AAAA Reports on Annual Meeting

The AAAA 33rd Annual Meeting was held at the Hilton Clearwater Beach, FL, on April 18-22, 2009. The AAAA strongly believes that the key to any successful educational meeting should...

Go With the Flow (of O2)

A free-standing ASC where I work has recently begun using the Datascope AS 3000 gas machines. I am concerned about the gas flow controls. I am concerned that when one...

Medication Safety in the Operating Room

Cross-Contamination Via Gas Sampling Lines?

Dear Q&A, The infection control Department at our hospital raised an alert for potential ICU patient cross-contamination via the CO2 sampling tubing in the operating rooms. My understanding is that...

Dangers of Postoperative Opioids – Is There A Cure?

—SPECIAL EDITORIAL— The following article is a special editorial authored by Robert K. Stoelting, MD, APSF President, and Matthew B. Weinger, MD, APSF Secretary. This editorial addresses the continuing problem...

Reader Notes Uncommonly Large Dose of Glycopyrrolate

To the Editor Regarding the previous letter to the editor by Dr. Li in the Winter 2008-2009 issue of this Newsletter, glycopyrrolate and dexamethasone come in vials with concentrations of...

In a Specified Context, Ketamine is Non-Adrenergic and Provides Preemptive Analgesia

To the Editor Dr. Durieux’s article “Does anesthetic management affect cancer outcome?” in the winter 2008-9 APSF Newsletter was really very interesting. However, his non-contextual inclusion of ketamine as a...

A Few Suggestions for Reduction of Medication Errors

Letter to the Editor In a consumer update dated April 2008, the FDA stated that they have received reports of more than 95,000 medication errors since the year 2000.1 This...

Hydrostatic Gradient is Important – Blood Pressure Should be Corrected

To the Editor In the Summer 2007 issue of the APSF Newsletter, Cullen and Kirby described 4 instances of catastrophic neurologic outcomes after surgical procedures performed in the beach chair...

Lower Limit of Cerebral Autoregulation Questioned

To the Editor In the Summer 2007 issue of the APSF Newsletter, the editors published our communication concerning catastrophic neurologic outcomes in patients having shoulder surgery in the beach chair...

Fluid Warmers Interfere With ECG

Our hospital has recently purchased new IV fluid warmers and installed them in our operating rooms. Although the device is very effective at warming fluid, we have found that it...

Cross-Contamination Via Anesthesia Equipment?

The APSF has received numerous questions regarding cross-contamination of one patient to another via the anesthetic machine and breathing circuit. They concern the need for and efficacy of various breathing...

Intralipid Treatment of Bupicavaine Toxicity

Background Cardiac toxicity associated with overdose of intravascular injection of local anesthetic is characterized by hypotension, atrioventricular conduction delay, idioventricular rhythms, and eventual cardiovascular collapse. Although all local anesthetics potentially...

Intraoperative Hypercapnea During Thoracoscopy – A Case Report

Introduction Thoracoscopy results in less blood loss, less postoperative pain, less respiratory dysfunction, and a faster recovery than open thoracotomy. To facilitate visualization, one-lung ventilation (OLV) and carbon dioxide insufflation...

Perioperative Coronary Stent Thrombosis: A Continuing Safety Concern

Today, more patients are presenting for non-cardiac surgery (NCS) after recent placement of either Bare Metal (BMS) or Drug-eluting (DES) stents. Stent thrombosis is an infrequent but devastating complication after...

Can Processed EEG Monitoring Detect Postural Cerebral Ischemia or Cerebral Hypoperfusion?

Recent reports about unrecognized cerebral ischemia under general anesthesia are alarming,1,2 and reveal that it may start insidiously, progress covertly, and result in devastating outcomes. Although much of the emphasis...

Cerebral Oximetry May Provide Helpful Information

Perioperative neurologic injury is a devastating complication that is not always predictable, but contributes to significant morbidity, mortality, and consumption of health care dollars.1 The etiologies for stroke and neurocognitive...

Cerebral Perfusion: Err on the Side of Caution

—SPECIAL EDITORIAL— As controversy continues regarding the hemodynamic management of patients in the head-up or beach chair position, the APSF Newsletter turns to Dr. William Lanier for editorial perspective. Dr. Lanier...

Look-alike Drugs Cause Near Miss

To the Editor I would like to report two look-alike medications and make other anesthesia professionals aware of them. The medications are dexamethasone and glycopyrrolate (see figure). Last month I...

Reader is Poised to Rethink Ischemic Optic Neuropathy in Light of “POISE” Study

To the Editor Several authors presented significant pertinent information in the Spring 2008 ASPF Newsletter, which deserve consideration together as very significant interrelated themes regarding patient safety. Dr. Lehner described...