Anesthesia E-ssential January 30, 2013

Anesthesia E-ssential

January 30, 2013 

Vital Signs

Medicare Carriers Implementing Access to CRNA Pain Care Rule
Medicare administrative contractors (MACs) are implementing the Medicare patient access to CRNA pain care rule that took effect Jan. 1, 2013. The AANA has been in communication with MACs to ensure that they have accurate information about CRNA scope of practice in states, so that those Medicare services provided by CRNAs can be reimbursed accurately by Medicare. However, it is important for CRNAs to help keep the AANA apprised of developments on Medicare reimbursement for chronic pain management services, as well as anesthesia and other services CRNAs provide. If your practice sees an unusual change in Medicare reimbursement, please email and include Medicare Reimbursement in the subject line, and spell out your issue as thoroughly as you can. An AANA Washington office team member will be back in touch with you.


The Pulse

Inside the Association
Hot Topics
  • Share Your National Nurse Anesthetists Week Successes
  • Mark your calendar for the Assembly of School Faculty
  • AANA, Lifebox, and Social Responsibility
  • Studying for the Journal Course #32 Examination and Evaluation?
State Government Affairs
  • Upcoming Webinar: State Grassroots 
Foundation and Research News
  • Attention Students: Applications Now Available
  • Call for Talent
  • AANA Foundation Asks...What to Do with those Annual Meeting Napkins
Professional Practice
  • Medication Errors from Injectable Drugs Harm 1 Million Inpatients Each Year Adding Billions in Cost, New Study Finds
Federal Government Affairs
  • AANA Makes CRNA Voices Heard at Inaugural
  • Healthcare in the President’s Inaugural Address
  • More Changes to Washington’s Healthcare Leadership Lineup
  • Answer the Call to Care to be Counted
  • HHS Releases Guidance on State Partnership Exchange
  • Website Updated
  • Opportunities with the National Institute of Nursing Research
  • Name Your State Reimbursement Director

Healthcare Headlines

Healthcare Headlines is for informational purposes, and its content should not be interpreted as endorsements, standards of care, or position statements of the American Association of Nurse Anesthetists.

Inside the Association

Hot Topics

Share Your National Nurse Anesthetists Week Successes
Now that National Nurse Anesthetists Week (NAW) 2013 is in the books, please take a moment to share your creativity, experiences, press clips, etc., with the AANA PR Department at Submissions will be posted on the AANA website here. Photos are always welcome! Good promotional ideas are meant to be shared so others can adapt them for their own use to promote nurse anesthesia throughout the year and during NAW 2014.
Mark your calendar for the Assembly of School Faculty
Feb. 21-23, 2013 at the JW Marriott Starr Pass Resort and Spa in Tucson
This year’s theme, “Information, Collaboration and Transformation in Education” will include insights into integrity and ethics in academia, whether programs really need rural clinical sites, how to teach students the economics of nurse anesthesia practice, developing a pain management curriculum, financial options for doctoral education, teaching health informatics, using electronic portfolios to document professional growth and more. In addition, the AANA Education Committee will be holding a hearing on the final first draft of the COA’s Practice Doctorate Standards for Nurse Anesthesia Programs. Click here to register.

AANA, Lifebox, and Social Responsibility
In 2012 the AANA joined with interprofessional societies worldwide to support safer surgery by endorsing Lifebox as a social responsibility focus. Unsafe surgery is recognized as a public health concern that results in more adverse outcomes than childbirth complications or any infectious disease cause. Use of audible pulse oximetry to monitor every surgical patient has been shown to reduce surgical risk. The Lifebox oximeter is not like other inexpensive models that line the shelves of developing country ORs in disrepair. Instead, it was designed for durable use in the developing world and comes with a multilingual teaching DVD, long-acting rechargeable battery pack, and available technical support. See this page to learn more about how the AANA and Lifebox missions for patient safety are aligned and a link donate.

