Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2007
Comparative StudyIntraoperative management of patients with carcinoid heart disease having valvular surgery: a review of one hundred consecutive cases.
Cardiac surgery for carcinoid heart disease is complicated by hemodynamic instability secondary to carcinoid crises, cardiovascular dysfunction, and blood loss. The safety of vasopressors and the benefit of aprotinin during concomitant octreotide administration are uncertain. ⋯ Vasopressors may be used in conjunction with octreotide in carcinoid patients. The increased mortality associated with epinephrine likely reflects selection bias rather than a primary adverse effect. The improved survival over time in carcinoid patients is multifactorial and unrelated to aprotinin administration, suggesting further inhibition of the kallikrein-kinin system has little added benefit for this outcome in the presence of octreotide.
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Anesthesia and analgesia · Nov 2007
Randomized Controlled Trial Comparative StudyA new technique to reduce epistaxis and enhance navigability during nasotracheal intubation.
Epistaxis is the most common complication of nasotracheal intubation. We compared endotracheal tubes (ETT) obturated with an inflated esophageal stethoscope with normal ETTs with regard to the prevention of epistaxis and navigability, both with and without thermosoftening. ⋯ The use of esophageal stethoscope-obturated ETTs was effective, and comparable to thermosoftening, in preventing epistaxis associated with nasotracheal intubation. Thermosoftened, obturated ETTs were more effective than simple thermosoftened ETTs in reducing epistaxis.
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Anesthesia and analgesia · Nov 2007
ReviewContinuous airway access for the difficult extubation: the efficacy of the airway exchange catheter.
The American Society of Anesthesiologists Task Force on the Management of the Difficult Airway regards the concept of an extubation strategy as a logical extension of the intubation process, although the literature does not provide a sufficient basis for evaluating the merits of an extubation strategy. Use of an airway exchange catheter (AEC) to maintain access to the airway has been reported on only a limited basis. ⋯ Maintaining continuous access to the airway postextubation via an AEC can be an important component of an extubation strategy in selected difficult airway patients. The indwelling AEC appears to increase the first-pass success rate in patients with known or suspected difficult airways and decrease the incidence of complications in patients intolerant of extubation and requiring tracheal reintubation.
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Anesthesia and analgesia · Nov 2007
Comparative StudyEpidural anesthesia for laminectomy lead placement in spinal cord stimulation.
Spinal cord stimulation (SCS) is used to treat chronic pain and requires an awake patient for optimized lead positioning to locate paresthesias. Epidural anesthesia may be a suitable anesthetic but has not been evaluated. ⋯ This is the first study using epidural anesthesia for SCS lead implants by laminectomy. The technique seems to be safe and effective.
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Anesthesia and analgesia · Nov 2007
Comparative StudyLeadership of United States academic anesthesiology programs 2006: chairperson characteristics and accomplishments.
We conducted an Internet-based survey of all current academic anesthesiology chairpersons to benchmark their characteristics and accomplishments, as well as to gain insights that might be useful to aspirant department chairs. ⋯ The survey suggests that anesthesiology chairs value peer-reviewed research, scholarship, and academic achievement, but do not believe that significant research experience is of great benefit to functioning as a chair.