Anesthesia and analgesia
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Anesthesia and analgesia · Jul 2011
Randomized Controlled Trial Comparative StudyA comparison of desflurane versus propofol: the effects on early postoperative lung function in overweight patients.
In this study, we evaluated the influence of propofol versus desflurane anesthesia in overweight patients on postoperative lung function and pulse oximetry values. ⋯ We conclude that, for superficial surgical procedures of up to 120 minutes, maintenance of anesthesia with propofol impairs early postoperative lung function and pulse oximetry values more than with desflurane. Furthermore, increasing obesity decreases pulmonary function at 2 hours after propofol anesthesia but not after desflurane anesthesia.
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Anesthesia and analgesia · Jul 2011
Case ReportsPositioning an intraaortic balloon pump using intraoperative transesophageal echocardiogram guidance.
A 72-year-old man with an ejection fraction of 25% is scheduled to undergo elective coronary artery bypass graft using cardiopulmonary bypass. Because of the high-risk nature of the operation, the surgeon wants to insert an intraaortic balloon pump (IABP) before initiating cardiopulmonary bypass. An intraoperative transesophageal echocardiogram (TEE) is requested to ensure correct placement.
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Anesthesia and analgesia · Jul 2011
Comparative StudyValidation of a system to detect scheduled drug diversion by anesthesia care providers.
We recently described a method to identify drug diversion in the operating room (OR) from automated drug dispensing carts by anesthesia care providers, based on a retrospective outlier analysis of atypical transactions. Such transactions included those occurring on patients after their exit from the OR and on patients whose drugs were not dispensed at the location where the case was performed. In this report, we demonstrate prospectively the utility of our methodology to detect diversion by unsuspected individuals. ⋯ The drug diversion screening methodology previously developed is valid for the prospective detection of unsuspected individuals diverting drugs from the OR. The system also provides material useful in the evaluation of possible diversion by anesthesia providers determined to be abusing drugs outside the workplace.
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Anesthesia and analgesia · Jul 2011
Comparative StudyAllergic reactions to propofol in egg-allergic children.
Egg and/or soy allergy are often cited as contraindications to propofol administration. Our aim was to determine whether children with an immunoglobulin (Ig)E-mediated egg and/or soy allergy had an allergic reaction after propofol use. ⋯ Despite current Australian labeling warnings, propofol was frequently administered to egg-allergic children. Propofol is likely to be safe in the majority of egg-allergic children who do not have a history of egg anaphylaxis.
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Anesthesia and analgesia · Jul 2011
ReviewCapillary refill time: is it still a useful clinical sign?
Capillary refill time (CRT) is widely used by health care workers as part of the rapid, structured cardiopulmonary assessment of critically ill patients. Measurement involves the visual inspection of blood returning to distal capillaries after they have been emptied by pressure. It is hypothesized that CRT is a simple measure of alterations in peripheral perfusion. ⋯ In this report, we examine this evidence and factors affecting CRT measurement. Novel approaches to the assessment of CRT are under investigation. In the future, CRT measurement may be achieved using new technologies such as digital videography or modified oxygen saturation probes; these new methods would remove the limitations associated with clinical CRT measurement and may even be able to provide an automated CRT measurement.