Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2009
Case ReportsMisalignment of disposable pulse oximeter probes results in false saturation readings that influence anesthetic management.
We report a small case series in which misaligned disposable pulse oximeter sensors gave falsely low saturation readings. In each instance, the sensor performed well during preinduction oxygen administration and the early part of the case, most notably by producing a plethysmographic trace rated as high quality by the oximeter software. The reported pulse oximeter oxygen saturation eventually decreased to concerning levels in each instance, but the anesthesiologists, relying on the reported high-quality signal, initially sought other causes for apparent hypoxia. ⋯ When the malpositioned sensors were discovered and repositioned, the apparent hypoxia was quickly relieved in each case. We then undertook a survey of disposable oximeter sensors as patients entered the recovery room, and discovered malposition of more than 1 cm in approximately 20% of all sensors, without apparent consequence. We conclude that the technology is quite robust, but that the diagnosis of apparent hypoxia should include a quick check of oximeter position early on.
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Anesthesia and analgesia · Nov 2009
Editorial CommentOn cricoid pressure: "may the force be with you".
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Anesthesia and analgesia · Nov 2009
Substance use among Iranian cardiac surgery patients and its effects on short-term outcome.
We assessed the prevalence of substance use among patients undergoing coronary artery bypass graft and valve surgery in northwest Iran. We evaluated the postoperative complications and in-hospital mortality of patients with substance dependence and abuse. ⋯ In cardiac surgery patients in northwest Iran, the prevalence of cigarette smoking is relatively low (very low in women), as is alcohol use, compared with Western countries; however, opium use is twice as prevalent. We found higher pulmonary complication rates in men who smoked, but no increase in postoperative cardiopulmonary complications and in-hospital mortality rates in patients who abused opium and consumed alcohol.