SEARCH · Search PubMed

Results for “ANESTHESIOLOGY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 127 records · Page 7Linked to original sources

PubMed2026

Immersive virtual reality-assisted anatomy training improves endotracheal intubation performance in simulation: a randomized controlled trial among Chinese non-anesthesiology residents.

INTRODUCTION: This study aimed to compare immersive virtual reality (IVR)-assisted versus conventional anatomy training for teaching endotracheal intubation (ETI) to novice non-anesthesiology residents enrolled in China's Standardized Residency Training program. METHODS: A total of 90 non-anesthesiology residents without prior ETI experience were randomly assigned to either an IVR group receiving IVR-assisted anatomy training (n = 45) or a control group receiving conventional anatomy training (n = 45). All participants underwent a standardized teaching protocol. The primary endpoint was residents' ETI performance on a simulator, assessed using both the Global Rating Scale (GRS) and a task-specific checklist. The secondary endpoints included changes in written multiple-choice question (MCQ) scores and residents' evaluations of the course. RESULTS: In practical ETI assessments on a manikin, the IVR group achieved significantly higher scores on the task-specific checklist than the control group (90.34 ± 2.89 vs. 87.20 ± 3.29; p < 0.001), whereas GRS scores were comparable between groups. Both groups showed significant post-training improvement in knowledge scores (p < 0.001), with the IVR group showing a greater gain in theoretical knowledge (54.0% vs. 36.3%; p < 0.001). Participants in the IVR group also expressed a stronger preference for their training method (80.8%) and reported higher levels of motivation, confidence, and enjoyment (all p < 0.05). CONCLUSION: IVR-assisted anatomy training enhances the effectiveness of ETI training for novice non-anesthesiology residents, offering an interactive, engaging, and reproducible approach within China's Standardized Residency Training framework.

Humans↗

PubMed2002

Evidence-based medicine in anesthesiology.

PURPOSE OF REVIEW: The principles of evidence-based medicine are now being applied in anesthesiology and intensive care medicine. The purpose of this review is to acquaint practitioners with the fundamentals of evidence-based medicine and to provide examples of how these principles can be incorporated into clinicians' practice. RECENT FINDINGS: Outcomes research utilizing evidence-based approaches are manifest in several areas of anesthesiology and intensive care medicine. Several examples are cited from various sub-specialty areas, including pediatric, obstetric, and general anesthesia, as well as intensive care medicine. SUMMARY: Evidence-based medicine is the term used to describe a practice paradigm that emphasizes the use of the best evidence available in the medical literature in making treatment decisions about the care of patients. Evidence-based approaches to care integrate individual expertise with data from externally conducted systematic research. Although evidence-based medicine has its origins in the 'treating' and 'diagnosing' specialty of internal medicine, its tenets are applicable to 'non-therapeutic' specialties such as anesthesiology and intensive care medicine. This review illustrates how evidence-based principles can be incorporated into the practice of perioperative medicine.

Journal Article↗

PubMed1993

Financial impact of the Medicare Fee Schedule on a department of anesthesiology in an academic medical center: two scenarios.

The purpose of this study was to model the financial impact of the Medicare Fee Schedule (MFS) on an anesthesiology department in a large academic medical center under two different scenarios. Scenario 1 assumes continued use of actual-time units throughout the five-year transition period. Scenario 2 assumes a change to the use of average-time units by the time the MFS is fully implemented in 1996. Twelve months of actual payments and frequencies for services billed to Medicare in 1991 were used as baseline data. It was assumed there would be no change in volume of services, billing practices, or staffing patterns. It was estimated that upon full implementation of the MFS, the anesthesiology department that was studied would lose $244,000 (13%) under Scenario 1 and $945,000 (51%) under Scenario 2. There is a full transition to final fee schedule rates in Year 1 of the MFS transition under Scenario 1, whereas there are additional incremental losses in each successive year under Scenario 2. This study shows that HCFA's future policy decisions with regard to anesthesiology reimbursement will have substantial financial consequences for many practicing anesthesiologists.

Academic Medical Centers↗

PubMed1983

EEG monitoring in anesthesiology and intensive care.

