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THE INDEPENDENT MONTHLY NEWSPAPER FOR ANESTHESIOLOGISTS AnesthesiologyNews.com • A p r i l 2 0 1 4 • Volume 40 Number 4
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EROS Program Hastens Post-Labor Discharge— And Moms Love It San Francisco—He may be the god of love in Greek mythology, but when it comes to elective cesarean deliveries, EROS is all business. Indeed, a British research group has found that its Enhanced Recovery in Obstetric Surgery (EROS) program significantly reduces length of stay in the hospital while keeping women satisfied with their care. The researchers stressed, however, that a multidisciplinary approach is critical to the
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he choicce to use regional anesthesia ratheer than general anesthesia for total kn nee arthroplasty correlates strongly with an anesthesiologist’s boardcertification stattus, new research shows. The study foound that, compared with their board-cerrtified counterparts, non– board-certifiedd anesthesiologists were more likely to use general anesthesia than neuraxial anestthesia or peripheral nerve blocks. A growiing body of evidence shows that neuraxial anesthesia leads to better outcomes for patients than general anesthesia in jointt replacement procedures,
see EROS page 22
see TKA page 20
Block Nurses Improve RA Care San Francisco—As regional anesthesia continues to increase in popularity, hospitals are looking for ways to improve patient care and satisfaction while streamlining the provision of nerve blocks. Enter the concept of block nursing, which helps clinicians at Thomas Jefferson University Hospital, in Philadelphia, achieve these goals with minimal disruption to existing processes. “Our surgical populations are getting older and sicker, so general anesthesia for surgery isn’t always an option,” said Bernadette Grady, BSN, a block nurse at Jefferson. “And now postoperative pain is also being controlled by regional procedures. So the concept of a regional anesthesia or block nurse is new, but as far as we’re concerned, it’s vital.”
At Jefferson, the block nurse has several responsibilities. Pre-blockk duties, both before and after surgery, if necessary, begin with setting up the room and equipment for designated blocks, including catheters, nerve stimulators, ultrasound equipment, monitoring devices, local anesthetics, relevant paperwork and emergency equipment. “Lots of patients don’t know what a block is,” said Elird Bojaxhi, MD, clinical instructor in anesthesiology at Jefferson Medical College, also in Philadelphia. “A patient new to regional anesthesia may be concerned that a block will make his or her arm numb. Therefore, see block page 29
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see page 8 X-Porte, from FujiFilm SonoSite, Incc
see pages 2 and 16
NEW ANESTHESIOLOGY NEWS iPAD APP See page 31 and scan to download
PAIN MEDICINE
A look inside the VA’s pain care program.
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CME: PREANESTHETIC ASSESSMENT
Lesson 309: Management of the Child With Emergence Delirium
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NEW & FEATURED PRODUCTS
COMMENTARY
Should the ASA spend $1 million on MD/CRNA outcomes research? Hint: This author says no.
PRN
ASA’s tool for OSA screening in children prone to false positives.