Journal of clinical anesthesia
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Preschool children depend on their parents for support and guidance in dealing with new or stressful situations. When requested, the parents should be allowed to support their children during ambulatory surgical procedures, especially during the induction of anesthesia. With proper understanding on our part, and with proper preparation and counseling, the parents can become our allies and help to smooth the experience for the child, for the staff, and for themselves. Future efforts should be directed at studying the effects of different methods of preoperative preparation and counselling on the parents' attitude and cooperation during induction.
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Managed care, especially health maintenance organizations (HMOs), has expanded rapidly in the United States, with nearly 52,300,000 enrollees. HMOs seek to provide health services in an efficient setting at the most reasonable price. To facilitate this objective, HMOs are shifting the financial risk from payors to the providers. ⋯ Subcapitation of anesthesia services is being implemented or discussed in regions with very high HMO market penetration. This paper reviews the concept of bundling of services involving anesthesia in ambulatory surgery. It also seeks to provide a process that will assist anesthesiologists to achieve appropriate capitation reimbursement rates from HMOs.
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Randomized Controlled Trial Clinical Trial
Effect of intrathecal sufentanil on isoflurane requirements during lower abdominal surgery.
To determine the effect of intrathecal sufentanil on volatile anesthetic requirements during lower abdominal surgery. ⋯ Prior administration of intrathecal sufentanil significantly decreases the isoflurane requirement in surgical patients, in addition to its previously demonstrated rapid onset and receptor efficacy.
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Randomized Controlled Trial Comparative Study Clinical Trial
Doxacurium block is not influenced by age.
To determine the influence of aging on the efficacy and safety of doxacurium. ⋯ The use of doxacurium in elderly patients is possible with no need for dose adjustment. Doxacurium might be a good choice for patients with cardiac disease who are scheduled for long surgical procedures.