International anesthesiology clinics
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In a little over 10 years, six new muscle relaxants have been introduced in clinical practice. The first two, intermediate-duration vecuronium and atracurium, were outstanding drugs and clearly an advance over the earlier, longer-acting drugs. With their introduction, the phenomenon of "recurarization" largely disappeared. ⋯ However, mivacurium has neither the rapid onset nor the ultra-short duration of succinylcholine. Rocuronium is the first nondepolarizing relaxant with an onset approaching that of succinylcholine. It is likely that we will see the introduction of at least two more drugs, Org 9487 and 51W89, by the end of this decade, and the goal of developing a nondepolarizing relaxant that is a complete replacement for succinylcholine may not be too far in the future.
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Int Anesthesiol Clin · Jan 1995
ReviewThe operating rooms: cost center management in a managed care environment.
The changing health care climate has triggered important changes in the management of high-cost components of acute care facilities. By integrating and better managing various elements of the surgical process, health care institutions are able to rationally trim costs while maintaining high-quality services. The leadership that physicians can provide is crucial to the success of this undertaking.