Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2012
Biography Historical ArticleSpecial Article: Howard Dittrick: curator to the McMechans' legacy journal.
A noted medical historian and museum curator, Canadian American Howard Dittrick was a Cleveland gynecologist who served as Directing Editor of Current Researches in Anesthesia and Analgesia (1940-1954). In the aftermath of World War II, even after Congresses of Anesthetists had resumed, Dittrick and his editorial board allowed their yellow, then tan-covered journal, the so-called "yellow peril," to languish into near irrelevance.
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Anesthesia and analgesia · Dec 2012
A case series of recombinant platelet factor 4 for heparin reversal after cardiopulmonary bypass.
Platelet factor 4 (PF4) is released by activated platelets and has a strong affinity for heparin. Recombinant PF4 (rPF4) has been previously considered as an alternative to protamine for heparin reversal. However, it has been demonstrated that antibodies directed against the PF4/heparin moiety are important in the pathophysiologic development of heparin-induced thrombocytopenia, a prothrombotic complication for which cardiac bypass patients are at increased risk. ⋯ Our case series demonstrates that heparin anticoagulation was effectively reversed by the administration of rPF4 without serious complications. Additional studies are needed to further validate the safety and efficacy of exogenous rPF4 administration.
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Anesthesia and analgesia · Dec 2012
Biography Historical ArticleSpecial article: Laurette McMechan (1878-1970): "mother of anesthetists".
Laurette van Varseveld McMechan (1878-1970) was married to Francis Hoeffer McMechan (1879-1939), who organized the International Anesthesia Research Society and was the editor of the first journal for physician and dentist anesthetists. Although she was not a physician, she made vital contributions to the development of worldwide organized anesthesia and its journals. ⋯ Her life was dedicated to the profession of anesthesia. A memorial tribute labeled her "the mother of anesthetists," a title she deserved.
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Anesthesia and analgesia · Dec 2012
Biography Historical ArticleSpecial article: Francis Hoeffer McMechan, MD: creator of modern anesthesiology?
If one person can be credited with the creation of the infrastructure of modern anesthesiology, that individual would be Francis Hoeffer McMechan. He has been largely forgotten since his death in 1939 despite his remarkable and enduring accomplishments. ⋯ His accomplishments are even more amazing given the severe arthritis that left him wheelchair-bound for almost his entire professional life and denied him the ability to practice anesthesia. Our specialty owes an incredible debt to this largely unknown and unsung hero.
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Anesthesia and analgesia · Dec 2012
Technical communication: anatomy and clinical implications of ultrasound-guided selective femoral nerve block.
In this study we evaluated the anatomic basis and clinical findings of ultrasound-guided femoral nerve block performed close to the distal apex of the femoral triangle. Cadaver studies were conducted in 9 thighs of fresh bodies within 24 hours postmortem. In all cases, during injection of 10 mL of blue dye, the skin proximal to the injection site was compressed to prevent the proximal flow. ⋯ The femoral nerve was successfully dyed in all cases of the cadaver study, whereas the muscular branch to the sartorius muscle and quadriceps muscle, with the exception of the vastus medialis muscle, evaded dyeing. All 20 patients with varus knee deformities reported analgesia; none of them experienced motor block. We conclude that local anesthetic injection at the site where the superficial femoral artery has passed beneath the medial border of the sartorius muscle (8 to 12 cm distal to the inguinal crease), combined with efforts taken to prevent proximal flow may anesthetize the sensation of the anterior-to medial aspect of the knee and motor branch of the vastus medialis muscle, without blocking the sartorius or quadriceps muscles.