Anesthesia E-ssential, June 29, 2012

Anesthesia E-ssential

June 29, 2012 

Vital Signs

AANA Election Results Announced
 
The AANA is pleased to announce the results of the election for open positions on the FY2013 Board of Directors, Nominating Committee, and Resolutions Committee.
 
Open Positions on the FY2013 AANA Board of Directors:
  • President–elect: Dennis C. Bless, CRNA, MS – Minnesota
  • Vice President: Sharon P. Pearce, CRNA, MSN – North Carolina
  • Treasurer: Henry C. Talley V, CRNA, PhD, MSN, MS, LTC(ret) – Michigan
  • Director, Region 2: Anthony J. Chipas, CRNA, PhD – South Carolina
  • Director, Region 3: Danette J. Plautz, CRNA, MSN – Indiana
  • Director, Region 6: Donna M. Jasinski, CRNA, PhD – District of Columbia
  • Director, Region 7: Juan F. Quintana, CRNA, DNP, MHS – Texas
FY2013 Nominating Committee:
  • Region 1: Laura H. Smith, CRNA, MSN – New York
  • Region 2: Sherry H. Owens, CRNA, MSN – North Carolina
  • Region 3: Sandra L. Larson, CRNA, PhD – Illinois
  • Region 4: Marcia A. Kluck, CRNA, MNA – Minnesota
  • Region 5: Dianna M. Heikkila, CRNA, MSN – Idaho
  • Region 6: Maria M. Magro, CRNA, MS, MSN – Pennsylvania
  • Region 7: Jessica L. Appel, CRNA, MSNA – Texas
FY2013 Resolutions Committee:
  • Robert J. Gauvin, CRNA, MS - Massachusetts
  • David A. Andrews, CRNA, MHS – South Carolina
  • Julie C. Zerwas, CRNA, MS - Minnesota
  • Leslie P. Sturgis, CRNA, BS, ARNP - Oregon
  • Kathleen Carney Thibeault, CRNA, MSN, ARNP - Florida
The official report from the AANA’s election services coordinator is posted on the member side of the AANA website. (Member login and password required.) The September issue of the AANA NewsBulletin will include detailed vote counts for all offices and a breakdown of the percentage of members who voted by state.
 
 

 

The Pulse

 
  • Provider Nondiscrimination Law to Increase Patient Choice, Reduce Healthcare Costs Now that the U.S. Supreme Court has Upheld Affordable Care Act
  • California Supreme Court Affirms Lower Courts' Unanimous Decisions: Nurse Anesthetists Can Practice without Physician Supervision
  • Volunteers Sought for Professional Delegation to Cuba
  • Proposed Bylaw Amendments Available on Website
  • Board of Directors Approves Updates to Professional Practice Manual Documents
  • AANA Wellness Would Like to Hear From You
  • Radio Program Discusses Patient Access to Healthcare
  • CPR Receives Response to its Letter of Support
  • Complete your Continuing Education Requirements with AANALearn®
  • AANA Foundation Anesthesia "Pioneers" Meeting - Past and Present
 
  • COA Composition: Student Representative
 
  • Congratulations to AANA PR Committee's Mid-Year Assembly Student Mentoring Program Participants
 
  • AMA Pledges to Seek Repeal of AANA-Backed Provider Nondiscrimination Provision
  • AANA Leaders Air CRNA Issues at White House Meeting on Access to Quality Healthcare
  • Medicare, Medicaid Commissions Make Alarming Recommendations to Congress
  • Congress Approves AANA-Backed Drug Shortage Relief Bill
  • Key Senate Panel OKs Level Funding for Nurse Workforce Development, Averting Cuts for Now
  • AANA Comments on Federally Facilitated Exchanges for Marketing Health Coverage
  • Hot Election-Year Summer with CRNA-PAC
  • Learn Your CRNA Reimbursement Basics
  • FEC REQUIRED LEGAL DISCLAIMER FOR CRNA-PAC
 
 

