Anesthesiology
-
Beware anesthesiologist number 7... the quality of intraoperative conduct of anesthesia effects patient outcomes.
pearl -
The authors demonstrated that soda lime will adsorb enflurane or isoflurane as a function of the water content of the soda lime. Various volumes of liquid enflurane or isoflurane were placed in an equilibration flask containing fresh (15% water by weight) or dried soda lime and the vapor phase anesthetic concentrations plotted. ⋯ This is qualitatively similar to data reported previously for halothane. The authors hypothesize that drying soda lime produces a molecular sieve-like structure, as adsorption is greatest for molecules with small carbon chain lengths and kinetic diameters, or with structural characteristics such as cis/trans isomerism, which effectively reduce molecular size.
-
Review
Opioid analgesics in anesthesia: with special reference to their use in cardiovascular anesthesia.
In this article, an attempt has been made to review the use of receptor stimulating pure agonist opioids in anesthesia, especially in patients with cardiovascular disease. Particular emphasis has been placed on the use of opioids in high doses to produce anesthesia, techniques that recently have become popular in cardiovascular anesthesia. A major benefit of opioid anesthesia is the cardiovascular stability obtained during induction and throughout operation, even in patients with severely impaired cardiac function. ⋯ The use of very large doses of opioids also will prolong postoperative respiratory depression. High doses of opioids can reduce or prevent the hormonal and metabolic responses to the stress of surgery. However, even very large doses of fentanyl or its newer analogues do not prevent marked increases in plasma catecholamine concentrations in response to cardiopulmonary bypass.(ABSTRACT TRUNCATED AT 400 WORDS)