Anesthesia and analgesia
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Anesthesia and analgesia · May 2009
Randomized Controlled TrialA combination of electroencephalogram and auditory evoked potentials separates different levels of anesthesia in volunteers.
It has been shown that the combination of electroencephalogram (EEG) and auditory evoked potentials (AEP) allows a good separation of consciousness from unconsciousness. In the present study, we sought a combined EEG/AEP indicator that allows both separation of consciousness from unconsciousness and discrimination among different levels of sedation and hypnosis over a wider range of anesthesia. ⋯ These results show that with the new indicator presented here, a combination of EEG and AEP parameters can be used to differentiate degrees of anesthetic effects over a wide range of hypnosis, from the conscious state to deep anesthesia (i.e., BSP).
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Anesthesia and analgesia · May 2009
Randomized Controlled Trial Comparative StudyA prospective randomized comparison of ultrasound and neurostimulation as needle end points for interscalene catheter placement.
In this prospective, randomized study, we tested the hypothesis that interscalene catheters placed for shoulder surgery using an ultrasound needle end point provide postoperative analgesia similar in quality to those placed using a neurostimulation needle end point. Secondary end points included needle time under the skin, procedure-related pain, and the incidence of early neurological complications. ⋯ Interscalene catheters placed for shoulder surgery using an ultrasound needle end point provide postoperative analgesia that is of similar quality to that obtained when using a neurostimulation needle end point. The ultrasound end point was associated with a reduction in needle under the skin time and procedure-related pain.
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Anesthesia and analgesia · May 2009
Improving alarm performance in the medical intensive care unit using delays and clinical context.
In an intensive care unit, alarms are used to call attention to a patient, to alert a change in the patient's physiology, or to warn of a failure in a medical device; however, up to 94% of the alarms are false. Our purpose in this study was to identify a means of reducing the number of false alarms. ⋯ Introducing a 19-s alarm delay and automatically detecting suctioning, repositioning, oral care, and washing could reduce the number of ineffective and ignored alarms from 934 to 274. More reliable alarms could elicit more timely response, reduce workload, reduce noise pollution, and potentially improve patient safety.
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Anesthesia and analgesia · May 2009
Levels of consciousness during regional anesthesia and monitored anesthesia care: patient expectations and experiences.
Complaints of "intraoperative awareness" after regional anesthesia and monitored anesthesia care have been reported. We hypothesized that this may be due to either unmet expectations regarding levels of consciousness or states of consciousness resembling general anesthesia. ⋯ Furthermore, only 58% of patients had expectations set by the anesthesia provider. These data indicate that, from the patient's perspective, the boundary between general and nongeneral anesthesia is obscured.
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Anesthesia and analgesia · May 2009
Practice GuidelineConsensus statement: First International Workshop on Anesthetics and Alzheimer's disease.
In order to review the current status of the potential relationship between anesthesia and Alzheimer's disease, a group of scientists recently met in Philadelphia for a full day of presentations and discussions. This special article represents a consensus view on the possible link between Alzheimer's disease and anesthesia and the steps required to test this more definitively.