Anesthesia and analgesia
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Anesthesia and analgesia · May 2015
Review Practice GuidelineCritical care basic ultrasound learning goals for american anesthesiology critical care trainees: recommendations from an expert group.
In this review, we define learning goals and recommend competencies concerning focused basic critical care ultrasound (CCUS) for critical care specialists in training. ⋯ Immediate bedside availability of ultrasound resources can dramatically improve the ability of critical care physicians to care for critically ill patients. Anesthesia--critical care medicine training should have definitive expectations and performance standards for basic CCUS interpretation by anesthesiology--critical care specialists. The learning goals in this review reflect current trends in the multispecialty critical care environment where ultrasound-based diagnostic strategies are already frequently applied. These competencies should be formally taught as part of an established anesthesiology-critical care medicine graduate medical education programs.
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Anesthesia and analgesia · May 2015
Comparative Study Clinical Trial Observational StudyDiagnosis of Postoperative Urinary Retention Using a Simplified Ultrasound Bladder Measurement.
In this study, we sought to determine whether a simplified ultrasound measurement of the largest transverse diameter, using a standard ultrasound machine, could be used to diagnose postoperative urinary retention (POUR). This method may replace expensive bladder volume measuring devices or a more complex ultrasound procedure (involving the measurement of 3 bladder diameters). ⋯ A simple ultrasound measurement of the largest transverse bladder diameter seemed to be helpful to exclude or confirm POUR.
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Anesthesia and analgesia · May 2015
Randomized Controlled TrialThe Disposition of Radiocontrast in the Interscalene Space in Healthy Volunteers.
We measured the spread of radiocontrast in the interscalene space after injection under low (<15 psi) and high (>20 psi) pressures. ⋯ Regardless of injection pressure, the interscalene space was filled with 10 mL of radiocontrast injectate.
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Anesthesia and analgesia · May 2015
Comparative StudyThe Contractile Effects of Oxytocin, Ergonovine, and Carboprost and Their Combinations: An In Vitro Study on Human Myometrial Strips.
The objective of this study was to compare the in vitro contractile effects of the combination of oxytocin (low dose and high dose) with either ergonovine or carboprost in myometrial strips from women undergoing cesarean delivery (CD), and to study the effect of oxytocin pretreatment on these contractions. We hypothesized that the use of ergonovine or carboprost in combination with oxytocin would improve contractility compared with oxytocin alone. ⋯ The attenuation of oxytocin-induced contractility in oxytocin-pretreated myometrial strips is in keeping with the previously established oxytocin-receptor desensitization phenomenon. Oxytocin is the most effective of the uterotonics tested if the myometrium is not preexposed to oxytocin. However, in the oxytocin-pretreated myometrium, a synergistic response is evident, and the combination of oxytocin with either ergonovine or carboprost produces superior response compared with oxytocin alone. Further in vivo studies in humans are necessary to determine whether these differences identified in vitro are clinically significant.
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Anesthesia and analgesia · May 2015
Case ReportsDexmedetomidine and mannitol for awake craniotomy in a pregnant patient.
We describe the use of dexmedetomidine for an awake neurosurgical procedure in a pregnant patient and quantify the effect of mannitol on intrauterine volume. A 27-year-old woman underwent a craniotomy, with intraprocedural motor and speech mapping, at 20 weeks of gestation. ⋯ Internal uterine volume was estimated at 1092 cm before surgery and decreased to 770 and 953 cm at 9 and 48 hours, respectively, after baseline assessment. No adverse maternal or fetal effects were noted during the intraoperative period or up to 48 hours postoperatively.