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Management of Postoperative Nausea and Vomiting
2/14/2012 Postoperative nausea and vomiting (PONV) is a common problem that affects approximately 30 percent of patients undergoing surgery, but can be as high as 80 percent in high risk patients. PONV is one of the most common reasons for unanticipated admissions after surgery.
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Airway Fire: Risk and Management
11/15/2011 The incidence of operating room fires has decreased over the past 100 years as less flammable anesthetic agents are being used. However, it still remains a constant threat to patient safety. It is imperative that all staff not only collaborate to prevent these fires but also understand how to manage them when they do occur.
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Peri-operative Diabetes Management for Dummies: Just Check the Sugar!
9/7/2011 What do we know about peri-operative glucose control? We know that infection rate, length of hospital stay, overall cost for the hospitalization, and morbidity and mortality are directly proportional to peri-operative blood glucose levels. We also know that there are numerous studies demonstrating improved overall outcomes with improved glucose control.
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Perioperative Management of Patients with Cardiac Rhythm Management Devices
8/15/2011 Patients presenting to the operating room or procedure room with a cardiac implantable electronic device (CIED) have become increasingly commonplace, and their devices have become increasingly sophisticated. There is an implicit understanding that patients with a CIED bring with them a complex medical history; a complete understanding of that history is paramount to preparing a skilled anesthesia plan.
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TEE for Non-Cardiac Surgery
7/21/2011 Transesophageal echocardiography (TEE) is increasingly becoming an important monitoring tool for noncardiac surgery. Although there are well-established guidelines for cardiac surgery, there is some controversy among clinicians regarding those for noncardiac surgery. Given the potential benefits of intraoperative monitoring with TEE, it is important that every anesthesiologist caring for high-risk patients has a basic understanding and recognizes the role TEE may play in their management.
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Anesthesia Induction Agents
7/11/2011 Induction of anesthesia is most often achieved using intravenous agents. Inhalational agents can also be used and are particularly useful in children. Propofol, thiopental, etomidate, and ketamine are the most commonly used intravenous agents. While opioids and benzodiazepines can also be used for induction, their use is less common and discussion of these agents is beyond the scope of this clinical review.
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Prolonged QT Syndrome: Drug Induced
6/24/2011 Long QT Syndrome (LQTS) is a disorder of myocardial repolarization that is displayed by a prolonged QT interval on electrocardiogram (EKG). The syndrome can be either congenital or acquired.
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Perioperative Cardiovascular Medicine Management
6/24/2011 As the current population ages and the anesthetic and surgical techniques become safer, we can only expect that the surgical patient population will be presenting at older ages and with more co-morbid conditions. Of the 27 million patients in the United States who are given anesthesia for surgical procedures each year, approximately 8 million have known coronary artery disease or coronary risk factors.1An estimated 50,000 patients who are scheduled to undergo noncardiac surgery will have a perioperative myocardial infarction, and an estimated 1 million patients will have a perioperative cardiac complication.2
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Perioperative Corneal Abrasions: Etiology, Prevention, and Management
1/10/2011 Corneal abrasions are the most frequent ocular complications following general anesthesia, and are a painful burden to the recovering postoperative patient. The most recent (1992) ASA closed claim analysis showed that eye injury occurred in 3 percent of all claims in the database. Of these claims, 35 percent represented corneal abrasions with a 16 percent incidence of permanent eye injury.
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Guidelines on Regional Anesthesia in Patients on Antithrombotic Therapy
3/31/2010 The third edition ASRA guidelines for neuraxial and regional anesthesia in patients on drugs that alter hemostasis were recently published. The authors presented a thorough review of the pharmacologic and scientific data available for several drugs combined with neuraxial anesthesia.
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Perioperative Visual Loss
3/17/2010 The American Society of Anesthesiologists (ASA) established the Postoperative Visual Loss (POVL) Registry in 1999 because of increasing reports of perioperative visual deficits. Debate has ensued that questions whether the incidence of the problem is actually increasing or if increased awareness has resulted in more frequent recognition and reporting. Although uncommon, POVL is devastating for the patient who awakens with visual deficits not present before surgery.
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