Anesthesiology
Article Abstract:
Recent changes in the field of anesthesiology have improved the quality of care, and reduced costs for services and malpractice insurance. Advances have been made in pain relief and control, monitoring devices used in the operating room, and pre-operative patient assessment. Patient-controlled analgesia (pain relief) is gaining wide acceptance, and new agents, which lack the undesirable side effects of morphine, are being developed. New ideas about chronic pain hold out hope for pain relief in some debilitating conditions. The total cost of anesthetic agents is partly determined by the amount of time patients must be in the recovery room; at least one new agent is less costly because it has shortened recovery room time. Outcome studies allow researchers to evaluate the anesthetic component of surgical procedures; in carotid endarterectomy (the removal of atherosclerotic deposits from the carotid artery, a major blood vessel that supplies the brain), anesthetic technique has a significant influence on surgical outcome. With computer technology the number of blood samples taken to determine blood oxygen saturation is reduced, lowering costs and, undoubtedly, helping reduce malpractice premiums. Advantages of other 'smart' technologies are discussed. Anesthesiologists now know the benefits of long-term smoking cessation prior to certain operations and must consider how to advise patients regarding this issue. Peri-operative risk control (around the time of surgery) has been discussed in recent anesthesiology research. A gene, located in a non-human species, appears to mediate the effects of anesthesia; it is likely that genes relevant for the action of known anesthetic agents in humans will be found. Such discoveries could lead to tailor-made anesthetic agents with specified properties. On the whole, anesthesiology is marked by flexibility and an ability to adapt to change. Its future looks bright. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
Anesthesiology
Article Abstract:
One of the more exciting recent events in anesthesiology is the introduction of the drug ketorolac tromethamine. This drug is as potent a pain killer as morphine, but it is not an opioid. Many opiates have the side effect of depressing respiration, presenting a delicate and potentially dangerous dilemma in the problem of pain control. The potential problems associated with the depression of respiration may be avoided with the use of this new drug. Another new development is the inhaled anesthetic desfluramine. Hailed as a "potent nitrous oxide", the new drug may finally replace laughing gas after almost two hundred years. For most people, anesthetic drugs are quite safe. But some individuals develop idiosyncratic reactions. Such reactions are so rare they are difficult to study, and therefore tend not to have a significant impact on the use of anesthesia. However, new research is clarifying the physiological mechanisms by which such reactions might occur. Some evidence indicates that the hepatitis that may result from the anesthetic gas halothane may actually be an immune disorder. Sophisticated techniques have shown that patients with halothane hepatitis have antibodies that recognize a metabolic product of halothane. Another interesting development in anesthesiology is the reexamination of the practice of 'Nil per os' (NPO), or 'nothing by mouth', after midnight. There is some evidence that providing a little water to the patient can actually hasten the desired emptying of the stomach. Although further evidence is needed, a small amount of water two hours before the induction of anesthesia may be beneficial. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Anesthesiology
Article Abstract:
Pediatric anesthesia, preoperative evaluation of adults and the cost-benefit of preoperative laboratory tests are major concerns for anesthesiologists. There is also debate over the use of general anesthesia rather than regional anesthesia with or without general anesthesia as well as discussion on difficulties and implementation of do-not-resuscitate (DNR) orders. One innovation is the use of inhaled nitric oxide for patients with pulmonary hypertension, particularly when sodium nitroprusside is ineffective or not the drug of choice. A 1992 study of anesthesia in infants reversed the use of light anesthesia combined with a muscle relaxant. Infants receiving deep anesthesia had lower mortality and infection rates and lower rates of metabolic acidosis and blood coagulation problems. Deeper anesthesia blunted the neonate's stress response to pain.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: The Los Angeles experience with laparoscopic cholecystectomy. Laparoscopic cholecystectomy
- Abstracts: Anaplastic carcinoma of the thyroid: a clinopathologic study of 121 cases. Islet cell carcinoma of the pancreas: a study of 98 patients
- Abstracts: Cardiovascular effects of the somatostatin analog octreotide in acromegaly
- Abstracts: Allergy and immunology. Future trends in allergy and immunology