This message was sent to you by: ethersage@...

http://www.ambu.com/Files/Billeder/com/Landingpages/aScope/IE_aScope_493200201_0509.pdf

Anyone knows the cost of this ? What do you think about it ?

Ivan Hronek MD
Los Angeles, CA
http://health.groups.yahoo.com/group/Anesthideas/
Do not fear to be eccentric in opinion, for every opinion now
accepted was once eccentric. Bertrand Russell

Confidentiality Notice: This transmission and any attached documents may be confidential and contain information protected by State and Federal Medical Privacy statutes and is legally privileged. They are intended for use only by the addressee. If you are not the intended recipient of this transmission, or an agent of the intended recipient, you are prohibited from reading, disclosing, printing, saving, copying, using, or otherwise disseminating any information contained in this transmission. If you received this transmission in error, please accept our apologies and notify me at ivanhronek@... and delete the entire message and its attachments. Thank you. Disclaimer: this message contains the personal views of the author. The author will not be responsible in any way for procedures or approaches performed in the way suggested in this note.

#5573

From: Ivan Hronek <ivanhronek@...>
Date: Mon Nov 16, 2009 5:19 am
Subject: Aspiration despite CP

ivanhronek

Offline

http://www.asahq.org/Newsletters/2000/06_00/aspiration0600.html

sorry for bringing up a previous subject, just came across another source showing aspiration can happen despite CP...

Ivan Hronek MD
Los Angeles, CA
http://health.groups.yahoo.com/group/Anesthideas/
Do not fear to be eccentric in opinion, for every opinion now
accepted was once eccentric. Bertrand Russell

#5572

From: Ivan Hronek <ivanhronek@...>
Date: Mon Nov 16, 2009 1:00 am
Subject: Trauma coagulopathy videos

ivanhronek

Offline

http://www.trauma.org/index.php/main/article/713/

For those interested in trauma - videos from 2008 London Trauma Transfusion and Coagulopathy Symposium:

Any members utilize massive transfusion protocols ? What's yur experience with them ?

Ivan Hronek MD
Los Angeles, CA
http://health.groups.yahoo.com/group/Anesthideas/
Do not fear to be eccentric in opinion, for every opinion now
accepted was once eccentric. Bertrand Russell

#5571

From: Steph Santos <sbsmmd@...>
Date: Sun Nov 15, 2009 4:49 pm
Subject: Re: [ai] Paracetamol / Acetaminophen

sbsmmd

Offline

In our setting Celebrex P.O. is a one of the common Cox2 ordered for pain relief post op when patients are started on diet... usual dose available 400mg tab PO OD or 200mg tab PO BID

Steph

--- On Sun, 11/8/09, Sandy Hancock <sandy_hancock@...> wrote:

From: Sandy Hancock <sandy_hancock@...>
Subject: Re: [ai] Paracetamol / Acetaminophen
To: Anesthideas@yahoogroups.com
Date: Sunday, November 8, 2009, 12:07 PM

On 08/11/2009, at 2:28 AM, Ivan Hronek wrote:
> I also gave Vioxx 50 mg..but wasn't sure what and when it would get
> absorbed with some patients being stressed out..anyone knows
> anything about p.o. drugs absorption perioperatively ?

I am hesitant to give COX inhibitors to fasted, slightly dehydrated
patients. I prefer to give them toward the end of the case when I have
had a chance to gauge the volume status and haemostasis. Paracetamol
is a non-issue in this situation and is *very* rapidly absorbed as
soon as it leaves the stomach.

> If there is some absorption we could also dissolve it and give it
> via NG tube during surgery (no i.v. Acetaminophen available in the
> US yet).

But then you'd have to subject the patient to an otherwise unnecessary
nasogastric tube. Rectal administration would be preferable in that
case where possible.

> Are you guys giving Perfalgan to almost every single patient then?

