Corey S. Scher · Anna Clebone Sanford M. Miller · J. David Roccaforte Levon M. Capan Editors You’re Wrong, I’m Right Dueling Authors Reexamine Classic Teachings in Anesthesia 123 ’ ’ You re Wrong, I m Right Corey S. Scher Anna Clebone (cid:129) Sanford M. Miller J. David Roccaforte (cid:129) Levon M. Capan Editors ’ ’ You re Wrong, I m Right Dueling Authors Reexamine Classic Teachings in Anesthesia 123 Editors CoreyS. Scher, MD J.David Roccaforte, MD Clinical Professorof Anesthesiology, Clinical AssociateProfessor of Departmentof Anesthesiology AnesthesiologyandSurgery, Perioperative CareandPainMedicine, Departmentof Anesthesiology NewYorkUniversitySchoolofMedicine BellevueHospitalCenter,PerioperativeCare NewYork,NY andPainMedicine,NewYorkUniversity USA Schoolof Medicine,Surgical Intensive CareUnit Anna Clebone, MD NewYork,NY Assistant Professor, Department USA ofAnesthesia andCritical Care TheUniversity of Chicago Levon M.Capan,MD Chicago, IL Department ofAnesthesiology USA Perioperative CareandPainMedicine, ViceChairFaculty Promotion Associate Sanford M.Miller, MD DirectorAnesthesia ServiceBellevue Clinical Professorof Anesthesiology Hospital Center (Emeritus),FormerAssistant Director of NewYork,NY Anesthesiology,BellevueHospitalCenter USA Retired from Departmentof Anesthesiology,BellevueHospitalCenter NewYork University Schoolof Medicine NewYork,NY USA ISBN978-3-319-43167-3 ISBN978-3-319-43169-7 (eBook) DOI 10.1007/978-3-319-43169-7 LibraryofCongressControlNumber:2016947744 ©SpringerInternationalPublishingSwitzerland2017 Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpartofthematerialis concerned,specificallytherightsoftranslation,reprinting,reuseofillustrations,recitation,broadcasting,reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation,computersoftware,orbysimilarordissimilarmethodologynowknownorhereafterdeveloped. Theuseofgeneraldescriptivenames,registerednames,trademarks,servicemarks,etc.inthispublicationdoesnot imply,evenintheabsenceofaspecificstatement,thatsuchnamesareexemptfromtherelevantprotectivelawsand regulationsandthereforefreeforgeneraluse. Thepublisher,theauthorsandtheeditorsaresafetoassumethattheadviceandinformationinthisbookarebelieved tobetrueandaccurateatthedateofpublication.Neitherthepublishernortheauthorsortheeditorsgiveawarranty, expressorimplied,withrespecttothematerialcontainedhereinorforanyerrorsoromissionsthatmayhavebeen made. Printedonacid-freepaper ThisSpringerimprintispublishedbySpringerNature TheregisteredcompanyisSpringerInternationalPublishingAGSwitzerland To all of my hearts, Lisa, Ryan, Danielle, Oliver, and Dakota —Corey S. Scher To my wonderful husband, Keith Ruskin —Anna Clebone To my wife, Marcia, who has stood with me for 61 years —Sanford M. Miller Preface Our journals are designed for critical readers to determine whether the best freshly published papers will become essential for practice or not. As anesthesiologists work more hours, with fewer resources and sicker patients than ever before, it is truly a challenge to maintain currency.Formany,readingonthesubjectofanesthesiadoesnottakeprioritywhilejuggling apersonalandprofessionallife.InvestinginprintcopiesorgainingInternetaccesstojournals in our field is low on the to-do list. Anesthesiologists love to talk to fellow anesthesiologists about cases. Even the most dour clinicianswillcome tolife when anotheranesthesiologistsays, “You will never believe what happenedtomeintheoperatingroomlastweek.”Itisreadilytransparentthanmanyclinicians areholdingontoclinicalparadigmsthatwerelearnedinresidencythatare,ataminimum,now controversial and sometimes no longer true. There has been a veritable explosion over the last 20 years of high-quality research in anesthesiology, pain medicine, and critical care. The merit of each journal is quantitatively determined by its “Impact Factor”—the frequency that its articles are cited in other papers or reports.Theimpactofanesthesiologyanditsrelatedfieldshassoaredbyover65%inthepast 5years.Fullyoverwhelmingevidencenowinfluencestheclinical careofpatientsinourfield and is the reason for this gain. Despite new statistical measures, project design, and editorial approval,manycliniciansareholdingontopracticeparametersthatareoutdatedorirrelevant. The process of practice change involves 3 steps. With the introduction of a new practice parameter, the provider goes through: (1) denial, (2) understanding that there is controversy, and (3) after more time than should be needed, acceptance. The editors of this book made a bold attempt at creating a book that is targeted at every clinicianinthefield,whethertheystaycurrentornot.Wepresent126cases,brokendownby subspecialty, where the author has a “split personality.” After a case is presented, the author