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Local anesthetic given pre-surgery can help improve breast cancer survival
Patients with breast cancer who received 0.5% lidocaine around all tumour surfaces after giving general anesthesia had 86.6% disease-free survival at 5 years compared to 82.6% in those who did not receive this injection. Overall survival rates were 90.1% vs 86.4%, as per a study. This one-time peritumoral injection is also believed to have pro-metastatic effects.
MedicalBrief
Doctor arrested for starting meningitis outbreak in Mexico
An anesthesiologist is accused of using infected medicines that could be the reason for the mysterious meningitis outbreak in Durango state. The outbreak caused over 35 deaths and 79 hospitalizations. The infected patients are believed to be affected by fungal meningitis while they were getting procedures done by the doctor who performed them without following regulations.
VOA News
Cutting down on anesthetics can help reduce climate changes
An expert anesthesiologist recommended doctors lower their use of anesthetic gases to fight climate change. He added that no matter how tiny the positive effect of reducing anesthetic gas use, it would add up to the efforts to mitigate global warming. Small changes in such daily practices without affecting patients' comfort could account for 0.1% reduction in carbon emissions.
New York Post
New guidelines for managing perioperative pain in cannabis users
The ASRA strongly recommends universal screening for cannabinoids for all patients before surgery, postponing surgery for patients with altered mental status due to cannabis intoxication, counselling heavy and frequent cannabis users about the adverse effects of cannabis on postoperative pain management, and educating pregnant women about the dangers of maternal cannabis use.
American Society of Regional Anesthesia and Pain Medicine
Using excess oxygen during surgery could cause organ injury
Supplemental oxygen given to patients under general anesthesia during surgeries when given excess at 75th centile can increase the risk of acute kidney injury by 26%, lung injury by 14%, and myocardial injury compared to 25th centile excess oxygen, according to a study. Excess oxygen also increased the risk of stroke by 9% and 30-day mortality by 6%.
Newswise
Anesthesiologist tampers with IV bags to cause the death of a patient
Dr Raynaldo Ortiz Jr. reportedly injected a nerve-blocking agent, bupivacaine, and other drugs into IV bags meant for another sick doctor, who died after self-administering the saline at home in June. The accused repeated similar actions on an 18-year-old patient who suffered a cardiac emergency while in surgery in August. Federal authorities arrested him on criminal charges.
D Magazine
A case of subacute degeneration associated with the use of nitrous oxide
A 32-year-old man presented to a hospital with a 2- and a 6-week history of inability to walk and tingling in arms and legs. MRI of the spine revealed hyperintensity in the posterior spinal cord from C1 to T12 and hyperintense lesions in the dorsal column. Based on the clinical findings, he was diagnosed with subacute combined degeneration linked with nitrous oxide use.
Twitter @NEJM
Etomidate shows fewer postoperative complications in older adults than propofol
Anaesthesia using intravenous etomidate did not raise the overall major in-hospital morbidity following abdominal operation in older patients, compared to propofol, according to a study. However, patients who received etomidate anaesthesia had transient adrenocortical suppression and an increased risk of developing pneumonia than patients who received propofol.
Twitter @JAMASurgery
A drug risk factor in people on life support identified
The commonly used anaesthetic agent, propofol, is strongly linked with an increased incidence of severe hypotension and cardiac arrest after intubation in critically ill patients, as per the Global ICU study. Further studies will be performed to develop and test alternative strategies to reduce the risk of CVD adverse events in patients needing urgent tracheal intubation.
National University of Ireland
Overlapping anesthesiologist responsibilities could increase patient mortality
Anesthesiologists supervising 3-4 overlapping surgeries were linked to a 14% relative rise in composite risk-adjusted patient mortality and morbidity compared to anesthesiologists covering 1-2 overlapping surgeries, according to a study. The study findings suggest hospitals consider the effects of perioperative team staffing ratios in clinical coverage efforts.
Twitter @JAMASurgery
