Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2015
Review Case ReportsObstetric Neuraxial Drug Administration Errors: A Quantitative and Qualitative Analytical Review.
A systematic review of 29 published cases of neuraxial obstetric drug errors, including four maternal deaths related to inadvertent intrathecall tranexamic acid.
What’s the first warning sign of an intrathecal drug error?
Block failure was the most frequent reported complication.
What were the most common human factors causing the errors?
- Similar drug ampoule appearance.
- Drug storage problems.
Any recommendations to reduce the risk of drug errors?
- Carefully read the ampoule before drawing up, and the syringe label before administering.
- Label syringes!
- Check labels with a second person or a device.
- Use non–luer lock connectors on all neuraxial catheters & devices.
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The last decade has seen an explosion in the growth of digital data. Since 2005, the total amount of digital data created or replicated on all platforms and devices has been doubling every 2 years, from an estimated 132 exabytes (132 billion gigabytes) in 2005 to 4.4 zettabytes (4.4 trillion gigabytes) in 2013, and a projected 44 zettabytes (44 trillion gigabytes) in 2020. This growth has been driven in large part by the rise of social media along with more powerful and connected mobile devices, with an estimated 75% of information in the digital universe generated by individuals rather than entities. ⋯ The amount of accumulating data has become so large that it has given rise to the term Big Data. In many ways, Big Data is just a buzzword, a phrase that is often misunderstood and misused to describe any sort of data, no matter the size or complexity. However, there is truth to the assertion that some data sets truly require new management and analysis techniques.
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Anesthesia and analgesia · Dec 2015
Randomized Controlled TrialThe Effect of Systemic Magnesium on Postsurgical Pain in Children Undergoing Tonsillectomies: A -Double-Blinded, Randomized, Placebo-Controlled Trial.
Tonsillectomy is a frequently performed surgical procedure in children; however, few multimodal analgesic strategies have been shown to improve postsurgical pain in this patient population. Systemic magnesium infusions have been shown to reliably improve postoperative pain in adults, but their effects in pediatric surgical patients remain to be determined. In the current investigation, our main objective was to evaluate the use of systemic magnesium to improve postoperative pain in pediatric patients undergoing tonsillectomy. We hypothesized that children who received systemic magnesium infusions would have less post-tonsillectomy pain than the children who received saline infusions. ⋯ Despite a large number of studies demonstrating the efficacy of systemic magnesium for preventing postsurgical pain in adults, we could not find evidence for a significant clinical benefit of systemic magnesium infusion in children undergoing tonsillectomies. Our findings reiterate the importance of validating multimodal analgesic strategies in children that have been demonstrated to be effective in the adult population.
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Anesthesia and analgesia · Dec 2015
Comparative StudyThe Accuracy of the CNAP® Device Compared with Invasive Radial Artery Measurements for Providing Continuous Noninvasive Arterial Blood Pressure Readings at a Medical Intensive Care Unit: A Method-Comparison Study.
In cases of intensive care unit (ICU) patients without an arterial line, noninvasive continuous blood pressure monitoring could be very beneficial. The CNAP® monitor (CNSystems Medizintechnik AG) provides noninvasive, beat-to-beat blood pressure (BP) estimates using the volume clamp method to measure finger arterial pressure calibrated to brachial pressure values. The aim of this study was to compare noninvasive BP estimates of the CNAP monitor with invasive blood pressure (IBP) measurements obtained via a radial arterial catheter in unselected medical ICU patients under routine clinical conditions. ⋯ The CNAP device provided feasible estimates of BP in unselected medical ICU patients under routine clinical conditions. Mean arterial pressure met interchangeability criteria for accuracy toward radial arterial pressure, as well as for percentage error, and showed good trending capabilities according to the Critchley predefined criteria.