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
Provider Nondiscrimination Law to Increase Patient Choice, Reduce Healthcare Costs Now that the U.S. Supreme Court has Upheld Affordable Care Act
The U.S. Supreme Court’s upholding of the Affordable Care Act means that provisions critical to patient access to care and making healthcare more affordable, such as the provider nondiscrimination law, will continue being implemented as scheduled, the AANA announced in the wake of the High Court’s decision. The AANA-backed provider nondiscrimination law is a bipartisan provision that promotes patient safety, access to care, healthcare provider choice, and lower costs through competition by prohibiting health plans from discriminating against qualified licensed healthcare professionals such as Certified Registered Nurse Anesthetists (CRNAs) solely on the basis of their licensure.
 
“Though implementation of the Affordable Care Act continues, this and other healthcare laws must continue to be improved,” said AANA President Debra Malina, CRNA, DNSc, MBA. “We believe, and the evidence shows, that CRNAs improve healthcare while reducing healthcare costs. The AANA and CRNAs will continue working to be part of the solution to the challenges facing the U.S. healthcare system.”
 
California Supreme Court Affirms Lower Courts’ Unanimous Decisions: Nurse Anesthetists Can Practice without Physician Supervision
In a resounding victory for the state’s nurse anesthetists, hospitals, and the patients they serve, the California Supreme Court has decided not to review California’s 2009 opt-out from Medicare’s facility reimbursement rule requiring physician supervision of Certified Registered Nurse Anesthetists, closing the book on a series of failed legal challenges by physician groups that began shortly after the exemption took effect. For further information, read the press release from California Association of Nurse Anesthetists.
 

Volunteers Sought for Professional Delegation to Cuba
CRNA volunteers are invited to be part of a professional delegation of nurse anesthetists led by AANA President Debra Malina, CRNA, DNSc, MBA, who will travel to Cuba in October 2012 to conduct research. For further information, read the news story on the AANA website. 
 

Proposed Bylaw Amendments Available on Website
The proposed amendments to the AANA Bylaws will be published in the July 2012 AANA NewsBulletin and are now available on the AANA website (member log in required). No resolutions were submitted.

Board of Directors Approves Updates to Professional Practice Manual Documents
The Board of Directors has recently approved three new position statements: Position Statement (PS) 1.12 “Patient-Centered Care: CRNAs and the Interprofessional Team,” PS 2.17 “Patient Safety: Fatigue, Sleep, and Work Schedule Effects,” and PS 2.18 “Mobile Device Use.” These statements are available on the Position Statements, Advisory Opinions, and Considerations webpage.

AANA Wellness Would Like to Hear from You
Are you a CRNA or student registered nurse anesthetist involved in a peer support group for an acute illness or condition, such as a cancer, post-traumatic stress disorder, or diabetes? We’re collecting information for the Annual Meeting presentation, “Lifeline: The Importance of Peer Support.” The educational session will look at the benefits from peer support for chemical dependency, as well as a broad range of health challenges. We would like to hear from you via email at wellness@aana.com

Radio Program Discusses Patient Access to Healthcare
Coalition for Patients’ Rights (CPR) spokespersons Janet Bezner, PT, PhD, from the American Physical Therapy Association, and Lisa Summers, CNM, DrPH, from the American Nurses Association, discussed the importance of ensuring that patients can access the full range of healthcare providers on RN.FM Radio on Monday, June 18. You can download the episode from iTunes or listen to it on RN.FM Radio’s website. A link to the interview is also posted on the CPR website.

CPR Receives Response to its Letter of Support
The Federal Trade Commission has responded to a letter of support from the Coalition for Patients’ Rights (CPR). Both letters can be viewed on the CPR website.

Complete your Continuing Education Requirements with AANALearn®

The July 31 recertification deadline is almost here—check out the courses in AANALearn® (www.aanalearn.com). Courses offered provide a total of 52 CE credits in topics ranging from health and wellness to clinical topics and procedures. Member prices range from $12-$35 for 1 CE credit courses, and the credits transfer to your transcript within one day—no other provider can offer this quick transfer.
 
