Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2007
Practice GuidelineACC/AHA 2006 guideline update on perioperative cardiovascular evaluation for noncardiac surgery: focused update on perioperative beta-blocker therapy--a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery).
The American College of Cardiology/American Heart Association (ACC/AHA) Task Force on Practice Guidelines makes every effort to avoid any actual, potential, or perceived conflict of interest that might arise as a result of an industry relationship or personal interest of the writing committee. Specifically, all members of the writing committee, as well as peer reviewers of the document, were asked to provide disclosure statements of all such relationships that might be perceived as real or potential conflicts of interest. These statements are reviewed by the parent task force, reported orally to all members of the writing committee at each meeting, and updated and reviewed by the writing committee as changes occur. ⋯ These guideline recommendations reflect a consensus of expert opinion after a thorough review of the available, current scientific evidence and are intended to improve patient care. If these guidelines are used as the basis for regulatory/payer decisions, the ultimate goal is quality of care and serving the patient's best interests. The ultimate judgment regarding care of a particular patient must be made by the healthcare provider and patient in light of all the circumstances presented by that patient.
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Anesthesia and analgesia · Jan 2007
Randomized Controlled TrialA randomized prospective study comparing the Cobra Perilaryngeal Airway and Laryngeal Mask Airway-Classic during controlled ventilation for gynecological laparoscopy.
An increasing number of noninvasive, supraglottic airway devices are currently available. In this randomized single-blind study, we compared the Cobra Perilaryngeal Airway (CobraPLA) to the [Laryngeal Mask Airway (LMA)-Classic] during gynecological laparoscopy. ⋯ During gynecological laparoscopy, the CobraPLA provides similar insertion characteristics, but higher airway sealing pressures than the LMA-Classic. The usefulness of this finding requires further investigation.
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Although few studies have been performed recently, several have suggested that some practitioners are not well able to detect preset anesthesia machine faults. ⋯ Our prospective study demonstrated that anesthesia machine checkout continues to be a problem.
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Anesthesia and analgesia · Jan 2007
Construction of the electroencephalogram player: a device to present electroencephalogram data to electroencephalogram-based anesthesia monitors.
Recently, an increasing number of electroencephalogram (EEG)-based monitors of the hypnotic component of anesthesia has become available. Most of these monitors calculate a numerical index reflecting the hypnotic component of anesthesia. Most of the underlying algorithms are proprietary. Therefore, a quality check or comparison of different indices is very complex. ⋯ The output of the player corresponds to the original EEG signal. A comparison of different indices based on identical EEGs is therefore possible. The index reproducibility can also be checked, if the same signal is presented to different monitors.
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Anesthesia and analgesia · Jan 2007
Remifentanil requirements during propofol administration to block the somatic response to skin incision in children and adults.
During sevoflurane administration, children require a remifentanil infusion rate twofold higher than adults to block responses to skin incision. Similar data concerning remifentanil requirements are unavailable during total IV anesthesia. ⋯ These results demonstrate that, similar to sevoflurane anesthesia, during total IV anesthesia with propofol, children require a remifentanil IR almost twofold higher than adults to block the somatic response to skin incision.