Anesthesiology
-
Randomized Controlled Trial
A randomized study of the effects of gabapentin on postamputation pain.
Pain after amputation is common but difficult to treat. Therefore, the authors examined whether postoperative treatment with gabapentin could reduce postamputation stump and phantom pain. ⋯ Gabapentin administered in the first 30 postoperative days after amputation does not reduce the incidence or intensity of postamputation pain.
-
Comparative Study
Measurement of carboxyhemoglobin and methemoglobin by pulse oximetry: a human volunteer study.
A new eight-wavelength pulse oximeter is designed to measure methemoglobin and carboxyhemoglobin, in addition to the usual measurements of hemoglobin oxygen saturation and pulse rate. This study examines this device's ability to measure dyshemoglobins in human volunteers in whom controlled levels of methemoglobin and carboxyhemoglobin are induced. ⋯ The Masimo Rad-57 is the first commercially available pulse oximeter that can measure methemoglobin and carboxyhemoglobin, and it therefore represents an expansion of our oxygenation monitoring capability.
-
Teamwork in the operating room: frontline perspectives among hospitals and operating room personnel.
The Joint Commission on Accreditation of Healthcare Organizations is proposing that hospitals measure culture beginning in 2007. However, a reliable and widely used measurement tool for the operating room (OR) setting does not currently exist. ⋯ Rigorous assessment of teamwork climate is possible using this psychometrically sound teamwork climate scale. This tool and initial benchmarks allow others to compare their teamwork climate to national means, in an effort to focus more on what excellent surgical teams do well.
-
Comparative Study Clinical Trial
No sex differences in memory formation during general anesthesia.
Women respond differently to anesthesia than men, initially recovering more rapidly, but having more postoperative morbidity. Studies on surgical patients report evidence of memory formation during anesthesia. However, sex differences in memory formation have not been explored. Therefore, the authors investigated sex differences in the implicit and explicit memory formation during general anesthesia. ⋯ Patients showed greater memory performance for words presented during general anesthesia than for words not presented. However, sex differences in memory formation were not observed. A relation between hypnotic state and memory during sevoflurane anesthesia was also established, suggesting that memory formation is possible even at hypnotic depths considered to be adequate anesthesia.
-
Dexmedetomidine, a selective alpha2-adrenoceptor agonist, has counteracting effects on the cardiovascular system. It mediates sympatholysis by activating alpha2 adrenoceptors in the central and peripheral nervous system, and vasoconstriction and vasorelaxation by activating postsynaptic alpha2 adrenoceptors in blood vessels. The goal of this study was to determine the effects of therapeutic and high concentrations of dexmedetomidine on myocardial perfusion and cardiac function in healthy subjects. ⋯ In healthy subjects, plasma concentrations of dexmedetomidine that significantly exceed the recommended therapeutic level do not seriously attenuate myocardial perfusion below the level that is observed with usual therapeutic concentrations and do not induce evident myocardial ischemia.