I use Perfalgan for pretty much any case where a modicum of post-
operative pain is expected. It's fairly cheap, and you don't have to
worry about bioavailability issues like you do with suppositories. The
only time I use suppositories now is when there is no IV access, like
myringotomy/ grommets in small children.

> Anyone knows when to use Caldolor (Ibuprofen) over Toradol
> (ketorolac)?

Ketorolac is the only injectable non-selective NSAID available in
Australia. Rectal diclofenac is much more popular in Adelaide for
historical reasons.

> Anyone able to use any COX 2 inhibitors like Celebrex p.o. or i.v. ?

We have paracoxib (Dynastat) for intravenous perioperative use. It is
very popular.

Sandy Hancock
Adelaide, South Australia

Reply | Forward | Messages in this Topic (7)

#5570

From: James Anderson <jsandersonmdelp@...>
Date: Sat Nov 14, 2009 4:57 pm
Subject: Dexmedetomidine and renal transplant

jsandersonmdelp

Offline

Steve Anderson, MD

Sent from my  iPhone 3GS

>
>

> Anyone using intraoperative dexmedetomidine for renal transplant
> recipients?
>
> Steve Anderson, MD
>
> Sent from my  iPhone 3GS
>

#5569

From: savitar malhotra <savitarmalhotra@...>
Date: Sat Nov 14, 2009 4:44 pm
Subject: inotropes and vasopressors

savitarmalhotra

Offline

Some insight into the use of different vasopressors in Septic shock- Surviving sepsis campaign 2008

Savitar

The INTERNET now has a personality. YOURS! See your Yahoo! Homepage.

1 of 1 File(s)

Surviving Sepsis.pdf.pdf

#5568

From: "Eric Hodgson" <iti20178@...>
Date: Sat Nov 14, 2009 12:48 pm
Subject: Paeds Airway.zip (33MB)

spud1964

Offline

Our national paediatric anaesthesia cogress has just taken place in
Cape Town. I was asked to do a talk on Rescuing the Paediatric
Airway. The talk and references are available on yousendit.
Click on:

https://download.yousendit.com/ZW9Bek9wTlFPSHhMWEE9PQ

Eric
Durban

#5567

From: "Vic Werlhof" <werlhof@...>
Date: Fri Nov 13, 2009 10:15 pm
Subject: RE: [ai] phenylephrine drips and BP

vicwerlhof

Offline

As for the phenylephrine and vascular perfusion, I will state there is simply a great deal of "voodoo medicine" and associated beliefs out there. Take a look at the OB literature which is NOW proclaiming phenyleprine to be superior to ephedrine! (personally, they both are only as good as they create BP, some people resopnd to the one or other drug).<<<<<<<

If I am understanding the literature correctly, the support for phenylephrine is not about BP control. During C-sections, ephedrine has been shown to lower pH in the fetus by increasing metabolic rate. That is why phenylephrine is being touted as superior.

Vic

#5566

From: Ivan Hronek <ivanhronek@...>
Date: Fri Nov 13, 2009 7:52 pm
Subject: Neo compensating for vasodilation

ivanhronek

Offline

Schwartz B, Hofstotter H, Salak N, Park W, Knotzer H, Mayr A, Labeck B, Kafka R, Ulmer H, Hasibeder W: Effects of norepinephrine and phenylephrine on intestinal oxygen supply and mucosal tissue oxygen tension. Int Care Med 2001; 27:593-601

Anyone can find better literature on which tissue beds are restricted by phenylephrine - I found only those below and the first is only a citation. Teleologically it would make sense that skin and splanchnic perfusion might be compromised after phenylephrine as it has been shown with vasopressin.

In the C-section spinal hypotension phenylephrine has been shown to be better than ephedrine also by better pH in the neonates, and the effect of those drugs on placental perfusion comes into play.

If you need good perfusion of skin (plastic surgery) or the splanchnic region it is probably better to stay away from phenylephrine if you can.

There was a lot of worry about the more recently introduced vasopressin but little have been shown beyond reasonable doubt.

