Common side effects after anesthesia include postoperative nausea and vomiting (PONV), sore throat, shivering and headache. Postoperative nausea and vomiting gets the most press: It’s listed as a specific MeSH® (Medical Subject Headings), and over 2500 manuscripts use PONV as a MeSH term compared to fewer than 600 articles where MeSH terms include sore throat […]
The September 2013 issue of Anesthesia & Analgesia has posted. What follows are some highlights from the issue. Despite intraoperative antiemetics, some patients have refractory postoperative nausea and vomiting. Dabu-Bondoc and colleagues (“Intravenous Dextrose Administration Reduces Postoperative Antiemetic Rescue Treatment Requirements and Postanesthesia Care Unit Length of Stay”) found that patients receiving intravenous dextrose (D5LR) during […]
The article “The Cytotoxicity of Bupivacaine, Ropivacaine, and Mepivacaine on Human Chondrocytes and Cartilage” was published in this month’s issue of Anesthesia & Analgesia. Increasing evidence suggests chondrotoxic effects of local anesthetics on chondrocytes. In this work we investigated the influence of local anesthetic agents on isolated human chondrocytes, as well as on intact and […]
The Nexfin is an non-invasive monitor of of cardiac output. Does it work? How does it compare to thermodilution measured using a pulmonary artery catheter?
Cardiac output is classically measured using thermodilution, which requires a pulmonary artery catheter (PAC). Pulmonary artery catheters are invasive and, as highlighted in 2 posts last month on AA2day (post 1; post 2), have multiple risks. The Nexfin determines cardiac output by analyzing the arterial pulse contour using an inflatable finger cuff. In the article “Noninvasive […]
The American Society of Anesthesiologists advises against the routine use of a magnet over an implantable cardioverter-debrillator or pacemaker in its 2011 Practice Advisory for cardiac implantable external devices (CIEDs). Instead, the ASA advice is to interrogate the device to assess function. In this month’s issue of Anesthesia & Analgesia, the article “Use Caution When […]
Most of us use lactated Ringer’s solution for fluid therapy intraoperatively, though in some institutions the preferred solution is normal saline. Normal saline’s chloride concentration is 154 mEq/l, substantially higher than typical serum chloride concentration (100-100 mEq/l). Given saline’s higher chloride concentration, do patients who receive that solution get hyperchloremic acidosis? If they do, what […]