304 results match your criteria Perioperative Management of the Female Patient


Acute Respiratory Distress Syndrome in a Preterm Pregnant Patient With Coronavirus Disease 2019 (COVID-19).

Obstet Gynecol 2020 07;136(1):46-51

Department of Obstetrics, Gynecology, & Reproductive Sciences, the Divisions of Critical Care Medicine and Obstetric Anesthesia, Department of Anesthesia and Perioperative Care, the Divisions of Pediatric Infectious Diseases and Neonatology, Department of Pediatrics, the Division of Infectious Diseases, Department of Medicine, and the Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, San Francisco, San Francisco, California.

Background: Data suggest that pregnant women are not at elevated risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or developing severe disease compared with nonpregnant patients. However, management of pregnant patients who are critically ill with coronavirus disease 2019 (COVID-19) infection is complicated by physiologic changes and other pregnancy considerations and requires balancing maternal and fetal well-being.

Case: We report the case of a patient at 28 weeks of gestation with acute respiratory distress syndrome (ARDS) from COVID-19 infection, whose deteriorating respiratory condition prompted delivery. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003949DOI Listing

Intraoperative Electronic Alerts Improve Compliance With National Quality Program Measure for Perioperative Temperature Management.

Anesth Analg 2020 05;130(5):1167-1175

From the Departments of Anesthesiology, Perioperative and Pain Medicine.

Background: Reimbursement for anesthesia services has been shifting from a fee-for-service model to a value-based model that ties payment to quality metrics. The Centers for Medicare & Medicaid Service's (CMS) value-based payment program includes a quality measure for perioperative temperature management (Measure #424, Perioperative Temperature Management). Compliance may impose new challenges in clinical practice, data collection, and reporting. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004546DOI Listing

Perioperative Considerations in Urgent Surgical Care of Suspected and Confirmed COVID-19 Orthopaedic Patients: Operating Room Protocols and Recommendations in the Current COVID-19 Pandemic.

J Am Acad Orthop Surg 2020 Jun;28(11):451-463

From the Hull College of Business, Augusta University (Dr. Awad), the Department of Orthopedic Surgery, Medical College of Georgia, Augusta University (Dr. Awad, Dr. Rumley, and Dr. Devine), the Division of Infectious Diseases, Department of Medicine, Medical College of Georgia, Augusta University (Dr. Vazquez), and Antimicrobial Stewardship Service, Augusta University (Dr. Vazquez), Augusta, GA.

By April 7, 2020, severe acute respiratory syndrome coronavirus 2 was responsible for 1,383,436 confirmed cases of Coronavirus disease 2019 (COVID-19), involving 209 countries around the world; 378,881 cases have been confirmed in the United States. During this pandemic, the urgent surgical requirements will not stop. As an example, the most recent Centers of Disease Control and Prevention reports estimate that there are 2. Read More

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http://dx.doi.org/10.5435/JAAOS-D-20-00227DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7197335PMC

Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 in Shanghai, China.

ASAIO J 2020 05;66(5):475-481

Department of Anesthesiology & Perioperative Medicine, University of Louisville, Louisville, Kentucky.

Severe cases of coronavirus disease 2019 (COVID-19) cannot be adequately managed with mechanical ventilation alone. The role and outcome of extracorporeal membrane oxygenation (ECMO) in the management of COVID-19 is currently unclear. Eight COVID-19 patients have received ECMO support in Shanghai with seven with venovenous (VV) ECMO support and one veno arterial (VA) ECMO during cardiopulmonary resuscitation. Read More

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http://dx.doi.org/10.1097/MAT.0000000000001172DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7273861PMC

Surgery versus Conservative Care for Persistent Sciatica Lasting 4 to 12 Months.

N Engl J Med 2020 03;382(12):1093-1102

From the Department of Surgery (C.S.B., P.R., D.T., S.I.B., K.R.G., F.S., A.G., J.C.U.) and Occupational Health and Safety (R.R.), London Health Sciences Centre, Schulich School of Medicine and Dentistry, Western University (C.S.B., P.R., D.T., S.I.B., K.R.G., F.S., A.G.), Lawson Health Research Institute (C.S.B., P.R., J.C.U.), Regional Rehabilitation and Spinal Cord Injury Outpatients, Parkwood Institute (K.S.), and the Departments of Physical Medicine and Rehabilitation (T.M.) and Anesthesia and Perioperative Medicine (J.W.), St. Joseph's Hospital - all in London, ON, Canada.

Background: The treatment of chronic sciatica caused by herniation of a lumbar disk has not been well studied in comparison with acute disk herniation. Data are needed on whether diskectomy or a conservative approach is better for sciatica that has persisted for several months.

Methods: In a single-center trial, we randomly assigned patients with sciatica that had lasted for 4 to 12 months and lumbar disk herniation at the L4-L5 or L5-S1 level in a 1:1 ratio to undergo microdiskectomy or to receive 6 months of standardized nonoperative care followed by surgery if needed. Read More

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http://dx.doi.org/10.1056/NEJMoa1912658DOI Listing

Effect of Cross-Sex Hormone Therapy on Venous Thromboembolism Risk in Male-to-Female Gender-Affirming Surgery.

Ann Plast Surg 2020 Feb 19. Epub 2020 Feb 19.

From the Division of Plastic and Reconstructive Surgery, University of California Los Angeles David Geffen School of Medicine.

Individuals with gender dysphoria often seek medical interventions, such as hormone treatment and surgery, to live as their identified gender. Cross-sex hormone therapy typically consists of various estrogen formulations which confer varying risks of venous thromboembolism (VTE). Currently, there is no standard practice by surgeons regarding the preoperative gender-affirming surgery (GAS) hormone regimen of male-to-female (MTF) patients to minimize thromboembolic postoperative complications. Read More

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http://dx.doi.org/10.1097/SAP.0000000000002300DOI Listing
February 2020

Effect of Preoperative Patient Education on Opioid Consumption and Well-Being in Breast Augmentation.

