Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2011
ReviewSpecial article: general anesthetic gases and the global environment.
General anesthetics are administered to approximately 50 million patients each year in the United States. Anesthetic vapors and gases are also widely used in dentists' offices, veterinary clinics, and laboratories for animal research. All the volatile anesthetics that are currently used are halogenated compounds destructive to the ozone layer. ⋯ Studies suggest that the influence of halogenated anesthetics on global warming will be of increasing relative importance given the decreasing level of chlorofluorocarbons globally. Despite these nonnegligible pollutant effects of the anesthetics, no data on the production or emission of these gases and vapors are publicly available. The primary goal of this article is to critically review the current data on the potential effects of general anesthetics on the global environment and to describe possible alternatives and new technologies that may prevent these gases from being discharged into the atmosphere.
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Anesthesia and analgesia · Jan 2011
Comparative StudyAccurate classification of difficult intubation by computerized facial analysis.
Bedside airway evaluation is conduced before anesthesia, but all current methods perform modestly, with low sensitivity and positive predictive value. We hypothesized that subjective features of patients' anatomies improve anesthesiologists' ability to predict difficult intubation, and derived a computer model to do so, based on analysis of photographs of patients' faces. ⋯ Computerized analysis of facial structure and thyromental distance can classify easy versus difficult intubation with accuracy significantly outperforming popular clinical predictive tests.
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Anesthesia and analgesia · Jan 2011
Randomized Controlled Trial Comparative Study Clinical TrialLearning curves of the Airtraq and the Macintosh laryngoscopes for tracheal intubation by novice laryngoscopists: a clinical study.
The curved laryngoscope blade described by Macintosh in 1943 remains the most widely used device to facilitate tracheal intubation. The Airtraq laryngoscope is a new, single-use device for tracheal intubation. Several studies compared the use of Airtraq and Macintosh laryngoscopes in simulated intubation scenarios on manikins. We evaluated learning and performance of tracheal intubation by novice laryngoscopists using the Airtraq or Macintosh laryngoscopes in a randomized controlled clinical trial. ⋯ The Airtraq laryngoscope facilitates a more rapid learning curve compared with the Macintosh laryngoscope when used in a clinical setting by novice laryngoscopists. The Airtraq laryngoscope was judged easier to use by novice users.