 

  
 
AANA Foundation Anesthesia “Pioneers” Meeting – Past and Present
 
In the early 1990s, Ruth Wright, CRNA, organized the AANA Pioneers to provide a place for retired CRNAs to meet and enjoy a luncheon during the AANA Annual Meeting. Dues of $10, or more if the member desired, were collected and donated to the AANA Foundation. The Foundation would organize graduate student research paper presentations for the first half of the one-hour Pioneer meeting.
 
More recently, the Pioneers have been given a session time and location on Saturday morning for one hour and the Foundation provides breakfast. The Pioneer group has requested to hear about the progress of the Foundation and also have time to relax and visit with old friends and make plans for Annual Meeting activities.
 
This year we are making a special outreach to all CRNA emeritus AANA members to attend this session. We invite any retiree who still has a desire to assist in the future of the nurse anesthesia profession. Dues are not required, but you may make a donation if you have a desire to assist in funding research and the future education of CRNAs.
 
Please join the Anesthesia “Pioneers” Meeting for an hour with old friends and colleagues at the AANA Annual Meeting in San Francisco on Saturday, August 4, 2012, from 9 to 10 a.m. We look forward to seeing you!
 
 

 
 
COA Composition: Student Representative
 
The Council on Accreditation of Nurse anesthesia Educational Programs (COA) is composed of 12 members, one of which is the student representative. The student representative serves a one-year term and is selected from students enrolled in accredited nurse anesthesia educational programs located in specific regions as identified in the COA’s Bylaws. From 2011-2012, Michael Wilhelm, RN, CEN, CCRN, served as the student representative on the COA and on the Selection and Evaluation Committee. Having worked in the engineering field for six years, Michael decided to switch careers and obtain his Bachelor of Science in Nursing degree from New York University. Wilhelm’s experiences as a volunteer emergency medical technician and responder to the 9/11 attacks in New York City led him to pursue a career that would allow him to give more back to his community. He is a student at the Hospital of Saint Raphael School of Nurse Anesthesia in New Haven, Conn. For further information about the student representative and Wilhelm’s insights on how the COA brings value to the nurse anesthesia profession, visit the COA’s website at http://home.coa.us.com/Pages/default.aspx and select the biography titled, “From the Student Representative’s Viewpoint.”
  
 

 
 
Congratulations to AANA PR Committee’s Mid-Year Assembly Student Mentoring Program Participants
On April 16, 2012, at the AANA Mid-Year Assembly (MYA), CRNA mentors provided students with a positive, welcoming, motivational, and educational experience as part of the Student Mentoring Program, coordinated by the AANA Public Relations Committee. We congratulate the mentors who helped shape the future of the AANA by giving so selflessly of their time at this year’s AANA Mid-Year Assembly. See a complete list of the mentors and students who participated in the program.
  
 

 
 
 
AMA Pledges to Seek Repeal of AANA-Backed Provider Nondiscrimination Provision
The AANA-backed Provider Nondiscrimination provision is a part of the Affordable Care Act upheld by the U.S. Supreme Court in its June 28 ruling. Though the provision remains intact to take effect as scheduled January 2014, the American Medical Association last week singled it out for organized medical advocacy – with an eye toward repealing this provision intended to promote competition, choice, patient access to quality care delivered by CRNAs, and lower healthcare costs.
 
According to American Medical News on June 21, “ ‘If the language remains unchanged and is allowed to proceed, it would put the ACA on a direct collision course to the states’ work on scope issues,’ said Michael Simon, MD, a delegate with the American Society of Anesthesiologists…. Under the policy, the AMA will promptly start a grassroots campaign to repeal the portion of the nondiscrimination clause referring to doctors.”
 


AANA Leaders Air CRNA Issues at White House Meeting on Access to Quality Healthcare
AANA President Debra Malina, CRNA, DNSc, MBA, and President-Elect Janice Izlar, CRNA, DNP, represented the nurse anesthesia profession at a White House discussion on Improving Care Quality and Patient Health on June 13.
 
