Anaesthesia
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Randomized Controlled Trial Comparative Study
The effects of general anaesthesia on memory in children: a comparison between propofol and sevoflurane.
We studied the effects of general anaesthesia on memory 7 days and 3 months following elective hernia surgery. Sixty children aged between 7 and 13 years were randomly allocated to receive either propofol or sevoflurane. ⋯ Neither general anaesthetic affected immediate or long-term memory. We conclude that propofol impairs short-term memory postoperatively in children.
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Multicenter Study Observational Study
A prospective multicentre observational study of adverse iatrogenic events and substandard care preceding intensive care unit admission (PREVENT).
We examined the current incidence, type, severity and preventability of iatrogenic events associated with intensive care unit admission in five hospitals in England. All unplanned adult admissions to intensive care units were prospectively reviewed over a continuous six-week period. In the week before admission, 76/280 patients (27%) experienced 104 iatrogenic events. ⋯ Seventy-seven per cent of the events were considered preventable and 80% caused or contributed to admission. Eleven events were thought to have contributed to a patient's death. The mean (SD) age of patients who had an event was greater (63 (21) years) than those who had not (57 (19) years, p = 0.023), and they had a longer median (IQR [range]) intensive care stay, 4 (1-8 [0-29]) days vs 3 (1-5 [0-20]) days, respectively, p = 0.043.
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J waves appear on an electrocardiogram as an elevation of the J point in the terminal portion of the QRS complex. J waves are often benign, but may be associated with malignant ventricular arrhythmias. ⋯ When early repolarisation (as shown by electrocardiographic J waves) is observed in the inferior ventricular wall pre-operatively, patients should be carefully monitored. Myocardial ischaemia and the use of drugs that might worsen J waves should be avoided.