Studying for the Journal Course #32 Examination and Evaluation?
The AANA has gathered the Journal Courses into a single page where you can go to download them in preparation for taking the Journal Course Exam. Check out our handy Study Page! 


State Government Affairs 

Upcoming Webinar: State Grassroots
Register now to attend the “State Grassroots” webinar on February 26, presented by the AANA Government Relations Committee and the AANA State Government Affairs Division. Mobilizing CRNAs for grassroots efforts in the states is more important than ever. Learn how to activate members, or how you yourself can get involved and help with your state’s grassroots efforts. Information will include how to build relationships with legislators and elected officials, and appropriate etiquette and information for making a positive impression. To register, go to


Foundation and Research News

Attention Students: Applications Now Available
The AANA Foundation is pleased to continue its 30+ year history of funding research and education to advance the science of anesthesia. The following applications are currently available on the AANA Foundation website (
  • Nurse Anesthesia Student Scholarships – Deadline: April 1, 2013
  • “State of the Science” Oral Poster Presentation Application – Deadline: April 1, 2013
  • “State of the Science” General Poster Presentation Application – Deadline: May 1, 2013
  • Dean Hayden Student Research Scholarship Application – Deadline: April 1, 2013
  • AANA Foundation Board Student Representative – Deadline: March 1, 2013
Contact the AANA Foundation at (847) 655-1170 or if you have any questions.
Call for Talent
Vegas – The Stars Come Out at Night
The AANA Foundation is planning a fabulous and fun event to take place on Monday, Aug. 12, 2013, at the AANA Annual Meeting. Comedian and actor Kenan Thompson will be our emcee, and CRNAs and student registered nurse anesthetists (SRNAs) from across the country will be showcasing their talent and creativity, competing for fabulous prizes, and supporting the AANA Foundation’s mission of advancing the science of anesthesia through education and research. If you, or a group with at least one CRNA or SRNA, have a talent you’d like to share, submit a Talent Application today. Visit our event webpage to learn more about the event and access the application. If you have any questions, please contact Luanne Irvin at the AANA Foundation at (847) 655-1173 or
AANA Foundation asks…What to Do with Those AANA Annual Meeting Banquet Napkins?
AANA Foundation volunteer Lynn Lebeck, CRNA, PhD, is ready and willing to create a quilt made using AANA Annual Meeting banquet napkins. Plans will be to auction this quilt at an upcoming AANA Annual Meeting with proceeds benefiting the AANA Foundation. If you have banquet napkins from past Annual Meetings that you are willing to donate, please send them to the AANA Foundation, 222 S. Prospect Avenue, Park Ridge, IL 60068.


Professional Practice

Medication Errors from Injectable Drugs Harm 1 Million Inpatients Each Year Adding Billions in Cost, New Study Finds
A recent study, published in the peer-reviewed journal American Health & Drug Benefits, reveals the significant national burden that harmful medication errors, also called preventable adverse drug events (ADEs), associated with injectable medications have on hospitals, patients, and our healthcare system. Results show that preventable ADEs associated with injectable medications cost an average of $600,000 per hospital annually and impact more than 1 million patient hospitalizations each year. Read the study in its entirety here.


