Journal of clinical anesthesia
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To investigate, in a group practice setting, the effects of combining information about drug costs with adoption of a voluntary low-cost protocol. ⋯ A private practice anesthesia group that followed a voluntary protocol could significantly reduce drug cost with little change in clinical outcome. However, the savings may not be completely maintained after the monitoring period.
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Comparative Study
Procaine spinal anesthesia: a pilot study of the incidence of transient neurologic symptoms.
To determine the approximate incidence of transient neurologic symptoms (TNS) [formerly known as transient radicular irritation (TRI)] associated with procaine spinal anesthesia, and whether fentanyl prolongs the duration of procaine spinal anesthesia. ⋯ Procaine may be a useful alternative to lidocaine for short procedures, and it is less likely to produce TNS. Fentanyl prolongs motor block when added to procaine.
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We report a case of interpleural misplacement of an epidural catheter possibly caused by inappropriate angle of the Tuohy needle. A 71-year-old man was scheduled for left lower lobectomy of the lung with general and epidural anesthesia. A 18-gauge Tuohy needle was introduced into the Th5-Th6 interspace with a right paramedian approach. ⋯ The surgeon then found the epidural catheter to be in the left pleural cavity. The catheter was immediately withdrawn. It is, therefore, necessary to employ the appropriate angle of the Tuohy needle on attempting epidural anesthesia to avoid the complication that we experienced.
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To determine whether an association exists between individual anesthesiologists and nonpatient care time in the operating room (OR). ⋯ The impact of a shorter time interval between cases on OR efficiency remains unknown. Further education and investigation of this issue are warranted.
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To test the hypothesis that the correct depth of the endotracheal tube can be confirmed by transillumination method using the Trachlight device, which is a newly introduced lighted stylet for guided, blind tracheal intubation. ⋯ To achieve proper depth of the endotracheal tube, it is recommended that the tip of the endotracheal tube be placed 3 cm beyond the sternal notch. The Trachlight provides a simple and easy technique to achieve this goal.