Opioid-Free Total Intravenous Anesthesia for Morbidly Obese Patient Undergoing Gastric Bypass with a History of Postoperative Nausea and Vomiting

Postoperative nausea and vomiting (PONV) is a common undesirable effect from general anesthesia. PONV is nausea and/or vomiting that occurs either in the post-anesthesia care unit (PACU), or up until 48 hours after surgery. Increased salivation, retching, and tachycardia are common when one experiences nausea. Since the typical surgical patient is volumed depleted from being NPO, vomiting can exacerbate other issues especially fluid and electrolyte balances. To mitigate PONV, anesthesia providers are avoiding agents that trigger nausea and vomiting, especially opioids and volatile inhalation anesthetics. This requires the use of total intravenous anesthesia, or TIVA, with multimodal opioid-free analgesic adjuncts. In this evidence-based case study, a 34-year-old morbidly obese female with a history of PONV presented to the hospital for gastric bypass surgery. The literature in this case study will examine the utilization of opioid-free TIVA in reducing the incidence of PONV in a highly susceptible morbidly obese, young, female patient presenting for laparoscopic surgery

Opioid-Free Total Intravenous Anesthesia for Morbidly Obese Patient Undergoing Gastric Bypass with a History of Postoperative Nausea and Vomiting

Postoperative nausea and vomiting (PONV) is a common undesirable effect from general anesthesia. PONV is nausea and/or vomiting that occurs either in the post-anesthesia care unit (PACU), or up until 48 hours after surgery. Increased salivation, retching, and tachycardia are common when one experiences nausea. Since the typical surgical patient is volumed depleted from being NPO, vomiting can exacerbate other issues especially fluid and electrolyte balances. To mitigate PONV, anesthesia providers are avoiding agents that trigger nausea and vomiting, especially opioids and volatile inhalation anesthetics. This requires the use of total intravenous anesthesia, or TIVA, with multimodal opioid-free analgesic adjuncts. In this evidence-based case study, a 34-year-old morbidly obese female with a history of PONV presented to the hospital for gastric bypass surgery

Freight Wing Trailer Aerodynamics

Freight Wing Incorporated utilized the opportunity presented by this DOE category one Inventions and Innovations grant to successfully research, develop, test, patent, market, and sell innovative fuel and emissions saving aerodynamic attachments for the trucking industry. A great deal of past scientific research has demonstrated that streamlining box shaped semi-trailers can significantly reduce a truck's fuel consumption. However, significant design challenges have prevented past concepts from meeting industry needs. Market research early in this project revealed the demands of truck fleet operators regarding aerodynamic attachments. Products must not only save fuel, but cannot interfere with the operation of the truck, require significant maintenance, add significant weight, and must be extremely durable. Furthermore, SAE/TMC J1321 tests performed by a respected independent laboratory are necessary for large fleets to even consider purchase. Freight Wing used this information to create a system of three practical aerodynamic attachments for the front, rear and undercarriage of standard semi trailers. SAE/TMC J1321 Type II tests preformed by the Transportation Research Center (TRC) demonstrated a 7% improvement to fuel economy with all three products. If Freight Wing is successful in its continued efforts to gain market penetration, the energy and environmental savings would be considerable. Each truck outfitted saves approximately 1,100 gallons of fuel every 100,000 miles, which prevents over 12 tons of CO2 from entering the atmosphere. If all applicable trailers used the technology, the country could save approximately 1.8 billion gallons of diesel fuel, 18 million tons of emissions and 3.6 billion dollars annually