During the meeting, which included senior administration and agency officials and nursing organization leaders from around the country, Malina and Izlar urged continued progress on implementing the Institute of Medicine’s “Future of Nursing” report intended to advance patient access to care, promote patient safety, and control healthcare costs.
 
AANA President-elect Izlar (l) and President Malina at White House.​
 
 
“CRNAs ensure accessible, affordable healthcare,” said President Malina. “We’ve seen progress at the federal level promoting access to CRNA care. The new Medicare hospital conditions of participation promoting advanced practice registered nurses to be on medical staffs represent a positive development. But there is much more work to do to eliminate unnecessary federal barriers to the use of CRNA anesthesia and pain care in the interests of the patients we serve.”
 

Medicare, Medicaid Commissions Make Alarming Recommendations to Congress
Two major commissions advising Congress on the Medicare and Medicaid programs presented their annual reports and recommendations to lawmakers on June 15, and an initial review of one of the reports finds suggestions problematic to patient access to CRNAs.

The Medicare Payment Advisory Commission (MedPAC) suggests for the second year that a fix to the Medicare sustainable growth rate funding formula cuts—estimated to reach 27 percent in 2013—should be partially funded by 17 percent reductions over three years to anesthesia and specialty physician services. In 2011, the AANA expressed opposition to such reductions, saying that CRNA anesthesia services were helping to control healthcare costs, not increase them. More than 90 members of the U.S. House of Representatives from both parties expressed agreement with the AANA’s views, urging their bipartisan House leaderships not to agree to the MedPAC view.
 
The MedPAC report on rural healthcare drew concern from the National Rural Health Association (NRHA), which noted that the MedPAC rural fact sheet said, “Service utilization for rural patients is maintained in part by patients traveling to urban areas for some care.” For rural and frontier patients, the alternative to receiving surgical, obstetrical, emergency, and pain management services locally due to the presence of a CRNA is to travel hundreds of miles to urban areas at great cost, inconvenience and risk.
 
The AANA continues reviewing the MedPAC and the Medicaid and Childrens Health Insurance Program Payment and Access Commission (MACPAC) reports, and will keep AANA members as well as members of Congress informed about the impact of these reports on access to quality CRNA care.
 
 
 
Congress Approves AANA-Backed Drug Shortage Relief Bill
Drug manufacturers will be required to give greater advance notice of conditions that threaten
shortages of anesthesia drugs, and products containing hydrocodone (Vicodin®) will not be
scheduled at the same level as the pure product, under legislation approved by the U.S. House and
Senate and sent to the President June 26 for his signature into law (S 3187).
 
The AANA had been working in support of the bill’s drug shortage advance notification provisions,
and against language that would have listed products containing hydrocodone (Vicodin®) on
Schedule II.  According to the final bill, manufacturers of drugs “intended for use in the
prevention or treatment of a debilitating disease or condition, including any drug used in
emergency medical care or during surgery,” would be required to provide the Food and Drug
Administration advance notice of conditions that might lead to shortages of such drugs. The
purpose of the advance notification is to give the marketplace for such drugs time to act and
keep shortages from taking place or reducing their incidence or severity.  In addition, the final
legislation did not change the controlled substances schedule on which products containing
hydrocodone currently appear.  Both outcomes met AANA’s advocacy objectives.
 
Read the bill (search bill numbers S 3187).
 
See the AANA’s letter in support of S 3187.

The House approved S 3187 by voice vote; see how your Senators voted.
 
 
Key Senate Panel OKs Level Funding for Nurse Workforce Development, Averting Cuts for Now
The Senate Appropriations Committee approved legislation (S. 3295) on June 14 that levels funding for nurse workforce development programs and averts their being cut, unlike other programs in the FY2013 Labor-HHS-Education appropriations bill that saw significant reductions.
 
Chaired by Sen. Daniel Inouye (D-HI), the committee’s action was seen as a victory for Title 8 program advocates who were concerned that the program is vulnerable to budget pressures even though nurses and advanced practice registered nurses help improve healthcare delivery and save the healthcare system money. Similar to current FY2012 funding levels, the panel’s package provides $232 million for Title 8 including $64 million for advanced education nursing. Nurse anesthetist educational programs and nurse anesthetist traineeships are provided $3-4 million annually through Title 8. The AANA had joined with the nursing community to support Title 8 appropriations.
 
