Anesthesia and analgesia
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Anesthesia and analgesia · Jun 2017
ReviewIndividualized Anesthetic Management for Patients Undergoing Electroconvulsive Therapy: A Review of Current Practice.
Electroconvulsive therapy (ECT) remains an indispensable treatment for severe psychiatric illness. It is practiced extensively in the United States and around the world, yet there is little guidance for anesthesiologists involved with this common practice. ⋯ In this review, we examine the literature on anesthetic management for ECT. A casual or "one-size-fits-all" approach may lead to less-than-optimal outcomes; customizing the anesthetic management for each patient is essential and can significantly increase treatment success rate and patient satisfaction.
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Anesthesia and analgesia · Jun 2017
Randomized Controlled TrialProphylactic Pentazocine Reduces the Incidence of Pruritus After Cesarean Delivery Under Spinal Anesthesia With Opioids: A Prospective Randomized Clinical Trial.
Prophylactic intraoperative IV pentazocine reduces the incidence and severity of post-operative pruritis due to intrathecal morphine used for elective Caesarean section.
pearl -
Anesthesia and analgesia · Jun 2017
Factors Affecting Acoustics and Speech Intelligibility in the Operating Room: Size Matters.
Noise in health care settings has increased since 1960 and represents a significant source of dissatisfaction among staff and patients and risk to patient safety. Operating rooms (ORs) in which effective communication is crucial are particularly noisy. Speech intelligibility is impacted by noise, room architecture, and acoustics. For example, sound reverberation time (RT60) increases with room size, which can negatively impact intelligibility, while room objects are hypothesized to have the opposite effect. We explored these relationships by investigating room construction and acoustics of the surgical suites at our institution. ⋯ Our results suggest that the size and contents of an OR can predict a range of psychoacoustic indices of speech intelligibility. Specifically, increasing OR size correlated with worse speech intelligibility, while increasing amounts of OR contents correlated with improved speech intelligibility. This study provides valuable descriptive data and a predictive method for identifying existing ORs that may benefit from acoustic modifiers (eg, sound absorption panels). Additionally, it suggests that room dimensions and projected clinical use should be considered during the design phase of OR suites to optimize acoustic performance.