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Laurence C Torsher

Publications and source records attributed to Laurence C Torsher.

4 recordsLinked to original sources
PubMed2007

A prospective study on anesthesia machine fault identification.

BACKGROUND: Although few studies have been performed recently, several have suggested that some practitioners are not well able to detect preset anesthesia machine faults. METHODS: We performed a prospective study to determine whether there is a correlation between duration of anesthesia practice and the ability to detect anesthesia machine faults. Our hypothesis was that more anesthesia practice would increase the ability to detect anesthesia machine faults. This study was performed during a nationally attended anesthesia meeting held at a large academic medical center, where 87 anesthesia providers were observed performing anesthesia machine checkouts. The participants were asked to individually check out an anesthesia machine with an unspecified number of preset faults. The primary outcome measures were the written listing of faults detected during an anesthesia machine checkout. RESULTS: Of the five faults preset into the test machine, participants with 0-2 yr experience detected a mean of 3.7 faults, participants with 2-7 yr experience detected a mean of 3.6 faults, and participants with more than 7 yr experience detected a mean of 2.3 faults (P < 0.001). CONCLUSIONS: Our prospective study demonstrated that anesthesia machine checkout continues to be a problem.

Anesthesiology↗
PubMed2006

BIS monitor findings during self-hypnosis.

OBJECTIVE: We describe BIS values for a patient undergoing breast surgery under self-hypnosis in order to access the value of global surface EEG measures occurring during this process. METHODS: Following verbal consent, a BIS(TM) monitor (Aspect Medical, Newton MA) was placed and values measured while the patient performed self-hypnosis for a simple mastectomy and sentinel node biopsy. RESULTS: Thirty-nine minutes after incision the BIS value decreased transiently to 72 followed by several other transient decreases, the lowest of which was 59. Values remained at approximately 90 throughout most of the operative period. The BIS value returned to baseline after completion of the operation. CONCLUSIONS: Our findings support the hypothesis that hypnosis is a dynamic cerebral process incorporating many changes within brain activation centers and one distinct from dissociative patterns seen under anesthesia. Current algorithms employed by the BIS(TM) monitor add little to the management of patients utilizing hypnosis for analgesia.

Aged↗
PubMed2006

Postoperative confusion and basilar artery stroke.

INTRODUCTION: Non-focal postoperative mental status changes can be challenging. METHODS: Single patient case report and medical literature review. RESULTS: We describe a 67-year-old male who was admitted for radical cystectomy and ileal conduit urinary diversion. General anesthesia was uneventful and the patient remained hemodynamically stable throughout the procedure. At the end of the procedure, the patient's trachea was extubated. Initially, he was arousable, able to move all extremities, and answer questions appropriately. Over the next 2 hours, his mental status waxed and waned and respirations became irregular. An emergent head computed tomogram without contrast revealed a hyperdense basilar artery consistent with acute thrombosis. Vascular radiology intervention occurred approximately 9 hours after the onset of symptoms, but there was no improvement in the patient's neurological status and he subsequently died. CONCLUSION: Although nonfocal postoperative mental status changes are common and often secondary to benign etiologies, they may herald more significant pathology, including stroke. Patients with postoperative mental status changes should be evaluated carefully to identify life-threatening and treatable etiologies. Recent advances in the acute care of stroke, such as thrombolysis and angioplasty, can improve outcome if instituted promptly.

Aged↗