Plast Reconstr Surg 2020 Feb;145(2):316e-323e

Honolulu, Hawaii; and San Francisco, Calif. From the Department of Surgery, Division of Plastic Surgery, the John A. Burns School of Medicine, and the Department of Medicine, University of Hawaii; and the Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California San Francisco.

Background: Perioperative use of opioids is common in surgical practice and frequently results in troublesome opioid-related side effects that often lead to suboptimal postsurgical outcomes. As such, multiple studies have sought to identify alternatives that may reduce reliance on opioid-based perioperative pain management. Recently, it has been shown that patient education and patient involvement in care positively impact surgical outcomes. Read More

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http://dx.doi.org/10.1097/PRS.0000000000006467DOI Listing
February 2020

Associations of Intraoperative Radial Arterial Systolic, Diastolic, Mean, and Pulse Pressures with Myocardial and Acute Kidney Injury after Noncardiac Surgery: A Retrospective Cohort Analysis.

Anesthesiology 2020 02;132(2):291-306

From the Departments of OUTCOMES RESEARCH, (S.A., E.J.M., D.Y., K.M., B.C., A.K.K., K.R., A.T., D.I.S.) Quantitative Health Sciences (E.J.M., D.Y.) General Anesthesiology (K.M., K.R., A.T.), Cleveland Clinic, Cleveland, Ohio the Department of Anesthesiology, Pain Management and Perioperative Medicine, Henry Ford Health System, Detroit, Michigan (S.A.) the Division of Anesthesia, Critical Care, and Pain Management, Tel-Aviv Medical Center, Tel Aviv University, Tel-Aviv, Israel (B.C.) the Department of Anesthesiology, Section on Critical Care Medicine, Wake Forest School of Medicine, Wake Forest Center for Biomedical Informatics, and the Critical Injury, Illness and Recovery Research Center, Winston-Salem, North Carolina (A.K.K.).

Background: Arterial pressure is a complex signal that can be characterized by systolic, mean, and diastolic components, along with pulse pressure (difference between systolic and diastolic pressures). The authors separately evaluated the strength of associations among intraoperative pressure components with myocardial and kidney injury after noncardiac surgery.

Methods: The authors included 23,140 noncardiac surgery patients at Cleveland Clinic who had blood pressure recorded at 1-min intervals from radial arterial catheters. Read More

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http://dx.doi.org/10.1097/ALN.0000000000003048DOI Listing
February 2020

Anesthetic Management Using Multiple Closed-loop Systems and Delayed Neurocognitive Recovery: A Randomized Controlled Trial.

Anesthesiology 2020 02;132(2):253-266

From the Department of Anesthesiology (A.J., A.B., V.J., L.V.O, L.B.) Department of Clinical and Cognitive Neuropsychology (H.S.) Erasme Hospital, and Department of Anesthesiology, Brugmann Hospital (P.V.d.L.), Université Libre de Bruxelles, Brussels, Belgium Department of Anesthesiology and Intensive Care, University of Paris-Saclay, Bicetre Hospital, Le Kremlin-Bicêtre, Paris, France (A.J.) Department of Anesthesiology and Perioperative Care, University of California, Irvine, Irvine, California (J.R.) Department of Anesthesiology, University of California, San Diego, San Diego, California (B.A.) Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California (M.C., S.V.) Department of Anesthesiology, Foch Hospital, Suresnes, Paris, France (N.L.) Outcome Research Consortium, Cleveland Clinic, Cleveland, Ohio (N.L.).

Background: Cognitive changes after anesthesia and surgery represent a significant public health concern. We tested the hypothesis that, in patients 60 yr or older scheduled for noncardiac surgery, automated management of anesthetic depth, cardiac blood flow, and protective lung ventilation using three independent controllers would outperform manual control of these variables. Additionally, as a result of the improved management, patients in the automated group would experience less postoperative neurocognitive impairment compared to patients having standard, manually adjusted anesthesia. Read More

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http://dx.doi.org/10.1097/ALN.0000000000003014DOI Listing
February 2020

Preventable Closed Claims in the AANA Foundation Closed Malpractice Claims Database.

AANA J 2019 Dec;87(6):468-476

is AANA chief advocacy officer and AANA Foundation chief executive officer, Park Ridge, Illinois.

Medical errors are among the top 3 causes of patient deaths in the United States, with up to 400,000 preventable deaths occurring in hospitalized patients each year. Although improvements have been made in anesthesia patient safety, adverse outcomes continue to occur. This study used thematic analysis to examine anesthesia closed claims that were associated with preventable morbidity and mortality. Read More

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December 2019

Lung Ultrasound in Emergency and Critically Ill Patients: Number of Supervised Exams to Reach Basic Competence.

Anesthesiology 2020 04;132(4):899-907

From the Multidisciplinary Intensive Care Unit, Department of Anesthesiology and Critical Care Medicine (C.A., H.B., R.D., A.M., J.-M.C., J.-J.R.) the Department of Parasitology-Mycology (F.G.), La Pitié-Salpêtrière Hospital, Public Assistance of Paris Hospitals (AP HP), Sorbonne University of Paris, Paris, France Intensive Care Unit, Federal University of Rio Grande do Sul, Ernesto Dornelles Hospital, Moinhos de Vento Hospital, Postgraduate Program for Pulmonology Science, Porto Alegre, Brazil (F.L.D.N.) the Department of Emergency Medicine, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Institute of Emergency Medicine, Hangzhou, China (Y.G., M.Z.) the Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing, China (W.C., D.B.) the Department of Critical Care Medicine, Peking University People's Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China (J.L., Y.A.) the Multidisciplinary Intensive Care Unit, Hospital Albert Einstein, São Paulo, Brazil (C.S.V.B.) the Department of Perioperative Medicine, Centre Hospitalo-Universitaire Clermont-Ferrand, University Clermont Auvergne, National Institute for Health and Medical Research (INSERM), National Center for Scientific Research (CNRS), Clermont-Ferrand, France (S.P.) University of São Paulo, Surgical and Trauma Intensive Care Unit, Hospital Das Clinicas, São Paulo, Brazil (F.P.C., L.M.) the Multidisciplinary Intensive Care Unit, Hospital da Bahia, Salvador and Santa Helena Hospital, Salvador, Brazil (E.J.S.L., J.N.) La Republica University, Intensive Care Unit, Hospital de Clínicas Dr. Manuel Qintela, University School of Medicine, Montevideo, Uruguay (A.C.) the Multidisciplinary Intensive Care Unit, Hospital Copa D'Or, Rio de Janeiro, Brazil (J.S.).

