The physician anesthesiologist vs. CRNA debate

Why is this even a debate? It seems to me that the CRNA-led debate is financial… once you tease through all the fluff. So here’s some literature I found: Evidence-based review did NOT find nurse anesthetists’ care equal to that of physician anesthesiologists Unsupervised anesthesia care by a nurse anesthetist is a threat to patient

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Walking labor epidurals

What is an epidural? American Pregnancy Association: Epidural Anesthesia N Engl J Med 2010;362:1503-10. Epidural analgesia for labor and delivery. What is a “walking” epidural? Brigham and Women’s Anesthesiology 2 2000, Vol.92, 387. Walking with Labor Epidural Analgesia: The Impact of Bupivacaine Concentration and a Lidocaine–Epinephrine Test Dose. MJAFI, Vol. 63, No. 1, 2007. Walking Epidural :

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Mitraclip and TEE for MR

  European Heart Journal – Cardiovascular Imaging (2013) 14, 935–949.  Peri-interventional echo assessment for the MitraClip procedure.  Everest Clinical Trial results PPT Open Heart 2014;1:e000056. Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome. ASE Echo 2016: Percutaneous approaches to MR. UofMichigan PPT. 2015: The role

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Lidocaine infusions for pain

BJA Educ, April 2016. Intravenous lidocaine for acute pain: an evidence-based clinical update Lidocaine Infusion for Perioperative Pain Management – Vanderbilt Cocharane Library, July 2015. Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery. Perioperative Use of Intravenous Lidocaine. Anesthesiology 4 2017, Vol.126, 729-737. Open Access Journals, Jan 2017. Lidocaine Infusion: A Promising Therapeutic Approach for

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Methadone and acute and chronic pain management

We had a journal club where we discussed this article: Anesthesiology, May 2017; Clinical effectiveness and safety of intraoperative methadone in patients undergoing posterior spinal fusion surgery: a randomized, double-blinded, controlled trial. IV Methadone 0.2 mg/kg vs IV hydromorphone 2mg at surgical closure in 2+ level spinal fusion Decreased postop IV and opioid requirements and

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Deep Hypothermic Circulatory Arrest

Case     OpenAnesthesia.org: Cerebral ischemia: deep hypothermia SCA 2013 PBLD: Anesthetic Management for Deep Hypothermic Circulatory Arrest BJA: Deep hypothermic circulatory arrest. July 2010 JCVA: Perioperative management of deep hypothermic circulatory arrest. Aug 2010. Anaesthesia, Pain, and Intensive Care: Deep hypothermic circulatory arrest – anesthetic considerations. Aug 2016. Annals of Thoracic and Cardiovascular Surgery:

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Cardiac Surgery in a Jehovah’s Witness Patient

AVR Brief case summary Literature Search Blood Transfusion: 2011; April 9(2); 189-217.  Recommendations for the transfusion management of patients in the peri-operative period. II. The intra-operative period. BMJ Case Rep. 2012; 2012: bcr1220115403.  Aortic valve replacement in a Jehovah’s Witness: a case of multi-disciplinary clinical management for bloodless surgery. Journal of Cardiothoracic and Vascular Anesthesia,

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