However, the idea with neosynephrine (and vasopressin) is that you're just compensating for the vasodilation caused by the anesthetic gases and so should really cause little or no harm !

http://www.ncbi.nlm.nih.gov/pubmed/6099360?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed

Ivan Hronek MD
Los Angeles, CA
http://health.groups.yahoo.com/group/Anesthideas/
Do not fear to be eccentric in opinion, for every opinion now
accepted was once eccentric. Bertrand Russell

From: Paul Kempen <kmpnpm@...>
To: Anesthideas@yahoogroups.com
Cc: ethersage@...
Sent: Fri, November 13, 2009 10:49:05 AM
Subject: [ai] phenylephrine drips and BP

The MAP measured via occillotonometry is the MOST reliable number and is a direct measured parameter. THis is why when patients move during measurement, the MAP is the only value displayed (i.e. in parentheses as it is alwyas pesented that way).
As for the phenylephrine and vascular perfusion, I will state there is simply a great deal of "voodoo medicine" and associated beliefs out there. Take a look at the OB literature which is NOW proclaiming phenyleprine to be superior to ephedrine! (personally, they both are only as good as they create BP, some people resopnd to the one or other drug).
Perfusion requires pressure (remember the placenta?) and without a pressure the vasculature is pretty moot. As for vasoconstriction from phenylephrin, you need to look at where alpha rece3ptors live and with what sensitivity. Many vascular beds are very locally regulated. Urine flow is greatly predicated on the perfusion pressure including the "pressure diuresis" phenomeneon which is very real, yet poorly explained via physiology texts.

P Kempen
Cleveland

------------ --------- --
Neosyn.drip part of anesth ?
Posted by: "Mauricio Mejia" drmejia@mac. com drmauriciomejia
Thu Nov 12, 2009 3:39 pm (PST)

I give Neosyn drips as well. My concern has always been the question
of where perfusion is improved and where it is compromised. With a
neosyn drip am I compromising gut circulation? renal circulation? Can
these be significant/ detrimental? Thanks, Mauricio
Mauricio Mejia, M.D.
Colorado Anesthesia Consultants, P.C.
Board Certified - American Board of Anesthesiology
www.cachealth. com

#5565

From: Paul Kempen <kmpnpm@...>
Date: Fri Nov 13, 2009 6:49 pm
Subject: phenylephrine drips and BP

kmpnpm

Offline

The MAP measured via occillotonometry is the MOST reliable number and is a
direct measured parameter. THis is why when patients move during measurement,
the MAP is the only value displayed (i.e. in parentheses as it is alwyas
pesented that way).
As for the phenylephrine and vascular� perfusion, I will state there is simply a
great deal of "voodoo medicine" and associated beliefs out there. Take a look at
the OB literature which is NOW proclaiming phenyleprine to be superior to
ephedrine! (personally, they both are only as good as they create BP, some
people resopnd to the one or other drug).
Perfusion requires pressure (remember the placenta?) and without a pressure the
vasculature is pretty moot. As for vasoconstriction from phenylephrin, you need
to look at where alpha rece3ptors live and with what sensitivity. Many vascular
beds are very locally regulated. Urine flow is greatly predicated on the
perfusion pressure including the "pressure diuresis" phenomeneon which is very
real, yet poorly explained via physiology texts.

P Kempen
Cleveland

-----------------------
Neosyn.drip part of anesth ?
Posted by: "Mauricio Mejia" drmejia@...�� drmauriciomejia
Thu Nov 12, 2009 3:39 pm (PST)

I give Neosyn drips as well. My concern has always been the question
of where perfusion is improved and where it is compromised. With a
neosyn drip am I compromising gut circulation? renal circulation? Can
these be significant/ detrimental? Thanks, Mauricio
Mauricio Mejia, M.D.
Colorado Anesthesia Consultants, P.C.
Board Certified - American Board of Anesthesiology
www.cachealth. com

#5564

From: James Anderson <jsandersonmdelp@...>
Date: Fri Nov 13, 2009 1:16 am
Subject: Re: [ai] Neodrip part of anesth

jsandersonmdelp

Offline

MAP is actually measured via oscillometry. The systolic and diastolic pressures are calculated via proprietary algorithms b

Steve Anderson, MD

Sent from my  iPhone 3GS

On Nov 12, 2009, at 17:46, Ron Shenker <ethersage@...> wrote:

Does the MAP that the automated BP gives you, have any real value as a true approx. of MAP?

