Delirium is defined as an acute cognitive decline in the form of inattention, disorganized thinking, and fluctuating mental status. It is seen most often in elderly hospitalized patients, especially those who are critically ill. A separate varietal, emergence delirium, is…
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Perioperative Surgical Home
The perioperative surgical home (PSH) model is a novel treatment paradigm in which the anesthesiologist serves as the coordinator of care from the preoperative to perioperative phase. In effect, the PSH model aims to increase efficiency in the care continuum…
Expanesthetics: Bringing Anesthesia Research to Venture Capitalism
There are anesthesia providers who recall using ether and halothane anesthetics, agents largely unheard of in American operating rooms today. Newer agents with fewer negative side effects and superior pharmacokinetic profiles have all but replaced them, each in its turn…
Pain Management After Cesarean Delivery
Cesarean delivery is the most commonly performed major surgery in the country. Effective postoperative pain management is of foremost concern for patients, and should be achieved through a multimodal approach. Potential complications for poor pain control in the immediate postoperative…
State Patient Compensation Funds for Medical Malpractice
Speciality-wide, anesthesiologists continue to report among the highest number of medical malpractice claims, with an average paid indemnity of $130,959 and an average defense cost of $40,724.[1] Of the claims submitted against anesthesiologists, roughly half can be attributed to a…
Enhanced Recovery After Surgery
Initiated in the 1990s, the Enhanced Recovery After Surgery (ERAS) protocol is an interdisciplinary, multimodal, and evidence-based approach to the perioperative management of patients undergoing major surgery. The protocol has been shown to reduce hospital stay and post-operative complications, resulting…
Nitrous Oxide for Labor Analgesia
Inhaled nitrous oxide has been used for labor analgesia since the late 1800s. It is not a potent labor analgesic, but it can provide effective pain relief and is safe for pregnant women, their newborns, and health care workers. Nitrous…
Anesthesia for Tonsillectomy
Tonsillectomy and adenoidectomy is a common procedure in pediatric anesthesia, and occasionally in adult anesthesia. It is unfortunately also associated with an increased risk of morbidity and mortality due to both patient population and surgical complications. Anesthetic technique can significantly…
Discerning a Patient’s Potential for Non-Medical Use of Opioids
The United States is experiencing an increase of opioid related deaths, driven by high rates of prescription, high prescription dosages, and high rates of opioid use and misuse.[1] The National Institute on Drug Abuse reported that 2.6 million Americans over…
Sharps Safety
Sharps related injuries are especially common in the perioperative setting. Anesthesia providers, perioperative nurses, and surgical staff are at particular risk for sustaining injuries from sharp instruments, given their need to administer medications, draw samples of blood and bodily fluid,…