Journal of clinical anesthesia
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Although postoperative nerve injury is infrequent in patients undergoing joint replacement, it is extremely distressing for the patient, surgeon, and anesthesiologist. The nature of nerve injury is often closely related to the type of surgery; this review details the potential surgical causes of nerve injuries following total hip arthroplasty. The current orthopedic literature (1943-2008) was reviewed to help anesthesiologists better understand the pathophysiology of surgery-related postoperative nerve injuries, including the relationship with hip joint anatomy and the surgical techniques.
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Randomized Controlled Trial Comparative Study
Neuroendocrine stress response in gynecological laparoscopy: TIVA with propofol versus sevoflurane anesthesia.
To compare intraoperative and postoperative neuroendocrine stress responses during total intravenous anesthesia (TIVA) using propofol and remifentanil versus sevoflurane anesthesia, during laparoscopic surgery. ⋯ TIVA inhibited the ACTH-cortisol axis and reduced NE, E, and GH levels, but it enhanced PRL and had a weak effect on thyroid hormone concentrations as compared to sevoflurane anesthesia.
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To evaluate the safety of intravenous (IV) fospropofol when used to provide minimal to moderate sedation in patients undergoing minor surgical procedures. ⋯ An initial dose of IV fospropofol 6.5 mg/kg with supplemental doses was safe and well-tolerated as moderate sedation for use in minor surgical procedures.
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Patient simulation has been widely incorporated into the educational programs of many anesthesiology residencies. These educational tools have been validated by a number of studies and have been recognized by the Accreditation Council for Graduate Medical Education (ACGME) as effective means of teaching domains of competency. The ACGME and the American Board of Medical Specialties (ABMS) have also recognized that these tools are effective devices for competency evaluation of resident and attending physicians. The use of simulation for both retraining and evaluation of a physician for medical licensure is presented.