Journal of clinical anesthesia
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Editorial Comment
Program director: the job you love to hate or the job you hate to love.
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Subarachnoid hemorrhage is associated with a number of cerebral insults as a result of cerebral vasospasm. Various pharmacological and non-pharmacological techniques are used for relief of cerebral vasospasm. ⋯ The case of a patient with an anterior communicating artery aneurysm, who received intracisternal papaverine by instillation after aneurysm clipping, is reported. It was associated with hypertension and tachycardia that was not responsive to usual treatment.
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To evaluate work-related stress as well as personal factors associated with professional burnout in program directors of anesthesiology. ⋯ Fifty-two percent of anesthesiology program directors are at high risk for developing burnout syndrome. Job-related stress, especially with administrative duties regarding compliance, was predictive of burnout among program directors.
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Case Reports
Profound bradycardia with lidocaine during anesthesia induction in a silent sick sinus syndrome patient.
Sick sinus syndrome is caused by sinus node dysfunction that renders it unable to function as a pacemaker. Patients with sick sinus syndrome are often asymptomatic or have symptoms that are mild and nonspecific. ⋯ Episodes of marked bradycardia with sinus arrest after prophylactic lidocaine injection are reported in a 69-y-old man with no apparent preoperative cardiac disease or electrocardiographic abnormality. Surgery was postponed, and he was later diagnosed with sick sinus syndrome.