Knowledge of the actual state of cerebral function and of the changes induced by psychotropic drugs is important not only to neurologically oriented specialties but also to other branches of medicine concerned with altering cerebral function. This applies especially to anesthesiology which involves numerous procedures leading to a temporary loss of cognitive brain function. Recently, the application of EEG combined with spectral analysis performed during anesthesia and intensive-care treatment has attracted attention: we investigated the changes in EEG during standardized anesthesiological and therapeutical procedures pre-, intra- and postoperatively, or during intensive-care treatment in 1,500 patients undergoing general surgery from 1977 to 1982. Two-track EEG leads accompanied by spectral analysis were used on line. The evaluation of routinely applied EEG monitoring justifies the following statements: EEG monitoring can be adapted technically and organized to comply with the working conditions and daily activities of an anesthesiological department. Spectral analytic representations allow the assessment of the EEG by the anesthesiologist. The various methods of general anesthesia produce specific EEG changes which can be obliterated by the cumulative effect of drugs. The actual depth of anesthesia is visible in the EEG. During a defined constant anesthetic depth, potentially hazardous cerebral dysfunctions can be detected early and treated accordingly. EEG monitoring can be useful in solving urgent medical problems of intensive-care therapy.

Anesthesia, General↗

PubMedDate not supplied

Group battles its way to anesthesiology department.

This is a story of the evolution of anesthesiology services in a small Mid-America town in which there is a developing multispecialty group. The location and author are not identified, because to do so would almost certainly intensify the hostility that still remains some years after the effort by the group to establish an anesthesiology department was successfully completed. The account is offered in the hope that other groups may recognize their situations and reach similar solution, or be encouraged to attempt such an approach to anesthesiology services.

Anesthesia Department, Hospital↗

PubMedDate not supplied

[The systems analysis of anesthesiological activities in a general hospital].

Using an information mathematical model of anesthesiological service suggested, the authors have performed system analysis of anesthesia management in a multi-profile hospital in Arkhangelsk. Changes in the scope and structure of anesthesia, indexes of anesthesiological activity, frequency of procedures, asepsis, incidence of complications have been analysed. The analysis performed demonstrates the possibility of the control and management of anesthesiological service and forms the necessary prerequisites for its further development on the basis of economic parameters and criteria.

Anesthesia↗

PubMedDate not supplied

[Characteristics of anesthesiological support in vertebral surgery].

Vertebral operations are highly traumatic, prolonged and can cause significant blood loss, which requires effective anesthesiological defense. Inclusion of clofelin, a stress protector, into the anesthesiological provision scheme is an effective way of potentiating the protection of a patient from surgical stress. The development of neurological disorders is a severest complication during surgical interventions in vertebral surgery. The task that is important for a surgeon and an anesthesiologist in performing such operations is the maximum early recovery of patients from anesthesia and their muscular activity in the postoperative period in order to make a timely evaluation of their neurological status. The hypnotics propofol and dormicum and the myorelaxant nimbex were included into an anesthesiological provision program in 210 patients during surgical treatment of vertebral orthopedic pathology. The study indicated that the use of propofol and dormicum permitted a postanesthetic rapid recovery of patients from anesthesia without undesirable side effects. The myorelaxant nimbex is highly controlled, shows a clear dose-effect relationship, and produces a rapid recovery of neuromuscular conduction, which makes it possible to establish a timely diagnosis of neurological disorders.

Adolescent↗

PubMedDate not supplied

[Anesthesiologic management of clinical orthotopic liver transplantation].

The first clinical experience of anesthesiological management during 6 orthotopic liver transplantations (5 primary operations and 1 retransplantation) in 2 males and 3 females, aged 20 to 52 years, is presented. The method of general anesthesia is described--the use of veno-venous bypass without systemic heparinization and rapid infusion system. Hemodynamic, temperature, metabolic and coagulologic homeostasis disturbances are analysed at different stages of orthotopic liver transplantation, especially upon reperfusion of the donor organ. The tactics of infusion-transfusion therapy, as well as correction of electrolyte disturbances and blood coagulation disorders are being discussed. Different intraoperative complications are characterized. It is concluded that anesthesiological management of liver transplantations is one of the most complex problems of modern anesthesiology which takes joint effort of a large team of specialists: surgeons, anesthesiologists, perfusiologists, transfusiologists, and laboratory assistants specializing in different areas.

Adult↗

PubMedDate not supplied

[Organization and volume of work in the department of anesthesiology and resuscitation in a central district hospital].

The experience accumulated during organization and functioning of an anesthesiology and intensive care unit in a central district hospital is described. The efficacy of anesthesiological aid and intensive care has been demonstrated in conditions of a rural region. The authors believe advisable the establishment of anesthesiology and intensive care units in large central district hospitals.

Anesthesia Department, Hospital↗

PubMedDate not supplied

[Anesthesiological methods in acoustic neuroma surgery using the translabyrinthine approach].

