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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Editor's Note Dedicated OR teams for a colorectal Enhanced Recovery after Surgery (ERAS) program at Johns Hopkins Hospital led to anesthesia providers becoming more central to the ERAS network, which increased process measure compliance and improved clinical outcomes in this study. Before the dedicated OR teams were instituted, surgeons were…

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Concern about opioid abuse has reached epic proportions in recent months, and healthcare providers have come under increasing pressure to help mitigate the problem. Curbing the tendency to overprescribe pain medications is considered the first, most obvious step, but there are other actions that can also improve patient safety. Nurse…

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Editor's Note Complete handover of intraoperative anesthesia care was significantly linked to adverse postoperative outcomes in this Canadian study. In this analysis of 313,066 adult patients having major surgery, complete intraoperative handover of anesthesia care, compared with no handover, was significantly associated with a higher risk of a composite of…

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Editor's Note A restrictive blood transfusion strategy (HGB <7.5 g/dL) was equivalent to a liberal strategy (HGB <9.5 g/dL in the OR or ICU and HGB<8.5 g/dL in the non-ICU ward) with regard to mortality and major disability in cardiac surgery patients who had a moderate-to-high risk of death, this…

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Editor's Note Electronic mandatory incident reporting system data entry and an initiative to understand and address reporting barriers and motivators were associated with sustained increases in adverse event reporting by pediatric anesthesiologists, in this study. Of 72,384 pediatric anesthetics analyzed, there were 2,689 adverse events. A subgroup of 54,469 cases…

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Editor's Note Elderly hip fracture patients were less likely to die or return to the emergency department (ED) after discharge if they received care under the Perioperative Surgical Home (PSH) model of care, finds this study presented October 21 at the Anesthesiology 2017 annual meeting in Boston. PSH patients also…

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Editor's Note Opioid use in total hip and knee patients decreased by one-third between 2006 and 2014, which reflects success in the use of a multimodal approach (ie, opioids plus additional pain management methods, such as peripheral nerve blocks and acetaminophen) to pain management, finds this study presented October 21…

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