Cell Salvage for Obstetric Hemorrhage

“Historically, implementation of cell salvage in obstetrics has been limited by concerns regarding maternal alloimmunization requiring additional Rho(D) immune globulin administration in Rh-negative mothers and a concern for amniotic fluid embolism, although there has only been one case report suggesting a potential link between amniotic fluid embolism after cell salvage”.

This study finds it cost effective only in high risk cases  Anesthesiology link

Weekly Medical News

Vitamin D is not of any proven value in MS prevention FDA

Bariatric surgery (from JAMA Issue) improves everything and sleeve gastrectomy fairly equivalent to Roux-en-Y except for higher GERD Medscape

Diclectin (Diclegis) of questionable benefit in pregnancy nausea and vomiting Link

Lactation duration may lower diabetes risk link

Calcium and Vitamin D don’t lower fracture risk in community dwelling older adults JAMA link

Steroids for ventilated septic shock patients did not decrease mortality NEJM link

Duration of opioids and refills more important than dose after surgery BMJ link

Patients prefer surgery for acute appendicitis rather than antibiotics. JAMA link

0.08% Alcohol legal limit too high, 0.05% recommended link

Buprenorphine perioperatively

Probably continue for less painful surgery and stop for major surgery, replacing with oral opioids, anticipating the need for higher dose opioids in a monitored setting. Multimodal analgesia techniques – PCA, acetaminophen, NSAIDs, regional techniques, gabapentinoids, Ketamine, Dexmedetomidine. Liaison with addiction specialist is advised

Anesthesiology article

Now if someone had their extended release Naltrexone there’s another conundrum!

periop Naltrexone