Editor's Note The Perioperative Surgical Home (PSH) model of care was successful in improving quality of care and outcomes in elderly hip fracture patients and children having cardiac surgery in two studies presented October 14 at the Anesthesiology 2018 annual meeting in San Francisco. One study compared 308 hip fracture…

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Editor's Note In this study, the composition of the anesthesia care team (anesthesiologist plus nurse anesthetist or anesthesiologist assistant) was not associated with any significant differences in mortality, length of stay, or inpatient spending. Of 443,098 Medicare beneficiaries who had inpatient surgery between 2004 and 2011, the adjusted mortality for…

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Editor's Note The Society of Anesthesia and Sleep Medicine (SASM) has issued a new guideline on Intraoperative Management of Adult Patients with Obstructive Sleep Apnea (OSA). Specific aims of the guideline are to: evaluate considerations of difficult airway management in patients with OSA assess the impact of anesthesia-related drugs and…

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Editor's Note In cardiac surgery patients at moderate-to-high risk for death, a restrictive strategy for red blood cell (RBC) transfusion was equivalent to a liberal strategy, with respect to death from any cause, myocardial infarction, stroke, or renal failure, at 6-months follow-up, this study finds. There also were no significant…

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Editor's Note In this study, no benefit of hypnosis before general anesthesia was found on postoperative pain, but it had other benefits, such as less fatigue and anxiety (especially in patients who thought they received hypnosis, but did not) and higher patient satisfaction scores. A total of 150 women having…

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Editor's Note A blood management program at Johns Hopkins using a hemoglobin transfusion threshold of 7 g/dl in orthopedic surgical patients reduced blood use by 32.5% and resulted in similar or improved outcomes. Improved outcomes were primarily in patients 65 years of age or older. For this study, researchers evaluated…

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Editor's Note In this study, researchers at UCLA Medical Center in Los Angeles applied machine learning to arterial pressure waveforms to develop an algorithm that predicted intraoperative hypotension 15 minutes before it occurred in 84% of cases. Two sets of data were used to build the algorithm. One set consisted…

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Editor's Note Contrary to what some studies are suggesting, use of the local anesthetic liposomal bupivacaine as part of a multimodal approach to postoperative pain did not reduce in-hospital opioid use or opioid-related complications after total knee arthroplasty (TKA) in this study. Researchers analyzed data on 88,830 TKAs performed with…

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Editor's Note The American Society of Anesthesiologists (ASA) on April 25 reported that a national drug shortage of injectable opioids and local anesthetics is negatively affecting care received by patients under anesthesia. An informal survey of 2,500 ASA members, found that 98% are now experiencing drug shortages at their institutions,…

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Editor's Note This study from the Mayo Clinic of children undergoing general anesthesia before age 3 supports earlier findings of no significant impact on intelligence. However, multiple exposures may be tied to behavioral or learning difficulties. In this analysis of 997 children (411 unexposed, 380 singly exposed, 206 multiply exposed)…

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