Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 1998
Comparative carbon dioxide output through injured and noninjured peritoneum during laparoscopic procedures.
Tension pneumoperitoneum may force gas into a small injured vessel if the opening is kept patent by surrounding tissues. However, the amount of carbon dioxide (CO2) that penetrates through injured or noninjured peritoneum has not been systematically determined. In 25 patients undergoing elective laparoscopic ultrasonography and cholecystectomy, CO2 output (VCO2) and O2 uptake (VO2) were measured at baseline and during anesthesia, pneumoperitoneum, laparoscopic surgical procedure (Surgery), and after hemostasis of the surgical field (Postsurgery). ⋯ Minute volume increased from 2.24 +/- 0.20 in anesthesia to 2.89 +/- 0.25, 4.01 +/- 0.32, and 3.46 +/- 0.28 L x min(-1) x m(-2) during pneumoperitoneum, Surgery, and Postsurgery, respectively, to maintain PaCO2. We conclude that the amount of CO2 absorbed following pneumoperitoneum prior to surgery is lower than that during Surgery or Postsurgery. The amount of CO2 absorbed through the surgical field was 2.3 times higher than that through the nonsurgical field while that from the peritoneum after hemostasis of surgical field was 1.6 times higher.
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Internet teleconferencing software can be used to hold "virtual" meetings, during which participants around the world can share ideas. A core group of anesthetic medical practitioners, largely consisting of the Society for Advanced Telecommunications in Anesthesia (SATA), has begun to hold regularly scheduled "virtual grand rounds." This paper examines currently available software and offers impressions of our own early experiences with this technology. Two teleconferencing systems have been used: White Pine Software CU-SeeMe and Microsoft NetMeeting. ⋯ While some effort is necessary to get these teleconferencing systems to work well, we have been using desktop conferencing for six months to hold virtual Internet meetings. The sound and video images produced by Internet teleconferencing software are inferior to dedicated point-to-point teleconferencing systems. However, low cost, wide availability, and ease of use make this technology a potentially valuable tool for clinicians and researchers.
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J Clin Monit Comput · Apr 1998
Randomized Controlled Trial Clinical TrialClonidine does not attenuate median nerve somatosensory evoked potentials during isoflurane anesthesia.
Clonidine, an alpha2 agonist, reduces the requirements of several anesthetics. However, the effects of clonidine on somatosensory evoked potentials (SEPs) are unclear. These effects on cortical SEPs during isoflurane anesthesia were studied in 20 ASA I-II patients scheduled for elective surgery. Furthermore, the isoflurane concentration required to induce electroencephalogram (EEG) burst-suppression with and without clonidine was studied. METHODS. Anesthesia was maintained with isoflurane at a FiO2 of 0.4. At 1 MAC isoflurane the patients were randomly given either intravenous clonidine 2 microg kg(-1) (ten patients) or saline (ten patients). Finally, the isoflurane concentration was increased to a point at which a burst-suppression pattern appeared in the EEG. SEPs upon median nerve stimulation were recorded (1) before induction of anesthesia, (2) at 1 MAC before clonidine/saline, (3) at 1 MAC after clonidine/saline, (4) at EEG burst-suppression. ⋯ The effect of clonidine in reducing the requirements of anesthetics during general anesthesia is not seen in the cortical SEPs. The isoflurane-induced burst-suppression in the EEG was not affected by clonidine, suggesting that the EEG effects of clonidine and isoflurane were not additive. If SEPs are monitored intraoperatively, clonidine can be used as an adjuvant during isoflurane anesthesia without harmful effects on SEP monitoring.