Journal of clinical anesthesia
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To allow for growth in our anesthesiology residency, we assumed control of the clinical base year (postgraduate year 1[PGY-1]) and adjusted the curriculum to accommodate the expanded size. With this opportunity to change the curriculum, we created a clinical base year to prepare PGY-1 for clinical anesthesia training in PGY-2 to PGY-4 using, for this purpose, the best resources of our clinical site. We describe the process and preliminary results of the change.
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Randomized Controlled Trial Clinical Trial
The intubating laryngeal mask airway: rocuronium improves endotracheal intubating conditions and success rate.
To assess intubating conditions without neuromuscular blocking drugs, to determine the relation between the dose of rocuronium and the probability of achieving excellent or at least good (good or excellent) intubating conditions with the intubating laryngeal mask airway (ILMA), and finally, to determine the relationship between rocuronium use and the success rate of endotracheal intubation. ⋯ To achieve good or excellent intubating conditions with the ILMA, a rocuronium dose lower than the standard intubating dose of 0.6 mg/kg can be used. Neuromuscular blockade increases the success rate of intubation if a second attempt is necessary.
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Randomized Controlled Trial Clinical Trial
Reduction of postoperative emetic episodes and analgesic requirements with dexamethasone in patients scheduled for dental surgery.
To evaluate the antiemetic and analgesic effects of dexamethasone for the first 24 hours postoperatively in patients scheduled for dental surgery. ⋯ Prophylactic dexamethasone 8 mg is effective for the prevention of nausea and vomiting after dental surgery and in the management of postoperative pain. Increasing the dose to 16 mg provides no further benefit.
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We report a case of general anesthesia for transurethral resection of the bladder in a 74-year-old male patient with uncorrected tetralogy of Fallot. This case illustrates the pertinent pathophysiology of the complex cardiac lesion related to tetralogy of Fallot as well as the feasibility and issues with regard to the anesthetic management.
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To quantify the prevalence of perioperative beta-blocker use and its impact on preoperative and preinduction heart rate (HR), in light of the recent publication of specific recommendations regarding perioperative beta-blocker use and desired HR. ⋯ Only half of the patients who qualify to receive preoperative beta-blockers by current recommendations actually receive them before noncardiac surgery, and the majority of these patients have preadmission and preinduction HR less than 60 bpm. Targeting beta-blocker therapy treatment to an HR less than 60 bpm may not be readily achievable in many patients.