., C.R.), and the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital (C.R.), Melbourne, VIC, and the Department of Anaesthesia, Royal Adelaide Hospital, and the Discipline of Acute Care Medicine, University of Adelaide, Adelaide, SA (T.W.P.) - all in Australia; University of Basel, Department of Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, and Klinik Hirslanden Zurich, Zurich - both in Switzerland (M.D.S.); Heart Care Associates, SAL Hospital, Gujarat, India (C.M.); and the Department of Cardiothoracic Anaesthesia, National Heart Center, and the Department of Anaesthesiology, Singapore General Hospital - both in Singapore (N.-C.H.).

Background: We reported previously that, in patients undergoing cardiac surgery who were at moderate-to-high risk for death, a restrictive transfusion strategy was noninferior to a liberal strategy with respect to the composite outcome of death from any cause, myocardial infarction, stroke, or new-onset renal failure with dialysis by hospital discharge or 28 days after surgery, whichever came first. We now report the clinical outcomes at 6 months after surgery.

Methods: We randomly assigned 5243 adults undergoing cardiac surgery to a restrictive red-cell transfusion strategy (transfusion if the hemoglobin concentration was <7. Read More

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http://dx.doi.org/10.1056/NEJMoa1808561DOI Listing
September 2018
33 Reads

Predicting Adverse Outcomes After Total Hip Arthroplasty: A Comparison of Demographics, the American Society of Anesthesiologists class, the Modified Charlson Comorbidity Index, and the Modified Frailty Index.

J Am Acad Orthop Surg 2018 Oct;26(20):735-743

From the Yale School of Medicine, Yale University, New Haven, CT (Mr. Ondeck, Mr. Bovonratwet, Mr. Anandasivam, Mr. McLynn, Mr. Cui, and Dr. Grauer), and the Rush University Medical Center, Chicago, IL (Dr. Bohl).

Introduction: No known study has compared the predictive power of the American Society of Anesthesiologists (ASA) class, modified Charlson Comorbidity Index, modified Frailty Index, and demographic characteristics for general health complications after total hip arthroplasty (THA).

Methods: Comorbidity indices and demographics from National Surgical Quality Improvement Program THA patients were evaluated for discriminative ability in predicting adverse outcomes using the area under the curve analysis from the receiver operating characteristic curves. Perioperative outcomes included any adverse event, severe adverse events, minor adverse events, extended hospital stay, and discharge to higher-level care. Read More

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http://dx.doi.org/10.5435/JAAOS-D-17-00009DOI Listing
October 2018
9 Reads

Ablation versus Resection for Stage 1A Renal Cell Carcinoma: National Variation in Clinical Management and Selected Outcomes.

Radiology 2018 09 3;288(3):889-897. Epub 2018 Jul 3.

From the Division of Interventional Radiology, Department of Radiology and Biomedical Imaging (J.U., N.K., M.X., H.S.K.), Division of Medical Oncology, Department of Medicine (H.S.K.), and Yale Cancer Center (H.S.K.), Yale School of Medicine, 330 Cedar St, TE 2-224, New Haven, CT 06510; Department of Diagnostic and Interventional Radiology, University Medical Center, Goettingen, Germany (J.U.); Division of Interventional Radiology and Image Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine (N.K.); and Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md (M.X.).

Purpose To compare patients in a national U.S. database who underwent thermal ablation or nephrectomy for renal cell carcinoma (RCC) in terms of demographic differences, perioperative outcomes, and survival. Read More

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http://dx.doi.org/10.1148/radiol.2018172960DOI Listing
September 2018
5 Reads

Novel Treatment Using Intravenous Dantrolene Sodium for Postoperative Exacerbated Spasticity in Multiple Sclerosis: A Case Report.

A A Pract 2018 Jul;11(1):25-27

From the Wright-Patterson Medical Center, Wright-Patterson Air Force Base, Ohio.

Patients with upper motor neuron disease, such as multiple sclerosis, can present with severe spasticity in the perioperative period. In most cases, this can be managed with a combination of preoperative oral medications, regional or neuraxial anesthetic techniques, and intravenous muscle relaxants. We describe the clinical presentation of a patient with multiple sclerosis and the successful use of intravenous dantrolene sodium postoperatively for the treatment of exacerbated spasticity refractory to traditional management. Read More

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http://Insights.ovid.com/crossref?an=02054229-201807010-0000
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http://dx.doi.org/10.1213/XAA.0000000000000801DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039402PMC
July 2018
2 Reads

T1 Paravertebral Catheter for Postoperative Pain Management After First Rib Resection for Venous Thoracic Outlet Syndrome: A Case Report.

A A Pract 2018 Jul;11(1):1-3

University of South Florida Morsani College of Medicine, Tampa, Florida.

While it has been shown that a paravertebral block provides effective postoperative analgesia for patients undergoing thoracic surgeries, including first rib resection, this is the first reported case of a paravertebral catheter used for perioperative analgesia in a patient undergoing first rib resection. We present the case of a 76-year-old woman with right upper extremity swelling who underwent infraclavicular first rib resection for venous thoracic outlet syndrome. Continuous infusion of ropivacaine through a T1 paravertebral catheter, which was placed before induction of general anesthesia but after T1 and T2 paravertebral blocks, provided effective postoperative pain control. Read More

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http://Insights.ovid.com/crossref?an=02054229-201807010-0000
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http://dx.doi.org/10.1213/XAA.0000000000000698DOI Listing
July 2018
5 Reads

Regional Anesthesia in the Setting of Arm Replantation: A Case Report.

A A Pract 2018 Jul;11(2):38-40

From the Department of Anesthesiology, San Antonio Military Medical Center, Joint Base San Antonio, Fort Sam Houston, San Antonio, Texas.

The perioperative implementation of continuous peripheral nerve blocks is poorly described within the literature for replantation surgeries beyond digital replantation. The management of replantation patients presents a challenging balance between pain control and limb perfusion. We report the successful use of a continuous interscalene catheter in a therapeutically anticoagulated patient after midshaft humerus arm replantation. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000728DOI Listing
July 2018
15 Reads

When Guidelines Fail: Euglycemic Diabetic Ketoacidosis After Bariatric Surgery in a Patient Taking a Sodium-Glucose Cotransporter-2 Inhibitor: A Case Report.

