Anesthesia and analgesia
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Opening of the first door of pulse photometry gave us pulse oximeter. The next door opens to multiwavelength pulse photometry. It will give us a high performance pulse oximeter, providing a wide variety of clinical information simultaneously. This next generation of pulse photometry should further improve bedside monitoring and patient care.
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Anesthesia and analgesia · Jan 2002
Case ReportsProlongation of rapacuronium neuromuscular blockade by clindamycin and magnesium.
We report a prolonged neuromuscular block with the nondepolarizing muscle relaxant rapacuronium in the presence of clindamycin. Even when using "short-acting" muscle relaxants, the anesthesiologist must routinely monitor the neuromuscular function.
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Anesthesia and analgesia · Jan 2002
Peripheral nerve blockade with long-acting local anesthetics: a survey of the Society for Ambulatory Anesthesia.
Despite the growth of ambulatory anesthesia and the renewed popularity of regional techniques, there is little current information concerning outpatient regional anesthesia practices or attitudes about discharge with an insensate extremity. We present results from a survey sent to all members of the Society for Ambulatory Anesthesia (SAMBA). The survey was mailed in January 2001 to 2373 SAMBA members, along with a self-addressed stamped return envelope. After 3 mo, 1078 surveys were returned (response rate 45%). Respondents indicated that they were most likely to perform axillary (77%), interscalene (67%), and ankle blocks (68%) on ambulatory patients. They were less likely to perform lower extremity conduction blocks in ambulatory patients (femoral blocks, 40%; all other types of blocks, <23%]. Eighty-five percent of respondents discharged patients with long-acting blocks, but this was mainly limited to three types. Of the 16% who never or rarely discharged patients with long-acting blocks, the primary reasons were concern about patient injury (49%) and the inability for patients to care for themselves (28%). Only 22% of office-based anesthesiologists would perform upper extremity blocks and only 28% would perform lower extremity blocks (P < 0.001). This survey demonstrates that use of regional anesthesia in outpatients is common but restricted to a few techniques. Discharge with an insensate upper extremity is prevalent but discharge with an insensate lower extremity is not common and remains controversial. Despite the reasoning for the reported practices, randomized data are necessary to confirm the validity of these concerns. ⋯ This survey demonstrates that use of regional anesthesia in outpatients is common but restricted to a few techniques. Discharge with an insensate upper extremity is common but discharge with an insensate lower extremity is not prevalent and remains controversial.
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Anesthesia and analgesia · Jan 2002
Combining transcutaneous blood gas measurement and pulse oximetry.
We are describing the preliminary results of tests performed in adult volunteers and in adult patients during and after general anesthesia with a miniaturized single sensor combining the continuous and non-invasive measurement of oxygen saturaiton by pulse oximetry (SpO2) and transcutaneous PCO2 (OxiCarbo sensor). The sensor is heated to 42 degrees C to arterialize the cutaneous tissue and is applied at the ear lobe with a special low-pressure clip. ⋯ The ear lobe OxiCarbog sensor detects the SpO2 change 5 to 37 sec faster than a finger sensor and the PCO2 change 9 to 48 sec faster than a transcutaneous sensor fixed at the upper arm. Further improvements versus single sensors are a higher stability of the SpO2 signal and the possibility of performing long term SpO2 and PCO2 measurement at the ear lobe.
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Anesthesia and analgesia · Jan 2002
Comment Letter Case ReportsAnother cause of epidural catheter breakage?