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Bradly J Narr

Publications and source records attributed to Bradly J Narr.

5 recordsLinked to original sources
PubMed2005

Update for nurse anesthetists--anesthetic considerations for patients with amyloidosis.

Amyloidosis is a rare disease process that results in the deposition of insoluble, fibrous amyloid proteins in extracellular spaces and tissues. Amyloid fibrils can be deposited locally or may involve every organ system of the body. Advancements in the treatment for amyloidosis allow longer survival, and patients are being seen in our operating rooms for diagnostic, interventional, and curative purposes. Amyloidosis has numerous implications for anesthesia providers due to the possibility of systemic involvement. This course describes 2 cases of amyloidosis and discusses the types of amyloidosis and their anesthetic implications.

Amyloidosis↗
PubMed2004

Developing a specialty: J.S. Lundy's three major contributions to anesthesiology.

John S. Lundy was able to accomplish three major goals during the early years of his stewardship of the section on anesthesia of the Mayo Clinic. In 1925, Lundy established the first anatomy lab at the Mayo Clinic. He believed that the lab would serve as a useful tool for teaching residents as well as research into regional anesthetic techniques. Second, Lundy desired to advance the science of anesthesiology. Lundy developed the concept of balanced anesthesia, pioneered the introduction of barbiturates to the practice of anesthesia, developed anesthesia section services for the use of ventilators, ventilator vests, oxygen tents, and nasal oxygen supplementation. Lastly, in 1935, he established the nation's first blood bank. Lundy and Ralph Tovell had the opportunity to do pioneering work in transfusion medicine, which led to an improvement in the quality of service, and patient safety. These three major accomplishments provided Lundy with abundant scientific material to present to the American Medical Association (AMA) in Chicago. These trips to Chicago allowed him to gain the ear of Olin West, Morris Fishbien, and James E. Pallin. Lundy was able to successfully lobby in 1939 for the creation of a section of anesthesia within the AMA. In 1940, Lundy's dream came true with the recognition of anesthesia as a specialty by the AMA.

Anatomy↗
PubMed2004

Intrathecal anesthesia and recovery from radical prostatectomy: a prospective, randomized, controlled trial.

BACKGROUND: Previous studies suggest that intraoperative anesthetic care may influence postoperative pain and recovery from surgery. The authors tested the hypothesis that the addition of intrathecal analgesia to general anesthesia would improve long-term functional status and decrease pain in patients undergoing radical retropubic prostatectomy. METHODS: One hundred patients received either general anesthesia supplemented with intravenous fentanyl or general anesthesia preceded by intrathecal administration of bupivacaine (15 mg), clonidine (75 microg), and morphine (0.2 mg). Patients and providers were masked to treatment assignment. All patients received multimodal pain management postoperatively. Primary outcomes included pain and functional status over the first 12 postoperative weeks. RESULTS: Patients receiving intrathecal analgesia required more intravenous fluids and vasopressors intraoperatively. Pain was well controlled throughout the study (mean numerical pain scores < 3 in both groups at all times studied). Intrathecal analgesia decreased pain and supplemental intravenous morphine use over the first postoperative day but increased the frequency of pruritus. Pain and functional status after discharge from the hospital did not differ between groups. Intrathecal analgesia significantly decreased the duration of hospital stay (from 2.8 +/- 2.0 to 2.1 +/- 0.5 days; P < 0.01) as a result of five patients in the control group who stayed in the hospital more than 3 days. CONCLUSIONS: The benefits of improved immediate analgesia and decreased morphine requirements resulting from intrathecal analgesia must be weighed against factors such as pruritus, increased intraoperative requirement for fluids and vasopressors, and resources needed to implement this modality. Further studies are needed to determine the significance of the decrease in duration of hospital stay.

Adult↗
PubMed2003

Computer-based anesthesiology paging system.

UNLABELLED: For more than a century, Mayo Clinic has used various communication strategies to optimize the efficiency of physicians. Anesthesiology has used colored wooden tabs, colored lights, and, most recently, a distributed video paging system (VPS) that was near the end of its useful life. A computer-based anesthesiology paging system (CAPS) was developed to replace the VPS. The CAPS uses a hands-off paradigm with ubiquitous displays to inform the practice where personnel are needed. The system consists of a dedicated Ethernet network connecting redundant central servers, terminal servers, programmable keypads, and light-emitting diode displays. Commercially available hardware and software tools minimized development and maintenance costs. The CAPS was installed in >200 anesthetizing and support locations. Downtime for the CAPS averaged 0.144 min/day, as compared with 24.2 min/day for the VPS. During installation, neither system was available and the department used beepers for communications. With a beeper, the median response time of an anesthesiologist to a page from a beeper was 2.78 min, and with the CAPS 1.57 min; this difference was statistically significant (P = 0.021, t(67) = 2.36). We conclude that the CAPS is a reliable and efficient paging system that may contribute to the efficiency of the practice. IMPLICATIONS: Mayo Clinic installed a computer-based anesthesiology paging system (CAPS) to inform operating suite personnel when assistance is needed in procedure and recovery areas. The CAPS is more reliable than the system it replaced. Anesthesiologists arrive at a patient's bedside faster when they are paged with the CAPS than with a beeper.

Anesthesiology↗