The origin of the magic MAC number

Eger EI, Saidman LJ & Brandstater B. Minimum alveolar anesthetic concentration: a standard of anesthetic potency. Anesthesiology 1965; 26:756-763.

RHH Journal Club. July 4th, 2013. Dr Niv Jena

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This seminal body of work performed by Eger and his team in the 1960’s provides the basis for much of how we practice anaesthesia today. It continues to be referenced nearly 50 years later because of its importance. They introduced the concept of MAC and using it as a standard and comparison of potency of inhalational agents.

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BIS Off? No need for that…

Avidan MS, Jacobsohn E, Glick D et al. A. Prevention of intraoperative awareness in a high-risk surgical population. New England Journal of Medicine, 2011; 365: 591-600.

RHH Journal Club. July 4th, 2013. Dr Helen Findley

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Is keeping BIS 40-60 better at preventing awareness than keeping end tidal at minimum 0.7 age adjusted MAC?

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The origin of DO2 and the magic 600….

Shoemaker WC, Appel PL, Kram HB, Waxman K, & Lee TS. Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients. CHEST Journal  1988; 94: 1176-1186.

RHH Journal Club. June 13th, 2013. Dr Andy Cruikshanks

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Does the targeting of supranormal oxygen delivery reduce mortality in high-risk surgical patients?

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Antacids for LSCS

Roberts RB, & Shirley MA. Reducing the risk of acid aspiration during cesarean section. Anesthesia & Analgesia 1974; 53: 859-868.

RHH Journal Club. June 6th, 2013. Dr Susan Yeung

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This paper from 1974 highlights the increased risk of aspiration in pregnant women undergoing caesarean section (CS). This has led to a change in practice whereby all women prior to elective or emergency section are given antacid prophylaxis.

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How to measure recovery…

Aldrete JA & Kroulik. A postanesthetic recovery score. Anesthesia & Analgesia 1970; 49: 924-934

RHH Journal Club. May 30th, 2013. Dr Iain Goodhart

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This paper describes the process by which the (Post Anaesthetist Recovery Score) PARS score was designed, evaluated and validated. This score is the foundation of many of the currently used patient risk assessment scores.

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Bad news for rabbits & pregnant ladies…

Mendelson CL. The aspiration of stomach contents into the lungs during obstetric anesthesia. Anesthesiology 1946; 7: 694-695.

RHH Journal Club. May 31st, 2012. Dr Sireesha Aluri 

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To describe the presentation, pathology, diagnosis, prevention and management of aspiration pneumonia.

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To block or not to block, that is the question…

Lewis SC, Warlow CP, Bodenham AR et al. General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial. Lancet 2008; 372: 2132

RHH Journal Club. May 24th, 2012. Dr Jamie Douglass

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Prediction and prevention of perioperative strokes [carotid surgery] might be easier under local anaesthesia than under general anaesthesia

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