Journal of clinical anesthesia
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Historical Article
A curious moment: the proposal to certify nurse anesthetists by the American Board of Anesthesiology.
During the 1930s, many different practitioners gave anesthetics to patients. Qualifications were not necessary, and economics often drove the choice of anesthetic administrator. Both physicians and nurse specialists in anesthesia understood the need for specialty certification. ⋯ For one curious moment, the ABS asked the ABA to certify nurse anesthetists. Neither the nurses nor the physician anesthetists were overwhelmingly in favor of the proposal. However, had the proposal succeeded, the face of American anesthesiology would have been quite different.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prospective, randomized, double-blind, placebo-controlled comparison of metoclopramide and ondansetron for prevention of posttonsillectomy or adenotonsillectomy emesis.
To compare the antimetic efficacy of prophylactic ondansetron, metoclopramide, and placebo for prevention of postoperative vomiting in pediatric tonsillectomy or adenotonsillectomy patients. ⋯ Prophylactic ondansetron is more effective than metoclopramide or placebo for the prevention of vomiting after tonsillectomy or adenotonsillectomy. Patients who do not vomit postoperatively have shorter LOS.
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Randomized Controlled Trial Comparative Study Clinical Trial
Control of blood pressure and heart rate in patients randomized to epidural or general anesthesia for lower extremity vascular surgery. Perioperative Ischemia Randomized Anesthesia Trial (PIRAT) Study Group.
To examine the degree of success at maintaining patients randomized to epidural or general anesthesia for peripheral vascular surgery within predetermined blood pressure (BP) and heart rate (HR) limits. To investigate associations between such hemodynamic control and intraoperative myocardial ischemia and postoperative major cardiac morbidity. ⋯ Prevention of elevated intraoperative BP and/on rapid changes in BP or HR may be more successful with epidural than with general anesthesia. Such vital sign abnormalities may occur more frequently in patients who have had intraoperative ischemia or are at risk for having it later in the procedure.
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Randomized Controlled Trial Comparative Study Clinical Trial
Preventing pain during injection of propofol: the optimal dose of lidocaine.
To define the optimal dose of lidocaine to be added to propofol to reduce the incidence of pain during its injection. ⋯ Within this dose range and in this patient population, 30 mg of lidocaine is optimal for reducing the pain during injection of propofol.
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To test the hypothesis that morbid obesity implies increased difficulty of liver transplantation and increased risk of adverse outcome. ⋯ Morbid obesity alone does not predispose to increased complications or decreased survival after liver transplantation.