Anesthesia and analgesia
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Anesthesia and analgesia · Jul 2014
Observational StudyA Prospective Observational Study of Ethnic and Racial Differences in Neuraxial Labor Analgesia Request and Pain Relief.
As ethnic and racial diversity increases, it is important that anesthesia providers understand the expectations and concerns of this changing population regarding labor analgesia. Our objective was to evaluate ethnic/racial differences in labor analgesia characteristics with regard to the timing of request for neuraxial analgesia. ⋯ Our data indicate that ethnicity/race plays a small role in acceptance and request for neuraxial labor analgesia.
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Anesthesia and analgesia · Jul 2014
Sequence-Dependent Anesthesia-Controlled Times: A Retrospective Study in an Ophthalmology Department of a Single-Site Hospital.
Anesthesia-controlled time (ACT) generally refers to the time durations before and after the period of surgery. The ACT is typically dependent on the sequence of 2 consecutive surgeries and thus adds to the complexity of operating room scheduling. We report a study on sequence-dependent ACTs at the West China Hospital (WCH), focusing on elective surgeries (also referred to as "procedures" below) performed by the ophthalmology department of WCH over a 5-year period, 2007 to 2012. ⋯ ACTs are usually sequence dependent and hence should be considered in operating room scheduling. Although identifying the best sequence in general is a difficult optimization problem, in certain departments (such as the ophthalmology department of WCH) where a set of high-volume small-variety procedures is present, the best sequences can be systematically identified using a combination of statistical tests and Monte Carlo simulation as illustrated in this study.
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Anesthesia and analgesia · Jul 2014
Case ReportsWrong site frenulectomy in a child: a serious safety event.
Wrong site surgery is a serious safety event that can result in temporary or even permanent harm. Various safety checklists and procedures have been added to our standard work in the operating room, but errors still get through our safety nets and patients are harmed. In this case report, we describe a wrong site frenulectomy in a child and discuss the root cause analysis of this error and also SMART (specific, measurable, achievable, realistic, timed) preventative actions that could be put into place to prevent a recurrence.
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Anesthesia and analgesia · Jul 2014
Long-term psychosocial outcomes after intraoperative awareness with recall.
Posttraumatic stress disorder, a common psychiatric disorder in the general population, may follow a traumatic experience of awareness with recall during general anesthesia. ⋯ We found no indication that intraoperative awareness with recall had any deleterious long-term effects on patients' psychosocial outcome.
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Anesthesia and analgesia · Jul 2014
National Pediatric Anesthesia Safety Quality Improvement Program in the United States.
As pediatric anesthesia has become safer over the years, it is difficult to quantify these safety advances at any 1 institution. Safety analytics (SA) and quality improvement (QI) are used to study and achieve high levels of safety in nonhealth care industries. We describe the development of a multiinstitutional program in the United States, known as Wake-Up Safe (WUS), to determine the rate of serious adverse events (SAE) in pediatric anesthesia and to apply SA and QI in the pediatric anesthesia departments to decrease the SAE rate. ⋯ WUS documented the incidence and types of SAE nationally in pediatric anesthesiology. Education and application of QI and SA in anesthesia departments are key strategies to improve perioperative safety by WUS.