Anesthesia 
Editor's Note Children with multiple exposures to anesthesia before age 3 are more likely to develop adverse outcomes related to learning and attention, this study finds. Of 116 multiply exposed, 457 singly exposed, and 463 unexposed children included in the analysis, multiple, but not single, anesthesia exposures were associated with…
Editor's Note This population-based analysis finds that implementation of obstructive sleep apnea (OSA) interventions in total joint patients is limited, with some current trends virtually in contrast to practice guidelines. Of more than 1 million patients analyzed, anesthetic techniques did not differ by OSA status, and overall, less than 25%…
Uncertainties pepper the healthcare landscape, but the shift to value-based care is expected to continue, even though momentum may slow under the current administration. That means perioperative services leaders must continue to explore new care delivery options such as the perioperative surgical home (sidebar, p 17). “The demand for value…
Editor's Note Discharge from the postanesthesia care unit (PACU) without assessment of lower limb motor function after spinal anesthesia for total hip or knee arthroplasty did not increase length of hospital stay or readmissions but significantly reduced time in the PACU (0.40 vs 1.56 hours), this study finds. This multicenter…
Editor's Note Ketamine does not decrease delirium or lower levels of pain in older adults after major surgery and might cause harm by inducing hallucinations and nightmares, this study finds. A total of 672 patients were randomly assigned to a placebo group (222 patients), a 0.5 mg/kg ketamine group (227),…
Editor's Note The Food and Drug Administration (FDA) on April 27 issued a Safety Alert saying the agency had approved label changes on the use of general anesthetic and sedation drugs in children younger than 3 years. The changes include: A new warning that exposure to these drugs for lengthy…
Editor's Note The combination of femoral and sciatic nerve blocks is the overall best approach to pain management after total knee arthroplasty, finds this meta-analysis. The best five modalities for pain at rest were: femoral/obturator, femoral/sciatic/obturator, lumbar plexus/sciatic, femoral/sciatic, and fascia iliaca compartment blocks. For reducing opioid consumption, the best…
Editor's Note Conscious sedation is a safe and viable option for anesthesia in patients having transcatheter aortic valve replacement (TAVR), finds this study. The use of conscious sedation rather than general anesthesia was associated with: similar rates of adverse events (1.5% in both groups) shortened ICU (30 vs 96 hours)…
Editor's Note Non-OR anesthesia (NORA) is a growing component of anesthesiology practice in the US, this study finds. The proportion of NORA cases overall increased from 28.3% in 2010 to 35.9% in 2014, and the proportion of NORA outpatient cases increased from 69.7% to 73.3%. Colonoscopy was the most common…
Editor's Note Opting out of the Medicare rule that requires anesthesia to be administered with physician supervision has little or no effect on access to inpatient or outpatient surgery, this study finds. The researchers also found that opting out does not reduce costs, and in fact increases costs for inpatient…
