Abstract:
BACKGROUND:Growing awareness of the negative impacts from the practice of health care on the environment and public health calls for the routine inclusion of life cycle criteria into the decision-making process of device selection. Here we present a life cycle assessment of 2 laryngeal mask airways (LMAs), a one-time-use disposable Unique™ LMA and a 40-time-use reusable Classic™ LMA. METHODS:In life cycle assessment, the basis of comparison is called the "functional unit." For this report, the functional unit of the disposable and reusable LMAs was taken to be maintenance of airway patency by 40 disposable LMAs or 40 uses of 1 reusable LMA. This was a cradle-to-grave study that included inputs and outputs for the manufacture, transport, use, and waste phases of the LMAs. The environmental impacts of the 2 LMAs were estimated using SimaPro life cycle assessment software and the Building for Environmental and Economic Sustainability impact assessment method. Sensitivity and simple life cycle cost analyses were conducted to aid in interpretation of the results. RESULTS:The reusable LMA was found to have a more favorable environmental profile than the disposable LMA as used at Yale New Haven Hospital. The most important sources of impacts for the disposable LMA were the production of polymers, packaging, and waste management, whereas for the reusable LMA, washing and sterilization dominated for most impact categories. DISCUSSION:The differences in environmental impacts between these devices strongly favor reusable devices. These benefits must be weighed against concerns regarding transmission of infection. Health care facilities can decrease their environmental impacts by using reusable LMAs, to a lesser extent by selecting disposable LMA models that are not made of certain plastics, and by ordering in bulk from local distributors. Certain practices would further reduce the environmental impacts of reusable LMAs, such as increasing the number of devices autoclaved in a single cycle to 10 (-25% GHG emissions) and improving the energy efficiency of the autoclaving machines by 10% (-8% GHG emissions). For both environmental and cost considerations, management and operating procedures should be put in place to ensure that reusable LMAs are not discarded prematurely.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Eckelman M,Mosher M,Gonzalez A,Sherman Jdoi
10.1213/ANE.0b013e31824f6959subject
Has Abstractpub_date
2012-05-01 00:00:00pages
1067-72issue
5eissn
0003-2999issn
1526-7598pii
ANE.0b013e31824f6959journal_volume
114pub_type
杂志文章abstract:BACKGROUND:The analgesic efficacy of transversus abdominis plane (TAP) block has been established for patients undergoing abdominal surgery. We evaluated the efficacy of a novel approach to TAP block for postoperative analgesia after colorectal surgery. METHODS:Forty adult ASA physical status I to III patients undergo...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3182159bf8
更新日期:2011-06-01 00:00:00
abstract:UNLABELLED:Propofol is a cardiac depressant with minimal diastolic effects in the adult myocardium. Cardiac effects of propofol in the newborn are unknown. We examined hemodynamic variables and systolic and diastolic left ventricular function in 12 newborn pigs exposed to propofol at three different infusion rates (7.5...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199804000-00008
更新日期:1998-04-01 00:00:00
abstract:UNLABELLED:Intraoperative recording of myogenic motor responses evoked by transcranial electrical stimulation (tcMEPs) is a method of assessing the integrity of the motor pathways during aortic surgery. To identify conditions for optimal spinal cord monitoring, we investigated the effects of manipulating the level of n...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-199901000-00005
更新日期:1999-01-01 00:00:00
abstract:UNLABELLED:The purpose of the investigation was to assess the effects of desflurane (DES) on left ventricular heart function during basal barbiturate anesthesia in a closed-pericardium, closed-chest acute swine model. The study was performed in 11 normoventilated adult pigs. Hemodynamic measurements were obtained using...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199809000-00003
更新日期:1998-09-01 00:00:00
abstract::Rifampin is commonly used for the treatment of tuberculosis and staphylococcal infections, as well as for prevention of infection in cardiac valve and bone surgeries. We report a case of profound hypotension after anesthesia induction with propofol in a patient who was treated with two 600 mg doses of rifampin for pro...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e318292cbd0
更新日期:2013-07-01 00:00:00
abstract::Clonidine in spinal and epidural blocks prolongs anesthesia, but can cause hypotension and bradycardia. The aim of our study was to compare hemodynamic and analgesic effects of spinal versus epidural clonidine alone and after repetitive dosing. In a prospective, randomized, double-blind study, we evaluated 40 patients...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199502000-00020
