AANA journal
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The mixture of 1% lidocaine and 0.2% tetracaine with 1:200,000 epinephrine, so-called "supercaine," has been used extensively for axillary brachial plexus blockade for several decades. Since the advent of bupivacaine, the supercaine mixture has fallen into relative disuse despite its record of effectiveness and safety. No studies have been done recently to evaluate quality of anesthesia, duration of postoperative analgesia, and degree of patient satisfaction with this mixture when used for axillary brachial plexus blockade. ⋯ Data are reported within a 95% confidence interval. Variables examined and compared were not statistically significant. We concluded that the duration of block supports findings reported in the literature, patients equate duration of sensory block with duration of motor block, differences in duration were probably due to levels of provider experience, and patients were extremely satisfied with the anesthetic.
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Biography Historical Article
Voice and touch: Florence Henderson on the skills of an ether specialist.
In this issue of the AANA Journal, "Imagining in Time" continues an occasional series that reprints historical articles by early and pioneer nurse anesthetists. The purpose is to keep the past alive and stimulate research interest. ⋯ Florence Henderson, CRNA (1874-1956), like her mentor Alice Magaw, CRNA (1860-1928), promoted excellence in anesthesia practices through professional society presentations and publications. Featured is Henderson's second article titled "Ether Anesthesia," which was published in a 1914 issue of The Saint Paul Medical Journal.
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Randomized Controlled Trial Comparative Study Clinical Trial
Relationship of auditory middle latency response and stem-word completion test as indicators of implicit memory formation during general anesthesia.
Anesthesia providers are unable to objectively evaluate the amnesic status of an anesthetized patient. One purpose of the study was to evaluate the anesthetized patient's ability to process auditory information while receiving an inhalational or intravenous anesthetic regimen. The other purpose was to examine the relationship of the Pa latency of the auditory middle latency response (AMLR) with the stem-word completion test as an intraoperative indicator of implicit memory formation during general anesthesia. ⋯ In contrast, no correlation was noted in the sevoflurane group (r = 0.43, P = .07). Thus, the continued evaluation of the AMLR as an intraoperative indicator of implicit memory formation is warranted. With the establishment of the AMLR as an indicator of implicit memory formation during general anesthesia, anesthesia providers could then address the occurrences of traumatic neurosis in the postoperative surgical patient and strive to avoid the medicolegal concerns that may face the healthcare team.
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Randomized Controlled Trial Multicenter Study Clinical Trial
The effect of flumazenil on patient recovery and discharge following ambulatory surgery.
Midazolam is a short-acting agent used for preoperative and conscious sedation. Despite a relatively short half-life, midazolam sedation contributes to postoperative sedation, delays in discharge, and increased costs. Administration of flumazenil, a benzodiazepine antagonist, can reverse the centrally mediated effects of midazolam and facilitate patient recovery and discharge, thereby reducing costs. ⋯ The flumazenil group exhibited less amnesia and sedation than the placebo group on initial arrival in the postanesthesia care unit. Discharge times between the groups were not significantly different. Factors such as staffing and institutional discharge policies were identified as determinants of discharge times.
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Randomized Controlled Trial Clinical Trial
Effect of intrathecal fentanyl dose on the duration of labor analgesia.
The short duration of effective analgesia produced by intrathecal fentanyl (ITF) at doses ranging from 5 to 25 micrograms limits the drug's use for the management of labor pain. The understanding of the potential of ITF related to duration of analgesia in the labor patient is derived from studies of and clinical experience with ITF at doses not exceeding 25 micrograms and less. We hypothesized that by increasing the dose beyond 25 micrograms, a prolonged duration of analgesia could be achieved. ⋯ Statistical analysis using a 1-way analysis of variance and considering a P value of < .05 to be significant revealed no difference in duration of effective analgesia between the groups. Statistical differences in the incidence of adverse effects, particularly uterine hyperstimulation, hypotension, pruritus, nausea, and fetal heart rate decelerations were not evident using the Fisher Irwin test and a significance of P < .05. The findings of the present study demonstrate that there is no real advantage of using doses of ITF greater than 25 micrograms in quality and duration of effective labor analgesia.