Anesthesia and analgesia
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Anesthesia and analgesia · Jul 2019
A Survey of Charge Sensitivity and Charge Awareness Among Intensive Care Unit Providers in a Large Academic Medical Center.
Little is known about charge sensitivity or charge awareness among intensive care unit (ICU) providers in the United States. In a survey of 295 ICU providers at a large, academic medical center, 92.5% of respondents agreed that controlling health care expenses is partly their responsibility. ⋯ Among surveyed participants, the correct charge for a medical procedure or test was selected only 35% of the time. While ICU providers overwhelmingly agree that controlling expenses is their responsibility, charge awareness is low and likely limits their ability to make value-based decisions.
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Anesthesia and analgesia · Jul 2019
ReviewImproving Access to Safe Anesthetic Care in Rural and Remote Communities in Affluent Countries.
Inadequate access to anesthesia and surgical services is often considered to be a problem of low- and middle-income countries. However, affluent nations, including Canada, Australia, and the United States, also face shortages of anesthesia and surgical care in rural and remote communities. Inadequate services often disproportionately affect indigenous populations. ⋯ Ultimately, we believe that it is the responsibility of specialist anesthesiologists and academic health sciences centers to facilitate access to high-quality care through partnership with other stakeholders. Professional medical organizations also play an important role in ensuring the quality of care and continuing professional development. Enhanced collaboration between academic anesthesiologists and other stakeholders is required to meet the challenge issued by the World Health Organization to ensure access to essential anesthesia and surgical services for all.
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Anesthesia and analgesia · Jul 2019
Comparative StudyEfficacy of Malignant Hyperthermia Association of the United States-Recommended Methods of Preparation for Malignant Hyperthermia-Susceptible Patients Using Dräger Zeus Anesthesia Workstations and Associated Costs.
The objective of this study was to assess the efficacy and cost of Malignant Hyperthermia Association of the United States-recommended methods for preparing Dräger Zeus anesthesia workstations (AWSs) for the malignant hyperthermia-susceptible patient. ⋯ Institutions in which demand for OR time has exceeded capacity should consider M3, and institutions with surplus OR capacity should consider M1.
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Anesthesia and analgesia · Jul 2019
Comparative Study Clinical TrialComparative Study of TOF-Cuff, a New Neuromuscular Blockade Monitor, and TOF-Watch, an Acceleromyography.
Train-of-four ratios were recorded to assess the agreement between the TOF-Cuff and TOF-Watch, and residual paresis was assessed to evaluate the clinical utility of TOF-Cuff. Train-of-four ratios were evaluated using Lin concordance correlation coefficient and Bland-Altman analyses. ⋯ Although precision and Lin concordance correlation coefficients decreased with train-of-four ratios >0.7, none of the patients showed signs of residual paresis. Because TOF-Cuff underestimated train-of-four ratios in the recovery period, the clinical safety of train-of-four ratios >0.9 indicated by TOF-Cuff is unclear; the issue of residual paresis requires future research that rigorously evaluates outcomes.
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Anesthesia and analgesia · Jul 2019
ReviewWhat's New in Obstetric Anesthesia? The 2017 Gerard W. Ostheimer Lecture.
The "What's New in Obstetric Anesthesia Lecture" is presented every year at the annual meeting of the Society for Obstetric Anesthesia and Perinatology. This lecture was established in 1975 to update the membership on the most relevant articles that were published in the preceding calendar year. ⋯ This review summarizes key articles published in 2017 that were presented in the 2018 Ostheimer Lecture with a focus on opioid prescriptions, anesthesia for external cephalic version, labor analgesia, maternal morbidity, and global health. A proposed list of action items based on the 2017 literature is also presented.