Do remifentanil and propofol undergo separation and layering when mixed in the same syringe for total intravenous anesthesia?
Our data indicate that remifentanil solution and propofol emulsion are immiscible: remifentanil separates from propofol and rises to the top. Thus, concentrations of remifentanil and propofol delivered to patients from the same syringe during TIVA are not those expected and cannot be reliable. Remifentanil and propofol should be administered in separate syringes when used in combination for TIVA.
Long-term recall of specific radiologic structures learned in the second year of medical school was poor despite evidence documenting good initial (short-term) retention of tested information. However, after a brief review, consisting of the Quiz itself, followed by 3 weeks of general radiology emphasizing abnormal chest imaging, the senior students demonstrated a near doubling of their ability to correctly identify these structures, as well as an improvement compared with scores obtained during the second year. Thus the value of a preclinical course in radiology may be not only to teach principles of radiology and to stimulate interest in the discipline, but also, by repetition and reinforcement, to facilitate and possibly improve later recall and retention of important radiographic material.