Removal of acoustic neuromas may often imply anesthesiological as well as surgical problems, especially in the case of large tumors (> 3 cm) which may have come into contact with vital neighbouring structures (brain stem, cerebellum). In this paper the use of two different anesthesiological methods during the translabyrinthine approach is analyzed and discussed in the light of the different needs in this type of surgery. More specifically, anesthesia maintenance was assured by constant infusion of either Propofol (4 mg/kg/h) or Isoflurane (1-1.5%). Withdrawal of curarization was also planned in order to allow the surgeon to take advantage of routine intraoperative facial nerve monitoring. Arterial pressure, CO2 and O2 were assessed at prefixed phases of the operation. Both anesthesiologic methods proved to be satisfactory during the entire surgical procedure. During dissection of the tumoral capsule, an increased heart rate (7% of the initial value) was noticed, whilst in only three patients (with tumors larger than 3.5 cm) a severe bradycardia, which did not respond to Atropine administration and which subsided spontaneously during temporary suspension of surgical manoeuvres, occurred. After this preliminary experience, the Authors believe that both techniques could have a major role in translabyrinthine acoustic tumor surgery and auspicate their further application.

Adult↗

PubMed1994

[Anesthesiological management of a patient with primary aldosteronism complicated with hypertrophic cardiomyopathy].

A 49-year-old male with primary aldosteronism, accompanied by hypertrophic cardiomyopathy (HCM), underwent our anesthesiological management for resection of a left adrenal tumor. The preoperative examination revealed hypertension, mild nephropathy and hypokalemia. Spilnolactone treatment was discontinued 3 days before surgery. In the operating room, a Swan-Ganz catheter was inserted for monitoring hemodynamic parameters. Anesthesia was maintained with nitrous oxide-oxygen-isoflurane and vecuronium. During the surgery, prostaglandin E1 and nitroglycerin were used as vasodilators. During surgery, the patient was successfully managed, anesthesiologically. In anesthesiological management of patients with primary aldosteronism, care is needed regarding changes in blood pressure and electolyte levels during adrenalectomy. In cases where aldosteronism is accompanied by HCM, as in the present case, hemodynamic changes can cause a fatal outcome, and hence, carefulness is needed in using anesthetics and drugs which act on the circulatory system.

Adrenalectomy↗

PubMed1992

Chromosome and sister-chromatid exchange analysis in peripheral lymphocytes, and mutagenicity of urine in anesthesiology personnel.

Genotoxic effects of occupational exposure to anesthetic gases (halothane and nitrous oxide) were studied in 24 persons working at departments of anesthesiology and resuscitation (14 anesthesiologists and 10 anesthesiologic nurses). Frequencies of chromosomal aberrations were determined in 48-h cultures, and sister-chromatid exchanges (SCEs) in 72-h cultures of peripheral lymphocytes. In parallel, the mutagenetic potential of urine was tested using Ames tester Salmonella typhimurium strains TA98 and TA100 in both the presence and the absence of a metabolic activation system. The control group consisted of 30 healthy blood donors from the Clinic of Hematology and Blood Transfusion. Halothane concentrations in the working environment of operating rooms were determined using gas-liquid chromatography. Halothane exposure levels were far above the maximum allowable concentration in most countries, ranging between 9 and 490 mg.m-3. Cytogenetic analysis of peripheral lymphocytes revealed significantly increased frequencies of aberrant cells (ABCs) and SCEs in the exposed group as compared with the controls (3.84% vs 1.87% ABCs, 8.69 +/- 1.30 vs 7.86 +/- 1.07 SCEs per cell). Results of the urine mutagenicity test were negative.

Adult↗

PubMedDate not supplied

The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: a review.

PURPOSE: To review current knowledge concerning the use of magnesium in anesthesiology, intensive care and emergency medicine. METHODS: References were obtained from Medline(R) (1995 to 2002). All categories of articles (clinical trials, reviews, or meta-analyses) on this topic were selected. The key words used were magnesium, anesthesia, analgesia, emergency medicine, intensive care, surgery, physiology, pharmacology, eclampsia, pheochromocytoma, asthma, and acute myocardial infarction. PRINCIPLE FINDINGS: Hypomagnesemia is frequent postoperatively and in the intensive care and needs to be detected and corrected to prevent increased morbidity and mortality. Magnesium reduces catecholamine release and thus allows better control of adrenergic response during intubation or pheochromocytoma surgery. It also decreases the frequency of postoperative rhythm disorders in cardiac surgery as well as convulsive seizures in preeclampsia and their recurrence in eclampsia. The use of adjuvant magnesium during perioperative analgesia may be beneficial for its antagonist effects on N-methyl-D-aspartate receptors. The precise role of magnesium in the treatment of asthmatic attacks and myocardial infarction in emergency conditions needs to be determined. CONCLUSIONS: Magnesium has many known indications in anesthesiology and intensive care, and others have been suggested by recent publications. Because of its interactions with drugs used in anesthesia, anesthesiologists and intensive care specialists need to have a clear understanding of the role of this important cation.

