Anesthesiology
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A recurring initiative in graduate education is to find more effective methods to assess specialists' skills. Life-sized simulators could be used to assess the more complex skills expected in specialty practice if a curriculum of relevant exercises were developed that could be simply and reliably scored. The purpose of this study was to develop simulation exercises and associated scoring methods and determine whether these scenarios could be used to evaluate acute anesthesia care skills. ⋯ This study suggests that simulation can be used to measure more complex skills expected in specialty training. Similar to other studies that assess a broad content domain, multiple encounters are needed to estimate skill effectively and accurately.
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Randomized Controlled Trial Clinical Trial
Impact of bispectral index monitoring on stress response and propofol consumption in patients undergoing coronary artery bypass surgery.
Bispectral Index (BIS)-titrated administration allows a reduction of propofol infusion rates in patients undergoing surgery. Resulting differences in anesthetic depth might affect the stress response to surgery involving neural circuitry not reflected in the electroencephalogram. ⋯ Total intravenous anesthesia using propofol-remifentanil effectively attenuates the neurohumoral stress response to coronary bypass surgery involving cardiopulmonary bypass. Titration of propofol using BIS allows for significant reduction of propofol consumption, with only minor effects on stress response under these conditions.