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Fluid therapy for kidney transplant surgery

January 20, 2015 By J. Lance Lichtor in Critical Care, Trauma, and Resuscitation

When you care for a patient who is undergoing a kidney transplant, what fluid do you use for maintenance? If your answer is normal saline, your fluid choice matches that of the majority of anesthesiologists in the United States. The reason for this practice, is, in part, because of the fear of causing hyperkalemia […]

Heart valve surgery and myocardial infarction treatment: does competition improve care and decrease cost? The answer is “no.”

January 16, 2015 By J. Lance Lichtor in Economics, Education, and Policy

Hospitals publish outcome data in accessible databases, including the Hospital Compare database created by the Center for Medicare and Medicaid Services. The Hospital Compare database has information about the quality of care at over 4,000 hospitals, and permits consumers to compare quality of care at different hospitals. Does access to hospital quality data lead to […]

Anesthesia for MRI

January 15, 2015 By Tal Levy in Pediatric Anesthesiology

Pediatric anesthesiologists debate the best way to anesthetize children for diagnostic radiology, particularly MRI. Although some anesthesiologists believe that there is less of a chance of postanesthetic nausea and vomiting with propofol anesthesia and less likelihood of airway complications in a spontaneously breathing patient, others feel that patients wake up faster after anesthetic gas maintenance […]

Are caudal blocks safe in children?

January 9, 2015 By Tal Levy in Pediatric Anesthesiology

The caudal block is the most commonly performed regional anesthesia technique in children. Unfortunately, there is little data available to support the safety of the procedure. The Pediatric Regional Anesthesia Network (PRAN) database was created in order to fill gaps in available knowledge about the safety of regional anesthesia in children by collecting large-scale statistics. […]

PTSD after surgery and anesthesia

January 8, 2015 By J. Lance Lichtor in Patient Safety

More than 10% of veterans who served in U.S. military operations after 9/11 suffer from PTSD. Patients who suffer awareness after anesthesia also suffer from PTSD. Up to 1.0 % of all general anesthetics are complicated by unintended intraoperative awareness with explicit recall. Dr. Elizabeth Whitlock (UCSF), Dr. Michael Avidan (Washington University), Dr. George A. Mashour (University of Michigan) […]

Ventilation of the child undergoing surgery: a review

January 7, 2015 By J. Lance Lichtor in Pediatric Anesthesiology

How should mechanical ventilation be managed for children undergoing anesthesia? In this month’s issue of Anesthesia & Analgesia, Dr. Jeffrey M. Feldman, Department of Anesthesiology, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, has reviewed current technology used to ventilate children during anesthesia in the article titled “Optimal Ventilation of […]