AANA journal
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of motor block between ropivacaine and bupivacaine for continuous labor epidural analgesia.
The aim of the present study was to compare the amount of motor block produced by different loading doses of ropivacaine and bupivacaine when delivered in a dilute solution with added opioid. Sixty-eight healthy term primigravid parturients were randomized to receive an initial bolus dose of 10 mL of 1 of the following: 0.25% bupivacaine (high bupivacaine), 0.25% ropivacaine (high ropivacaine), 0.125% bupivacaine (low bupivacaine), or 0.125% ropivacaine (low ropivacaine). Each loading dose had 10 micrograms of sufentanil added to it. ⋯ A statistically significant greater percentage of parturients receiving bupivacaine had motor block than those who received ropivacaine, with a marked decrease in the occurrence of motor block in the low ropivacaine group. The pain relief seemed to be less satisfactory in the ropivacaine groups, but the difference was not statistically significant. Ropivacaine produced significantly less motor block than bupivacaine in the 0.25% and the 0.125% loading doses, with the greatest difference seen in the lower concentration loading dose of ropivacaine.
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Randomized Controlled Trial Clinical Trial
Reducing anxiety in parents before and during pediatric anesthesia induction.
Fear and anxiety in a child undergoing surgery are correlated positively with the parent's level of anxiety, and interventions to decrease the parent's anxiety are appropriate. The purpose of this study was to determine whether viewing a video of an actual pediatric inhalation induction would reduce the level of parental anxiety. Eighty patients requiring an inhalation anesthetic induction were selected and randomized to 2 groups. ⋯ The level of anxiety postoperatively of children and parents in group 1 was significantly lower than that of children and parents in group 2 (P < .05). Viewing a preoperative video seems to be beneficial. Decreasing the parent's level of anxiety preoperatively may have a positive effect on the child's level of anxiety expressed postoperatively.
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Multicenter Study
The prevalence of visible and/or occult blood on anesthesia and monitoring equipment.
The Occupational Safety and Health Administration (OSHA) and the Centers for Disease Control and Prevention (CDC) have attempted to stop the spread of blood-borne pathogens by issuing several recommendations and regulations. However, unless healthcare workers comply with these standards, they are not effective. In the anesthesia care environment, the anesthetist is responsible for ensuring that the equipment is clean, and disinfected, before use. ⋯ The presence of blood on this equipment may be in direct violation of the OSHA Blood-borne Pathogen Standard and the infection control guidelines of the American Association of Nurse Anesthetists. Furthermore, the presence of blood on this equipment may increase the risk for nosocomial and occupational exposure to viral and bacterial pathogens. Recommendations were made to decrease the risks from this contamination by redesigning equipment, increasing the use of disposable equipment, and ensuring compliance with effective infection control practices.
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In the United States, molar pregnancy occurs between 1 in 1,200 and 1 in 2,500 pregnancies. The critical nature of complications associated with a molar pregnancy requires advanced perioperative anesthetic management. This case report details the perioperative events of a 34-year-old gravida 5, para 3, with a partial molar pregnancy who underwent general anesthesia for a dilatation and curettage procedure, following therapeutic termination of a coexisting fetus at 18 weeks' gestation. ⋯ The medical and anesthetic interventions required for treatment of molar pregnancy are reviewed. Of molar pregnancies, 80% are uncomplicated and follow an unremarkable course. However, for the remaining 20%, complications can be severe and may lead to substantial morbidity and mortality in otherwise healthy women.