Journal of clinical anesthesia
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To determine the accuracy of body surface area (BSA) calculations proposed in the literature and their applicability to patient populations such as neonates and parturients. ⋯ Several BSA formulas, including the DuBois and DuBois formulas adequately predict measured BSA over a wide range of patient populations. Although the original subjects studied by Dubois and DuBois excluded extremes of height and weight, their formula appears to be a valid predictor.
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Editorial Historical Article
A historic occasion: an anesthesia journal turns 70.
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A 27-year-old parturient developed a severe headache after placement of a labor epidural catheter. A presumptive diagnosis of an occult postdural puncture headache (PDPH) was made, and the patient was treated with an intravenous (IV) infusion of 500 mg of caffeine sodium benzoate (CSB) to vasoconstrict dilated cerebral vessels. ⋯ Despite a neurologic consultation and extensive testing, no definitive cause for the seizure was found. In light of the temporal relationship between caffeine use and the development of seizure activity, reports implicating caffeine's contribution to seizure activity, and evidence of a prolongation of the substance's half-life during and after pregnancy, we urge caution in the use of this drug in parturients.
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Perioperative smoking causes acute changes in cardiopulmonary function that can have unfavorable implications for patients undergoing anesthesia. These cardiopulmonary effects are carbon monoxide and nicotine mediated changes in oxygen (O2) delivery and myocardial O2 balance. ⋯ Bringing about a decrease in postoperative pulmonary complications requires a much longer period of preoperative abstinence. Because the perioperative period is in many ways an ideal time to abandon the smoking habit permanently, anesthesiologists, in cooperation with other health professionals, can perhaps play a more active role in facilitating this process.