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The Independent Monthly Newspaper for Anesthesiologists AnesthesiologyNews.com • A p r i l 2 0 1 3 • Volume 39 Number 4
Focus on Anemia May Alter Transfusion Practices New York—Blood transfusions have been among the most commonly performed invasive procedures in the United States, with a significant percentage occurring perioperatively to treat anemia. Now, there is a movement within anesthesiology to change the way anemia is managed in patients undergoing elective surgery. During a session at the 2012 PostGraduate Assembly in Anesthesiology (PGA), a panel of blood conservation specialists
Doctor Group Claims Drug Purchasing Organizations Causing Chronic Shortages
F
rustrated with ongoing shortages of key drugs, a new grassroots group led by anesthesiologists is calling for the repeal of federal legislation that permits group purchasing organizations (GPOs) to engage in what they call collusive and anticompetitive activities. Several senior U.S. lawmakers have asked the Government Accountability Office (GAO), the investigative arm of Congress, to look into the allegations that GPOs are at least partly responsible for the nation’s drug shortages.
see transfuse page 22
see shortage page 16
Breathing for Two: a Life in Anesthesiology The following is the first in a three-part installment of excerpts from Breathing for Two, a new memoir on a career in anesthesiology, by Wolf Pascoe (a pen name). The book is available at http:// www.amazon.com/dp/1939803012 and wolfpascoe.com.
W
hen I was in medical school, I heard about a curious malady called Ondine’s curse. It was a breathing disorder, and the professor had casually mentioned it during a lecture on the mechanics of breathing—an afterthought, more or less.
Gustav Klimt’s Ondines
New Product
Featured Products
3M™ SpotOn™ Temperature Monitoring System from Arizant Healthcare Inc., a 3M company, see pages 24 and 34.
Arrow FlexBlock Echogenic cPNB Catheter from Teleflex, see pages 21 and 38.
“Who was Ondine?” someone asked. The professor didn’t know. Who coined the name? It was an anesthesiologist who had observed it in patients with injuries to the respiratory center—the part of the brain that controls breathing. “What’s the cure?” someone else said. “There isn’t one.” You hear about many disorders when you’re in medical school, of course. Some you think about a lot. Some you even begin to think you have, but usually you get over it.
NAROPIN® from Fresenius Kabi USA, LLC, see pages 22 and 25.
see breathing page 34
INside
08 | COMMENTARY Meta-headache: How the Boldt scandal complicates studies of fluid treatment.
13 | Pain Medicine Inside the Comprehensive Pain Center of Sarasota.
26 | CLinical Anesthesiology Improving ICU transfer after heart surgery.
33 | Ad LIB Ancient texts trip up would-be diagnosticians.
Educational Review
Regional Anesthesia for Ambulatory Surgery: The Ideal Technique for a Growing Practice see insert at page 20.
CME: PreAnesthetic Assessment
Lesson 303: PreAnesthetic Assessment of the Patient with Cirrhosis-Related Pulmonary Complications, see page 28.