Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Use of analgesics during propofol sedation: a comparison of ketorolac, dezocine, and fentanyl.
To evaluate the comparative efficacy and side effect profile of ketorolac 60 mg, dezocine 6 mg, and fentanyl 100 micrograms when used as analgesic supplements to a propofol infusion during monitored anesthesia care (MAC). ⋯ Compared with ketorolac 60 mg, fentanyl 100 micrograms and dezocine 6 mg produced a greater decrease in the propofol sedation requirement during MAC. However, the use of ketorolac in combination with propofol for MAC was associated with an improved recovery profile.
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Randomized Controlled Trial Clinical Trial
Factors that influence an anesthesiologist's decision to cancel elective surgery for the child with an upper respiratory tract infection.
To examine factors that anesthesiologists consider when making decisions regarding elective surgery cancellation of the pediatric patient with an upper respiratory infection (URI). ⋯ The results of this survey demonstrate a wide range of opinions and approaches to this enduring clinical dilemma. However, it appears that the practice of cancelling elective surgery for children with URIs may be changing over time, since younger anesthesiologists appear to cancel less often than their more experienced counterparts. It is hoped that this information will be useful to practioners in their evaluation and management of children with colds and will stimulate further investigation into this important clinical problem.
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Randomized Controlled Trial Clinical Trial
A post-anesthetic discharge scoring system for home readiness after ambulatory surgery.
To evaluate the validity and reliability of an objective scoring system, the Post-Anesthetic Discharge Scoring System (PADSS), which was compared against existing Clinical Discharge Criteria in the ambulatory surgery unit of our hospital. ⋯ We have found PADSS to have superior measurement scaling and diagnostic properties.
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Femoral nerve "sheath" for inguinal paravascular lumbar plexus block is not found in human cadavers.
To determine if a femoral nerve sheath capable of conveying local anesthetic to the lumbar plexus and the obturator nerve exists in human cadavers. ⋯ A femoral nerve sheath capable of conveying a solution to the cadaver lumbar plexus does not exist in human cadavers. Dye injected into the cadaver femoral nerve does not reach either the lumbar plexus or the obturator nerve. When 40 ml of methylene blue dye is injected into the cadaver femoral nerve, some dye usually diffuses under the iliacus muscle fascia to the lateral femoral cutaneous nerve. This study indicates that in patients the "3-in-1 block" always blocks the femoral nerve, it usually blocks the lateral femoral cutaneous nerve, but it probably does not block the lumbar plexus or the obturator nerve.
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Biography Historical Article
Ralph Waters and the beginnings of academic anesthesiology in the United States: the Wisconsin Template.
The University of Wisconsin, Madison, was one of the few places offering postgraduate training in the science and art of anesthesia in the late 1920s and 1930s. Weaving together clinical and basic science research, and fully supported by his surgical colleagues, Ralph Waters was able to create the first collegiate-based academic anesthesiology department. While Waters' department was an important milestone establishing anesthesia within the university setting, it did not guarantee true academic standing nationwide. ⋯ Waters searched for institutions where surgeons desired an academic anesthesia department. Additionally, he sought basic scientists ready to collaborate in scientific research in anesthesiology and a brisk clinical service. Successful application of the Wisconsin model was best reflected in the work of Waters' academic descendants: "sons" Emery Rovenstine and Robert Dripps, and "grandsons" Stuart Cullen and Emanuel Papper.