A A Pract 2018 Jul;11(2):46-48

Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.

A 42-year-old woman with diabetes mellitus type 2 treated with the sodium-glucose cotransporter-2 inhibitor canagliflozin underwent elective bariatric gastric bypass. The canagliflozin was held for 24 hours preoperatively. She physiologically decompensated on postoperative day 2. Read More

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http://Insights.ovid.com/crossref?an=02054229-201807150-0000
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http://dx.doi.org/10.1213/XAA.0000000000000734DOI Listing
July 2018
7 Reads

Intraoperative Use of Desmopressin for Treatment of Profound Hyponatremia in the Setting of Emergency Surgery: A Case Report.

A A Pract 2018 Jul;11(2):54-56

From the Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland.

Correction of profound hyponatremia requires careful planning and close monitoring to reduce the risks of neurologic injury. Although there are various suggested treatment strategies in the setting of a medical ward or intensive care unit, reports of intraoperative management to prevent rapid increases in serum sodium are lacking. We present a case of profound hyponatremia of 102 mmol/L in a patient who required emergent operative repair for bowel obstruction. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000738DOI Listing
July 2018
1 Read

Oropharyngeal Stenosis Leading to an Unanticipated Difficult Airway in a Patient After Uvulopalatopharyngoplasty: A Case Report and Review of the Literature.

A A Pract 2018 Sep;11(5):124-127

From the Departments of Anesthesiology and Perioperative Medicine.

Oropharyngeal stenosis can manifest as a rare complication after surgery for obstructive sleep apnea or tonsillectomy. Scar tissue formation from oropharyngeal stenosis may impede tracheal intubation or laryngeal mask airway insertion. We report the case of an asymptomatic adult woman found to have oropharyngeal stenosis after induction of anesthesia and discuss the management of this challenging scenario. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000758DOI Listing
September 2018

Defining the Intrinsic Cardiac Risks of Operations to Improve Preoperative Cardiac Risk Assessments.

Anesthesiology 2018 02;128(2):283-292

From the American College of Surgeons, Chicago, Illinois (J.B.L., Y.L., M.E.C., C.Y.K.); the Department of Surgery, University of Chicago Medicine, Chicago, Illinois (J.B.L.); the Department of Surgery, University of California Los Angeles David Geffen School of Medicine, Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, California (C.Y.K.); and the Department of Anesthesiology, Northwestern University, Chicago, Illinois (B.J.S.).

Background: Current preoperative cardiac risk stratification practices group operations into broad categories, which might inadequately consider the intrinsic cardiac risks of individual operations. We sought to define the intrinsic cardiac risks of individual operations and to demonstrate how grouping operations might lead to imprecise estimates of perioperative cardiac risk.

Methods: Elective operations (based on Common Procedural Terminology codes) performed from January 1, 2010 to December 31, 2015 at hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program were studied. Read More

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http://dx.doi.org/10.1097/ALN.0000000000002024DOI Listing
February 2018
5 Reads

Long-Term Outcomes After Overlapping Sphincteroplasty for Cloacal-Like Deformities.

Female Pelvic Med Reconstr Surg 2018 Jan 10. Epub 2018 Jan 10.

From the University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, Dallas, TX.

Objective: The aim of this study was to report subjective, long-term outcomes and describe patient demographics, presenting symptoms, perioperative management, and complications after overlapping sphincteroplasty repair for chronic fourth-degree lacerations (cloacal-like deformities).

Methods: In this retrospective study, hospital records were reviewed for women who underwent overlapping anal sphincteroplasty for a cloacal-like deformity of the perineum at a single institution from 1996 to 2013. Details including patient demographics, presenting symptoms, perioperative management, and complications were abstracted from the medical record. Read More

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http://dx.doi.org/10.1097/SPV.0000000000000543DOI Listing
January 2018
5 Reads

Years Versus Days Between Successive Surgeries, After an Initial Outpatient Procedure, for the Median Patient Versus the Median Surgeon in the State of Iowa.

Anesth Analg 2018 03;126(3):787-793

Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami, Miami, Florida.

Background: Previously, we studied the relative importance of different institutional interventions that the largest hospital in Iowa could take to grow the anesthesia department's outpatient surgical care. Most (>50%) patients having elective surgery had not previously had surgery at the hospital. Patient perioperative experience was unimportant for influencing total anesthesia workload and numbers of patients. Read More

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http://dx.doi.org/10.1213/ANE.0000000000002774DOI Listing

Peripartum Perineal Hernia: A Case Report and a Review of the Literature.

Female Pelvic Med Reconstr Surg 2018 Sep/Oct;24(5):e38-e41

From the Department of Urology, Wake Forest Baptist Health Medical Center, Winston Salem, NC.

Objectives: This article reviews the literature for the management and repair of perineal hernias and presents a previously undescribed case of perineal bladder herniation after intrapartum pubic symphysis rupture.

Methods: A review of the literature was completed through the PubMed database using the search terms "bladder," "canal of Nuck," "labial hernia," "gynecology," "hernia," "obstetrics," "perineal hernia," "postpartum," "pubic diastasis," "pubic symphysis," "vaginal delivery," "symphyseal rupture," and "symphyseal separation." The electronic medical record for the patient was reviewed and used with the consent of the patient. Read More

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http://dx.doi.org/10.1097/SPV.0000000000000534DOI Listing
January 2018
4 Reads

Multidisciplinary Perioperative Management of Pulmonary Arterial Hypertension in Patients Undergoing Noncardiac Surgery.

South Med J 2018 01;111(1):64-73

From the Department of Critical Care Medicine, and the Divisions of Pulmonary Medicine and Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, Florida.

Objectives: To describe the effect of implementing a contemporary perioperative pulmonary hypertension (PH)-targeted protocol in patients with pulmonary arterial hypertension (PAH) undergoing noncardiac surgery (NCS).