Background: Lung ultrasound is increasingly used in critically ill patients as an alternative to bedside chest radiography, but the best training method remains uncertain. This study describes a training curriculum allowing trainees to acquire basic competence.

Methods: This multicenter, prospective, and educational study was conducted in 10 Intensive Care Units in Brazil, China, France and Uruguay. Read More

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http://dx.doi.org/10.1097/ALN.0000000000003096DOI Listing

Preoperative Risk and the Association between Hypotension and Postoperative Acute Kidney Injury.

Anesthesiology 2020 03;132(3):461-475

From the University of Michigan Medical School, Departments of Anesthesiology (M.R.M., A.M.S., M.L.B., D.A.C., A.J., M.C.E., L.S., K.K.T., S.K.) Internal Medicine (M.H.), Ann Arbor, Michigan University of Virginia Health System, Department of Anesthesiology and Neurosurgery, Charlottesville, Virginia (B.I.N.) Vanderbilt University Medical Center, Department of Anesthesiology, Division of Anesthesiology Critical Care Medicine, Nashville, Tennessee (R.E.F.) Columbia University Medical Center, Department of Anesthesiology, New York, New York (M.K.) University of Chicago Medical Center, Department of Anesthesia and Critical Care, Chicago, Illinois (G.R.). Oregon Health & Science University, Department of Anesthesiology, Portland, Oregon Saint Joseph Mercy Health System, Department of Anesthesiology, Ann Arbor, Michigan University of Virginia Health System, Department of Anesthesiology, Charlottesville, Virginia University of Pennsylvania Health System, Department of Anesthesiology, Philadelphia, Pennsylvania Columbia University Medical Center, Department of Anesthesiology, New York, New York Beaumont Hospital of Troy, Michigan, Department of Anesthesiology, Troy, Michigan Beaumont Hospital of Dearborn, Michigan, Department of Anesthesiology, Dearborn, Michigan Columbia University Medical Center, Department of Anesthesiology, New York, New York Beaumont Health, Farmington Hills, Michigan University of Oklahoma Health Sciences Center, Department of Anesthesiology, Oklahoma City, Oklahoma Bronson Healthcare, Kalamazoo, Michigan University of Tennessee Medical Center, Department of Anesthesiology, Knoxville, Tennessee Cleveland Clinic, Anesthesiology Institute, Cleveland, Ohio St. Joseph Mercy Oakland, Pontiac, Michigan Weill Cornell Medical College, Department of Anesthesiology, New York, New York Washington University School of Medicine, Department of Anesthesiology, St. Louis, Missouri University of Colorado, Department of Anesthesiology, Aurora, Colorado University Medical Center Utrecht, Department of Anesthesiology, Utrecht, The Netherlands Academic Medical Center, Department of Anesthesiology, Amsterdam, The Netherlands Mercy Health, Muskegon, Michigan Bronson Healthcare, Battle Creek, Michigan Wake Forest School of Medicine, Department of Anesthesiology, Winston-Salem, North Carolina St. Mary Mercy Hospital, Livonia, Michigan University of Washington, Department of Anesthesiology and Pain Medicine, Seattle, Washington University of Vermont College of Medicine, Department of Anesthesiology, Burlington, Vermont Sparrow Health System, Lansing, Michigan NYU Langone Medical Center, Department of Anesthesiology, Perioperative Care, and Pain Medicine, New York, New York Vanderbilt University Medical Center, Department of Anesthesiology, Nashville, Tennessee Holland Hospital, Holland, Michigan.

Background: Despite the significant healthcare impact of acute kidney injury, little is known regarding prevention. Single-center data have implicated hypotension in developing postoperative acute kidney injury. The generalizability of this finding and the interaction between hypotension and baseline patient disease burden remain unknown. Read More

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http://dx.doi.org/10.1097/ALN.0000000000003063DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015776PMC

Electrocardiographic Effects of Propofol versus Etomidate in Patients with Brugada Syndrome.

Anesthesiology 2020 03;132(3):440-451

From the Department of Anesthesiology and Perioperative Medicine (P.F., H.C., J.T.B., S.B., V.U., C.V., P.F., J.P.) the Heart Rhythm Management Center, Center of Heart and Vascular Disease (V.V., W.D., G-B.,C., P.B., C.d.A.), University Hospital Brussels the Interfaculty Center Data processing & Statistics (W.C.), Free University Brussels, Laarbeeklaan, Brussels, Belgium.

Background: Brugada Syndrome is an inherited arrhythmogenic disease, characterized by the typical coved type ST-segment elevation in the right precordial leads from V1 through V3. The BrugadaDrugs.org Advisory Board recommends avoiding administration of propofol in patients with Brugada Syndrome. Read More

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http://dx.doi.org/10.1097/ALN.0000000000003030DOI Listing
March 2020
5.879 Impact Factor

A Population-Based Analysis of Intraoperative Cardiac Arrest in the United States.

Anesth Analg 2020 03;130(3):627-634

From the Department of Anesthesiology & Perioperative Medicine.

Background: A new billable code for intraoperative cardiac arrest was introduced with the International Classification of Diseases, Tenth Revision, classification system. Using a national administrative database, we performed a retrospective analysis of intraoperative cardiac arrest in the United States.

