Journal of clinical anesthesia
-
To develop a rapid online test of graft liver function during liver transplantation. ⋯ A significant reduction in rocuronium infusion requirement during the neohepatic phase may be suggestive of impaired organ function after reperfusion of the graft liver. Rocuronium may serve as a potential online indicator of graft liver function during liver transplantation by measurement of its infusion requirements during transplantation.
-
To evaluate the components of commonly used central venous catheter kits with respect to the potential for guidewire-mediated complications during catheter placement.Prospective, nonrandomized, observational study. ⋯ The design of commonly employed central venous access catheter kits is such that there is a mismatch between guidewire and catheter length and a general lack of guidewire markings. We believe that these designs may predispose to the introduction of excess guidewire and result in guidewire-mediated complications during catheter placement. This risk can likely be reduced by matching the guidewires to the devices placed over them and by standardizing guidewire distance markings.
-
To determine the necessity for ionized magnesium (iMg) assay by evaluating the effect of abdominal surgery without massive transfusion on total magnesium (Mg) and iMg concentrations. ⋯ During abdominal surgery without massive transfusion, both total and ionized hypomagnesemia occur. Changes in iMg and total serum Mg concentrations are closely correlated. Total serum Mg assay, while overestimating the prevalence of ionized hypomagnesemia, is sufficient to screen for hypomagnesemia.
-
Surgery on the eye is performed using topical anesthesia, retrobulbar anesthesia, peribulbar anesthesia, and general anesthesia. Retrobulbar anesthesia is associated with a number of complications that include apnea (respiratory arrest), seizures, or both. ⋯ We provided ventilation with 100% oxygen, treated the hypertension with nicardipine, and the tachycardia with esmolol. The patients did not have any residual complications.
-
This essay examines the effects of unexpected pediatric death on anesthesiology house staff, and offers a discussion of normal and abnormal patterns of grieving. The increased incidence of substance abuse and suicide among anesthesiologists is discussed, and the relationship of stress following patient death and appropriate coping skills is explored. A blueprint for managing stress is given based on a military combat stress model, and recommendations for residency training programs are made.