Journal of clinical anesthesia
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Randomized Controlled Trial Clinical Trial
Anesthetic-postoperative morphine regimens for cesarean section and postoperative oxygen saturation monitored by a telemetric pulse oximetry network for 24 continuous hours.
To document the effects of compromised respiratory function on oxygen saturation (SpO2) after cesarean section via the telemetric pulse oximetry network (TPON) for 24 continuous hours. ⋯ All 3 regimens risked low SpO2, with the EA/EM regimen having the highest risk but the best analgesia. Neither general nor epidural anesthesia combined with postoperative parenteral morphine influenced SpO2 postoperatively. In this study, the TPON provided a feasible method of detecting hypoxemia early on in the general ward setting.
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To evaluate the independent effects of opioid induction and paralysis on changes in mixed venous oxygen saturation (SvO2). ⋯ Opioid anesthesia, not paralysis, increases SvO2. Most of the decrease in VO2 occurs from anesthesia, not paralysis. The direct relationship between CI and SvO2 no longer holds upon induction of anesthesia. Parallel changes in CI cannot be inferred based on SvO2 alone.
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To estimate the market costs of short-term physician and certified registered nurse-anesthesia (CRNA) services. ⋯ Despite competitive pressures, the locum tenens market charges 55% more for physician than CRNA services. The implications for the different charges are discussed.
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For the patient scheduled for head and neck cancer surgery, careful assessment of the airway demonstrates the most appropriate course of action for securing the airway before surgery begins. Often the patient may be anesthetized safely before intubation of the trachea. The patient may require an awake examination of the airway under sedation and topical analgesia or an awake fiberoptic intubation before the induction of general anesthesia. ⋯ After the operation, extubation of the trachea requires careful attention and may be even more of a challenge than the original intubation. Current principles and techniques for the anesthetic management of the patient undergoing head and neck cancer surgery are reviewed. Emphasis is placed on avoiding the airway problems associated with this kind of surgery.