The next step is for the full Senate to take up the bill later this summer, but its fate is unclear for two reasons: One, the bill was approved in committee on a 16-14 party line vote, with Democrats in favor and Republicans opposed, and two, House action on FY2013 Labor-HHS-Education appropriations is not yet scheduled.
 
Read the Senate committee report. Portions relating to nurse workforce development begin on p. 47.
 

AANA Comments on Federally Facilitated Exchanges for Marketing Health Coverage
Federally facilitated exchanges (FFE) for marketing healthcare coverage in the states should recognize CRNA services, promote provider nondiscrimination, and allow CRNAs and other healthcare providers to have a seat at the table on the exchanges’ implementation and assessment, the AANA said in comments to the U.S. Department of Health and Human Services on June 18. What drew the AANA’s attention to this matter?
 
The AANA was responding to agency guidance on the HHS’s approach to implementing an FFE in any state where an exchange for marketing health coverage is not operating. It discusses how states can partner with the HHS to implement selected functions in an FFE; key policies organized by exchange function; and how HHS will consult with a variety of stakeholders to implement an FFE. In the AANA’s comment letter, President Debra Malina, CRNA, DNSc, MBA, asked the agency to require that CRNAs be included in FFE qualified health plan (QHP) provider networks and require QHPs participating in state partnerships with FFEs to align their payment systems to comply with state and federal nondiscrimination provisions. The AANA also requested the agency to allow nonphysician providers who bill for Medicare Part B to provide input on the development and implementation of FFEs.
 
Read the AANA comment letter  (AANA Member ID and password required). Read the HHS guidance.
 

Hot Election-Year Summer with CRNA-PAC
Temperatures are rising and so are election-year activities, with more than half of all states already concluding their primary elections and the November general elections just four months away. Across the country AANA members and the AANA Federal Government Affairs team are mobilizing to evaluate and support pro-CRNA congressional candidates in time to strengthen their efforts to win on Election Day. If you would like to learn more about getting involved in federal election contests in your state, contact your state association’s Federal Political Director, or email the AANA Washington office at info@aanadc.com. To learn more about the CRNA-PAC and upcoming elections, see www.caretobecounted.org (requires AANA member login and password).
 
The CRNA-PAC continues providing strong support to CRNA-friendly and CRNA-issue influencing incumbent members of the U.S. House and Senate as well as emerging leaders in open seat and challenger races. This summer, the CRNA-PAC is hosting at AANA’s Washington office Reps. Ron Kind (D-WI) and Brett Guthrie (R-KY), Sen. Jeanne Shaheen (D-NH), and others, all prominent members on healthcare issues, for fundraising events benefiting their reelection campaigns. With the involvement of local CRNAs and the support of the CRNA-PAC, several candidates for open seats for Congress have also recently won their primary elections, including Michelle Lujan Grisham (D-NM) and Tom Cotton (R-AR).
 
The involvement of local AANA members is crucial to the success of the AANA in supporting CRNA-friendly candidates for Congress, and in helping educate legislators influential to CRNA interests about nurse anesthesia issues. If you would like to learn more about getting involved in federal election contests in your state, contact your state association’s Federal Political Director, or email the AANA Washington office at info@aanadc.com . To learn more about the CRNA-PAC and upcoming elections, see www.caretobecounted.org (requires AANA member login and password).
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Learn Your CRNA Reimbursement Basics
In response to AANA member requests for more in-depth information on CRNA reimbursement and issues affecting the market for CRNA services, the AANA has published a new online document titled “Issue Briefs on Reimbursement and Nurse Anesthesia.” Initially developed for participants in the AANA 2011 Summit on Anesthesia Reimbursement, this new AANA document includes updates reflecting developments in Medicare, Medicaid and other public benefit programs, commercial health plans, pain management reimbursement, and health reform implementation. The document provides helpful links to other resources that AANA members might find useful in learning more about the economic and reimbursement factors shaping the present and future of CRNA practice. Download this 35-page electronic document (requires AANA member login & password). Your comments are welcome at info@aanadc.com.
 
