AA2day.org

Laparoscopic equipment safety: children and neonates

January 29, 2015 By Susan P. Taylor in Technology, Computing, and Simulation

Laparoscopic equipment, originally designed for use in adult procedures, is now widely used for pediatric and neonatal surgery. As commonly occurs in medical practice, the transition from adult to pediatric use occurs “off-label” and without further investigation into the safety and efficacy of the practice. After a number of reports of catastrophic events associated with […]

Does use of PEEP affect bleeding during functional endoscopic sinus surgery?

January 28, 2015 By J. Lance Lichtor in Ambulatory Anesthesiology

Mechanical ventilation in the operating room frequently includes application of positive end expiratory pressure (PEEP). This is done to improve intraoperative oxygen delivery, as well as to improve lung mechanics postoperatively. PEEP increases intrathoracic pressure, decreasing venous return, and potentially raising venous pressure. This raises potential concern that PEEP may increase bleeding, particularly in operations […]

Cardiac arrest: a determination using the National Anesthesia Clinical Outcomes Registry

January 27, 2015 By J. Lance Lichtor in Patient Safety

How many patients die as a result of cardiac arrest under the care of an anesthesiologist? The number is sufficiently low that we need large databases to answer the question. Many perioperative databases are composed of patients who underwent an operative procedure. Anesthesiologists provide anesthesia care for patients both inside and outside the operating room. […]

The accuracy of ETCO2 is based on nasal cannula design

January 23, 2015 By Tal Levy in Technology, Computing, and Simulation

Basic anesthesia care includes monitoring exhaled end-tidal carbon dioxide (ETCO2) concentration in patients undergoing sedation. The challenge is to measure end-tidal gas concentration through a cannula that is also tasked with delivering supplemental oxygen. In their article published in this month’s issue of Anesthesia & Analgesia titled “The Effectiveness of Oxygen Delivery and Reliability of […]

February 2015: Anesthesia & Analgesia

January 22, 2015 By Steven Shafer in This issue

The February issue of Anesthesia & Analgesia has just posted. Dr. Steven Shafer, editor-in-chief, Anesthesia & Analgesia: Nunnally and colleagues (The Incidence and Risk Factors for Perioperative Cardiac Arrest Observed in the National Anesthesia Clinical Outcomes Registry) found that the incidence of perioperative cardiac arrest was 5.6 per 10,000, based on data collected in the National […]

Levetiracetam: a case report where the drug is associated with a global decrease in transcranial electrical motor-evoked potentials

January 21, 2015 By J. Lance Lichtor in A & A Case Reports

Those who perform neurosurgical and orthopedic spine procedures know the sinking feeling when transcranial electrical motor-evoked potential (tceMEP) amplitude abruptly falls. The differential diagnosis includes hypotension, hypocapnia, hypothermia, hypoxemia, and direct surgical injury. Dr. Allan F. Simpao, Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania and The […]