Federal Government Affairs

AANA Makes CRNA Voices Heard at Inaugural
The AANA made the voice of CRNAs heard at the inauguration of President Obama on Jan. 21 in Washington, participating in events with members of Congress influential on CRNA issues and joining with other leading healthcare organizations to host an inaugural watch event.
AANA President Janice Izlar, CRNA, DNAP, and President-elect Dennis Bless, CRNA, MS, joined Executive Director/CEO Wanda Wilson, CRNA, PhD, and the AANA Federal Government Affairs team in meeting Senate Finance Committee chairman Max Baucus (D-MT) during the inaugural activities.  An inaugural ceremony watch event, cohosted by the AANA and its media partner, The Hill newspaper, welcomed officials from the AARP, the American Podiatric Medical Association, Johnson & Johnson and other leading health groups.
The intent of the AANA’s activities was to continue to demonstrate the nurse anesthesia profession’s leadership and to strengthen relationships with legislators and organizations shaping CRNA practice and reimbursement. 
Photo captions from top to bottom:  An Inauguration Day display ad by AANA and its event cosponsors; AANA President Janice Izlar, CRNA, DNAP, with former U.S. Surgeon General Dr. David Satcher, MD, PhD, now on the board of Johnson & Johnson; and Senate Finance Committee Chairman Max Baucus (D-MT, center) with (L to R) AANA Senior Director of Federal Government Affairs Frank Purcell, Executive Director/CEO Wanda Wilson, CRNA, PhD; Past President Brian Thorson, CRNA, MA; and President-Elect Dennis Bless, CRNA, MS.


