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Post anesthesia care unit

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https://www.readbyqxmd.com/read/28434475/music-listening-alleviates-anxiety-and-physiological-responses-in-patients-receiving-spinal-anesthesia
#1
Wen-Ping Lee, Pao-Yuan Wu, Meng-Ying Lee, Lun-Hui Ho, Whei-Mei Shih
OBJECTIVE: The aim of this study was to explore the effects of listening to music on the anxiety levels and physiological responses of surgical patients receiving spinal anesthesia. METHODS: An experimental design was used in the study with an experimental group (n=50) and a control group (n=50). The experimental group received 30min of musical intervention and routine nursing care in the Post-Anesthesia Care Unit (PACU) while the control group received only routine nursing care...
April 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28413629/american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-optimal-analgesia-within-an-enhanced-recovery-pathway-for-colorectal-surgery-part-1-from-the-preoperative-period-to-pacu
#2
Matthew D McEvoy, Michael J Scott, Debra B Gordon, Stuart A Grant, Julie K M Thacker, Christopher L Wu, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver "optimal analgesia," which we define in this paper as a technique that optimizes patient comfort and facilitates functional recovery with the fewest medication side effects. METHODS: With input from a multi-disciplinary, international group of clinicians, and through a structured review of the literature and use of a modified Delphi method, we achieved consensus surrounding the topic of optimal analgesia in the perioperative period for colorectal surgery patients...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28413628/american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-optimal-analgesia-within-an-enhanced-recovery-pathway-for-colorectal-surgery-part-2-from-pacu-to-the-transition-home
#3
Michael J Scott, Matthew D McEvoy, Debra B Gordon, Stuart A Grant, Julie K M Thacker, Christopher L Wu, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver "optimal analgesia", which we define in this paper as a technique that optimizes patient comfort and facilitates functional recovery with the fewest medication side effects. METHODS: With input from a multidisciplinary, international group of experts and through a structured review of the literature and use of a modified Delphi method, we achieved consensus surrounding the topic of optimal analgesia in the perioperative period for colorectal surgery patients...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28412051/-impact-of-postoperative-cognitive-decline-in-quality-of-life-a-prospective-study
#4
Joana Borges, Joana Moreira, Adriano Moreira, Alice Santos, Fernando J Abelha
BACKGROUND: Regardless the progress in perioperative care postoperative cognitive decline (PCD) has been accepted unequivocally as a significant and frequent complication of surgery in older patients. The aim of this study was to evaluate the incidence of postoperative cognitive decline and its influence on quality of life three months after surgery. METHODS: Observational, prospective study in a Post-Anesthesia Care Unit (PACU) in patients aged above 45 years, after elective major surgery...
April 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28410818/-use-of-protocol-and-evaluation-of-postoperative-residual-curarization-incidence-in-the-absence-of-intraoperative-acceleromyography-randomized-clinical-trial
#5
Filipe Nadir Caparica Santos, Angelica de Fátima de Assunção Braga, Carla Josefine Barbosa de Lima Ribeiro, Franklin Sarmento da Silva Braga, Vanessa Henriques Carvalho, Fernando Eduardo Feres Junqueira
OBJECTIVE: Evaluate the incidence of PORC in the post-anesthesia care unit (PACU) after the use of protocol and absence of intraoperative acceleromyography (AMG). METHODS: Randomized clinical trial with 122 patients divided into two groups (protocol and control). Protocol group received initial and additional doses of rocuronium (0.6mg/kg and 10mg, respectively); the use of rocuronium was avoided in the final 45minutes; blockade reversal with neostigmine (50μg/kg); time ≥ 15minutes between reversion and extubation...
April 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28390605/association-of-sleep-disordered-breathing-symptoms-with-early-postoperative-analgesic-requirement-in-pediatric-ambulatory-surgical-patients
#6
Kamie Yang, Anne Baetzel, Wilson T Chimbira, Yuliya Yermolina, Paul I Reynolds, Olubukola O Nafiu
INTRODUCTION: Sleep disordered breathing (SDB) symptoms are associated with increased rates of opioid-induced respiratory depression as well as enhanced nociception. Consequently, practitioners often withhold or administer lower intraoperative doses of opioids out of concern for postoperative respiratory depression. Therefore, SDB may be a critical determinant of analgesic requirement in the post-anesthesia care unit (PACU). We investigated whether preoperative SDB classification was independently associated with need for PACU analgesic intervention in a cross-sectional sample of 985 children who underwent elective, painful ambulatory surgical procedures...
May 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28377942/an-evaluation-of-ca-1-residents-adherence-to-a-standardized-handoff-checklist
#7
Madeline C Heck, Peter Huges, Mojca Konia
BACKGROUND: Poor-quality handoffs are a significant cause of preventable medical errors and adverse events. Handoff checklists improve handoffs but adherence to these tools is often inconsistent. In our study we aimed to investigate the effects of simulated handoff workshop and clinical instruction on resident handoff quality. METHODS: A three-week pre-education intervention observation period of handoffs was conducted to assess the deficits, variability, and common practice in handoffs at the University of Minnesota Fairview Hospital...