Methods: The data of consecutive patients with PAH diagnosed by right heart catheterization who underwent NCS between January 1, 2006 and February 9, 2016 were reviewed. Patient demographics, etiology of PAH, clinical features, diagnostic data, utilization of PH-specific medications, and trend of perioperative complications rate were recorded during the study period. Read More

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http://dx.doi.org/10.14423/SMJ.0000000000000755DOI Listing
January 2018
15 Reads

Anesthetic Management and Procedural Outcomes of Patients Undergoing Off-Pump Transapical Implantation of Artificial Chordae to Correct Mitral Regurgitation: Case Series of 76 Patients.

Anesth Analg 2018 03;126(3):776-784

Clinic of Cardiac and Vascular Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

Background: Transapical implantation of artificial chordae using the NeoChord system (NeoChord Inc, Minneapolis, MN) is an emerging beating-heart technique for correction of mitral regurgitation (MR) through a minimally invasive left minithoracotomy. The purpose of the study was to describe the anesthetic management and procedural success of patients undergoing this procedure.

Methods: All patients (n = 76) who underwent mitral valve repair with the NeoChord system in our institution from December 2011 to December 2016 were included in this observational prospective study. Read More

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http://dx.doi.org/10.1213/ANE.0000000000002767DOI Listing
March 2018
14 Reads

Macintosh Blade Videolaryngoscopy Combined With Rigid Bonfils Intubation Endoscope Offers a Suitable Alternative for Patients With Difficult Airways.

Anesth Analg 2018 03;126(3):988-994

Department of Anesthesiology and Pain Management, Maastricht University Medical Centre, Maastricht, the Netherlands.

Background: In the armamentarium of an anesthesiologist, videolaryngoscopy is a valuable addition to secure the airway. However, when the videolaryngoscope (VLS) offers no solution, few options remain. Earlier, we presented an intubation technique combining Macintosh blade VLS and Bonfils intubation endoscope (BIE) for a patient with a history of very difficult intubation. Read More

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http://dx.doi.org/10.1213/ANE.0000000000002739DOI Listing
March 2018
4 Reads

Management of 1-Lung Ventilation-Variation and Trends in Clinical Practice: A Report From the Multicenter Perioperative Outcomes Group.

Anesth Analg 2018 02;126(2):495-502

Anesthesiology, University of Virginia Health System, Charlottesville, Virginia.

Background: Lung-protective ventilation (LPV) has been demonstrated to improve clinical outcomes in surgical patients. There are very limited data on the current use of LPV for patients undergoing 1-lung ventilation (1LV) despite evidence that 1LV may be a particularly important setting for its use. In this multicenter study, we report trends in ventilation practice for patients undergoing 1LV. Read More

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http://dx.doi.org/10.1213/ANE.0000000000002642DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836497PMC
February 2018
10 Reads

Period-dependent Associations between Hypotension during and for Four Days after Noncardiac Surgery and a Composite of Myocardial Infarction and Death: A Substudy of the POISE-2 Trial.

Anesthesiology 2018 02;128(2):317-327

From the Departments of Outcomes Research (D.I.S., N.M.Z., G.M.) and Quantitative Health Sciences (N.M.Z., G.M.), Cleveland Clinic, Cleveland, Ohio; the Department of Anaesthesia and Intensive Care, Bispebjerg Hospital (C.S.M.) and the Department of Anaesthesiology, Herlev Hospital (C.S.M., R.M.D.), University of Copenhagen, Copenhagen, Denmark; the Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Australia (K.L.); the Department of Research, Grupo de Cardiología Preventiva Universidad Autónoma de Bucaramanga, Fundación CardioInfantil Instituto de Cardiología, Bucaramanga, Colombia (S.M.V.); the Anaesthetic Department, Hull and East Yorkshire Hospitals, National Health Service Trust, Hull, East Yorkshire, United Kingdom (P.B.); Department of Cardiology, Hospital de la Santa Creu i Sant Pau, IIB-SantPau, Universidad Autónoma de Barcelona, Barcelona (J.A.-G.); the Research Institute, Hospital do Coração, São Paulo, Brazil (A.B.C.); the Department of Anesthesia, Queen's University and Kingston General Hospital, Kingston, Canada (J.L.P.); Rahate Surgical Hospital, Nagpur, Maharashtra, India (P.V.R.); the Department of Anesthesia and Intensive Care Medicine, University Hospital Basel, University of Basel, Basel, Switzerland (M.D.S.); the Department of Vascular Surgery, Sapienza University of Rome, Rome, Italy (B.G.); Counties Manukau District Health, Aukland, New Zealand (S.A.W.); the Krishna Institute of Medical Sciences, Hyderbad, India (R.K.P.); the Department of Pediatrics, Hvidovre Hospital, Copenhagen, Denmark (R.M.D.); the Department of Anaesthetics, University of KwaZulu-Natal, Pietermaritzburg, South Africa (R.R.), the Hypertension and Vascular Aging Center, Hospital Universitario Austral, Pilar, Argentina (F.B.); the Departments of Health Research Methods, Evidence, and Impact and Medicine, McMaster University, Hamilton, Canada (P.J.D.); and the Population Health Research Institute, Hamilton, Canada (E.D., P.J.D., D.I.S.).

Background: The relative contributions of intraoperative and postoperative hypotension to perioperative morbidity remain unclear. We determined the association between hypotension and a composite of 30-day myocardial infarction and death over three periods: (1) intraoperative, (2) remaining day of surgery, and (3) during the initial four postoperative days.

Methods: This was a substudy of POISE-2, a 10,010-patient factorial-randomized trial of aspirin and clonidine for prevention of myocardial infarction. Read More

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http://dx.doi.org/10.1097/ALN.0000000000001985DOI Listing
February 2018
19 Reads

Two-Year Follow-up Survey: Views of US Anesthesiologists About Health Care Costs and Future Practice Roles.

Anesth Analg 2018 02;126(2):611-614

From the Department of Anesthesiology and Perioperative Care, University of California, Irvine, California.

