Journal of clinical anesthesia
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To determine the number of interscalene blocks that are necessary for a resident in anesthesiology to complete so as to achieve autonomous success with that specific block. ⋯ Experience with only 40 unspecified peripheral nerve blocks, as currently required by the Residency Review Committee as of January 2001, may not provide adequate opportunity for an individual to develop expertise in regional anesthesia.
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To develop a rapid online test of graft liver function during liver transplantation. ⋯ A significant reduction in rocuronium infusion requirement during the neohepatic phase may be suggestive of impaired organ function after reperfusion of the graft liver. Rocuronium may serve as a potential online indicator of graft liver function during liver transplantation by measurement of its infusion requirements during transplantation.
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To reexamine, in a follow-up to our first study, those factors responsible for house staff (i.e., residents and clinical fellows) selecting anesthesiology as a career and a specific training program, as well as house staff satisfaction with various educational aspects of our training program, and their perceptions of the future for graduating anesthesiology trainees. ⋯ Data from one institution indicate that selection of an anesthesiology career and training program remain strongly associated with concerns regarding educational experiences and postgraduate employment opportunities. In contrast to our results from our 1995-1996 study, significantly fewer house staff had concerns about securing employment following training. Our observations-coupled with favorable National Resident Matching Program results during the past few years-bode well for the future recruitment of graduating American medical students into anesthesiology.
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Case Reports
Epicardial echocardiography: diagnostic utility for evaluating aortic valve disease during coronary surgery.
Intraoperative epicardial echocardiography is commonly used to evaluate the ascending aorta for atheromatous disease before cannulation and cross clamping. In addition, it may serve as a cardiac imaging technique in patients where placement of a transesophageal echocardiography (TEE) probe is contraindicated, probe advancement is difficult, or a TEE probe is not available. ⋯ However, attempts to place a TEE probe were abandoned due to high resistance on probe insertion. Epicardial echocardiography revealed previously undiagnosed aortic valve disease resulting in replacement of this valve.
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To evaluate the components of commonly used central venous catheter kits with respect to the potential for guidewire-mediated complications during catheter placement.Prospective, nonrandomized, observational study. ⋯ The design of commonly employed central venous access catheter kits is such that there is a mismatch between guidewire and catheter length and a general lack of guidewire markings. We believe that these designs may predispose to the introduction of excess guidewire and result in guidewire-mediated complications during catheter placement. This risk can likely be reduced by matching the guidewires to the devices placed over them and by standardizing guidewire distance markings.