Anesthesia and analgesia
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Anesthesia and analgesia · Feb 2013
Determinants of a subject's decision to participate in clinical anesthesia research.
A top priority for research studies is to ensure that potential participants receive adequate information to make a truly informed decision. Understanding patient experiences with the recruitment process may identify areas for improvement in the consent process. We examined which factors were associated with the decision to consent in a clinical research study. ⋯ The 2 strongest predictors of consent were male gender and comfort; predictors of refusal were protocol type that requires additional testing, greater concern about blood sampling and study risks, and lower overall patient comfort with the study. These patient and study characteristics may inform modification of the consent process for clinical research studies and facilitate the development of more accurate enrollment projections and strategies.
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Anesthesia and analgesia · Feb 2013
Visual acuity during direct laryngoscopy at different illuminance levels.
Adequate light is essential for vision during direct laryngoscopy. The ISO 7376:2009 standard specifies the minimal illuminance for laryngoscopes. No studies have objectively examined the relationship between laryngoscope illumination and visual acuity during laryngoscopy. ⋯ Visual acuity improves as the laryngoscope illuminance increases up to 700 lux. No statistically significant improvement was measured by increasing the illuminance up to 2000 lux. Subjectively, anesthesiologists favor illuminance of 2000 lux for direct laryngoscopy.
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Anesthesia and analgesia · Feb 2013
Peripheral perfusion index as an early predictor for central hypovolemia in awake healthy volunteers.
In healthy volunteers, we investigated the ability of the pulse oximeter-derived peripheral perfusion index (PPI) to detect progressive reductions in central blood volume. ⋯ These results indicate that the pulse oximeter-derived PPI may be a valuable adjunct diagnostic tool to detect early clinically significant central hypovolemia, before the onset of cardiovascular decompensation in healthy volunteers.
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Anesthesia and analgesia · Feb 2013
Marfan's syndrome during pregnancy: anesthetic management of delivery in 16 consecutive patients.
Marfan's syndrome is characterized by progressive dilatation of the aortic root. This dilatation is accelerated by pregnancy, exposing patients to an increased risk of aortic dissection. Literature on the anesthetic management of delivery in patients with Marfan's syndrome consists only of case reports. We therefore conducted a retrospective review of medical records focusing on anesthetic management of delivery in patients with Marfan's syndrome in a national referral center. ⋯ Pregnant women with Marfan's syndrome who received care in a multidisciplinary tertiary care setting that included active peripartum involvement of anesthesiologists had good clinical outcomes.
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Anesthesia and analgesia · Feb 2013
Brief report: Availability of lipid emulsion in United States obstetric units.
Lipid emulsion is recommended in the guidelines for the management of local anesthetic systemic toxicity. In this study, we sought to identify the current level of lipid emulsion availability in U.S. obstetric units. ⋯ U.S. academic obstetric anesthesia units are equipped to administer lipid emulsion in the setting of local anesthetic systemic toxicity.