Anesthesiology
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Beware anesthesiologist number 7... the quality of intraoperative conduct of anesthesia effects patient outcomes.
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Comparative Study
Comparison of histamine release in human skin mast cells induced by morphine, fentanyl, and oxymorphone.
Human leukocyte and skin mast cell preparations were incubated with morphine sulfate in concentrations ranging from 1.5 X 10(-5) M to 4.5 X 10(-3) M. Skin mast cells also were incubated with oxymorphone and fentanyl in the same concentrations. Human leukocytes did not release histamine in response to any concentration of morphine. ⋯ The release of histamine by morphine but not equimolar concentrations of fentanyl and oxymorphone indicates that histamine release by narcotics is not a nonspecific effect of high drug concentration. The failure of naloxone to inhibit morphine-induced histamine release suggests that histamine release by morphine is not dependent on opiate receptor binding or activation. These results indicate that this human mast cell preparation will be useful in further understanding the mechanism of histamine release induced by morphine and other agents.
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The purpose of this study was to examine the effects of ketamine and pentobarbital on venous capacitance in rats. Venous capacitance was assessed by measuring the mean circulatory filling pressure (MCFP) at three levels of blood volume in conscious rats as well as during anesthesia with ketamine (125 mg/kg, ip) or pentobarbital (50 mg/kg, ip). MCFP was measured during brief periods of circulatory arrest produced by inflating an indwelling balloon in the right atrium. ⋯ These results suggest that ketamine did not alter but pentobarbital increased venous capacitance. The slope of the regression line relating MCFP and blood volume was not altered by ketamine but was increased (P less than 0.05) by pentobarbital, which suggests that ketamine did not alter but pentobarbital decreased total vascular compliance. These results suggest that ketamine maintains but pentobarbital decreases venous tone.
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In order to continue to enhance the educational quality of residency training in anesthesiology and ultimately to improve patient care, the American Board of Anesthesiology has adopted a modification in the curriculum for the 4-year Continuum of Education in Anesthesiology to provide for a CA-3 year replacing the Specialized Year and the Alternate Pathways. This CA-3 year will be required for residents beginning their CA-1 year of training on or after May 1, 1986. There will be a 2-year transition period beginning May 1, 1984, to facilitate its implementation.