In this issue:

Opioid Prescribing: Methadone Risk Mitigation

A Sad Parting: Patient Safety Pioneer Ellison C. Pierce, Jr., MD

Improving Patient Safety in the Office: The Institute for Safety in Office-Based Surgery

Risks of Anesthesia Care in Remote Locations

Dear SIRS: Wires Block APL Valve Interfering with Ventilation

Avoiding Catastrophic Complications from Epidural Steroid Injections

Q&A: Validity of Using Pulse Oximeter to Detect Adequate Blood Flow to Lower Extremity Questioned

Opioid Prescribing: REMS Sleep, Need Reawakening

Letter to the Editor:

Breathing Bag has
Faulty Connection


Archives of Past Issues
Sponsorship Opportunities
Corporate Donors

Anesthesia Patient Safety Foundation Officers, Directors, and Committees, 2011

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—Featured Article—

Opioid Prescribing: Methadone Risk Mitigation

by Joan M. Christie, MD

Methadone is a synthetic opioid with an exceptionally prolonged elimination half-life. It is modestly priced and has a unique ability among opiates to block NMDA receptors, leading to a resurgence in its use for chronic pain.1 In 2007, for example, over 4 million prescriptions were issued for methadone, most for chronic, non-malignant pain. Even though it has an association with torsades de pointes ventricular tachycardia, methadone has been dubbed the “darling of the pain management community.”. . .[more]


A Sad Parting:

Patient Safety Pioneer Ellison C. Pierce, Jr., MD...[more]


Improving Patient Safety in the Office: The Institute for Safety in Office-Based Surgery... [more]






The Official Journal of the Anesthesia Patient Safety Foundation

The Anesthesia Patient Safety Foundation Newsletter is the official publication of the nonprofit Anesthesia Patient Safety Foundation and is published quarterly in Wilmington, Delaware. Annual contributor cost: Individual–$100, Corporate–$500. This and any additional contributions to the Foundation are tax deductible.  © Copyright, Anesthesia Patient Safety Foundation, 2011.

The opinions expressed in this Newsletter are not necessarily those of the Anesthesia Patient Safety Foundation. The APSF neither writes nor promulgates standards, and the opinions expressed herein should not be construed to constitute practice standards or practice parameters. Validity of opinions presented, drug dosages, accuracy, and completeness of content are not guaranteed by the APSF.

APSF Executive Committee:

Robert K. Stoelting, MD, President; Nassib G. Chamoun, Vice President; Jeffrey B. Cooper, PhD, Executive Vice President; George A. Schapiro, Executive Vice President; Matthew B. Weinger, MD, Secretary; Casey D. Blitt, MD, Treasurer; Sorin J. Brull, MD; Robert A. Caplan, MD; David M. Gaba, MD; Patricia A. Kapur, MD; Lorri A. Lee, MD; Robert C. Morell, MD; A. William Paulsen, PhD; Richard C. Prielipp, MD; Steven R. Sanford, JD; Mark A. Warner, MD. Consultants to the Executive Committee: John H. Eichhorn, MD; Maria Magro, CRNA, MS, MSN.

Newsletter Editorial Board:

Robert C. Morell, MD, Co-Editor; Lorri A. Lee, MD, Co-Editor; Sorin J. Brull, MD; Joan Christie, MD; Jan Ehrenwerth, MD; John H. Eichhorn, MD; Susan R. Fossum, RN; Steven B. Greenberg, MD; Rodney C. Lester, PhD, CRNA; Glenn S. Murphy, MD; Karen Posner, PhD; Andrew F. Smith, MRCP, FRCA; Wilson Somerville, PhD; Jeffery Vender, MD.

Address all general, contributor, and subscription correspondence to:

Administrator, Deanna Walker
Anesthesia Patient Safety Foundation
Building One, Suite Two
8007 South Meridian Street
Indianapolis, IN 46217-2922
e-mail address:
FAX: (317) 888-1482

Address Newsletter editorial comments, questions, letters, and suggestions to:

Robert C. Morell, MD
Co-Editor, APSF Newsletter
c/o Addie Larimore, Editorial Assistant
Department of Anesthesiology
Wake Forest University School of Medicine
9th Floor CSB
Medical Center Boulevard
Winston-Salem, NC 27157-1009