ANESTHESIOLOGY 2015
The annual meeting of the American Society of Anesthesiologists was held from Oct. 24 to 28 in San Diego and attracted approximately 15,000 participants from around the world, including anesthesiologists and other health care professionals. The conference featured presentations focusing on the latest advances in the relief of pain and total care of surgical patients prior to, during, and after surgery.
In one study, Karen L. Posner, Ph.D., of the University of Washington in Seattle, and colleagues found that giving patients decision aids during the pre-anesthesia clinic visit improved their engagement in discussions about their anesthesia options and improved their knowledge about regional anesthesia, better preparing them to discuss their options with their anesthesiologist.
“When patients are offered the option of regional anesthesia for their procedure or postoperative pain management, the ‘best’ choice for each individual patient depends not only on medical concerns but also on their individual preferences and how they personally balance the various risks and benefits,” Posner said. “Patients who received information about their anesthesia options during the pre-anesthesia clinic visit were more likely to engage in discussions about their anesthesia options. They also demonstrated a better understanding of regional anesthesia, including its benefits and risks.”
In another study, Elizabeth Lange, M.D., of Northwestern Memorial Hospital in Chicago, and colleagues found that magnesium may play a protective role against the development of maternal fever.
“Maternal fever, defined as a temperature greater than or equal to 100.4 degrees Fahrenheit, complicates approximately one-third of all deliveries. Maternal fever has been associated with severe adverse neonatal outcomes such as hypotonia, the need for assisted ventilation, neonatal seizures, and cerebral palsy,” Lange said. “While there are multiple etiologies of maternal fever, neuraxial labor analgesia (epidural) has been associated with a rise in maternal temperature likely due to an increase in interleukin-6, an inflammatory mediator.”
The investigators performed a retrospective cohort study to compare the incidence of maternal fever in those patients who received intrapartum magnesium with those who did not. The investigators looked at all deliveries occurring between Jan. 1, 2007, and Sept. 1, 2014, in which a maximum temperature in labor was recorded.
“Inclusion criteria were met by 62,258 deliveries. Of these, 6,173 had an intrapartum fever and 2,190 patients received intrapartum magnesium therapy,” Lange said. “There was a decreased incidence of fever in women who had received intrapartum magnesium, were preterm, or had a diagnosis of preeclampsia.”
The investigators are currently working on a prospective observational study to compare fever curves in women on magnesium therapy intrapartum and women not on magnesium, while also examining the timing and dosage of magnesium therapy in relation to these fever curves.
Alparslan Turan, M.D., of the Cleveland Clinic, and colleagues evaluated whether methylprednisolone may aid in reducing the risk of incision-site persistent pain associated with open heart surgery. The investigators evaluated 1,043 individuals who had open heart surgery, including 520 who received methylprednisolone and 523 who received placebo.
“Unfortunately, methylprednisolone did not reduce the risk of this long lasting pain,” Turan said in a statement. “While we’re not sure what causes ongoing incisional pain, we believe it’s tied to inflammation. We were hopeful the steroid would help because it’s used to treat a number of inflammatory conditions, such as arthritis and colitis.”
ASA: Peri-Op Medication Errors Far Too Common
THURSDAY, Oct. 29, 2015 (HealthDay News) — In a new study on how often medication errors occur during surgery, researchers report that mistakes were made during almost half of the operations they analyzed. The findings were published online Oct. 21 in Anesthesiology to coincide with the annual meeting of the American Society of Anesthesiologists, held from Oct. 24 to 28 in San Diego.
ASA: Surgeon’s Calming Words May Ease Stress of Surgery
WEDNESDAY, Oct. 28, 2015 (HealthDay News) — Some reassuring words from a doctor just before an operation begins may be more effective than drugs in easing patient anxiety, according to research presented at the annual meeting of the American Society of Anesthesiologists, held from Oct. 24 to 28 in San Diego.
ASA: Patients Undergoing Surgery Should Stay on Statins
WEDNESDAY, Oct. 28, 2015 (HealthDay News) — Discontinuing statins before non-cardiac surgery is unnecessary and may increase the risk of death following the operation, researchers report. The findings were to be presented at the annual meeting of the American Society of Anesthesiologists, held from Oct. 24 to 28 in San Diego.
ASA: Nitrous Oxide Deemed Safe for Surgical Patients With CVD
MONDAY, Oct. 26, 2015 (HealthDay News) — Nitrous oxide is a safe anesthetic for surgery patients who have or are at risk for cardiovascular disease, according to research scheduled to be presented at the annual meeting of the American Society of Anesthesiologists, held from Oct. 24 to 28 in San Diego.
ASA: Peri-Op Surgical Home Beneficial After Joint Arthroplasty
MONDAY, Oct. 26, 2015 (HealthDay News) — A perioperative surgical home (PSH) program improves outcomes for patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA), according to a study presented at the annual meeting of the American Society of Anesthesiologists, held from Oct. 24 to 28 in San Diego.
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