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Use of concatemers of ligand-gated ion channel subunits to study mechanisms of steroid potentiation | Synaptic receptors of the nicotinic receptor gene family are pentamers of subunits. This modular structure creates problems in studies of drug actions, related to the number of copies of a subunit that are present and their position. A separate issue concerns the mechanism of action of many anesthetics, which involves ... |
Testing the link between sympathetic efferent and sensory afferent fibers in neuropathic pain | Systemic α-adrenergic Blockade with Phentolamine: A Diagnostic Test for Sympathetically Maintained Pain. By S. N. Raja, R. D. Treede, K. D. Davis, and J. N. Campbell. ANESTHESIOLOGY 1991; 74:691-8. Reprinted with permission. ABSTRACT:: The diagnosis of sympathetically maintained pain (SMP) is typically established by a... |
No Silver Medal for Nobel Prize Contenders: Why Anesthesia Pioneers Were Nominated for but Denied the Award | Taking the examples of the pioneers Carl Ludwig Schleich, Carl Koller, and Heinrich Braun, this article provides a first exploratory account of the history of anesthesiology and the Nobel Prize for physiology or medicine. Besides the files collected at the Nobel Archive in Sweden, which are presented here for the first... |
Competency-based education in anesthesiology history and challenges | The Accreditation Council for Graduate Medical Education is transitioning to a competency-based system with milestones to measure progress and define success of residents. The confines of the time-based residency will be relaxed. Curriculum must be redesigned and assessments will need to be precise and in-depth. Core a... |
Addressing the mandate for hand-off education: A focused review and recommendations for anesthesia resident curriculum development and evaluation | The Accreditation Council for Graduate Medical Education requires that residency programs teach residents about handoffs and ensure their competence in this communication skill. Development of hand-off curricula for anesthesia residency programs is hindered by the paucity of evidence regarding how to conduct, teach, an... |
Oxygen and Life on Earth: An Anesthesiologist's Views on Oxygen Evolution, Discovery, Sensing, and Utilization | The advent of oxygenic photosynthesis and the accumulation of oxygen in our atmosphere opened up new possibilities for the development of life on Earth. The availability of oxygen, the most capable electron acceptor on our planet, allowed the development of highly efficient energy production from oxidative phosphorylat... |
The Evolution, Current Value, and Future of the American Society of Anesthesiologists Physical Status Classification System | The American Society of Anesthesiologists (ASA) Physical Status classification system celebrates its 80th anniversary in 2021. Its simplicity represents its greatest strength as well as a limitation in a world of comprehensive multisystem tools. It was developed for statistical purposes and not as a surgical risk predi... |
Practice advisory on anesthetic care for magnetic resonance imaging: An updated report by the American Society of Anesthesiologists Task Force on Anesthetic Care for Magnetic Resonance Imaging | The American Society of Anesthesiologists Committee on Standards and Practice Parameters and the Task Force on Anesthetic Care for Magnetic Resonance Imaging presents an updated report of the Practice Advisory on Anesthetic Care for Magnetic Resonance Imaging. Copyright © 2014, the American Society of Anesthesiologists... |
Senior medical students' knowledge of and attitudes toward anesthesiology in ten medical schools | The American Society of Anesthesiologists has sponsored a national preceptorship program in anesthesiology for medical students since 1966. The purpose of the program is to enhance students' understanding of and interest in anesthesiology. An evaluation of the effectiveness of the first 5 years of the program has been ... |
Practice guidelines for acute pain management in the perioperative setting: An updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management | The American Society of Anesthesiologists Task Force on Acute Pain Management presents an updated set of recommendations based on the analysis of the current literature and a synthesis of expert opinion. |
Practice guidelines for pulmonary artery catheterization: An updated report by the American Society of Anesthesiologists Task Force on Pulmonary Artery Catheterization | The American Society of Anesthesiologists Task Force on Guidelines for Pulmonary Artery Catheterization presents a systematically developed set of recommendations based on analysis of the current literature and a synthesis of expert opinion. |
Practice guidelines for management of the difficult airway: An updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway | The American Society of Anesthesiologists Task Force on Management of the Difficult Airway presents a systematically developed set of recommendations based on analysis of the current literature and a synthesis of expert opinion. |