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:Modulation of γ-aminobutyric acid type A receptors (GABAARs) by general anesthetics may contribute to their ability to produce amnesia. Receptors containing α5 subunits, which mediate tonic and slow synaptic inhibition, are co-localized with β3 and γ2 subunits in dendritic layers of the hippocampus and are s...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000423
更新日期:2014-12-01 00:00:00
abstract:UNLABELLED:Certain dietary proteins and oils are capable of decreasing chronic neuropathic pain levels in rats after partial sciatic nerve ligation injury. We tested, for the first time, the role of dietary polyunsaturated fatty acids in suppressing pain in partial sciatic nerve ligation-injured rats. Six groups of mal...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000158469.11775.52
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Improved pain control after cesarean delivery remains a challenging objective. Poorly treated acute pain following delivery is associated with an increased risk of chronic pain and depression. This study was conducted to determine whether the addition of systemic acetaminophen and an increased dose of intrat...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000000695
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:The aim of this study was to identify patient and procedural characteristics associated with postoperative respiratory depression or sedation requiring naloxone intervention. METHODS:We identified patients who received naloxone to reverse opioid-induced respiratory depression or sedation within 48 hours aft...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000792
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Endotracheal tubes (ETTs) are commonly secured with tape to prevent undesirable tube migration. Many methods of taping have been described, although little has been published comparing various methods of taping to one another. In this study, we evaluated several methods for securing ETTs with tape. We hypoth...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000004206
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:The extent to which insufflation of oxygen into the posterior pharynx during laryngoscopy prolongs adequate saturation in infants and small children remains unknown. Therefore, we compared oxygen saturation over time in preoxygenated small children with and without posterior pharynx oxygen insufflation. MET...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001189
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:The status of neuropathic pain alters the responsiveness to formalin injection in rats. However, the mechanism by which this alteration occurs is unknown. METHODS:We used immunocytochemistry to examine the expression of brain-derived neurotrophic factor (BDNF) and calcitonin gene-related peptide (CGRP) in t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000258762.22607.15
更新日期:2007-04-01 00:00:00
abstract::Availability of physiologic monitoring equipment to ensure the safe administration of anesthesia is an expected standard in many parts of the world. Many hospitals in China may not have an adequate quantity and variety of anesthesia delivery and patient monitoring equipment to assure safe administration of anesthesia ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31825018cf
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:The clinical utility of focused transthoracic echocardiography (TTE) is increasingly recognized in perioperative medicine. However its use is limited among anesthesiologists because of a lack of training. The most efficient training methods have not been determined. We hypothesized that simulation-based TTE ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e318265408f
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Local anesthetics cause reversible block of pain and robustly inhibit TWIK-related K channel (TREK-1) currents. Before local anesthesia onset, injection of local anesthetics can cause unwanted transient pain. TREK-1 is an anesthetic-sensitive potassium channel that when inhibited produces pain. A disordered ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000004216
更新日期:2019-10-01 00:00:00
abstract::We tested whether anesthesia that includes nitrous oxide (N2O) results in the development of intraoperative and postoperative pulmonary complications, including hypoxemia. We also tested whether aging contributes to the development of such complications, particularly when anesthesia includes N2O. We randomly allocated...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1990-12-01 00:00:00
abstract::To assess the evolution of satisfactory neohepatic graft function or failure, hemodynamic variables, along with data for oxygen delivery and utilization, were analyzed retrospectively in 99 patients undergoing orthotopic liver transplantation. Caval cross-clamping without venovenous bypass initiated a series of hemody...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199303000-00022
更新日期:1993-03-01 00:00:00
