Anesthesia and analgesia
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Anesthesia and analgesia · Jul 2013
Incidence of intraoperative hypoxemia in children in relation to age.
Although respiratory problems are by far the most frequent complications of pediatric anesthesia, there are currently no reliable data on the incidence of perioperative hypoxemia in children. Most studies investigating the incidence of pediatric respiratory complications were based on self-report. ⋯ The incidence of intraoperative hypoxemia increased with younger age, with the highest incidence in neonates. Because of the high artifact rate, unvalidated pulse oximeter data in AIMS should be interpreted with caution because only up to 65% of all hypoxemic episodes recorded during pediatric anesthesia were caused by true hypoxia.
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Anesthesia and analgesia · Jul 2013
Case ReportsCase report: inadvertent intrathecal placement of a pulmonary artery catheter introducer.
We present a case of unintended intrathecal cannulation by a pulmonary artery catheter introducer in a patient scheduled for coronary surgery. This complication was likely due to multiple attempts of placing the guidewire. Switching to the straight tip of the guidewire may have created a false route, facilitating entrance in the subarachnoid space. ⋯ A lumbar epidural blood patch alleviated all complaints. One month later the patient underwent surgery successfully. We hypothesize that ultrasound imaging may have prevented this complication.
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Anesthesia and analgesia · Jul 2013
Editorial Comment"Never" events: anesthesiology's dirty little secret.
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Anesthesia and analgesia · Jul 2013
The prevalence of burnout and depression and their association with adherence to safety and practice standards: a survey of United States anesthesiology trainees.
The prevalence of burnout and depression in anesthesiology residents has not been determined. It is also unknown whether anesthesiology resident burnout/depression may affect patient care and safety. The primary objective of this study was to determine the prevalence of burnout and depression in anesthesiology residents in the United States. We hypothesized that residents at high risk of burnout and/or depression would report more medical errors as well as a lower rate of following principles identified as the best practice of anesthesiology. ⋯ Burnout, depression, and suicidal ideation are very prevalent in anesthesiology residents. In addition to effects on the health of anesthesiology trainees, burnout and depression may also affect patient care and safety.
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Anesthesia and analgesia · Jul 2013
Technical communication: the effect of the double mask on anesthetic waste gas levels during pediatric mask inductions in dental offices.
A significant portion of office-based general anesthesia for pediatric patients is performed in dental offices and involves mask inductions with inhaled drugs. This can lead to significant pollution with waste gases. ⋯ Levels of sevoflurane decreased from a median of 4.60 ppm (IQR = 3.10-7.00 ppm, n = 9) to 0 ppm (IQR = 0-0.39 ppm, n = 9, P = 0.0024) and exceeded 2 ppm in 0% of the 9 offices (upper 95% confidence limit 34%) when using the double mask. We demonstrated in our study that the double-mask system, when used with dental "high-volumes" suctions (high-volume evacuators producing approximately 12 m(3)/h) in freestanding dental offices, was sufficient to decrease the exposure to anesthetic waste gas during pediatric mask induction in at least two thirds of offices when compared with the traditional mask.