AANA journal
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Recent clinical studies using the bispectral index monitor to predict movement, measure the level of consciousness, and reduce the cost of anesthesia have renewed interest in the use of a monitor to assess the effects of anesthetics on the brain. In 1937, Gibbs described electroencephalographic changes during the administration of general anesthetics. ⋯ The purpose of this article is to provide a historical perspective of the development and use of the processed electroencephalographic monitor. This article also describes studies of clinical usefulness of the bispectral index monitoring device in anesthesia practice today.
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Review
AANA journal course: update for nurse anesthetists--refrigerated anesthesia-related medications.
Medications have strength, expiration date, and storage conditions printed on the medication bottle or package. Some anesthesia medications require refrigeration to maintain the stated strength and safety until the expiration date. These medications may expire in days rather than years when left at room temperature in anesthesia carts or emergency boxes. The following AANA Journal course discusses anesthesia-related medications that require refrigeration and how long potency and safety is maintained out of the refrigerator and provides a chart for future referral.
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A universal goal of anesthesia providers is to provide the safest, most effective anesthesia and analgesia for their patients. When reports emerge showing problems or complications with an agent or technique that previously was thought safe, recommendations often are adopted in anesthesia departments to avoid or abandon the agent or technique, or alternatives are sought. Hyperbaric 5% lidocaine has been an effective and safe spinal anesthetic agent for short procedures for years. ⋯ Substantial research has been conducted detailing the search for reasons these complications occur and how to prevent them. A sample of the findings is summarized in an attempt to present current knowledge about the apparent causes and prevention of transient neurologic symptoms. There is promising research showing that safe and effective short-acting intrathecal anesthesia can be accomplished with procaine, prilocaine, meperidine, and sufentanil.
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Anesthesia for the patient with a perforated globe can be complicated. Cognizance of the anatomy and physiology of the eye, including maintenance of intraocular pressure, is essential for the development of an anesthetic plan. ⋯ However, methods to achieve this end may place the patient at risk for aspiration. Various techniques that attempt to accomplish this goal are described, including the use of narcotics, lidocaine, nitroglycerin, alpha (alpha 2) agonism, beta (beta) adrenergic and calcium channel blockades, plus the laryngeal mask airway.
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This column will give a brief history of the development of guidelines for isolation precautions in hospitals. The current Centers for Disease Control and Prevention (CDC) guidelines will be reviewed along with examples of the disease processes that apply to each category. An example of an anesthesia department's guide for the care of patients with transmissible diseases requiring anesthesia care will be presented. The guide can be used by readers as a template for the development of a guide applicable to their practice.