Healthcare in the President’s Inaugural Address
President Obama’s inaugural address on Jan. 21 included two references to healthcare and reimbursement of interest to CRNAs, and pointed to his coming State of the Union address slated for the evening of Feb. 12 at the U.S. Capitol.
From the official transcript:
  • “We, the people, still believe that every citizen deserves a basic measure of security and dignity.  We must make the hard choices to reduce the cost of health care and the size of our deficit.  But we reject the belief that America must choose between caring for the generation that built this country and investing in the generation that will build its future.  (Applause.)  For we remember the lessons of our past, when twilight years were spent in poverty and parents of a child with a disability had nowhere to turn.”
  • “We do not believe that in this country freedom is reserved for the lucky, or happiness for the few.  We recognize that no matter how responsibly we live our lives, any one of us at any time may face a job loss, or a sudden illness, or a home swept away in a terrible storm.  The commitments we make to each other through Medicare and Medicaid and Social Security, these things do not sap our initiative, they strengthen us.  (Applause.) They do not make us a nation of takers; they free us to take the risks that make this country great.  (Applause.)”
More Changes to Washington’s Healthcare Leadership Lineup
As President Obama begins his second term of office, and the 113th Congress sworn in Jan. 3 gets under way, the lineup of healthcare policymakers in Washington influential to CRNA practice continues to turn over.
  • At the White House, deputy chief of staff Nancy Ann DeParle, a former Medicare agency administrator, announced she is leaving the Administration for a post at the Brookings Institution. Her post is being filled by Rob Nabors, a budget expert with significant tenure on congressional staffs.
  • Health and Human Services Secretary Kathleen Sebelius is staying.
  • And on Capitol Hill, the House Ways and Means Health Subcommittee gets a new chairman, Rep. Kevin Brady (R-TX), and ranking Democratic member, Rep. Jim McDermott (D-WA).
Answer the Call to Care to be Counted
To continue strengthening CRNAs’ voice in Washington, the CRNA-PAC is kicking off its Care to be Counted 2013 campaign in February. The CRNA-PAC is coming off a record setting election cycle, raising more than $1.6 million in 2011-2012 and contributing to 260 federal candidates in last year’s national elections, winning 94 percent of the election contests in which it made an investment. The strong support of AANA members allowed the CRNA-PAC to maintain its status as the largest federal nursing political action committee in the healthcare industry, collecting twice as many contributions as any other federal nursing political action committee.
As the new 113th Congress gets under way, the CRNA-PAC helps make the profession’s voice heard in a politically polarized U.S. Capitol that has many new faces – 80 new members of the House and Senate.  And even though the CRNA-PAC raised more money than ever before –– the American Society of Anesthesiologists ASAPAC raised an astounding $3.5 million in 2011-2012, more than twice that of CRNA-PAC.
Over the next couple of months, you may get a call from the CRNA-PAC asking you to support the Care to be Counted campaign once again.  If you have any questions about the call, please contact AANA’s Washington office at The challenges we faced and overcame last year highlight the need to remain vigilant against future attempts to limit our scope of practice and reimbursements and underscore the importance of every AANA members’ contribution.
Thank you in advance for your support. Please consider giving today by visiting (AANA member login and password required).
HHS Releases Guidance on State Partnership Exchange
The Center for Consumer Information and Insurance Oversight (CCIIO) released a guidance document providing a framework on the “state partnership exchange,” which is a hybrid model where states may assume primary responsibility for many of the functions of the federally-facilitated exchange (FFE) permanently or as they work towards running a state-based exchange. The issue is important to CRNAs that are tracking the implementation of the Affordable Care Act health reform law in their states.
The Affordable Care Act directs the Department of Health and Human Services (HHS) to establish an FFE in any state that does not elect to establish a state-based exchange and in any state where HHS determines that there will not be an operational state-based exchange by Jan. 1, 2014. With a state partnership exchange, states can continue to serve as the primary points of contact for issuers and consumers, and will work with HHS to establish an exchange that best meets the needs of state residents.
The overall goal of a state partnership exchange is to enable the exchange to benefit from efficiencies when states have existing regulatory authority and capability, and to provide a framework for tailoring aspects of the FFE to state markets and residents while maintaining a seamless experience for consumers.
The state partnership exchange can also serve as a path for states toward future implementation of a state-based exchange. The state partnership exchange options provide states with a high level of participation in plan management and consumer assistance/outreach either on a permanent basis or as a stepping stone to a state-based exchange in the future. In a state partnership exchange, the scope of state responsibilities includes: recommending plans for qualified health plan (QHP) certification, recertification and decertification; QHP issuer account management; and day-to-day administration and oversight of QHP issuers. States in a state partnership exchange will carry out similar plan management activities for stand-alone dental plans certified by the exchange.
Read the guidance document at Learn about the profiles of insurance exchanges in each state in this guide from the Kaiser Family Foundation, developments in the world of exchanges on this Kaiser Family Foundation page at Website Updated
The government website updating patients and providers about the implementation and impact of health reform got a substantial reworking as the New Year gets under way, including information useful to CRNAs. The new site enables users to get real-time updates on health reform implementation issues, provides guidance on health coverage through state-based exchanges, and offers a downloadable widget on health reform implementation that users can add to their own web pages. Under the Affordable Care Act health reform law, enrollment in health plans marketed through exchanges begins Oct. 1, 2013, and the effective date of coverage expansions and consumer protections is Jan. 1, 2014. For further information, see the public information toolkit.
Opportunities with the National Institute of Nursing Research
AANA staff attended the National Advisory Council for Nursing Research meeting this week at the National Institutes of Health (NIH) in Baltimore. A CRNA serves on this council: Bruce Schoneboom, CRNA, PhD, FAAN, Colonel, US Army Nurse Corps and Commander, USAMRICD, is the military representative on the Advisory Council for a term of three years. Several research and training opportunities are available with the NINR. The AANA encourages CRNAs and nurse anesthesia students to contribute a nurse anesthesia presence at the NIH in the following programs:
National Institute of Nursing Research (NINR) Fatigue/Sleep Methodologies Boot Camp (July 22-26, 2013).  This one-week intensive research training course at the NIH features lecturers, classroom discussion and laboratory training.  The NINR provides the course at no cost although participants are required to pay for housing, food and transportation expenses.  Applications are available April 1 – May 20.
Summer Genetics Institute (SGI) (June 3-28, 2013).  The NINR SGI is a one month, intensive program of classroom and laboratory instruction in genetics that provides a foundation of biobehavioral research and clinical practice.  The NINR provides the SGI at no cost to program attendees although participants are required to pay for housing, food and transportation expenses.  Applications are available Jan. 14 – March 18.
Introduction to Research Grantsmanship (NINR) online video series.  This NINR workshop will help nurse anesthetists and nurse anesthesia students to learn the basics of grantsmanship at their convenience.  The video modules include downloadable slides from NINR presentations given throughout the country in honor of the NINR’s 25th anniversary.
Graduate Partnerships Program (NINR).  The deadline for the Graduate Partnerships Program application has been extended to January 25, 2013.  The program combines the academic environment of a university and the breadth and depth of research at the NIH.
Name Your State Reimbursement Director
Has your state association of nurse anesthetists named its State Reimbursement Director (SRD) yet? Now’s the time, and the breadcrumb trail for what to do and why to do it is available to state association leaders right now.
In September, your AANA Board of Directors approved the development of an SRD program, with the goal of representation from all 50 state associations of nurse anesthetists for effective reimbursement advocacy in each state.  With the AANA’s Federal Political Director (FPD) Program as a template, the SRD will be the point person for reimbursement knowledge and advocacy in each individual state. 
To appoint that person in your state, state presidents should email the name and contact information of their SRD to: with the words “State Reimbursement Director” in the SUBJECT line.  To request more information about the SRD program, any AANA member may contact us at that same email address and SUBJECT line.
See the SRD official solicitation including a job description here, and you can also read more CRNA reimbursement essentials here (requires AANA member login and password). ​
The following is an FEC required legal notification for CRNA-PAC
Gifts to political action committees are not tax deductible. Contributions to CRNA-PAC are for political purposes. All contributions to CRNA-PAC are voluntary. You may refuse to contribute without reprisal. The guidelines are merely suggestions. You are free to contribute more or less than the guidelines suggest and the association will not favor or disadvantage you by reason of the amount contributed or the decision not to contribute. Federal law requires CRNA-PAC to use its best efforts to collect and report the name, mailing address, occupation, and the name of the employer of individuals whose contributions exceed $200 in a calendar year. Each contributor must be a US Citizen.





