AANA journal
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A 64-year old female requiring prolonged ventilatory support was scheduled for an elective tracheostomy. Anesthesia consisted of surgical infiltration of 1% lidocaine and supplemental isoflurane. The patient was mechanically ventilated with an FIO2 of 1.0. ⋯ Proper management of an endotracheal tube fire includes stopping ventilation, disconnecting the oxygen source, removing the endotracheal tube, diagnosing injury, administering short-term steroids, administering antibiotics if indicated, providing ventilation and medical support as necessary and monitoring the patient for at least 24 hours. Extreme caution is necessary when using electrocautery in close proximity to an endotracheal tube. If electrocautery is used in close proximity to an endotracheal tube, an FIO2 of 0.3 or less with helium should be used.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of three techniques on time to awakening, time to orientation and incidence of nausea and vomiting using alfentanil in balanced anesthesia in an outpatient surgical setting.
Maximizing patient safety and comfort while minimizing adverse sequelae are continuing anesthetic challenges. The purpose of this study was to examine three anesthetic techniques utilizing alfentanil with regard to time to awakening, time to orientation and incidence of nausea and vomiting. Surgical procedures were limited to knee arthroscopy, laparoscopy and dental extractions. ⋯ The two N2O groups did not differ significantly in either measure. The incidence of vomiting in the postanesthesia recovery room (PARR) indicated a significant difference (p = .0317) among groups with vomiting occurring 45.8% of the time in Group I, 28.8% of the time in Group II and 8% of the time in Group III. Total emetic score (nausea and vomiting) in the PARR indicated a significant difference (p = .03) among groups with symptoms occurring 50% of the time in Group I, 28% of the time in Group II, and 16% of the time in Group III.
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Randomized Controlled Trial Comparative Study Clinical Trial
The efficiency of a reflective heating blanket in preventing hypothermia in patients undergoing intra-abdominal procedures.
This study determined the efficiency of a reflective blanket in preventing hypothermia during intra-abdominal gynecological procedures. Forty female patients were studied. A table of random numbers was used to assign patients to the reflective blanket group (experimental) or the warmed cotton blanket group (control). ⋯ In conclusion, the reflective blanket was no more efficient than warmed cotton blankets in preventing intraoperative hypothermia. Previous studies showing the greatest decrease in temperature occurred within the first hour of anesthesia and surgery were supported. The reflective blanket may be useful for operating rooms where the storage and heating of cotton blankets is not feasible due to limited space or cost.
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The ankle block is a safe and effective means of providing sensory anesthesia to the foot. The nerve supply to the foot at the level of the ankle is relatively superficial and consists of five nerve branches. The posterior tibial, which supplies the plantar aspect of the foot; the saphenous, supplying the medial portion of the foot; the deep peroneal, supplying an area between the great and second toes; the superficial peroneal, two branches supplying the majority of the dorsum of the foot; and the sural nerve, which supplies the lateral aspect of the foot. Using a small amount of local anesthesia, these nerves can be effectively anesthetized to prepare areas of the foot for surgical intervention.