Sent from my iPhone
Ron Shenker

On Nov 12, 2009, at 6:36, Paul Kempen <kmpnpm@yahoo.com> wrote:

More important than WHAT you use to support blood pressure is in my mind the whole issue of just WHAT is an adequate BP in patients under anesthesia!
These studies used cut offs of 100 systolic and heart rates of 45-50 to withhold beta blockers.
ACLS always defined 90 systolic as "shock"
We see this sort of number daily and accept 60 torr means as "adequate" (based on urine flow studies in dogs from the ' 60's)
Many patients come in hypertensive and now the Vision loss initiative is starting to give conern that 10=20% reduction in "baseline" is what it is all about!

Personally, MAP is more important than any given systolic in terms of blood flow, and a heart rate of 45 and systolic BP of 100 could very well mean a MAP of 45-50 in a calcific aorta and low inotropy.

It is time we rethink just what a "parameter is" as Occillotonometry is pretty much standard in the civilized anesthesia comunity and MAP is THE most accurate and meaningful measure obtained by this or direct art line measurements!

P Kempen
Cleveland

Neodrip part of anesth ?
syn.Posted by: "Ivan Hronek" ivanhronek@yahoo.com ivanhronek
Wed Nov 11, 2009 12:00 pm (PST)

We've recently discussed several reports showing hypotension may lead to strokes (beta blockers, sitting position shoulder sx, similar etiology in POVL although there multifactorial) .
Both general and regional anesthesia typically decrease blood pressure, mainly by vasodilation.
Should a phenylephrine drip be commonly used as compensation for the anesthesia-related vasodilation ?
Ivan Hronek MD

#5563

From: Ron Shenker <ethersage@...>
Date: Fri Nov 13, 2009 12:46 am
Subject: Re: [ai] Neodrip part of anesth

ethersage

Offline

Does the MAP that the automated BP gives you, have any real value as a true approx. of MAP?

Sent from my iPhone

Ron Shenker

On Nov 12, 2009, at 6:36, Paul Kempen <kmpnpm@...> wrote:

More important than WHAT you use to support blood pressure is in my mind the whole issue of just WHAT is an adequate BP in patients under anesthesia!
These studies used cut offs of 100 systolic and heart rates of 45-50 to withhold beta blockers.
ACLS always defined 90 systolic as "shock"
We see this sort of number daily and accept 60 torr means as "adequate" (based on urine flow studies in dogs from the ' 60's)
Many patients come in hypertensive and now the Vision loss initiative is starting to give conern that 10=20% reduction in "baseline" is what it is all about!

Personally, MAP is more important than any given systolic in terms of blood flow, and a heart rate of 45 and systolic BP of 100 could very well mean a MAP of 45-50 in a calcific aorta and low inotropy.

It is time we rethink just what a "parameter is" as Occillotonometry is pretty much standard in the civilized anesthesia comunity and MAP is THE most accurate and meaningful measure obtained by this or direct art line measurements!

