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Anaesthesia patient safety

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https://www.readbyqxmd.com/read/27913269/the-structure-organisation-and-perioperative-management-of-ambulatory-surgery-and-anaesthesia-in-france-methodology-of-the-sfar-opera-study
#1
Pierre Albaladejo, Frédéric Aubrun, Charles-Marc Samama, Laurent Jouffroy, Marc Beaussier, Dan Benhamou, Pauline Romegoux, Kristina Skaare, Jean Luc Bosson, Claude Ecoffey
The organization of health care establishments and perioperative care are essential for ensuring the quality of care and safety of patients undergoing outpatient surgery. In order to correctly inventory these organizations and practices, in 2013-2014, the French Society of Anaesthesia and Intensive Care organized an extensive practical survey in French ambulatory surgery units entitled the "OPERA" study (Organisation PERiopératoire de l'anesthésie en chirurgie Ambulatoire). From among all of the ambulatory surgery centres listed by the Agences Régionales de Santé [Regional Health Agencies, France], 206 public and private centres were randomly selected...
November 29, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27909595/effect-of-smoking-on-reversing-neuromuscular-block
#2
Ömür Öztürk, Gülbin Yalçın Sezen, Handan Ankaralı, Onur Özlü, Yavuz Demiraran, Hakan Ateş, Burhan Dost
OBJECTIVE: Rocuronium is a non-depolarising, intermediate-acting, monoquaternary amino steroid and was brought into clinical use as a potentially ideal muscle relaxant. Post-operative residual curarisation (PORC) results from the prolonged effects of non-depolarising neuromuscular blocking agents. This is a common problem and seriously affects patient safety. No recent study has investigated the effects of sugammadex on smokers, which is often used to restore neuromuscular block and avoid PORC...
August 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27867510/effect-of-adding-intrathecal-morphine-to-a-multimodal-analgesic-regimen-for-postoperative-pain-management-after-laparoscopic-bariatric-surgery-a-prospective-double-blind-randomized-controlled-trial
#3
Fatma Adel El Sherif, Ahmed Hassan Othman, Ahmad Mohammad Abd El-Rahman, Osama Taha
BACKGROUND: Pain control after bariatric surgery is a major challenge. Our objective was to study the efficacy and safety of intrathecal (IT) morphine 0.3 mg added to bupivacaine 0.5% for postoperative pain after laparoscopic bariatric surgery. METHODS: After local ethics committee approval, 100 morbidly obese patients scheduled for laparoscopic bariatric surgery were enrolled in this study. Patients were randomly assigned into two groups: Group I received IT 0...
November 2016: British Journal of Pain
https://www.readbyqxmd.com/read/27867133/fiberoptic-bronchoscopy-and-remifentanil-target-controlled-infusion-in-critically-ill-patients-with-acute-hypoxaemic-respiratory-failure-a-descriptive-study
#4
Saïda Rezaiguia-Delclaux, Florent Laverdure, Talna Kortchinsky, Léa Lemasle, Audrey Imbert, François Stéphan
INTRODUCTION: Sedation optimizes patient comfort and ease of execution during fiberoptic bronchoscopy (FOB). Our objective was to describe the safety and efficacy of remifentanil-TCI during FOB in non-intubated, hypoxaemic, thoracic-surgery ICU patients. METHODS: Consecutive spontaneously breathing adults requiring FOB after thoracic surgery were included if they had hypoxaemia (PaO2/FiO2 < 300mmHg or need for non-invasive ventilation [NIV]) and prior FOB failure under topical anaesthesia...
November 17, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27853812/ultrasound-guided-percutaneous-laser-ablation-of-unifocal-t1n0m0-papillary-thyroid-microcarcinoma-preliminary-results
#5
Wei Zhou, Shan Jiang, Weiwei Zhan, Jianqiao Zhou, Shangyan Xu, Lu Zhang
OBJECTIVES: To evaluate the efficacy and safety of percutaneous laser ablation (PLA) for unifocal T1N0M0 papillary thyroid microcarcinoma(PTMC). METHODS: A retrospective study was conducted in 30 patients with single PTMC which was diagnosed by fine-needle aspiration biopsy (FNAB). PLA was performed for proper time to achieve adequate ablation zones. The extent of ablation was assessed by contrast-enhanced ultrasound (CEUS) immediately and 7 days after PLA. Complications were recorded...