Healthcare Headlines

Lidocaine + Propofol = Less Injection Pain
Researchers presented findings at the 2012 PostGraduate Assembly in Anesthesiology, showing that the administration of lidocaine along with propofol during IV sedation reduces the burning sensation that patients often experience with injection. A retrospective analysis of two groups of patients revealed that members of the group that received the combined injection were about half as likely to report pain as those who received lidocaine followed by propofol. The researchers explained the rationale for combining the two injections, noting that "lidocaine may act as a stabilizer of the kinin cascade" that can be activated by propofol. "Another possible mechanism," according to the team, "is that mixing the two agents decreases the pH of propofol, resulting in a lower concentration of propofol in its aqueous phase and subsequently less pain."
From "Lidocaine + Propofol = Less Injection Pain"
Anesthesiology News (01/01/13) Vol. 39, No. 1 Marcus, Adam

Conscious Sedation Potential for Intracranial Aneurysm Intervention
The use of conscious sedation and local anesthesia for coil embolization of ruptured intracranial aneurysms is the subject of new research by Elad Levy of the University of Buffalo and colleagues. The study cites the avoidance of risks associated with general anesthesia, simpler and cheaper operations, and reduced turnover time as potential advantages of the approach. However, the anesthesia team must be immediately available, in case a patient does not tolerate conscious sedation or complications arise. The clinicians performed 78 procedures using conscious sedation, seven of which required conversion to general anesthesia. In this scenario, general anesthesia is given emergently, and conversion is possible in fewer than 10 minutes if an anesthesia professional is on standby. "Conscious sedation also allows direct and frequent neurological examination of the patient without relying on the interpretation of electrophysiological monitoring," the researchers write in Neurosurgery. This could make faster detection of and response to intraprocedural complications possible. The difference between adverse event rates during procedures using conscious sedation and those using general anesthesia was not significant.
From "Conscious Sedation Potential for Intracranial Aneurysm Intervention"
News-Medical.Net (01/25/13) McDermid, Eleanor

