Journal of clinical anesthesia
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Review Case Reports
Intraoral vascular malformation and airway management: a case report and review of the literature.
A patient with a large airway venous malformation underwent anesthesia for a tooth extraction. The procedure was uneventful until extubation, immediately after which complete airway obstruction resulted. After unsuccessful attempts to relieve the problem, the patient's trachea was reintubated. ⋯ Anesthesiologists must be concerned with any airway vascular abnormality. Most abnormalities involving the airway are either hemangiomas or venous malformations. The anesthesiologist must diagnose the problem correctly because even minor manipulation of a venous malformation may result in exsanguination, or the malformation may become engorged and compromise the airway.
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To investigate whether hyperventilation significantly altered oxygen consumption in anesthetized and paralyzed patients undergoing surgery. ⋯ In anesthetized paralyzed patients, there is an increase in whole-body VO2 with hypocapnic alkalosis.
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Historical Article
To define a specialty: a brief history of the American Board of Anesthesiology's first written examination.
The initial written examination of the American Board of Anesthesiology, a division of the American Board of Surgery, was given on March 28, 1939. For all anesthesiologists, this date has double significance. First, what was meant by anesthesiology as a medical specialty was defined through the questions posed on the first examination. ⋯ A triumvirate of visionaries, Paul Wood, John Lundy, and Ralph Waters, was necessary to crystalize the goal of specialty recognition of physician-anesthetists. The first written examination was the consummation of this dream of equal status for anesthesia. The examination would not become repetitious, and within the first decade of testing, the style would change from an essay format to multiple-choice questions similar to the current form.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the efficacy of esmolol and alfentanil to attenuate the hemodynamic responses to emergence and extubation.
To define the ability of esmolol and alfentanil to control the hemodynamic changes associated with extubation and emergence. ⋯ Emergence and extubation after inhalation general anesthesia result in significant increases in BP and HR in healthy patients. An esmolol bolus dose and subsequent infusion significantly attenuated these responses. A small bolus dose of alfentanil minimized the responses to emergence but prolonged the time to extubation and was no longer protective at that point.