Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2016
Case ReportsPausing With the Gauze: Inhibition of Temporary Pacemakers by Radiofrequency Scan During Cardiac Surgery.
Radiofrequency identification (RFID) detection systems are used to detect retained surgical sponges and may cause electromagnetic interference (EMI), altering intended function of cardiac pacing systems. Three pediatric patients requiring temporary pacing for postoperative atrioventricular block experienced transient inhibition of ventricular pacing during the use of RFID detection system. Bench testing was performed to evaluate the mechanism of pacemaker inhibition. ⋯ Normal operation of RFID detection systems may cause inhibition of temporary pacing systems consistent with oversensing from EMI. Precaution should be taken, including considering pacing asynchronously to avoid effects of inhibition.
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Anesthesia and analgesia · Nov 2016
Observational StudyHemodynamic Instability Following Airway Spray Cryotherapy.
Spray cryotherapy (SCT) of airway lesions is used to effectively palliate respiratory symptoms related to airway obstruction, but significant intraoperative hemodynamic complications have been noted. We reviewed the experience at a single institution using SCT for the treatment of obstructive airway tumors. ⋯ Unpredictable life-threatening hemodynamic instability can follow endobronchial SCT. We propose that the most likely cause is pulmonary venous gaseous emboli entering the right heart, the coronary arteries, and the systemic circulation. Although SCT may offer advantages over airway laser therapy (such as no risk of fire and rapid hemostasis), further study is needed to delineate the relative likelihood of therapeutic benefit versus catastrophic complications.
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Anesthesia and analgesia · Nov 2016
A Procedural Electroencephalogram Simulator for Evaluation of Anesthesia Monitors.
Recent research and advances in the automation of anesthesia are driving the need to better understand electroencephalogram (EEG)-based anesthesia end points and to test the performance of anesthesia monitors. This effort is currently limited by the need to collect raw EEG data directly from patients. ⋯ Anesthesia monitor response to a procedural simulator can reveal significant differences in internal signal processing algorithms. The ability to synthesize EEG signals at different anesthetic depths potentially provides a new method for systematically testing EEG-based monitors and automated anesthesia systems with all sensor hardware fully operational before human trials.