Anesthesia and analgesia
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Anesthesia and analgesia · Sep 2007
Comparative StudyMeasurement of anesthetics in blood using a conventional infrared clinical gas analyzer.
Measurement of the partial pressure of volatile anesthetics in blood is usually done using a "headspace equilibration" method with gas chromatography. However, it is not often performed in clinical studies because of the technical, equipment, and logistic requirements. To improve the accessibility of this measurement, we tested the use of a common infrared clinical gas analyzer, the Datex-Ohmeda Capnomac, for this purpose. ⋯ The accuracy and precision of measurement of volatile anesthetic gas partial pressures in blood by a double headspace equilibration technique, using a clinical infrared gas analyzer, were comparable to that achieved by previous studies using gas chromatography.
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Anesthesia and analgesia · Sep 2007
Improving operating room efficiency by applying bin-packing and portfolio techniques to surgical case scheduling.
An operating room (OR) department has adopted an efficient business model and subsequently investigated how efficiency could be further improved. The aim of this study is to show the efficiency improvement of lowering organizational barriers and applying advanced mathematical techniques. ⋯ Efficient OR departments can further improve their efficiency. The paper shows that a radical cultural change that comprises the use of mathematical algorithms and lowering organizational barriers improves OR utilization.
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Anesthesia and analgesia · Sep 2007
Case ReportsThe use of three-dimensional computed tomography images for anticipated difficult intubation airway evaluation of a patient with Treacher Collins syndrome.
A 13-year-old girl with Treacher Collins syndrome who had a history of difficult intubation was scheduled for plastic surgery. We took three-dimensional computed tomography images to better evaluate the anatomical features of the upper airway. The patient's anesthetic airway management was influenced by the findings of the images.
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Anesthesia and analgesia · Sep 2007
Clinical TrialExhaled carbon monoxide levels change in relation to inspired oxygen fraction during general anesthesia.
Heme oxygenase produces carbon monoxide (CO) during the breakdown of heme molecules. A variety of stressors upregulate this enzymatic activity and can increase exhaled CO levels. Recently, exhaled CO levels have been reported to increase in critically ill patients and after anesthesia and surgery. To use this measurement during mechanical ventilation, it is important to clarify the effects of factors which interfere with exhaled CO levels. The fraction of inspired oxygen (Fio2) is often changed during artificial ventilation. To investigate the effect of changes of Fio2 on exhaled CO, we measured exhaled CO levels during general anesthesia. ⋯ When monitoring exhaled CO levels during mechanical ventilation, it is important to consider the effects of Fio2.
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Anesthesia and analgesia · Sep 2007
Comparative StudyEpidural, intrathecal pharmacokinetics, and intrathecal bioavailability of ropivacaine.
Ropivacaine is used by the epidural route for postoperative pain management with various neuraxial techniques. Given the widespread use of these techniques and the relative paucity of data on spinal disposition of local anesthetics, we evaluated through an experimental animal model, the spinal disposition of ropivacaine, allowing further studies of factors influencing their intrathecal bioavailability. ⋯ Using an animal model, we showed that drug dispositions in the intrathecal and epidural compartments are different, and that the intrathecal bioavailability of ropivacaine after epidural administration is low, and highly variable.