The impact of capnography monitoring among children and adolescents in the postanesthesia care unit: a randomized controlled trial.

Background: Pulse oximetry does not reliably recognize respiratory depression, particularly in the presence of supplemental oxygen. Capnography frequently detects hypoventilation and apnea among children recovering from anesthesia. Although children are routinely monitored with capnography during anesthesia, reducing the rate of adverse events, it is not routinely used in the postanesthesia care unit (PACU), where patients remain at risk for respiratory depression.

Respiratory depression detected by capnography among children in the postanesthesia care unit: a cross-sectional study.

Background: Children are at risk for respiratory depression while recovering from anesthesia. Currently, monitoring children in the postanesthesia care unit (PACU) with pulse oximetry is recommended. However, pulse oximetry does not reliably recognize hypoventilation or apnea, particularly in the presence of supplemental oxygen.

Nausea and vomiting after surgery: it is not just postoperative.

Purpose Of Review: The purpose of this review is to highlight postoperative nausea and vomiting (PONV), to discuss why it occurs, how it might be prevented and then how it can be treated.

Recent Findings: PONV/postdischarge nausea and vomiting (PDNV) is a problem that patients identify as one of the worst, if not the worst problem that can occur after surgery. Therapy is not perfect, yet there are anaesthesia techniques that can help minimize the problem and drugs that can be used both to prevent and also treat the problem once it occurs.

Residual sleepiness after N2O sedation: a randomized control trial [ISRCTN88442975].

BACKGROUND: Nitrous oxide (N2O) provides sedation for procedures that result in constant low-intensity pain. How long do individuals remain sleepy after receiving N2O? We hypothesized that drug effects would be apparent for an hour or more. METHODS: This was a randomized, double blind controlled study.

Sleep tendency as a measure of recovery after drugs used for ambulatory surgery.

Background: Although tests of psychomotor function indicate that drug effects after ambulatory anesthesia are short-lived, patients often feel washed out for long periods of time. Among the psychomotor tests that measure different motor and cognitive functions, none directly measures sleepiness or alertness. The authors hypothesized that sleepiness, measured by a sleep latency test, would be a more sensitive indicator of drug effect after an anesthetic than psychomotor tests.

Subjective, psychomotor, and physiological effects of cumulative doses of mixed-action opioids in healthy volunteers.

Rationale: Conducting complete dose-response evaluations of multiple drugs in a single within-subjects experiment is very time-consuming when a complete session is required for evaluation of each dose.

Objective: To evaluate a within-session cumulative-dosing procedure as a potentially efficient method for conducting dose-response evaluations of mixed-action opioids.

Methods: Fifteen healthy volunteers received intravenous injections of saline, butorphanol, nalbuphine, pentazocine, or morphine in a randomized, double-blind, crossover design.

The relative potency of oral transmucosal fentanyl citrate compared with intravenous morphine in the treatment of moderate to severe postoperative pain.

Unlabelled: Pharmacokinetic studies have shown that oral transmucosal absorption of fentanyl is relatively rapid compared with gastrointestinal absorption, and it results in increased bioavailability. We designed this study to establish the relative potency of oral transmucosal fentanyl citrate (OTFC) compared with i.v.

Early reversal of rapacuronium with neostigmine.

Background: Rapacuronium is a rapid-onset, short-acting neuromuscular relaxant. This multiple-center study determined neuromuscular recovery when neostigmine was given 2 or 5 min after rapacuronium.

Methods: One hundred seventeen patients were randomized to receive two different doses of rapacuronium and to receive neostigmine in two different doses and at two different times.

Improving the efficiency of survey research in postoperative patients.

Study Objective: To increase the contact rate with eligible patients for quality assurance/improvement surveys by modifying survey rounds to accommodate the schedules of individual nursing units.

Design: Two-phase, interventional time series study.

Setting: Postoperative inpatients at a university hospital.

Awakening, clinical recovery, and psychomotor effects after desflurane and propofol anesthesia.

We compared postanesthetic and residual recovery of desflurane versus propofol anesthesia. Twenty volunteers were anesthetized for 1 h at 1-wk intervals with either propofol (induction) plus desflurane (1.25 minimum alveolar anesthetic concentration) in O2 (PD), propofol plus desflurane in N2O-O2 (PDN), propofol plus propofol infusion with N2O-O2 (PPN), or desflurane (induction) plus desflurane in O2 (DD).

Propofol at conscious sedation doses produces mild analgesia to cold pressor-induced pain in healthy volunteers.

Study Objective: To determine whether subanesthetic doses of propofol have analgesic effects in healthy volunteers.

Design: Prospective, double-blind, placebo-controlled, randomized, crossover trial.

Setting: Human psychomotor performance laboratory within our anesthesia and critical care department.

Lack of acute tolerance development to the subjective, cognitive, and psychomotor effects of nitrous oxide in healthy volunteers.

A crossover, double-blind trial was conducted using eleven healthy volunteers to determine whether and the degree to which acute drug tolerance occurred to the subjective, cognitive, and psychomotor effects of a range of subanesthetic nitrous oxide doses (0, 10, 20, 30, and 40%). There was little evidence of acute drug tolerance to the subjective measures or to the cognitive/psychomotor impairing effects of nitrous oxide at any of the concentrations tested over the course of the 120-min inhalation.