Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2012
Descriptive study of case scheduling and cancellations within 1 week of the day of surgery.
We performed a descriptive study of operating room (OR) case scheduling within 1 week of the day of surgery. ⋯ Planning anesthesia assignments, ORs to target, etc., can be done productively starting 2 working days ahead of surgery. There are so many changes to the OR schedule those last 2 workdays that anesthesia groups should be engaged with the scheduling office during that period. The primary predictor of additional net hours of cases to be scheduled is the difference between the allocated (i.e., forecasted) OR time and the hours scheduled so far.
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Anesthesia and analgesia · Nov 2012
Deficits in the provision of cardiopulmonary resuscitation during simulated obstetric crises: results from the Israeli Board of Anesthesiologists.
Cardiac arrest in the parturient is often fatal, but appropriate resuscitation in this special situation may save the lives of the mother and/or unborn baby. Concern has arisen as to application of recommended techniques for resuscitation in the obstetric patient. The Israel Board of Anesthesiology has incorporated simulation assessment into accreditation examinations. ⋯ Cricoid pressure during bag-mask ventilation was performed by 48% (25%) but described in debriefing by 80% of candidates (53%) (P = 0.08), and time setting for perimortem cesarean delivery was performed by 40% (29%) but described by 80% (53%) (P = 0.05) of examinees. CONCLUSIONS Senior anesthesiology residents have poor knowledge of resuscitation of the pregnant patient. The results suggest 2-stage simulation including an oral component may reveal disparities in knowledge not assessed by simulation alone, but definitive conclusions require further study.
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Anesthesia and analgesia · Nov 2012
Comparative StudyLocal neurotoxicity and myotoxicity evaluation of cyclodextrin complexes of bupivacaine and ropivacaine.
Bupivacaine (BVC) and ropivacaine (RVC) are local anesthetics widely used in surgical procedures. In previous studies, inclusion complexes of BVC or RVC in hydroxypropyl-β-cyclodextrin (HP-β-CD) increased differential nervous blockade, compared to the plain anesthetic solutions. In this study we evaluated the local neural and muscular toxicity of these new formulations containing 0.5% BVC or RVC complexed with HP-β-CD (BVC(HP-β-CD) and RVC(HP-β-CD)). ⋯ We concluded that the new formulations presented a lower myotoxicity and a similar cytotoxic effect when compared to plain local anesthetic solutions.
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Anesthesia and analgesia · Nov 2012
Volumetric three-dimensional ultrasound imaging of the anatomy relevant for thoracic paravertebral block.
While ultrasound imaging of the thoracic paravertebral space in 2-dimensional (D) mode allows examination of the paravertebral anatomy in the transverse or sagittal axis, volumetric 3D ultrasound imaging provides multiplanar images in several orthogonal (perpendicular) planes and may provide additional anatomical information. In this imaging study we assessed the feasibility of 3D ultrasound imaging of the anatomical area relevant to the thoracic paravertebral block. ⋯ Volumetric 3D ultrasound imaging of the thoracic paravertebral space is feasible and provides more detailed spatial anatomical information than 2D ultrasound imaging.