P Kempen
Cleveland

Neodrip part of anesth ?
syn.Posted by: "Ivan Hronek" ivanhronek@yahoo.com ivanhronek
Wed Nov 11, 2009 12:00 pm (PST)

We've recently discussed several reports showing hypotension may lead to strokes (beta blockers, sitting position shoulder sx, similar etiology in POVL although there multifactorial) .
Both general and regional anesthesia typically decrease blood pressure, mainly by vasodilation.
Should a phenylephrine drip be commonly used as compensation for the anesthesia-related vasodilation ?
Ivan Hronek MD

#5562

From: Mauricio Mejia <drmejia@...>
Date: Thu Nov 12, 2009 11:38 pm
Subject: Re:Neosyn.drip part of anesth ?

drmauriciomejia

Offline

I give Neosyn drips as well. My concern has always been the question of where perfusion is improved and where it is compromised. With a neosyn drip am I compromising gut circulation? renal circulation? Can these be significant/detrimental? Thanks, Mauricio

Mauricio Mejia, M.D.

Colorado Anesthesia Consultants, P.C.

Board Certified - American Board of Anesthesiology

www.cachealth.com

drmejia@...

303-888-2812

#5561

From: Dino Kattato <dinokattato@...>
Date: Thu Nov 12, 2009 3:43 pm
Subject: IPhone

dinokattato

Offline

i use medscape's app for drugs(free), oxford's handbook of anesthesiology($) and skyscape's apps(free) (ACC, OCM and Archimedes mostly).

dino kattato crna

#5560

From: James Anderson <jsandersonmdelp@...>
Date: Thu Nov 12, 2009 3:23 pm
Subject: Re: [ai] IPhone Anesthesia Applications

jsandersonmdelp

Offline

Epocrates, Skyscape with Harrison's Manual of Medicine, American College of Cardiology guidelines, and a Perioperative Medicine text. Skyscape also has Barash (the manual size version I believe.

Sonosite also has a free app with some nice video tutorials.

There is a free Kindle app from Amazon, so you can purchase and download a variety of books to the device in that way.

Steve Anderson, MD

On Nov 12, 2009, at 7:57 AM, Docv wrote:

Hello All ,

I wonder if some members of the group have some expericence with Anesthesia applications for Iphone and can share experience.

I know that Epocrates is compatible with Iphone as well as some others as : Barash Anesthesia Textbook ( Latest edition ?) .

I don�t know if some refference of Rare Diseses/Syndromes ( Like Stoelting�s Anesthesia for Uncommon diseases ) is available � it could come handy at the �point of care� .

Anyone care to send input to the list ?

Best :

Virgil Priscu MD

#5559

From: Docv <docv@...>
Date: Thu Nov 12, 2009 2:57 pm
Subject: IPhone Anesthesia Applications

virgil_priscu

Offline

Hello All ,

I wonder if some members of the group have some expericence with Anesthesia applications for Iphone and can share experience.

I know that Epocrates is compatible with Iphone as well as some others as : Barash Anesthesia Textbook ( Latest edition ?) .

I don’t know if some refference of Rare Diseses/Syndromes ( Like Stoelting’s Anesthesia for Uncommon diseases ) is available – it could come handy at the “point of care” .

Anyone care to send input to the list ?

Best :

Virgil Priscu MD

#5558

From: Paul Kempen <kmpnpm@...>
Date: Thu Nov 12, 2009 2:36 pm
Subject: Neodrip part of anesth

kmpnpm

Offline

More important than WHAT you use to support blood pressure is in my mind the
whole issue of just WHAT is an adequate BP in patients under anesthesia!
These studies used cut offs of 100 systolic and heart rates of 45-50 to withhold
beta blockers.
ACLS always defined 90 systolic as "shock"
We see this sort of number daily and accept 60 torr means as "adequate" (based
on urine flow studies in dogs from the ' 60's)
Many patients come in hypertensive and now the Vision loss initiative is
starting to give conern that 10=20% reduction in "baseline" is what it is all
about!

Personally, MAP is more important than any given systolic in terms of blood
flow, and a heart rate of 45 and systolic BP of 100 could very well mean a MAP
of 45-50 in a calcific aorta and low inotropy.

It is time we rethink just what a "parameter is" as Occillotonometry is pretty
much standard in the civilized anesthesia comunity and MAP is THE most accurate
and meaningful measure obtained by this or direct art line measurements!

