Alpha 2 adrenergic agonists bind to alpha 2 receptors located in the dorsal horn of the spinal cord and brainstem, modulating the release of substance P, calcitonin gene-related peptide and various other neurotransmitters involved in rostral transmission of nociceptive information.
Patient stress is probably a contributing factor in some cases of adverse patient outcome. Stress during induction of anesthesia can increase circulating catecholamine concentration predisposing the heart to arrhythmias.
Use of analgesics prior to surgery (preemptive analgesia) may also be beneficial. Non-steroidal anti-inflammatory drugs are commonly being administered during the perioperative period. Debate exists as to when to administer the drugs (preoperatively vs. postoperatively).
A continuous rate infusion (CRI) is a dosing regimen used to deliver a constant amount of drug per unit time. The most common CRIs are administered intravenously; however, other methods such as transdermal deliver mimic the characteristics of CRIs.
Anesthetic and pain related mortality would appear to be an easily quantifiable statistic that could be used to measure the outcome of the profession's current anesthetic practices. However, to rely solely on death rate as the measure of the quality of anesthetic care provided is inadequate. The anesthetist's goal should be to minimize the risks to the patient's health while reducing pain and stress.
Patients are typically sedated or anesthetized and placed in sternal or lateral recumbency. Next, the cranial edge of the wings of the ilia are palpated. Once located, a 10 cm by 10 cm area of hair directly over the lumbosacral junction is clipped and the skin is surgically prepared.
In the past blood gas analysis and interpretation was performed primarily at university and large referral hospitals. The main argument against not using blood gas analysis to guide case management in private practice was the cost of purchasing and maintaining a bench-top blood gas analyzer. With the availability of relatively inexpensive point of care units such as the i-STAT and IRMA, blood gas analysis and interpretation has become more common.
Anesthetic related mortality would appear to be an easily quantifiable statistic that could be used to measure the outcome of the profession's current anesthetic practices. However, to rely solely on death rate as the measure of the quality of anesthetic care provided is inadequate.