Anesthesia and analgesia
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Anesthesia and analgesia · Aug 2013
Randomized Controlled TrialThe effect of a bolus dose of intravenous lidocaine on the minimum alveolar concentration of sevoflurane: a prospective, randomized, double-blinded, placebo-controlled trial.
The anesthetic effect of volatile anesthetics can be quantified by the minimum alveolar concentration (MAC) of the drug that prevents movement in response to a noxious stimulus in 50% of patients. The underlying mechanism regarding how immobilization is achieved by volatile anesthetics is not thoroughly understood, but several drugs affect MAC. In this study, we investigated the effect of a single IV bolus dose of lidocaine on the MAC of sevoflurane in humans. ⋯ IV 1.5 mg·kg(-1) lidocaine decreased the MAC by at least 0.03% sevoflurane (mean difference 0.23% sevoflurane [95% adjusted CI, 0.03-0.43]). We did not observe a significant reduction in the MAC of sevoflurane with the IV administration of 0.75 mg·kg(-1) lidocaine.
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Anesthesia and analgesia · Aug 2013
Biography Historical ArticleSpecial article: sites and artifacts related to horace wells in hartford, connecticut.
Horace Wells, a contender for recognition as the discoverer of anesthesia, is celebrated in the town where he conducted most of his work, Hartford, CT. His only descendant was his son, Charles Thomas Wells (1839-1909), an influential and successful business executive at Aetna Insurance Company. He was a man of considerable influence, and he worked tirelessly with city officials and the Connecticut Dental Association in celebrating the 50th anniversary of his father's contribution to medicine. ⋯ Sites in Jefferson, GA; Hartford, CT; and Boston, MA and their environs celebrate this most precious contribution to modern medicine, especially since the introduction of safe anesthesia permitted the development of surgical specialties and obstetrics. We trace the history and relationship between Horace Wells and several sites and artifacts in Hartford, CT. These sites span the most important, distinctive, and attractive parts of the city: Bushnell Park, Trinity College, Cedar Hill Cemetery, the Athenaeum, and the Connecticut Historical Society.
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Anesthesia and analgesia · Aug 2013
Technical communication: decision support using anesthesia information management system records and accreditation council for graduate medical education case logs for resident operating room assignments.
Our goal in this study was to develop decision support systems for resident operating room (OR) assignments using anesthesia information management system (AIMS) records and Accreditation Council for Graduate Medical Education (ACGME) case logs and evaluate the implementations. We developed 2 Web-based systems: an ACGME case-log visualization tool, and Residents Helping in Navigating OR Scheduling (Rhinos), an interactive system that solicits OR assignment requests from residents and creates resident profiles. Resident profiles are snapshots of the cases and procedures each resident has done and were derived from AIMS records and ACGME case logs. ⋯ Separately, we developed an ACGME case-log visualization tool that allows individual resident experiences to be compared against case minimums as well as resident peer groups. We conclude that it is feasible to use ACGME case-log data in decision support systems for informing resident OR assignments. Additional analysis will be necessary to assess the educational impact of these systems.
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Anesthesia and analgesia · Aug 2013
Multicenter StudyReversal with sugammadex in the absence of monitoring did not preclude residual neuromuscular block.
Sugammadex use does not avoid either the need or benefit of neuromuscular monitoring, although it does result in less residual neuromuscular block than neostigmine reversal.
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