Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2009
Comparative StudyA comparison of transmittance and reflectance pulse oximetry during vascular surgery.
New reflectance pulse oximetry probes placed on the forehead may be an improvement over transmittance probes placed on a finger, toe, or earlobe in patients with compromised perfusion. We compared the reliability and accuracy of the 2 types of probes in patients undergoing vascular surgery. ⋯ The new reflectance forehead Spo(2) probe tested has acceptable agreement with the older transmittance probe placed on the earlobe for pulse oximetry within typical ranges of Spo(2) in patients undergoing vascular surgery.
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Anesthesia and analgesia · Dec 2009
A comparison of micropore membrane inlet mass spectrometry-derived pulmonary shunt measurement with Riley shunt in a porcine model.
The multiple inert gas elimination technique was developed to measure shunt and the ratio of alveolar ventilation to simultaneous alveolar capillary blood flow in any part of the lung (V(A)'/Q') distributions. Micropore membrane inlet mass spectrometry (MMIMS), instead of gas chromatography, has been introduced for inert gas measurement and shunt determination in a rabbit lung model. However, agreement with a frequently used and accepted method for quantifying deficits in arterial oxygenation has not been established. We compared MMIMS-derived shunt (M-S) as a fraction of total cardiac output (CO) with Riley shunt (R-S) derived from the R-S formula in a porcine lung injury model. ⋯ Shunt derived from MMIMS inert gas retention data correlated well with R-S during breathing of oxygen. Shunt as derived by MMIMS was generally less than R-S.
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Anesthesia and analgesia · Dec 2009
Comparative StudyAirway injury during emergency transcutaneous airway access: a comparison at cricothyroid and tracheal sites.
Oxygenation via the cricothyroid membrane (CTM) may be required in emergencies, but inadvertent tracheal cannulation may occur. In this study, we compared airway injury between the tracheal and CTM sites using different techniques for airway access. ⋯ Airway injury and luminal compression were more common at the tracheal site than at the CTM. The ST and TT were associated with the highest incidence of injury. This has implications for emergency airway access in cases in which it may be difficult to accurately identify the CTM.
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Anesthesia and analgesia · Dec 2009
Superficial cervical plexus neuropathy after single-injection interscalene brachial plexus block.
Interscalene brachial plexus block (ISB) using the modified lateral approach provides a well-established method of anesthesia and analgesia for patients undergoing shoulder surgery. Considering the neural anatomy at the site of injection, the superficial cervical plexus may be at risk of injury. We evaluated the incidence and characteristics of superficial cervical plexus neuropathy. ⋯ Superficial cervical plexus neuropathy is not uncommon after ISB using the modified lateral approach and the possibility should be discussed with patients preprocedurally.
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Anesthesia and analgesia · Dec 2009
Historical ArticleCardiac anesthesia: thirty years later--the second annual Arthur E. Weyman lecture.
Cardiac anesthesiology has evolved spectacularly over the past 30 yr, changing from a practice focused on the anesthetic management of patients with cardiovascular diseases to a practice of cardiovascular medicine that contributes to the medical and surgical management of cardiovascular patients. The second Weyman lecture reviews this history, the critical role of the Society of Cardiovascular Anesthesiologists in the evolution of the specialty, and the prospects for continued development for the specialty, the society, and the patients they care for.