Anesthesia and analgesia
-
Anesthesia and analgesia · Sep 2014
Acute Resistance Exercise Induces Antinociception by Activation of the Endocannabinoid System in Rats.
Resistance exercise (RE) is also known as strength training, and it is performed to increase the strength and mass of muscles, bone strength, and metabolism. RE has been increasingly prescribed for pain relief. However, the endogenous mechanisms underlying this antinociceptive effect are still largely unexplored. Thus, we investigated the involvement of the endocannabinoid system in RE-induced antinociception. ⋯ The present study suggests that a single session of RE activates the endocannabinoid system to induce antinociception.
-
Anesthesia and analgesia · Sep 2014
In Vitro Evaluation of a Novel System for Monitoring Surgical Hemoglobin Loss.
Accurate measurement of intraoperative blood loss is an important clinical variable in managing fluid resuscitation and avoiding unnecessary transfusion of blood products. In this study, we measured surgical blood loss using a tablet computer programmed with a unique algorithm modeled after facial recognition technology. The aim of the study was to assess the accuracy and performance of the system on surgical laparotomy sponges in vitro. ⋯ Mobile blood loss monitoring using the Triton system is accurate in assessing Hb mass on surgical sponges across a range of ambient light conditions, sponge saturation, saline contamination, and initial blood Hb. Utilization of this tool could significantly improve the accuracy of blood loss estimates.
-
Anesthesia and analgesia · Sep 2014
Bernoulli Cumulative Sum (CUSUM) Control Charts for Monitoring of Anesthesiologists' Performance in Supervising Anesthesia Residents and Nurse Anesthetists.
We describe our experiences in using Bernoulli cumulative sum (CUSUM) control charts for monitoring clinician performance. The supervision provided by each anesthesiologist is evaluated daily by the Certified Registered Nurse Anesthetists (CRNAs) and/or anesthesia residents with whom they work. Each of 9 items is evaluated (1 = never, 2 = rarely, 3 = frequently, 4 = always). ⋯ For example, when an evaluation of an anesthesiologist 1 day by a CRNA had a low score, there was an increased chance that another CRNA working in a different operating room on the same day would also give that same anesthesiologist a low score (P < 0.0001). This correlation among scores does affect the Bernoulli CUSUM, such that detection is more likely. This is an advantage for our continual process improvement application since it flags individuals for further evaluation by managers while maintaining confidentiality of raters.
-
Anesthesia and analgesia · Sep 2014
Ultrasound-Guided Greater Palatine Nerve Block: A Case Series of Anatomical Descriptions and Clinical Evaluations.
Greater palatine nerve (GPN) block is commonly performed for maxillary and palatal anesthesia by using bony landmarks. Ultrasound (US) can be used to consistently identify greater palatine foramen (GPF) as a defect in the bony palate enabling US-guided injections near the foramen. ⋯ US has the potential to successfully locate and characterize GPF in normal and edentulous maxilla. US-guided GPN blocks can be technically challenging. The clinical applicability of US guidance or assistance for GPN block needs further evaluation in a larger sample of patients.
-
Anesthesia and analgesia · Sep 2014
Editorial CommentThe growing burden of perioperative heart failure.