FEC REQUIRED LEGAL DISCLAIMER 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 our 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. I am a U.S. Citizen.
 
 

 
 
 

 
 
 
Anesthesia Type Affects Complications and Mortality After Hip Fracture Surgery
New research published in the July issue of Anesthesiology suggests that the type of anesthesia used for hip fracture surgery could affect post-operative complications and mortality. Investigators at the University of Pennsylvania studied more than 18,000 hip fracture discharges and their outcomes from 126 hospitals in New York over a period of two years. Of all the discharges, 29 percent of patients received regional anesthesia. The study found that of these patients, 3.4 percent experienced respiratory failure and 6.8 percent suffered pulmonary complications. Patients who received general anesthesia, meanwhile, had a 5 percent rate of respiratory failure and an 8.1 percent rate of pulmonary complications. There also appeared to be lower risk of mortality among the patients who received epidurals, spinal anesthesia, or nerve blocks compared to those who underwent general anesthesia. "Our study provides an initial suggestion that hip fracture outcomes may be improved by promoting more widespread use of regional anesthesia," said Dr. Mark Neuman, lead study author. "Future research needs to use prospective studies and look at longer-term outcomes."
 
From "Anesthesia Type Affects Complications and Mortality After Hip Fracture Surgery"
Newswise (06/20/12)
 
 

Stanford Study Shows Opiates' Side Effects Rooted in Patients' Genetics
Genetics may partly predict how opiates will affect patients, researchers at Stanford University School of Medicine suggest. Side effects of opiates include nausea, slowed breathing, and the possibility of addiction. Genetics may also be involved in determining which patients will suffer from the itchiness and sedation associated with the use of the drugs, which include morphine and oxycodone. Dr. Martin Angst, a principal researcher and director of the Stanford Human Pain Research Laboratory, said: "Our findings strongly encourage the use of downstream molecular genetics to identify patients who are more likely or less likely to benefit from these drugs—to help make decisions on how aggressive you want to be with treatment, how carefully you monitor patients, and whether certain patients are suitable candidates for prolonged treatment." Researchers recruited 121 twin pairs and compared individual variations in levels of sedation, mental acuity, respiratory depression, nausea, and drug-liking/disliking. These comparisons were made between identical twins, non-identical twins, and non-related participants. When identical twins were more similar in their responses to opiates, this suggested that inheritance was involved in the response. Heritability accounted for 30 percent of the variability for respiratory depression, 59 percent of the variability for nausea, and 36 percent for drug disliking, an indicator of the potential for addiction. The study is published in the journal Anesthesiology.
 
From "Stanford Study Shows Opiates' Side Effects Rooted in Patients' Genetics"
Science Codex (06/20/12)
 
 

Obese Patients Experience Fewer Post-Op Complications
Obese adults who undergo non-bariatric surgery experience fewer post-operative complications than do thinner surgical patients, report researchers at the University of Michigan. The team reviewed data from 235,076 general and vascular inpatient surgeries performed between 2005 and 2008, comparing the results of normal-weight, obese, and morbidly obese patients. Surprisingly, the investigators discovered that the greatest likelihood of mortality and severe post-op problems presented in normal-weight adults under 65 years of age. This "obesity paradox" has surfaced previously, according to lead researcher Olubukola Nafiu, MD, who cites earlier studies indicating that obese patients suffering from heart failure and stroke and ICU patients coming out of surgery tend to have better outcomes than normal-weight patients. "The reasons for the obesity paradox are still largely unresolved," Nafiu acknowledges. "Some of the reasons may be physiologic, such as having higher nutritional buffers of inflammation or earlier manifestations of symptoms."
 
