Week in review December 26-30
Myron Yaster MD
We posted the “best of” PAADs during this holiday week. We currently have over 3,000 daily reader/subscribers (Hooray!). Substack, the app we use to publish the daily PAAD, provides statistics on how many readers opened the PAAD and based on those statistics I picked the most viewed PAADs of the last year Myron Yaster MD
ABRs: Time to standardize to a propofol technique?
Myron Yaster MD and Lynne G. Maxwell MD
Original article
Ali I Kandil, Michale S Ok, Kelly A Baroch, Rajeev Subramanyam, Mohamed A Mahmoud, John J McAuliffe 3rd. Why a Propofol Infusion Should Be the Anesthetic of Choice for Auditory Brainstem Response Testing in Children. Anesth Analg. 2022 Apr 1;134(4):802-809. PMID: 35113042
“Anesthetic agent choice can significantly alter ABR interpretability. For ABR testing, propofol seems to be a preferable anesthetic choice compared to sevoflurane. Moreover, our results challenge the previously accepted notion that ABRs are very resistant to inhaled anesthetic agents such as sevoflurane”.
Toddlers and Button Batteries: A Deadly Combination
Debnath Chatterjee, MD, FAAP, and Alan Jay Schwartz, MD, MSEd
Original Publication
Chandler MD, Ilyas K, Jatana KR, et al. Pediatric Battery-Related Emergency Department Visits in the United States: 2010-2019. Pediatrics. 2022;150(3): e2022056709. PMID: 36032018.
DO NOT DELAY the case for NPO status since the risk of ongoing damage to the esophagus far outweighs the risk of pulmonary aspiration.
CO2 is good for you!
Myron Yaster MD and Jeffrey R. Gross MD
Editorial
Derek J Sakata. Carbon Dioxide as the Other Therapeutic Carrier Gas? Anesth Analg. 2022 Jul 1;135(1):60-61. PMID: 35709445
Original article
Zhijie Wu, Junjie Yu, Tianhua Zhang, Hongying Tan, Huiting Li 1, Lan Xie, Wenqian Lin, Danping Shen, Longhui Cao. Effects of Etco2 on the Minimum Alveolar Concentration of Sevoflurane that Blunts the Adrenergic Response to Surgical Incision: A Prospective, Randomized, Double-Blinded Trial. Anesth Analg. 2022 Jul 1;135(1):62-70. PMID: 34744156 1
There are many advantages to hypercapnia during a general anesthetic. Today’s article points out that it also reduces MAC and hastens wake up
How to slay a vampire: When some ideas just won’t die part 2
Myron Yaster MD and Lynn Martin MD
Original article
Ong, SY, Walker, A. Using Kotter's 8 steps of change to tackle over-fasting of children attending day surgery. Pediatr Anesth. 2022; 32: 1238- 1245. doi: 10.1111/pan.14499
The Case for Change in Clear Fluid Fasting Policy - Panel Discussion Society for Pediatric Anesthesia 36th Annual meeting. Mark Thomas, BSc MBBChir FRCA; Alexander Schmidt, MD; Sulpicio G. Soriano, III, MD, FAAP https://www2.pedsanesthesia.org/meetings/2022annual/guide/program/index.iphtml
The case for making clear fluids mandatory on arrival to the preop center on the day of surgery.
Quantitative neuromuscular blockade and implementation science: How to get anesthesiologists to “Drink the Kool-Aid”
Myron Yaster MD, Lynn D. Martin MD, MBA, Debra Faulk MD
Original article
Wade A Weigel, Barbara L Williams, Neil A Hanson, C Craig Blackmore, Randy L Johnson, Gary M Nissen, Andrew B James, Wyndam M Strodtbeck. Quantitative Neuromuscular Monitoring in Clinical Practice: A Professional Practice Change Initiative. Anesthesiology. 2022 Jun 1;136(6):901-915. PMID: 35188958
Editorial
Meghan B Lane-Fall. What Anesthesiology Has to Learn from Implementation Science and Quality Improvement. Anesthesiology. 2022 Jun 1;136(6):875-876. PMID: 35405007
Clinical and qualitative assessment of neuromuscular blockade are no better than flipping a coin. Quantitative monitoring is the gold standard. How can we get practitioners to change practice?