Anesthesia and analgesia
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Anesthesia and analgesia · Feb 2008
Comparative StudyThe immediate and sustained effects of volume challenge on regional blood flows in pigs.
The postoperative assessment of volume status is not straightforward because of concomitant changes in intravascular volume and vascular tone. Hypovolemia and blood flow redistribution may compromise the perfusion of the intraabdominal organs. We investigated the effects of a volume challenge in different intra- and extraabdominal vascular beds. ⋯ A volume challenge in clinically euvolemic postoperative animals was associated with a sustained increase in blood flow to all vascular beds, although the increase in the celiac trunk and the hepatic artery was very modest and did not reach statistical significance. Whether improved postoperative organ perfusion is accompanied by a lower complication rate should be evaluated in further studies.
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Anesthesia and analgesia · Feb 2008
Comparative StudyThe use of distributed displays of operating room video when real-time occupancy status was available.
On the day of surgery, real-time information of both room occupancy and activities within the operating room (OR) is needed for management of staff, equipment, and unexpected events. ⋯ Our nurses and physicians both accepted and used distributed OR video as it provided useful information, regardless of whether real-time display of milestones was available (e.g., through anesthesia information system data).
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Anesthesia and analgesia · Feb 2008
Comparative StudyPredicting orthopedic surgeons' preferences for peripheral nerve blocks for their patients.
A 2002 survey of 468 Canadian orthopedic surgeons found that the "two principal reasons regional anesthesia is not favored" are "delays in operating rooms" and "unpredictable success." We reanalyzed the data from the study to evaluate whether these concerns were the best predictors of an individual surgeon's willingness to use peripheral nerve blocks for their patients. ⋯ A surgeon's preference for peripheral nerve blocks for his or her own surgery predicted a surgeon's preference for his or her patients. Perceptions of delays and success rate did not add sufficient incremental information to the surgeon's preferences to be of economic importance. These results are important to better forecast the net economic impact on an anesthesia group of a regional block team.
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Anesthesia and analgesia · Feb 2008
Biography Historical ArticleA tribute to Dr. Paul A. J. Janssen: entrepreneur extraordinaire, innovative scientist, and significant contributor to anesthesiology.
Dr. Paul Janssen was the founder of Janssen Pharmaceutica and the developer of over 80 pharmaceutical compounds that proved useful in human, botanical, and veterinary medicine. He and his coworkers synthesized the fentanyl family of drugs, many other potent analgesics, droperidol, etomidate, and numerous other important medicines that were extremely useful in psychiatry, parasitology, gastroenterology, cardiology, virology, and immunology. Anesthesiology and medicine as a whole have benefited a great deal from his resourcefulness, creativity, and entrepreneurial spirit.
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Anesthesia and analgesia · Feb 2008
Comparative StudyPractice patterns in choice of left double-lumen tube size for thoracic surgery.
Some anesthesiologists choose smaller than body size-appropriate left sided double-lumen tubes (DLTs) ("down-size") for lung isolation in an attempt to limit the risk of airway trauma. There are few data on the effects of DLT size on intraoperative outcome measures. ⋯ Under the conditions of this pilot study, the use of smaller than conventionally sized DLT was not associated with any differences in clinical intraoperative outcomes.