November 16, 2016: European Radiology
https://www.readbyqxmd.com/read/27843340/the-danish-anaesthesia-database
#6
REVIEW
Kristian Antonsen, Charlotte Vallentin Rosenstock, Lars Hyldborg Lundstrøm
AIM OF DATABASE: The aim of the Danish Anaesthesia Database (DAD) is the nationwide collection of data on all patients undergoing anesthesia. Collected data are used for quality assurance, quality development, and serve as a basis for research projects. STUDY POPULATION: The DAD was founded in 2004 as a part of Danish Clinical Registries (Regionernes Kliniske Kvalitetsudviklings Program [RKKP]). Patients undergoing general anesthesia, regional anesthesia with or without combined general anesthesia as well as patients under sedation are registered...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27798454/laryngeal-tube-suction-ii-or-endotracheal-intubation-for-laparoscopic-radical-prostatectomy-in-a-head-down-position-a-randomised-controlled-trial
#7
Alexander Dünnebier, Daniel Gardill, Ina Kowalski, Udo X Kaisers, Thilo Busch, Claudia Höhne, Jens-Uwe Stolzenburg, Sven Bercker
BACKGROUND: The laryngeal tube suction II (LTS II) is a supraglottic airway device (SAD) with a gastric drainage tube and enhanced seal properties as compared with other SADs. Therefore, its use has been proposed in situations with an elevated risk of aspiration. OBJECTIVES: To compare the safety and efficacy of airway management and controlled mechanical ventilation when using either an LTS II or an endotracheal tube for laparoscopic radical prostatectomy. DESIGN: Randomised, controlled, blinded and single-centre study...
October 27, 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27797095/anaesthesia-for-carotid-endarterectomy-ultrasound-guided-superficial-intermediate-cervical-plexus-block-combined-with-carotid-sheath-infiltration
#8
Paweł Mądro, Alina Dąbrowska, Jarosław Jarecki, Piotr Garba
BACKGROUND: Carotid endarterectomy carries a significant risk of intraoperative brain ischaemia. Various methods for intraoperative cerebral function monitoring can be utilized, but the assessment of the patient's consciousness remains the easiest and most available method, requiring that the patient remain awake and under local/regional anaesthesia. The aim of this study was to compare infiltration anaesthesia with an ultrasound-guided superficial/combined cervical plexus block for patient safety and comfort...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27797094/comparison-of-the-techniques-for-the-identification-of-the-epidural-space-using-the-loss-of-resistance-technique-or-an-automated-syringe-results-of-a-randomized-double-blind-study
#9
Larysa Duniec, Piotr Nowakowski, Jakub Sieczko, Marcin Chlebus, Tomasz Łazowski
BACKGROUND: The conventional, loss of resistance technique for identification of the epidural space is highly dependent on the anaesthetist's personal experience and is susceptible to technical errors. Therefore, an alternative, automated technique was devised to overcome the drawbacks of the traditional method. The aim of the study was to compare the efficacy of epidural space identification and the complication rate between the two groups - the automatic syringe and conventional loss of resistance methods...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27795775/-prioperative-adverse-events-critical-reading-of-the-data-registry-used-in-the-surgery-department-of-military-hospital-moulay-ismail-meknes
#10
Hicham Kechna, Omar Ouzzad, Khalid Chkoura, Jaouad Loutid, Moulay Ahmed Hachimi, Sidi Mohamed Hanafi
INTRODUCTION: Despite significant progress made in the field of safety in anesthesia, morbidity (serious or not, completely or partially related to anesthesia) remains common and no health practitioner is immune from accidents. In the current context where priority is given to training programmes, to quality and safety improvement in health care, the occurrence of an anesthesia-related accident in the surgery department is an extremely traumatic event. The fear of prosecution, the emotional context make it difficult to manage...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27791240/feasibility-of-day-case-total-hip-arthroplasty-a-single-centre-observational-study
#11
Jens Rolighed Larsen, Birgitte Skovgaard, Thomas Prynø, Laimonas Bendikas, Lone R Mikkelsen, Malene Laursen, Mette T Høybye, Søren Mikkelsen, Lene Bastrup Jørgensen
INTRODUCTION: Recent reports indicate that total hip arthroplasty (THA) can be further accelerated and might be managed as day-case. This could provide benefits to health care expenditure, lower patient risks and change patient satisfaction. We evaluated the feasibility, efficacy, safety and patient satisfaction of same-day (<12 hours) THA operation and discharge. METHODS: Consecutive patients were screened for eligibility (primary THA, ASA 1 or 2 physical status) and the presence of a support person to follow the patient for 48 hours postoperatively in an observational study...
