Anesthesiology review
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Anesthesiology review · Sep 1993
Comparative StudyA comparison of the incidence of nausea after laparoscopic cholecystectomy and diagnostic laparoscopy.
Thirty-four patients undergoing gynecologic diagnostic laparoscopy and 30 patients undergoing laparoscopic cholecystectomies were followed prospectively for nausea and vomiting 24 hours postoperatively. Diagnostic laparoscopy patients had a significantly higher incidence of nausea and vomiting than laparoscopic cholecystectomy patients with similar anesthetic techniques, duration of surgery, and population parameters. ⋯ While both procedures involve bowel manipulation, patient position and organ manipulation differ: diagnostic laparoscopy involves the Trendelenburg position and laparoscopic cholecystectomy involves the reverse Trendelenburg; diagnostic laparoscopy involves the uterus, ovaries, and fallopian tubes while laparoscopic cholecystectomy involves mainly the gall-bladder and its appendages. These factors may contribute to the differences found in this study.
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Anesthesiology review · Sep 1993
Review Historical ArticleA historical overview and update on pulse oximetry.
Pulse oximetry has revolutionized the way in which blood oxygenation is measured. It provides an accurate and relatively reliable noninvasive means for the continuous measurement of peripheral oxygen saturation in a variety of patients. The pulse oximeter has detected many clinical situations in which arterial hypoxemia (SaO 2 less than 90%) was not previously known to occur. ⋯ The pulse oximeter is accurate under the following conditions: SaO 2 is greater than 22% in hemodynamically stable patients and greater than 35% in hemodynamically unstable patients; core body temperature is greater than 32 degrees C; cardiac index is greater than 1.5 L/min per m 2; pulse pressure is > 20 mm Hg; hematocrit is greater than 10%; hyperbilirubinemia is corrected for carboxyhemoglobin; fetal hemoglobin is at any level. Pulse oximeter readings have limited accuracy in the presence of methemoglobin, carboxyhemoglobin, nail polish, fluorescent light, and motion. This article presents a historical overview of pulse oximetry and an update on its current uses.
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Anesthesiology review · Sep 1993
The Anesthesia Simulator Consultant: simulation plus expert system.
The Anesthesia Simulator Consultant was designed to provide anesthesiologists the opportunity to practice the management of anesthesia-critical incidents. The program simulates the operating room environment in a graphic display on the screen of a personal computer. ⋯ An expert system provides interpretations of patient information, differential diagnosis, and treatment for abnormal patient conditions. The coupling of the simulator, recorder, and expert system creates a unique self-study and evaluation environment.