Effect of Simulation Training on Cognitive Performance Using Transesophageal Echocardiography.

Simulation is used in anesthesia training to reinforce didactic learning. The authors hypothesized that knowledge acquisition in the use of transesophageal echocardiography (TEE) could be accomplished better through the use of a simulator than with online or web-based learning. A total of 71 student registered nurse anesthetists were randomly assigned to either web-based or simulator-based TEE training.

Selective bilateral bronchial intubation for large, acquired tracheoesophageal fistula.

The anesthetic management of patients undergoing tracheoesophageal fistula repair often involves lung separation, usually selective bronchial intubation with a double-lumen endotracheal tube. However, in patients with airway fistulas arising below the tracheal lumen, selective lung ventilation and separation may require unusual methods of airway management. In the patient described in this report, the airway fistulas involved the distal 3 cm of the trachea, approximately half of the left main bronchus 1.

Heart block and prolonged Q-Tc interval following muscle relaxant reversal: a case report.

Heart block and Q-Tc interval prolongation have been reported with several agents used in anesthesia, and the US Food and Drug Administration mandates evaluation of the Q-T interval with new drugs. Drug-induced Q-T interval prolongation may precipitate life-threatening arrhythmias, is considered a precursor for torsades de pointes, and may predict cardiovascular complications. In the patient described in this article, heart block occurred and the Q-Tc interval became prolonged after muscle relaxant reversal with neostigmine; both were considered to be related to the combination of agents used in the case, as well as to other predisposing factors such as morbid obesity.

Acute hypoxemia after repositioning of patient: a case report.

Hypoxemia occurred after induction of anesthesia and repositioning in a patient undergoing hip pinning. The patient had previously presented to the emergency department with multiple fractures and hemodynamic instability sustained in a motor vehicle accident. Three days after admission to the intensive care unit the patient remained intubated with respiratory insufficiency and had developed acute respiratory distress syndrome with marginal oxygen saturation.

The hemodynamic effects of rapacuronium in patients with coronary artery disease: succinylcholine and vecuronium compared.

Unlabelled: Rapacuronium is a nondepolarizing muscle relaxant similar in structure to pancuronium, rocuronium, and vecuronium. Rapacuronium has a mild to moderate effect on heart rate and arterial blood pressure in ASA physical status I and II patients. However, rapacuronium was often administered after, e.