Methods: Hospital admissions involving patients ≥18 years of age who underwent operating room procedures in 2016 were identified using the National Inpatient Sample. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004477DOI Listing

Assessment of Fluid Responsiveness in Prone Neurosurgical Patients Undergoing Protective Ventilation: Role of Dynamic Indices, Tidal Volume Challenge, and End-Expiratory Occlusion Test.

Anesth Analg 2020 03;130(3):752-761

From the Department of Anesthesia and Intensive Care, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy.

Background: In patients in the prone position, the reliability of pulse pressure variation and stroke volume variation (PPV and SVV) and the use of functional hemodynamic tests to predict fluid responsiveness have not previously been established. Perioperatively, in this setting, optimizing fluid management can be challenging, and fluid overload is associated with both intraoperative and postoperative complications. We designed this study to assess the sensitivity and specificity of baseline PPV and SVV, the tidal volume (VT) challenge (VTC) and the end-expiratory occlusion test (EEOT) in predicting fluid responsiveness during elective spinal surgery. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004494DOI Listing
March 2020
1 Read
3.472 Impact Factor

Management of Difficult Tracheal Intubation: A Closed Claims Analysis.

Anesthesiology 2019 10;131(4):818-829

From the Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington (A.M.J., K.L.P., S.L.M., K.B.D.) the Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, Oregon (M.F.A.) the Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada (L.V.D.).

Background: Difficult or failed intubation is a major contributor to morbidity for patients and liability for anesthesiologists. Updated difficult airway management guidelines and incorporation of new airway devices into practice may have affected patient outcomes. The authors therefore compared recent malpractice claims related to difficult tracheal intubation to older claims using the Anesthesia Closed Claims Project database. Read More

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http://dx.doi.org/10.1097/ALN.0000000000002815DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6779339PMC
October 2019
1 Read

Anesthetic Management of a Unique Case of Double-Outlet Right Ventricle With Glenn Shunt for Cesarean Delivery: A Case Report.

AANA J 2018 Oct;86(5):408-411

is a senior resident, in the Department of Anesthesiology, at AIIMS, in New Delhi, India.

Double-outlet right ventricle is a rare congenital cardiac anomaly resulting in intracardiac mixing of oxygenated and deoxygenated blood. Surgical palliation involves staged conversion to Fontan circulation, with an intermediate stage using a Glenn shunt. We report the case of a patient at 36 weeks of gestation, with a partially palliated double-outlet right ventricle and a Glenn shunt, who presented with severe dyspnea and worsening cyanosis. Read More

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October 2018

Prevention of Early Postoperative Decline: A Randomized, Controlled Feasibility Trial of Perioperative Cognitive Training.

Anesth Analg 2020 03;130(3):586-595

From the Department of Anesthesia, Critical Care and Pain Medicine.

Background: Postoperative delirium and postoperative cognitive dysfunction (POCD) are common after cardiac surgery and contribute to an increased risk of postoperative complications, longer length of stay, and increased hospital mortality. Cognitive training (CT) may be able to durably improve cognitive reserve in areas deficient in delirium and POCD and, therefore, may potentially reduce the risk of these conditions. We sought to determine the feasibility and potential efficacy of a perioperative CT program to reduce the incidence of postoperative delirium and POCD in older cardiac surgery patients. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004469DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7154961PMC
March 2020
4 Reads

Effects of Shared Decision Making on Opioid Prescribing After Hysterectomy.

Obstet Gynecol 2019 10;134(4):823-833

Departments of Obstetrics and Gynecology, Anesthesia, and Surgery, and the Section of Plastic Surgery, Department of Surgery, University of Michigan, the University of Michigan Medical School, and the University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan.

Objective: To evaluate the effects of shared decision making using a simple decision aid for opioid prescribing after hysterectomy.

Methods: We conducted a prospective quality initiative study including all patients undergoing hysterectomy for benign, nonobstetric indications between March 1, 2018, and July 31, 2018, at our academic institution. Using a visual decision aid, patients received uniform education regarding postoperative pain management. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003468DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6945818PMC
October 2019
1 Read

Supplemental Intraoperative Oxygen Does Not Promote Acute Kidney Injury or Cardiovascular Complications After Noncardiac Surgery: Subanalysis of an Alternating Intervention Trial.

Anesth Analg 2020 04;130(4):933-940

From the Departments of Outcomes Research.

Background: Perioperative hyperoxia has been recommended by the World Health Organization and the Centers for Disease Control and Prevention for the prevention of surgical site infections. Based on animal studies and physiological concerns, the kidneys and heart may be at risk from hyperoxia. We therefore conducted 2 unplanned subanalyses of a previous alternating cohort trial in which patients having colorectal surgery were assigned to either 30% or 80% inspired intraoperative oxygen. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004359DOI Listing
April 2020
2 Reads

Anesthetic Management During Electroconvulsive Therapy in Children: A Systematic Review of the Available Literature.

Anesth Analg 2020 01;130(1):126-140

From the Department of Anesthesiology, Perioperative Medicine and Pain Management, Jackson Memorial Hospital/Holtz Children's Hospital, Miller School of Medicine, University of Miami Health System, Miami, Florida.

Electroconvulsive therapy (ECT) is indicated in a myriad of pediatric psychiatric conditions in children, and its use is increasing. Literature on the clinical features salient to anesthetic care is lacking. The objective of this systematic review is to describe the available literature on the anesthetic considerations of pediatric ECT. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004337DOI Listing
January 2020
2 Reads

Cognitive Aids in Obstetric Units: Design, Implementation, and Use.

Anesth Analg 2020 05;130(5):1341-1350

From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California.

Obstetrics has unique considerations for high stakes and dynamic clinical care of ≥2 patients. Obstetric crisis situations require efficient and coordinated responses from the entire multidisciplinary team. Actions that teams perform, or omit, can strongly impact peripartum and perinatal outcomes. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004354DOI Listing
May 2020
1 Read

Weeding Out the Problem: The Impact of Preoperative Cannabinoid Use on Pain in the Perioperative Period.

Anesth Analg 2019 09;129(3):874-881

From the Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada.

