Journal of clinical anesthesia
-
Meta Analysis
Postoperative patient-controlled analgesia: meta-analyses of initial randomized control trials.
To compare outcomes during conventional analgesia (as-needed intramuscular dosing) and patient-controlled analgesia (PCA) in postoperative patients by analyzing data from published comparative trials. ⋯ Patient preference strongly favors PCA over conventional analgesia. Patients using PCA also obtain better pain relief than those using conventional analgesia, without an increase in side effects. Favorable effect of PCA upon analgesic usage and length of hospital stay did not in the initial trials attain statistical significance. Nonetheless, the favorable trends in the mean effect sizes for both outcomes argue that further studies of both outcomes should be performed to determine whether the favorable impact of PCA upon either may become statistically significant if larger numbers of patients are enrolled.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of dexmedetomidine and midazolam sedation and antagonism of dexmedetomidine with atipamezole.
To evaluate the effects of dexmedetomidine, an alpha-2 agonist, as an intravenous sedative drug and the effects of atipamezole, an alpha-2 antagonist, on recovery. ⋯ Atipamezole is an effective antagonist for reversing psychomotor impairment following dexmedetomidine sedation.
-
Randomized Controlled Trial Clinical Trial
Role of the laryngeal mask airway in the immobile cervical spine.
To determine whether the laryngeal mask airway has a useful role in the airway management of patients whose cervical spines are immobilized in a rigid cervical collar. ⋯ The laryngeal mask airway compared favorably with an endotracheal tube in success rate, difficulty of insertion, and time to position correctly in this patient population. Although the laryngeal mask does not reliably protect against aspiration, we believe it may play a useful role if more conventional methods of airway management fail. Further studies in the trauma scenario are indicated.
-
Historical Article
For all the world to see: anesthesia at the 1939 New York World's Fair.
The 1939 New York World's Fair presented a unique opportunity for the newly recognized specialty of anesthesiology to be presented to the general public. With funding supplied by the Winthrop Chemical Company of New York City and careful planning, a committee of physician-anesthetists was able to design a display that illustrated all aspects of the physician-anesthetist's role in health care: general "gas" anesthesia, regional techniques, pain management, resuscitation, and oxygen therapy. ⋯ Surprisingly, issues and discussions concerning the fashion in which anesthesia was to be presented at this exhibit remain germane to current presentations of the specialty to the general public. Although no record remains of the public's response to the exhibit, the World's Fair was an international showcase and an important opportunity for public recognition of anesthesiology.