Literature Reviews: November / December 1996

Current perspectives on latex allergy

• Intraoperative anaphylactic reactions to latex have only been described in the last 10 years, are increasingly common, and may be fatal.

Parents' management of children's pain following 'minor' surgery

• Most procedures for children are performed on an outpatient basis, and most anesthesiologists' knowledge of the amount of post-operative pain that these children have is limited to what they see during the brief in-hospital recovery period.

Benchmarking the perioperative process

• Systematic management of the perioperative process involves far more than simple staff reductions, decreases in"OR turnover times" and "decreasing PACU times".

The importance of the postoperative anesthetic visit: do repeated visits improve patient satisfaction or physician recognition?

• The anesthesiologist as "perioperative physician" is a common catch-phrase in today's uncertain medical climate, as anesthesiologists struggle to establish a secure place in the new firmament of Managed Care.

More or better - educating the patient about the anesthesiologist's role as perioperative physician

• The anesthesiologist as "perioperative physician" is a common catch-phrase in today's uncertain medical climate, as anesthesiologists struggle to establish a secure place in the new firmament of Managed Care.

Small, oral dose of clonidine reduces the incidence of intraoperative myocardial ischemia in patients having vascular surgery.

• Ischemic cardiac complications remain an important concern in the patient undergoing major vascular surgery. Some years ago the Cleveland Clinic performed cardiac catheterization on 1,000 consecutive patients undergoing vascular surgery - a feat which will probably never be repeated!

Cancer Pain, Regional Risks

• Development of the World Health Organization Guidelines on cancer pain relief and palliative care in children
  
  
• Epidemiology and morbidity of regional anesthesia in children: A one-year prospective survey of the French Language Society of Pediatric Anesthesiologists

Alpha-Adrenergic Receptor Agonist Activity

• Alpha-2-Adrenergic agonists for regional anesthesia.

Small, oral dose of clonidine reduces the incidence of intraoperative myocardial ischemia in patients having vascular surgery.

• The application of drugs with alpha-adrenergic receptor agonist activity, e.g., clonidine, has been long promoted in various clinical contexts--the treatment of pain, and as adjunct therapy in regional and general anesthesia.
  
  
• Alpha-2-Adrenergic agonists for regional anesthesia.

The Cynic's Corner: by Dr. Lubarsky

• Should a Moratorium be Placed on Sublingual Nifedipine Capsules For Hypertensive Emergencies and Pesudoemregencies.
  
  
• The Effectiveness of Right Heart Catheterization in the Initial Care of Critically Ill Patients.

Decreases in Anesthesia-Controlled Time Cannot Permit One Additional Surgical Operation to Be Reliably Scheduled During the Workday.

• Analysis of Strategies to Decrease Postanesthesia Care Unit Costs.

Desflurane-mediated neurocirculatory activation in humans

• Desflurane can produce sympathetic activation. This study seeks to identify the threshold for this response and whether the threshold is affected by the rate of change of desflurane or the concentration.

Intraoperative hetorolac has an opioid-sparing effect in women after diagnostic laparoscopy but not after laparoscopic tubal ligation.

• Ketorolac is used extensively to provide postoperative analgesia. This study investigates whether intraoperative ketorolac with fentanyl would decrease postoperative analgesic requirements, and evaluates the effect of surgical procedure on these requirements.

Compound A concentrations during sevoflurane anesthesia in children

• Compound A is produced by the degradation of sevoflurane. Sevoflurane is gaining popularity for induction and maintenance of pediatic inhalation anesthesia, and this paper quantifies the amount of Compound A produced in this population.

Ambulatory Notes

• Assessment of recovery following day-case arthroscopy. A comparison between propofol and isoflurane-based anaesthesia.
  
  
• Does post-laparoscopy pain relate to residual carbon dioxide?