Journal of clinical anesthesia
-
Clinical Trial
Transesophageal echocardiographic assessment of right heart hemodynamics during high-frequency jet ventilation.
To evaluate right ventricular dimensions and function by echocardiography in anesthetized patients during superimposed high-frequency jet ventilation (HFJV). ⋯ Transesophageal echocardiographic evaluation of right heart hemodynamics did not show any significant difference after transition of ventilation to superimposed HFJV applying similar airway pressures. Furthermore, superimposed HFJV was safe and effective, it improved oxygenation, and it facilitated carbon dioxide elimination.
-
Randomized Controlled Trial Clinical Trial
The effect of propofol and thiamylal on hypertensive responses to a rapid increase in isoflurane concentration.
To compare the effects of propofol and thiamylal on the hyperdynamic circulatory response caused by a rapid increase in isoflurane concentration. ⋯ Propofol induction of anesthesia more effectively attenuates the circulatory responses to a sudden increase in isoflurane concentration than does thiamylal.
-
Randomized Controlled Trial Clinical Trial
Individualized outcome feedback produces voluntary antiemetic prescribing practice changes.
To determine the impact of individualized outcome feedback on antiemetic prescribing practices and compare outcomes of a cost-effective, standardized antiemetic protocol (PROT) to that of customized antiemetic therapy (NONPROT). ⋯ Individualized outcome feedback produced a 48% reduction in monthly expenditures for ondansetron and droperidol, which was sustained after the study. Patients satisfaction between ondansetron 4 mg and droperidol 0.625 mg given in the PACU did not differ in spite of a slightly greater efficacy of ondansetron as a first-line drug.
-
Cost containment, as an essential part of current effort to manage health care, has been examined thoroughly from the perspectives of finance and patient care. In this article, the ethics of cost containment are discussed from the vantage point of the health care provider. Cost-cutting initiatives, however necessary and sound, nevertheless may place anesthesiologists in situations of ethical conflict and ultimately interfere with their rights as workers and professionals. The anesthesiology community is encouraged to investigate the effect of cost-cutting measures on patients and physicians alike.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the analgesic effects of intrabursal oxycodone and bupivacaine after acromioplasty.
To compare the peripheral analgesic effect of oxycodone, an opioid agonist, to the effect of bupivacaine infiltration and parenteral oxycodone administration in conjunction with shoulder surgery. ⋯ Intrabursal oxycodone and intrabursal bupivacaine reduced perioperative analgesic requirements similarly. Intrabursal oxycodone may offer an effective, simple, and safe method for postoperative analgesia after shoulder surgery.