P Kempen
Cleveland

Neodrip part of anesth ?
syn.Posted by: "Ivan Hronek" ivanhronek@...�� ivanhronek
Wed Nov 11, 2009 12:00 pm (PST)

We've recently discussed several reports showing hypotension may lead to strokes
(beta blockers, sitting position shoulder sx, similar etiology in POVL although
there multifactorial) .
Both general and regional anesthesia typically decrease blood pressure, mainly
by vasodilation.
Should a phenylephrine drip be commonly used as compensation for the
anesthesia-related vasodilation ?
Ivan Hronek MD

#5557

From: ethersage@...
Date: Thu Nov 12, 2009 4:30 am
Subject: An Item of Interest from Anesthesiology

ethersage

Offline

This message was sent to you by: ethersage@...

Message:
Thought you might appreciate this item(s) I saw at Anesthesiology.

The Impact of Systemic Vasoconstrictors on the Cerebral Circulation of Anesthetized Patients
Strebel, Stephan P.; Kindler, Christoph; Bissonnette, Bruno; Tschaler, Gabriela; Deanovic, Dubravka
Anesthesiology, July 1998,89(1):67-72
Clinical Investigations

	You are receiving this email as a result of actions taken on the Wolters Kluwer Health website. For all requests, please do not reply to this email. Instead, please contact Customer Service at 1-800-638-3030 or via email. Copyright © 2009 Wolters Kluwer. Published by Lippincott Williams & Wilkins. All rights reserved. The product and brand names, images and photos mentioned in this email are copyright protected.

#5556

From: ethersage <ethersage@...>
Date: Thu Nov 12, 2009 4:11 am
Subject: (No subject)

ethersage

Offline

http://thejns.org/doi/abs/10.3171/jns.1995.83.6.0949

Ron Shenker

#5555

From: "Mark Weinert" <mark.weinert@...>
Date: Thu Nov 12, 2009 1:59 am
Subject: Re: RE: [ai] Neosyn.drip part of anesth ?

mark.weinert@...

me too
-------- Original-Nachricht --------
> Datum: Wed, 11 Nov 2009 16:18:37 -0500
> Von: John Doyle <djdoyle@...>
> An: anesthideas@yahoogroups.com
> Betreff: RE: [ai] Neosyn.drip part of anesth ?

>
> I use it alot, especially when using remifentanil.
>
> D. John Doyle MD PhD FRCPC
> Professor of Anesthesiology




> Both general and regional anesthesia typically decrease blood pressure,
> mainly by vasodilation.
>
> Should a phenylephrine drip be commonly used as compensation for the
> anesthesia-related vasodilation ?
>
> Ivan Hronek MD
>
>


--
--------
Dr. med. Mark Weinert, D.E.S.A.
FA An�sthesie
Prov. Fellow cardiac Anaesthesia

Wellington Hospital
Wellington 6002
New Zealand
all opinion strictly personal
Page 2216
---------
air goes in and out,
blood goes round and round,
any variation of this is a bad thing

Jetzt kostenlos herunterladen: Internet Explorer 8 und Mozilla Firefox 3.5 -
sicherer, schneller und einfacher! http://portal.gmx.net/de/go/atbrowser

#5554

From: John Doyle <djdoyle@...>
Date: Wed Nov 11, 2009 9:18 pm
Subject: RE: [ai] Neosyn.drip part of anesth ?

djdoyle

Offline

I use it alot, especially when using remifentanil.

D. John Doyle MD PhD FRCPC
Professor of Anesthesiology
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
Staff Anesthesiologist
Department of General Anesthesiology
Cleveland Clinic Foundation
9500 Euclid Avenue, E31
Cleveland, Ohio, 44195, USA
doylej@... [professional]
djdoyle@... [personal]
Tel 216-444-1927
Fax 216-444-9247
Cell 216-312-4373
Pager 216-444-2200; ask for pager 29456
http://djdoylemd.googlepages.com

To: Anesthideas@yahoogroups.com
From: ivanhronek@...
Date: Wed, 11 Nov 2009 12:00:51 -0800
Subject: [ai] Neosyn.drip part of anesth ?

