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THE INDEPENDENT MONTHLY NEWSPAPER FOR ANESTHESIOLOGISTS AnesthesiologyNews.com • F e b r u a r y 2 0 1 5 • Volume 41 Number 2
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Palliative Care: Another Role For ‘Titrationologists’? New York—Perry Fine, MD, believes anesthesiologists should play a role in the delivery of palliative care. “We as anesthesiologists are perfectly aligned to spend more of our time, knowledge and skills involved with patients who are facing endoff life lif issues or are actively suffeering,” the professor of aneesthesiology at the University of Utah and strateegic advisor to Capital Caring , Washington C D.C., told the audience gathered for the R.W.
Monitor Triglycerides To Avoid Propofol Infusio New Orleans—It is disturbingly common, dangerously lethal and difficult to diagnose, yet propofol-related infusion syndrome (PRIS) may be detected before it happens, given proper vigilance by anesthesiologists. Indeed, research has found a positive correlation between the duration of propofol infusion and increasing triglyceride (TG) levels, which may indicate onset of the deadly complication. “Obviously, propofol has many beneficial properties, including rapid emergence and
see palliative page 6
see PRIS page 37
Bellevue Hospital: A Place for Teaching We reprint here an article about New York City’s iconic Bellevue Hospital that appeared in SPHERE, the quarterly publication of the New York State Society of Anesthesiologists, Inc. (2014;66[3]:13-22).We thank the authors, Drs. Mackersey and Nacht, as well as the editor of SPHERE, Jason Lok, MD.
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crooked 1919 photograph shows members of the Barnum & Bailey Circus, in the middle of an annual show in Bellevue’s garden courtyard. On an average summer evening, when New York City tempers are stretched and some citizens’ behavior is perhaps not at its best, it is easy to imagine the hijinks of the modern “performers” we treat as part of
a long Bellevue tradition. While the characters have changed and the original site has shifted, one thing has remained steadfast since 1736: “No One Is Turned Away.”1 From the curved iron railings facing First Avenue, to the stone-carved entrance sign “EMPLOYES,”2 history permeates the now-modern buildings. This history is the fascinating draw see Bellevue page 18
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see pages 7 & 26 i-gel™ from Intersurgical Inc.
PRN
One in three Americans enters a hospital malnourished, increasing adverse events.
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PAIN MEDICINE
Sensory blockade prolonged with neosaxitoxin, a paralytic shellfish toxin.
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CLINICAL ANESTHESIOLOGY
Preoperative IV ibuprofen improves recovery.
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COMMENTARY
Reducing costs and improving care are incongruent goals.
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FEATURED PRODUCT
POLICY & MANAGEMENT
The Perioperative Surgical Home envisions anesthesiologists as perioperativists.
CME: PREANESTHETIC ASSESSMENT
Lesson 314: Preoperative Assessment of the Patient for Stent Placement
ffor iPad see pages 4 and 45