Anesthesiologists' perspectives on US health care finance reform are increasingly germane to recent policy reforms. The aim of this follow-up survey was to examine how anesthesiologists' views of health care costs and future practice roles have changed since 2014. Six thousand randomly chosen active members of the American Society of Anesthesiologists were again surveyed and were also asked several new questions regarding specialties and perioperative management. Read More

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http://dx.doi.org/10.1213/ANE.0000000000002571DOI Listing
February 2018

Impact of Enhanced Recovery After Surgery and Opioid-Free Anesthesia on Opioid Prescriptions at Discharge From the Hospital: A Historical-Prospective Study.

Anesth Analg 2017 11;125(5):1784-1792

From the *Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles, California; †UCLA Fielding School of Public Health, Los Angles, California; ‡Department of Anesthesiology, Osaka City University, Osaka, Japan; §Department of Anesthesiology, Nimes University, Nimes, France; ∥Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan; and ¶Department of Surgery, University of California, Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles, California.

Background: The United States is in the midst of an opioid epidemic, and opioid use disorder often begins with a prescription for acute pain. The perioperative period represents an important opportunity to prevent chronic opioid use, and recently there has been a paradigm shift toward implementation of enhanced recovery after surgery (ERAS) protocols that promote opioid-free and multimodal analgesia. The objective of this study was to assess the impact of an ERAS intervention for colorectal surgery on discharge opioid prescribing practices. Read More

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http://dx.doi.org/10.1213/ANE.0000000000002510DOI Listing
November 2017
24 Reads

A Contemporary Medicolegal Analysis of Outpatient Medication Management in Chronic Pain.

Anesth Analg 2017 11;125(5):1761-1768

From the *Department of Anesthesia and Perioperative Care, Division of Pain Medicine, University of California San Francisco, San Francisco, California; †Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts; ‡Controlled Risk Insurance Company (CRICO) Strategies, Boston, Massachusetts; and §Harvard Medical School, Boston, Massachusetts.

Background: Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO). Read More

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http://dx.doi.org/10.1213/ANE.0000000000002499DOI Listing
November 2017
18 Reads

Perioperative Patient Beliefs Regarding Potential Effectiveness of Marijuana (Cannabinoids) for Treatment of Pain: A Prospective Population Survey.

Reg Anesth Pain Med 2017 Sep/Oct;42(5):652-659

From the Departments of *Anesthesiology, Perioperative and Pain Medicine, †Neuroscience, and ‡Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY; and §Icahn School of Medicine at Mount Sinai, New York, NY.

Background And Objectives: Cannabinoids have an expanding presence in medicine. Perioperative patients' perceptions of the effectiveness of these compounds, and acceptance if prescribed for pain, have not been previously described. Our primary objective was to describe patients' beliefs regarding the potential effectiveness of cannabinoids for the treatment of acute and chronic pain, as well as gauge patient acceptance of these compounds if prescribed by a physician. Read More

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http://dx.doi.org/10.1097/AAP.0000000000000654DOI Listing
September 2018
14 Reads

Effects of anaesthesia and analgesia on long-term outcome after total knee replacement: A prospective, observational, multicentre study.

Eur J Anaesthesiol 2017 10;34(10):665-672

From the Department of Anaesthesiology, Intensive Care and Pain Therapy, University Hospital of Parma (DB, MA), Department of Surgical Sciences, University of Parma, Parma (DB, MA), Department of Anaesthesiology, Intensive Care, IRCCS Ospedale San Raffaele, Milano (MG), Department of Anaesthesiology, Intensive Care and Pain Therapy, Ospedale di Circolo, Varese (ALA), Department of Anaesthesiology, Intensive Care, AORN dei Colli Monaldi Cotugno CTO, Napoli (GG, FC), Department of Anaesthesiology and Pain Therapy, Presidio Sanitario Ospedale Cottolengo, Torino (DD), Department of Anaesthesia, IRCCS Istituto Auxologico Italiano, Milano (FN), Department of Anaesthesiology and Intensive Care, Azienda Ospedaliero-Universitaria Policlinico S. Orsola-Malpighi, Bologna (AF), Department of Orthopaedic and Traumatology, ASST-Gaetano Pini-CTO (PF, MB); and Department of Anaesthesiology and Pain Therapy, ASST-Gaetano Pini-CTO, Milano, Italy (GC).

Background: Perioperative regional anaesthesia may protect from persistent postsurgical pain (PPSP) and improve outcome after total knee arthroplasty (TKA).

Objectives: Aim of this study was to evaluate the impact of regional anaesthesia on PPSP and long-term functional outcome after TKA.

Design: A web-based prospective observational registry. Read More

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http://dx.doi.org/10.1097/EJA.0000000000000656DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5588609PMC
October 2017
24 Reads

Perioperative Gabapentin Does Not Reduce Postoperative Delirium in Older Surgical Patients: A Randomized Clinical Trial.

Anesthesiology 2017 10;127(4):633-644

From the Departments of Anesthesia and Perioperative Care (J.M.L., S.K.), Neurosurgery (C.A., D.C., P.W.), Orthopedic Surgery (S. Bergven, S. Burch, V.D., M.R., B.T., T.V.), and Medicine (K.C.) and Memory and Aging Center (J.H.K.), University of California San Francisco, San Francisco, California; Virginia Tech, Blacksburg, Virginia (L.P.S.); Department of Statistics, Purdue University, West Lafayette, Indiana (N.C.); Department of Surgery & Perioperative Care, Dell Medical School, University of Texas at Austin, Austin, Texas (K.B.). participated in patient recruitment, cognitive assessments, data entry, and data management participated in patient recruitment, cognitive assessments, data entry, and data management participated in patient recruitment, cognitive assessments, data entry, and data management participated in patient recruitment, cognitive assessments, data entry, and data management participated in patient recruitment, cognitive assessments, data entry, and data management participated in patient recruitment, cognitive assessments, data entry, and data management.

Background: Postoperative pain and opioid use are associated with postoperative delirium. We designed a single-center, randomized, placebo-controlled, parallel-arm, double-blinded trial to determine whether perioperative administration of gabapentin reduced postoperative delirium after noncardiac surgery.

