Journal of clinical anesthesia
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Historical Article
The role of anesthesiology in the health care system of The Netherlands.
With the initiation of regular anesthesia services in the Netherlands in 1947, anesthesiology has grown to a large and influential profession, including intensive care, resuscitation, pain therapy, and emergency medical care. Pre- and postgraduate training programs are formalized and compete with some of the best in the world. ⋯ Anesthesia is restricted to medical specialists, but with the permanent support of fully trained and qualified nurses. Anesthesia in the Netherlands is a "two person" job.
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Randomized Controlled Trial Comparative Study Clinical Trial
Bair hugger forced-air warming maintains normothermia more effectively than thermo-lite insulation.
To compare the ability of forced-air warming and reflective insulation to maintain intraoperative normothermia. ⋯ Reflective insulation was unable to maintain intraoperative normothermia during total hip arthroplasty. Active warming, such as that provided by forced air, was required to prevent hypothermia.
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Randomized Controlled Trial Clinical Trial
Clinical pharmacology of rocuronium (Org 9426): study of the time course of action, dose requirement, reversibility, and pharmacokinetics.
To evaluate the time course of action, dose requirement, reversibility, and pharmacokinetics of rocuronium (Org 9426) under 3 anesthetic techniques (nitrous oxide-fentanyl supplemented with propofol, halothane, or isoflurane). ⋯ Isoflurane potentiates the rocuronium-induced neuromuscular block, resulting in a longer clinical duration and lower maintenance dose requirement. This difference is not explained by differences in pharmacokinetics but is probably due to increased sensitivity of the neuromuscular junction to rocuronium during isoflurane anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Continuous administration of fentanyl for postoperative pain: a comparison of the epidural, intravenous, and transdermal routes.
To evaluate the influence of the route of administration [epidural, intravenous (IV), or transdermal] on onset and quality of analgesia and to evaluate the pharmacokinetics of continuous administration of fentanyl. ⋯ The epidural, transdermal, and IV administration of identical doses of fentanyl given at a constant rate provided almost equivalent degrees of analgesia. But continuing epidural administration produced a steady rise in systemic fentanyl concentrations into the ventilatory-depressant range, affecting the hypoxemic regulation of breathing.
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Comparative Study Clinical Trial Controlled Clinical Trial
Epidural administration of liposome-associated bupivacaine for the management of postsurgical pain: a first study.
To explore the influence of liposomes on the pharmacodynamic action of bupivacaine and to determine whether postsurgical analgesic advantages can be obtained from epidural delivery of liposomal bupivacaine compared with the current formulation. ⋯ The liposomal formulation of bupivacaine increased duration of analgesia without motor block or adverse side effects.