Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2006
Outpatient management of continuous peripheral nerve catheters placed using ultrasound guidance: an experience in 620 patients.
Continuous peripheral nerve block (CPNB) is an optimal choice for analgesia after orthopedic procedures, but is not commonly used in outpatients because of concern regarding the possibility of catheter-related complications. In addition, it may be difficult to provide adequate patient access to physicians in this setting. We present 620 outpatients who were treated with CPNB using an established protocol. ⋯ In this large series of outpatients treated with CPNB, there were surprisingly few interventions requiring an anesthesiologist. Likewise, patients were able to manage and remove their catheters at home without additional follow-up. This suggests that with adequate instruction and telephone access to health care providers, patients are comfortable with managing and removing CPNB catheters at home.
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Anesthesia and analgesia · Dec 2006
Use of magnetic resonance imaging to define the anatomical location closest to all three cords of the infraclavicular brachial plexus.
Infraclavicular techniques are often used to perform brachial plexus blocks. In our volunteer study we used magnetic resonance imaging to identify the brachial plexus and axillary vessels in a sagittal plane corresponding to the lateral sagittal infraclavicular block. ⋯ We conclude that this knowledge may be useful for the performance of infraclavicular blocks aided by ultrasound. However, our proposals should be tested by clinical studies.
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Anesthesia and analgesia · Dec 2006
Holiday and weekend operating room on-call staffing requirements.
Every facility that performs cases on holidays has in some way decided on its operating room (OR) and anesthesia staffing for holidays. Previous studies have not examined how best to calculate appropriate holiday staffing. ⋯ The number of cases starting during each period of a holiday is a statistically valid end point for OR managers to use to evaluate how busy holidays are relative to weekend days. To be useful, the statistic must be combined with mathematically valid assessments of appropriate weekend staffing on-call, whether in-house, or from home.
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Anesthesia and analgesia · Dec 2006
The effect of electroencephalogram-targeted high- and low-dose propofol infusion on histopathological damage after traumatic brain injury in the rat.
Propofol is commonly used to sedate patients after traumatic brain injury. However, the dose-dependent neuroprotective effects of propofol after head trauma are unknown. We compared histopathological damage after 6 h of electroencephalogram-targeted high- and low-dose propofol infusion in rats subjected to controlled cortical impact (CCI). ⋯ Despite different levels of cortical neuronal function, there were no relevant differences in the short-term histopathological damage. These results challenge the view that the neuroprotective effect of propofol relates to the suppression of cerebral metabolic demand.