Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2015
Randomized Controlled Trial Comparative StudyA Phase 1c Trial Comparing the Efficacy and Safety of a New Aqueous Formulation of Alphaxalone with Propofol.
Phaxan™, an alphaxalone-cyclodextrin preparation offers fast-onset & short-duration anesthesia equivalent to propofol without pain on injection and with less hypotension.
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Anesthesia and analgesia · Oct 2015
Randomized Controlled TrialPreparing Parents to Be Present for Their Child's Anesthesia Induction: A Randomized Controlled Trial.
The purpose of this study is to compare the effectiveness of a brief preparation intervention for parental presence during induction of anesthesia (PPIA preparation) with a PPIA with standard preparation (PPIA standard). ⋯ A brief, video-based intervention aimed at preparing parents to be present for their child's anesthesia induction was not successful in reducing the children's preoperative anxiety. However, it is unclear whether parents included in this study actually performed as instructed in the intervention to reduce their children's anxiety. Future research should monitor parent behavior and support parental performance to reduce their children's preoperative anxiety.
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Anesthesia and analgesia · Oct 2015
ReviewClinical Research Methodology 2: Observational Clinical Research.
Case-control and cohort studies are invaluable research tools and provide the strongest feasible research designs for addressing some questions. Case-control studies usually involve retrospective data collection. Cohort studies can involve retrospective, ambidirectional, or prospective data collection. ⋯ Causality-the most clinically useful relation between exposure and outcome-can rarely be definitively determined from observational studies because intentional, controlled manipulations of exposures are not involved. In this article, we review several types of observational clinical research: case series, comparative case-control and cohort studies, and hybrid designs in which case-control analyses are performed on selected members of cohorts. We also discuss the analytic issues that arise when groups to be compared in an observational study, such as patients receiving different therapies, are not comparable in other respects.
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Anesthesia and analgesia · Oct 2015
Comparative StudyMajor Upper Abdominal Surgery Alters the Calibration of Bioreactance Cardiac Output Readings, the NICOM, When Comparisons Are Made Against Suprasternal and Esophageal Doppler Intraoperatively.
Minimally invasive continuous cardiac output measurements are recommended for use during anesthesia to guide fluid therapy, but such measurements must trend changes reliably. The NICOM Cheetah, a BioReactance monitor, is being recommended for intraoperative use. To validate its use, Doppler methods, suprasternal USCOM and esophageal CardioQ, were used in tandem to provide reliable estimates of changing trends in cardiac output. Preliminary comparisons showed that upper abdominal surgical interventions caused shifts in the calibration of the NICOM. The purpose of this study was to confirm and measure these calibration shifts. ⋯ Doppler monitoring used in tandem provided valid trend lines of cardiac output changes against which NICOM readings could be compared. Intraoperatively, the NICOM was shown to track changes in cardiac output reliably in most circumstances. However, surgical interventions to the upper abdomen caused shifts in readings by >1 L/min/m, and the direction of the shifts was unpredictable. Anesthesiologists need to be aware of these calibration shifts and anticipate their occurrence, whenever the NICOM is used intraoperatively.
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Anesthesia and analgesia · Oct 2015
Comparative StudyDiscrepancies Between Randomized Controlled Trial Registry Entries and Content of Corresponding Manuscripts Reported in Anesthesiology Journals.
Clinical trial registries have been created to reduce reporting bias. Study registration enables the examination of discrepancies between the original study design and the final results reported in the literature. The main objective of the current investigation is to compare the original clinical trial registrations and the corresponding published results in high-impact anesthesiology journals. Specifically, we examined the rates of major discrepancies (i.e., involving primary outcome, sample size calculation, or study intervention). ⋯ We detected a high rate of major discrepancies between the published results and the original registered protocols for clinical trial manuscripts in high-impact anesthesiology journals. Future action to reduce the negative impact of reporting bias in the anesthesiology field is warranted.