We've recently discussed several reports showing hypotension may lead to strokes (beta blockers, sitting position shoulder sx, similar etiology in POVL although there multifactorial).

Both general and regional anesthesia typically decrease blood pressure, mainly by vasodilation.

Should a phenylephrine drip be commonly used as compensation for the anesthesia-related vasodilation ?

Ivan Hronek MD

#5553

From: "Kofke, Andrew" <andrew.kofke@...>
Date: Wed Nov 11, 2009 8:07 pm
Subject: RE: [ai] Neosyn.drip part of anesth ?

andrew.kofke

Offline

yes

W Andrew Kofke MD MBA FCCM

Professor, Director of Neuroanesthesia

Co-Director Neurocritical Care

Departments of Anesthesia and Neurosurgery

University of Pennsylvania

7 Dulles Building

3400 Spruce St

Philadelphia, PA 19104-4283

215-662-3774

fax 215-615-3898

kofkea@...

From: Anesthideas@yahoogroups.com [mailto:Anesthideas@yahoogroups.com] On Behalf Of Ivan Hronek
Sent: Wednesday, November 11, 2009 3:01 PM
To: Anesthideas
Subject: [ai] Neosyn.drip part of anesth ?

The information contained in this e-mail message is intended only for the personal and confidential use of the recipient(s) named above. If the reader of this message is not the intended recipient or an agent responsible for delivering it to the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution, or copying of this message is strictly prohibited. If you have received this communication in error, please notify us immediately by e-mail, and delete the original message.

#5552

From: Ivan Hronek <ivanhronek@...>
Date: Wed Nov 11, 2009 8:00 pm
Subject: Neosyn.drip part of anesth ?

ivanhronek

Offline

We've recently discussed several reports showing hypotension may lead to strokes
(beta blockers, sitting position shoulder sx, similar etiology in POVL although
there multifactorial).

Both general and regional anesthesia typically decrease blood pressure, mainly
by vasodilation.

Should a phenylephrine drip be commonly used as compensation for the
anesthesia-related vasodilation ?


Ivan Hronek MD

#5551

From: "Eric Hodgson" <iti20178@...>
Date: Wed Nov 11, 2009 12:21 pm
Subject: Evaluation of the Efficiency of Medical masks (free .pdf)

spud1964

Offline

Click on:

http://snipurl.com/t6llp   [www_ingentaconnect_com]

and follow the link to the .pdf

#5550

From: mirza nasir iqbal <drnasmir68@...>
Date: Tue Nov 10, 2009 4:35 pm
Subject: RE: [ai] Sublingual airway ultrasound

drnasmir68@...

http://springerlink.com/content/c4l4n7g6005g9p74/fulltext.pdf

hi i did lot of work on it , and the anatomic landmark in this initial letter are not correct as he excepted in the recent paper too , so it is still food for thougt
dr nasir iqbal
canada

To: Anesthideas@yahoogroups.com
From: ivanhronek@...
Date: Mon, 9 Nov 2009 13:21:38 -0800
Subject: [ai] Sublingual airway ultrasound

Initial experience with sublingual US for airway difficulty determination:

http://www.springerlink.com/content/ggk337l783072543/#ContactOfAuthor1

Ivan Hronek MD
Los Angeles, CA
http://health.groups.yahoo.com/group/Anesthideas/
Do not fear to be eccentric in opinion, for every opinion now
accepted was once eccentric. Bertrand Russell

Windows Live: Make it easier for your friends to see what you�re up to on Facebook.