Background: The recreational and medical use of cannabinoids has been increasing. While most studies and reviews have focused on the role of cannabinoids in the management of acute pain, no study has examined the postoperative outcomes of surgical candidates who are on cannabinoids preoperatively. This retrospective cohort study examined the impact of preoperative cannabinoid use on postoperative pain scores and pain-related outcomes in patients undergoing major orthopedic surgery. Read More

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http://dx.doi.org/10.1213/ANE.0000000000003963DOI Listing
September 2019
3 Reads

Variability and Costs of Low-Value Preoperative Testing for Carpal Tunnel Release Surgery.

Anesth Analg 2019 09;129(3):804-811

From the Center for Innovation to Implementation, Veterans Affairs Palo Alto Healthcare System, Palo Alto, California.

Background: The American Society of Anesthesiologists (ASA) Choosing Wisely Top-5 list of activities to avoid includes "Don't obtain baseline laboratory studies in patients without significant systemic disease (ASA I or II) undergoing low-risk surgery - specifically complete blood count, basic or comprehensive metabolic panel, coagulation studies when blood loss (or fluid shifts) is/are expected to be minimal." Accordingly, we define low-value preoperative tests (LVTs) as those performed before minor surgery in patients without significant systemic disease. The objective of the current study was to examine the extent, variability, drivers, and costs of LVTs before carpal tunnel release (CTR) surgeries in the US Veterans Health Administration (VHA). Read More

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http://Insights.ovid.com/crossref?an=00000539-201909000-0002
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http://dx.doi.org/10.1213/ANE.0000000000004291DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6760302PMC
September 2019
4 Reads

Feasibility of a Perioperative Text Messaging Smoking Cessation Program for Surgical Patients.

Anesth Analg 2019 09;129(3):e73-e76

From the Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota.

Although surgical patients who smoke could benefit from perioperative abstinence, few currently receive support. This pilot study determined the feasibility and acceptability of a perioperative text messaging smoking cessation program. One hundred patients (73% of eligible patients approached) enrolled in a surgery-specific messaging service, receiving 1-3 daily messages about smoking and surgical recovery for 30 days. Read More

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http://dx.doi.org/10.1213/ANE.0000000000003715DOI Listing
September 2019

Outcomes of Sympathetic Blocks in the Management of Complex Regional Pain Syndrome: A Retrospective Cohort Study.

Anesthesiology 2019 10;131(4):883-893

From the Departments of Pain Management (J.C., V.S., M.G., O.T.C., F.Z., R.W.R.) Neurosciences (J.C.) Quantitative Health Sciences and Outcomes Research (J.Y., D.Y., E.J.M.), Cleveland Clinic, Cleveland, Ohio Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California (V.S.).

Background: Sympathetic dysfunction may be present in complex regional pain syndrome, and sympathetic blocks are routinely performed in practice. To investigate the therapeutic and predictive values of sympathetic blocks, the authors test the hypotheses that sympathetic blocks provide analgesic effects that may be associated with the temperature differences between the two extremities before and after the blocks and that the effects of sympathetic blocks may predict the success (defined as achieving more than 50% pain reduction) of spinal cord stimulation trials.

Methods: The authors performed a retrospective study of 318 patients who underwent sympathetic blocks in a major academic center (2009 to 2016) to assess the association between pain reduction and preprocedure temperature difference between the involved and contralateral limbs. Read More

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http://dx.doi.org/10.1097/ALN.0000000000002899DOI Listing
October 2019
3 Reads

Analgesic efficacy of ultrasound-guided interscalene block vs. supraclavicular block for ambulatory arthroscopic rotator cuff repair: A randomised noninferiority study.

Eur J Anaesthesiol 2019 Oct;36(10):778-786

From the Department of Anaesthesiology (JC, TV), Department of Shoulder Surgery, Ramsay Générale de Santé - Hôpital Privé Jean Mermoz, Centre Paul Santy (LN-J), and Department of Anaesthesiology, Ramsay Générale de Santé - Hôpital Privé Claude Galien, Quincy-Sous-Sénard, France (LM).

Background: Ultrasound-guided interscalene block (ISB) is the reference technique for pain control after ambulatory upper limb surgery, but supraclavicular block (SCB) is an alternative.

Objectives: The aim of this study was to compare the efficacy of SCB vs. ISB in patients undergoing ambulatory arthroscopic rotator cuff repair (ARCR), with the hypothesis of noninferiority of SCB analgesia compared with ISB. Read More

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http://dx.doi.org/10.1097/EJA.0000000000001065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6738543PMC
October 2019
1 Read

Total Hip Replacement in a Patient With a Fontan Circulation: A Case Report.

A A Pract 2019 Oct;13(8):316-318

From the Department of Anesthesia, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.

Anesthetic management of the adult patient with a Fontan circulation is complex and requires understanding of the specific physiology of the individual patient. Long-term survival in this cohort has increased to the point where patients are presenting for noncardiac surgery related to degenerative diseases of aging. We describe the perioperative management of a patient with a Fontan circulation undergoing total hip arthroplasty using combined spinal-epidural anesthesia and discuss the issues requiring special consideration for this surgical procedure in this group of patients. Read More

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http://dx.doi.org/10.1213/XAA.0000000000001064DOI Listing
October 2019
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Impact of an Opioid Safety Initiative on Patients Undergoing Total Knee Arthroplasty: A Time Series Analysis.

Anesthesiology 2019 08;131(2):369-380

From the Patient Safety Center of Inquiry, Veterans Affairs Boston Healthcare System, Boston, Massachusetts (Q.C.) the Patient Safety Center of Inquiry, Durham Veterans Affairs Healthcare System (H.-L.H., W.B., M.P., T.B., K.R.) the Department of Anesthesiology, Duke University Health System (H.-L.H., T.B., V.K., K.R.) NoviSci, LLC. (R.O., M.A.B.), Durham, North Carolina Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Healthcare System and the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California (E.R.M., S.C.M.) Veterans Affairs Pharmacy Benefits Management Services, Hines, Illinois (C.B.G.) the Center for Value Based Pharmacy Initiatives, University of Pittsburgh Medical Center Health Plan, Pittsburgh, Pennsylvania (C.B.G.).

