Anesthesiology
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To establish guidelines for the preparation of the Primus anesthetic workstation (Dräger, Lübeck, Germany) for malignant hyperthermia-susceptible patients, the authors evaluated the effect of replacing the workstation's exchangeable internal components on the washout of isoflurane. ⋯ Washout of isoflurane increased 20-fold with the use of an autoclaved ventilator diaphragm and integrated breathing system. To prepare the Primus for malignant hyperthermia-susceptible patients, the authors recommend replacing the ventilator diaphragm and integrated breathing system with autoclaved components, flushing the workstation for 5 min at a fresh gas flow of 10 l/min, and maintaining this flow for the duration of anesthesia.
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Procedure times are important variables that often are included in studies of quality and efficiency. However, due to the need for costly chart review, most studies are limited to single-institution analyses. In this article, the authors describe how well the anesthesia claim from Medicare can estimate chart times. ⋯ Anesthesia chart time can be well estimated using Medicare claims, thereby facilitating studies with vastly larger sample sizes and much lower costs of data collection.
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Randomized Controlled Trial
Risk factors for the occurrence of electroencephalogram abnormalities during induction of anesthesia with sevoflurane in nonepileptic patients.
The aim of this prospective study was to determine the risk factors of epileptiform discharge during induction with sevoflurane in healthy adult patients. ⋯ Induction with sevoflurane may result in epileptiform electroencephalographic activity. Only electroencephalographic monitoring allows the diagnosis. Risk factors are mainly female sex, short delay to onset of anesthesia, and high alveolar sevoflurane concentration. Induction with high sevoflurane concentration is controversial mainly in women.