#5549

From: "Miller, Sanford" <sanford.miller@...>
Date: Tue Nov 10, 2009 2:38 pm
Subject: RE: [ai] the Airway site test etc.

sanfordmmiller

Offline

http://www.theairwaysite.com/pages/page_content/airway_anesthesia.aspx

Both questions leave a lot to be desired. Question 2 gives the likelihood of SCI as the correct answer, without defining what the 3-fold increase is compared to. Furthermore, answer 4: “The safest way of proceeding with intubation is proven to be the flexible fiberoptic bronchoscope.” is also true—truer than the “correct” answer.

Sanford M. Miller, MD

sanford.miller@...

From: Anesthideas@yahoogroups.com [mailto:Anesthideas@yahoogroups.com] On Behalf Of icalder@...
Sent: Tuesday, November 10, 2009 3:09 AM
To: Anesthideas@yahoogroups.com
Subject: Re: [ai] the Airway site test etc.

Setting exam questions is really, really difficult.

In question 1 RSI is given as the "wrong" answer - possibly correct for an exam - but in real life quite possibly the right one. Case near here with angioedema (captopril) who had a failed awake fiberoptic and failed awake trachy (could not lie flat or cooperate) and successful RSI. No rules in a knife fight.

Ian

-----Original Message-----
From: Ivan Hronek <ivanhronek@...>
To: Anesthideas@yahoogroups.com
Sent: Tue, 10 Nov 2009 4:38
Subject: [ai] the Airway site test etc.

Ivan Hronek MD
Los Angeles, CA
http://health.groups.yahoo.com/group/Anesthideas/
Do not fear to be eccentric in opinion, for every opinion now
accepted was once eccentric. Bertrand Russell

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#5548

From: icalder@...
Date: Tue Nov 10, 2009 8:08 am
Subject: Re: [ai] the Airway site test etc.

icalder@...

http://www.theairwaysite.com/pages/page_content/airway_anesthesia.aspx

Setting exam questions is really, really difficult.

Ian

-----Original Message-----
From: Ivan Hronek <ivanhronek@...>
To: Anesthideas@yahoogroups.com
Sent: Tue, 10 Nov 2009 4:38
Subject: [ai] the Airway site test etc.

Ivan Hronek MD
Los Angeles, CA
http://health.groups.yahoo.com/group/Anesthideas/
Do not fear to be eccentric in opinion, for every opinion now
accepted was once eccentric. Bertrand Russell

#5547

From: Ivan Hronek <ivanhronek@...>
Date: Tue Nov 10, 2009 4:56 am
Subject: Fogarty inflation on lar-scope blade

ivanhronek

Offline

http://www.anesthesia-analgesia.org/cgi/content/full/91/2/495

Ivan Hronek MD
Los Angeles, CA
http://health.groups.yahoo.com/group/Anesthideas/
Do not fear to be eccentric in opinion, for every opinion now
accepted was once eccentric. Bertrand Russell

#5546

From: Ivan Hronek <ivanhronek@...>
Date: Tue Nov 10, 2009 4:38 am
Subject: the Airway site test etc.

ivanhronek

Offline

http://www.theairwaysite.com/pages/page_content/airway_anesthesia.aspx

Ivan Hronek MD
Los Angeles, CA
http://health.groups.yahoo.com/group/Anesthideas/
Do not fear to be eccentric in opinion, for every opinion now
accepted was once eccentric. Bertrand Russell

#5545

From: Ivan Hronek <ivanhronek@...>
Date: Mon Nov 9, 2009 9:21 pm
Subject: Sublingual airway ultrasound

ivanhronek

Offline

http://springerlink.com/content/c4l4n7g6005g9p74/fulltext.pdf

Initial experience with sublingual US for airway difficulty determination:

http://www.springerlink.com/content/ggk337l783072543/#ContactOfAuthor1

Ivan Hronek MD
Los Angeles, CA
http://health.groups.yahoo.com/group/Anesthideas/
Do not fear to be eccentric in opinion, for every opinion now
accepted was once eccentric. Bertrand Russell