Journal of clinical anesthesia
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The study objective is to investigate the effects of a simple price list sticker placed on vaporizers on anesthetic use and costs. The price list only showed the cost per hour of the annually most expensive drugs, which had a low-cost alternative. ⋯ Price sticker on vaporizers may be an effective, simple, and cheap method to reduce anesthetic costs.
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Review Case Reports
Valsalva hemorrhagic retinopathy presenting as a rare cause of impaired vision after a general anesthetic-a case report and review of the literature.
Postoperative visual loss from any cause is potentially catastrophic. We present a case of Valsalva hemorrhagic retinopathy (VHR) as a rare cause of impaired vision after an apparently uneventful general anesthetic. ⋯ Although VHR is considered to be rare, the events and activities with which it is associated are relatively common, both in everyday life and in the operating room. We suggest that the occurrence of VHR after anesthesia and surgery may be more frequent than previously appreciated and make recommendations for further investigations.
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Clinical Trial
Identification of location of nerve catheters using pumping maneuver and M-Mode-a novel technique.
Optimum positioning of the nerve catheter is crucial for a successful nerve block. We present a novel technique for confirmation of catheter position. ⋯ Pumping maneuver and M-Mode can be additional tools in the array of modalities applied to verify proper positioning of a nerve catheter.
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The computer-integrated patient-controlled epidural analgesia (CIPCEA) system can automatically adjust the background infusion rate during combined spinal-epidural analgesia based on the parturient's need, as labor progresses. ⋯ Low successful to total patient demand bolus ratio was the factor with the strongest association with breakthrough pain. Breakthrough pain was also associated with dysfunctional labor and poorer maternal satisfaction.
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The initial developmental standards for Maintenance of Certification programs proposed by the American Board of Medical Specialties included the administration of patient and peer surveys by the diplomate every 5 years. The aim of this pilot study was to determine the feasibility of Maintenance of Certification in Anesthesiology Program (MOCA) patient and peer surveys in a selected group of American Board of Anesthesiology (ABA) diplomates. ⋯ These results suggest that threats to the validity of these surveys include distribution bias for peer surveys and response bias for patient surveys and that surveys often do not provide actionable information useful for practice improvement. Alternative approaches, such as including anesthesiologists within an integrated institutional evaluation system, could be explored to maximize the benefits of physician assessments provided by peers and patients.