Practice guidelines for postanesthetic care: A report by the American Society of Anesthesiologists Task Force on Postanesthetic Care | The American Society of Anesthesiologists Task Force on Postanesthetic Care presents a systematically developed set of recommendations based on analysis of the current literature and a synthesis of expert opinion. |
2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway | The American Society of Anesthesiologists; All India Difficult Airway Association; European Airway Management Society; European Society of Anaesthesiology and Intensive Care; Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care; Learning, Teaching and Investigation Difficult Airway Group; Soci... |
Status of women in academic anesthesiology | The authors compared anesthesia faculties with the rest of medical school faculties at each of four academic ranks and found a significant difference in proportion of men and women anesthesia faculty members at the assistant professor rank only (P < 0.001). When the faculty status of women and men academic anesthesiolo... |
Bacterial interaction between anesthesiologists, their patients, and equipment | The authors examine the following: liberation of organisms from the airway of an infected patient; inoculum size needed to infect a subsequent patient; effect of aerosols (including droplet size and evaporation) on the viability of microorganisms; effect of relative humidity on microorganism viability; effect of anesth... |
Respiratory excretion of halothane after clinical and occupational exposure | The authors have demonstrated measurable levels of halothane in patients for as long as 20 days following anesthesia. Significant accumulations of halothane in operating room personnel following occupational exposure was also observed. Toxicity studies of chronic exposure to low concentrations of anesthetic gases are l... |
Erratum: Subomohyoid Anterior Suprascapular Block versus Interscalene Block for Arthroscopic Shoulder Surgery: A Multicenter Randomized Trial (Anesthesiology (2020) 132 (839-853) DOI: 10.1097/ALN.0000000000003132) | The authors of an article published in the April 2020 issue, “Subomohyoid Anterior Suprascapular Block versus Interscalene Block for Arthroscopic Shoulder Surgery: A Multicenter Randomized Trial,”1 note two errors in their published article and present below the relevant corrections. 1. The description of the area unde... |
Erratum: Reversal of rocuronium-induced neuromuscular blockade with sugammadex in pediatric and adult surgical patients (Anesthesiology (2009) 110 (284-294) DOI: 10.1097/ALN.0b013e318194caaa) | The authors of the article beginning on page 284 in the February 2009 issue wish to add the following ClinicalTrials.gov identifier to their article: NCT00421148. © Copyright 2017, the American Society of Anesthesiologists, Inc. Wolters Kluwer Health, Inc. All Rights Reserved. |
Erratum: Reversal of neuromuscular blockade by sugammadex after continuous infusion of rocuronium in patients randomized to sevoflurane or propofol maintenance anesthesia (Anesthesiology (2009) 111 (30-35) DOI: 10.1097/ALN.0b013e3181a51cb0) | The authors of the article beginning on page 30 in the July 2009 issue wish to add the following ClinicalTrials.gov identifier to their article: NCT00559468. © Copyright 2017, the American Society of Anesthesiologists, Inc. Wolters Kluwer Health, Inc. All Rights Reserved. |
Erratum: Efficacy, safety, and pharmacokinetics of sugammadex for the reversal of rocuronium-induced neuromuscular blockade in elderly patients (Anesthesiology (2011) 114 (318-329) DOI: 10.1097/ALN.0b013e3182065c36) | The authors of the article beginning on page 318 in the February 2011 issue wish to add the following ClinicalTrials.gov identifier to their article: NCT00474617. © Copyright 2017, the American Society of Anesthesiologists, Inc. Wolters Kluwer Health, Inc. All Rights Reserved. |
Erratum: Perioperative Management of Aneurysmal Subarachnoid Hemorrhage: A Narrative Review (Anesthesiology (2020) 133 (1283-1305) DOI: 10.1097/ALN.0000000000003558) | The authors regret this error. The online version and PDF of the article have been corrected. © 2021, the American Society of Anesthesiologists, Inc. |
A study of decision making: how faculty define competence | The authors studied decision making in evaluation of residents by 34 faculty members in a university training program by simulating the evaluation process. Twenty-seven hypothetical residents were described in terms of six criteria used by the American Board of Anesthesiology: Pre-operative Evaluation, Anesthetic Manag... |
Calcium entry blockers: Uses and implications for anesthesiologists | The Ca++ entry blockers are valuable new drugs in the treatment of many cardiovascular diseases. Because of the prevalence of these diseases, anesthesiologists will anesthetize many patients maintained on Ca++ antagonists and will wish to administer them to some patients under their care. Verapamil and nifedipine are a... |
Occupational disease among operating room personnel | The conclusions of the Ad Hoc Committee on occupational disease, appointed by the American Society of Anesthesiologists, based on questionnaires sent to 73,496 individuals, are critically discussed. The authors come to the conclusion that so far no proof is given of the existence of occupational disease in operating ro... |