January 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/28365134/utility-of-sonoclot-in-prediction-of-postoperative-bleeding-in-pediatric-patients-undergoing-cardiac-surgery-for-congenital-cyanotic-heart-disease-a-prospective-observational-study
#8
Vishwakarma Rajkumar, Bhupesh Kumar, Vikas Dutta, Anand K Mishra, Goverdhan Dutt Puri
OBJECTIVES: To assess the utility of Sonoclot in prediction of postoperative bleeding in pediatric patients undergoing cardiac surgery with cardiopulmonary bypass for congenital cyanotic heart disease. DESIGN: Prospective, observational study. SETTING: Single university hospital. PARTICIPANTS: Eighty-seven pediatric patients undergoing cardiac surgery for congenital cyanotic heart disease. INTERVENTIONS: Laboratory coagulation parameters (prothrombin time, international normalization ratio, activated partial thromboplastin time, fibrinogen, D-dimer) as well as point-of-care Sonoclot glass bead activation time, clot rate, and platelet function (gbPF) were done before induction of anesthesia and following heparin reversal after termination of cardiopulmonary bypass (CPB) in all patients...
February 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28363470/time-driven-activity-based-costing-a-dynamic-value-assessment-model-in-pediatric-appendicitis
#9
Yangyang R Yu, Paulette I Abbas, Carolyn M Smith, Kathleen E Carberry, Hui Ren, Binita Patel, Jed G Nuchtern, Monica E Lopez
OBJECTIVES: Healthcare reform policies are emphasizing value-based healthcare delivery. We hypothesize that time-driven activity-based costing (TDABC) can be used to appraise healthcare interventions in pediatric appendicitis. METHODS: Triage-based standing delegation orders, surgical advanced practice providers, and a same-day discharge protocol were implemented to target deficiencies identified in our initial TDABC model. Post-intervention process maps for a hospital episode were created using electronic time stamp data for simple appendicitis cases during February to March 2016...
March 18, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28343639/the-benefits-of-a-preoperative-mrsa-swabbing-protocol
#10
Hope Herd
Infection control practices pose a challenge to nursing care in general, but can have a huge negative impact on the perioperative process. Prior to July of 2012, our institution did not perform routine methacillin resistant staphylococcus aureus (MRSA) screening on preoperative patients with a prior history of MRSA. This resulted in patients remaining in isolation throughout their entire perioperative course. Screening for MRSA was delayed until the patient arrived in the medical surgical unit. Many of these patients were later found to have negative nasal swabs...
April 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28333299/bilateral-breast-reduction-without-opioid-analgesics-a-comparative-study
#11
Fereydoun Don Parsa, Justin Cheng, Brad Stephan, Nikki Castel, Leslie Kim, Daniel Murariu, Alan A Parsa
Background: Breast reduction has traditionally been performed under general anesthesia with adjunct opioid use. However, opioids are associated with a wide variety of adverse effects, including nausea, vomiting, constipation, postoperative sedation, dizziness, and addiction. Objectives: This study compares bilateral breast reduction using a multimodal opioid-free pain management regimen vs traditional general anesthesia with adjunct opioids. Methods: A total of 83 female patients were enrolled in this study...
March 3, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28328759/topical-ropivacaine-in-prevention-of-post-tonsillectomy-pain-in-adults
#12
Hanna Kaisa Tolska, Annika Takala, Karin Blomgren, Katri Hamunen, Vesa Kontinen
BACKGROUND: Post-tonsillectomy pain is 1 of the most intense postoperative pain conditions. However, optimal and sufficient postoperative analgesic treatment remains unclear. We investigated the effect of topical ropivacaine for post-tonsillectomy pain in 160 adult outpatient surgery patients over 2 postoperative weeks. METHODS: At the end of tonsillectomy, 2 swabs soaked in either 1% ropivacaine or saline were packed into the tonsillar beds for 5 minutes. We used ibuprofen and a combination of acetaminophen (500 mg)-codeine (30 mg) tablets as postoperative analgesics for 2 weeks...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28317003/peri-operative-inflammatory-cytokines-in-plasma-of-the-elderly-correlate-in-prospective-study-with-postoperative-changes-in-cognitive-test-scores
#13
R Kline, E Wong, M Haile, S Didehvar, S Farber, A Sacks, E Pirraglia, M J de Leon, A Bekker
Increasingly, postoperative cognitive dysfunction (POCD) is recognized as a complication after surgery in the elderly; but it's etiology remains unclear. Here we examine changes in cytokine levels during both the pre-operative and postoperative period, comparing them with long term variation in cognitive test scores. Forty-one patients aged 65 and older undergoing major surgery with general anesthesia were recruited after written consent in this IRB approved study. Thirty went on to complete this prospective, non-interven-tional and non-randomized study...
