Consider Using Ketamine When Appropriate—If Managed Carefully, the Benefits will Usually Outweigh the Potential Side Effects Elizabeth E. Costello MD In 1970, 8 years after it was first synthesized, ketamine…
Consider Chloroprocaine for Regional Blockade When Appropriate—It Is a Rapid-Onset Local Anesthetic with Low Systemic Toxicity Joshua M. Zimmerman MD Randal O. Dull MD, PhD 2-Chloroprocaine is an ester local…
Consider Perioperative Clonidine Administration—it Has Anxiolytic, Antiemetic, and Analgesic Properties Bryan J. Fritz MD Shashank Saxena MD Clonidine, originally introduced clinically as a nasal decongestant and subsequently used as a…
Use Bicarbonate as A Buffer to Local Anesthetics, Especially for Skin Infiltration Hooman Rastegar Fassaei MD Steven L. Orebaugh MD Local anesthetics reversibly block impulse conduction along nerve axons and…
Remember that the Unthinkable is Possible—Follow These Principles in the Evaluation and Treatment of Patients Suffering from Nerve Agent Poisoning Daniel J. Bochicchio MD, FCCP It’s rush hour on a…
Acknowledge the Complex Medical and Legal Issues Surrounding Off-Label Drug Use Angela M. Pennell MD Imagine this scene: Your healthy, 5-year-old patient has just emerged from anesthesia after a routine,…
Be Aware that Many Drugs Commonly Given in the Perioperative Period Have Significant P-Glycoprotein Transport Pump Activity Neil B. Sandson MD In today’s medical climate, the anesthesiologist must be prepared…
Remember that Administration of Angiotensin System Inhibitors within 10 Hours Before Surgery Is A Significant Independent Risk Factor for Hypotension in the Postinduction Period* Thomas B. O. Comfere MD Juraj…
Stop Metformin before Elective Surgery or Intravascular Contrast Dye Study to Decrease the Risk of Lactic Acidosis Serge Jabbour MD, FACP, FACE Michael J. Moritz MD Metformin is an insulin-sensitizing…
Consider Insulin Therapy to Correct Perioperative Hyperglycemia in both Diabetic and Nondiabetic Patients Heather A. Abernethy MD Serge Jabbour MD, FACP, FACE Outcome studies have shown evidence of an association…