October 24, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27790577/hemostasis-and-post-operative-care-of-oral-surgical-wounds-by-hemcon-dental-dressing-in-patients-on-oral-anticoagulant-therapy-a-split-mouth-randomized-controlled-clinical-trial
#12
K R Ashok Kumar, Jambukeshwar Kumar, Jagadesh Sarvagna, Praveen Gadde, Shwetha Chikkaboriah
INTRODUCTION: Hemostasis is a fundamental management issue post-operatively in minor oral surgical procedures. To ensure safety and therapeutic efficacy in patients, under oral anti coagulant therapy, is complicated by necessity for frequent determination of prothrombin time or international normalised ratio. AIM: The aim of the study was to determine whether early hemostasis achieved by using Hemcon Dental Dressing (HDD) will affect post-operative care and surgical healing outcome in minor oral surgical procedures...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27790557/oral-clonidine-vs-oral-pregabalin-premedication-to-attenuate-pressor-response-to-direct-laryngoscopy-in-patients-undergoing-laparoscopic-cholecystectomy-a-randomized-double-blind-study
#13
Shirin Parveen, Devendra Singh Negi, Rajesh Kumar, Mohd Chand Bagwan
INTRODUCTION: Direct laryngoscopy and tracheal intubation has adverse effects like tachycardia, hypertension, myocardial ischemia and cerebral haemorrhage. There are several studies on various pharmacological agents to attenuate this response. AIM: This study was designed to compare efficacy and safety of oral clonidine and oral pregabalin premedication to attenuate stress response in patients undergoing laparoscopic cholecystectomy. MATERIALS AND METHODS: Total 80 patients of ASA grade I and II, aged between 20-60 years of both sexes scheduled for elective laparoscopic cholecystectomy were included in the study...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27790555/efficacy-and-safety-of-clonidine-as-an-adjuvant-to-bupivacaine-for-caudal-analgesia-in-paediatric-infra-umbilical-surgeries
#14
Samita Priolkar, Shirley Ann D'Souza
INTRODUCTION: Caudal analgesia, has gained popularity in paediatric intraoperative and postoperative pain management, more so with the use of adjuvants to prolong its duration, each of them having various results. Clonidine, an alpha2-adrenergic agonist is being used for its analgesic effects in various doses with 0.25% Bupivacaine. AIM: The study was conducted to compare the analgesic efficacy, haemodynamic safety and side effects of 1 μg/kg Clonidine added to 1 ml/kg of 0...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27746556/a-comparison-of-dexamethasone-and-clonidine-as-an-adjuvant-for-caudal-blocks-in-pediatric-urogenital-surgeries
#15
Chandni Sinha, Bindey Kumar, Umesh Kumar Bhadani, Ajeet Kumar, Amarjeet Kumar, Alok Ranjan
BACKGROUND: Caudal block is a reliable regional analgesic technique for pediatric urogenital surgeries. Various adjuvants have been tried to enhance the duration of action of bupivicaine. Though clonidine is extensively used as an adjuvant in caudal anaesthesia, it can have troublesome adverse effects like bradycardia, hypotension and sedation. Lately dexamethasone has become popular as an adjuvant in paediatric caudals due to its safety profile. AIM: The aim of this study was to compare dexamethasone and clonidine coadministered with bupivicaine caudally in paediatric patients undergoing urogenital surgeries in terms of analgesia and adverse effects...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27716217/ultrasound-guided-gastrocnemius-recession-a-new-ultra-minimally-invasive-surgical-technique
#16
Manuel Villanueva, Álvaro Iborra, Guillermo Rodríguez, Pablo Sanz-Ruiz
BACKGROUND: Isolated gastrocnemius contracture is thought to lead to numerous conditions. Although many techniques have been described for gastrocnemius recession, potential anesthetic, cosmetic, and wound-related complications can lead to patient dissatisfaction. Open and endoscopic recession techniques require epidural anesthesia, lower limb ischemia, and stitches and may lead to damage of the sural nerve, which is not under the complete control of the surgeon at all stages of the procedure...
