Anesthesia and analgesia
-
Anesthesia and analgesia · Mar 2020
Practical Training of Anesthesia Clinicians in Electroencephalogram-Based Determination of Hypnotic Depth of General Anesthesia.
Electroencephalographic (EEG) brain monitoring during general anesthesia provides information on hypnotic depth. We hypothesized that anesthesia clinicians could be trained rapidly to recognize typical EEG waveforms occurring with volatile-based general anesthesia. ⋯ A brief training session was associated with improvements in clinicians without prior EEG training in (1) identifying EEG waveforms corresponding to different hypnotic depths and (2) recognizing when the hypnotic depth suggested by the EEG was discordant with the pEEG index.
-
Anesthesia and analgesia · Mar 2020
Comparative Study Observational StudyImpact of the Addition of Examples to the American Society of Anesthesiologists Physical Status Classification System.
Examples of comorbidities for the widely used American Society of Anesthesiologists physical status (ASA-PS) classification system were developed and approved in 2014. We conducted a retrospective cohort study of patients with 4 comorbidities included in the examples as warranting a specific minimum ASA-PS class. ⋯ Rates of underclassification ranged from 4.8% to 38.7%. We observed no evidence of a significant impact on ASA-PS classification with the introduction of examples in 2014.
-
Anesthesia and analgesia · Mar 2020
Individualized Quality Data Feedback Improves Anesthesiology Residents' Documentation of Depth of Neuromuscular Blockade Before Extubation.
Reversal of neuromuscular blockade is an important anesthesia quality measure, and anesthesiologists should strive to improve both documentation and practice of this measure. We hypothesized that the use of an electronic quality database to give individualized resident anesthesiologist feedback would increase the percentage of cases that residents successfully documented quantitative depth of neuromuscular blockade before extubation. The mean baseline success rate among anesthesiology residents was 80% (95% confidence interval [CI], 78-81) and increased by 14% (95% CI, 11-17; P < .001) after the residents were given their individualized quality data. Practice patterns improved quickly but were not sustained over 6 months.