Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2013
Automated, Real-Time Fresh Gas Flow Recommendations Alter Isoflurane Consumption During the Maintenance Phase of Anesthesia in a Simulator-Based Study.
The Low Flow Wizard (LFW) provides real-time guidance for user optimization of fresh gas flow (FGF) settings during general inhaled anesthesia. The LFW can continuously inform users whether it determines their FGF to be too little, efficient, or too much, and its color-coded recommendations respond in real time to changes in FGF performed by users. Our study objective was to determine whether the LFW feature, as implemented in the Dräger Apollo workstation, alters FGF selection and thereby volatile anesthetic consumption without affecting patient care. ⋯ Our data in a simulated anesthetic suggest that enabling the display of FGF efficiency data by the LFW results in a median percent reduction in volatile liquid anesthetic consumption rate of 53.2%. Since the lower limit of the 95% confidence interval for the median is 39.4%, this finding is likely to translate into cost savings and less waste anesthetic gas generated in the clinical setting and released into the atmosphere.
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Anesthesia and analgesia · Nov 2013
Cesarean Delivery in the Hybrid Operating Suite: A Promising New Location for High-Risk Obstetric Procedures.
The increasing cesarean delivery rate and attendant placental implantation abnormalities, coupled with increasing general medical complexity in the obstetric population, has driven innovation to optimize the care of high-risk parturients during delivery. Novel and multidisciplinary approaches and locations may enhance the options available for care. ⋯ The hybrid operating suite may be an alternative location for obstetric delivery, and our experience suggests that this environment may prove advantageous for patients with a variety of comorbid conditions.
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Anesthesia and analgesia · Nov 2013
ReviewThe Use of Cognitive Aids During Emergencies in Anesthesia: A Review of the Literature.
Cognitive aids are prompts designed to help users complete a task or series of tasks. They may take the form of posters, flowcharts, checklists, or even mnemonics. It has been suggested that the use of cognitive aids improves performance and patient outcomes during anesthetic emergencies; however, a systematic assessment of the evidence is lacking. ⋯ Cognitive aids should continue to be developed from established clinical guidelines where guidelines exist. They would also benefit from more extensive simulation-based usability testing before use. Further evidence is required to explore the effects of cognitive aids in anesthetic emergencies, how they affect team function, and their design considerations.
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Anesthesia and analgesia · Nov 2013
Randomized Controlled TrialA Phase Ib, Dose-Finding Study of Multiple Doses of Remimazolam (CNS 7056) in Volunteers Undergoing Colonoscopy.
We performed the first multiple dose study of remimazolam designed to assess both the feasibility of maintaining suitable sedation during colonoscopy and reversing the sedative effects of remimazolam with flumazenil. ⋯ Remimazolam has the attributes of a sedative drug, with success rates comparable with recent studies of other drugs. Remimazolam provided adequate sedation in 33 of 44 subjects undergoing colonoscopy, and its sedative effects were easily reversed with flumazenil.