Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2012
Randomized Controlled TrialStreamed video clips to reduce anxiety in children during inhaled induction of anesthesia.
Anesthesia induction in children is frequently achieved by inhalation of nitrous oxide and sevoflurane. Pediatric anesthesiologists commonly use distraction techniques such as humor or nonprocedural talk to reduce anxiety and facilitate a smooth transition at this critical phase. There is a large body of successful distraction research that explores the use of video and television distraction methods for minor medical and dental procedures, but little research on the use of this method for ambulatory surgery. In this randomized control trial study we examined whether video distraction is effective in reducing the anxiety of children undergoing inhaled induction before ambulatory surgery. ⋯ Playing video clips during the inhaled induction of children undergoing ambulatory surgery is an effective method of reducing anxiety. Therefore, pediatric anesthesiologists may consider using video distraction as a useful, valid, alternative strategy for achieving a smooth transition to the anesthetized state.
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Anesthesia and analgesia · Nov 2012
Randomized Controlled TrialCartoon distraction alleviates anxiety in children during induction of anesthesia.
We performed this study to determine the beneficial effects of viewing an animated cartoon and playing with a favorite toy on preoperative anxiety in children aged 3 to 7 years in the operating room before anesthesia induction. ⋯ Allowing the viewing of animated cartoons by pediatric surgical patients is a very effective method to alleviate preoperative anxiety. Our study suggests that this intervention is an inexpensive, easy to administer, and comprehensive method for anxiety reduction in the pediatric surgical population.
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Loss of information occurs frequently during handover and affects the continuity of care. Improving handovers is therefore a key patient safety goal. After surgery, the patient is transferred to the postanesthesia care unit (PACU), and handover to the nurse includes both handover of monitoring equipment (connecting electrocardiogram, calibrating arterial lines, infusion pumps, etc.) and patient/procedure-specific information. Multitasking is likely to increase the risk of information loss during handover. It is unknown to what extent the transfer of equipment and information occurs simultaneously or sequentially in daily practice. ⋯ In most videotaped handovers from OR to the PACU, there was simultaneous transfer of equipment and information. Although most health care providers are unaware of it, this form of multitasking during patient handover in the PACU is common. Future studies should evaluate whether this multitasking also leads to loss of critical patient information and reduced patient safety.
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Anesthesia and analgesia · Nov 2012
Comparative StudyLocal neurotoxicity and myotoxicity evaluation of cyclodextrin complexes of bupivacaine and ropivacaine.
Bupivacaine (BVC) and ropivacaine (RVC) are local anesthetics widely used in surgical procedures. In previous studies, inclusion complexes of BVC or RVC in hydroxypropyl-β-cyclodextrin (HP-β-CD) increased differential nervous blockade, compared to the plain anesthetic solutions. In this study we evaluated the local neural and muscular toxicity of these new formulations containing 0.5% BVC or RVC complexed with HP-β-CD (BVC(HP-β-CD) and RVC(HP-β-CD)). ⋯ We concluded that the new formulations presented a lower myotoxicity and a similar cytotoxic effect when compared to plain local anesthetic solutions.
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Anesthesia and analgesia · Nov 2012
Use of analgesic, anesthetic, and sedative medications during pediatric hospitalizations in the United States 2008.
The wide need for analgesia, anesthesia, and sedation in children and the lack of pediatric labeling leads to widespread off-label use of medications for pain and sedation in children. Any attempt to address the lack of labeling will require national estimates of the numbers of children using each medication, their ages, and other factors, to understand the overall use of these medications. We describe use of analgesics, anesthetics, and sedatives in pediatric inpatients by result of conducting a statistical analysis of medication data from >800,000 pediatric hospitalizations in the United States. The purpose was to provide national estimates for the percentage of hospitalized children receiving specific analgesics, anesthetics, and sedatives and their use by age group. ⋯ A variety of drug classes and individual medications were used to manage pain and sedation in hospitalized children. The variation in patterns of use reflects the heterogeneity of the dataset, comprising a wide range of ages and conditions in which analgesia, anesthesia, and sedation might be required. It was not possible to assess whether use of a specific medication was clinically appropriate, except to note use of medications in age subgroups without pediatric labeling.