Journal of clinical anesthesia
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Comparative Study
Medicare payment trends compared to inflation for anesthesia services.
Identify changes and trends in the real value of Medicare payments for anesthesia services between 2000 and 2020 and how it may affect practices. ⋯ Average Medicare payment for common anesthesia services after adjusting for inflation have decreased from 2000 to 2020, consistent with findings in other physician specialties. Understanding these trends is important for practice viability and suggests significant financial implications for anesthesia practices and hospitals if the trend were to continue.
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Sugammadex, a selective steroidal neuromuscular blocking agent reversal agent, is increasingly employed for the rapid restoration of neuromuscular function. This study aimed to conduct a comprehensive evaluation of sugammadex's safety profile. ⋯ The study identified unexpected and potentially life-threatening AEs associated with sugammadex, a valuable agent for rapidly reversing neuromuscular blockade. Clinicians are advised to be mindful of these potential risks, particularly in patients with allergies or existing cardiovascular or respiratory conditions.
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The hemodynamic assessment of patients with left ventricular assist devices (LVAD) using noninvasive blood pressure (NIBP) monitoring may be unreliable without pulsatile blood flow. The primary goal of this study is to examine the association between intraoperative blood pressure monitoring gaps of 10 min or greater and LVAD type in patients undergoing noncardiac surgeries with NIBP monitors at induction. ⋯ Patients with a HM2 undergoing noncardiac surgery had nearly three-fold higher odds of blood pressure monitoring gaps of 10 min or greater compared to patients with a HM3. Morbid obesity and prolonged surgical duration were also associated with a significant increase in monitoring gaps. Morbid obesity, general anesthesia, and longer surgical duration were found to have a greater odds of arterial line placement after induction. These results may help anesthesiologists determine the appropriateness of NIBP in patients with LVADs undergoing noncardiac surgeries.
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To determine the association of practitioner dashboard feedback of intraoperative glycemic and temperature control on maintenance of normoglycemia and normothermia. ⋯ Individualized practitioner dashboard distribution may be an effective tool to increase intraoperative glycemic control.