Anesthesia and analgesia
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Anesthesia and analgesia · Apr 2010
Monitoring with head-mounted displays in general anesthesia: a clinical evaluation in the operating room.
Patient monitors in the operating room are often positioned where it is difficult for the anesthesiologist to see them when performing procedures. Head-mounted displays (HMDs) can help anesthesiologists by superimposing a display of the patient's vital signs over the anesthesiologist's field of view. Simulator studies indicate that by using an HMD, anesthesiologists can spend more time looking at the patient and less at the monitors. We performed a clinical evaluation testing whether this finding would apply in practice. ⋯ An HMD of patient vital signs reduces anesthesiologists' surveillance of the anesthesia workstation and allows them to spend more time monitoring their patient and surgical field during normal anesthesia. More research is needed to determine whether the behavioral changes can lead to improved anesthesiologist performance in the operating room.
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Anesthesia and analgesia · Apr 2010
ReviewReview article: glucose measurement in the operating room: more complicated than it seems.
Abnormalities of blood glucose are common in patients undergoing surgery, and in recent years there has been considerable interest in tight control of glucose in the perioperative period. Implementation of any regime of close glycemic control requires more frequent measurement of blood glucose, a function for which small, inexpensive, and rapidly responding point-of-care devices might seem highly suitable. However, what is not well understood by many anesthesiologists and other staff caring for patients in the perioperative period is the lack of accuracy of home glucose meters that were designed for self-monitoring of blood glucose by patients. ⋯ Clinicians who are accustomed to the high level of accuracy of glucose measurement by a central laboratory device or by an automated blood gas analyzer may be unaware of the potential for harmful clinical errors that are caused by the inaccuracy exhibited by many self-monitoring of blood glucose devices, especially in the hypoglycemic range. Knowledge of the limitations of these meters is essential for the perioperative physician to minimize the possibility of a harmful measurement error. In this article, we will highlight these areas of interest and review the indications, technology, accuracy, and regulation of glucose measurement devices used in the perioperative setting.
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Anesthesia and analgesia · Apr 2010
Randomized Controlled TrialBrief report: improved pain relief using intermittent bupivacaine injections at the donor site after breast reconstruction with deep inferior epigastric perforator flap.
Deep inferior epigastric perforator flap surgery usually results in postoperative pain from the donor site requiring opioids. ⋯ We conclude that intermittent delivery of bupivacaine at the abdominal donor site significantly reduces the postoperative pain and need for narcotic rescue medication.
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Anesthesia and analgesia · Apr 2010
The influence of age on sample size calculation in acute pain trials using morphine consumption as an end point.
Many trials in acute postoperative pain use morphine consumption as an end point. Age has been shown to have a significant influence on morphine consumption but is rarely considered in end point analysis. ⋯ The model suggests that variations in age have a profound effect on sample size. Researchers may need to account for this to prevent both type 1 and type 2 error.