Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2016
ReviewDecreasing the Hours That Anesthesiologists and Nurse Anesthetists Work Late by Making Decisions to Reduce the Hours of Over-Utilized Operating Room Time.
In this special article, we evaluate how to reduce the number of hours that anesthesiologists and nurse anesthetists work beyond the end of their scheduled shifts. We limit consideration to surgical suites where the hours of cases in each operating room (OR) average 8 hours or more per day. Let "allocated hours" refer to the hours into which cases are scheduled, calculated months in advance for each combination of service and day of the week. ⋯ Such decisions include increasing the number of first case starts and planning staffing for turnovers and lunch breaks during the busiest times of the day. However, most decisions substantively influencing Over-Utilized OR time are made within 1 workday before the day of surgery and on the day of surgery, because only then are ORs sufficiently full that changes can be made to minimize Over-Utilized time. Decisions to reduce Over-Utilized time on the day of surgery include targeting ORs with expected Over-Utilized time and taking steps to reduce it, including making effective staff assignments and appropriately scheduling add-on cases.
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Anesthesia and analgesia · Mar 2016
Review Meta AnalysisIntravenous Therapies for Complex Regional Pain Syndrome: A Systematic Review.
Complex regional pain syndrome (CRPS) remains a challenging clinical pain condition. Multidisciplinary approaches have been advocated for managing CRPS. Compared with spinal cord stimulation and intrathecal targeted therapy, IV treatments are less invasive and less costly. ⋯ We evaluated the relevant studies and provided recommendations according to the level of evidence. We conclude that there is evidence to support the use of IV bisphosphonates, immunoglobulin, ketamine, or lidocaine as valuable interventions in selected patients with CRPS. However, high-quality studies are required to further evaluate the safety, efficacy, and cost-effectiveness of IV therapies for CRPS.
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Anesthesia and analgesia · Mar 2016
Review Meta AnalysisIntravenous Therapies for Complex Regional Pain Syndrome: A Systematic Review.
Complex regional pain syndrome (CRPS) remains a challenging clinical pain condition. Multidisciplinary approaches have been advocated for managing CRPS. Compared with spinal cord stimulation and intrathecal targeted therapy, IV treatments are less invasive and less costly. ⋯ We evaluated the relevant studies and provided recommendations according to the level of evidence. We conclude that there is evidence to support the use of IV bisphosphonates, immunoglobulin, ketamine, or lidocaine as valuable interventions in selected patients with CRPS. However, high-quality studies are required to further evaluate the safety, efficacy, and cost-effectiveness of IV therapies for CRPS.
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Anesthesia and analgesia · Mar 2016
Review Meta AnalysisThe Effectiveness of Midazolam for Preventing Postoperative Nausea and Vomiting: A Systematic Review and Meta-Analysis.
Previous randomized controlled trials regarding the effectiveness of perioperative midazolam in preventing postoperative nausea and vomiting (PONV) have produced conflicting results. Consequently, the present systematic review was performed to assess the effect of perioperative administration of midazolam on PONV. ⋯ Perioperative administration of midazolam was effective in preventing PON, POV, and PONV.
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Anesthesia and analgesia · Mar 2016
Review Meta AnalysisThe Effectiveness of Midazolam for Preventing Postoperative Nausea and Vomiting: A Systematic Review and Meta-Analysis.
Previous randomized controlled trials regarding the effectiveness of perioperative midazolam in preventing postoperative nausea and vomiting (PONV) have produced conflicting results. Consequently, the present systematic review was performed to assess the effect of perioperative administration of midazolam on PONV. ⋯ Perioperative administration of midazolam was effective in preventing PON, POV, and PONV.