Background: The Opioid Safety Initiative decreased high-dose prescriptions across the Veterans Health Administration. This study sought to examine the impact of this intervention (i.e. Read More

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http://dx.doi.org/10.1097/ALN.0000000000002771DOI Listing
August 2019
1 Read
5.879 Impact Factor

BOSTN Bundle Intervention for Perioperative Screening and Management of Patients With Suspected Obstructive Sleep Apnea: A Hospital Registry Study.

Anesth Analg 2020 05;130(5):1415-1424

From the Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Background: We developed and implemented a perioperative guideline for obstructive sleep apnea (OSA), comprising a preoperative screening tool (BOSTN) and clinical management pathways. OSA was suspected with 2 or more of the following: body mass index ≥30 kg/m, observed apnea, loud snoring, daytime tiredness, and neck circumference ≥16.5 inches in women or ≥ 17. Read More

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http://Insights.ovid.com/crossref?an=00000539-900000000-9607
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http://dx.doi.org/10.1213/ANE.0000000000004294DOI Listing
May 2020
8 Reads

Anesthesia Type Is Not Associated With Postoperative Complications in the Care of Patients With Lower Extremity Traumatic Fractures.

Anesth Analg 2019 10;129(4):1034-1042

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

Background: Lower extremity fracture fixation is commonplace and represents the majority of orthopedic trauma surgical volume. Despite this, few studies have examined the use of regional anesthesia or neuraxial anesthesia (RA/NA) versus general anesthesia (GA) in this surgical population. We aimed to determine the overall rates of RA/NA use and whether RA/NA was associated with lower mortality and morbidity versus GA for patients with lower extremity orthopedic trauma. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004270DOI Listing
October 2019
8 Reads

Preoperative Pulmonary Function Test Results Are Not Associated With Postoperative Intubation in Children Undergoing Posterior Spinal Fusion for Scoliosis: A Retrospective Observational Study.

Anesth Analg 2019 07;129(1):184-191

From the Department of Pediatric Anesthesiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.

Background: Preoperative pulmonary function tests are routinely obtained in children with scoliosis undergoing posterior spinal fusion despite unclear benefits as a perioperative risk assessment tool and frequent inability of patients to provide acceptable results. The goal of this study was to determine whether preoperative pulmonary function test results are associated with the need for postoperative intubation or intensive care unit admission after posterior spinal fusion.

Methods: The electronic medical records of patients who underwent posterior spinal fusion at a pediatric tertiary hospital between June 2012 and August 2017 were reviewed. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004143DOI Listing
July 2019
5 Reads

Factors Affecting Patient Satisfaction With Their Anesthesiologist: An Analysis of 51,676 Surveys From a Large Multihospital Practice.

Anesth Analg 2019 10;129(4):951-959

Department of Anesthesia and Critical Care, University of Chicago, Chicago, Illinois.

Background: An increasing focus of health care quality is the assessment of patient-reported outcomes, including satisfaction. Because anesthesia care occurs in the context of perioperative surgical care, direct associations between anesthetic management and patient experience may be difficult to identify. We analyzed anesthesia-specific patient satisfaction survey data from a large private practice group to identify patient, procedure, and anesthetic-specific predictors of patient satisfaction with their anesthesiologist, measured via responses to a validated patient satisfaction survey instrument. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004256DOI Listing
October 2019
11 Reads

Heterogeneity Among Hospitals in the Percentages of All Lumbosacral Epidural Steroid Injections Where the Patient Had Received 4 or More in the Previous Year.

Anesth Analg 2019 08;129(2):493-499

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

Background: Current guidelines for the administration of therapeutic epidural injections suggest that these be limited to a maximum of 4 per year. We sought to gain an understanding of the proportion of lumbosacral epidural injections administered to patients who had received ≥4 such injections during the preceding 364 days, and whether these proportions varied among hospitals.

Methods: This observational cohort study included data from all facilities owned by the 121 nonfederal hospitals in the State of Iowa, July 2012 through September 2017. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004253DOI Listing
August 2019
7 Reads

Elevated Presepsin Is Associated With Perioperative Major Adverse Cardiovascular and Cerebrovascular Complications in Elevated-Risk Patients Undergoing Noncardiac Surgery: The Leukocytes and Cardiovascular Perioperative Events Study.

Anesth Analg 2019 06;128(6):1344-1353

From the Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany.

Background: Perioperative major adverse cardiovascular and cerebrovascular events (MACCEs) are incompletely understood, and risk prediction is imprecise. Atherogenic leukocytes are crucial in cardiovascular events. However, it is unclear if surgical interventions affect leukocyte counts or activation status. Read More

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http://dx.doi.org/10.1213/ANE.0000000000003738DOI Listing
June 2019
9 Reads

Factors Associated With Recovery Room Intravenous Opiate Requirement After Pediatric Outpatient Operations.

Anesth Analg 2019 06;128(6):1225-1233

From the Department of Anesthesiology, Section of Pediatric Anesthesiology, University of Michigan, Ann Arbor, Michigan.

Background: Many children recovering from anesthesia experience pain that is severe enough to warrant intravenous (IV) opioid treatment within moments of admission to the postanesthesia care unit (PACU). Postoperative pain has several negative consequences; therefore, preventing significant PACU pain in children is both a major clinical goal and a moral/ethical imperative. This requires identifying patient-level and perioperative factors that may be used to predict PACU IV opioid requirement. Read More

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http://dx.doi.org/10.1213/ANE.0000000000003701DOI Listing
June 2019
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A Contemporary Analysis of Medicolegal Issues in Obstetric Anesthesia Between 2005 and 2015.

