Journal of clinical anesthesia
-
Percutaneous radiofrequency ablation (PRFA) is a minimally invasive procedure used for the treatment of small hepatocellular carcinomas. PRFA is regarded as a much safer alternative to surgical resection or orthotopic liver transplantation. However, serious complications, including cardiac tamponade, have been reported. Two cases of severe cardiac tamponade during PRFA were successfully treated.
-
Case Reports
Continuous hemoglobin monitoring during massive blood transfusion in amultivisceral pediatric transplant patient.
A 10 year old, 25 kg girl, who was formerly a conjoined twin at the heart, diaphragm, liver, duodenum, bile ducts, and intestine, was admitted for a repeat liver, small bowel, pancreas, and kidney multivisceral transplant after having intestinal and liver failure. Intraoperatively, the patient had excessive bleeding, coagulopathy, and acidosis. ⋯ Although noninvasive Hb appeared to follow a trend that correlated with arterial Hb concentration, it did not show accurate agreement with measured values from intermittent blood gas analysis. It may not be reliable during cases with abnormal physiology, rapid blood loss, and massive transfusion.
-
To determine whether patients receiving perioperative glycopyrrolate during midurethral sling surgery had more acute but temporary postoperative urinary retention. ⋯ Acute temporary postoperative urinary retention is rare after midurethral slings. Glycopyrrolate during anesthesia induction does not appear significantly to increase this rate.
-
To survey anesthesiologists to assess medication injection safety knowledge and practices, and to improve infection control programs of the New York City Department of Health and Mental Hygiene and the New York State Society of Anesthesiologists (NYSSA). ⋯ Although they were not necessarily representative of all anesthesiologists in New York State, unacceptable or high-risk injection practices were common among respondents despite widespread knowledge regarding injection-contamination mechanisms. System barriers contribute to the use of medication vials for multiple patients.
-
To determine needs, adequacy, types of resources, and challenges in teaching faculty how to provide feedback to residents. ⋯ While the perceived gap in providing training for faculty in giving feedback to anesthesia residents has narrowed, program director responses suggest a substantial unmet need remains. Innovative new approaches are in order.