Journal of clinical anesthesia
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(1) To introduce anesthesia clinical pathways as a management tool to improve the quality of care; (2) to use the Procedural Times Glossary published by the Association of Anesthesia Clinical Directors (AACD) as a template for data collection and analysis; and (3) to determine the effects of anesthesia clinical pathways on surgical processes, outcomes, and costs in common ambulatory orthopedic surgery. ⋯ Clinical pathway patient management systems in anesthesia care are likely to produce useful outcome data of current practice patterns when compared with historical controls. This management tool may be useful in simultaneously containing costs and improving process efficiency and patient outcomes.
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(1) To incorporate regional anesthesia options for common outpatient orthopedic surgery into clinical pathways; (2) to use the clinical pathway format and the Procedural Times Glossary published by the Association of Anesthesia Clinical Directors (AACD) as management tools to measure postoperative same-day surgery processes and discharge outcomes; and (3) to determine the effects of general, regional, and combined general-regional anesthesia on these processes and outcomes. ⋯ Clinical pathway regional anesthesia care for outpatient orthopedics may have a significant role in simultaneously containing costs and improving both process efficiency and patient outcomes.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prophylactic antiemetics for laparoscopic cholecystectomy: a comparison of perphenazine, droperidol plus ondansetron, and droperidol plus metoclopramide.
To compare the prophylactic administration of ondansetron plus droperidol, droperidol plus metoclopramide, and perphenazine to determine effects on postoperative nausea, vomiting, and sedation after laparoscopic cholecystectomy. ⋯ These three drug regimens are equivalent for antiemetic prophylaxis before laparoscopic cholecystectomy.
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Randomized Controlled Trial Clinical Trial
Oral clonidine premedication does not prolong analgesia after herniorrhaphy under subarachnoid anesthesia.
To determine the effect of oral clonidine premedication on duration of sensory and motor block, postoperative analgesia, hemodynamic stability, sedation, and respiratory parameters after subarachnoid anesthesia (SA). ⋯ In healthy patients, premedication with oral clonidine provided useful sedation and anxiolysis and stable hemodynamics, without prolongation of sensory and motor block. Side effects occurred only with clonidine 5 mcg/kg. Thus, a dose of 2.5 mcg/kg is recommended.
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Randomized Controlled Trial Clinical Trial
Alfentanil decreases the excitatory phenomena of sodium methohexital.
To evaluate the effects of alfentanil or lidocaine on the excitatory phenomena (myoclonus, cough, hiccough) caused by methohexital anesthesia and on the hemodynamic changes induced by retrobulbar block. ⋯ A small dose of alfentanil (5 micrograms/kg i.v.) decreases myoclonus and cough induced by sodium methohexital anesthesia i.v., resulting in improved quality of induction of anesthesia. Alfentanil also attenuates the cardiovascular responses caused by placement of a retrobulbar block.