Anesthesia and analgesia
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Anesthesia and analgesia · Oct 1994
Body position does not affect the hemodynamic response to venous air embolism in dogs.
Current therapy for massive venous air embolism (VAE) includes the use of the left lateral recumbent (LLR) position. This recommendation is based on animal studies, conducted 50 yr ago, which looked primarily at survival. Little is known, however, about the concomitant hemodynamic response after VAE in various body positions. ⋯ The acute hemodynamic changes occurring during the first 5-15 min after VAE recovered to 80% of control within 60 min. Our data suggest that body repositioning does not influence the cardiovascular response to VAE. Specifically, our data do not support the recommendation of repositioning into the LLR position for the treatment of VAE.
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Anesthesia and analgesia · Oct 1994
Randomized Controlled Trial Clinical TrialEffect of injection rate on sensory level and duration of hypobaric bupivacaine spinal anesthesia for total hip arthroplasty.
We prospectively studied 18 male patients undergoing total hip arthroplasty in the lateral decubitus position to determine the effect of injection rate on sensory level and duration of 0.3% hypobaric bupivacaine spinal anesthesia. Patients were randomized into one of two groups according to rate of injection. Dural puncture was performed in the midline at the L3-4 interspace with a 22-gauge needle, with the patient in the lateral decubitus position (operative side uppermost). ⋯ Fast rate of injection also resulted in a higher maximum sensory level on both nondependent and dependent sides compared to the slow rate of injection (mean difference four segments). The specific gravity of the local anesthetic solution was significantly less than that of patient cerebrospinal fluid (CSF), indicating that 0.3% bupivacaine is hypobaric. We conclude that fast injection of 0.3% bupivacaine at room temperature results in a higher maximum sensory level than slow injection.
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Anesthesia and analgesia · Oct 1994
Randomized Controlled Trial Comparative Study Clinical TrialBlood transfusion with autologous and leukocyte-depleted or standard allogeneic red blood cells and the immune response to open heart surgery.
Allogeneic blood transfusions have been associated with impaired outcome in surgical patients. This effect may be mediated by leukocytes. Animal experiments have shown that at least some of the effect can be modified by removal of leukocytes from transfused blood. ⋯ Three of the 12 patients in the allogeneic leukocyte-containing red blood transfusion group became human lymphocyte antigen (HLA) alloimmunized. No infections or other complications occurred in any patients. We conclude that HLA alloimmunization was the only effect that could be modified by use of autologous blood.
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Anesthesia and analgesia · Oct 1994
Randomized Controlled Trial Clinical TrialPrevention of endotracheal tube-induced coughing during emergence from general anesthesia.
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Anesthesia and analgesia · Oct 1994
Prevention of occupational transmission of human immunodeficiency virus and hepatitis B virus among anesthesiologists: a survey of anesthesiology practice.
In light of the increasing prevalence of the human immunodeficiency virus (HIV) and hepatitis B virus (HBV), anesthesiologists are now likely to see more patients who are at high risk for these viruses. Therefore, it is important that they adopt infection control policies aimed at preventing occupational transmission of these and other pathogens during their clinical practice. This study was designed, using a questionnaire format, to evaluate anesthesiologist compliance with Centers for Disease Control (CDC) guidelines for the prevention of occupational transmission of HIV and HBV. ⋯ However, anesthesiologists who reported recapping needles using the one-handed technique were less likely to sustain a needlestick injury than those who recapped using the two-handed technique. Thirty-one percent and 72% of respondents respectively reported a clean or contaminated needlestick within the preceeding 12 mo. Only 45.4% of those receiving a contaminated needlestick sought treatment.(ABSTRACT TRUNCATED AT 250 WORDS)