abstract::Anesthesia information systems (AIS) record data from patient monitors and create a detailed electronic anesthesia record. Because the anesthesia record is a primary piece of evidence used in court during a malpractice proceeding, the ability to create an anesthesia record has fostered considerable debate concerning t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000130259.52838.3B
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Percutaneous cricothyroidotomy may be a life-saving procedure in cannot intubate-cannot ventilate situations. In this study we compared the insertion times of a new indicator-guided cricothyroidotomy device and a wire-guided device in mannequins. METHODS:This study was a crossover trial comparing the insert...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000266439.43797.9e
更新日期:2007-07-01 00:00:00
abstract::Women in labor who receive epidural analgesia are more likely to experience hyperthermia and overt clinical fever. The gradual development of modest hyperthermia observed in laboring women with epidural analgesia is not seen in those electing other forms of analgesia or unmedicated labor. Clinical fever is also far mo...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0b013e3181f713d4
更新日期:2010-12-01 00:00:00
abstract::We evaluated risk of heart block after cardiopulmonary by-pass (CPB) in patients with normal conduction undergoing coronary artery bypass grafting who chronically received calcium-entry blockers, beta-blockers, or combined therapy. Before CPB, calcium-entry blockers alone produced an increase in P-R intervals but no c...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1984-05-01 00:00:00
abstract:UNLABELLED:Carpal tunnel release is often performed as an outpatient procedure. We designed this retrospective study to assess the effect of different anesthesia techniques on intraoperative cardiovascular stability and discharge time. According to the anesthesia technique received, 62 consecutive patients were categor...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200208000-00020
更新日期:2002-08-01 00:00:00
abstract::Pituitary adenomas often present with the symptoms of hormonal hypersecretion, and although medical therapy is available for most hyperfunctioning states, it is not curative. As a result, transsphenoidal pituitary surgery has become a commonly performed neurosurgical procedure with unique challenges for the anesthesio...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/01.ane.0000166976.61650.ae
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Many animal models can be used to study the underlying pathophysiological mechanisms of neuropathic pain. Most of these models rely on a partial denervation of the limb of the animal by ligating a selected nerve. In this study, we performed nerve lesions on three peripheral nerves supplying the plantar side ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000260319.12133.89
更新日期:2007-05-01 00:00:00
abstract::Dexmedetomidine hydrochloride is a potent, highly selective alpha-2 adrenergic receptor agonist, broadly used as a sedative drug in intensive care units. We describe the case of a 59-yr-old patient who experienced drug fever caused by dexmedetomidine hydrochloride. The patient was transferred to the intensive care uni...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e31819f1985
更新日期:2009-05-01 00:00:00
abstract:UNLABELLED:We compared the effects of oral clonidine (4 microg/kg) and midazolam (0.5 mg/kg) on the preanesthetic sedation and postoperative recovery profile in children during tonsillectomy with or without adenoidectomy. In a double-blinded, double-dummy study design, 134 ASA physical status I-II children aged 4-12 yr...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200101000-00011
更新日期:2001-01-01 00:00:00
abstract::One approach to elucidating the general anesthetic target has used genetic selection procedures, wherein animals are bred for sensitivity or resistance to general anesthetics and correlations are sought with a specific neuronal structural or functional defect. For example, murine strains have been developed that are e...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199376060-00022
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:Aspirin-resistant platelet activation in whole blood is attributable to a transcellular pathway not detected by isolated platelet aggregometry. Aspirin resistance as defined by urinary thromboxane levels is associated with increased risk for myocardial infarction or cardiac death. Whole blood point-of-care a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e318277de06
更新日期:2013-02-01 00:00:00
abstract:UNLABELLED:Genitofemoral neuritis, which occurs when the neurolytic solution spreads into the psoas muscle, is the most common complication after neurolytic lumbar sympathetic block. We developed a transdiscal approach for neurolytic lumbar sympathetic block to reduce the danger of genitofemoral neuritis by making a sy...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199712000-00024
更新日期:1997-12-01 00:00:00