2011
Buyer’s Guide Summer/Fall
accompanies this issue
The Independent Monthly Newspaper for Anesthesiologists AnesthesiologyNews.com • J u n e 2 0 1 1 • Volume 37 Number 6
More Evidence One Size of Anesthesia Doesn’t Fit All
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or women at risk for pain and depression in the months following a cesarean delivery, adding more pain medicine during the operation may help, according to a small study presented at the annual meeting of the Society for Obstetric Anesthesia and Perinatology (SOAP).
ACE Inhibitors Before Surgery May Do No Harm
T
see dose page 16
aking angiotensin-converting enzyme inhibitors until the day of surgery may pose fewer risks than doctors have feared—and may even provide some benefit, according to a new study. Researchers at Toronto General Hospital used data from more than 61,000 patients to compare people who took ACE inhibitors with those who did not, and found that being on the blood pressure medication long-term leading up to noncardiac surgery was associated with lower 30-day mortality. When they looked more closely at the ACE inhibitor group, they found that those who chose to stop taking the drugs a few days prior to surgery, and delayed restarting it, fared no better than those who took the drug up to the morning of the procedure, and resumed once they were stable. “Maintaining ACE inhibitors prior to surgery might be of some benefit,” said study author Jason Toppin, MD. “And they see ACE page 20
INside
Anesthesia Billing Cases Allege Rampant Fraud
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New York anesthesiologist is the driving figure behind a pair of lawsuits involving millions of dollars in what he claims are fraudulent anesthesia billing claims. The physician, Berton Forman, MD, and his lawyers allege that for years hospitals have been dramatically overcharging patients for anesthesia services—doubling or tripling bills and even charging for general anesthesia when none was provided. Dr. Forman says the scope of the fraud could total more than $1 billion nationally.
08 | Pain Medicine Experts debate nerve blocks for patients with chronic pain.
Meanwhile, Dr. Forman, who stands to make millions should he win the suits, said a major insurer for whom he conducted a fraud inquiry to detect precisely such misconduct failed to act on his findings out of fear that it would lose the business of preferred provider organizations (PPOs). These companies act as middlemen between physicians and insurers and, according to Dr. Forman, force the latter to sign contracts that prevent them providers in the network, savings from carefully auditing claims. In that in theory they can pass along return, insurers receive discounts, to plan members. see suits page 30 ranging from 10% to 35%, from
Newproduct
XPREZZON from Spacelabs Healthcare, see pages 5 &16.
19 | CLinical Anesthesiology For cesarean deliveries: catheter dosing needs less than single shots.
22 | CLinical Anesthesiology Studies probe anesthesia-brain risk in peds.
34 | COMMENTARY ACO angst? The cure for what ails.
25 | CME—PreAnesthetic Assessment Lesson 292: PreAnesthetic Assessment Of the Patient With Mucopolysaccharidosis
McMahonMedicalBooks.com
Basics of Anesthesia: with Evolve Website: 5th edition Robert K. Stoelting, MD, Ronald D. Miller, MD
see page 29
Featuredproduct Specialreport
SonoPlex from Pajunk Medical Systems, see page10.
Multimodal Management of Acute Pain: The Role of IV NSAIDs, see insert at page 18.