August 2016: International Journal of Anesthesiology & Research
https://www.readbyqxmd.com/read/28302227/anaesthetic-concerns-of-surgical-emphysema-following-thyroidectomy
#14
Sanum Kashif, Amna Gulrez
Surgical emphysema secondary to tracheal tear is a rare but serious complication after thyroidectomy. It is usually resolved by conservative management; but in case of compromised airway, early airway control and surgical intervention is required. This is the case report of a 52-year woman diagnosed as thyroid carcinoma, who developed rapidly progressive surgical emphysema involving head and upper thorax, following total thyroidectomy, in post anesthesia care unit (PACU). The complication was related to tracheal tear occurring during excision of huge thyroid mass, encroaching trachea...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28294528/effect-of-intraoperative-dexamethasone-on-pain-scores-and-narcotic-consumption-in-patients-undergoing-total-knee-arthroplasty
#15
Jason Samona, Carrie Cook, Kyle Krupa, Krystle Swatsell, Andrew Jackson, Chase Dukes, Sidney Martin
OBJECTIVE: To examine whether the addition of intravenous dexamethasone during total knee arthroplasty (TKA) would be effective at reducing postoperative pain scores and postoperative opioid consumption. METHODS: A total of 102 patients undergoing TKA were placed into two groups: 55 subjects received intraoperative dexamethasone 8 mg intravenously (treatment group) and 47 did not receive dexamethasone at any time during the perioperative period. Comparison was made using the 0-10 numeric pain rating scale and the amount of opioids used in each group...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#16
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28285395/two-techniques-for-assessing-postoperative-voiding-function-a-randomized-trial
#17
Erinn M Myers, Catherine A Matthews, Andrea K Crane, AnnaMarie Connolly, Jennifer M Wu, Elizabeth J Geller
INTRODUCTION AND HYPOTHESIS: Post-operative voiding dysfunction is common after sling placement and is assessed with a voiding trial (VT) before discharge. We hypothesized that an operating room (OR) initiated retrograde VT (OR-fill) would decrease time to discharge compared with a post-anesthesia care unit (PACU) initiated retrograde VT (PACU-fill). METHODS: This was a parallel non-blinded randomized trial, of women undergoing outpatient sling surgery at a university hospital...
March 11, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28275978/infrared-pupillometry-helps-to-detect-and-predict-delirium-in-the-post-anesthesia-care-unit
#18
Eric Yang, Matthias Kreuzer, September Hesse, Paran Davari, Simon C Lee, Paul S García
This study evaluates the capability of pupillary parameters to detect and predict delirium in the post-anesthesia care unit (PACU-D) following general anesthesia. PACU-D may complicate and prolong the patient's postoperative course, consequently increasing hospital costs. After institutional approval, 47 patients undergoing surgical interventions with general anesthesia were included in the study. We measured the pupillary reflexes at signing of informed consent, during surgery 20 min after intubation and when the primary inhaled anesthetic was turned off, and 15 and 45 min after PACU admittance and upon discharge from the PACU...
March 8, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28270298/risk-factors-and-prognosis-of-reintubation-following-surgeries-under-general-anesthesia
#19
Kan Wang, Yiqing Yin
Objective To investigate the independent risk factors and the prognosis of reintubation following surgeries under general anesthesia in post-anesthesia care unit (PACU). Methods  We retrospectively analyzed the clinical data of 14 407 patients undergoing elective surgeries from October 2013 to October 2014 in the China-Japanese Friendship Hospital. Patients were divided into reintubation group and control group according to the application of reintubation (or not) in PACU. Multivariate Logistic analysis was performed for factors showing significant difference between these two groups to screen for risk factors and analyze the prognosis...
February 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28268686/using-hilbert-huang-transform-to-assess-eeg-slow-wave-activity-during-anesthesia-in-post-cardiac-arrest-patients
#20
Jukka Kortelainen, Eero Vayrynen, Usko Huuskonen, Jouko Laurila, Juha Koskenkari, Janne T Backman, Seppo Alahuhta, Tapio Seppanen, Tero Ala-Kokko
Hypoxic ischemic encephalopathy (HIE) is a severe consequence of cardiac arrest (CA) representing a substantial diagnostic challenge. We have recently designed a novel method for the assessment of HIE after CA. The method is based on estimating the severity of the brain injury by analyzing changes in the electroencephalogram (EEG) slow wave activity while the patient is exposed to an anesthetic drug propofol in a controlled manner. In this paper, Hilbert-Huang Transform (HHT) was used to analyze EEG slow wave activity during anesthesia in ten post-CA patients...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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