Anesthesia and analgesia
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Anesthesia and analgesia · Apr 1995
Preventing perioperative transmission of infection: a survey of anesthesiology practice.
Given the societal and economic impact of perioperative infection, it is essential that anesthesiologists and other operating room personnel use appropriate precautions to reduce the potential for transmission of infectious agents to the patients under their care. This study, therefore, was designed to evaluate the degree to which anesthesiologists utilize appropriate hygienic techniques for the prevention of infection in the perioperative period. A total of 1149 questionnaires were mailed to anesthesiologists randomly selected from the membership of the American Society of Anesthesiologists (ASA). ⋯ The practice of reusing syringes was significantly greater among private than university practitioners (P < 0.01). On a scale of 0-10 (10 = high) anesthesiologists rated their potential for transmitting or contributing to patient potential for transmitting or contributing to patient infection as 4.7 +/- 0.12 (mean +/- SE). Results of this study suggest that, whereas most responding anesthesiologists exhibit appropriate infection control behaviors, there are several potentially hazardous practices that continue.
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Anesthesia and analgesia · Apr 1995
Comparative StudyThe cerebrospinal fluid and plasma pharmacokinetics of sufentanil after thoracic or lumbar epidural administration.
The cerebrospinal fluid (CSF) and plasma pharmacokinetics of sufentanil were studied in 29 adult patients undergoing thoracotomy under general anesthesia. Sufentanil, 75 micrograms, diluted in 10 mL saline, was given preoperatively in either the lumbar or thoracic epidural space to 14 and 15 patients, respectively. Lumbar CSF and plasma were frequently sampled for 10 h and analyzed for sufentanil concentration by radioimmunoassay. ⋯ In the lumbar group, the AUC and Cmax values in CSF were 19 (P < 0.01) and 45 (P < 0.01) times higher than in plasma, and 4.7 (P < 0.01) and 8.2 (P < 0.001) times higher than in CSF in the thoracic group. The decline in sufentanil concentration was more rapid in CSF than plasma; in the lumbar group the CSF/plasma concentration-ratio was eight and five at 6 and 10 h, respectively, after sufentanil administration. This study shows that after epidural administration sufentanil concentrations are higher in CSF than in plasma, and are highly localized within CSF to the site of administration.
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Anesthesia and analgesia · Apr 1995
Effects of CAS 754, a new nitric oxide donor, on regional cerebral blood flow in focal cerebral ischemia.
Nitric oxide (NO) plays an important role in regulating regional cerebral blood flow (rCBF). This study was performed to compare the effects of the NO donor, CAS 754, a sydnonimine derivative, and sodium nitroprusside (SNP) on rCBF in ischemic and nonischemic brain regions. Twenty-eight rats were anesthetized with 1.4% isoflurane and were mechanically ventilated. ⋯ Phenylephrine infusion in the CAS 754-treated animals did not significantly affect the rCBF of the ischemic or nonischemic brain regions. In conclusion, our study demonstrated that CAS 754 was a more effective cerebral vasodilator than nitroprusside when administered systemically. In the ischemic cortex, neither CAS 754 nor nitroprusside improved rCBF Failure of CAS 754 to improve the rCBF of the ischemic cortex does not appear to be due to hypotension induced by CAS 754.