Anesthesiology
-
Randomized Controlled Trial
Prevention of atelectasis in morbidly obese patients during general anesthesia and paralysis: a computerized tomography study.
Morbidly obese patients show impaired pulmonary function during anesthesia and paralysis, partly due to formation of atelectasis. This study analyzed the effect of general anesthesia and three different ventilatory strategies to reduce the amount of atelectasis and improve respiratory function. ⋯ A recruitment maneuver followed by PEEP reduced atelectasis and improved oxygenation in morbidly obese patients, whereas PEEP or a recruitment maneuver alone did not.
-
Comparative Study
Ultrasound evaluation of the sacral area and comparison of sacral interspinous and hiatal approach for caudal block in children.
Although caudal block via the sacral hiatus is a common regional technique in children, it is sometimes difficult to identify the hiatus. A needle approach via the S2-3 interspace can be used as an alternative to the conventional approach. The authors compared the feasibility and clinical characteristics between the S2-3 approach and hiatal approach, in addition to ultrasound study. ⋯ The S2-3 approach can be applied as a useful fallback method to the conventional landmark approach in children, especially in those older than 36 months who present with difficult identification of the sacral hiatus.
-
Knowledge of patterns related to patient visits in a multispecialty group is important for helping anesthesia groups make strategic and tactical decisions relevant to increasing anesthesia workload. ⋯ Investment in outpatient primary care clinics, nonsurgical specialty clinics, or scheduling systems to facilitate patient appointments would not materially affect anesthesia workload. The workload of the anesthesia department depends on facilitating surgeon-dependent processes: (1) open access to operating room time on any future workday, (2) well-calculated blocks to permit high surgeon productivity, and (3) open access to surgeon clinics to reduce days from referral to first appointment.