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Is the use of dextrose-containing solution in the PACU associated with less PONV?

September 13, 2013 By J. Lance Lichtor in Ambulatory Anesthesiology

Is the use of dextrose-containing solution in the PACU associated with less PONV?

When your patient arrives in the PACU, what kinds of fluid do you ask the PACU nurse to administer?  Does the fluid contain dextrose?  Maybe it should! There’s evidence that dextrose administration decreases postoperative nausea and vomiting.  However, the story isn’t completely clear. For example, last month, AA2day summarized a study that showed dextrose administered […]

A practical preoperative smoking cessation program effectively reduced smoking incidence before surgery

September 11, 2013 By J. Lance Lichtor in Ambulatory Anesthesiology

A practical preoperative smoking cessation program effectively reduced smoking incidence before surgery

Preoperative clinics can do more than prepare patients for surgery: they can also teach healthy habits, such as smoking cessation.  In the article “The Effectiveness of a Perioperative Smoking Cessation Program: A Randomized Clinical Trial” published in the current issue of Anesthesia & Analgesia, Dr. Susan M. Lee, Department of Anesthesia and Perioperative Medicine, University […]

Is it detrimental to warm platelets during infusion?

September 9, 2013 By J. Lance Lichtor in Cardiovascular Anesthesiology

Is it detrimental to warm platelets during infusion?

Do you warm platelets while they are being infused?  If so, you are violating guidelines published by the AABB, formerly known as the American Association of Blood Banks.  But does warming platelets affect platelet function? In the study “Stored Platelet Functionality Is Not Decreased After Warming with a Fluid Warmer,” Dr. Gerhardt Konig, Department of […]

Cancer recurrence: epidural analgesia compared to use of PCA

September 6, 2013 By J. Lance Lichtor in Patient Safety

Cancer recurrence: epidural analgesia compared to use of PCA

Since epidural anesthesia is known to reduce immunosuppression, should it be preferred in patients with cancer who are undergoing surgery? Additionally, do systemic opioids contribute to cancer recurrence, metastasis, and biochemical progression, further encouraging the use of epidural anesthesia for patients with cancer? In the article featured in this month’s issue of Anesthesia & Analgesia, […]

A lower dose of epidural morphine is as effective as the standard dose but with fewer side effects

September 4, 2013 By J. Lance Lichtor in Obstetric Anesthesiology

A lower dose of epidural morphine is as effective as the standard dose but with fewer side effects

For patients experiencing pain after cesarean delivery, pain is better relieved after administration of epidural morphine rather than parenteral opioids. How much epidural morphine is appropriate? The question is addressed in “The Efficacy of 2 Doses of Epidural Morphine for Postcesarean Delivery Analgesia: A Randomized Noninferiority Trial” by Dr. Sudha I. Singh and colleagues from […]

Spinal anesthesia is reasonable for patients with severe preeclampsia for caesarean delivery.

August 30, 2013 By J. Lance Lichtor in Obstetric Anesthesiology

Spinal anesthesia is reasonable for patients with severe preeclampsia for caesarean delivery.

Should spinal anesthesia be used for caesarean delivery in a patient with preeclampsia,? Spinal anesthesia was once considered contraindicated because the ensuing hypotension would compromise uteroplacental blood flow. This has not been supported by evidence, and indeed spinal anesthesia is a reasonable treatment method. Dr. Vanessa G. Henke, Department of Anesthesia, Stanford University School of […]

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  • January 2019: Anesthesia & Analgesia

    January 2019: Anesthesia & Analgesia

    The January 2019 issue of Anesthesia & Analgesia has been published. Patient blood management is the timely application of evidence-based medical and surgical concepts designed to maintain hemoglobin concentration, optimize hemostasis, and minimize blood loss to improve patient outcomes. In their article, Zaleski and colleagues provide suggestions for successful, safe and bloodless treatment for patients […]

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    April 2015: Anesthesia & Analgesia

    Dr. Steven Shafer, editor-in-chief, Anesthesia & Analgesia: Recent news reports have highlighted the risks of nosocomial infection. Fourteen articles in this issue of Anesthesia & Analgesia document how anesthesiologists make a difference in perioperative infection. Research papers identify the reservoirs of bacterial contamination in the operating room, our role in hospital-acquired infections, and changes in […]

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    We’ve gone to the IARS meeting

    We’ve gone to the IARS meeting.  Posts will continue after the meeting.  Anyone know the location of this image? To see it, go to the Hawaii Tropical Botanic Garden, near Hilo: on the Ocean Front trail, the twin rocks, based on legend, are where two young lovers were turned to stone as they protected their village […]

  • A Summary of Research on Perioperative Neurotoxicity in the Elderly

    A Summary of Research on Perioperative Neurotoxicity in the Elderly

    Scientists and clinicians from ten countries attended the International Workshop on Perioperative Neurotoxicity in the Elderly this past May in Stockholm, Sweden. In this month’s issue of Anesthesia & Analgesia, Dr. Roderic G. Eckenhoff, Department of Anesthesiology & Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, and colleagues review the workshop proceedings […]

  • Can the anesthesiologist affect outcome after CABG surgery?  A study from New York (reader note: this article has been retracted)

    Can the anesthesiologist affect outcome after CABG surgery? A study from New York (reader note: this article has been retracted)

    Anesthesia care has changed significantly since that time. However, the question remains whether a subset of anesthesiologists is particularly skilled relative to a different subset. That’s the “glass half full” question. You can invert that if you prefer the “glass half empty” question. Dr. Laurent G. Glance, Department of Anesthesiology, University of Rochester School of […]

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