Anesthesia and analgesia
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In conclusion, sevoflurane appears to be similar to isoflurane and desflurane with a few exceptions. Sevoflurane was not associated with increases in heart rate in adult patients and volunteers, whereas higher MACs of isoflurane and desflurane and rapid increases in the inspired concentrations of these two anesthetics have been associated with tachycardia. Increasing concentrations of sevoflurane progressively decrease blood pressure in a manner similar to the other volatile anesthetics, and in unstimulated volunteers this decrease may be slightly less than with isoflurane at a higher MAC. ⋯ Sevoflurane reduces baroreflex function in a manner similar to other volatile anesthetics. In several multicenter studies where patients with CAD or patients at high risk for CAD were randomized to receive either sevoflurane or isoflurane for cardiac or noncardiac surgery, the incidence of myocardial ischemia, infarction, and cardiac outcomes did not differ between treatment groups. Thus, sevoflurane has not been associated with untoward cardiovascular changes in volunteers and patients undergoing elective surgery compared with other volatile anesthetics, and it appears to offer a more stable heart rate profile than either isoflurane or desflurane.
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Anesthesia and analgesia · Dec 1995
Decreases in anesthesia-controlled time cannot permit one additional surgical operation to be reliably scheduled during the workday.
We tested whether anesthesiologists can decrease operating room (OR) costs by working more quickly. Anesthesia-controlled time (ACT) was defined as the sum of 1) the time starting when the patient enters an OR until preparation or surgical positioning can begin plus 2) the time starting when the dressing is finished and ending when the patient leaves the OR. Case time was defined as the time starting when one patient undergoing an operation leaves an OR and ending when the next patient undergoing the same operation leaves the OR. ⋯ Statistical analysis of measured OR times showed that ACt would have to be decreased by more than 100% to permit one additional scheduled, short (30-min) operation to be performed in an OR during an 8-h workday after a prior series of cases, each lasting more than 45 min. Anesthesiologists alone cannot reasonably decrease case times sufficiently to permit one extra case to be reliably scheduled during a workday. Methods to decrease ACT (e.g., using preoperative intravenous catheter teams, procedure rooms, and/or shorter acting drugs) may simply increase costs.
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Anesthesia and analgesia · Dec 1995
Letter Case ReportsAccidental prolonged mydriasis in anesthesiologists.