Locoregional Anesthesia Boosts Amputation Success
An analysis by Duke University researchers revealed that locoregional anesthesia positively impacts the surgical success rate for amputations involving lower extremities. Led by Dr. P. Joshua O'Brien, the group reviewed nearly 9,000 patients who underwent an above-the-knee, below-the-knee, or transmetatarsal amputation between 2005 and 2010. A fifth of the patients received locoregional anesthesia, which proved to lower the rate of amputation failure. Compared to general anesthesia, the approach reduced the failure rate by fully 25 percent, according to the research team. An operation duration of fewer than 40 minutes also curbed amputation failures; but emergency surgery, versus nonemergency surgery, and the participation of surgical trainees raised the rate of failure. O'Brien presented the findings at the annual meeting of the Southern Surgical Association.
From "Locoregional Anesthesia Boosts Amputation Success"
IMNG Medical Media (01/23/13) Zoler, Mitchel L.

Acetaminophen May Improve Postoperative Outcomes
A review of 30 studies and 2,364 patients has found that prophylactically administered intravenous (IV) acetaminophen (paracetamol) may reduce postoperative nausea and vomiting (PONV). The reduction in PONV with prophylactic acetaminophen was associated with reduced pain but not reduced use of postoperative opioids. This may mean that "the anti-emetic effect of IV acetaminophen is not mediated through the reduction of postoperative opioid consumption but through direct mechanisms or through the reduction of post-surgical pain," the authors report in the journal Pain. In the studies, 1,223 patients received acetaminophen and 1,141 received placebo. The researchers noted that IV acetaminophen was associated with a 27 percent reduction in nausea and a 37 percent reduction in vomiting.
From "Acetaminophen May Improve Postoperative Outcomes" (01/16/2013) Mahendra, Piriya
Study Explores Impact of Secondhand Smoke on GA for Kids
Children undergoing general anesthesia (GA) who have been exposed to environmental tobacco smoke (ETS) have significantly longer recovery times, according to a new study from the Ohio State University College of Dentistry. These findings persisted even when these children did not have significantly more dental caries or longer procedure times. The average additional time for children exposed to ETS was 11 minutes, the researchers noted in Anesthesia Progress. Previous research has already shown that adverse respiratory events are more likely to occur in children exposed to ETS at home while recovering from GA. The newer study included 99 children, ages 18 months to 12 years, who were undergoing GA with propofol for restorative dental work. Children in the study were otherwise healthy, so chronic illness did not influence the results. The researchers noted that although there were statistically longer postanesthesia recovery times in children with ETS exposure, it did not have a measurable impact on the six specific respiratory events considered: coughing, laryngospasm, bronchospasm, breath-holding, hypersecretion, and airway obstruction.
From "Study Explores Impact of Secondhand Smoke on GA for Kids"
Dr. Biscupid (01/15/13) Goszkowski, Rob
Study: What Determines Patient Participation in Clinical Anesthesia Research?
Anesthesia-Analgesia reports that researchers at the Duke University Medical Center department of anesthesiology investigated what factors encourage or deter participation in clinical anesthesia studies. A total of 282 patients who had scheduled elective surgery were asked to fill out a questionnaire about their process for granting consent. Of those surveyed, 63 percent agreed to participate; and the model created to identify which factors were associated with consent indicated that male gender and level of comfort were the strongest predictors for whether a patient would agree to participate in research.
From "Study: What Determines Patient Participation in Clinical Anesthesia Research?"
Becker's Hospital Review (01/15/13) Linder, Heather

