Epidural anesthesia for cesarean delivery in a morbidly obese parturient with spinal meningioma.

We report our experience with epidural anesthesia for cesarean section in a morbidly obese parturient with progressive paraplegia from a spinal meningioma. Epidural anesthesia may represent a safe anesthetic choice in such clinical situations.

Does anesthesiology residency training result in decreasing intraoperative drug cost from a resident's first to second month's experience in adult cardiac anesthesiology?

Background: All physicians bear the responsibility of minimizing cost while providing care that meets or exceeds national quality benchmarks. Intraoperative anesthetic drug costs constitute a small but significant fraction of the total cost in the perioperative period. Previous studies have revealed that anesthesiologists are generally unaware of drug costs.

Influences observed on incidence and reporting of medication errors in anesthesia.

Background: Medication errors are a common occurrence during the conduct of anesthesia (one in 133-450 [corrected] patients). Several factors contribute to medication errors in anesthesia, including experience of the anesthesia provider, severity of comorbidities, and type of procedure. The inexperience of anesthesia providers-in-training also leads to increased error rates.

Increase in venous complications associated with etomidate use during a propofol shortage: an example of clinically important adverse effects related to drug substitution.

Etomidate is a widely used intravenous induction agent that is especially useful for patients at risk for hypotension during anesthesia induction. Side effects limiting its use include adrenocortical suppression, acidosis, myoclonus, venous irritation, and phlebitis. The osmolality of etomidate prepared in propylene glycol appears to play a crucial role in causing phlebitis.

Evaluating safety of handoffs between anesthesia care providers.

Background: Anesthesia care providers frequently exchange care of patients among one another. This daily process of information exchange could be a potential source for adverse events.

Objectives: Our objectives were to determine if the current handoff system is ineffective and if more standardized methods available for the exchange of patient information could improve the effectiveness of handoffs.