Methods: Patients were randomly assigned to receive placebo (N = 347) or gabapentin 900 mg (N = 350) administered preoperatively and for the first 3 postoperative days. Read More

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http://dx.doi.org/10.1097/ALN.0000000000001804DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605447PMC
October 2017
66 Reads

Malignant Hyperthermia in a Morbidly Obese Patient Depletes Community Dantrolene Resources: A Case Report.

A A Case Rep 2017 Nov;9(9):251-253

From the Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Saskatchewan, Royal University Hospital, Saskatoon, Saskatchewan, Canada.

During resection of a duodenal carcinoid tumor, a 28-year-old morbidly obese woman developed suspected malignant hyperthermia. This hypermetabolic state posed a diagnostic challenge given the similar intraoperative presentation of carcinoid crisis and malignant hyperthermia. The patient's weight posed therapeutic challenges as massive doses and prolonged administration of dantrolene were required that quickly depleted the available supply. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000581DOI Listing
November 2017
33 Reads

In-Patient Code Stroke: A Quality Improvement Strategy to Overcome Knowledge-to-Action Gaps in Response Time.

Stroke 2017 08 27;48(8):2176-2183. Epub 2017 Jun 27.

From the Division of Neurology, Department of Medicine (C.D.K., J.D.W., K.S., P.K., D.S., G.S.) and Applied Health Research Centre, Li Ka Shing Knowledge Institute (R.N.), St. Michael's Hospital, Toronto, Ontario, Canada; Division of Neurology (C.D.K., D.S., G.S.) and Dalla Lana School of Public Health (R.N.), University of Toronto, Ontario, Canada; and Ryerson University, Toronto, Ontario, Canada (J.B.).

Background And Purpose: Stroke is a relatively common and challenging condition in hospitalized patients. Previous studies have shown delays in recognition and assessment of inpatient strokes leading to poor outcomes. The goal of this quality improvement initiative was to evaluate an in-hospital code stroke algorithm and educational program aimed at reducing the response times for inpatient stroke. Read More

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http://dx.doi.org/10.1161/STROKEAHA.117.017622DOI Listing
August 2017
22 Reads

Videolaryngoscopy versus Fiber-optic Intubation through a Supraglottic Airway in Children with a Difficult Airway: An Analysis from the Multicenter Pediatric Difficult Intubation Registry.

Anesthesiology 2017 09;127(3):432-440

From the Department of Pediatric Anesthesiology, Ann and Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (N.E.B., N.J.); Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania (A.N., J.E.F., K.N.P.); Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida (H.D.A.); Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Ohio State University, Columbus, Ohio (V.T.R.); Department of Anesthesiology and Pain Management, University of Texas Southwestern and Children's Health System of Texas, Dallas, Texas (P.N.O.); and Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital of Boston, Harvard School of Medicine, Boston, Massachusetts (P.G.K.). Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington Department of Anesthesiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas Department of Anesthesiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas Department of Anesthesiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas Department of Anesthesiology and Pain Management, University of Texas Southwestern and Children's Health System of Texas, Dallas, Texas Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee Department of Pediatric Anesthesiology, University of Michigan Health Center, Ann Arbor, Michigan Department of Anesthesiology, University of Texas Medical School at Houston, Houston, Texas Department of Anesthesiology, University of Texas Medical School at Houston, Houston, Texas Department of Anesthesiology, University of Texas Medical School at Houston, Houston, Texas Department of Anesthesiology, Children's Hospital of Colorado, Aurora, Colorado Department of Anesthesiology, Children's Hospital of Colorado, Aurora, Colorado Department of Anesthesiology, Children's Hospital of Colorado, Aurora, Colorado Department of Anesthesiology, University of Mississippi Medical Center, Jackson, Mississippi Department of Anesthesiology, Duke University, Durham, North Carolina Department of Anesthesiology and Pain Management, Children's Hospital of Cleveland Clinic, Cleveland, Ohio Department of Anesthesia, Critical Care and Pain, Massachusetts General Hospital, Boston, Massachusetts Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Ohio State University, Columbus, Ohio Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Anesthesiology and Pain Management, University of Western Australia, Crawley, Australia Department of Anesthesiology and Pain Management, University of Western Australia, Crawley, Australia Department of Anesthesiology, University of New Mexico, Albuquerque, New Mexico Department of Anesthesiology, Weill Cornell Medical College, New York, New York Dep.artment of Anesthesiology, University of Minnesota, Minneapolis, Minnesota Dep.artment of Anesthesiology, University of Minnesota, Minneapolis, Minnesota Department of Anesthesiology, National Institute of Pediatrics, Mexico City, Mexico Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University Medical Center, Stanford, California Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital of Boston, Harvard School of Medicine, Boston, Massachusetts Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital of Boston, Harvard School of Medicine, Boston, Massachusetts.

Background: The success rates and related complications of various techniques for intubation in children with difficult airways remain unknown. The primary aim of this study is to compare the success rates of fiber-optic intubation via supraglottic airway to videolaryngoscopy in children with difficult airways. Our secondary aim is to compare the complication rates of these techniques. Read More

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http://dx.doi.org/10.1097/ALN.0000000000001758DOI Listing
September 2017
37 Reads

Creation and Execution of a Novel Anesthesia Perioperative Care Service at a Veterans Affairs Hospital.

Anesth Analg 2017 11;125(5):1526-1531

From the *Department of Anesthesiology, Pain Management & Perioperative Medicine, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee; †Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee; ‡Department of Anesthesiology, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee; §Department of Orthopaedic Surgery, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee; ‖Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee; ¶Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee; #Department of Urology, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee; and **Department of Surgery, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee.

Physician-led perioperative surgical home models are developing as a method for improving the American health care system. These models are novel, team-based approaches that help to provide continuity of care throughout the perioperative period. Another avenue for improving care for surgical patients is the use of enhanced recovery after surgery pathways. Read More

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http://dx.doi.org/10.1213/ANE.0000000000001930DOI Listing
November 2017
23 Reads

Perioperative Surgical Home: Evaluation of a New Protocol Focused on a Multidisciplinary Approach to Manage Children Undergoing Posterior Spinal Fusion Operation.

