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THE INDEPENDENT MONTHLY NEWSPAPER FOR ANESTHESIOLOGISTS AnesthesiologyNews.com • J u n e 2 0 1 3 • Volume 39 Number 6
Liver Transplant Anesthesia Guidelines A ‘Landmark’
Marathon Bombing Put Local Anesthetists to Grim Test
xperts are applauding new recommendations for the administration of anesthesia during liver transplant surgery that offer formal recognition that anesthesiologists are critical to optimizing transplant patient care. The document, from the Organ Procurement and Transplant Network (OPTN)/United Network for Organ Sharing (UNOS), set qualification requirements for directors of liver transplant anesthesia. “The recommendations are really a landmark development in
Boston—Anesthesiologists who treated victims of the Boston Marathon bombing in April could not bring themselves to find a silver lining. Terrorist attacks have no silver linings. But the clinicians who spoke with Anesthesiology Newss about their experiences allowed that if such an event were to happen, it could not have happened in a better place at a better time or in better weather. The finish line where the twin bombs exploded is within two miles of five worldclass trauma centers. The attack took place just before 3 p.m., shift change time at most of the hospitals, so many workers were just arriving while the previous shift was still on duty or nearby. It was Patriots’ Day,
see organs page 18
see Boston page 25
E
Breathing for Two: A Life in Anesthesiology
Drug shortages and medication errors a bad mix.
10 | PAIN MEDICINE Sternotomy pain after CABG can sap daily living.
I
EDUCATIONAL REVIEW
Perioperative Approach to Patients With Opioid Abuse and Tolerance, see insert at page 14.
16 | CLINICAL ANESTHESIOLOGY Common colds pose uncommon problems in pediatric heart surgery.
The second Viking term was fey, and this was new to me. Here is what Sandlin wrote: People now understand [ fey] to mean effeminate. Previously it meant odd, and before that uncanny, see breathing page 6
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INSIDE 08 | PRN
The following is the third in a three-part - t installment of excerpts from Breathing for Two, o 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. once read an essay titled “Losing the War” whose relevance will become apparent shortly. The author, Lee Sandlin, was writing about the psychology of war. The essay appeared in the Chicago Readerr in March 1997. In his essay, Sandlin proposed that the mindset of war could be best explained by two Viking terms. The first term was berserker, familiar to me as a man in battle who killed without restraint.
REUTERS/Jessica Rinaldi
Accompanies this issue
CME: PREANESTHETIC ASSESSMENT Lesson 304: Perioperative Pain Management Of the Patient With Chronic Pain—Part 1, see page 20.