Response of Chinese Anesthesiologists to the COVID-19 Outbreak | The coronavirus disease 2019, named COVID-19 officially by the World Health Organization (Geneva, Switzerland) on February 12, 2020, has spread at unprecedented speed. After the first outbreak in Wuhan, China, Chinese anesthesiologists encountered increasing numbers of infected patients since December 2019. Because the... |
Erratum: Population volume kinetics in Volunteers: Comment:(Anesthesiology DOI: 10.1097/ALN.0000000000003210) | The correspondence published Online First on February 20, 2020, "Population Volume Kinetics in Volunteers: Comment"1 has been retracted because the original article being discussed, "Population Kinetics of 0.9% Saline Distribution in Hemorrhaged Awake and Isoflurane-anesthetized Volunteers,"2 has been retracted at the ... |
Erratum: Population Volume Kinetics in Volunteers: Reply: (Anesthesiology DOI: 10.1097/ALN.0000000000003211) | The correspondence published Online First on February 20, 2020, "Population Volume Kinetics in Volunteers: Reply"1 has been retracted because the original article being discussed, "Population Kinetics of 0.9% Saline Distribution in Hemorrhaged Awake and Isoflurane-anesthetized Volunteers,"2 has been retracted at the re... |
The American Society of Anesthesiologist's efforts in developing guidelines for sedation and analgesia for nonanesthesiologists: The 40th rovenstine lecture | The current shortage of anesthesiologists exceeds their capacity to administer all sedation in hospitals, ambulatory care facilities, and offices. The American Society of Anesthesiologists must take the lead in developing evidence-based research to quantify the risks of anesthesia administration by nonanesthesiologists... |
Ca2+ uptake and Ca2+ release by skeletal muscle sarcoplasmic reticulum: Differing sensitivity to inhalational anesthetics | The effects of halothane, enflurane, and isoflurane were measured on two different mechanisms of Ca2+ regulation by isolated skeletal muscle sarcoplasmic reticulum (SR) membranes. A 100,000-dalton Ca2+-ATPase protein transports Ca2+ from outside to inside the SR membrane. At concentration ranges representing anesthetic... |
Potential hazards and applications of lithium in anesthesiology | The element lithium (Li) is ubiquitous in nature, yet only in the last decade has its use as a therapeutic agent been approved in the United States. Although it is a simple element Li's pharmacologic mechanism of action remains to be fully understood, and as its therapeutic use becomes more widespread, it poses particu... |
Military anesthesia trainees in WWII at the University of Wisconsin: Their training, careers, and contributions | The emerging medical specialty of anesthesiology experienced significant advances in the decade prior to World War II but had limited numbers of formally trained practitioners. With war looming, a subcommittee of the National Research Council, chaired by Ralph M. Waters, MD., was charged with ensuring sufficient number... |
Foregger 705® malfunction resulting in loss of gas flow | The Foregger 705® has an indexing key pin-plunger that is subject to damage by regular use, possibly because it is brazed rather than welded. In our situation, as this pin developed a greater 'wobble', it allowed damage of a common outlet poppet valve, damaging that valve in such a way that no flow could pass through e... |
Nitrate-nitrite-nitric oxide pathway: Implications for anesthesiology and intensive care | The gaseous radical nitric oxide is involved in numerous physiologic and pathophysiological events important in anesthesiology and intensive care. Nitric oxide is endogenously generated from the amino acid l-arginine and molecular oxygen in reactions catalyzed by complex nitric oxide synthases. Recently, an alternative... |
Erratum: Pregnancy and labor epidural effects on gastric emptying: A prospective comparative study (Anesthesiology (2022) 136 (542-550) DOI: 10.1097/ALN.0000000000004133) | The gastric emptying rate referenced throughout the article is not a true “rate,” but is rather a fraction.Accordingly, gastric emptying “rate” has been changed to gastric emptying “fraction” throughout the article. The authors regret this error.The online version and PDF of the article have been corrected. Copyright ©... |
Organization and physician education in critical care medicine | The goal of critical care medicine is to improve care for acute life threatening illnesses and injuries, leading to increased salvage of life with human mentation. Recent advances in the knowledge and technology of acute care still await application through regional emergency and critical care medicine systems, all com... |
Addiction and anesthesiology | The goal of this article is to describe drug addiction, its adverse consequences on our profession, and what can be done about it. |
Thoughts on a paleoanesthetic | The great importance of the introduction into clinical anesthesia of cyclopropane 40 yr ago is pointed out, and it is argued that even nowadays with many more anesthetics, muscle relaxants and types of equipment available, this general anesthetic, unique in that it does not induce cardiovascular depression, can be of g... |