forcefully represents 2 adversarial positions: a pro stance and a con stance. In each case, the authors speak freely, having checked their academic title at the door. During a freewheeling discussion, the case authors alternate between talking off the cuff and presenting current evidence.Thebookismeant asaneasyread that canbeopened upatanypage.Eachcaseis onlyafewpageslongandcancapturetheattentionofthereaderforaslongasneeded.Thisis not meant to be a reference book. Simply stated, the cases are meant to be entertaining and a “fun read.” In almost every clinical arena, concepts that we thought were written in stone are on the road to becoming myths. Examples include the utility of cricoid pressure, the use of normal saline, left uterine displacement, and the neurotoxicity of inhaled anesthetics in young chil- dren. These are just the tip of the iceberg of controversial topics recently debated in our high-impact journals. Large database analyses on an increasingly large number of topics demand a change in practice. Anotherobjectiveofthisbookistohelpthereadertakeasmallsteptowardcurrency.The informal presentation of topics is what we believe is the most accessible way to convey new informationtoalargenumberofreaders.Thisishowinformationismostfrequentlysharedin the“realworld”bothinsideandoutsideofmedicine.Webelievethatthisbookaccomplishes vii viii Preface this goal of information sharing, and that most of the cases in the book address the most relevant controversies in anesthesiology today. The pro–con approach offers advantages over other methods of teaching. These cases can be presented to residents in a manner similar to the Socratic method. In our experience, residents do prefer to be taught using a case-based method. Long intervals exist in the operating room during which minimal activity occurs, although vigilance must still be maintained. Case-based discussions are a perfect way to spend this time. This book is essentially a library for a teacher who is looking for high-quality case-based topics. Theenthusiasmoftheauthorsofeachcasewasthemostsatisfyingaspectofthisbook.The qualityofeachcasedemonstratesthatsentiment.Eachcaseauthoristobecommendedforthe wisdom and skillful writing contributed to these cases. While we are grateful for everyone involvedingettingthisworktoprint,wewillbemostgratefulifthereaderssimplyenjoythis book and use it as a road to currency and an important mode of teaching anesthesia. New York, USA Corey S. Scher Chicago, USA Anna Clebone Contents Part I General 1 Should Recent Clinical Trials Change Perioperative Management in Patients with Cardiac Risk Factors? . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Corey S. Scher 2 Should Real-Time Ultrasound Guidance Be Routinely Used for Central Venous Catheter Placement?. . . . . . . . . . . . . . . . . . . . . . 7 James Leonard 3 A Patient with Chronic Kidney Disease Is Coming to the Operating Room for an Emergent Procedure, Which Intravenous Fluid Do You Plan to Give Her?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Jacob Tiegs and Arthur Atchabahian 4 Just Say NO to Nitrous! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Corey S. Scher 5 Closed-Loop Anesthesia: Wave of the Future or No Future? . . . . . . . . . . . 19 Cedar J. Fowler and Howard Ching 6 Should Acute Respiratory Distress Syndrome (ARDS) Preventative Ventilation Be Standard in the Adult Operating Room?. . . . . . . . . . . . . . . 21 Samir Kendale 7 I Gave Rocuronium 3 Hours Ago, Do I Need to Reverse?. . . . . . . . . . . . . . 23 Daniel Kohut and Kevin Turezyn 8 How Do You Recognize and Treat Perioperative Anaphylaxis?. . . . . . . . . . 25 Amit Prabhakar, Melville Q. Wyche III, Paul Delahoussaye, and Alan David Kaye 9 Is Monitored Anesthesia Care (MAC) Safe for All Cases? . . . . . . . . . . . . . 29 Kenneth M. Sutin and Jonathan Teets 10 Does Electrophysiology Really Have to Reprogram My Patient’s Pacemaker Prior to Electroconvulsive Therapy? . . . . . . . . . . . . . . . . . . . . 33 Ethan O. Bryson 11 When Can Transesophageal and Trans-Thoracic Echocardiography Be Useful in a Non-Cardiac Case?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Lisa Q. Rong 12 Should Antifibrinolytics Be Used in Patients Undergoing Total Joint Replacements? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Suzuko Suzuki 13 Will Operating Rooms Run More Efficiently When Anesthesiologists Get Involved in Their Management?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Steven D. Boggs, Mitchell H. Tsai, and Mohan Tanniru ix x Contents 14 Are Outcomes Better for Trauma Patients Who Are Treated Early with Clotting Factors?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Steven D. Boggs and Ian H. Black 15 Should Cerebral Oximetry Be Employed in Morbidly Obese Patients Undergoing Bariatric Surgery? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 David Porbunderwala 16 Is Normal Saline Solution the Best Crystalloid for Intravascular Volume Resuscitation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Saad Rasheed Part II Cardiac 17 Should Local Anesthesia with Conscious Sedation Be Considered the Standard of Care Over General Anesthesia for Transcatheter Aortic Valve Replacement via the Transfemoral Approach?. . . . . . . . . . . . 59 Glen D. Quigley and Jennie Y. Ngai 18 Should Antiplatelet Therapy Be Stopped Preoperatively in a Patient with Coronary Artery Stents?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Caitlin J. Guo and Katherine Chuy 19 Is Extubating My Cardiac Surgery Patient Postoperatively in the Operating Room a Good Idea? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Joseph Kimmel and Peter J. Neuburger 20 Is a Pulmonary Artery Catheter Needed If You Have Transesophageal Echocardiography in a Routine Coronary Artery Bypass Grafting? . . . . . . 71 Christopher Y. Tanaka and John Hui 21 When Should You Transfuse a Patient Who Is Bleeding After Cardiopulmonary Bypass? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Cindy J. Wang 22 Neuraxial Versus General Anesthesia in a Patient with Asymptomatic Severe Aortic Stenosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Patrick B. Smollen and Arthur Atchabahian 23 Should High-Risk Cardiac Patients Receive Perioperative Statins? . . . . . . . 81 Himani V. Bhatt 24 Cardiopulmonary Bypass Cases: To Hemodilute or Not? . . . . . . . . . . . . . . 83 Nicole R. Guinn 25 Are Seizures Really a Problem After the Use of Antifibrinolytics?. . . . . . . . 85 Dmitry Rozin and Madelyn Kahana 26 Is Regional Anesthesia for Cardiac Surgery a Good Idea? . . . . . . . . . . . . . 87 M. Megan Chacon 27 Are Surgical and Anesthesia Medical Missions in Low- and Middle-Income Countries Helping or Hurting? The Evolving Fields of Global Anesthesia and Global Surgery. . . . . . . . . . . . . . . . . . . . . 89 Jamey Jermaine Snell Part III Thoracic 28 Can Oxygenation in Single-Lung Thoracic Surgery Be Affected by Inhibition of Hypoxic Pulmonary Vasoconstriction?. . . . . . . . . . . . . . . . 95 Rebekah Nam Contents xi 29 Is a Bronchial Blocker Just as Good as a Double-Lumen Tube for Achieving Adequate Lung Isolation?. . . . . . . . . . . . . . . . . . . . . . 97 Alexandra Lewis and David Amar 30 Your Thoracic Epidural is Not Working: How Do You Provide Analgesia Post-thoracotomy?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 Angela Renee Ingram and Anuj Malhotra Part IV Pediatric 31 Pediatric Upper Respiratory Infection: You Cancelled the Case and Told the Parents to Reschedule, Right?. . . . . . . . . . . . . . . . . . . . . . . . 105 Brian Blasiole 32 Does a Low Mean Blood Pressure in the Neonate Under Anesthesia Lead to Cognitive Deficits? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Anna Clebone and Corey S. Scher 33 Does Rapid Sequence Induction Have a Role in Pediatric Anesthesia? . . . . 111 Michale Sofer 34 Anesthetic Neurotoxicity: Is Anesthesia Toxic to the Developing Brain? Should I Cancel My Baby’s Surgery?. . . . . . . . . . . . . . . . . . . . . . . 115 Misuzu Kameyama and Corey S. Scher 35 Should an Anxious Parent Be Allowed to Be Present for the Induction of Anesthesia in Her Child? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Paul A. Tripi and Mark M. Goldfinger 36 What Is the Role of Premedication in the Pediatric Patient?. . . . . . . . . . . . 121 Elliot S. Schwartz and Anna Clebone 37 Presence of Family Members in the Operating Room: Is This Really Helpful?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 Michelle N. Gonta and Misuzu Kameyama 38 Is It Appropriate for Complicated Pediatric Surgical Patients to Receive Care Outside of Specialized Pediatric Centers? . . . . . . . . . . . . . 127 Mark M. Goldfinger and Paul Tripi 39 Are the Transfusion Goals for a Premature Infant the Same As for a 7-Year-Old? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 Olga N. Albert 40 How Should You Get the Autistic Child into the Operating Room When the Mother Objects to Intramuscular Ketamine? . . . . . . . . . . 133 Glenn E. Mann and Jerry Y. Chao 41 Is “Deep” Extubation Preferable in Patients at Risk for Bronchospasm?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 Manoj Dalmia 42 What Is the Best Approach to a Pediatric Patient with an Unexplained Intraoperative Cardiac Arrest? . . . . . . . . . . . . . . . . . 139 Sherryl Adamic and Anna Clebone 43 Malignant Hyperthermia: “It Certainly Is” Versus “It Certainly Is Not!” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 Corey S. Scher