Adrenal Medulla↗

PubMed2005

Online vs live methods for teaching difficult airway management to anesthesiology residents.

OBJECTIVE: To compare the effectiveness of traditional and online teaching methods for educating anesthesiology residents in the principles and practice of difficult airway management. DESIGN: Prospective, randomized, controlled trial. SETTING: University hospital. PARTICIPANTS: Two randomly selected groups, each containing 28 physicians enrolled from among residents in Anesthesiology and Intensive Care Medicine in Italy. INTERVENTIONS: Residents in Group 1 took a traditional 5-h course on the principles and practice of airway management, which included lectures, slide projection, and dummy demonstrations. The same material was presented to Group 2 in an exclusively online format, which could be individually accessed for a period of 36 h. In the online course, student-instructor interaction was provided through threaded discussion forums during three 30-min real-time question-and-answer sessions. MEASUREMENTS AND RESULTS: Differences in baseline and post-course scores on written tests and practical skills tests were measured. Knowledge gains in Group 2 were slightly, but not significantly, greater compared with Group 1 both in written (P=0.228) and practical skills (P=0.376) tests. Semi-quantitative ratings of learner satisfaction were significantly higher in the online group (P=0.014). Almost all online students (93%) were logged in for at least 45 of the 90 min of real-time question-and-answer sessions. The four instructors spent an average of 144+/-10 min preparing answers and interacting with online students. CONCLUSIONS: Online teaching formats may be a valid alternative for teaching residents the principles and practice of difficult airway management. Interaction with instructors seems to be an important element, but it may require substantial time commitments by instructors.

Adult↗

PubMedDate not supplied

Objectives to direct the training of emergency medicine off-service rotations: anesthesiology.

This is the 15th article in a continuing series of "off-service" goals and objectives for resident education in emergency medicine. Knowledge and skills in providing anesthesia and analgesia are essential in managing patients in the emergency department, critical care unit, and surgery. However, Anesthesiology off-service rotations are often limited to a 2-week rotation. Therefore, clear goals and objectives in Anesthesiology are essential for the resident in training.

Anesthesiology↗

PubMedDate not supplied

To define a specialty: a brief history of the American Board of Anesthesiology's first written examination.

The initial written examination of the American Board of Anesthesiology, a division of the American Board of Surgery, was given on March 28, 1939. For all anesthesiologists, this date has double significance. First, what was meant by anesthesiology as a medical specialty was defined through the questions posed on the first examination. Second, the physicians being tested that day were among the first physician-anesthetists to exploit the newly created path to recognition as specialists in the science and art of anesthesia by the American medical hierarchy. Gaining the support of organized medicine was an involved and arduous struggle that consumed most of the 1930s. A triumvirate of visionaries, Paul Wood, John Lundy, and Ralph Waters, was necessary to crystalize the goal of specialty recognition of physician-anesthetists. The first written examination was the consummation of this dream of equal status for anesthesia. The examination would not become repetitious, and within the first decade of testing, the style would change from an essay format to multiple-choice questions similar to the current form.

Anesthesiology↗

PubMedDate not supplied

Anesthesiology in the Belgian health care environment.

This article focuses on anesthesiology practice in the context of Belgian health care. The first part describes the organization of Belgian health care, the role of private and public initiatives, the division of responsibilities between the different health authorities, the financing mechanisms, and the central role of the compulsory social health care insurance. Quantitative information on the evolution of expenditures, services, providers, and facilities is presented. The second part of the article deals more specifically with anesthesiology and contains information on current practice. The emphasis, however, concerns recent developments in training and accreditation.

Accreditation↗

PubMedDate not supplied

The role of anesthesiology in the health care system of The Netherlands.

With the initiation of regular anesthesia services in the Netherlands in 1947, anesthesiology has grown to a large and influential profession, including intensive care, resuscitation, pain therapy, and emergency medical care. Pre- and postgraduate training programs are formalized and compete with some of the best in the world. After a long struggle, anesthesiology's social and legal status now compares with all other medical sciences. Anesthesia is restricted to medical specialists, but with the permanent support of fully trained and qualified nurses. Anesthesia in the Netherlands is a "two person" job.

Anesthesia↗