Seven Red Flags for Outpatient Surgery
Outpatient surgery has become more common—and more complicated—than ever before, raising questions of whether some patients are at a greater risk for negative outcomes than others. Under the direction of University of Michigan anesthesiology resident Michael Mathis, MD, researchers looked at 244,397 patients nationwide who received common ambulatory procedures. The review flagged 629 of the patient records for major morbidity or mortality—which most often presented as unplanned reintubation, postoperative pneumonia, surgical site infection, intraoperative blood transfusion, and/or the inability to intubate. Investigators also identified seven preoperative risk factors that independently raise the risk for morbidity and mortality following an outpatient operation: a history of cancer; paraplegia or quadriplegia; an age of 70 years or more; current steroid use; chronic obstructive pulmonary disease; history of transient ischemic attack or stroke; and history of renal failure/dialysis. Ambulatory surgery is safe overall, Mathis stressed, but "the results of the study can be used to direct outpatient surgical centers in adopting improvements in preoperative patient screening."
From "Seven Red Flags for Outpatient Surgery"
Anesthesiology News (01/01/13) Vol. 39, No. 1 Vlessides, Michael

Standard Written Checklists Can Improve Patient Safety During Surgical Crises
Operating room staff, including doctors and nurses, are 75 percent less likely to miss a critical clinical step when they follow a written safety checklist for responding to crisis during surgery. Use of checklists is becoming a standard in surgical care, but they have not been widely tested during a surgical crisis, researchers report in the New England Journal of Medicine. Surgical crises, such as cardiac arrest or severe allergic reaction, can be life threatening without appropriate clinical response. For their study, researchers simulated multiple operating room crises and assessed 17 operating room teams from three Boston-area hospitals on their use of life-saving steps for each simulated crisis. In half of the scenarios, teams were provided with evidence-based, written checklists. For the other half, the teams had to work from memory alone. When a checklist was used during a surgical crisis, teams were able to reduce the chances of missing a life-saving step by nearly 75 percent. Simulated surgical emergencies included air embolism, irregular heart rhythms associated with bleeding, or an unexplained drop in blood pressure. Overall, the participating teams said that the checklists were easy to use, helped them feel better prepared, and would be used during actual surgical emergencies.
From "Standard Written Checklists Can Improve Patient Safety During Surgical Crises"
Infection Control Today (01/21/13)
FDA Panel Calls for New Curbs on Common Painkiller
The U.S. Food and Drug Administration (FDA) advisory panel voted 19-to-10 in favor of new restrictions on products containing hydrocodone, including Vicodin, that would reclassify the drugs from Schedule III to Schedule II controlled substances alongside Oxycodone. If approved, the change could determine how doctors prescribe the pills, forcing them to prescribe fewer pills at one time, and the pill would face stronger handling and storage rules. The vote of the advisory panel could make it hard for the FDA to ignore the recommendation as concerns about the drugs' role in addiction and overdose deaths rise. Drug manufacturers say the change would not solve the problem of drug abuse tied to opioids, and the Centers for Disease Control and Prevention estimates that more than 16,500 people died from overdoses on those painkillers in 2010.
From "FDA Panel Calls for New Curbs on Common Painkiller"
Wall Street Journal (01/28/13) P. B2 Catan, Thomas; Martin, Timothy W.; Barrett, Devlin

New Brain Monitor Aims to Alert Doctors When Patients Wake During Surgery
A new device that monitors consciousness could alert doctors if patients are fully conscious while under general anesthesia. The device, from Dr. Giulio Tononi, a neuroscientist and psychiatrist at the University of Wisconsin, Madison, is designed to stimulate the brain with an electrical current and then determine if the signal has spread or not. Anesthesia stops electrical signals from spreading during surgery, making a person completely unconscious, Tononi believes, while the spread of those electrical signals—sight, sound, and pain—across the brain create consciousness. "You don't want the patient to move, to feel any pain, to have any memory [during a surgical operation]," he says. "You're actually injecting current to the brain and finding out whether the various parts of the brain are talking to each other or not." For every 1,000 patients under general anesthesia, one or two will experience anesthesia awareness, according to the International Anesthesia Research Foundation.
From "New Brain Monitor Aims to Alert Doctors When Patients Wake During Surgery"
KMBZ (Kansas City) (01/17/2013)

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