Anesth Analg 2017 09;125(3):812-819

From the Department of Anesthesiology Critical Care Medicine-Pain Service, Children's Hospital Los Angeles, Los Angeles, California.

Background: The concept of Perioperative Surgical Home has been gaining significant attention in surgical centers. This model is delivering and improving coordinated care in a cost-effective manner to patients undergoing surgical procedures. It starts with the decision for surgical intervention, continues to the intraoperative and postoperative periods, and follows into long-term recovery. Read More

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http://dx.doi.org/10.1213/ANE.0000000000002030DOI Listing
September 2017
31 Reads

Adenotonsillectomy for the Management of Pulmonary Hypertension in a Patient With Complex Congenital Heart Disease: A Case Report.

A A Case Rep 2017 Nov;9(10):283-285

From the *Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiovascular Anesthesiology and †Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.

Pulmonary hypertension is a feared complication in congenital heart disease patients. Patients with pulmonary hypertension are at risk for major perioperative cardiopulmonary complications when undergoing any surgical procedure, especially airway and laparoscopic procedures. We present the anesthetic management for a 2-year old with Down syndrome and complex cyanotic congenital heart disease undergoing tonsillectomy and adenoidectomy for severe obstructive sleep apnea. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000593DOI Listing
November 2017
5 Reads

Costs and Length of Stay for the Acute Care of Patients with Motor-Complete Spinal Cord Injury Following Cervical Trauma: The Impact of Early Transfer to Specialized Acute SCI Center.

Am J Phys Med Rehabil 2017 Jul;96(7):449-456

From the Hôpital du Sacré-Coeur (AR-D, CT, J-MM-T); Faculty of Medicine, University of Montreal (AR-D, DEF, ÉB-M, J-MM-T); Hôpital Sainte-Justine (J-MM-T), Montréal; and Centre for Interdisciplinary Research in Rehabilitation, Québec (DEF), Québec, Canada.

Objective: Acute spinal cord injury (SCI) centers aim to optimize outcome following SCI. However, there is no timeframe to transfer patients from regional to SCI centers in order to promote cost-efficiency of acute care. Our objective was to compare costs and length of stay (LOS) following early and late transfer to the SCI center. Read More

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http://dx.doi.org/10.1097/PHM.0000000000000659DOI Listing
July 2017
23 Reads

Perioperative Low Arterial Oxygenation Is Associated With Increased Stroke Risk in Cardiac Surgery.

Anesth Analg 2017 07;125(1):38-43

From the Departments of *Surgery, †Neurology, ‡Anesthesiology, and §Cardiac Surgery, the Johns Hopkins University School of Medicine, Baltimore, Maryland.

Background: Both patient characteristics and intraoperative factors have been associated with a higher risk of stroke after cardiac surgery. We hypothesized that poor systemic oxygenation in the perioperative period is associated with increased risk of stroke following cardiopulmonary bypass.

Methods: In this study of 251 adult patients who underwent cardiopulmonary bypass procedures at a single center from 2003 to 2006, cases (patients with a postoperative stroke at least 24 hours after surgery) were matched 1:2 to controls without stroke. Read More

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http://dx.doi.org/10.1213/ANE.0000000000002157DOI Listing
July 2017
12 Reads

Perioperative Anesthetic Management for Cesarean Delivery in a Parturient With Type IV Loeys-Dietz Syndrome: A Case Report.

A A Case Rep 2017 Sep;9(6):182-185

From the *University of Texas MD Anderson Cancer Center, Houston, Texas; and †Texas Children's Hospital, Houston, Texas.

Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder predisposing to aortic and arterial aneurysms. Presentations are classified into subtypes based on gene mutations. Pregnancy in patients with LDS is considered very high risk due to the potential for aortic dissection and uterine rupture. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000561DOI Listing
September 2017
6 Reads

Liver Transplantation in a Patient With Antiphospholipid Syndrome: A Case Report.

A A Case Rep 2017 Sep;9(5):148-150

From the Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, California.

Antiphospholipid syndrome (APS) is an acquired thrombophilic disorder characterized by autoantibodies to cell membrane phospholipids. While altered coagulation can complicate end-stage liver disease, there are few reports describing the perioperative management for liver transplantation in recipients with a preexisting hypercoagulable disorder, such as APS. We present a patient with a history of APS, Budd-Chiari syndrome with cirrhosis, hepatopulmonary syndrome, and heparin-induced thrombocytopenia who underwent liver transplantation complicated by hepatic artery thrombosis. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000551DOI Listing
September 2017
15 Reads

Association Between Opioid Intake and Disability After Surgical Management of Ankle Fractures.

J Am Acad Orthop Surg 2017 Jul;25(7):519-526

From the Department of Orthopaedics, Massachusetts General Hospital, Boston, MA (Ms. Finger, Dr. Hageman, Ms. Ziady, and Dr. Heng), the Department of Plastic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands (Dr. Teunis), and the Department of Surgery and Perioperative Care, University of Texas at Austin Dell Medical School, Austin, TX (Dr. Ring).

Background: Opioid-centric pain management strategies have created an epidemic of prescription opioid abuse. This study assesses whether opioid intake is associated with disability, satisfaction with treatment, and pain at the time of suture removal and at 5 to 8 months after suture removal following open reduction and internal fixation of ankle fractures.

Methods: We enrolled 102 adult patients in the study at the time of suture removal, 59 of whom were available for follow-up at 5 to 8 months. Read More

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http://dx.doi.org/10.5435/JAAOS-D-16-00505DOI Listing
July 2017
29 Reads

Relationship Between a Sepsis Intervention Bundle and In-Hospital Mortality Among Hospitalized Patients: A Retrospective Analysis of Real-World Data.