Gut Microbiome in Anesthesiology and Pain Medicine | The gut microbiome plays critical roles in human health and disease. Recent studies suggest it may also be associated with chronic pain and postoperative pain outcomes. In animal models, the composition of the gut microbiome changes after general anesthesia and affects the host response to medications, including anesth... |
Role of network science in the study of anesthetic state transitions | The heterogeneity of molecular mechanisms, target neural circuits, and neurophysiologic effects of general anesthetics makes it difficult to develop a reliable and drug-invariant index of general anesthesia. No single brain region or mechanism has been identified as the neural correlate of consciousness, suggesting tha... |
'There shall be no pain' | The history of the discovery of laughing gas anesthesia by Wells is described. The tendency of the modern anesthesiologist to oocupy himself with critical care medicine (CCM) is discussed. According to the author, CCM is only a detail of anesthesiology and it would be regretted if the anesthesiologist were no longer to... |
Impact of the World Health Organization Surgical Safety Checklist on Patient Safety | The incidence of surgical complications has remained largely unchanged over the past two decades. Inherent complexity in surgery, new technology possibilities, increasing age and comorbidity in patients may contribute to this. Surgical safety checklists may be used as some of the tools to prevent such complications. Us... |
Erratum: Interscalene Brachial Plexus Block with Liposomal Bupivacaine versus Standard Bupivacaine with Perineural Dexamethasone: A Noninferiority Trial (Anesthesiology (2022) 136 (434-447) DOI: 10.1097/ALN.0000000000004111) | The last sentence in the Results section paragraph on the primary outcome (page 438) was incorrect as published: "Superiority testing (one-sided t test) demonstrated that the average numerical rating scale pain score over 3 days postoperatively for the liposomal bupivacaine group was not superior to that of the bupivac... |
Electrocution in the operating room. | The manner in which a patient sustained an electrical shock injury from improperly wired equipment during the course of an operation was described in order to acquaint others with a potentially hazardous situation. A patient requiring surgical treatment had the ground plate of an electrocautery unit placed under her bu... |
Forensic anesthesiology? | The members of the health care profession, in assuming responsibility for a patient's medical treatment, not only have an obligation to see that they do no harm to the patient, but also to protect the susceptible patient from harm. In this case, the actions of parents and other visitors must be closely monitored. |
Serendipity: Being in the right place at the right time | The minimum alveolar concentration (MAC) of an inhaled anesthetic preventing movement in response to a surgical incision as a measure of equipotency was “invented” in 1964 at the University of California, San Francisco. The principal advantage of MAC is that it allows the pharmacologic effects of inhaled anesthetics to... |
Manipulating neural circuits in anesthesia research | The neural circuits underlying the distinct endpoints that define general anesthesia remain incompletely understood. It is becoming increasingly evident, however, that distinct pathways in the brain that mediate arousal and pain are involved in various endpoints of general anesthesia. To critically evaluate this growin... |
Perioperative Management of Patients Infected with the Novel Coronavirus: Recommendation from the Joint Task Force of the Chinese Society of Anesthesiology and the Chinese Association of Anesthesiologists | The outbreak of the new Coronavirus disease, COVID-19, has been involved in 77,262 cases in China as well as in 27 other countries as of February 24, 2020. Because the virus is novel to human beings, and there is no vaccine yet available, every individual is susceptible and can become infected. Healthcare workers are a... |
Anesthesia for cesarean section | The past decade has witnessed a series of major changes in the practice of obstetrics, including a three-to fourfold increase in the incidence of delivery by cesarean section. At the same time, obstetric anesthesia has emerged as a recognized subspecialty of anesthesiology, with increasing attention focused on measurin... |
Alteration of warfarin kinetics in man associated with exposure to an operating room environment | The plasma half life of warfarin (mean±SE) in five normal, nonmedicated control subjects given a single 40 mg/m2 oral dose of warfarin was 38.8±4.1 hours. It was essentially the same (37.7±2.6 hours) in these subjects when determined again four months later. The effect of the single dose of warfarin on prothrombin comp... |
"Gentlemen! This Is No Humbug": Did John Collins Warren, M.D., proclaim these words on October 16, 1846, at Massachusetts General Hospital, Boston? | The proclamation, "Gentlemen! this is no humbug," attributed to John Collins Warren, M.D., was not identified in any contemporaneous eyewitness report of William T. G. Morton's October 16, 1846, demonstration of ether at Massachusetts General Hospital. The earliest known documentation of the proclamation is in Nathan P... |
