Anesthesia and analgesia
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A technique for brachial plexus anesthesia is described consisting of the injection of 20 ml of local anesthetic solution into the lower part of the posterior triangle of the neck at a point 1.5 to 2 cm above the clavicle at the lateral border of the anterior scalene muscle. The technique is simple, safe, and produced satisfactory anesthesia of the entire extremity in 97 of the first 100 cases in which it was used. Side effects and complications were minor and transient.
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Anesthesia and analgesia · May 1979
Anesthesiology and the graduating medical student: a national survey.
Each year, many anesthesiology housestaff positions remain vacant or are filled by foreign medical graduates. While possibly reflecting an overabundance of such housestaff positions, this situation also suggests a lack of U. S. student interest in anesthesiology. ⋯ When such exposure occurs, it comes after many students have developed strong specialty preferences. Many students saw anesthesiology as limited in scope and unchallenging and indicated that they did not select anesthesiology because it entails insufficient primary patient care. Contrasts between those entering and not entering anesthesiology suggest, however, that certain variables which are subject to manipulation--such as amount, timing, and content of exposure to anesthesiology--could alter student attitudes and potentially generate increased student interest in the specialty.
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Anesthesia and analgesia · May 1979
Comparative StudySodium nitroprusside: hemodynamic dose-response during enflurane and morphine anesthesia.
To date there has been no description of the hemodynamic dose-response relationship between enflurane and sodium nitroprusside (SNP), although these drugs are often used together to induce deliberate hypotension. Utilizing aortic root cannulation and thermistor-tipped pulmonary artery catheters, this relationship was studied in six beagles during 1 and 2% enflurane anesthesia and compared with the hemodynamic response induced by SNP in the awake state and during anesthesia with intravenous morphine (6 mg/kg). ⋯ Enflurane potentiated the hypotensive effects of SNP in a dose-related fashion. During morphine anesthesia, however, the hemodynamic effects of SNP were virtually indistinguishable from those observed in the awake state.
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Anesthesia and analgesia · May 1979
Cardiovascular effects of fentanyl during enflurane anesthesia in man.
The cardiovascular effects of three doses of intravenous fentanyl (50, 100, and 200 microgram) were determined in 42 adult patients undergoing intraabdominal surgical procedures with enflurane (2--3%) and nitrous oxide (50%) in oxygen. Fentanyl was administered a minimum of 40 minutes after induction of anesthesia and 30 minutes after initiation of the surgical procedure. Stroke volume, heart rate, cardiac output, mean arterial and central venous blood pressures, and peripheral arterial resistance were determined by computer analysis of the central aortic pulse-pressure curve according to the method of Warner. ⋯ Fentanyl (1l (200 microgram) produced sustained decreases in stroke volume, cardiac output and mean arterial blood pressure and increased central venous pressure but did not alter heart rate or peripheral arterial resistance. The data indicate that fentanyl (50--100 microgram) stimulates or has no effect on cardiovascular dynamics during enflurane-nitrous oxide anesthesia but fentanyl (200 microgram) produces significant cardiovascular depression. Our findings suggest that small doses of intravenous fentanyl may be of benefit during enflurane-nitrous oxide but larger doses should probably be avoided.