Anesth Analg 2019 06;128(6):1199-1207

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

Background: Detailed reviews of closed malpractice claims have provided insights into the most common events resulting in litigation and helped improve anesthesia care. In the past 10 years, there have been multiple safety advancements in the practice of obstetric anesthesia. We investigated the relationship among contributing factors, patient injuries, and legal outcome by analyzing a contemporary cohort of closed malpractice claims where obstetric anesthesiology was the principal defendant. Read More

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http://Insights.ovid.com/crossref?an=00000539-201906000-0002
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http://dx.doi.org/10.1213/ANE.0000000000003395DOI Listing
June 2019
8 Reads

Feasibility of Fully Automated Hypnosis, Analgesia, and Fluid Management Using 2 Independent Closed-Loop Systems During Major Vascular Surgery: A Pilot Study.

Anesth Analg 2019 06;128(6):e88-e92

From the Department of Anesthesiology, Cliniques Universitaires de Bruxelles Erasme, Université Libre de Bruxelles, Brussels, Belgium.

Automated titration of intravenous anesthesia and analgesia using processed electroencephalography monitoring is no longer a novel concept. Closed-loop control of fluid administration to provide goal-directed fluid therapy has also been increasingly described. However, simultaneously combining 2 independent closed-loop systems together in patients undergoing major vascular surgery has not been previously detailed. Read More

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http://dx.doi.org/10.1213/ANE.0000000000003433DOI Listing
June 2019
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Days Alive and Out of Hospital: Validation of a Patient-centered Outcome for Perioperative Medicine.

Anesthesiology 2019 07;131(1):84-93

From the Department of Anesthesia and Pain Management, Toronto General Hospital (A.J., D.N.W.) the Department of Anesthesia, University of Toronto (A.J., D.N.W.) the Institute for Clinical Evaluative Sciences (A.J., P.C.A., D.N.W.) the Toronto General Hospital Research Institute (A.J.) the Li Ka Shing Knowledge Institute, St. Michael's Hospital (D.N.W.), Toronto, Ontario, Canada.

Background: Days alive and out of hospital is a potentially useful patient-centered quality measure for perioperative care in adult surgical patients. However, there has been very limited prior validation of this endpoint with respect to its ability to capture differences in patient-level risk factor profiles and longer-term postoperative outcomes. The main objective of this study was assessment of the feasibility and validity of days alive and out of hospital as a patient-centered outcome for perioperative medicine. Read More

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http://dx.doi.org/10.1097/ALN.0000000000002701DOI Listing
July 2019
4 Reads

Society for Obstetric Anesthesia and Perinatology Consensus Statement: Monitoring Recommendations for Prevention and Detection of Respiratory Depression Associated With Administration of Neuraxial Morphine for Cesarean Delivery Analgesia.

Anesth Analg 2019 08;129(2):458-474

Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California.

The majority of women undergoing cesarean delivery in the United States receive neuraxial morphine, the most effective form of postoperative analgesia for this surgery. Current American Society of Anesthesiologists (ASA) and American Society of Regional Anesthesia and Pain Medicine (ASRA) recommend respiratory monitoring standards following neuraxial morphine administration in the general surgical population that may be too frequent and intensive when applied to the healthy obstetric population receiving a single dose of neuraxial morphine at the time of surgery. There is limited evidence to support or guide the optimal modality, frequency, and duration of respiratory monitoring in the postoperative cesarean delivery patient receiving a single dose of neuraxial morphine. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004195DOI Listing
August 2019
3 Reads

Heparin Resistance due to an Acquired Antithrombin Deficiency in a Patient With Sickle Cell Disease During a Pregnancy Complicated by Bilateral Pulmonary Emboli: A Case Report.

A A Pract 2019 May;12(9):305-307

From the Department of Anesthesiology, Perioperative & Pain Medicine.

We report a 31-year-old woman with sickle beta thalassemia zero who presented at 21 weeks gestational age with multiple bilateral pulmonary emboli and no hemodynamic instability. Acquired antithrombin deficiency was suspected due to a refractory response to therapeutic anticoagulation with enoxaparin, unfractionated heparin, and fondaparinux, and a reduced antithrombin antigen level. At 26 4/7 weeks, she developed signs concerning for increased pulmonary clot burden. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000917DOI Listing
May 2019
12 Reads

High-Frequency Heart Rate Variability Index: A Prospective, Observational Trial Assessing Utility as a Marker for the Balance Between Analgesia and Nociception Under General Anesthesia.

Anesth Analg 2020 04;130(4):1045-1053

Perinatal Environment and Health, Faculté of Médicine, University of Lille, Centre Hospitalier Universitaire, Lille, France.

Background: Maintaining a balance between nociception and analgesia perioperatively reduces morbidity and improves outcomes. Current intraoperative analgesic strategies are based on subjective and nonspecific parameters. The high-frequency heart rate (HR) variability index is purported to assess the balance between nociception and analgesia in patients under general anesthesia. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004180DOI Listing
April 2020
2 Reads

Outcomes and Safety Among Patients With Obstructive Sleep Apnea Undergoing Cancer Surgery Procedures in a Freestanding Ambulatory Surgical Facility.

Anesth Analg 2019 08;129(2):360-368

From the Department of Anesthesiology and Critical Care, Josie Robertson Surgery Center.

Background: Patients with obstructive sleep apnea (OSA) may be at increased risk for serious perioperative complications. The suitability of ambulatory surgery for patients with OSA remains controversial, and several national guidelines call for more evidence that assesses clinically significant outcomes. In this study, we investigate the association between OSA status (STOP-BANG risk, or previously diagnosed) and short-term outcomes and safety for patients undergoing cancer surgery at a freestanding ambulatory surgery facility. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004111DOI Listing
August 2019
4 Reads

Allergic Acute Coronary Artery Stent Thrombosis After the Administration of Sugammadex in a Patient Undergoing General Anesthesia: A Case Report.

A A Pract 2019 Aug;13(4):133-136

From the Department of Anesthesiology, Hamamatsu Rosai Hospital, Japan Organization of Occupational Health and Safety, Hamamatsu, Japan.

