Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2012
ReviewBrain monitoring with electroencephalography and the electroencephalogram-derived bispectral index during cardiac surgery.
Cardiac surgery presents particular challenges for the anesthesiologist. In addition to standard and advanced monitors typically used during cardiac surgery, anesthesiologists may consider monitoring the brain with raw or processed electroencephalography (EEG). There is strong evidence that a protocol incorporating the processed EEG bispectral index (BIS) decreases the incidence intraoperative awareness in comparison with standard practice. ⋯ There has been a resurgence of interest in the anesthesia literature in limited montage EEG monitoring, including nonproprietary processed indices. This has been accompanied by research showing that with structured training, anesthesiologists can glean useful information from the raw EEG trace. In this review, we discuss both the hypothesized benefits and limitations of BIS and frontal channel EEG monitoring in the cardiac surgical population.
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Anesthesia and analgesia · Mar 2012
Randomized Controlled Trial Comparative StudyThe impact of perioperative catastrophes on anesthesiologists: results of a national survey.
Most anesthesiologists will experience at least one perioperative catastrophe over the course of their careers. Very little, however, is known about the emotional impact of these events and their effects on both immediate and long-term ability to provide care. In this study, we examined the incidence of perioperative catastrophes and the impact of these outcomes on American anesthesiologists. ⋯ A perioperative catastrophe may have a profound and lasting emotional impact on the anesthesiologist involved and may affect his or her ability to provide patient care in the aftermath of such events.
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Anesthesia and analgesia · Mar 2012
Randomized Controlled Trial Comparative StudyPartner's presence during initiation of epidural labor analgesia does not decrease maternal stress: a prospective randomized controlled trial.
Epidural analgesia reduces pain and anxiety during childbirth. In this randomized controlled trial, we sought to determine whether partner presence during the initiation of epidural analgesia reduces stress of both the mother and her partner and their perception of maternal pain. ⋯ Partner presence during epidural catheter insertion for labor analgesia did not decrease anxiety levels. To the contrary, anxiety and pain of epidural catheter placement were greater if the partner remained in the room.