Anesth Analg 2017 08;125(2):507-513

From the *Division of General Internal Medicine, School of Medicine, University of California, San Francisco, California; †Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California; ‡Department of Quality, Sepsis Program, University of California, San Francisco, California; and §Department of Anesthesia and Perioperative Care, School of Medicine, University of California, San Francisco, California.

Background: Sepsis is a systemic response to infection that can lead to tissue damage, organ failure, and death. Efforts have been made to develop evidence-based intervention bundles to identify and manage sepsis early in the course of the disease to decrease sepsis-related morbidity and mortality. We evaluated the relationship between a minimally invasive sepsis intervention bundle and in-hospital mortality using robust methods for observational data. Read More

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http://dx.doi.org/10.1213/ANE.0000000000002085DOI Listing
August 2017
61 Reads

Impact of Left Ventricular Diastolic Dysfunction on Lung Transplantation Outcome in Patients With Pulmonary Arterial Hypertension.

Am J Transplant 2017 Oct 3;17(10):2705-2711. Epub 2017 Jul 3.

Multiorgan Transplant Program, University Health Network, and the Division of Respirology, University Health Network, Toronto, Ontario, Canada.

Diastolic dysfunction may influence perioperative outcome, early graft function, and long-term survival. We compared the outcomes of double lung transplantation (DLTx) for patients with pulmonary arterial hypertension (PAH) with preoperative left ventricular (LV) diastolic dysfunction with the outcomes of patients without diastolic dysfunction. Of 116 consecutive patients with PAH (who underwent transplantation between January 1995 and December 2013), 44 met our inclusion and exclusion criteria. Read More

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http://dx.doi.org/10.1111/ajt.14352DOI Listing
October 2017
7 Reads

Preoperative Low-Dose Aspirin Exposure and Outcomes After Emergency Neurosurgery for Traumatic Intracranial Hemorrhage in Elderly Patients.

Anesth Analg 2017 08;125(2):514-520

From the *Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; †Anesthesiology Division, VA Puget Sound Health System, Seattle, Washington; ‡College of Arts and Sciences, University of Washington, Seattle, Washington; §Department of Anesthesiology, Prasat Neurological Institute, Bangkok, Thailand; ‖Department of Anesthesiology and Pain Medicine, University of Washington Medical Center, Seattle, Washington; ¶Department of Anesthesiology, University of Alabama, Birmingham, Alabama; #Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington; and **Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington.

Background: Antiplatelet medications are usually discontinued before elective neurosurgery, but this is not an option for emergent neurosurgery. We performed a retrospective cohort study to examine whether preoperative aspirin use was associated with worse outcomes after emergency neurosurgery in elderly patients.

Methods: We analyzed all cases of emergency neurosurgical procedures for traumatic intracranial hemorrhage from 2008 to 2012 at a level 1 trauma center. Read More

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http://dx.doi.org/10.1213/ANE.0000000000002053DOI Listing
August 2017
51 Reads

A Structured Transfer of Care Process Reduces Perioperative Complications in Cardiac Surgery Patients.

Anesth Analg 2017 08;125(2):477-482

From the *Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; and †Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, Oregon.

Introduction: Serious complications are common during the intensive care of postoperative cardiac surgery patients. Some of these complications may be influenced by communication during the process of handover of care from the operating room to the intensive care unit (ICU) team. A structured transfer of care process may reduce the rate of communication errors and perioperative complications. Read More

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http://dx.doi.org/10.1213/ANE.0000000000002020DOI Listing
August 2017
37 Reads

Numerical Correlation of Levator Advancement in Preoperative Planning.

Ann Plast Surg 2017 Jun;78(6S Suppl 5):S279-S281

From the *University of Alabama at Birmingham School of Medicine; †Division of Plastic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL; ‡Department of Pediatrics, University of California, San Diego, La Jolla, CA; and §Morsani School of Medicine, University of South Florida, Tampa, FL.

Background: Several procedures have been proposed for the treatment of eyelid ptosis, and both levator advancement and levator plication are widely used to shorten the levator palpebrae superioris. The purpose of this study was to quantify perioperative lid measurements in patients undergoing bilateral levator aponeurosis advancements to aid in preoperative planning.

Methods: Between July 2014 and June 2016, the authors performed a retrospective analysis of all bilateral upper eyelid levator advancement procedures for ptosis performed by the senior surgeon. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001143DOI Listing
June 2017
11 Reads

The Emergency Surgery Score (ESS) accurately predicts the occurrence of postoperative complications in emergency surgery patients.

J Trauma Acute Care Surg 2017 07;83(1):84-89

From the Division of Trauma, Emergency Surgery and Surgical Critical Care (A.R.N., J.D.B., N.F.S., T.P., K.H., D.D.Y., J.L., M.D.M., G.C.V., D.C.C., H.M.A.K.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; and Codman Center for Clinical Effectiveness in Surgery (D.C.C., H.M.A.K.), Massachusetts General Hospital, Boston, Massachusetts.

Background: The Emergency Surgery Score (ESS) was recently validated as a scoring system to predict mortality in emergency surgery (ES) patients. We sought to examine the ability of ESS to predict the occurrence of 30-day postoperative complications in ES.

Methods: The 2011-2012 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was screened for all surgical operations classified as "emergent. Read More

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http://dx.doi.org/10.1097/TA.0000000000001500DOI Listing
July 2017
26 Reads

Status Asthmaticus and Central Herniation: A Case for Multidisciplinary Critical Care.

A A Case Rep 2017 Jun;8(11):286-290

From the Departments of *Anesthesiology and Perioperative Medicine, †Neurosurgery, and ‡Pulmonary and Critical Care Medicine, Oregon Health and Sciences University, Portland, Oregon; and §Anesthesiology, Columbia University, New York, New York.

A 24-year-old woman with history of asthma was intubated emergently for acute status asthmaticus triggered by acute respiratory syncytial virus infection and treated with permissive hypercapnia. Her ventilation was complicated by auto-positive end-expiratory pressure and elevated peak airway, plateau, and central venous pressures. On hospital day 2, she was noted to have anisocoria. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000491DOI Listing
June 2017
9 Reads

Mechanical Support With Impella During Malignant Arrhythmia Ablation: A Case Report on the Growing Trend in the Electrophysiology Laboratory.

