Analysis of the application of cricoid pressure: implications for the clinician.

The application of cricoid pressure may reduce the incidence of pulmonary aspiration of gastric contents in at-risk patients. Cricoid pressure may be applied during intubation in a variety of settings including the operating room, postanesthesia care unit, intensive care unit, and emergency department. Significant deficits in cognitive knowledge and practical application skills have been demonstrated among medical personnel responsible for the application of cricoid pressure.

Metoclopramide and extrapyramidal symptoms: a case report.

Metoclopramide is a useful medication in the anesthesia provider's armamentarium. Its primary indication in the preoperative phase is to reduce gastric contents and increase lower esophageal sphincter tone for pharmacologic pulmonary aspiration prophylaxis. Metoclopramide can precipitate extrapyramidal symptoms (EPS)/drug-induced movement disorders (DIMD).

Methemoglobinemia and benzocaine.

Benzocaine administration to facilitate upper endoscopic procedures can result in the relatively uncommon but potentially fatal complication known as methemoglobinemia. For this reason, the Veterans Health Administration (VA) announced on February 8, 2006, that they would stop using benzocaine-containing sprays for procedures involving the mouth and throat. Methemoglobinemia should be considered in any patient who demonstrates cyanosis, respiratory distress, headache, lightheadedness, and a dark, chocolate-colored blood after receiving pharyngeal anesthesia.

Central anticholinergic syndrome: a case report.

Postoperative central anticholinergic syndrome (CAS) is caused by anticholinergic medications that cross the blood-brain barrier. Medications with central anticholinergic effects block muscarinic cholinergic receptors, resulting in a wide array of symptoms. Symptoms may range from coma to a highly agitated state.

Obstructive sleep apnea and sedation in the endoscopy suite.

Patients with obstructive sleep apnea are at risk of mortality and morbidity related to the administration of sedatives, anesthetics, and opioids. Commonly employed sedatives and analgesics promote pharyngeal collapse and alter normal respiratory responses to obstruction and apnea. Literature concerning patients with obstructive sleep apnea undergoing moderate and deep sedation in the endoscopy suite is lacking.

Detection and treatment of perioperative corneal abrasions.

Corneal abrasion is the most common ocular injury occurring in the perioperative period. Corneal abrasion may occur during general anesthesia, monitored anesthesia care, regional anesthesia, or in the immediate recovery period. This injury is not usually apparent until the patient is in the PACU, and the perianesthesia nurse may be the first clinician to detect this complication.

Implications of obstructive sleep apnea syndrome for the perianesthesia nurse.

Perianesthesia nurses care for patients who receive anesthesia, sedation, and analgesia. Anesthesia, sedation, and analgesia can adversely affect the patient with obstructive sleep apnea syndrome (OSAS). Increased patient morbidity and mortality have been associated with the perianesthesia management of the patient with OSAS and can potentially impact every phase of the perianesthesia experience.

Droperidol's effect on QT interval.

The Food and Drug Administration (FDA) issued a letter to health care providers on December 4, 2001, concerning the medication, droperidol. The purpose of the warning was to alert health care providers to the possible role of droperidol in the development of torsades de pointes (TdP) in susceptible patients. The purpose of this article is to explore the role of droperidol in the development of TdP in susceptible patients and current recommendations for the use of droperidol as an antiemetic.

Are patients with obstructive sleep apnea syndrome appropriate candidates for the ambulatory surgical center?

Ambulatory surgery centers (ASCs) provide surgical care for patients not requiring hospital admission for their postoperative care. Obstructive sleep apnea syndrome (OSAS) is a disease process affecting every phase of anesthesia care delivery. The potential complications of OSAS and anesthesia care have been well documented in the preoperative, intraoperative and postoperative phases.

Perianesthesia nursing at an ophthalmic hospital in the Middle East.

Health care delivery differs from the United States among different cultures and countries. This descriptive article describes health care delivery at two ophthalmic hospitals in a Middle Eastern country. This description may not be representative of health care delivery throughout that country but is limited to the hospitals described.

Sevoflurane and emergence behavioral changes in pediatrics.

Sevoflurane has rapidly replaced halothane as the inhaled anesthetic agent of choice for the pediatric population. Benefits of sevoflurane use include a quick induction and emergence from anesthesia, a nonpungent odor, which allows for mask induction, and decreased airway irritation, which results in a decrease in the incidence of bronchospasm and laryngospasm. Despite the positive aspects of sevoflurane, there are several side effects, including seizures during induction and maintenance, elevations in plasma inorganic fluoride and compound A concentrations, and an increased incidence of emergence delirium when compared to halothane.