Journal of clinical anesthesia
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Historical Article
A curious moment: the proposal to certify nurse anesthetists by the American Board of Anesthesiology.
During the 1930s, many different practitioners gave anesthetics to patients. Qualifications were not necessary, and economics often drove the choice of anesthetic administrator. Both physicians and nurse specialists in anesthesia understood the need for specialty certification. ⋯ For one curious moment, the ABS asked the ABA to certify nurse anesthetists. Neither the nurses nor the physician anesthetists were overwhelmingly in favor of the proposal. However, had the proposal succeeded, the face of American anesthesiology would have been quite different.
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Review Comparative Study
Effects of regional anesthesia on perioperative outcome.
To provide an overview of current knowledge, this article reviews experimental and clinical data from investigations examining effects of regional anesthesia on perioperative morbidity in specific physiologic systems. The issues of morbidity and mortality following general and regional anesthesia are addressed, as are the development of perioperative thromboembolism and blood loss, which are known to be increased during general anesthesia. Finally, the effects of regional anesthesia on the vascular system, the perioperative stress response, and the pulmonary function are discussed.
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Until 1952, the administration of inhaled volatile anesthetics was inexact because vaporizers in general use were not calibrated for either concentration or volume of vapor produced. These devices diverted a variable portion of fresh gas flow either through or over the liquid to be vaporized, but they lacked vernier or fine control. Therefore, changes in the concentration of the anesthetic vapor were not easily controlled. ⋯ Morris standardized the administration of volatile anesthetics with his invention of the Copper Kettle, which produced known volumes of saturated vapor, then diluted to calculated concentrations necessary for anesthesia. To achieve this, modifications had to be made in the liquid container, circuit design, and vaporizing surfaces in use at the time. Morris' design incorporated a separately metered flow of carrier gas through the vaporizer to produce known volumes of saturated vapor for introduction into the fresh gas flow delivery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of intravenous lidocaine and/or esmolol on hemodynamic responses to laryngoscopy and intubation: a double-blind, controlled clinical trial.
To evaluate the efficacy of intravenous lidocaine and two doses of esmolol for attenuating the cardiovascular responses to laryngoscopy and intubation, and to assess whether a combination of both drugs is more effective than either drug alone. ⋯ Esmolol 1 to 2 mg/kg is reliably effective in attenuating HR response to tracheal intubation. Neither of the two doses of esmolol tested nor that of lidocaine affected the BP response. Only the combination of lidocaine and esmolol attenuated both HR and BP responses to tracheal intubation.