The Connecticut state Senate voted 25 to 11 Wednesday night to allow nurse practitioners to practice independent of physicians, a controversial concept that has gained traction amid growing concerns about the availability of primary care providers in the state.
The proposal, which now goes to the House, originated in Gov. Dannel P. Malloy’s administration, which pitched it as a way to increase access to primary care at lower costs as thousands more state residents gain insurance as part of the federal health law.
Rep. Andy Harris didn’t forget his long-time buddies in the medical field after he began serving in Congress in 2011 — and they didn’t forget him.
The Maryland Republican, who continues practicing as an anesthesiologist, has kept the interests of fellow anesthesiologists and other doctors in mind, pushing policies they consider a priority. And health professionals from across the country have played a significant role in helping finance Harris’ races.
In fact, health professionals have contributed more than any other industry group to Harris, donating more than $1.5 million from when he first announced his bid
EXPAREL Use in Femoral Nerve Block for Total Knee Arthroplasty Further Supported by Additional Data from Phase 3 Pivotal Study, sNDA Submission Planned for Second Quarter 2014
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PARSIPPANY, N.J. & CHICAGO — Pacira Pharmaceuticals, Inc. (NASDAQ: PCRX) today announced additional Phase 3 data supporting the efficacy and safety of EXPAREL® (bupivacaine liposome injectable suspension) to achieve a femoral nerve block in patients undergoing total knee arthroplasty. The Company previously announced results of the primary efficacy endpoint, a statistically significant reduction in cumulative pain scores over 72 hours compared to placebo (P<0.0001). Secondary endpoints presented at the 39th Annual Meeting of the American Society of Regional Anesthesia and Pain Medicine (ASRA) found that a higher percentage of patients who received EXPAREL were pain-free, consumed fewer opioids and reported higher satisfaction with their pain control. This randomized, double blind, placebo controlled study evaluated 278 patients who received either a femoral nerve block with EXPAREL or a placebo. A femoral nerve block provides pain control for the anterior (front) of the knee; in this trial there was no pain medication provided at the time of surgery for the posterior (back) of the knee, which explains the lack of a significant difference in time to first opioid rescue between the two study groups. In addition to pain scores through 72 hours, investigators also measured total opioid consumption through 72 hours, time to first opioid rescue, patient satisfaction with pain control and safety. The key findings are summarized below:
A 24 percent reduction in total opioid use in the EXPAREL group (P<0.05); there was no significant difference between groups in the time to first opioid rescue
A greater number of patients who were “extremely satisfied” with pain control in the EXPAREL group vs. placebo group at day 7 (55 percent vs. 43 percent) and day 30 (65 percent vs. 50 percent)
A statistically significantly higher percentage of “pain-free” patients in the EXPAREL group (~50 percent vs. 40 percent for placebo group at 60 hours; [P<0.05])
Safety was comparable between the EXPAREL and placebo groups, with similar numbers of patients displaying a normal ability to do a 20-meter walk test and similar physician satisfaction with return of motor function
Five additional studies evaluating the use of EXPAREL in transversus abdominis plane infiltration and nerve block will also be presented at the ASRA meeting. About Pacira Pacira Pharmaceuticals, Inc. (NASDAQ: PCRX) is a specialty pharmaceutical company focused on the clinical and commercial development of new products that meet the needs of acute care practitioners and their patients. The company’s current emphasis is the development of non-opioid products for postsurgical pain control, and its lead product, EXPAREL® (bupivacaine liposome injectable suspension), was commercially launched in the United States in April 2012. EXPAREL and two other products have utilized the Pacira proprietary product delivery technology DepoFoam®, a unique platform that encapsulates drugs without altering their molecular structure and then releases them over a desired period of time. Additional information about Pacira is available at www.pacira.com. About EXPAREL® EXPAREL (bupivacaine liposome injectable suspension) is indicated for single-dose infiltration into the surgical site to produce postsurgical analgesia. The product combines bupivacaine with DepoFoam, a proven product delivery technology that delivers medication over a desired time period. EXPAREL represents the first and only multivesicular liposome local anesthetic that can be utilized in the peri- or postsurgical setting in the same fashion as current local