In addition to cutaneous, gastrointestinal, hemodynamic, and respiratory symptoms, allergic reactions can induce an acute coronary syndrome in normal or atheromatous coronary arteries and can cause coronary stent thrombosis. Here, we report a case of coronary stent thrombosis due to allergic acute coronary syndrome during anaphylaxis induced by sugammadex in a female patient undergoing general anesthesia. She was emergently treated with percutaneous transluminal coronary balloon angioplasty with catecholamine, vasodilator, and intraaortic balloon support. Read More

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http://dx.doi.org/10.1213/XAA.0000000000001015DOI Listing
August 2019
7 Reads

Pediatric Risk Stratification Is Improved by Integrating Both Patient Comorbidities and Intrinsic Surgical Risk.

Anesthesiology 2019 06;130(6):971-980

From the Division of Cardiac Anesthesia (V.G.N., J.A.D.) Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts (S.J.S., D.Z.) the Division of Cardiac Anesthesia, Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario Canada (D.F).

What We Already Know About This Topic: Risk stratification models to predict perioperative mortality in pediatric surgical populations are based on patient comorbidities, but do not take into consideration the intrinsic risk of the surgical procedures.

What This Article Tells Us That Is New: Surgical procedures identified by specialty are not independent risk factors for perioperative mortality in pediatric patients. However, in multivariable predictive algorithms, the interaction of patient comorbidities with the intrinsic risk of the surgical procedure strongly predicts 30-day mortality. Read More

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http://dx.doi.org/10.1097/ALN.0000000000002659DOI Listing
June 2019
17 Reads

A Contemporary Medicolegal Analysis of Outpatient Interventional Pain Procedures: 2009-2016.

Anesth Analg 2019 07;129(1):255-262

Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts.

Background: Closed malpractice claim studies allow a review of rare but often severe complications, yielding useful insight into improving patient safety and decreasing practitioner liability.

Methods: This retrospective observational study of pain medicine malpractice claims utilizes the Controlled Risk Insurance Company Comparative Benchmarking System database, which contains nearly 400,000 malpractice claims drawn from >400 academic and community medical centers. The Controlled Risk Insurance Company Comparative Benchmarking System database was queried for January 1, 2009 through December 31, 2016, for cases with pain medicine as the primary service. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004096DOI Listing
July 2019
9 Reads

Epidemiology and Perioperative Complications in Patients With Sickle Cell Disease After Orthopaedic Surgery: 26 Years' Experience at a Major Academic Center.

J Am Acad Orthop Surg 2019 Dec;27(23):e1043-e1051

From the Department of Orthopaedic Surgery (Mr. Cusano, Ms. Curry, Dr. Kingston, Dr. Li), Boston University School of Medicine, and the Center of Excellence in Sickle Cell Disease (Dr. Klings), Boston University School of Medicine, Boston, MA.

Introduction: Surgical management of patients with sickle cell disease (SCD) poses a unique challenge to orthopaedic surgeons due to increased operative and perioperative risk. Studies evaluating perioperative complications among patients with SCD undergoing orthopaedic surgery have been limited. We sought to review the clinical characteristics and perioperative complications in our patients with SCD who required orthopaedic surgery. Read More

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http://dx.doi.org/10.5435/JAAOS-D-18-00288DOI Listing
December 2019
3 Reads

A Restrictive Hemoglobin Transfusion Threshold of Less Than 7 g/dL Decreases Blood Utilization Without Compromising Outcomes in Patients With Hip Fractures.

J Am Acad Orthop Surg 2019 Dec;27(23):887-894

From the Department of Orthopaedic Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD (Dr. Amin, Dr. Best, Dr. Shafiq, Dr. Hasenboehler, Dr. Sterling, and Dr. Khanuja), and the Department of Anesthesiology and Critical Care Medicine, The Armstrong Institute for Patient Safety and Quality, The Johns Hopkins Medical Institutions, Baltimore, MD (Mr. DeMario and Dr. Frank).

Introduction: In patients with hip fracture, a transfusion threshold of hemoglobin (Hb) <8 g/dL is associated with similar or better outcomes than more liberal thresholds. Whether a more restrictive threshold of <7 g/dL Hb produces equivalent outcomes in such patients is unknown. The aim of the study was to examine whether a restrictive threshold of <7 g/dL Hb is safe in this population. Read More

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http://dx.doi.org/10.5435/JAAOS-D-18-00374DOI Listing
December 2019
23 Reads

Retrospective Analysis of Obstetric Intensive Care Unit Admissions Reveals Differences in Etiology for Admission Based on Mode of Conception.

Anesth Analg 2020 02;130(2):436-444

From the Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Background: The use of in vitro fertilization is increasing. The incidence of adverse outcomes is greater for women who undergo in vitro fertilization, potentially leading to intensive care unit admission. This study aimed to assess the etiology and course of intensive care unit admission in women who underwent in vitro fertilization compared to those who did not, with specific focus on intensive care unit admission due to postpartum hemorrhage. Read More

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http://dx.doi.org/10.1213/ANE.0000000000004056DOI Listing
February 2020
17 Reads

Perioperative Adverse Events in Women Undergoing Concurrent Hemorrhoidectomy at the Time of Urogynecologic Surgery.

Female Pelvic Med Reconstr Surg 2019 Mar/Apr;25(2):88-92

From the Center for Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics, Gynecology & Women's Health Institute, Cleveland Clinic, Cleveland, OH.

Objective: The aim of this study was to describe the incidence and trends of outcomes after concurrent surgeries for symptomatic hemorrhoids and pelvic floor disorders.

Methods: This was a retrospective matched cohort study. Women who underwent concurrent vaginal urogynecologic and hemorrhoid surgery between 2007 and 2017 were identified by their surgical codes and matched to a cohort of women who underwent vaginal urogynecologic surgery only. Read More

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http://dx.doi.org/10.1097/SPV.0000000000000663DOI Listing
June 2019
12 Reads