Anesthesia and analgesia
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Anesthesia and analgesia · Sep 2014
Review Meta Analysis Comparative StudyNeuraxial Anesthesia for the Prevention of Postoperative Mortality and Major Morbidity: An Overview of Cochrane Systematic Reviews.
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Anesthesia and analgesia · Sep 2014
Influence of Provider Type (Nurse Anesthetist or Resident Physician), Staff Assignments, and Other Covariates on Daily Evaluations of Anesthesiologists' Quality of Supervision.
At many U.S. healthcare facilities, supervision of anesthesiology residents and/or Certified Registered Nurse Anesthetists (CRNAs) is a major daily responsibility of anesthesiologists. Our department implemented a daily process by which the supervision provided by each anesthesiologist working in operating rooms was evaluated by the anesthesiology resident(s) and CRNA(s) with whom they worked the previous day. ⋯ Although the attributes that residents and CRNA perceive as constituting "supervision" significantly share commonalities, supervision scores should be analyzed separately for residents and CRNAs. Although mean supervision scores differ markedly among anesthesiologists, supervision scores are influenced negligibly by staff assignments (e.g., how busy the anesthesiologist is with other operating rooms).
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Diagnosis of sepsis in the postoperative period is a challenge. Measurements of inflammatory markers, such as C-reactive protein (CRP), have been proposed in medical patients, but the interpretation of these values in surgical patients is more difficult. We evaluated the changes in blood CRP levels and white blood cell count in postoperative patients with and without infection. ⋯ CRP levels increase in the first week after major surgery but to a much larger extent in infected than in noninfected patients. Persistently high CRP levels after POD 4, especially when >100 mg/L, suggest the presence of a postoperative infection.