anesthetics. By utilizing the DepoFoam platform, a single dose of EXPAREL delivers bupivacaine over time, providing analgesia with reduced opioid requirements for up to 72 hours. Pivotal studies have demonstrated the safety and efficacy of EXPAREL in patients undergoing bunionectomy or hemorrhoidectomy procedures and additional studies are underway to further demonstrate the safety and efficacy in other procedures. Additional information is available at www.EXPAREL.com. Important Safety Information EXPAREL is contraindicated in obstetrical paracervical block anesthesia. EXPAREL has not been studied for use in patients younger than 18 years of age. Non-bupivacaine-based local anesthetics, including lidocaine, may cause an immediate release of bupivacaine from EXPAREL if administered together locally. The administration of EXPAREL may follow the administration of lidocaine after a delay of 20 minutes or more. Other formulations of bupivacaine should not be administered within 96 hours following administration of EXPAREL. Monitoring of cardiovascular and neurological status, as well as vital signs should be performed during and after injection of EXPAREL as with other local anesthetic products. Because amide-type local anesthetics, such as bupivacaine, are metabolized by the liver, EXPAREL should be used cautiously in patients with hepatic disease. Patients with severe hepatic disease, because of their inability to metabolize local anesthetics normally, are at a greater risk of developing toxic plasma concentrations. In clinical trials, the most common adverse reactions (incidence greater-than or equal to 10%) following EXPAREL administration were nausea, constipation, and vomiting. Please see the full Prescribing Information for more details available athttp://www.exparel.com/pdf/EXPAREL_Prescribing_Information.pdf.
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Nurses have always served on the front lines of health care. Now, nurses find themselves on the front lines of health care reform, and they stand ready and able to take on the challenge of improving
FTC is bolstering state legislative efforts to expand nurses' scope of practice by arguing in a new paper and in letters to states that states' efforts to keep nurses from gaining a larger health care role could be viewed as anticompetitive.
The FTC's competition advocacy program, which commonly submits comments on laws and regulation that it believes impact competition, weighed in on state legislation in a recent paper
Dressed in bright green scrubs, he swiftly made his way through brightly lit halls of Fort Campbell’s Blanchfield Army Community Hospital. After reaching his destination, a room full of tubes, monitors and cluttered instruments,
UPDATE 6:30 p.m.-- The House Select Committee on Workforce Innovation approved a massive bill that would expand the authority of nurse practitioners and open a door for them to practice independently. The vote, with only two dissents, followed testimony against
During a day in the hospital, it is frequent that a patient is transferred from another health care facility to my care. To facilitate the transfer, a phone conversation occurs during which I formally accept
Title: Equipment in Anaesthesia and Critical Care Authors: Daniel Aston BSc, MBBS, FRCA, Angus RIvers BSc, MBBS, FRCA, Asela Dharmadasa MA, BM BCh, FRCA Paperback: 404 pages Publisher: Scion Publishing Ltd.; 1 edition December 15, 2013
Equipment in Anaesthesia and Critical Care is written specifically for anesthesia trainees, including residents and nurse anesthetists in training.
The book is beautifully illustrated and features high quality color photographs throughout. The text is engaging and comprehensive, relating each piece of equipment back to its basic physics, mechanics and clinical context. The clear, concise and standardized format means that information is easy to access and perfect for reference and review. Every
As the overall landscape of Florida's health care delivery system continues to change and adapt to provisions of the Affordable Care Act and legislative reform, there is one reality that should not be ignored
Meta-analysis of secure randomised controlled trials of β-blockade to prevent perioperative death in non-cardiac surgery
Background Current European and American guidelines recommend the perioperative initiation of a course of β-blockers in those at risk of cardiac events undergoing high- or intermediate-risk surgery or vascular surgery. The Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography (DECREASE) family of trials, the bedrock of evidence for this, are no longer secure. We therefore conducted a meta-analysis of randomised controlled trials of β-blockade on perioperative mortality, non-fatal myocardial infarction, stroke and hypotension in non-cardiac surgery using the secure data. Methods The randomised controlled trials of initiation of β-blockers before non-cardiac surgery were