Cognitive processes in anesthesiology decision making | The quality and safety of health care are under increasing scrutiny. Recent studies suggest that medical errors, practice variability, and guideline noncompliance are common, and that cognitive error contributes significantly to delayed or incorrect diagnoses. These observations have increased interest in understanding... |
Anesthesiology in the People's Republic of China | The same drugs that are used in the USA are available in China, local and regional anesthesia are very popular. The author saw 15 operations performed under acupuncture anesthesia. In his opinion the method can be of value in selected cases. There is a great difference in technique for the same operative procedure. Vir... |
Scientific Accuracy Matters | The Solubility of Halothane in Blood and Tissue Homogenates. By Larson CP, Eger EI, Severinghaus JW. Anesthesiology 1962; 23:349-55. Measured samples of human and bovine blood, human hemoglobin, and tissue homogenates from human fat and both human and bovine liver, kidney, muscle, whole brain, and separated gray and wh... |
Research training in anesthesiology: Expand it now! | The specialty is well served by the questions and proposals raised by the authors of these two important publications. We believe current ACGME program requirements and ABA criteria for entering its examination system, along with ACGME and ABA interests in accommodating well-designed, exceptional curriculums on a case-... |
Should we all have a sympathectomy at birth? Or at least preoperatively? | The sympathetic nervous system appears useful to wild animals in helping to mobilize energy stores and in facilitating escape from threatening situations. But, as the article by Stone et al. in this issue of ANESTHESIOLOGY suggests, such reactions may not be beneficial in anesthetized humans inasmuch as myocardial oxyg... |
Chronobiology and Anesthesia | The time of day influences physiologic functions, pain, the pharmacologic aspects of drugs used for anesthesia, and the efficacy of many drugs used in the perioperative period. However, information regarding circadian rhythms for general anesthetics and newer analgesic agents remains fragmentary. Introduction of chrono... |
Anesthetic and analgesic drug products advisory committee activity and decisions in the opioid-crisis era | The United States Food and Drug Administration is tasked with ensuring the efficacy and safety of medications marketed in the United States. One of their primary responsibilities is to approve the entry of new drugs into the marketplace, based on the drug's perceived benefit-risk relationship. The Anesthetic and Analge... |
Postoperative epidural morphine is safe on surgical wards | The use of epidural morphine for postoperative analgesia outside of intensive care units remains controversial. In this report our anesthesiology-based acute pain service documents experience with 1,106 consecutive postoperative patients treated with epidural morphine on regular surgical wards. This experience involved... |
Determining Associations and Estimating Effects with Regression Models in Clinical Anesthesia | There are an increasing number of "big data"studies in anesthesia that seek to answer clinical questions by observing the care and outcomes of many patients across a variety of care settings. This Readers' Toolbox will explain how to estimate the influence of patient factors on clinical outcome, addressing bias and con... |
Can simulation help to answer the demand for echocardiography education? | There has been a recent explosion of education and training in echocardiography in the specialties of anesthesiology and critical care. These devices, by their impact on clinical management, are changing the way surgery is performed and critical care is delivered. A number of international bodies have made recommendati... |
Monitoring depth of anesthesia: With emphasis on the application of the Bispectral Index and the middle latency auditory evoked response to the prevention of recall | There is considerable current interest in the issue of awareness. The concern that, in our patients, unnecessary anxiety about the risk of awareness and unrealistic expectations about the ability of the BIS monitor to prevent the phenomenon have developed has already been discussed in ANESTHESIOLOGY.34,35 It has also b... |
2007 In review: A dozen steps forward in anesthesiology | These 12 articles represent an inspiring collection of advances in our specialty. Yet another dozen could easily have been chosen, including: • Long-term neuroprotection from isoflurane: Sakai et al. ANESTHESIOLOGY 2007; 106:92-9 • The first human application of a novel local anesthetic: Rodriquez-Navarro et al. ANESTH... |
Research training grants in anesthesia: Seventeen years of NIH support | Thirteen centers were granted a total of $10,709,000 from the National Institutes of Health for research training in anesthesia in fiscal years 1959 to 1975, inclusive. Eighty nine per cent ($9,543,000) of the funds were spent. Of 442 trainees supported, 376 have made career decisions. Two hundred and seventeen (58%) o... |
Type 2 Perioperative Myocardial Infarction: Can We Close Pandora's Box? | This article has been selected for the Anesthesiology CME Program. Learning objectives and disclosure and ordering information can be found in the CME section at the front of this issue. Copyright © 2018, the American Society of Anesthesiologists, Inc. Wolters Kluwer Health, Inc. All Rights Reserved. |
