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Biomedical subjects

T E Kole

Publications and source records attributed to T E Kole.

4 recordsLinked to original sources
PubMed1993

Assessing the potential for awareness and learning under anesthesia.

The problems of intraoperative learning and awareness during surgery have consequences for both the patient and the medical team. With or without recall, the patient can suffer severe emotional trauma that may result in psychological damage. Successful litigation against the anesthesia professional has been increasing in numbers as failure to provide adequate anesthesia can be considered a breach of the unwritten contract between patient and anesthetist. Balanced anesthesia and its use of muscle relaxants can mask indicators of anesthesia depth such as movement or lacrimation. To date, means of monitoring real-time levels of intravenous agents have not yet been fully tested and proven. Therefore, monitoring minimum alveolar concentrations of inhaled anesthetics may be the best currently available method of ensuring anesthetic depth. Investigations comparing the correlation between nitrous oxide and isoflurane minimum alveolar concentrations and anesthetic depth have indicated specific levels at which intraoperative learning ceases to occur.

Anesthesia, Inhalation↗
PubMed1990

Environmental and occupational hazards of the anesthesia workplace.

Our present state of research and knowledge strongly suggests that the volatile agents, halothane, enflurane and isoflurane, present only a minimal threat to our environment. Nitrous oxide, however, has ozone-depleting potential as well as a greenhouse gas effect which may contribute much to the problem of global warming over the next few decades. Release of anesthetic gases into the atmosphere presents a small problem in contrast to other sources of ozone-depleting chemicals and greenhouse gases, but anesthesia providers have a responsibility to minimize unnecessary atmospheric pollution by reevaluating the use of N2O, using low flows of gases and exploring the use of activated charcoal absorption in the scavenging systems to remove volatile agents. Infectious waste, radiation, lasers, chemicals and waste gases pose possible occupational health hazards in the operating room. Each of us should play a critical role in monitoring harmful substances and should actively practice techniques which would lessen the hazards. We should be cognizant of the fact that sources not yet introduced into our environment may have adverse effects on our health and that vigilance and education are key factors in maintaining a safe work environment.

Anesthesia↗