Journal of clinical anesthesia
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Comparative Study
The impact of price labeling of muscle relaxants on cost consciousness among anesthesiologists.
To determine whether placing price labels on the vial caps of muscle relaxants increases cost consciousness among anesthesiologists. ⋯ Expenditures for the less costly pancuronium increased while expenditures for vecuronium and atracurium decreased. Price labeling of muscle relaxants in conjunction with education reduces total pharmacy expenditure on muscle relaxants.
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To determine whether an association exists between individual anesthesiologists and nonpatient care time in the operating room (OR). ⋯ The impact of a shorter time interval between cases on OR efficiency remains unknown. Further education and investigation of this issue are warranted.
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Randomized Controlled Trial Clinical Trial
Effects of nicardipine and labetalol on the acute hemodynamic response to electroconvulsive therapy.
To examine the acute hemodynamic effects of intravenous (i.v.) nicardipine and its ability to attenuate the hyperdynamic response to electroconvulsive therapy (ECT), when used alone or in combination with labetalol. ⋯ Nicardipine 2.5 mg i.v. bolus in combination with labetalol 10 mg i.v. was the most effective pretreatment regimen for preventing the acute hyperdynamic response to ECT. However, this combination produced a 20% decrease in MAP immediately prior to ECT and a lower MAP at the time of discharge.
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Randomized Controlled Trial Comparative Study Clinical Trial
Differential effects of serial hemodilution with hydroxyethyl starch, albumin, and 0.9% saline on whole blood coagulation.
To determine by thrombelastography assessed coagulation, the effects of progressive hemodilution with three intravascular volume expanders. ⋯ No differences were found after 11% hemodilution with any volume expanders. Hemodilution with up to 50% saline maintained thrombelastographic indices. Albumin produced early and profound hypocoagulable effects. Significant hypocoagulability occurred for all three diluents at 75% hemodilution. The study supports the use of albumin in patients at risk for thrombosis, and saline in patients with a need for normal hemostasis.
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To investigate, in a group practice setting, the effects of combining information about drug costs with adoption of a voluntary low-cost protocol. ⋯ A private practice anesthesia group that followed a voluntary protocol could significantly reduce drug cost with little change in clinical outcome. However, the savings may not be completely maintained after the monitoring period.