Consensus Guidelines for the Management of PONV -

Despite significant advances in the treatment and prevention of postoperative nausea and vomiting (PONV), this adverse event remains a frequent surgical complication, with incidence rates estimated between 20% and 30%. The complication is associated with varying degrees of medical and surgical consequences that can necessitate prolonged stays in postanesthesia care units and is a leading cause of hospital readmission, thereby increasing medical costs and morbidity.

Measuring Total Hemoglobin Continuously and Noninvasively: An Up-to-the-Minute Approach - Traditional hemoglobin diagnostics do not allow for continuous or noninvasive measurement of total hemoglobin. In surgeries associated with extensive blood loss, rapid fluid administration or transfusion, in emergency care situations, or in any instance where hemoglobin levels are rapidly changing, it has been noted that rapid, noninvasive measuring capabilities would be extremely beneficial for improving patient outcomes. 

Recent Advances in Biologic Hemostatic Agents - Despite the advances made to reduce postoperative complications, blood loss remains a significant problem and can lead to morbidity and mortality. Traditional surgical techniques (eg, cautery and suture ligation) may not adequately control bleeding, or it may not be possible to use them during certain surgical procedures. During the past few decades, biologic hemostatic agents that mimic and enhance stages of the coagulation cascade have emerged. This special report discusses these agents, which can be categorized as systemic and topical agents.

Controlling Perioperative Nausea and Vomiting - Perioperative nausea and vomiting includes both postoperative (PONV) and postdischarge (PDNV) nausea and vomiting. The potential clinical, economic, and patient-related consequences of PONV and PDNV have been well characterized and documented. Yet, despite the availability of a wide range of antiemetic agents, the use of multimodal interventions, a better understanding of patient-related risk factors, and the development of numerous practice guidelines, PONV and PDNV still remain clinical concerns. Nausea and vomiting are not limited to the postanesthesia care unit (PACU) or the hospital; rather, the side effects often persist after patients have been discharged home. This underscores the need for new antiemetic agents and techniques that not only offer greater efficacy and proven safety but also provide an extended duration of action. Potentially, this would protect patients from nausea and vomiting over a prolonged time course and might improve patient outcomes. This monograph is intended to provide current information on PONV and PDNV and their prophylaxis, and to explore the practical implications of recent findings on antiemetic practices, in order to enable practitioners to make more informed decisions regarding antiemetic use both now and in the future.

Hot Topics in Neuropathic Pain - In the United States, 2% to 3% of the population is affected by neuropathic pain, with postherpetic neuralgia and diabetic peripheral neuropathic pain being the most common. Symptoms include allodynia, paresthesia, and hyperalgesia, as well as partial or complete loss of sensation and muscle weakness. The impact of neuropathic pain on a patient's quality of life is overwhelmingly negative.
Optimal identification and treatment of neuropathic pain is particularly challenging for physicians. In an effort to improve the identification and management of patients with neuropathic pain, the International Association for the Study of Pain (IASP) supported the development of a new definition of neuropathic pain and updated its guidelines. This monograph provides the latest developments in diagnosing neuropathic pain and approaching treatment as presented at the International Association for the Study of Pain 12th World Congress of Pain held in Glasgow, Scotland,