The Perception and Use of Dexmedetomidine Among Anesthesia Providers: A Quality Improvement Project.

Purpose: Intraoperative opioid use is associated with postoperative nausea and vomiting, respiratory depression, and persistent postoperative pain, all of which contribute to increased length of stay and health care costs. Although research shows adding dexmedetomidine as an adjunct leads to reduced opioid-related postoperative complications, many anesthesia providers are not using this medication. The purpose of this quality improvement project was to increase the use of dexmedetomidine among anesthesia providers to improve outcomes among spinal and orthopedic surgery patients.

Spontaneous Pancreatic Pseudocyst-Superior Mesenteric Vein Fistula.

Pancreatic pseudocyst formation is a common complication of chronic pancreatitis. Rarely, a fistula develops between the pseudocyst and the portal venous system. We present a case of a 50-year-old man who was found to have a pancreatic pseudocyst-superior mesenteric vein fistula after being evaluated for several months of abdominal pain and weight loss.

Validation of a nonwearable device in healthy adults with normal and short sleep durations.

Study Objectives: To determine the accuracy of early and newer versions of a nonwearable sleep tracking device relative to polysomnography and actigraphy, under conditions of normal and restricted sleep duration.

Methods: Participants were 35 healthy adults (mean age = 18.97; standard deviation = 0.

Incarcerated Colonoscope in a Left Inguinal Hernia During Diagnostic Colonoscopy.

Colonoscope entrapment in an inguinal hernia is rare and few cases have been described in the literature. We present a 54-year-old patient who underwent a diagnostic colonoscopy which was complicated by incarceration of the colonoscope in a left inguinal hernia. This rare complication occurs more frequently during withdrawal, and our case was unique, given the incarceration of the colonoscope occurred during the insertion phase.

Endoscopic Botulinum Toxin Injection for Tacrolimus-Induced Achalasia in a Renal Transplant Recipient.

Post-transplantation achalasia secondary to immunosuppression is a rare complication. Here we present a man who developed dysphagia 4 days after his renal transplant and was found to have achalasia thought to be due to his tacrolimus. Switching from one calcineurin inhibitor to another was not possible in our patient due to the high risk of inducing rejection; thus he was successfully treated with the botulinum injection.