From "Obese Patients Experience Fewer Post-Op Complications"
Anesthesiology News (06/01/12) Vol. 38, No. 6 Wild, David
 
 

Study: Etanercept Not Equal to Steroids for Sciatic Pain
Etanercept may be less effective than steroids for treating severe leg and lower back pain in patients with sciatica, according to research published in Annals of Internal Medicine. Previous research has shown significant improvements in leg and back pain among etanercept-treated patients compared with saline-treated patients. In the new study, 84 adults with sciatica were randomized to receive two epidural injections of either 60 mg of a steroid, 4 mg of etanercept, or 2 mL of saline every two weeks. Of the patients treated with steroids, 75 percent reported 50 percent more leg pain relief and said they felt better overall after a month of treatment compared with 50 percent of patients who received saline and 42 percent who received etanercept. After one month, patients who received steroids reported an average pain score of 2.1 on a scale of 0 to 10, compared with 3.6 in the etanercept group and 3.8 in the saline group. However, the effects of saline and etanercept lasted longer than those of the steroids. The researchers recommended that future research look into the safety and effectiveness of higher doses of etanercept and similar drugs.
 
From "Study: Etanercept Not Equal to Steroids for Sciatic Pain"
Pain Medicine News (06/01/2012) Vol. 10, No. 6
 
 
Study: Anesthesia's Electronic Records May Not Be Accurate
New research says that anesthesia information management systems (AIMS) may record only 50 percent or less of anesthesia-related critical events. Researchers from the University of Pennsylvania School of Medicine looked at data from a previous clinical trial that evaluated fasting gastric volumes and incidences of nausea and vomiting in 995 same-day surgery patients. While researchers found that the clinical trial records had documentation of eight occurrences of induction-related vomiting, only three occurrences were recorded in the AIMS. According to statistical analysis, AIMS was 38 percent sensitive and 100 percent specific, with a 100 percent positive predictive value. There were not enough cases of emesis to determine AIMS' negative predictive value, said study leader Dr. Mohamed Rehman. There must be further research into AIMS and quality improvement reporting practices among anesthesia providers, as this particular study used research assistants. The results, Rehman said, "indicate that there is under-reporting of significant events and suggest that user-dependent reports extracted from AIMS records may not be a reliable source for either realizing the occurrence of clinical events or conducting outcomes research."
 
From "Study: Anesthesia's Electronic Records May Not Be Accurate"
Outpatient Surgery (06/12/12) McGraw, Mark
 
 
SmartTots Awards $200,000 to Pediatric Anesthesia Research
Robert Block, PhD, and Caleb Ing, MD, have been selected by SmartTots to receive research grants as part of its inaugural round of funding. The recipients each will receive $100,000 to finance separate studies that focus on the impact anesthetics may have on early brain development. Block will compare adolescents who were exposed to anesthesia during operations in infancy with unexposed, but otherwise matched, control subjects to evaluate the hypothesis that this exposure affects brain and cognitive development. Ing, meanwhile, will study the correlation between neurophysical deficits at age 10 and the length of exposure to volatile anesthetics by evaluating behavior, cognitive function, language, and motor skills in children who were exposed to anesthesia when younger than 3 years as compared to those who were not. The grants were made possible by a research contribution from the International Anesthesia Research Society.
 
From "SmartTots Awards $200,000 to Pediatric Anesthesia Research"
Newswise (06/25/12)
 
 

FDA Appeals Lethal Injection Ruling
The U.S. Food and Drug Administration (FDA) is appealing a federal ruling against importing the lethal injection drug sodium thiopental. Several states began to use overseas suppliers when the only U.S. manufacturer of sodium thiopental ceased production in 2010. However, in March, a Washington, D.C.-based federal judge ruled that the FDA wrongly allowed states to import the drug for lethal injections and ordered the agency to remove the drugs from state prisons. Some of the states, including Nebraska, have refused requests from the FDA to turn over the drug. However, the Nebraska Attorney General's office recommended that the FDA appeal the federal judge's ruling, and the agency filed a notice of appeal on May 25.
 
From "FDA Appeals Lethal Injection Ruling"
Omaha World-Herald (NE) (06/05/12)
 
 

 
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