Anesthesiology
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Randomized Controlled Trial Comparative Study
The effects of ketamine and rocuronium on the A-Line auditory evoked potential index, Bispectral Index, and spectral entropy monitor during steady state propofol and remifentanil anesthesia.
The authors studied the effects of ketamine and rocuronium on the Bispectral Index, A-Line auditory evoked potential index, state entropy, and response entropy during a calculated steady state anesthesia with propofol and remifentanil. ⋯ The response of all monitors after ketamine administration is not affected by simultaneous administration of rocuronium. Interpretation of all studied indices must be done cautiously while taking into account the clinical setting during measurement.
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Randomized Controlled Trial
A multicenter clinical study of the safety and activity of maleimide-polyethylene glycol-modified Hemoglobin (Hemospan) in patients undergoing major orthopedic surgery.
Hemospan (Sangart Inc., San Diego, CA), a polyethylene glycol-modified hemoglobin with unique oxygen transport properties, has successfully completed a phase I trial in healthy volunteers. Because adverse events are expected to increase with age, the authors conducted a phase II safety study of Hemospan in elderly patients undergoing elective hip arthroplasty during spinal anesthesia. ⋯ In comparison with Ringer's acetate, Hemospan mildly elevates hepatic enzymes and lipase and is associated with less hypotension and more bradycardic events. The absence of a high frequency of serious adverse events suggests that further clinical trials should be undertaken.
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Clinical Trial
Forehead pulse oximetry: Headband use helps alleviate false low readings likely related to venous pulsation artifact.
This study investigated whether a tensioning headband that applies up to 20 mmHg pressure over a forehead pulse oximetry sensor could improve arterial hemoglobin oxygen saturation reading accuracy in presence of venous pooling and pulsations at the forehead site. ⋯ Application of up to 20 mmHg pressure on the forehead pulse oximetry sensor using an elastic tensioning headband significantly reduced reading errors and provided consistent performance when subjects were placed between supine and up to 15 degrees head-down incline (Trendelenburg position).
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This study describes a nationwide survey that estimates the number and characteristics of anesthesia-related deaths for the year 1999. ⋯ In comparison with data from a previous nationwide study (1978-1982), the anesthesia-related mortality rate in France seems to be reduced 10-fold in 1999. Much remains to be done to improve compliance of physicians to standard practice and to improve the anesthetic system process.