A A Case Rep 2017 Jun;8(11):282-285

From the *Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiovascular Anesthesiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas; and †The Children's Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, Division of Cardiothoracic Anesthesiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

Congenitally corrected transposition of the great arteries is a rare form of congenital heart disease in which the persistence of the right ventricle as the systemic ventricle leads to heart failure, tricuspid valve insufficiency, and arrhythmia. Supraventricular arrhythmias are especially common in these patients. We discuss the anesthetic management of a 33-year-old patient with congenitally corrected transposition of the great arteries who required a ventricular assist device to maintain cardiac output during ablation of supraventricular tachyarrythmia. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000490DOI Listing
June 2017
10 Reads

Case Report of a Patient With Idiopathic Hypersomnia and a Family History of Malignant Hyperthermia Undergoing General Anesthesia: An Overview of the Anesthetic Considerations.

A A Case Rep 2017 May;8(9):238-241

From the *Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada; †Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; ‡Toronto Sleep and Pulmonary Centre, Toronto, Ontario, Canada; and §Women's College Hospital, Toronto, Ontario, Canada.

The pathophysiologic underpinnings of idiopathic hypersomnia and its interactions with anesthetic medications remain poorly understood. There is a scarcity of literature describing this patient population in the surgical setting. This case report outlines the anesthetic considerations and management plan for a 55-year-old female patient with a known history of idiopathic hypersomnia undergoing an elective shoulder arthroscopy in the ambulatory setting. Read More

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http://Insights.ovid.com/crossref?an=01720097-201705010-0000
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http://dx.doi.org/10.1213/XAA.0000000000000481DOI Listing
May 2017
22 Reads

A Contemporary Medicolegal Analysis of Implanted Devices for Chronic Pain Management.

Anesth Analg 2017 04;124(4):1304-1310

From the *Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; and †CRICO Strategies, Boston, Massachusetts.

Background: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. Read More

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http://dx.doi.org/10.1213/ANE.0000000000001702DOI Listing
April 2017
10 Reads

Process Improvement Initiative for the Perioperative Management of Patients With a Cardiovascular Implantable Electronic Device.

Anesth Analg 2017 07;125(1):58-65

From the *Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, Oregon; †Operative Care Division, Veterans Affairs Portland Healthcare System, Portland, Oregon; ‡STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Boston, Massachusetts; §Department of Cardiology, University of Texas MD Anderson Cancer Center, Houston, Texas; ‖Center for Health Systems Effectiveness, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon; and ¶Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon.

Background: Economic, personnel, and procedural challenges often complicate and interfere with efficient and safe perioperative care of patients with cardiovascular implantable electronic devices (CIEDs). In the context of a process improvement initiative, we created and implemented a comprehensive anesthesiologist-run perioperative CIED service to respond to all routine requests for perioperative CIED consultations at a large academic medical center. This study was designed to determine whether this new care model was associated with improved operating room efficiency, reduced institutional cost, and adequate patient safety. Read More

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http://dx.doi.org/10.1213/ANE.0000000000001953DOI Listing
July 2017
28 Reads

A Perioperative Smoking Cessation Intervention With Varenicline, Counseling, and Fax Referral to a Telephone Quitline Versus a Brief Intervention: A Randomized Controlled Trial.

Anesth Analg 2017 08;125(2):571-579

From the *Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada; †Department of Anesthesia, Mount Sinai Hospital, University of Toronto, Ontario, Canada; ‡Department of Pharmacy, Mount Sinai Hospital, Toronto, Ontario, Canada; §Departments of Family and Community Medicine and Psychiatry, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada; and ‖Addictions Program and Ontario Tobacco Research Unit, Centre for Addiction and Mental Health, University of Toronto, Ontario, Canada.

Background: The effectiveness of perioperative interventions to quit smoking with varenicline has not been compared with brief interventions. Our objective was to determine the efficacy of a comprehensive smoking cessation program versus a brief intervention for smoking cessation.

Methods: In this prospective, multicenter study, 296 patients were randomized to participate in a smoking cessation program (one 10- to 15-minute counseling session, pharmacotherapy with varenicline, an educational pamphlet, and a fax referral to a telephone quitline); or brief advice and self-referral to a telephone quitline. Read More

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http://dx.doi.org/10.1213/ANE.0000000000001894DOI Listing
August 2017
15 Reads

Do-Not-Resuscitate Status Is Associated With Increased Mortality But Not Morbidity.

Anesth Analg 2017 11;125(5):1484-1493

From the Harvard Medical School, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Background: Do-not-resuscitate (DNR) orders instruct medical personnel to forego cardiopulmonary resuscitation in the event of cardiopulmonary arrest, but they do not preclude surgical management. Several studies have reported that DNR status is an independent predictor of 30-day mortality; however, the etiology of increased mortality remains unclear. We hypothesized that DNR patients would demonstrate increased postoperative mortality, but not morbidity, relative to non-DNR patients undergoing the same procedures. Read More

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http://dx.doi.org/10.1213/ANE.0000000000001904DOI Listing
November 2017
9 Reads

Case Report of Serratus Plane Catheter for Pain Management in a Patient With Multiple Rib Fractures and an Inferior Scapular Fracture.

A A Case Rep 2017 Mar;8(6):132-135

From the *Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, New York; †Department of Anesthesiology, Divisions of Pain Medicine and Critical Care, Columbia University Medical Center, New York, New York; and ‡Staff Anesthesiologist at Kaiser Permanente in San Francisco, California; Clinical Instructor in Anesthesiology, Perioperative & Pain Medicine, Stanford University School of Medicine, Stanford, California.

We placed a superficial serratus anterior plane catheter in an elderly woman with dementia and elevated clotting times who presented with multiple rib fractures after a mechanical fall. She was not a surgical candidate, and treatment consisted of conservative management with physical therapy and pain control. She was not a candidate for a patient-controlled analgesia regimen because of her dementia. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000431DOI Listing
March 2017
13 Reads