AANA journal
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This retrospective study was designed to compare the cost of anesthesia in three different groups of patients who received general anesthesia for a diagnostic dilatation and curettage procedure. The analysis included 194 patients, ASA physical status I, II, or III. All patients were outpatients with similar body mass index and age. ⋯ The three anesthesia providers, Certified Registered Nurse Anesthetists, student registered nurse anesthetists (SRNA), and anesthesia residents were reviewed looking at anesthesia supply cost, personnel cost, and total direct anesthesia costs. No statistically significant differences were found between the groups. We conclude that an anesthetic using thiopental/isoflurane is more cost-effective than propofol/desflurane or propofol/isoflurane anesthetics and the postoperative length of stay is no different for the three anesthetic approaches.
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Fifty-two anesthesia-related claims filed with the Maryland Office of Health Claims Arbitration from January 1990 through February 1994 were analyzed in terms of patient care variables, types of anesthesia, surgical categories, legal causes of action, and patient outcomes to determine whether differences existed in the rate of filing of cases provided by CRNAs and anesthesiologists. In Maryland, all claims against a healthcare provider in excess of $20,000 must be filed with the Office of Health Claims Arbitration. During the study period, 70% of the claims were filed against anesthesiologists, 17% were against nurse anesthetists, and 13% named both the anesthesiologist and the nurse anesthetist. ⋯ The second most prevalent cause of action concerned problems securing or maintaining a safe airway. Death was the most frequent adverse outcome (21.2%). Airway trauma (15.4%), nerve damage (15.4%), and brain damage (7.7%) were also cited as adverse outcomes.
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Nitrous oxide, a commonly used agent in the dental and anesthesia practice, carries serious risks to healthcare providers. Complications from its exposure can range from hematological abnormalities and neurological deficits to increased risk of spontaneous abortions in women. A concentrated effort by all anesthesia personnel is necessary to prevent the adverse effects associated with the use of this agent.
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Femoral nerve blocks and 3-in-1 blocks are simple and useful alternatives to other regional or general anesthetic techniques for selected surgeries. These blocks also may provide postoperative analgesia that may be a useful alternative to epidural or parenteral analgesia. Understanding the techniques of blockade, its appropriate applications, and the relevant anatomy may provide the anesthetist with a valuable alternative.