Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2019
Characterization of the Rapid Drop in Pulse Oximetry Reading After Intraoperative Administration of Methylene Blue in Open Thoracoabdominal Aortic Repairs.
This study evaluates the changes of oxygen saturation (SpO2) after intravenous administration of methylene blue in 103 patients undergoing open repair of thoracoabdominal aortic aneurysms. We found that SpO2 decreased by a median (interquartile range [IQR]) of 49% (37%-81%) <1 minute after methylene blue administration and recovered completely after approximately 6 minutes-median (IQR) of 270 seconds (180-510). A shorter time to nadir SpO2 was associated with a higher nadir (Spearman r [95% confidence interval {CI}], -0.32 [-0.50 to -0.13]; P = .001). Body surface area (BSA) was positively correlated with nadir SpO2 (Spearman r [95% CI], 0.36 [0.15-0.51]; P < .001).
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Anesthesia and analgesia · Nov 2019
Perioperative Management of the Pediatric Patient on Medicinal Marijuana: What Anesthesiologists Should Know.
In 2018, 29 states allow the use of medicinal marijuana. In these states, minors, with parental permission, are granted access. Use has increased in some states, although there remains a paucity of clear evidence regarding usefulness and dosing. ⋯ One purified compound was just approved by the Food and Drug Administration, and another is undergoing Food and Drug Administration review. This article will review the literature regarding the use of each of these compounds in the literature, with particular attention to data in children. The history, known pharmacology, data from nonmedicinal use, current evidence, and anesthetic considerations will be described.
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Anesthesia and analgesia · Nov 2019
Customizable Curriculum to Enhance Resident Communication Skills.
Communication remains challenging to teach and evaluate. We designed an online patient survey to assess anesthesia residents' communication skills from August 2014 to July 2015. ⋯ Based on the Hodges-Lehmann 2-sample aligned rank-sum test, overall ratings, reported as the median (interquartile range) of residents' average overall ratings, differed significantly between the preintervention (3.86 [3.76-3.94]) and postintervention (3.91 [3.84-3.95]) periods (P = .025). Future studies should assess the intervention's effectiveness and generalizability.
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Anesthesia and analgesia · Nov 2019
Association Between Participation and Performance in MOCA Minute and Actions Against the Medical Licenses of Anesthesiologists.
In January 2016, as part of the Maintenance of Certification in Anesthesiology (MOCA) program, the American Board of Anesthesiology launched MOCA Minute, a web-based longitudinal assessment, to supplant the former cognitive examination. We investigated the association between participation and performance in MOCA Minute and disciplinary actions against medical licenses of anesthesiologists. ⋯ Both timely participation and meeting performance standard in MOCA Minute are associated with a lower likelihood of being disciplined by a state medical board.
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Anesthesia and analgesia · Nov 2019
The American Board of Anesthesiology's Staged Examination System and Performance on the Written Certification Examination After Residency.
This study compared anesthesiology residency graduates' written certification examination performance before and after the American Board of Anesthesiology (ABA) introduced the staged examination system. After equating test scores using common test items, the first 2 cohorts (2013, 2014) in the staged system scored 7.1 points and 8.3 points higher than the 2011 baseline cohort in the former examination system. The 2013 and 2014 cohorts' pass rates (94.2% and 95.9%) were also higher than the 2011 and 2012 cohorts (91.9% and 92.6%) if a common standard had been applied. The staged examination system may be associated with improved knowledge of anesthesiology graduates.