Journal of clinical anesthesia
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When spinal and epidural anesthesia were introduced into clinical practice, their primary use was as an alternative to general anesthesia. Later, largely as a result of the realization that opioids could be safely and effectively used to produce selective spinal analgesia, spinal and epidural (neuraxial) analgesia began to be used specifically for the treatment of perioperative pain. We present a systematic review of the literature on neuraxial anesthesia and analgesia, new meta-analyses that illustrate the powerful effect of improvements in perioperative safety in general on the ability of neuraxial techniques to make a difference, and a consideration of why a literature analysis does not provide clear answers.
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Randomized Controlled Trial Comparative Study
Propofol concentration requirement for laryngeal mask airway insertion was highest with the ProSeal, next highest with the Fastrach, and lowest with the Classic type, with target-controlled infusion.
To determine propofol concentration of plasma 50% (Cp50, concentration at which there is a 50% chance that patients show no movement in response) for the Classic-, Fastrach-, and ProSeal-type laryngeal mask airway (LMA) insertion using target-controlled infusion (TCI) technique. ⋯ Required propofol TCI concentrations for LMA insertion were significantly highest for the ProSeal, second highest for the Fastrach, and lowest for the Classic LMA.
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Leroy D Vandam, MD was a remarkable man--an intricate amalgamation of an artist, scientist, and physician. He was a bastion of medical historical knowledge. Dr Vandam became a most influential anesthesiologist, some say, a giant. ⋯ Dr Vandam published more than 250 original articles, chapters, abstracts, and other reports on a wide variety of subjects including history, art, and pharmacology. His classic article on the complications of neuroaxial blocks is a seminal work in anesthesiology. This article describes how an anesthesiologist who shared an interest with Dr Vandam in the history of anesthesiology came to produce a movie based on his career, the evolution of anesthesia equipment, and the transformation of our specialty.
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Recently, there has been a focus on the teaching of professionalism in postgraduate medical education. Many discussions and studies have been performed to help in teaching professionalism and in the evaluation of the effectiveness of this teaching process. Unfortunately, many anesthesiologists are unaware of the literature and the discussions that have taken place. This review article serves as a primer for those individuals faced with the task of instilling the concepts of professionalism, not only in trainees but also in anesthesiologists practicing today.