The centennial of spinal anesthesia | This article reviews the life and profession of Dr. August Bier, who performed the first operation under spinal anesthesia on August 16, 1898, at the Royal Surgical Hospital of the University of Kiel, Germany. |
Musings from an Unlikely Clinician-Scientist: 2018 American Society of Anesthesiologists Excellence in Research Award | This article, which stems 2018 American Society of Anesthesiologists Excellence in Research Award Lecture, aims to encourage young investigators, offer advice, and share several early life experiences that have influenced the author's career as an anesthesiologist and clinician-scientist. The article also describes key... |
Obstetric anesthesia for a patient with malignant hyperthermia susceptibility | This is a follow-up on a case report previously published in Anesthesiology concerning a patient with a family history of hyperthermia. The same patient has subsequently had spinal anesthesia for vaginal delivery. Creatine phosphokinase (CPK) levels in her plasma rose from 1,605 IU before labor to 2,390 IU during spina... |
Assessing the past and shaping the future of anesthesiology: The 43rd Rovenstine Lecture | This lecture, honoring Dr. Emery A. Rovenstine, recounts the accomplishments of anesthesiologists over the past seven decades since he ushered in a new era in anesthesiology discovery and patient care. Dedication to discovery, involvement, commitment, and compassionate service are ecessary for current and future genera... |
An Anesthesiologist's Perspective on the History of Basic Airway Management | This second installment of the history of basic airway management covers the early - artisanal - years of anesthesia from 1846 to 1904. Anesthesia was invented and practiced as a supporting specialty in the context of great surgical and medical advances. The current-day anesthesia provider tends to equate the history o... |
An Anesthesiologist's Perspective on the History of Basic Airway Management: The "progressive" Era, 1904 to 1960 | This third installment of the history of basic airway management discusses the transitional-"progressive"-years of anesthesia from 1904 to 1960. During these 56 yr, airway management was provided primarily by basic techniques with or without the use of a face mask. Airway maneuvers were inherited from the artisanal era... |
Obstetric anesthesia: A national survey | To assess obstetric anesthesia in the United States, and to determine why more anesthesia personnel are not involved in this subspecialty, a questionnaire was sent to the heads of obstetric and anesthesia services in 1,200 hospitals. Both obstetric and anesthesia respondents agreed on several characteristics of obstetr... |
Trust, but verify: The accuracy of references in four anesthesia journals | To determine the accuracy of bibliographic citation in the anesthesia literature, we reviewed all 1988 volumes of Anesthesiology, Anesthesia and Analgesia, British Journal of Anaesthesia, and Canadian Journal of Anaesthesia and sequentially numbered all references appearing in that year (n = 22,748). One hundred refere... |
Home noninvasive ventilation: What does the anesthesiologist need to know? | Treatment of chronic respiratory failure with noninvasive ventilation (NIV) is standard pediatric practice, and NIV systems are commonly used in the home setting. Although practice guidelines on the perioperative management of children supported with home NIV systems have yet to be published, increasingly these patient... |
Potential adverse ultrasound-related biological effects: A critical review | Ultrasound energy exerts important cellular, genetic, thermal, and mechanical effects. Concern about the safety of ultrasound prompted several agencies to devise regulatory limits on the machine output intensities. The visual display of thermal and mechanical indices during ultrasound imaging provides an aid to limit t... |
Physician payment reform: Anesthesiology as a case study | We examined the effects of Resource-based Relative Value Scale (RBRVS)- and physician diagnosis-related groups (MDDRG)-based payment for anesthesiology services related to surgery by simulating these physician payment reform options. We merged Medicare Part A (hospital) and Part B (anesthesiology) payment data for 7,77... |
A continuous indicator of the zero level of central venous pressure | When using a U tube to indicate the zero level of central venous pressure, this zero level is lost when the patient is moved upwards and downwards. Therefore, the authors attach a partially filled large syringe barrel (without the plunges) to one end of the U tube and fix this barrel at the site of the right atrium. |
The role of World War II and the European theater of operations in the development of anesthesiology as a physician specialty in the USA | World War II was a juncture in the development of anesthesia asa physician specialty because of the wartime education in anesthesia, the nature of wartime practice, and the impression trained physician-anesthetists made on surgeons and other physicians. |
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