Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2015
Randomized Controlled TrialA Randomized Trial of a Supplemental Alarm for Critically Low Systolic Blood Pressure.
Intraoperative hypotension is associated with complications that might be ameliorated by earlier intervention. We therefore tested the primary hypothesis that a supplemental decision support alert for critically low systolic blood pressure (SBP) decreases the duration of intraoperative hypotension. ⋯ An additional warning for severe hypotension did not reduce the duration of hypotension or hospitalization. Decision support alerts may be more useful for more complicated situations.
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Anesthesia and analgesia · Dec 2015
Observational StudyThe Effect of General Anesthesia on Aminotransferase Levels in Patients with Elevated Aminotransferase Levels: A Single-Center 5-Year Retrospective Study.
The effect of commonly used anesthetics on postoperative aminotransferase levels in patients with preoperatively elevated values is unclear. ⋯ In most cases, postoperative alanine aminotransferase levels did not worsen even in patients with preoperatively elevated levels. Sevoflurane was associated with increased odds for postoperative elevation of these levels after general surgery compared with TIVA.
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Anesthesia and analgesia · Dec 2015
Anesthesia Workload Nationally During Regular Workdays and Weekends.
We analyze data from the American Society of Anesthesiologist's (ASA) Anesthesia Quality Institute (AQI) to report the U.S. anesthesia workload by time of day and day of the week. We consider the extent to which first case starts, rather than durations of workdays and weekend cases, influence the number of anesthesia providers nationally. ⋯ The results are inconsistent with widespread use of surgical facilities (i.e., anesthesia providers) in mornings only, especially at University and large community hospitals. The observed national work hours match with what would be expected if most anesthesiologists work at least 8 hours on regular workdays. Opportunity for greater use of the capital (building and equipment) probably would involve the use of additional anesthesia providers representing a second shift or use of weekends.
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Anesthesia and analgesia · Dec 2015
Occupational Chronic Sevoflurane Exposure in the Everyday Reality of the Anesthesia Workplace.
Although sevoflurane is one of the most commonly used volatile anesthetics in clinical practice, anesthesiologists are hardly aware of their individual occupational chronic sevoflurane exposure. Therefore, we studied sevoflurane concentrations in the anesthesiologists' breathing zones, depending on the kind of induction for general anesthesia, the used airway device, and the type of airflow system in the operating room. Furthermore, sevoflurane baselines and typical peaks during general anesthesia were determined. ⋯ Anesthesiologists are chronically exposed to trace concentrations of sevoflurane during work. Inhalational inductions, LMA™, and TF air-conditioning systems in particular are associated with higher sevoflurane exposure. However, the amount of inhaled sevoflurane per day was lower than expected, perhaps because concentrations in previous measurements could be overestimated (10%-15%) because of the cross-sensitivity reaction.