In a development that may have you undergo your next medical procedure the old-fashioned way, two researchers from the University of California-San Francisco and the University of Oslo are reporting that inhaled anesthetics significantly contribute to the destruction of the ozone layer and add to the overall global warming gas content in the atmosphere.
Moreover, the study’s authors conclude with some valuable advice for your own practice: “From our calculations, avoiding N2O and unnecessarily high fresh gas flow rates can reduce the environmental impact of inhaled anesthetics.”
We’d like to venture even further. Not only would we recommend closed-circuit, low-flow anesthesia even with sevoflurane (damn those kidneys!), we’d also suggest that patients arrive by bicycle or, if absolutely necessary, a biodiesel-powered ambulance.
Toxicity reports are re-emerging in southern California this week after a dozen hospitalizations of kids using teas made from a fragrant flowering plant called Angel’s Trumpet.
A tea made from the plant is used to produce hallucinations, but they can progress to extremely unpleasant experiences. Moreover, Angel’s Trumpet can be deadly, accelerating the heart rate and causing fatal cardiac rhythmic disturbances and bronchoconstriction that can trigger asthma attacks in sensitive individuals. Read more »
*This blog post was originally published at Terra Sigillata*
More than 10 million Americans undergo elective cosmetic procedures each year. Dr. Jon LaPook reports on what every patient should know about anesthesia with Dr. Panchali Dhar, author of “Before the Scalpel.”
Last year — despite the recession — there were about 10 million cosmetic procedures in the United States. According to the American Society for Aesthetic Plastic Surgery, over 90 percent were in women and about 1.5 million were surgical.
The top five surgical procedures were breast augmentation (311,957), liposuction (283,735), eyelid surgery (149,943), rhinoplasty (138,258), and abdominoplasty (127.923). As you awaken on the morning of your elective surgery, there’s no way you haven’t yet met the surgeon who will be performing the procedure. But odds are you still haven’t met the person who will be most responsible for keeping you alive: the anesthesiologist. Read more »
Doctors have been coming under increasing scrutiny for their relationships with pharmaceutical companies.
Many hospitals and medical schools have outright banned any involvement of their physician staff with drug companies. This isn’t a contentious issue most of the time.
But a recent case at Boston’s Brigham and Women’s Hospital raised some eyebrows. Apparently, an asthma specialist was so dependent on drug company money, that he chose to quit the hospital instead. According to the Boston Globe, “Out of thousands of US doctors hired by drug-maker GlaxoSmithKline to talk about its products, [this physician] was the highest paid during a three-month period last year, the company recently disclosed: He made $99,375 for giving 40 talks to other physicians last April, May, and June, almost one every other day.” Read more »
*This blog post was originally published at KevinMD.com*
Swaroup Anand, 23, from Bangalore, is fully conscious as he undergoes open-heart surgery. An epidural to the neck, administered at the city’s Wockhardt Hospital, has numbed his body. Dr Vivek Jawali pioneered the technique ten years ago and has recently released a tutorial on DVD which gives a step-by-step guide to the procedure – sorry, but you can only get a copy if you’re a surgeon or an anaesthetist.
Seems there would be considerable risk of respiratory compromise is the epidural went too high. But according to this video, over 400 cases have been performed, including a bypass with aortic valve replacement!
I don’t know… I’m not sure I could stomach the sound of the bone saw or, worse, if the surgeon said “Oh, crap…”
Reference:
Chakravarthy MR, Jawali V, Patil TA, Srinivasan KN, Manohar M, Khan J, Jayaprakash K, Das JK, Mahajan V. “High thoracic epidural anaesthesia as the sole anaesthetic technique for minimally invasive direct coronary artery bypass in a high-risk patient.” Ann Card Anaesth. 2003 Jan;6(1):62-4.Musings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*
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