Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2006
An anesthesia information system designed to provide physician-specific feedback improves timely administration of prophylactic antibiotics.
Surgical site infections are a frequent cause of morbidity and mortality and add significantly to the cost of care. One component of the national Surgical Infection Prevention (SIP) program is to ensure timely administration of prophylactic antibiotics, a key factor to reduce postoperative infection. Our anesthesia department decided to assume the responsibility for timing and administration of antibiotic prophylaxis and we initiated a multitiered approach to remind the anesthesiologist to administer the prophylactic antibiotics. ⋯ After the program began, there was a steady increase in compliance to 92% 1 yr later. Provider-specific feedback increases compliance with practice guidelines related to timely administration of prophylactic antibiotics. Anesthesia information systems hold promise for implementing and monitoring new practice guidelines and the anesthesiologist may play a key role in influencing surgical outcomes by ensuring appropriate therapy that may not be directly related to anesthesia care.
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Malignant hyperthermia has rarely been reported in China. We report the first case of malignant hyperthermia, verified by caffeine-halothane contracture test and genetic testing, in a Chinese patient.
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Anesthesia and analgesia · Oct 2006
Case ReportsBleeding complications from femoral and sciatic nerve catheters in patients receiving low molecular weight heparin.
After knee replacement surgery, the use of continuous local anesthetic infusions in femoral and sciatic peripheral nerve catheters is an effective analgesic option. Limited data are available concerning the safety of peripheral nerve infusions in patients receiving low molecular weight heparin thromboprophylaxis. ⋯ Physical therapy and discharge from the hospital were delayed in two cases but no other complications were seen. More data are needed to determine if it is necessary to use the same guidelines for managing peripheral nerve infusion catheters in patients receiving enoxaparin as with epidurals and other types of central nerve catheter infusions.
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Anesthesia and analgesia · Oct 2006
Comparative StudyThe characteristics of intravenous adenosine-induced antinociception in a rabbit model of acute nociceptive pain: a comparative study with remifentanil.
Adenosine and remifentanil are potent IV analgesics with ultrashort half-lives. The antinociceptive effect of IV adenosine has not been clearly characterized. We compared the antinociceptive effects of adenosine and remifentanil in rabbits. ⋯ Remifentanil had a rapid onset and short duration of action, and probably showed signs of tolerance development, whereas the antinocieptive effect of adenosine was slow in onset and long-lasting, despite its ultrashort plasma half-life and the immediate on-off profiles of its vasodilating effect.