Anesthesiology
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Comparative Study
Hearing acuity of anesthesiologists and alarm detection.
With rapid technological advances in anesthesiology, we are acquiring an ever increasing number of auditory alarm systems in the operating room the value of which depend on the hearing acuity of the anesthesiologist monitoring the patient. Presbycusis, the effect of aging on the auditory system, characteristically results in a bilaterally symmetric neurosensory high-frequency hearing loss ( > 2,000 Hz). In this study we attempt to assess the impact of this common hearing disorder on alarm detection. ⋯ Although high-frequency hearing acuity of individuals in our study was better than that of the general population, hearing deficits at high frequencies were of the magnitude to interfere with alarm detection. Also background noise levels vary greatly in different operating rooms. These two problems create a hindrance to alarm detection for certain anesthesiologists. From our data we conclude that the aging human ear may not be capable of accurately detecting some auditory alarms in the operating room. Alarm design should consider hearing acuity because high-frequency alarms may go undetected.
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Randomized Controlled Trial Comparative Study Clinical Trial
Onset of action of mivacurium chloride. A comparison of neuromuscular blockade monitoring at the adductor pollicis and the orbicularis oculi.
The optimal site for monitoring neuromuscular blockade for intubations facilitated with mivacurium chloride has not been established. The primary purpose of this evaluation was to determine the difference in onset of neuromuscular blockade between the orbicularis oculi and adductor pollicis in patients administered mivacurium chloride. We also evaluated intubating conditions when intubation was timed to maximal neuromuscular blockade at either the orbicularis oculi or the adductor pollicis. The results for patients administered mivacurium chloride were compared with those for a control group administered succinylcholine. ⋯ When monitoring 95% twitch height depression of the orbicularis oculi muscle, intubation can be accomplished in approximately 2 min after administration of mivacurium chloride (0.15 mg.kg-1). Because intubating conditions were comparable to the patients administered succinylcholine or intubated during monitoring of the twitch height depression of the adductor pollicis, we believe that optimal site for monitoring during intubation using mivacurium chloride is the orbicularis oculi muscle.