October 3, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27688037/hydrodisplacement-of-sural-nerve-for-safety-and-efficacy-of-endovenous-thermal-ablation-for-small-saphenous-vein-incompetence
#17
Omar Rodriguez-Acevedo, Kristen E Elstner, Kui Martinic, Aaron Zea, Jenny Diaz, Rodrigo T Martins, Fernando Arduini, Alexandra Hodgkinson, Nabeel Ibrahim
BACKGROUND: Endovenous radio frequency ablation for small saphenous vein incompetence by and large appears to be superior and safer than conventional open surgery. Small saphenous vein ablation from approximately mid-calf to the point proximally where the small saphenous vein dives into the popliteal fossa is considered to be safe, as the sural nerve is in most cases separated from this segment of the small saphenous vein by the deep fascia. The outcome of the distal incompetent small saphenous vein remains unclear...
September 29, 2016: Phlebology
https://www.readbyqxmd.com/read/27676415/impact-of-opening-hours-of-the-post-anaesthetic-care-unit-on-fast-track-success-in-cardiac-surgery
#18
Christian Graß, Federica Stretti, Waseem Zakhary, Edwin Turton, Sophia Sgouoropoulou, Meinhard Mende, Joerg Ender
BACKGROUND: Fast track (FT) treatment in cardiac anaesthesia is state of the art. Aim of our study was to compare FT treatment in a post anaesthetic care unit (PACU) with limited opening hours with a PACU opened for unlimited hours. Primary endpoints were extubation time (ET), length of stay (LOS) in PACU and LOS in intermediate care unit (IMC). Secondary endpoints were FT success/failure, hospital LOS, re- intubation and in hospital mortality. METHODS: At our institution, FT is usually managed in a PACU with limited opening hours from 10am to 10pm, Monday to Friday (PACU12)...
September 27, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27651627/role-of-thromboelastography-versus-coagulation-screen-as-a-safety-predictor-in-pre-eclampsia-eclampsia-patients-undergoing-lower-segment-caesarean-section-in-regional-anaesthesia
#19
Asrar Ahmad, Monica Kohli, Anita Malik, Megha Kohli, Jaishri Bogra, Haider Abbas, Rajni Gupta, B B Kushwaha
PURPOSE: In this study, we aimed to correlate thromboelastography (TEG) variables versus conventional coagulation profile in all patients presenting with pre-eclampsia/eclampsia and to see whether TEG would be helpful for evaluating coagulation in parturients before regional anaesthesia. MATERIALS AND METHODS: This was a prospective study on 100 pre-eclampsia/eclampsia patients undergoing lower-segment caesarean section under regional anaesthesia. Two blood samples were collected...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27647768/day-surgery-nurses-selection-of-patient-preoperative-information
#20
Mark Mitchell
AIMS AND OBJECTIVES: To determine selection and delivery of preoperative verbal information deemed important by nurses to relay to patients immediately prior to day surgery. BACKGROUND: Elective day-case surgery is expanding, patient turnover is high and nurse-patient contact limited. In the brief time-frame available, nurses must select and precisely deliver information to patients, provide answers to questions and gain compliance to ensure a sustained, co-ordinated patient throughput...
September 19, 2016: Journal of Clinical Nursing
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