British journal of anaesthesia
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Comparative Study
Effect of timing on the response to postal questionnaires concerning satisfaction with anaesthesia care.
There is little information on the effect of time on the assessment by the patient of quality of anaesthesia care. This study compared the patient's assessment of anaesthesia care after three different periods of time following discharge from hospital. Materials. Three groups of patients were assigned to receive a standardized, validated psychometric questionnaire either 1, 5, or 9 weeks after discharge from hospital. We measured response rate and the total mean problem score of six dimensions. ⋯ The response rate is significantly lower at 9 weeks compared with 1 and 5 weeks after discharge. The total mean problem score remains unchanged but certain fields show fewer problems after 9 weeks compared with 1 and 5 weeks. Questionnaires on patient satisfaction with anaesthesia care should be sent within 5 weeks of discharge.
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A non-invasive estimation of cerebral perfusion pressure (CPP) using transcranial Doppler sonography was assessed in brain-injured patients by comparing conventional measurements of CPP (difference between mean arterial pressure and intracranial pressure) (CPPm) with the difference between AP(mean) and the critical closing pressure of the cerebral circulation (CPPe). ⋯ Non-invasive estimation of CPP can be used for brain monitoring of head-injured patients, but the accuracy of the method may depend on the level of intracranial hypertension.
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Volatile anaesthetics precondition the heart against infarction, an effect partly mediated by activation of the epsilon isoform of protein kinase C (PKCepsilon). We investigated whether cardioprotection by activation of PKCepsilon depends on the isoflurane concentration. ⋯ Although isoflurane preconditioning resulted in a reduction in infarct size at all concentrations used, the protection was mediated by phosphorylation and translocation of PKCepsilon only at 0.4 MAC.
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Ultrasound imaging used to facilitate performance of a femoral nerve block also affords imaging of adjacent anatomical structures. Following a fracture of the femur, an ultrasound guided femoral nerve block (UGFNB) was performed to provide analgesia; this led to the incidental finding of a previously undiagnosed femoral vein thrombosis (DVT), resulting in a change in patient management before surgery. An inferior vena cava (IVC) filter was placed before intramedullary nailing of the fracture.