Journal of clinical anesthesia
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Historical Article
A curious moment: the proposal to certify nurse anesthetists by the American Board of Anesthesiology.
During the 1930s, many different practitioners gave anesthetics to patients. Qualifications were not necessary, and economics often drove the choice of anesthetic administrator. Both physicians and nurse specialists in anesthesia understood the need for specialty certification. ⋯ For one curious moment, the ABS asked the ABA to certify nurse anesthetists. Neither the nurses nor the physician anesthetists were overwhelmingly in favor of the proposal. However, had the proposal succeeded, the face of American anesthesiology would have been quite different.
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Case Reports
Reexpansion pulmonary edema occurring after thoracoscopic drainage of a pleural effusion.
Video assisted thoracoscopic drainage and tale pleurodesis was used to treat a recurrent pleural effusion in a 60 year-old woman undergoing major gynecologic surgery. She developed reexpansion pulmonary edema immediately following surgery. Several important risk factors that were present in this patient are discussed. In addition to almost, complete collapse of the underlying lung for several weeks, thoracoscopy resulted in manipulations and rapid re-inflation of the underlying lung, which further increased the risk to the patient.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prospective, randomized, double-blind, placebo-controlled comparison of metoclopramide and ondansetron for prevention of posttonsillectomy or adenotonsillectomy emesis.
To compare the antimetic efficacy of prophylactic ondansetron, metoclopramide, and placebo for prevention of postoperative vomiting in pediatric tonsillectomy or adenotonsillectomy patients. ⋯ Prophylactic ondansetron is more effective than metoclopramide or placebo for the prevention of vomiting after tonsillectomy or adenotonsillectomy. Patients who do not vomit postoperatively have shorter LOS.
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Randomized Controlled Trial Comparative Study Clinical Trial
Preventing pain during injection of propofol: the optimal dose of lidocaine.
To define the optimal dose of lidocaine to be added to propofol to reduce the incidence of pain during its injection. ⋯ Within this dose range and in this patient population, 30 mg of lidocaine is optimal for reducing the pain during injection of propofol.
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Randomized Controlled Trial Comparative Study Clinical Trial
Lidocaine plasma levels following two techniques of obturator nerve block.
To assess plasma levels and the potential toxicity of lidocaine following two different approaches to the obtruator nerve. ⋯ Despite a lower total dose of lidocaine administered (450 mg), higher mean and peak plasma levels were reached sooner with bilateral direct obturator nerve block compared with the indirect obturator nerve block (600 mg), indicating a faster blood absorption of lidocaine following direct block. Both types of obturator nerve block prevented adductor muscle contraction in a large percentage of cases.